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Rural health coalition approaches 25th anniversary

For the rural population in North Carolina, access to primary health care is often meager. Many do not have insurance and sometimes the closest health facility is more than 15 miles away.

For nearly 25 years, however, the North Carolina Student Rural Health Coalition--a group of medical students working together with members of the community--has aimed to meet the basic health care needs of the underserved population.

The coalition was founded in 1978, and originally offered a two-week health fair for rural North Carolinians. However, when it became clear that the rural poor areas demanded more access to basic medical services, the NCSRHC began offering free health clinics for the rural poor in 1986.

Community members organize and run these clinics, and university medical students provide the medical care. In this region, three universities have NCSRHC chapters: Duke, the University of North Carolina at Chapel Hill and East Carolina University. Many volunteers feel the connection between the medical students and the direct community aids in the program's effectiveness.

"Working directly with the community members creates a cohesiveness which is important for these poverty stricken areas," said Julia Dombrowski, last year's medical student co-coordinator. "We staff the clinics, but the community manages them."

The clinic's services are free and open to anyone in need of assistance. The primary care services offered include physical exams, blood sugar testing, cholesterol testing, prescribed medications, referrals and counseling on diet and exercise.

Duke's NCSRHC chapter consists of 75 medical students. On the third Saturday of every month, four of these students accompany Dr. Charles Beauchamp, an assistant clinical professor in general internal medicine, to the clinic in Fremont, N.C. The clinic operates in a large trailer with three exam rooms, a waiting room and a lab area. The volunteers see as many patients as possible, beginning in the morning and ending usually in the late afternoon.

For the medical students, the clinical visits offer more than a volunteering experience. Making trips into the rural community exposes them to a population and medical services they would not see in a typical medical training environment.

"I have learned a lot from the patients," said Karen Moore, also a co-coordinator last year. "It is nice to get into the community and see people who exist outside the standard medical system."

The clinic offers first year medical students a rare opportunity to see actual patients, participants said. Typically, two of the four students who attend the clinic each month are first year medical students. They see the patients first, and establish the patient's medical history. Then, one of the older students assists the first year student in his diagnosis.

"Working at the clinic is a wonderful learning experience," said Joanne Wu, one of this year's coordinators. "It offers younger medical students their first opportunity to work directly providing care to patients. In addition, it offers older medical students a chance not only to learn more themselves, but also to teach younger students."

Along with providing medical services, the clinic also offers a variety of health education programs. In March, the clinic is dedicated to women's health issues, and the clinic offers a Pre-Health Career Interns Week to high school students. This outreach program encourages youth to enter professions in the health industry.

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