It’s funny how a vision gets its start, comes into being and then takes a turn in a totally unexpected direction. Just ask Stan Brock, pilot, adventurer, author, former TV star and founder of Remote Area Medical (RAM), an all-volunteer, free, mobile medical service he established 23 years ago to provide desperately-needed healthcare to people in rural, isolated areas of countries with no access to doctors or medical assistance. Brock never imagined a day when the greatest part of his organization’s work would be providing healthcare to people in the United States.
“Sixty percent of everything we do is here in the US. We’re actually cutting back on our overseas commitment,” he explains, after discovering the need that exists in our own backyard – the result of a healthcare system which by everyone’s assessment is broken.
When we spoke by phone, Brock had just returned from RAM’s 544th expedition, a two- and-a-half-day event in Wise County, Virginia where more than 1,500 volunteer doctors, dentists, ophthalmologists, optometrists, nurses, and other healthcare professionals provided free care to 2,670 patients. In total there were 5,475 patient encounters. Brock explains that once inside the makeshift medical facility a patient is often seen by more than one medical professional. In fact, most patients are seen by at least two, which accounts for the difference in numbers between “patients” and “patient encounters.”
At the Wise County event fewer than four percent of those seen were children, which is just the opposite of what Brock finds overseas, and what he believes indicates that children here are receiving adequate medical care. The majority of RAM services in the U.S. are provided to adults who either have no health insurance, or who are underinsured with high deductibles, and/or limited benefits. “After you pass 18 years of age, you are on your own. Healthcare in the United States,” he adds, “is the privilege of the wealthy or the very well insured.”
When word gets out that RAM is coming to an area, it’s not uncommon for some patients to drive hundreds of miles to be seen. Many arrive in the early morning hours to help ensure they have the opportunity to have an infected tooth extracted, or receive an eye exam and new eyeglasses, or to have the first medical exam in years – all of which is done right on the spot.
The total value of the health services RAM provided that July weekend was nearly two million dollars – $1,725,418, to be exact – and to date RAM has provided almost $35 million in medical health care and veterinary services. “We are experts at stretching the healthcare dollar,” Brock says. “The quality of care is excellent; the cost is low.”
He attributes the quality and value to the RAM volunteers who pay their own way, their own hotel and often bring their own supplies. RAM can provide both dental and vision care – the two most needed services – for less than $4 each, not including fuel costs. So, Brock explains, a donation of as little as $12 can provide treatment for three patients. For years RAM, without benefit of PR or fancy brochures, has provided its free care through the dedication of its volunteers and the small, private donations of Americans across the country with little corporate backing and no government assistance, a fact Brock notes with pride.
Brock’s life, like the organization he founded, has been filled with a series of unexpected turns, a trend which started early. During the summer of 1953 at the age of 17, British-born Brock boarded a boat from England en route to what was then British Guiana to visit his father who had taken a temporary job in the South American British colony. He didn’t return to England, or to school. “I’m a sort of high school dropout,” the 72-year old confesses. Instead he remained in the Latin American country, and with encouragement from his father found work on the world’s largest cattle ranch, the Dadanawa, a 4,000-square mile spread in the Amazon basin along the northern Brazilian border – its savannas filled with thousands of wild longhorns and horses left behind centuries earlier by the Spanish Conquistadors.
Sent to fill a clerk position, Brock wanted to be a cowboy, or “vaquero” as they were called. “All the Indians were cowboys,” he says of the Wapishana Indians who worked the range. At first the Indians were reluctant to teach the young English boy their skills, but eventually agreed. Brock was given an old horse he named Butterball. “Butterball taught me a whole lot about being a cowboy,” he says. “I had more tumbles off Butterball than I can remember.”
As he became more adept and skilled the Indians gave him a large, grey Mustang called Cang, a name which meant “devil” in the Wapishana language. Cang had already killed two cowboys. Brock recalls the day the cowboys lassoed Cang and tied him to a tree, blindfolding him, and strapping on Brock’s saddle. Brock climbed aboard; the cowboys cut Cang loose; Brock pulled the blindfold off. Cang, completely out of control, went bucking across the savanna with Brock as nothing more than a passenger. The horse eventually collided head on with a corral, and Brock, suffering “considerable structural damage” including crushed ribs, ended up pinned beneath the brute. As the cowboys pulled Brock out from under the horse, he heard one of them comment that the nearest doctor was 26 days away on foot. “I believe it was right about that time that I decided if I got over this, sometime I would bring those doctors a little bit closer. That was the germ of the idea, you might say.”
Brock lived and worked on the Dadanawa for 15 years eventually becoming the ranch’s foreman. Over the years he witnessed sickness and injuries claim the lives of people because they didn’t have access to the simplest of medical care. When he later learned to fly a small plane to help transverse the ranch’s vast acreage, he also included among his duties flying in medical supplies and transporting the injured or sick to towns to receive medical care.
His life took another unexpected turn in the 1960s when wildlife motion picture photographer Warren Garst made his way to the remote region. Garst worked for the television series “The Wild Kingdom” and was in search of wildlife footage. He needed an English-speaking guide and had been told of Brock, so he sought out the Englishman- turned- barefooted vaquero (the cowboys did their work in bare feet). Over the next few years Garst made several trips to the area, utilizing Brock’s services and even including him in on-camera appearances.
Eventually the show’s producers offered Brock (who had never even seen television) a job on the TV series, and asked him to come to Chicago. “They really sweetened the offer,” Brock recalls, “by asking me if I went to Africa with them would I be able to lasso some of the large animals over there in capture situations from horseback. So the prospect of chasing down wildebeest, and giraffe, and buffalo on horseback and lassoing them was sort of intriguing for somebody that was into that kind of adventure. After all, that’s what I’d been doing at the Dadanawa ranch for all those years – going out everyday lassoing wild cattle on horseback.”
Brock left the ranch in 1968 and moved to Chicago, but never abandoned his dream to bring medical services to the people he’d left behind. The Wild Kingdom series ran until 1971, and ran in syndication until the 1980s. Brock became involved in other TV ventures and “made some really bad movies” with Flipper producer Ivan Tors. He and Tors also produced a TV series entitled Stan Brock’s Expedition Danger, which despite good rating was canceled when the company was purchased by another corporation.
He calls his television, and especially movie years, the “frivolous era,” but when pressed to explain he says “it really did do a lot for inspiring people.” He is often approached by people who tell him they became a marine biologist, or veterinarian, etc. because of watching The Wild Kingdom program. He adds, “What we are doing now is so important and impacts the lives of so many more people in a very direct way.”
Brock moved to Florida to help design the Central Florida Zoo. Part of his early volunteer work included traveling about the country supporting local efforts to raise funds for community zoos, which usually entailed posing before cameras with a couple of cute lion cubs, saying “Support your local zoo.” After a few such trips to Knoxville in the southeast corner of Tennessee, Brock says he got to like the place and felt it fit in well with his desire to form the RAM organization and to take free medical care to the northern Amazon where he had spent so many years.
The hardest part was convincing people to believe that it was even possible. Though he started in 1985, the first expedition didn’t occur until 1991 when a small group of four traveled on horseback and mule to assist the Huichol Indians in an isolated region of the Mexican state of Zacatecas. RAM also traveled to India, the Dominion Republic, Haiti, Honduras, and Guatemala.
The first expedition in the U.S. occurred in 1992 when Brock learned that a hospital had closed in Hancock County, located in the northeast corner of Tennessee near the Kentucky border. The response helped drive home the desperate need for medical care assistance in the nearby Appalachians of Tennessee, Kentucky, and Virginia.
Brock did keep his vow to bring medical help to Guyana and the northern Amazon area. In 2001 RAM established a free air service providing emergency transportation for the injured and sick. They have already made 1,300 emergency runs. The service is also used by doctors, dentists, nurses and veterinarians to deliver care and supplies to sites throughout Guyana.
In addition, the Guyana Cervical Cancer Project provides critical screening of the indigenous native women not only for cervical cancer, but breast cancer and STD detection as well, and birth control.
The organization obtained its first donated airplane in 1993, a Douglas C47 which had flown as part of the historic WWII D-day mission. Three years ago they received a second donation of another classic aircraft, the Twin Beech 18. The Cessna 206 Bush plane was also donated and is used in Guyana for the free air service.
About 12 years ago the City of Knoxville began leasing Brock a 37,000 sq. ft. school building built in 1927 for $1 a year. It serves as RAM Headquarters, though Brock admits the building is a mess, with falling ceiling tiles and little climate control. It’s brutal, he says, but the rent is perfect. They also have a $1 a year lease agreement with the Greater Knoxville Airport Authority for an old hangar to house their planes.
Over the years the organization has acquired portable dental chairs and portable eye exam equipment, and other pieces of set-up equipment along with a couple of 18-wheelers to help keep the show on the road. Though RAM has coordinated the efforts of more than 36,000 volunteers, there are only six part-time employees who receive small stipends. Brock is not one of them. He is uncompensated for his work.
Despite the untiring efforts of Brock and the volunteers, the organization has operated as a virtual unknown for nearly a quarter of a century. “The poor were the only ones who knew about Remote Area Medical,” Brock explains. “No one else had a clue.” Even people in downtown Knoxville didn’t know who they were.
But November of 2007 brought another unexpected turn when a reporter for The New York Times, working on a story about healthcare in the Appalachias, showed up at one of RAM’s expeditions. Subsequently an eight-page photo spread appeared in The New York Times Sunday Magazine. The next day Brock received a call from CBS 60 Minutes which produced a segment that aired in March of this year and re-aired in July.
The response was overwhelming. Media from all over the world – Canada, Japan, Germany, Australia, Poland, Switzerland, and Holland – has been calling. “It seems that everyone is interested in understanding: what is the problem; why does America have it; and what do you need to do to fix it?” Brock says.
In addition, as RAM’s work has become better known, so too has the number of requests for its services, which now pour in from everywhere. “We’ve received requests from Dallas, Houston, El Paso, Los Angeles, San Francisco, New York City, Detroit – you name it,” Brock says. They have received over 15,000 letters.
Brock’s greatest frustration and the biggest impediment to getting his service to more people are state laws that prohibit doctors from practicing across state lines. In 1995 Brock petitioned the Tennessee State Legislature to ease this restriction. It took two years, but the Tennessee Volunteer Healthcare Services Act allows doctors with a valid, current license out of state to provide services in Tennessee. It is the only state with such a law, Brock notes. A similar bill submitted at the federal level in 1997, House Concurrent Resolution 69, never made it out of committee.
“There are so many willing volunteers around this country who want to help but they can’t cross state lines to do it,” he says.
Brock explains it’s easier to get doctors to travel 300 or 1,000 miles to provide free services than to have them do so in their own hometown. Doctors fear that if word were to get out there would be a long line of people at their door. Doctors say, “Not in my office. I want to do it with your group.”
With all the new demand generated by the recent exposure, Brock feels they have been given a mandate, and in fact have a responsibility to expand their services – plans for which are already in the making. He recently appeared before the Congressional House Ways and Means Committee to discuss his view of the healthcare issues. Brock cited the need to address the issue of state lines, and the need for universal care especially for dental and vision care.
If anyone can fix healthcare in America, I’d put my bets on the barefoot vaquero who isn’t afraid to lasso any wild beast.
Author’s Note: This appeared in Change Magazine.