WISE, Va. | Doug Sproles, a resident of this far southwest corner of Virginia, describes basic heath care as going to a doctor, running up a bill he struggles to pay, then living with bad credit.

His story was similar to those of the thousands who came this weekend to the Wise County fairgrounds seeking free medical, dental or vision care from the Remote Area Medical Volunteer Corps (RAM).

Mr. Wise, 32, who is unemployed, arrived at the fairground’s grassy parking lot Thursday afternoon with a tent, cooler and toothache. He didn’t want to miss getting a free root canal when the gates opened at 6 a.m. Friday.

Many residents in this region, compared with Virginia as a whole, have a higher incidence of death from cancer, diabetes, heart disease, pulmonary disease and suicide, according to state Health Department statistics.

Only 1,500 patients a day are admitted on the county fairgrounds, a number reached about an hour after the gates opened Friday morning. Hundreds were turned away; volunteers advised them to return Saturday morning.

“We heard it was going to be crowded, and this is the worst number I’ve got in the past three years,” Mr. Sproles, of Abingdon, Va., said while smoking a cigarette and holding a ticket marking him as patient No. 128. “I’ll just make the best of it.”

More than 8,400 procedures were performed last year, and organizers predicted more this year.

The 2 1/2-day clinic is the largest in the county by Knoxville, Tenn.-based RAM, said volunteer coordinator Jean Brady Jolly.

The organization stages one or two clinics a month, but most serve 500 to 800 people and focus on dental and vision services.

Services offered this weekend included treatments for high blood pressure, heart disease and mental health. In addition, there were colon-, cervical- and breast-cancer screenings.

About two hours after the gates opened Friday, 845 volunteers were busy doing everything from drilling teeth and listening to hearts to passing out coffee and doughnuts. The number of pre-registered volunteers was 1,645 - about 350 more than last year. More were expected before the event closes at noon Sunday.

The volunteers - including doctors, dentists, nurses and pharmacists - came from such organizations as the Health Wagon, the Lions Club of Virginia, the University of Appalachia College of Pharmacy, Virginia Commonwealth University, the Virginia Dental Association and the University of Virginia Health System.

Procedures were done in tents and barns, where sheets were drawn across former horse stalls to create examination rooms.

Most of the patients came for dental and vision care, including Joyce Waddell, 64, from Hiltons, Tenn, who needed five teeth extracted.

“I’m in a lot of pain, and I can’t chew my food because my teeth hurt so bad,” she said. “Swallowing food whole is causing me all types of stomach problems, and I’ve been vomiting violently and fainting.”

Mrs. Waddell said she mostly lives out of her Ford van and sees a dentist only when she can afford it. She’s hoping her situation improves when she turns 65 and becomes eligible for Medicare.

The majority of attendees were adults who either are not covered by Medicaid or do not receive dental care through Medicaid. Because of funding, Medicaid does not cover non-health-related dental care such as cleanings and fillings, said Patrick W. Finnerty, state director of Medicaid.

Mr. Finnerty manned the dental station over the weekend, directing eager patients to triage chairs, where dentists examined mouths and performed free cleanings, extractions or restoration work.

“It’s hard to come to one of these [events] and not be changed,” he said. “It’s by far the most challenging and rewarding job.”

Organizers said Virginia Commonwealth University dental students can use for course work just 10 percent to 20 percent of the teeth extracted because the remainder have too many cavities.

Dr. Roger Wood, a pediatric dentist in Richmond who helped bring the event to Wise Countymade his ninth trip this weekend to the remote coal county.

“It’s the feedback that keeps me coming back,” he said. “At your office, you don’t usually get hugs and personal satisfaction that you get here.”

While most patients came because of their physical pain, others took full advantage of the services, including the free mammograms and colon screenings.

“I just found out that I could get women’s health tests for free in my area,” said Dianna Hines, while she waited for new glasses. “I let these things go neglected because I can’t afford them, but they’re things that could hurt me.”

Mrs. Hines, 50, said she could barely keep up with high gas and food prices, much less insurance or doctor visits.

One in seven Virginians are without health care, a problem the state legislature takes up every year.

Beyond providing immediate medical care, the RAM events also have prompted state lawmakers to allocate more money to the Health Wagon’s budget, to free clinics in Southwest Virginia and to health-education programs.

RAM was organized to serve Guyana, but now 60 percent of its clinics are domestic. Most are in Tennessee because many states have laws that restrict access to out-of-state doctors.

Most of the cars packing the fairground lot had Virginia or Tennessee tags, with a few from Kentucky and North Carolina.

“It gets me in a greater sense of urgency, every time I come here, of the things I want to push when I look at the budget in September,” said Gov. Tim Kaine, a Democrat.

This article is based in part on wire service reports.

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