Ms. McGuire described War as almost biblically divided between forces of dark and light: between the working blue- and white-collar residents who anchor churches, schools and the city government, and the “pill head” community. As she drove down the main street, past municipal offices with the Ten Commandments painted in front, she pointed out the signs of a once-thriving town sunk into hopelessness. The abandoned American Legion hall. A pharmacy with gates to prevent break-ins. The decrepit War Hotel, its filthy awning calling it “Miner’s City,” where the sheriff’s department has made drug arrests.

When coal was king, there were two movie theaters and a high school, now closed. “Everybody worked,” Ms. McGuire said.

She turned up Shaft Hollow, where many people live in poorly built houses once owned by a coal company, their roofs sagging and the porches without railings. At the foot of Shop Hollow, a homemade sign advertised Hillbilly Fried Chicken. Another pointed the way to the True Light Church of God in Jesus Name. “This is one of the most country places, but I love these people,” Ms. McGuire said. She said it was a bastion of Pentecostal faith, where families are strict and their children well behaved.

She and others who seek to lift McDowell County have attracted some outside allies. Reconnecting McDowell, led by the American Federation of Teachers union, is working to turn schools into community centers offering health care, adult literacy classes and other services. Its leaders hope to convert an abandoned furniture store in Welch to apartments in order to attract teachers.

“Someone from Indiana or Pennsylvania, they’re not going to come to McDowell County and live in a house trailer on top of a mountain,” said Bob Brown, a union official.

Another group, the West Virginia Healthy Kids and Families Coalition, is working to create a home visitation service to teach new parents the skills of child-rearing.

Sabrina Shrader, the former neighbor of Marie Bolden in Twin Branch, has spoken on behalf of the group to the State Legislature and appeared before a United States Senate committee last year. Ms. Shrader, who spent part of her youth in a battered women’s shelter with her mother, earned a college degree in social work.

“It’s important we care about places like this,” she said. “There are kids and families who want to succeed. They want life to be better, but they don’t know how.”