×

News publications and other organizations are encouraged to reuse Direct Relief-published content for free under a Creative Commons License (Attribution-Non-Commercial-No Derivatives 4.0 International), given the republisher complies with the requirements identified below.

When republishing:

  • Include a byline with the reporter’s name and Direct Relief in the following format: "Author Name, Direct Relief." If attribution in that format is not possible, include the following language at the top of the story: "This story was originally published by Direct Relief."
  • If publishing online, please link to the original URL of the story.
  • Maintain any tagline at the bottom of the story.
  • With Direct Relief's permission, news publications can make changes such as localizing the content for a particular area, using a different headline, or shortening story text. To confirm edits are acceptable, please check with Direct Relief by clicking this link.
  • If new content is added to the original story — for example, a comment from a local official — a note with language to the effect of the following must be included: "Additional reporting by [reporter and organization]."
  • If republished stories are shared on social media, Direct Relief appreciates being tagged in the posts:
    • Twitter (@DirectRelief)
    • Facebook (@DirectRelief)
    • Instagram (@DirectRelief)

Republishing Images:

Unless stated otherwise, images shot by Direct Relief may be republished for non-commercial purposes with proper attribution, given the republisher complies with the requirements identified below.

  • Maintain correct caption information.
  • Credit the photographer and Direct Relief in the caption. For example: "First and Last Name / Direct Relief."
  • Do not digitally alter images.

Direct Relief often contracts with freelance photographers who usually, but not always, allow their work to be published by Direct Relief’s media partners. Contact Direct Relief for permission to use images in which Direct Relief is not credited in the caption by clicking here.

Other Requirements:

  • Do not state or imply that donations to any third-party organization support Direct Relief's work.
  • Republishers may not sell Direct Relief's content.
  • Direct Relief's work is prohibited from populating web pages designed to improve rankings on search engines or solely to gain revenue from network-based advertisements.
  • Advance permission is required to translate Direct Relief's stories into a language different from the original language of publication. To inquire, contact us here.
  • If Direct Relief requests a change to or removal of republished Direct Relief content from a site or on-air, the republisher must comply.

For any additional questions about republishing Direct Relief content, please email the team here.

Health Workers Go Above and Beyond for Vulnerable Patients in Rural North Carolina

Flooding from Hurricane Florence still impacting many, and local clinicians are stepping up.

News

Hurricane Florence

Nurse Gena Byrd, a clinician for local farmworkers at Greene County Health Care, at the home of an elderly patient outside Snow Hill, North Carolina. The home had recently flooded as a result of Hurricane Florence. Byrd and other staff and volunteers made repairs to make the home safer. (Lara Cooper/Direct Relief)

House calls may be a thing of the past for most health providers these days, but not for Nurse Gena Byrd.

The nurse is so involved with her vulnerable patients that last week found her swinging a hammer in the kitchen of an elderly, home-bound patient whose home had been damaged by Hurricane Florence several days earlier.

Byrd’s patients are some of the most vulnerable in Greene County, a mostly rural area of eastern North Carolina, where she works in farm worker services for Greene County Health Care.

About half of the health center’s patients are farm workers, and 85 percent of the clinic’s patients are uninsured.

On Friday, Byrd and Imelda Moye, a case worker and health educator for Greene County Health Care, were working alongside a group of volunteers, ripping up soaked carpet and hauling away a damaged refrigerator from the patient’s home.

Nurse Gena Byrd (right), who does medical outreach for local farmworkers for Green County Health Care, coordinates with volunteers to move a new refridgerator into the home of an elderly patient in Snow Hill, North Carolina. Byrd often goes above and beyond for local patients. (Lara Cooper/Direct Relief)
Nurse Gena Byrd (right), who does medical outreach for local farm workers for Greene County Health Care, coordinates with volunteers to move a new refrigerator into the home of an elderly patient outside Snow Hill, North Carolina. (Lara Cooper/Direct Relief)

As the pair worked to create room for the fridge, they found some unwelcome visitors.

“There are black widows in there,” Byrd called out to Moye, and they worked to dispose of the nest safely.

One could argue that ripping out boards and repairing flood damage is way beyond Byrd and Moye’s job descriptions.

But going above and beyond for patients has long been in encoded in the DNA of health centers in the United States.

Nurse Gena Byrd and case worker Imelda Moye, both of whom conduct medical outreach for local farmworkers for Greene County Health Care, work to remove flood-damaged wood in the home of an elderly patient in Snow Hill, North Carolina. (Lara Cooper/Direct Relief)
Nurse Gena Byrd and case worker Imelda Moye, both of whom conduct medical outreach for local farm workers for Greene County Health Care, repair the flood-damaged home of an elderly patient. (Lara Cooper/Direct Relief)

Dr. Jack Geiger, who formed the model for community health centers in the American South in the 1960s, sought to not only address the health issues of patients living in extreme poverty, but account for the underlying causes of those illnesses, including unsafe living conditions.

Digging clean water wells and installing screens on windows to protect from insect-borne diseases were all done by Geiger and his health center staff, in the name of protecting their patients.

Echoes from that history came through loud and clear with every thud of Byrd’s hammer.

Because this patient’s home is heated by wood, Byrd and her husband will often bring by chopped wood to stack nearby.

“We always have patients that we check on,” the nurse said.

Medical care is still at the heart of her work, though, and Byrd has worked with the woman living in the home to manage her health. The patient, a farm worker for 18 years, is now relatively home-bound, managing chronic conditions like high blood pressure and struggling to afford medication.

Among the bag of medicines she takes daily were several medications donated by Direct Relief to Greene County Health Care, which receives ongoing support of donated medicines and supplies.

Byrd and Moyes' patient requires a number of daily medication to manage chronic conditions like high blood pressure. Some of that medication was donated to Greene County Health Care from Direct Relief, so that medicine was provided for free. (Lara Cooper/Direct Relief)
Byrd and Moye’s patient requires a number of daily medication to manage chronic conditions like high blood pressure. Some of that medication was donated to Greene County Health Care from Direct Relief, so that medicine was provided for free. (Lara Cooper/Direct Relief)

The system has sites in Greene, Pamlico and Pitt Counties, which were seriously impacted by recent flooding.

Though the health system’s facilities didn’t experience any damage, many patients were impacted.

Just before the storm struck, local farm workers were right in the middle of cultivating and harvesting crops for the season, said Doug Smith, CEO of Greene County Health Care.

Hurricane Florence blew through, leaving nothing but destroyed crops behind, which will no doubt prove economically devastating for those that count on the work. Many of those farm workers have already returned to Mexico, Texas, Florida or other places they live when not harvesting in North Carolina.

“The tobacco is ruined, the sweet potatoes ruined,” Smith said.

The waters of the Neuse River continued to rise on Friday, Sept. 21, flooding parking lots and infrastructure in Kinston, North Carolina. Hurricane Florence has left many people displaced and without power. (Lara Cooper/Direct Relief)
Flooding in Greene County from Hurricane Florence damaged infrastructure in the area and destroyed local crops.

Smith said that most of the center’s patients fall into the category of “working poor,” and that about half of those patients work as farm labor for the agricultural operations that quilt the county landscape with soybeans, sweet potatoes, tobacco and other cash crops.

The state has not expanded Medicaid, meaning that there is a significant population of people that can’t afford to buy private insurance but don’t qualify for safety-net programs.

This makes the health center’s work even more vital, since many who receive care there would be unable to afford it otherwise.

“We’re here for everybody,” Smith said.

Year round, Greene County Health Care provides everything from dental care to pre- and post-natal care, health screening and lab services.

But Hurricane Florence found their staff doing even more. “During disasters, health centers step up,” he said.

The home of an elderly patient outside of Snow Hill, North Carolina. Greene County Heath Care staff visited the patient on Sept. 21, 2018. The home had recently flooded from Hurricane Florence and volunteers were working to rip out carpet and make repairs. (Lara Cooper/Direct Relief)
The home of an elderly patient outside of Snow Hill, North Carolina. Greene County Heath Care staff visited the patient on Sept. 21, 2018. The home had recently flooded from Hurricane Florence and volunteers were working to rip out carpet and make repairs. (Lara Cooper/Direct Relief)

Back in the yellow house, Byrd and Moye talked about why they do what they do.

“It’s the reward of helping others,” Byrd said, and Moye agreed.

The case worker has known this patient for 15 years. As she scrubbed down the kitchen with bleach, Moye said it’s rewarding to help patients in such a hands-on way.

“It makes me feel like I did something important,” she said.

Giving is Good Medicine

You don't have to donate. That's why it's so extraordinary if you do.