What I Have Learned

Hart County, Ga. is a very interesting town.

What I have learned in trying to report on the health issues that surround the county is that location is everything. To really understand how someone lives their day to day lives one needs to be there for a full day.

Working in a small town to get my feet wet would not be my first choice, but if it were required it is NECESSARY that a reporter is able to immerse themselves into the town. I was not able to do that unfortunately.

Now that the summer is coming and someone has expressed interest in this conundrum that exists between the health department and MedLink I will probably be spending some time their this summer.

I am sure that every town has their secrets and their problems, but what I also understand now is that every place has problems and secrets. Like the swine flu, it is irresponsible to represent a common problem as some unheard of crime against humanity. Citizens not receiving proper healthcare and commuting to see specialized doctors is not fair, but it is also not uncommon.

It is unfair that healthcare is not equal throughout the nation. If everyone did have equal access to healthcare; would there be healthcare options available locally?

Medicare without a car is pretty much useless for some. Money to pay for nursing homes that are already overcrowded doesn't serve much of a purpose either. The solution is not clear, but that doesn't mean that a solution doesn't exist.

Hopefully the new administration will find it.

Slight Recant

So after rants and raves from people online and abroad an article has finally given voice to the idea that the swine flu may indeed just be the flu.

Yahoo article.

The article cites a flu expert who sees no reason to believe that this strain of the virus is more lethal than any other.

The President is hopeful that the virus may be just a seasonal one.

I am relieved to hear this revealation. After receiving several phone calls from worried family and friends; I have at times become enraged by the fear instilled by a lack of proper reporting and over-exposure.

I am glad they have finally consulted with professionals in determining whether or not this strain is extremely dangerous.

In all of the coverage I had seen before, no one every quantified how deadly the swine flu was only that it existed and killed people.

A friend of mine had reserved a room with a family over the summer for an internship. The family called only a couple days ago to tell him that they were going overseas for the summer to try to avoid the flu.

My grandmother was busy stockpiling water and food and my cousin I'm told is wearing a surgical mask and gloves around the house.

Hopefully this will improve the way people are reacting to this flu and hopefully more people will seek more scientific backing when reporting stories.

H1N1 Hysteria

Remember H5N1 (Avian Flu) or SARS (Severe Acute Respiratory Syndrome) or how about even MRSA (Methicillin resistant Staphylococcus aureus)?

What do all three of those diseases have in common? Well they were all over-hyped by the media and subsequently dropped when the bigger, better story came along.

Currently there are no confirmed cases of H1N1 (Swine Influenza) in Georgia, but think about the repercussions an over-hyped story could play on a small town.

Now not to discredit the intelligence or ability to discern truth from fiction of a smaller city, but Hart County is home to a large older population—one of the groups most at risk for suffering complications from influenza.

The 2007-2008 Flu Season

These are the facts. There have been deaths associated with the swine flu. No one in the United States has died from swine influenza. In fact, most of the people in the US who have had confirmed cases of the influenza recovered without severe complications or hospitalization.

There are confirmed cases in Canada and there have been deaths in Mexico, where the coverage first started. At last count there were 6 confirmed cases in Canada.

The United States has reported 68 cases. How has this number jumped from 20 to 68? Because doctors are looking for it.

Swine influenza does not present symptoms atypical of any other influenza strain. Swine flu is being treated like Paris Hilton all of the coverage none of the depth.

How do journalists decide what’s newsworthy, and what can be made newsworthy? I don’t feel that swine flu is a newsworthy story. It’s not Mad Cow disease.

Swine flu is the natural progression of influenza. With several strains floating around globally at any given time always mutating and always affecting people, I don’t understand why this strain is getting the headlines.

People die from influenza every year. In 2004 when the US was short on vaccines the nation went into a mad panic. The year we had more than enough vaccines, the flu got no more than a blip on the radar.

I remember an old saying, “And this too shall pass.” Video on my opinion of H1N1 on CNN iReport

Cold Calls

So I am not so sure if it is the best method of conducting interviews but for me I have gotten use to it. I expect everyone to be on their P’s and Q’s and ready to talk at all times. Most of the time I am successful, but it’s usually because I know exactly what questions I want to ask.

Is it fair that I am catching someone off guard?

I think so, sometimes you need to hear exactly what’s coming off the top of their head because giving a professional time to polish and compose their message is the best way to get a skewed version of the truth I think.

What I won’t use cold calls for is to obtain statistical information. If I don’t have the numbers in front of me I won’t ask them on the first call. If they are willing to send me documentation or get it to me at a later time I will accept that, but people can be dyslexic with numbers and so they say 100 when they meant 100,000.

It happens; I do it all the time.

I will verify statistics that I have acquired on my own, and that usually seems to work out well.

The reason I like cold calls the most is because it gets the interview over and done with and helps me finish the article quickly.

Traveling to Hart County from Athens is a time-consuming process, and if I’m not guaranteed an interview it can be the most maddening thing ever.

I made an appointment with the nurse manager at the ER and the day of the interview she called, cancelled, and pushed it back two weeks.

When I simply just walked into the ER and asked to speak to people. Not only was I able to speak with the nurse manager, but I was able to speak with a couple nurses on duty.

So for now I will stick to cold calls and impromptu visits for the late-breaking story and quick news quip.

It may not be the fairest, but it’s effective.

Investing in Youth

Hart Youth Development Resource Association or HYDRA is a government funded program in Hart County, Ga. HYDRA gives the youth of Hart County an outlet for positive activities and educational growth.

There are no charges for the services that HYDRA offers they offer recreational activities like Tae Kwan Do, mentoring, and various after school programs to help you move in the right direction.

HYDRA was one of several programs in Hart County that receive severe budget cuts after being deemed a non-core county function.

The high school in Hart County has seen an increase in graduation rates due to an investment in graduation coaches. That says to me that an investment in the youth at an even younger level will have even greater reprecussions for the future of Hart County youth.

The website states that it runs monday thru friday from 10am-6pm with the exception of Wednesday, but the website has not be recently updated and those hours are probably significantly shorter.

Police and Courts are important and budgets are small. How do these groups cope with less funds?

The Color of Health

Facts and figures show that being African-American is a detriment to the overall health and well-being of a person.

Blacks are more susceptible to HIV/AIDS, diabetes, heart disease, hypertension, and a number of several other diseases.

While other races and minorities also have various diseases that they are more vulnerable too. Caucasians have more access to health care and health options than minorities.

How do we overcome health disparities and give everyone an equal opportunity to survive and thrive in one of the most powerful nations in the world.

CDC has outlined its objectives in a plan called Healthy People 2010 (http://www.cdc.gov/omhd/About/disparities.htm). The goal is to eliminate health disparities that exist.

Plenty of information is available on the CDC website.

Blood From A Rock

Is there always a crisis lying beneath the surface? Is there always some secret drug ring or child abuse scandal to be unearthed?

I know that everyone has a story to tell, but is every story interesting? I struggle with this beat trying to discern the realities from the falsehoods, and trying to uncover the problems that exist in Hart County’s healthcare system.

I have found problems: unnecessary trips to the ER, an underserved community, low-income families; but is there a place in the nation where these problems are not found?

The real story would be a community where everyone is healthy and lives to be 103. As I struggle to deal with asking the hard and/or right questions, I find myself thinking so what?

A, by all appearances, underutilized senior center has faced a reduction in hours. Is the reduction a result of budget cuts or the county’s attempt to trim the fat? In my travels to Hart County I have noticed that things deemed “non-core county functions” appear aptly named.

I was taken aback to find out that the Board of Commissioners would designate the health department, senior center, mental health center, and other vital health places as non-core county functions, but they aren’t being overrun with clientele. I say that based on what I have seen, but employees tell another story.

Of course what town would be complete without a litany of bureaucratic blameworthiness?

Health department officials blame commissioners. Commissioners blame the state. State blames the nation, and the nation blames AIG.

When everyone feels like the victim, whose story do you tell?

I guess step one would be to find residents in Hart County. If they aren’t in the health department, MedLink, or even the ER; where are these people and why aren’t they miserable?

Is my task to tell the story of their struggles or convince them that they are struggling?

Illogical Loyalty

So I actually found another clinic in Hart County. The MedLink Clinic in Hartwell provides services to both the insured and the uninsured based on a sliding fee scale.

The scale is based on the federal poverty levels because the clinic is federally funded. Medlink is really nice. Bright carpet and paint on the walls, plenty of chairs, and just and overall welcoming ambience. What I found most disturbing is that people in the county aren’t beating down the doors for an appointment.

There is a small sign outside of the clinic that advertises accepting new patients. Of course that is to be expected because it is not the best advertised clinic. I didn’t know it existed until I saw it upon leaving the Hart County Hospital ER.

Don’t worry I’m fine.

But internet searches and several resource inquiries did not bring Medlink to my attention. I asked both the office manager and a nurse if they had any kind of advertising material and they could not provide me with any.

Meanwhile, at the Hart County Health Department approximately 90 people are on a waiting list to be seen by the nurses. Even though the nurses recommend the Medlink Clinic at times, it is still underutilized.

Health department employees attribute their waiting list to patient loyalty, but from a personal -perspective if I am sick and need to be checked out my last concern would be perceived loyalty.

I since that the underutilization of the MedLink Clinic is due to their failure to advertise and inform the public of their services. Even employees at the health department were misinformed about how the Medlink Clinic determines fees for services.

It is really unfortunate that the MedLink clinic has a subtle image problem because it is a really nice place. The staff was extremely polite to me and gave me lots of great information, but I sought out that information.

What about people that get information via word-of-mouth? -- A common practice in small towns.

I have decided to delve deeper into the dynamic that exists between the two clinics. Some surprising information has surfaced.

Show Me How The Steak Is Made

I never imagined journalism would trigger old calculus courses from college.

In speaking with the Hart County Health Department and the Chief of the Board of Commissioners, I cannot help but hear my old professor saying “Show your work.”

The health department has received drastic funding cuts. In response to these cuts, the health department has cut staff and clinic hours.

Pat Brake, the office manager, is concerned. She fears that the cut in hours will result in more incidences of teen pregnancy and STD infection.

However, I have not yet seen solid evidence that shows a growing trend among infections. Also, the graduation rate for the county has increased 8%.

My gut tells me that dropout rates should increase with pregnancy rates, but it seems that students in Hart County are on the upswing.

I have made two trips to the health department. Both times have been after lunch and both times I have been able to sit and talk with both the office and nurse manager.

I hope that me putting this information out does not encourage them to find things to make them busy, but if the place is being ransacked with new patients, a walk-in interview should not be so simple.

Today I spoke with the County Administrator, Jon Caime. I asked him about how the county decides what is and is not a core county function. He was not able to give me that information, but he was able to tell me that the focus of the commissioners in deciding budget cuts was to maintain what they saw as necessities.

Speaking with the Chief Commissioner, Dan Reyen, I was told that those functions that were designated core functions were things that maintained law and order. EMS, courts, road management, and the like are services that are being maintained by the commissioners.

However, when I asked Reyen if he expected to see in increase in county funds due to the Obama stimulus plan he was unsure specifically how the plan would help his county. Of course the stimulus plan is a hefty piece document, but a vital one; especially for members of government who are suffering from a bare bones economy.

The county commissioner stated that state debt is causing issues at the county level. According to Reyen, the county is now responsible for paying a larger portion of functions that the state use to handle. However, I have not been able to see proof of the state’s forcing counties to be more dependent.

So I plan to press harder with both the commissioners and the health department to show me all the messy details. I have been told that things are difficult and that cuts were necessary; but I need more evidence that the cuts were justified and most efficient.

With the health department, I am not quite ready to say that they are facing a dilemma until they can show me a trend of health problems. I think it will also be important to get in touch with those people who are not able to obtain services because of the department being overbooked.

I cannot be so quick to take the word of others as truth. I will be looking for solid numbers to back up their claims.

Bloodlines

The museum in Hart County documents the changing landscape of the county as well as the changing faces.

The museum, which shares its’ location with the Chamber of Commerce, houses old clothes and photos documenting the ever-changing façade of a small city.

The county’s historical society maintains the museum and provides many of the items found within.

I met the President of the Chamber of Commerce, Pat Dipert, for an interview a few weeks ago and she gave me a tour of the museum.

At the conclusion of the tour I spent a short time exploring the small house.

The smell of mothballs clinged to the old garments and old photos had been enlarged and placed in the corner.

One photo, of a few teenagers in front of the Nancy Hart hotel, was interesting. Not because the hotel is gone, being replaced by a Bank of America; but because I actually met a woman who was in the photo.

I met living history. Exploring the small space further, I came across a book that listed the families in Hart County and their origins.

Some families were traced back to their European origins. It amazed me how much history the town was able to save and display for the public to see.

As a journalist with an interest in health and medicine something else appealed to me about this fascination with genealogy.

Do they know their family health histories as well as they know their family tree?

I thought about how predisposition plays a major role in many people’s health.

Family health history can be very useful in preventative medicine.

But alas, there was no book that traced the cause of death of the residents of Hart County.

I think a book of death would probably be a little too morbid anyway.

Health Isn't A Necessity

The health department in Hart County is a not a core function according to the Hart County Board of Commissioners.

The Board of Commissioners made more cuts to the county budget. According to an article in the local newspaper, an additional $120,000 was removed from the budget.

The commissioners made cuts to what they called non-core county functions. The Hart County Health Department, Behavioral Health Department, and the Division of Family and Children Services all suffered budget cuts as a result.

The reduction in funds has caused the availability of services in the county to be reduced

With an unemployment rate of 11.9%, more residents rely on the free government services.

The nurse manager for the health department, Rhonda Dyer, said there has been in increase in STD rates and teen pregnancies due to cuts in the budget.

Services for STD screening operate out of the health department half a day, once a week. The family planning services are available only twice a week.

Both of these services are consistently booked.

“We don’t have any [available] appointments till the end of March,” said Dyer.

An increase in teen pregnancies is likely due to the inability of teens to access birth control measures, she said.

STD rates for the county are already on the rise.

The department expects to see more cuts to their budget in the new fiscal year that begins in July.

The health department cannot put out fires our prevent crime, but it can prevent trips to the emergency room.

Dyer believes that the county will see an increase in ER visits because preventative measures cannot be taken.

Health is a vital part of any community. Sick residents cannot work.

Their Hands Are Full

With today’s failing economy more people are becoming susceptible to health problems because they are unable to get the medical care that they need.

A conversation with Pat Brake, the office manager at the Hart County Health Department, revealed that the incidence of people utilizing her facility for healthcare has increased.

The increase in patients at the health department has unfortunately been met with a reduction in staff.

The clerical and nursing staff at the health department has been reduced by half. Reduction in the staff has led to cutbacks in general clinic days.

Clinic days allowed patients to be seen for a variety of reasons. Family planning clinic days have been reduced from four days a week to once a week.

Brake says that they are not allowed to compile a waiting list for patients who cannot be seen. They circumvent this problem by obtaining the contact information of women who cannot be seen, and they are called if a position becomes available.

Because it is so difficult to make an appointment with the health department, it is rare that a patient misses an appointment said Brake.

Brake has even appealed to outside sources to provide funding for the health department. She has applied for grants from various organizations even trying to solicit the help of talk show host Oprah Winfrey.

The health department asks the local hospital to spare nurses to assist with the clinic days at the health department, but because of staff cutbacks at the hospital it is rare that they are able to function short-handed.

On the day that I spoke to Brake she said that they had scheduled 27 appointments with two nurses on call and one visiting nurse assisting.

How long will the clinic be able to function short-handed, and how many people are being left out of the loop because there just is not enough staff?

I was given the invitation to just observe the health department for a day; I hope to paint a clearer picture of the plight by witnessing the problem first hand.

What Does This Button Do?

As a 20-something who thinks that the term "floppy drive" is arcane, it is easy for me to jump on board the train known as E-health.

E-health or electronic health refers to the new style of communication that involves the use of the internet. While I can log onto WebMD, give myself a diagnosis, and in the near future probably begin to prescribe my own medications; what happens to the baby boomers who did not grow up in the electronic age?


Hart County has a large elderly population. Looking through various statistics for the county one can't help but wonder how this new wave of health information will get to the older population.

My grandmother is one of those people who refuses to learn how to use the internet and only uses here cell phone for dire emergencies. I remember being a teenager and she still had a rotary phone. It would be hilarious to see her trying to diagnose herself using WebMD.

My mother loves the internet, but when she first used WebMD because she had a persistent cough results said that she had, sinusitis or brain cancer. I exaggerate a little, but using a self-diagnosis tool can be difficult without the proper knowledge. It sometimes encourages people to not seek doctors opinions until things get more severe.

As more information becomes conveyed electronically and the average age of US citizens increases it will be interesting to see how websites develop in order to increase accessibility for older adults.

Some History...Some Demographics

If the empty railroad tracks and dilapidated, abandoned buildings in and around Hart County could talk they would tell the story of textile mills and the once booming city of Bowersville.

Now the textile factories that surround the outskirts of Hartwell are abandoned, replaced with manufacturing plants. These new plants create items such as kitchen counter tops and toothbrushes.

Although the factories provide jobs for residents, many still have not found work.

According to Ilka Decker, a member of the Archway Project which is a collaboration between the county and the University of Georgia, the unemployment rate for the county is approximately 10 percent.

Many in the county grow their own crops for both profit and personal use.

A majority of Hart County revenue comes from those who retire in the county. Lake Hartwell has become a popular place for retirees who wish to flee the hustle and bustle of Atlanta.

Decker said that those who live in town refer to those who live along the lake as the "lake people." They are comprised of mostly affluent people.

As one could surmise, the demographics of the county are skewed by these retirees. Hart County is comprised of a large population of older adults.

Over 50 percent of the county is 35 and older. With a population of 23,000, the birth rate for the county according to a 2001 census was 282.

Also according to records, the majority of those births occurred in women between the ages of 20 to 34.

Conversely, the death rate for the population was 268. In those deaths more than 200 occurred in adults 65 and older.

A large population of older adults signifies a need to focus on adequate elder care. More than 100 of the deaths recorded by the census were due to cardiovascular disease.

More in-depth research will need to be done to discern if these deaths due to cardiovascular diseases are a result of diet, lack of physical activity, or lack of proper care.

Here I Come Hart County

For the next several weeks, I will be reporting on health-related matters that effect Hart County in the state of Georgia.

Hartwell, GA is the major city located in Hart County.

The county has one hospital, an interesting fact is that the hospital has more physicians than beds.

The county has two nursing facilities and one personal care home. The hospital and nursing facilities constitute the care offered in Hart County.

The county has a population of approximately 23,000.

I have only been able to gather information, from the reference website. I hope to have more information that my travels to the county will reveal.