Alva Review-Courier -

Raccoons, bears and critical mission training weren't factors for many of us this past summer, but for one Alva citizen they were a reality.

U.S. Navy Reserve Commander Philip Self, or Dr. Self as we know him, deployed to Wise County, Virginia, last August for a unique training mission organized by the Department of Defense's Innovative Readiness Training (IRT) program. The mission, called Appalachian Care 2019, brought together more than 130 military medical specialists from the U.S. National Guard, Air Force, Army, Army Reserve and Navy Reserve to receive hands-on readiness training while providing much-needed care to some of the state's most impoverished.

Dr. Self, having practiced medicine since the mid-'80s, joined the Navy Reserves immediately following the 9/11 terrorist attacks in 2001 and has participated in similar training missions internationally over the years; missions that use his 30+ years of civilian medical experience and knowledge to provide care to patients who might otherwise not get it.

Wise, Virginia (the county seat of Wise County), located high on the Appalachian Plateau in the far southwestern corner of the state, played host to Self's most recent training mission where the deployment and readiness training for military personnel was to happen; units were to conduct critical mission training and logistical movement in order to simulate hands-on deployment readiness operations and healthcare delivery in the time of crisis, conflict or disaster.

Partnering with the mission was a nonprofit organization called The Health Wagon that provides mobile health services in and to the medically underserved in southwest Virginia. (It was incepted in 1980 and is the oldest mobile clinic in the nation to date.) Its impact on the region has been huge – 16,670 encounters/visits were documented in 2018 alone according to their website (thehealthwagon.org). Hoping to cast a wider net of help, The Health Wagon requested assistance from the IRT program to bring military medical services to the Appalachian region.

A camp was set up and medical operations were staged for medical professionals at the Wise County Fairgrounds (where raccoons and bears were spotted roaming freely). These professionals, also called the Appalachian Care IRT 2019 team, were to provide medical, dental, optometry and even veterinary care at no cost to the medically underserved community – a community where poverty rates tend to be significantly higher than the rest of Virginia.

Though seemingly primitive (Self said he was set up in the paddocks area of the fairgrounds with basically a horse stall for a clinic), the training site was fit to see patients as they were being triaged and undergoing initial screenings for blood pressure and blood sugar. Self said if a patient's sugar was over 200 or blood pressure over 140, he was sent on to Medical before going on to see his specialty. The initial screenings proved to be important – one woman didn't even know she was diabetic before that day.

"Most of the people we saw didn't come there complaining of a medical issue; they came there wanting to get their teeth pulled or get free eyeglasses, and because you could get your pets spayed or neutered for free."

The doctor and commander said one thing that stood out to him about the patients was their blunt, brutal honesty; Many of them were generous with details of their struggle with drugs and incarceration. Another thing he noted was the incidence of black lung in men. "These people have been in coal-mining families for generations," Self noted.

Self said he was surprised, though, at how many patients said they have lived in the area their entire life. "Maybe it's because they don't have good schools or don't get good skillsets, maybe they just can't make it out of the 'black hole' as one patient put it," he said. "It's beautiful there, very scenic – there's a branch of WVU there in Wise, but there's also a lot of trailer parks, squalor, opioid and methamphetamine problems."

Of the experience, Self said the training – learning the logistics of a convoy and also how the command structure works – is helpful to reservists like him who aren't used to full-time military structure. "Besides all the training, actually helping people is the goal. If we can do that while showing the flag, we can help the military be seen in a positive light."