Eula Hall pushed to create a medical clinic in rural Floyd County in the early 1970s to improve health care in the area when other options were limited. When the first clinic burned, she spearheaded efforts to raise money for a new one. Today, at age 90, she still comes to work every day to help patients with a variety of needs, including pharmacy co-payments, housing and food. The clinic is named for her. (Brittany Greeson/The GroundTruth Project)

At 90, she’s still fighting to change health care in Appalachia

GRETHEL, Ky. — Eula Hall got home from her son’s baseball game one night in 1982 just in time to see a big piece of her life’s work go up in flames.

Hall had scratched to help create and sustain the Mud Creek Clinic in a rural part of Floyd County so people could receive health care, even if they couldn’t pay, and it was burning to ash.

Hall wept that night, but she rallied clinic employees and volunteers the next morning to get back in business. She pushed the telephone company to install a phone on a willow tree next to the rubble of the clinic, and staffers scrounged for supplies at convenience stores.

The clinic staff saw patients for two days at a picnic table near the tree before moving operations to the cafeteria of a nearby elementary school, then ultimately to a new building.

“We never missed a day,” Hall said in a recent interview.

Such is the grit of Hall, who at age 90 works every day at the clinic, now called the Eula Hall Health Center.

Her title is patient advocate, and that covers a lot of jobs.

She raises money — and sometimes gives out of her own salary — to help poor people cover co-payments at the pharmacy and other needs. She helps keep the food pantry going and arranges rides to the clinic for people without transportation. She counsels people on benefits including housing aid, Medicaid and food stamps.

Hall grew up poor on a small farm in Pike County and has an eighth-grade education, but she has received four honorary doctorates for her work.

She helped give U.S. Sen. Ted Kennedy, D-Mass., a tour in 1983 when he came to Eastern Kentucky while surveying hunger in America. She was honored alongside Archbishop Desmond Tutu, who won the Nobel Peace Prize. She met with activist Jesse Jackson when he visited in 1998 to advocate for health care.

She didn’t set out to rub shoulders with the famous, however.

“I just wanted to be somebody that could help people,” she said.

‘PEOPLE SUFFERED’

Access to health care was spotty in rural Eastern Kentucky when Hall was a child in the 1930s.

There were relatively few doctors, and many people couldn’t afford to see the ones there were. Tuberculosis was common, and there was little routine preventive care, she said.

Many women had their babies at home, and complications could turn deadly.

Hall saw her mother nearly bleed to death while giving birth when Hall was 6 years old.

Her father gave a neighbor a cow and a hog to bring a doctor from Pikeville, but the baby died, according to a 2013 biography of Hall by Kiran Bhatraju.

She had a neighbor who died from tetanus after stepping on a nail. She saw classmates die from whooping cough.

“People suffered, they really suffered and died for the lack of health care,” she said.

She saw another kind of pain in her first marriage, to a coal miner who was mean when he was drunk. He abused her, breaking two of her ribs and her jaw at separate times, but she stayed with him for the sake of their children, according to Bhatraju’s book.

Hall developed a deep empathy for people facing hard times, and a determination to help.

“I knew what it was like to suffer,” she said.

In the 1960s, she got a job as a community organizer through a federal anti-poverty program, and she decided to make access to health care her mission.

She ultimately founded the Mud Creek Clinic in 1973 with $1,400 in donations, when she was in her mid-40s. Two doctors from a Catholic hospital in the county called Our Lady of the Way saw patients one day a week at first, accepting $1 a day for their work.

The clinic had a sliding scale for payment based on the patient’s income. The scale went all the way to zero.

“Nobody was turned away regardless of their income,” Hall said.

At Hall’s request, the United Mine Workers of America approved paying the clinic to see miners and retirees in the early days, providing a steadier source of revenue for the clinic.

‘I’VE FOUGHT LIKE HELL’

The clinic proved so popular it outgrew its first small rented space. Hall moved to a mobile home and set up the clinic in her house, converting bedrooms into examination rooms.

Money was tight, so she asked people to donate glass baby food jars, which the clinic boiled to sterilize and used as specimen jars for urine samples.

She put a rack on top of her Volkswagen to take the jars to the lab, and they clinked at every bump.

“You could hear me coming a mile away.”

The clinic didn’t have a pharmacy in the early years, so she worked late many nights to deliver medicine, with her children in tow.

She tackled other needs, for instance, agitating for free school lunches.

A survey she helped conduct showed that many people relied on contaminated wells for water, so she pushed for better water service, ultimately serving more than 30 years as chairman of the local water board.

She was president of the Kentucky Black Lung Association in the early 1970s, advocating for coal miners suffering from the debilitating disease, and for their families.

The woman who grew up hard turned out tough, and she didn’t hesitate to pester politicians if she thought it would help the community.

Her biography recounts a day in the early 1970s when she threatened to punch another black-lung advocate — a man — who was reluctant to support her call for benefits for miners’ widows.

Another time, she called then-Gov. John Y. Brown in the early 1980s and asked him to force a regional health care provider to withdraw its application for a federal grant to rebuild the Mud Creek Clinic, because she wanted to apply for the money, according to Bhatraju’s book.

Hall makes no apologies for playing hardball if she thought it would help people in need.

“I’ve fought like hell to get what we’ve got,” she said. “I don’t care who I stand up to, as long as I’m right.”

And, she said, “I’m right until somebody proves to me I’m wrong.”

Floyd County Judge-Executive Ben Hale said Hall has “such a good heart” and has worked to make the community better.

“She’s just one of the special, special people who sees a need and just goes out and achieves it,” Hale said.

‘YOU JUST COULDN’T WALK AWAY’

The clinic was the centerpiece of her efforts to improve the community, however, so it was one of the worst days of her life when it burned in June 1982.

There wasn’t so much as a stethoscope left after the fire.

Fire officials told her that someone deliberately torched the clinic, but no one was ever charged.

Hall said it’s possible that someone set the fire while stealing drugs, but there also was speculation that her criticism of the coal industry brought retribution.

Hall said there was no thought of not trying to resurrect the clinic.

“Our patients were so sick that you just couldn’t walk away and say, ‘We don’t know what we’re gonna do,’” she said.

The clinic moved from the school cafeteria to a double-wide mobile home after the fire, but the Appalachian Regional Commission soon threw a lifeline, notifying Hall that it would provide $320,000 for a new clinic in Mud Creek.

The grant required the recipient to come up with $80,000, however.

Hall and other supporters dug in for a determined fundraising campaign, contacting donors, holding potluck dinners at the school, taking up change in buckets at roadblocks and holding a radio telethon. One man reportedly offered to donate moonshine to sell during the telethon.

Local banks and the Catholic Diocese of Covington donated, and John Rosenberg, a Prestonsburg attorney who started the Appalachian Research and Defense Fund of Kentucky to help poor people with legal representation, coordinated donations from lawyers and doctors, according to Hall’s biography.

In the end, supporters raised more than $100,000 to help build and equip a new clinic that opened in 1984.

‘PEOPLE’S NOT POOR BY CHOICE’

The clinic offers a range of medical services these days, including primary care, dental care, optometry and a pharmacy.

About 40 percent of the patients are Medicaid participants, but the clinic has a sliding fee scale for uninsured people and provides free care if needed, said Ancil Lewis, chief executive officer of Big Sandy Health Care. The clinic at Mud Creek became part of Big Sandy in 1977, allowing it to receive federal money. Big Sandy has clinics in Floyd, Pike, Magoffin and Martin counties.

The Eula Hall Health Center has 15,000 to 20,000 patient visits annually, Lewis said.

He said he has no doubt that Hall’s work has helped save lives.

“Just having a clinic open up that anyone could come to … people came and all kinds of illnesses were found because they had access to health care,” he said.

In terms of access to health care and the quality of care, Hall said, Eastern Kentucky is a different, much-improved region now than when she was a child.

The need remains great, however, and her philosophy on access to care remains straightforward: Everyone should be entitled to adequate health care.

“Nobody should have to suffer for the lack of health care in a country like ours,” she said. “People’s not poor by choice.”

Hall has diabetes and other health problems of her own these days, and she has trouble hearing. She doesn’t drive anymore; a volunteer takes her to the clinic.

Her children have urged her to slow down, but she has no desire to sit at home when she thinks she can help people at the clinic.

“It gives me joy to help people. If I get down here, I can do it or get it done,” she said. “I’m gonna do what I want to as long as I know what I’m doing.”