It's 5:30 a.m. on a summer morning, and in the pre-dawn darkness a man, carved walking stick in hand, knapsack on his back, arrives at the Wise County, Va., fairgrounds.
Robert Ellis has walked 15 miles, through the night, to get here. But he isn't here for a summertime fair.
"I really need my teeth fixed. They are really bad. And my hearing," Ellis says. "I don't know which one's worse, my hearing or my teeth."
For this weekend, the fairgrounds have been turned into a one-stop-shopping, outdoor medical clinic. Remote Area Medical has arrived for its annual visit to Wise, bringing free dental, eye and medical care to this remote southwest corner of Virginia.
"I didn't have enough gas to put in my truck to get here, so I told the old lady I would just walk," Ellis said. "I got up at 12:30 this morning, got ready and started walking."
Ellis joins some 2,500 other people who over the course of three days line up in the wee hours of the morning in the hopes of getting free medical care. Many want their teeth checked or even pulled, others need their eyes examined, but some, like Sheila Johnson, are also looking for specialized medical care.
"I have a lot of trouble with my lungs right now and I need to see a pulmonary specialist, so this was my only option," she said.
Stan Brock started Remote Area Medical in 1985 after years of working deep in the Amazon, where health care was 26 days away by foot.
"They might as well be on the moon for the opportunity that they have to get the care that they need," Brock says of the isolated community where he once lived and worked.
Brock began bringing health care to remote corners of the world such as Haiti, Africa, India and Guyana, but after setting up his headquarters in Knoxville, Tenn., he quickly realized that pockets of the United States were severely underserved and filled with people who couldn't afford health care.
"You've got 40 or 50 million people that are in this category that don't have insurance and can't get the care that they need or they can't afford it," Brock said.
The RAM event in Wise is now one of the largest "expeditions" as Brock calls his clinics. He's held more than 700 around the world, helping more than 550,000 patients in this country alone.
"It's always an amazing sight, isn't it? That here in America at 5 o'clock in the morning, with rain threatening, there are 1,500 people out there," Brock said, standing by the entrance gate overlooking the crowd on the first morning. "It's sort of the one time opportunity that they know they can afford to get the care that they need. ... It's a pretty sad sight."
Teresa Gardner was born and raised in Wise and now runs the local free clinic, The Health Wagon.
"The economy here has hit a downturn. We've had a lot of mining layoffs, which is really the only industry here," Gardner said. "It's just incredible the desperation that people have for health care."
Gardner first invited Stan Brock and RAM to Wise 14 years ago and helps organize the 1,400 dentists, eye specialists, doctors and volunteers who all donate their time and expertise. Approximately 80 dental chairs are fully manned, as well as 16 eye examination stations.