Rural lives matter: EMS troubles in Greene County, Alabama
What is happening in Greene County, Alabama?
Emergency medical services in Greene County, Alabama, are on life support. The Greene County Emergency Management Services (GCEMS) provides ambulance services throughout the entire county, responding, treating, and transporting people as necessary. It is the only EMS in the county, stretching 660 square miles.
In a letter to the State EMS Agency, Greene County Interim EMS Director Zac Bolding cited a lack of local funding as the reason for the pending service suspension, communicating how difficult it was to provide emergency medical services to an entire county while covering twenty-eight miles of Interstates 20/59, four highways (State Highways 43, 11,14, and 39), and parts of the Black Warrior, Tombigbee, and Sipsey rivers without adequate funding.
Last week, Bolding provided an ominous picture of the county’s EMS future, which the Greene County Democrat described as a critical service facing “imminent collapse.”
“We are providing an ALS-1 ambulance service (a vehicle with a driver and paramedic onboard) on a 24/7 basis. We are doing this with one usable ambulance and two other transport vehicles, which are well behind their safe-service life in terms of mileage and wear and tear,” he said.
One resident told CBS 42, “It’s going to be a sad day on Friday,” as news will tell whether the county’s emergency medical services shall remain alive or wither and die. Fear has crept into the souls of many folks — most of which are Black people.
Greene County has been described as the “blackest county” outside of Mississippi.
According to the US Census, Greene County has a population of more than 7,500 people, with approximately eighty-one percent Black folks while nineteen percent are white.
A population this size should not be losing its fire and rescue services.
Questions arise as to how we got here.
Speculation about governmental negligence on a county level is one resolution that can be derived from this crisis. However, conclusive evidence must be the source of such a claim.
Until then — here is what we know:
We know that the state government and federal government often fail at treating Alabama’s Black Belt, especially the predominantly Black counties and communities, with the same tenderness as homogenous exurbs, diversified suburbs, citified areas, and predominantly white rural communities. This lack of tenderness towards rural Black communities encompasses a perpetual decline in population, economic and job growth, and health services in places like Perry, Wilcox, Greene, and even Dallas counties.
Alabama writer, poet, and scholar Alexus M. Cumbie said, “Alabamians from all over the rural south like Lowndes County, Bibb County, and York, Alabama (where my dad grew up), fear for their lives just to get to the nearest emergency room with quality care for health concerns that could have been prevented.”
These words reflect the ever-present delay in funding and services brought upon rural folks in Alabama’s Black Belt simply because of where they live. Alabama’s land area is more than ninety percent rural, with forty-one percent of the state’s population living in what could be defined as a “rural community.” However, ruralness is not entirely synonymous with “poorness,” which is why conditions of literacy rates, median income, and economic growth can often vary, pending the area, region, and community in question. And as more of Alabama’s population trends towards urbanization, folks in rural communities will continue to be pushed to the margins.
Last year, WSFA reported that the Green County Hospital lost $100,000 a month over the past five years. Such depravity reflects more than eighty percent of rural hospitals in Alabama that operate in the red, with negative operating margins. And while COVID-19 exacerbated health inequities and inequalities in rural Alabama, current conditions of emergency services and hospitals reflect years of neglect, particularly in a state that has refused to expand Medicaid time and time again.
On April 19, 2022, Congresswoman Terri Sewell delivered a check for over half a million dollars to Hill Hospital in York, Alabama, thirty-eight miles down the road of Eutaw, Alabama — the county seat of Greene County, where the GCEMS lives. This direct financial assistance to York, Alabama (Sumter County), sent a message more people need to understand. A message that highlights a fundamental truth: There is still life in these communities — communities that have been forgotten for too long.
Congresswoman Sewell’s championing of rural Black lives comes with mighty obstacles, as she must wrestle through a red state amid heavy red tape just to tell the stories of the people she represents.
Alabama’s state government might give the impression that it is about life amid the living, preserving breath as civic and religious duties, but sometimes one must check for bugs in the buttermilk to assess the truth.
As an attempt to aid the recovery of COVID-19, Governor Kay Ivey announced recovery grants in the amount of $30 million for rural hospitals and $10 million dollars for emergency rescue services through the State Fiscal Recovery Fiscal Fund from the American Rescue Plan Act (ARPA).
While this sounded promising, sometimes access and opportunity don’t live on the same side of the neighborhood but are rather segregated for reasons rooted in a systematic divergence, mazed by the walls of systemic injustice. And even if a county like Greene was able to receive this “award,” which maxed up to $10,320, it is not enough to amend a historical error, where value often measures body count rather than critical need. For example, rural hospital grant funding is dependent on bed count. Perhaps such measurements seem reasonable on Excel sheets, but maybe our funding allocations would be better if we measured dollars through the lens of equity. This is a federal responsibility as it is a state responsibility.
Measuring funding through an equitable lens would ensure that our rural hospitals — no matter where they are in the state — received funding that treated people like people rather than numbers on a spreadsheet.
An equitable lens for state resources and funding — including the kind of governmental support to help local, rural governments make wise accounting decisions — would safeguard counties like Greene from the kind of response the State EMS Director, Jamie Gray, provided amid GCEMS’s cry for help.
“Transitions happen all the time. It’s just very unfortunate when one loses in the nature of this county that only has one service,” he said.
These words are synonymous with laying by a bedside, extending goodbyes to a loved one, particularly a relative that lacked the connection of an immediate family member. It’s cold, stale, and disturbing.
Community leaders and residents of Greene County have committed to raising funds to keep their EMS services alive. But this noble act is a mighty tragedy.
Greene County is the third poorest county in the state of Alabama.
As such, what must these potential donors give up in order to keep their emergency medical services alive? A public service that should be an uncompromising, impenetrable resource.
Food? Gas? Life insurance? And that’s assuming such needs are currently obtainable.
There is a thin line between life and death when it comes to health care and services in Alabama.
And Alabama’s failure to expand Medicaid has made that line virtually invisible for Black and poor white folks in rural Alabama, as rural hospitals close and emergency medical services die.
The suspension of emergency medical services in Greene County could be interpreted as a death sentence for so many people. The inability of Greene County to bear the fruit of healing, rescue, recovery, and transportation when lives are on the line is not just a moral dilemma. It is indeed a moral catastrophe.
And now, when someone calls 911 near Greene County, and they say, “Please help me. I can’t breathe,” or “Please help me, I can’t move,” or “Please help me, I’m dying.”
What used to be — and could be — “Help is on the way” will now be, “I’m sorry, but we can’t help you.”
Surely, these hyperboles get to the heart of the matter. A grave matter in Greene County, Alabama — an area so many Alabamians travel to attend college, go to the river, visit family, or simply head home.
It’s a sad day indeed. But this can’t be the end.
Somebody has to do something.
Until then — surrounding counties will have to bear the weight of the 911 request, but it shouldn’t have to be this way.)
Lives depend on it.
See the most recent story of Greene County EMS saving lives: