Pay it ForwardRural communities across South Carolina face long-standing challenges that have proven difficult to overcome for the people living there. Read on to learn more and consider which challenge your team may be interested in researching and, hopefully, solving.

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Garbage Trucks for Fire Engines

AIKEN COUNTY — Many emergency service providers are forced to operate on a shoe-string budget. Glenn Poole, Chief of the Hollow Creek Fire Department, admits he has always struggled to pay for even basic departmental necessities. “When I started,” Poole recalls. “[the chairman] wouldn’t even let me buy fuel for the trucks.” This lack of administrative support forced Poole to solicit donations from his own firemen. “When you came in our door,” Poole says, “you better have some money in your hand.” When the offering was insufficient for the department's needs, Poole and his team found creative ways to stretch their budget. “[At one point, years ago] we took trash trucks,” Poole says, “and made them into [fire engines].” While the department’s financial situation has improved over the years, it still can’t afford some essential supplies. To this day, the firefighters don’t even have proper uniforms, just t-shirts and polos. “That’s all we need,” Poole reassures, unconvincingly.

Many of the problems Poole and his team face are systemic. For instance, parts of Aiken County are severely lacking in emergency infrastructure. According to Poole, there are still only three fire hydrants in the 32 square mile district his department serves. He recognizes that solving issues like this is a major undertaking. “When you’re messing with rural development,” Poole says, “that’s a pain.” Despite these seemingly insurmountable obstacles and even at the cost of his own health his flagging health — likely weakened by years of on-the-job smoke and chemical exposure — Poole remains committed to serving. “If someone’s in [a burning] house…” he says, “I’ll be the first one in the door.” While valiant, resolving the broader issue of paltry emergency services will require more than the efforts of one man. It will take many minds and creative efforts to address.

Holistic Solutions to Hidden Problems 

YORK COUNTY — Homelessness is an invisible crisis. “[It’s] on the rise,” says Ainsees Moss, director of Tender Hearts Ministries, a local women’s shelter, “[But] people put blinders on and go, ‘not in my community.’” Since Tender Hearts opened in 2007, they have strived to deal with homelessness holistically by targeting the cycle of poverty directly by providing shelter residents with financial literacy education and assistance with tasks like getting a driver's license. Since January of 2020, they have also begun delivering nutritious food to homebound seniors who aren’t able to shop for themselves. Moss recalls that one senior was so grateful to Tender Hearts that they “donated half of [their stimulus check]” because of “what a difference [the program] was making in their life.”

Tender Hearts does quality work, but its capacity to serve is extremely limited. Their shelter is routinely at maximum capacity, and they recently had to retire one of their transitional homes due to damage. Additionally, COVID-19 cut off large sources of food items for their homebound seniors’ program. If poverty, hunger, and homelessness are to be eradicated, Tender Hearts and organizations like it will need a tremendous number of resources and community support.

When Grief Sends a Bill

LEXINGTON COUNTY — Mental illness is an epidemic that cripples communities, not just emotionally but financially, too. One woman, Donna Anderson, has grown keenly aware of its toll. Over the past 25 years, she has lost six family members — including both her twin brother and her son — to suicide. For Donna, this was traumatic and a source of great pain which became only more acute in 2018 when her husband passed away after a short battle with cancer. Anderson did her best to pay her bills, but without her husband’s income some slipped through the cracks and one in particular kept growing. “[My property tax] bill was $600,” Anderson says, “By November, that tax bill had blown up to $3600.” Though she had scraped together the money to pay the original amount, she could not afford the exorbitant penalties. “I knew there was no way,” she says, “It’s highway robbery,”

Her husband’s death as well as her inability to stay afloat financially taxed her emotionally. “I didn’t even have the power to fight,” Anderson says. At that point, she was on the verge of losing everything. “I stood to lose my property [that I’ve had for 40 years],” she says. Anderson’s problem is not uncommon. While Anderson eventually found help, many in her situation have to deal with the trauma of mental illness and suicide without assistance; financial instability and stress only further compound the problem. For these people, it is urgent that new resources be made available so that they can have a fighting chance.

Foster Care in the Age of COVID

YORK COUNTY — Child abuse and neglect is a persistent problem. For many children, their situations are so volatile that they are removed from their homes and placed in alternative housing. Children’s Attention Home (CAH), a foster home for abused children and homeless teens, is one such housing option that has been serving the county for over 50 years. Here they shelter children from a variety of unfortunate backgrounds. “[They are] coming to us from very broken circumstances,” says Katy Motsinger, Community Resource Director at CAH. She explains that the abuse and neglect they’ve been subjected to often puts them at a disadvantage academically and personally relative to their peers. “[M]any of them come in behind in school…” Motsinger says, “or they might not do very well socially because they might have been isolated in the past.” CAH does their best to teach their children skills for independent living. “They need to know a lot of things to be able to live on their own,” Motsinger says, “whether that’s financial education, how to get a job, how to drive… [or] finding housing in a lot of cases. They just have to figure out how to ‘adult’ for lack of a better term.”

COVID-19 has complicated the CAH’s mission to serve its community. “It’s hard to talk about what is gonna come next or what our challenges are…” Motsinger says, “Because what were challenges before are exacerbated by what we’re seeing with the coronavirus.” One of these challenges comes from the transition to online classes. “[N]ormally, [students would] be in school every day or would be seeing people who would be able to identify something is going wrong in the household,” she says. “You don’t have those mandated reporters seeing them as much right now.” To face this new wave of harm, institutions like CAH will need a new wave of community support.

My Therapist, the Horse                         

YORK COUNTY — Alternative therapy programs have arisen to treat community health problems in unique, engaging ways. One such program, RideAbility, provides therapeutic horseback rides to neurologically disabled and mentally ill members of their community. “We work with children with autism, Down syndrome, cerebral palsy, traumatic brain injury,” says program founder Wendy Schonfeld. “We also have a large veterans’ program as well [for] our veterans with PTSD.” In their program, Schonfeld says students “get to work on balance, core strength, focus, [and] attention,” all of which benefit their overall wellness. The program addresses several important needs in York County where other therapy options are limited, but new hurdles may soon put this to an end.

In the past, RideAbility has been a popular success, even becoming a Special Olympics training center for both S.C. and N.C. However, the program has recently faced financial setbacks. “United Way changed their mission,” Schonfeld says, “and [the] charities they were funding aren’t going to get funding from them anymore.” Additionally, the pressure caused by the coronavirus has strained the program’s budget. “We still have rent to pay,” she says. “We have 10 therapy horses. COVID doesn’t stop them from having to eat.” RideAbility and other alternative therapy programs are vital to their communities. Insecure funding jeopardizes the health and well-being of those they serve.

Weathering the Worst Alone

OCONEE COUNTY — Resources for homelessness are severely lacking. “I didn’t realize the need was this great…” says Tracy, who lost her home in February, “until I was actually homeless myself.” “It was devastating,” she says, “because I’ve always had my stuff together.” Tracey, who raised her three boys as a single mother, was no stranger to overcoming adversity. However, it hasn’t been a lack of determination that has slowed her escape from homelessness, but rather a lack of local support. “I had reached out to two pages of resources for Pickens and Oconee County,” Tracey says, “with no luck as far as housing or even food.” Since there was no local Salvation Army homeless shelter, Tracey had to drive to a shelter in Anderson County. Unfortunately, her experience there was extremely unpleasant. “It was horrible,” she says, “it was like being in jail.”

After two days in the shelter, Tracy decided she would rather sleep in her car where she ended up staying for much of the past few months. Aside from limited access to restrooms and safe parking, Tracey describes how her living situation left her vulnerable to extreme weather. “[On the night of Easter] I got an alarm going off on my phone telling me a tornado was coming,” she says. “I’m in my car and my car was swinging back and forth.” Tracey’s brush with death traumatized her emotionally and as a result she spent the next week in a local hospital. This was not the only time her situation caused her mental health to suffer. “[At one point] I was just feeling really discouraged because I couldn’t seem to get anywhere,” Tracey says, beginning to cry. “Suicide did cross my mind.” For the most part, she has had to endure depression on her own. “I don’t have much of a support group,” she says.

Despite her circumstances, Tracey has taken solace in her faith in God and has done her best to put others first through her volunteer work at both a local hospital and jail. Even through her hardship, she remains cheery and hopeful about her future. Thanks to generous members of her community, Tracey no longer lives in her car — she has upgraded to a camper — and is working with United Way of Oconee County to get back on her feet. While Tracey now has a more suitable place to stay, many in her situation have not been as fortunate. More resources and community-based solutions are necessary if the broader issue of homelessness is to be resolved.

When Insurance Offers No Reassurance

COLUMBIA — “His case is one in 6.25 million,” says Ryan Crane, a father of five whose nine-year-old son, Tim, suffers from an unidentified illness. “The doctors still can’t figure it out.” Tim’s condition has caused him to suffer multiple strokes necessitating intubation and a number of invasive medical procedures including the removal of his colon. He is routinely treated by multiple doctors and observed for notetaking by several more. However, even with so many medical professionals working on solutions, Crane has not gotten any answers. “They don’t know what’s going on with him,” he says. “There’s nothing in the books.”

Tim’s treatments have been extremely expensive and, unfortunately, Crane’s insurance has not offered sufficient coverage for them. “The state insurance is good on some parts,” he says, “but with stuff like what my son’s going through, there were certain medications that they weren’t going to cover.” Crane’s inability to pay Tim’s medical expenses and cover his family’s financial needs strained him emotionally. “I [felt] like ‘I’m not taking care of my family,’” he says, “and as a father, I was not providing.” The pressure was so agonizing for Crane, that he had to step away from his job to recover. “I myself took off a year,” he says, “because you hold everything, and you hold everything, and I try not to let my family see and I’m weak.”

Since then, Tim’s health has stabilized, and Crane has returned to work at Amazon. However, the spread of COVID-19 presents a new challenge to his son’s safety. “I’ve been there the past two months,” Crane says, “and there’s been reported 27 cases [of COVID-19].” Tim is still immuno-compromised and exposure to the virus could be fatal. Since Tim’s in-home nurse tested positive for the virus, Crane has taken no chances. Every day, he performs an elaborate, multi-stage routine to properly sanitize himself and his clothes before he returns home each night. “My worst fear is bringing something from there to my family,” he says. Crane fully understands the risk his work presents, but realizes in his financial situation, without access to comprehensive insurance, it is the only option to care for his son. He hopes that others will be spared the experience he has had. “I really don’t wish anybody to see their child on a breathing machine.”

Empty Stores and Empty Stomachs

AIKEN COUNTY — The Coronavirus has created a shockwave of poverty that is preventing residents from putting food on the table. “You don’t realize how much people have to deal with the food insecurities right now,” says Sharon Rodgers, President of United Way of Aiken County. She attributes this insecurity to the COVID-induced mass layoffs. “[It’s] because people have lost their jobs, particularly small businesses, restaurants, people in service industries.” Additionally, the virus has handicapped community resources to fight hunger. Programs for seniors have become especially vulnerable and have had to adapt to avoid health hazards. “[For instance, one local program is] not able to have senior congregate dining,” says Rodgers. “[It’s] greatly increased the number of home delivery meals.” The higher demand for home delivery has stretched thin the organization at an inopportune time. “It’s put a lot of pressure on staff,” Rodgers says. “And, of course, volunteers are afraid to come out.” Rodgers acknowledges that dealing with the virus has been hard for everyone, but highlights that it has hit some harder than others. “It’s just difficult all the way around,” she says, “[but] particularly for seniors and disabled folks, children, families that [were] already struggling.” While United Way has made efforts to meet the needs of its community, they simply don’t have the necessary resources. “A week ago, we [partnered] with our community to do a [catered] drive-by COVID-testing.” Rodgers says. “We ran out of food.” Without mobilizing more volunteers and resources, the problem may continue to worsen.

When a Mask Ordinance Becomes a Gag Order

ABBEVILLE, LAURENS, & SALUDA COUNTY — South Carolina has one of the highest rates of domestic violence in the country, and it is especially evident in its rural counties. The rise of COVID-19 has made this already alarming issue all the more urgent. “We cover three very rural counties and are very familiar with the struggles that it brings,” says Dawn Ardelt, Executive Director of The Safe Home, a 24- hour service for victims of domestic violence. “And how, on top of the daily struggles they already had, COVID-19 has just added another layer to those that we serve and created the perfect storm.” In 2019, Ardelt and The Safe Home served 1131 abuse victims. But since the coronavirus lockdowns started several months ago, they have seen a surge in domestic violence cases. “The level of violence has been so severe [since the start of the pandemic],” says Ardelt, “The amount of incidents has definitely increased.” Unfortunately, during this time that The Safe Home is most needed, they are least able to help. New health and safety guidelines are inhibiting them from performing crucial functions. “[For example,] we weren’t welcome at bond hearings at one point…” says Ardelt. “That’s usually a very important place where we go for the victim.” This has reduced The Safe Home’s visibility and limited their opportunities to connect with victims. “[D]ue to COVID procedures, we weren’t allowed where we might’ve gone before just to give a card,” says Ardelt. “It’s definitely changed how we’ve approached things to let clients know that we’re even here.” One of the ways The Safe Home has had to adapt is by meeting with victims remotely via online video calls. However, poor rural infrastructure has complicated this method of communication. “[A]ccess to internet in some of our communities [is so bad],” says Ardelt, “we cannot even set up a Facetime call.” Additionally, The Safe Home has had to adapt to limited funding. Donations have decreased due to the virus and, on top of that, one of their largest grants was recently slashed by 18%. This has put immense strain on The Safe Home, but it has not shaken their commitment to meeting the needs of their community whatever the cost may be.

Ardelt recalls a time that COVID forced The Safe Home to go above and beyond for a client. “When [COVID] first hit, we couldn’t find a box of Goodnites Pull-ups in a size 5T for the life of us for over eight weeks,” Ardelt says, “It was like I was looking for the Holy Grail.” However, they were relentless and eventually succeeded. “We got creative and went to a local pharmacy,” Ardelt says, “They were able to help us get a medical grade comparable thing…” This is just one illustration of the lengths The Safe Home is willing to go for their clients. While COVID-19 has made the task of addressing domestic violence in SC harder than it’s ever been, they are ready to take it head on. When asked what she wanted victims in her community to know about The Safe Home, Ardelt replied, “[Let them know] that even though they’re in isolation, we’re still there for them during this time.” It is this type of organization that South Carolina needs many more of in order to fully address the state’s domestic violence problem.

Serving Meals, Changing Lives

BARNWELL COUNTY — Childhood hunger is still a prevalent issue in South Carolina, especially when school is out. In the summer months, children living in poverty, who would otherwise have access to school lunches, often end up not eating at all. “We have a lot of kids [who come to our food drives] where that’s some of the only meals they get,” says William Toney, president of 100 Suits For 100 Men’s Williston Chapter, who partnered with SmartBox over the summer to provide meals for school children and their families. While there are certainly other organizations serving the Williston community, few have roots as deep as Toney’s. “My mother actually started that program [back in the 1980s]...” says Toney. “She drug me out there to help her do it.” Though he was reluctant to participate as a child, he’s now driven to continue the legacy of his mother’s work and feed his community. “I just really wanted to keep it going,” says Toney.

Toney’s summer meal program has been a major uniting force in the Williston community. It seems like everybody wants to be involved. “[At a recent food drive] I had superintendents, principals, [the] mayor, police department, city hall, fire department,” Toney says, “everybody was out there volunteering and pitching in.” The exceptionally high community participation was only surpassed by the massive attendance of the food drive itself. “It started at 11, [and] we had people lining up at 8 that morning,” says Toney. “We didn’t realize there’d be a turnout like that…”

If the 1000-plus families they served at the food drive are any indication, the community needs Toney’s organization now more than ever. While the rise of COVID-19 has hampered Toney’s operation, he continues to persevere and keep the faith. “[B]asically [COVID-19] slowed us down...because we’re not able to get out there and do any type of fundraising,” says Toney. “…but God has always made a way.” Despite the Coronavirus setbacks, Toney has no intention of slowing down. In fact, he’s looking to expand his organization and finally get his own building. Toney’s not going away, and as long as he’s around, hungry children will have a tireless advocate. “I don’t believe in no kids going hungry,” he says, “I’m never gonna tolerate that, not if I can help it.” South Carolina will need a lot of people like Toney if it intends to eradicate hunger in the state.

Hiding in Plain Site

PICKENS COUNTY — Homelessness is so prolific that several roving “tent cities” have sprung up around the county. The people who live in these cities try to evade government officials and social workers, so they often go uncounted among the county's homeless population. They are so insular, and their lifestyle is so entrenched that it is extremely difficult to lift them out of their poverty. “[T]he struggle for us that we really see is trying to change someone’s thought process,” says Jim Abott, Service Center Director for the Pickens County Salvation Army, “the immediacy and the survival mode of poverty is counterproductive to saving money and investing in the future.” Abott explains that counterproductive thinking like this is often passed down from family who don’t know any better. “[It’s] a thought process that is now generational,” says Abott, “we’re talking about people who have not seen [good financial judgement] from their parents or for some even their grandparents…”

However, Abott acknowledges that making wise financial choices in the rural south is difficult. In fact, sometimes escaping poverty is almost paradoxical.  “Probably the biggest factor we see that makes it difficult to empower someone in this rural setting is transportation…” says Abott, “[it’s] the limiting factor of finding [work] that pays living wages when you don’t have a vehicle, when you don’t have any way to get to [work].” Without a car, options for employment are severely limited. “[Finding] a job means you’ve got to find a place you can walk to,” says Abott. However, finding such a job can prove difficult due to the geography of Pickens County. “[W]e’ve got the same resources out in Pickens County that Greenville County has,” says Abott, “The difference is it’s a four-mile radius in Greenville and it’s a 40-mile radius here.” This is just one of many hurdles the homeless in rural South Carolina have to clear in order to get back on their feet.

For many, navigating this landscape of rural poverty is overwhelming and the only way to get through it is to have somebody work with them as a guide. “[T]he number one factor that helps someone that wants to work their way out of poverty is to be supported [and mentored],” says Abott, “so we have begun on a small scale.” While the Salvation Army primarily offers crisis services — food, shelter, and clothing — it is also innovating ways to partner with homeless residents and give them a leg up. “[W]e are now starting what we call a cycle of hope program,” says Abott, “where we come alongside them…and we begin to talk about defined next steps, five components being income, education, transportation, healthcare, and social support.” These five components are crucial for those trying to escape homelessness. “We consider them foundational principles of someone who wants to get from a tent to independent living,” says Abott. However, the program has run into a roadblock with a largely lethargic homeless population. “[T]he hardest factor we’ve found is finding someone who has the willpower, has the desire to do the work,” says Abott. If homelessness programs like that of the Pickens County Salvation army are going to have a wider impact, they will have to figure out how to convince those in the tent cities that it’s worth the time and energy to participate, even if the rural hurdles make it hard to believe.

Income: Fixed, Everything Else: Broken

FAIRFIELD COUNTY — For many elderly South Carolinians, one emergency expense can be the difference between a comfortable retirement and financial ruin. Fairfield resident Carolyn Rabon has experienced this firsthand. “[My husband and I] had the house paid for and everything,” said Rabon. “And then he was in an accident, and they sued our insurance.” To afford the $28,000 in legal fees they accrued during the lawsuit, the Rabons had to take out a mortgage on their home. This triggered an avalanche of expenses that overwhelmed them financially. “[W]e have a high mortgage to pay,” says Rabon. “And then everything started building up, building up. We couldn’t pay our credit card payment.” This pushed them into a corner financially. “[E]verything got so bad, we finally had to go into bankruptcy,” says Rabon.

The couple lives on a fixed income: Carolyn receives $600 in Social Security benefits a month and her husband receives $1200 (minus withholdings for Medicare). Considering that their bankruptcy payments alone are $820 a month, they make barely enough to scrape by. “Everyone thinks old people have it made,” says Rabon, “but we struggle…I struggle more now than I ever did when I was young because I could work then.” These days, neither of the Rabons are able to work. Carolyn’s husband has been largely immobilized since he had a stroke, and Carolyn’s time is consumed caring for him, their disabled 32-year-old son, and a homeless man who the Rabons generously allowed to move into their home. Many of Carolyn’s days are spent attending to medical needs and driving to and from medical appointments — an especially arduous task in rural Fairfield County. “[My husband] can’t drive…[and] his doctor is three towns away,” says Rabon. “[W]e don’t have busses around here...we don’t even have a taxicab service.” Caring for the health of her family and herself on top of finances has been incredibly stressful for Rabon and she doesn’t feel she has anyone to turn to for help. “Right now, I’ve got a heavy load I’m bearing…” she says, “I’ve run out of resources.” However, despite her burdens, Rabon has taken time to invest in herself, too. “I just graduated four years ago. I took psychology and got my associate degree,” says Rabon. “I did it for myself…I feel better about myself for doing it.” While she still has many hurdles to clear, Rabon has learned to take things slowly and accept that some things are beyond her control. “I take it day by day, and pray that things will get better,” she said. “That’s all I can do.” For many in her situation, this is all they can do. They’re desperate, and they need assistance and support from people who care.

A Shelter Overwhelmed

GREENVILLE — There was already a homeless youth crisis, but COVID-19 has brought it to the forefront. “People assume we saw diminishing numbers [come to the shelter] during COVID,” says Jed Dews, executive director of Pendleton Place, a home for vulnerable youths, “but the truth is we did not. We saw really increasing numbers.” Dews describes how managing the influx of homeless youths during the pandemic has been an unprecedented challenge for the organization. “We had to adapt and adjust to COVID,” he says, “while at the same time seeing more clients than we have seen before possibly ever.” Generally, homeless youth like to hide in plain sight and stay in insular social circles instead of reaching out for assistance. “They are really good at blending in,” says Dews. “They don’t like to be known as homeless youth, so you would usually not even know that they’re homeless because of how they present themselves.” Thus, Dews speculates that the coronavirus has not caused the homeless youth population to grow, it has just made it more visible. “It’s not that there’s more of them,” says Dews, “It’s that they’re more willing to ask for help… because there’s a lot of fear on the street with this [virus].” In a way, the virus has been a positive catalyst forcing at risk youth in the community to get the resources they need to stay safe and healthy. “[The Youth Resource Center] since COVID started saw a steady increase in youth that were coming of their own volition to our drop-in hours,” says Dews. “[T]hose are just open hours that anyone can walk in the door, grab a hot meal, take a shower, do laundry, jump on a computer, and talk with our staff.” While the growing number of people willingly seeking help has been a blessing for the community, it has also caused some setbacks for Pendleton Place. Dews outlines how much more expensive it is to operate during COVID due to the increased financial burden of health and safety guidelines as well as the cost of quarantine apartment space. Inversely, in the face of rising costs, the budget for Pendleton Place has decreased. “All of our programs, about 50% of our revenue comes from external events — big external fundraisers,” says Dews, “but those events can’t happen now. So that’s where we’ve really been struggling.” Dews argues, “The whole point of our programming is to be there for [the youths] in crisis.” But who can Pendleton Place turn to when they’re in crisis?

Losing the Golden Hour

LEXINGTON COUNTY — During a medical emergency, every second counts. Swift transport and treatment are crucial to ensuring positive health outcomes for patients. “When you look at a lot of real critical care situations, you’ll come up a lot with people talking about the “golden hour,” says Britton Herbert, program manager at the SC Office of Rural Health, “that first hour after an incident or a condition really sets on when having it addressed in that time period is going to make a significant difference in overall outcomes.” Unfortunately, in several of South Carolina’s rural counties, local care is not available, and that window of time expires during a patient’s transportation to the hospital. “The transport time for some of these trauma cases [for example, is] almost an hour when you factor in the ambulance getting to the patient and then transporting them to a trauma center,” says Herbert, “which right there is the golden hour before they’re receiving the trauma specific care.” These long transportation times are a consequence of shrinking medical infrastructure. “South Carolina, right off the bat, has eight counties that don’t have a hospital within their borders,” says Herbert. He explains that the state’s lack of facilities is part of a national trend in rural hospital shutdowns: “[T]here’s claimed to be more than 130 hospitals [closed] across the nation over the past decade.” These closures mean that EMS (emergency medical services) personnel have to traverse county lines to get their patients to the appropriate care facilities. “[W]hen EMS is called [to counties without hospitals, they] must transfer patients to an emergency room which is a county away at least,” says Herbert. Oftentimes, EMS personnel may not even be able to take patients to the facility closest to them. “[D]ue to EMS transport protocols from SCDHEC…they may not be able to transport the patient to the rural hospital they’re closest with,” says Herbert, “[trauma and stroke patients, for example] need to be transported to a specific designated facility which often times aren’t the ones located in rural counties but rather the large urban population centers.” In order to address this issue, Herbert, along with the SC Office of Rural Health, has helped counties start programs to retrain rural EMS personnel. “[A] big focus of our office has been on community paramedicine,” says Herbert. “This is an endorsement which a paramedic can receive after completing some significant training above and beyond normal paramedic certification both in classroom and in-field training.” This training would allow EMS to offer vital treatment off site in a timely manner. “[T]hrough this program, community paramedics, under physician’s order, can go into a patient’s home…and monitor and manage chronic health conditions.”

Such programs can prove lifesaving to vulnerable rural residents. It is, however, jeopardized by challenges SC’s EMS are facing. The sprawling rural terrain takes an exorbitant amount of time, energy, and manpower to navigate. “[W]hen the transport plan per patient has to be significantly longer than their counterparts in states with hospitals,” Herbert says, “[t]his places a real strain on the EMS agency which is already gonna have a limited number of EMS vehicles and personnel… “Furthermore, there are a lack of EMS workers available in general. “The South Carolina EMS Association developed a workforce survey for our state a couple years back…” Herbert says, “[w]hich identified across the state some really deep shortages…especially…in rural areas.” He believes this is due to the demanding nature of the job. “[I]t’s a really difficult job physically, and emotionally draining with long shifts and constant exposure to real difficult things that you come across.” Despite all the setbacks, Herbert and the SC Office of Rural Health are still pushing ahead and starting community paramedicine programs in three counties without hospitals. He doesn’t know what the future holds — especially with emerging complications due to COVID-19 — but he concludes with a hopeful dedication to the EMS personnel who provide for SC. “It’s a special kind of person who can be an EMT and be an EMT in a rural agency. They’re some of the hardest working and dedicated people that you’ll meet,” says Herbert. “They do not have it easy. And it’s amazing what they persevere through, and the heart that these individuals have to make sure that their community has access to the care that they need.” In order to combat a problem of this magnitude, it’ll take many more people like this to get the job done.

Too Much of a Good Thing

MARION COUNTY — For some rural counties, even their best successes are undercut by systematic challenges. This is beginning to become apparent in Marion. Over the past decade, their economy has had a meteoric rise. “[W]e took an unemployment rate of 16.8% down to 2.7% in only six years,” says Dr. Julie Norman, executive director of Marion County Economic Development. They’ve done so by attracting numerous new businesses to the county. “Marion County has had more [business] announcements last year than any other county in the Pee Dee Region,” says Norman, “and we had four announcements this month alone…” This has not come easy. They’ve had to overcome a slew of obstacles to get to this point. “I can point to a whole series of challenges,” says Norman. “[W]e don’t have public transportation, we don’t have an interstate, we don’t have a good communication system…we have a declining population, and we have an average age of 40.” She says the secret to their economic successes is their attentiveness. “We’re very responsive,” says Norman, “and that sounds trite, but I think it does make a difference. We pride ourselves on excellent customer service…” For Norman, part of excellent customer service is fast turnaround and delivery. “[I]n a lot of these deals we have to act very very quick, and we have been able to do that,” she says. “I think our responsiveness aids a lot of us being able to clear deals.” The value of those deals over the years has been staggering. “[P]rojects that I’ve been involved with have totalled almost $118 million, resulting in 1064 jobs.”

Dr. Norman’s aggressive technique with Marion County Economic Development has brought the county a long way. However, despite her success to this point, she may finally be meeting her match. The lack of industrial real estate has created a bottleneck to new business growth in Marion. “I don’t have enough buildings,” says Norman. “I’ve turned down projects all the time because I don’t have suitable buildings.” And when she says she doesn’t have any buildings, she means it. “[A] lot of our dilapidated buildings that I thought would never sell have sold in the last six months — deplorable buildings,” says Norman. “I truly don’t have any more buildings...So now we’re really in a tough position.” While she has the land for new developments, she doesn’t have the resources to get a project off the ground. “I’ve got lots of sites — I’ve got pad-ready sites,” says Norman. “I don’t have any money to build these buildings.” This issue is becoming compounded by the shortage of residential housing in Marion — crucial for attracting a workforce. “You bring in new companies to the area, they bring people,” says Norman. “People aren’t going to buy stately old southern mansions when they first get to town. They need to rent something.” The way forward in light of these issues is unclear. Norman dismissed out of hand the idea of applying for grants: “Nope, not gonna do that this time.” And she plans to convince someone else to invest in a project. “I’m gonna get somebody else to build on their dime…” Hopefully, this plan pays off. But more than likely, others will need to come in with innovative solutions to address the problem.

Hard Times on Harden Street

COLUMBIA — According to a 2020 study by Feeding America, 600,440 people in South Carolina (one in eight residents) are struggling with hunger. Many of them go hungry because they live in what are called “food deserts.” SCDHEC, whose 2015 map of South Carolina’s many food deserts (shaded red) is attached below, defines this term as,...geographic areas where access to healthy food options, especially fruits and vegetables, are limited or nonexistent because of an absence of healthy food retail, such as a farmers’ market or a grocery store.

Since the closure of their Save-A-Lot grocery store in 2019, the Harden Street community in Columbia has been one of these food deserts. Despite its urban setting and a growing need for a new store over the past year, no progress has been made towards installing one. “It’s very frustrating,” says Jazmyne McCrae, University of South Carolina graduate student and co-founder of the social justice organization Empower SC. “It’s frustrating when you see people struggling and the people in power who can really make a difference either don’t listen or don’t seem to want to try.”

Since nobody else was stepping up to address the issue, McCrae and Empower SC launched the Harden Food Justice Initiative and partnered with FoodShare, a fellow Columbia non-profit dedicated to providing fresh produce to underserved communities, to host a drive-thru fresh food and grocery bank for the community. People of all ages rushed to the food bank to be served. “I met many families — young, old, intergenerational homes — that are desperate for affordable food that’s accessible,” says McCrae.

In many of these hungry faces, she saw herself and her own family. “Coming from a family that was very low income itself, I understand not being able to have the most nutritious meal,” she says, “and I know what that did to my mom. Feeling helpless in a way. Not being able to provide for her children.” McCrae wants to ensure that nobody goes through what her mother did, “That’s a very cruel feeling that no one should ever experience.”

Unfortunately, the demand at their food and grocery bank was so intense, they quickly ran out of supplies. “We had about 300-plus families pour out into Drew Wellness Center on a Friday afternoon,” says McCrae. “[We] ran out of seven thousand dollars’ worth of groceries within four hours.” She was discouraged that they weren’t able to fully meet the need for the community. “[It] was honestly heartbreaking to have cars still coming [after we ran out of food] and not being able to give them…everything I had to offer.”

However, though McCrae couldn’t feed everyone herself, her event brought the hunger of the Harden Street community to the attention of local public officials. “[T]he mayor was there when we did start to run out [of food] and he saw the need, the people in power saw that,” says McCrae. She hopes that the event will inspire the mayor and others in power to take action. “[It should make] them realize, ‘Okay, these are my constituents and I need to take care of them,’” says McCrae. She elaborated on potential policy solutions that local officials could employ to address the problem, such as installing a new subsidized grocery store in the old building or allowing one of the many eager nutrition-conscious non-profit organizations to move in. “There’s [only] so much that we can do [as organizers], there’s a lot more that the people in power can do.”

These policy solutions will take time to get off the ground. In the meantime, McCrae has brokered a temporary solution to ensure that Harden Street residents have access to grocery stores. “I had The COMET [nickname for the Central Midlands Regional Transit Authority] agree to add that area to their free [grocery store bus] rides.” These buses — which serve Richland County and Lexington County, and are financed primarily by county, state, and federal subsidies — will now take residents to local grocery chains including Kroger, Publix, and a local business McCrae recommended called Rare Variety Cafe which offers fresh produce from South Carolina farmers. This creative solution will accommodate even disabled residents who can’t travel to a regular bus stop. “[E]ven if you are [elderly] and need a van, they’ll come get you.”

McCrae’s creative problem solving is exactly what South Carolina needs to combat the complex issue of food insecurity. Perhaps other urban communities, like the North Charleston community on the corner of Rivers and McMillan avenue which has been without a store since 2005, can implement similar public transit strategies to get residents to grocery stores. Or maybe they can take the opposite approach and bring the groceries to the residents directly like the Lowcountry Street Grocery bus that serves up to 50 residents a day on the East Side of Charleston. There are a number of possible solutions cities can employ. However, things are more complicated for rural counties.

While urban centers have many options for how to tackle food insecurity, rural counties without the benefit of services like public transit have a tougher road to hoe. Their problems will require the dedication of more creative thinkers to solve. As McCrae emphasizes, this isn’t about individual charity, but a responsibility to fellow residents. “[A]ny kind of community work that I do is not out of charity,” McCrae says, “it’s out of solidarity.” She continues, “It’s not a handout…it’s what the community is supposed to be…” She hopes that others will adopt a similarly holistic mindset about community service and will take the crises in their own cities and towns as opportunities to make a difference.

Unplugged and Unaware

RURAL SOUTH CAROLINA — In much of the state, the internet is taken for granted. However, 344,000 people don’t have access to a >25 Mbps wired broadband connection and roughly 171,000 have no access to the internet at all. This reflects the endemic lack of broadband coverage in rural South Carolina.  Many rural counties are severely underserved. Four in particular (Allendale, Bamberg, McCormick, and Marlboro) each have less than 45% broadband coverage — Allendale being the most underserved with only 16.8% coverage. “A lot of these areas [are] internet deserts,” says Jim Stritzinger, CEO and Founder of Revolution D, who’s working to document internet speeds throughout South Carolina — his map is attached below — and increase internet connectivity statewide. “[But] not only can you not get internet in your house...the cell phone service is also weak.” In rural areas with no internet and little to no cell reception, residents have no alternative means to get online. Stritzinger continues, “[I]n areas where you are double-whammied [like that], you really don’t have any options.” While the SC Department of Education has distributed mobile Wi-Fi hotspots to some homes without access to the internet, their efficacy has been limited because they rely on often non-existent cell reception.

Access to the internet used to be a luxury, but it’s quickly becoming a necessity. Stritzinger outlines how internet access is crucial in three primary domains: education, healthcare, and economic development. Since Covid-19 lockdowns started in March, internet access has been a requirement for K-12 and college education. Limited ability to get online is not only inconvenient, but academically disadvantageous for students. “[M]ost classes have moved to virtual or at least part virtual.” says Stritzinger. “[I]magine how far back your education would be set back [as a student with limited or no internet access] versus a student who has full access.”

During the lockdown months, many rural South Carolinians have not been able to see their doctors and have had to rely on online alternatives. “[A] lot of hospitals in rural South Carolina have shut down,” says Stritzinger, “So the rural residents are dependent on telehealth.” The ability to attend telehealth appointments — video calls with a doctor — is vital during a pandemic. “[L]et’s say you got a rash on your leg,” he says, “do you want to risk going to the doctor and getting Covid over a simple rash?” Inability to access telehealth could force them to take unnecessary health risks that could cost them their lives.

Internet access also plays a major role in economic development. Without quality internet connectivity, there is no incentive for businesses to set up shop in rural South Carolina. “If you’re an entrepreneur,” says Stritzinger, “are you going to go to a town that has no internet service?” Additionally, the lack of connectivity makes it difficult for rural citizens to start their own businesses. “[Just] think about simple things like swiping a credit card [that you need internet for],” says Switzinger. “[H]ow are you going to launch a business with no internet service?”

These three domains are all crippled in rural areas without proper access to the internet and rural residents suffer as a result. Stritzinger and Revolution D are working to overcome these barriers and modernize rural South Carolina. “We’re fighting hard to give people [internet] access in their homes so they can do what they need to do,” says Stritzinger.

Thanks to the passage of the CARES Act in March, South Carolina has been able to fund other initiatives to bring internet to rural counties. Gary L. Stooksbury, CEO of the Aiken Electric Cooperative, for example, has led a project to put WiFi hotspots near Aiken schools. Stooksbury has gone above and beyond with the cooperative’s project, even providing internet hotspots near schools that aren’t Aiken Electric members. “[S]ome of these schools we do not serve electrically,” Stooksbury explains, “but a lot of our members’ children go to these schools.” If they had more time and resources, he says the co-op would expand services to provide hotspots in local community hubs and recreation centers as well as consider becoming an independent internet service provider.

However, the limitations of the CARES Act have been a bottleneck to the project’s progress. For example, the short timeline narrowed its scope. “We’ve had to do a lot of things in a very short period of time,” says Stooksbury. The consequences are dire. If Aiken Electric doesn’t use its grant by the deadline, it loses access to the funds. “In the new year, there won’t be any of this money available,” says Stooksbury. “[W]hatever money is not spent goes back to the state of South Carolina.” However, he is hopeful that the state legislature will allot more money to his project. “[When] the South Carolina legislators passed the broadband bill last year, one of the things they said was ‘This bill is a first step,’” says Stooksbury. “‘We will come back in January and try to look for funding to help people build out their broadband infrastructure to rural America…’” If he can acquire the funding, he already has plans for what the co-op will do next to help rural communities in and around its service territory. “If [new government stimulus] were to come about, we probably would look to does it make sense to do fiber to the home in some of our areas,” says Stooksbury. “[T]hat is the biggest barrier to getting fiber to the home is just tremendous capital cost.” The cost is no joke. The USDA has already invested $9.1 million this year to improve access to broadband internet in rural South Carolina — and that was just for 6,251 homes in Kershaw County, which already has 89.8% broadband coverage. Addressing rural internet access with traditional broadband solutions will take years and likely hundreds of millions of dollars. In order to get internet to rural South Carolinians in a more timely fashion, creative minds will have to look to more efficient and less expensive solutions — such as installing a community cell tower — in order to make headway.