They came in large numbers, America's uninsured and working poor, descending on this coal mining town in Virginia's southwest corner in search of the elusive medical care they could not otherwise afford.
Some slept overnight in their cars in the grass parking lot in front of the Wise fairgrounds, where some 1,700 medical professionals had set up dental chairs, mammogram stations, panoramic X-ray machines and more, ready to diagnose maladies, numb mouths, pull teeth and take pap smears for Americans down on their luck and battered by economic realities.
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Remote Area Medical (RAM), a travelling collective of volunteer medical practitioners, was set up in 1985 by British expatriate Stan Brock, who wanted to take medical care to those who were too poor, or live in areas too remote, to otherwise access it.
"The appearance of a RAM team means an opportunity for poor folks to get some real treatment free of charge," Brock said.
Poor folks like 50-year-old Cindy Ridings, who two years ago lost her job as an occupational therapist and with it her health insurance.
"It's only by the grace of God that we get by each month," said Ridings, who is nine dollars out of pocket each month after paying her rent and buying the 30 pills she takes daily for ailments ranging from restless leg syndrome to asthma to diabetes.
Daniel Moore, 38, was waiting to have a broken wisdom tooth extracted and, he hoped, his lungs X-rayed.
"The tooth has been broken for a year and I can't afford to pay a 1,000 dollar dental bill. And the company I work for doesn't supply any insurance," he told AFP.
Moore earns just under 3,000 dollars a month driving trucks for a company that hauls coal from the mines that have long been the lifeblood of Wise and other towns in this corner of Virginia.
The divorced father-of-four pays child maintenance, helps his elderly mother when he can, is paying off a 13,000 dollar hospital bill for a collapsed lung, and has gone hungry in the past to buy his 20-year-old son life-saving insulin for the type one diabetes he has had since birth.
"Sometimes," Moore told AFP as he shuffled forward one spot in the queue toward the dental surgeons who were pulling out the abscessed and rotten teeth of others before him, "it becomes a bit hard to bear."
Paul Cook, a mortician, drove nine hours from Detroit, Michigan to have his teeth fixed in Wise.
The 54-year-old lay in one of dozens of dental chairs packed almost headrest-to-headrest under a white marquee, his hand draped across the push-chair in which his infant son Elijah slept peacefully as volunteer dentist Robert Field drilled and filled his molars.
Cook has health insurance, but like many Americans, his policy does not cover dental work and so RAM is a godsend.
"For people that don't have the extra insurance that they need to get all these things that they're offering I think this whole situation called RAM is a blessing," he told AFP.
Over the years, 26,000 medical professionals have "temporarily left comfortable homes, jobs and families and signed up as RAM volunteers," caring for more than a quarter of a million patients, Brock said.
Last week in Wise, RAM provided more than 1.6 million dollars worth of care to 2,715 patients.
RAM's health fair was held against the backdrop of a debate in Washington about President Barack Obama's proposal to reform healthcare and make it accessible to all Americans.
The plan would only provide limited coverage for dental or vision care, but it still sounded good to the people who slept in cars and tents in the surprisingly chilly summer night at Wise fairgrounds.
For those who walked through dew-soaked grass before dawn to wait outside the fairground gates, wrapped their children in blankets against the cold and then waited hours, if not days, in the hot sun to see a dentist or doctor, there was no debate.
"There's a large portion of America that's in the same boat that I'm in, people that have no medical coverage whatsoever," said Ridings, who was diagnosed by RAM doctors as having an heart defect.
The doctors advised her to consult a cardiologist -- another expense she can ill afford.
Moore was praying to anyone prepared to listen that Obama's proposed reforms get through.
"Universal healthcare is probably the most important step the administration has ever tried to take," he said.
"Canadians have had universal healthcare for years. It doesn't always work the way it's supposed to but at least you have your basic medical necessities.
"And insulin is a necessity," he added, thinking of his diabetic son, who has been admitted to intensive care twice in recent months because his insulin supply is so erratic. His health insurance was cut off when he reached age 19.
Doctors have told Moore that he is now likely to outlive his own son.
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