A hospital or clinic near where miners work is a life-and-death question for coal miners, who face health and safety perils daily.

All three counties are major coal producers with some of the largest strip and underground mines in the state. There are some 140 mines in these three counties alone. In the past decade, Logan County, where Man is located, has become the largest surface mining county in the state, producing more than 14 million tons of coal in 1997. Three of the largest "mountain top removal" sites are centered in Logan.

Man Regional, owned by Appalachian Regional Healthcare, Inc., (ARH) is one of the largest employers in the region with some 200 hospital workers, most of whom are represented by the United Steelworkers of America and the Nurses Association.

The hospital was originally established in 1956 by the United Mine Workers union and the UMWA Welfare and Retirement Fund to provide low-cost health care for miners and their families. The Man hospital, one of ten "Miners Memorial" hospitals established in the 1950s in Kentucky, Virginia, and West Virginia, was the product of big battles by the union in the 1940s to redress the abysmal conditions miners faced on the job and in their communities.

According to the United Mine Workers Journal, miners' life expectancy increased from 56.2 years to 62.5 years in the first five years of the Fund. When the first miners' hospital was dedicated in Beckley, West Virginia, in 1956, some 5,000 UMWA members attended the ceremony.

The hospital provides services for patients with minor and severe health care needs, from prenatal care and kidney dialysis to treating miners who have black lung. The hospital also provides home care for patients too sick to get to the hospital on their own. This fact is important because many workers are too poor to afford a car. In most rural areas there is no public transportation and walking is more and more the main form of transportation for West Virginia's rural poor.

Last November officials from Man Hospital announced that the hospital would shut its doors on December 31 due to financial losses of $8 million over the past few years. Hospital administrators blame the planned closing on cuts in the federal Medicare program from the Balanced Budget Act of 1997, which will cut government disbursements to West Virginia hospitals by $548 million over five years.

According to the Charleston Daily Mail, an estimated "4,789 fewer Medicare patients" will be "admitted to home health services" as a result of the budget act. In the region, ARH also plans to close the Accoville Clinic, Gilbert Clinic, Pineville Physical Therapy Clinic, and the Man ARH Home Health Agency. Eleven home health agencies have closed in the state.

The cuts have come down the hardest on retired coal miners and the elderly in a state that has the oldest population in the country. West Virginia is also last in the nation in household income and many rural counties have unemployment figures that remain in double digits. "Most of my friends that I grew up with have moved out of West Virginia because they couldn't find jobs," said a 25-year-old hospital worker. "Most of them got jobs in factories in Roanoke, Virginia, and North Carolina."

Unemployment rates stand at 10.9 percent in Logan County, 12 percent in Mingo, 8.5 percent in Wyoming, 18.3 percent in Calhoun, and 12.9 percent in McDowell. While the unemployment rate for the country is 4.2 percent, statewide the official rate is 6.4 percent. The child poverty rate of 30 percent has increased by nearly two-thirds since 1980 and some 18,000 workers were forced off welfare in 1998.

This comes in the face of Clinton's much heralded "new markets" proposal--meant to lure capitalist development in poor rural areas--featured in his January 28 "state of the union" address.

If Man Regional Hospital closed, Logan General Hospital, which filed for bankruptcy in 1998, would be the only hospital left in the county. Logan General is 13 miles away. To get there from Man you have to drive on Route 10, a highway that people here call the "most dangerous" in the state. Many cars in the town have stickers on their fenders that say, "Pray for me, I drive on rte 10."

After the announcement, no new patients were accepted in the hospital and some who needed emergency care were turned away.

For the past few months residents in this coal community have fought to keep the hospital open. Shortly after the announcement of the hospital closing community residents formed Man Community Hospital Inc., and are currently negotiating with ARH to take over the hospital. The group had paid $1 million for equipment and hospital supplies, and agreed to take on $2.5 million in liabilities. However, ARH rejected this proposal, saying it wanted "a $3.5 million irrevocable letter of credit" to cover debt and future liabilities.

Two hundred area residents rallied at Man Junior High School December 27 to protest the announced closing of the hospital. Local politicians, union and community representatives spoke at the rally. According to the Logan Banner, Roger Horton from the United Mine Workers said, "We are here to support and help keep the hospital open. We will be there tomorrow to back the community in its effort to keep the hospital open."

The next day two hundred marched through the streets of Logan to the county courthouse, where a hearing on the future of the hospital was held. After hours of testimony, Circuit Judge Eric O'Briant issued an 120-day injunction ordering the hospital to remain open until another hearing could be set.

The hospital has a broader social significance in that the surrounding coal communities were hit by the worst flood in West Virginia's history in what became known as the 1972 Buffalo Creek Disaster. The flood was caused when a Pittston Coal Company's dam burst. A wave of black water between 20 and 30 feet high, filled with thousands of tons of sludge and coal waste, poured down over 16 coal mining towns, destroying five completely. The man-made disaster killed 125 people and left 4,000 homeless. More than 1,100 people were injured or treated for illnesses.

Without Man Regional, which played a major role in treating the victims, residents estimate that scores more would have died. Although the disaster occurred 28 years ago, it left indelible scars. Just mentioning the event today brings emotions instantly to the surface.  
 
 
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