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By Jaymie Baxley

When your house is flooded and all your soggy belongings are piled on the street in front of your home, having a cavity or a toothache might seem like a small problem. 

But it could become a bigger problem for residents of Avery County, where one of the primary dental clinics was inundated with floodwaters generated by the remnants of Hurricane Helene in late September.

More than a month after the storm, most stores and restaurants in Newland, the county seat, are still closed. Piles of ruined belongings sit waiting for collection in the yards of battered homes throughout the little town, which lies in a bowl surrounded by mountains and is bisected by the North Toe River. 

On a recent afternoon in the lobby of Avery Medical, a clinic near the center of Newland, two women shared stories about the devastation they’d witnessed. One told the other she would have been “assed out” if the floodwaters that surged through her home had risen just a few inches higher.

“I’m just blessed that we made it out alive,” she said.

A total of 102 Helene-related deaths have been confirmed in North Carolina as of Nov. 8. At least five people from Avery County perished in the storm.

Avery Medical is run by High Country Community Health, a nonprofit that provides affordable care to low-income patients who lack health insurance. Many people in this rural county, which has a population of about 17,500, depend on the organization.

Nearly 15 percent of Avery County’s residents live below the federal poverty line, and 14.6 percent are uninsured, according to data from the N.C. Rural Center. The median household income for the county is only $53,500, well below the statewide average of $70,800. 

Alice Salthouse, CEO of High Country, said seeing the storm’s toll on the struggling community has been “gut-wrenching.”

“Every day on my way to work, I drive past people’s homes — and everything they’ve owned is outside waiting for somebody to come take it all to the dump,” she said. “We’ve got older adults who have lived in their homes for years and years, and now their homes are gone. People’s lives have changed and will never be the same again.”

Care during a crisis

High Country moved quickly to help residents in the immediate aftermath of the storm.

Providers for the organization, which has nine locations in western North Carolina, deployed southeast of Avery to Hickory Regional Airport in Catawba County to care for patients who had been evacuated there from nursing homes and rehabilitation centers in Helene’s path. 

Staff members traveled hazard-strewn roads to deliver food, medicine and other essential items to people in the federally declared disaster area. Avery Medical became a distribution hub for supplies donated by local charities and churches.

But the organization did not emerge unscathed from what The Avery Journal-Times described as the “one of the greatest natural disasters” in the county’s 117-year history.

Avery Dental, a High Country-run clinic in Newland, suffered heavy flooding, with waters rising as high as four feet inside the facility. Salthouse said everything in the seven-chair clinic, from dental equipment to the insulation packed behind its sheetrock walls, was either destroyed or contaminated.

“We’ll have to put up new walls, put down new flooring and redo the electrical,” she said. “It’s almost like building a whole new place, only more complicated.”

High Country experienced an estimated $3.6 million in lost revenue and property damage in connection with Helene, with most of that tally tied to the ruination at Avery Dental. 

Salthouse said it will be months before the clinic reopens.

Dearth of dentists 

Avery Dental shares a plaza with a half-dozen other businesses, including the Times-Journal, in Newland’s commercial center near the North Toe River. Those businesses also flooded, but the loss of the clinic dealt an especially harsh blow to an area where access to dental services was already limited. 

According to data from the University of Wisconsin Population Health Institute, the average ratio of dentists to residents in North Carolina is 1-to-1,630. But in Avery County, there is just one dentist for every 2,200 residents.

Salthouse said the disparity was much worse before Avery Dental opened its doors in 2015. That year, there was only one dentist per 5,860 people.

While there are other dental offices in the community, the clinic is the only option for many residents because of its sliding-scale fee system. Patients are charged what they can afford to pay based on their income.

“They can come in and see the dentist for far, far less,” Salthouse said. “I mean, when was the last time you went to the dentist and got your teeth cleaned for $45?”

Avery Dental is also one of the only local providers that accepts Medicaid. Data from the N.C. Department of Health and Human Services show that more than 4,300 Avery County residents are currently enrolled in the program, with children accounting for about 43 percent of the county’s enrollees.

“You have a huge population of children that are on Medicaid,” Salthouse said. “Having a dentist in this county is crucial, but recruiting them to this county is difficult.” 

One barrier to recruitment, she said, is the area’s topography. The roads to Avery County cut through snow-prone mountains, making travel hazardous in the winter.

The mountainous terrain also amplified Helene’s impact on the county. Steep slopes and ravines funneled water from the swollen North Toe River and its tributaries into low-lying areas. 

Serving the underserved

Ashton Johanson joined the staff of Avery Dental less than two months before the clinic was flooded.

A disc golf enthusiast from Colorado, Johanson earned his degree in dental surgery from the Utah School of Dentistry and went on to work with low-income patients at public health clinics in the Salt Lake Valley. He had been thinking about moving to North Carolina when he learned about a job opening for a dentist in Newland.

“I had a few opportunities around the state, but this seemed like the best fit for me and my family,” he said. “We wanted to try something different, and this was an area with a population that really needed dentists. It seemed like a chance to serve the underserved, which is something I’m passionate about.”

Johanson, who began seeing patients at Avery Dental in August, was still adjusting to his new environment when the environment was upended by Helene.

Since early October, he has been working out of a van parked in front of High Country’s medical clinic about half a mile from the waterlogged dentist’s office. The vehicle was previously used as a mobile clinic for cleaning children’s teeth at local schools.

While it can’t accommodate all the same services as the dental clinic, the mobile unit has enough space and equipment for Johanson to provide emergency exams, tooth extractions and fillings.

“The first week we were open, we had a hard time getting patients in here,” he said. “Even if people had tooth pain or some other dental emergency, their houses were underwater and the roads weren’t drivable. They had bigger problems than coming in to see us.”

Business began to pick up once the waters receded. Johanson said more than 100 patients have visited the mobile unit over the past month, with about eight people stopping by each day.

In the meantime, High Country has contracted with a demolition crew to gut the flood-damaged interior of Avery Dental. After the facility has been stripped to its frame, air quality studies will be conducted to ensure that it is free of mold spores and disease-spreading bacteria. 

High Country is soliciting bids to rebuild the clinic at the same location and restock it with dental equipment. Salthouse estimates the project will cost between $500,000 and $750,000. 

“This is a very big deal for this county, for us to get this dental clinic back up and running,” she said.

The post In rural Avery County, Helene washed away one of the only dental clinics appeared first on North Carolina Health News.

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By Emily Vespa

Weeks after the remnants of Hurricane Helene ravaged western North Carolina, tens of thousands of kids across the region still don’t know when they’ll be able to return to a sense of normalcy. 

At a Chapel Hill park on a recent sunny afternoon, displaced families, many from the Asheville area, found a place to connect over the unknown.

“Life around here goes on as normal, but we are people who just experienced an extremely traumatic event that we weren’t necessarily prepared for,” said Joe Ainsworth, a school counselor for Buncombe County Schools and the organizer of the picnic for displaced families. 

At the park, kids of all ages doted on therapy dogs and picked at pizza. With the muffled sound of basketballs thudding on nearby courts in the background, mental health providers talked with families about ways to cope with the devastation that has upended their lives. 

It’s an early but important step in the long-term healing process, Ainsworth said. 

“The broad implications of what displacement looks like is huge,” he said. “I think we’re still trying to figure out what that even looks like — and how we can help.”

Helping kids cope

In the aftermath of a disaster, it’s normal for kids to feel anxious or overwhelmed, said Nivee Roy, a licensed professional counselor who specializes in trauma. 

“Kids are people. They’re little people, but they’re people nevertheless,” said Roy, who drove from Charlotte for the picnic. “They have feelings and emotions, and because this disaster was so monumental in its dimensions, it’s sometimes so hard to comprehend.”

Research shows children can be more vulnerable to adverse, long-term mental health effects after a hurricane, but experts say most young people are resilient.

 Parents and guardians might see some of these behaviors in children after a disaster:

• Trouble sleeping
• Forgetfulness
• Difficulty following directions
• More meltdowns

In the first one to three months after a traumatic event, people experience short-term stress, Roy said. After that, stress becomes chronic. For Helene survivors, the early months are an important “window of intervention” to provide mental health support and help children recover long-term, she said.

“Our brain has the full capacity to heal itself,” Roy said. “We want to foster that.

“We want to introduce healthy coping skills, a safe place to connect and share those feelings, and then pick up a routine that is the new normal.”

It doesn’t take a mental health professional to support kids after a disaster, Robin Gurwitch, a professor in the Duke University Department of Psychiatry and Behavioral Sciences and at the Center for Child and Family Health, told NC Health News in an interview.   

“Sometimes, particularly as parents and caregivers, we worry: ‘Oh my gosh, what if I don’t get my child the help they need immediately?’” Gurwitch said. “You’re the help they need immediately.”

Roy joined other mental health professionals in teaching families at the picnic about ways to help each other heal. Most important, she said, is simply for parents to talk to their kids about what they’re feeling. Creating a routine can also help children grapple with the disruption in their ordinary habits.  

If children have changes in behavior that worsen or persist for more than six weeks after the disaster, then it’s important to seek help from a mental health provider, experts say.

Returning to a new normal

It’s college application season for high school seniors like Jayden Thomas, who attends A.C. Reynolds High School in Asheville. Though many state schools have extended deadlines and will waive application fees for western North Carolina students, she said it’s been hard to navigate the process without having access to her guidance counselor. She also misses marching band, which she’s been in for four years. 

“It’s kind of apocalyptic, almost,” said Thomas, 17, at the picnic. “I want to go home, but it’s not really the same anymore.”   

Thomas had been displaced with her family for nearly two weeks in Raleigh. 

“I felt a little guilty leaving, honestly, leaving all my friends behind and wanting to help with the relief efforts, wanting to volunteer,” Thomas said. “But it just wasn’t safe for us.”

Buncombe County Schools Superintendent Rob Jackson said Thursday that the system plans to have a reopening date soon and is “working very hard for the emotional well-being of our staff and students when we return to the buildings after the challenges of the past few weeks.”

School counselors and social workers from across the state will assist Buncombe County’s staff when schools return, Jackson said.

In the meantime, communities are organizing to provide support for students. One Asheville elementary school’s staff visited students at their homes to pass out goody bags. 

“When our students can’t come to us, we go to them!” the school’s Facebook post read.

Staff from another Asheville school created a “Bookmobile” to hand out books in local neighborhoods and keep kids reading, the district posted in a different Facebook group.

Ainsworth, the school counselor, said he was overwhelmed by the generosity of volunteers as he was organizing the picnic. But the need is still extremely great, he said, especially for smaller school districts with less resources than Asheville’s.

“I think forever moving forward, western North Carolina will be pre-Helene and post-Helene, and we just have to work on defining what that post-Helene looks like,” Ainsworth said. “And hopefully, when it comes to how it’s affected our students, we can get the help that we need to help them kind of work through this and become resilient and strong moving forward.”

The National Child Traumatic Stress Network offers an app called “Help Kids Cope” with guidance for how to support children after various disasters. The app is free to download on the Google and Apple app stores.  

The post Post-Helene, mental health providers help kids cope  appeared first on North Carolina Health News.

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The staff of the Asheville-based Manna Foodbank tried their best to prepare for Hurricane Helene. 

Workers at the nonprofit’s primary distribution site just feet from the Swannanoa River moved tens of thousands of food items onto tall shelves ahead of the storm’s arrival. The shelves, they thought, would be high enough to protect the food if the building flooded. 

But after the storm’s catastrophic lurch through western North Carolina, the region’s largest and most wide-reaching food bank was almost fully submerged in rippling waves of brown water. Its stockpile of food, now more badly needed than ever, was gone.

“We weren’t even able to go in and rescue any of the top-shelf food or anything because of how severely damaged everything was,” said Micah Chrisman, director of communications for Manna. “We lost everything. Our forklifts, our warehouse, all of our computers. The whole operation, basically.”

That operation served more than 150,000 people a month in western North Carolina, which struggles with worse levels of food insecurity than other parts of the state. About 20 percent of adults in the region have limited or uncertain access to food, according to the WNC Health Network. 

The area’s hunger issues arise from several economic, geographic and social factors: Poverty and unemployment are more pervasive there than in eastern and central North Carolina, and many residents are unable to afford food. The predominantly rural and mountainous terrain can make a trip to the nearest grocery store challenging for people without transportation. 

“We definitely had an issue with food insecurity already, especially in rural communities where some of these families that I’ve met and talked with have to drive over 30 minutes in any direction just to get food of any kind,” Chrisman said. “There were a lot of food deserts that already existed here. People might have been able to get junk food from a gas station, but they didn’t have access to actual groceries.”

Helene, he said, has “only exacerbated the need” for nourishment. In the days after the deadly storm, western North Carolina went from being one of the most food-insecure parts of the state to being, arguably, one of the hardest places to find food in the nation.

Wiped out 

Fortunately, Manna moved its fleet of trucks to higher ground before Helene barreled through the area. The vehicles were undamaged, which allowed the food bank to quickly establish a pop-up distribution site with supplies donated by Feeding America, a nonprofit national network of more than 200 food banks, and the N.C. Department of Agriculture and Consumer Services.

“All of our inventory was completely wiped out at the start of this, and so we had to replenish the supplies,” Chrisman said. “Since then, some incredible efforts have come together where grocery chains and different places that are coming back online are able to give us some of their food resources that are still safe to consume.”

Several of the families who have relied on Manna for meals in recent weeks did not struggle for food before the storm, Chrisman said. Some may have had refrigerators loaded with food that went bad after days without power. Others might have been forced to flee their flooded homes and were unable to find food elsewhere.

“There are people from the hardest-hit communities who are coming to us in need of food assistance that maybe would not normally need assistance because they might have been laid off from their job because the business was flooded,” Chrisman said.

Many people in the area, he added, have been “humbled by this whole ordeal of having no running water for all this time and not having access to food.”

Chrisman said some of the food bank’s employees and volunteers “lost their homes and everything else” to the hurricane. Undeterred by their own hardship, they have continued working throughout the crisis.

“They’re still showing up every day helping deliver food or distribute food to families in need,” he said.

Manna has leased a shuttered FedEx facility near the Asheville Regional Airport to serve as its new center of operations. The food bank has also been rebuilding its stockpile with donated goods.

“As the word’s gotten out, people have been sending orders from Amazon and Instacart or driving up with bags of groceries because they had extra and just wanted to give to the people who need it most,” Chrisman said. 

Road to recovery 

Other efforts are being made to address food insecurity in Helene’s wake. 

Last week, Gov. Roy Cooper’s office said FEMA and other “federal partners” had delivered 9.7 million liters of water and 7.7 million meals “to support both responders and people living in the affected communities.” Writing in a news release on Sunday, the White House said FEMA “continues to send commodity shipments and voluntary organizations are supporting feeding operations with bulk food and water deliveries coming via truck and aircraft.”

“Mobile feeding operations are reaching survivors in heavily impacted areas, including three mass feeding sites in Buncombe, McDowell and Watauga counties,” the release said, adding that the “massive operation” is being bolstered by The Salvation Army, which has deployed mobile kitchens to the area. 

William Ray, director of N.C. Emergency Management, said his agency is assisting with “feeding operations in concert with our local partners.” 

“This is a historic disaster, the magnitude of which we have never experienced before in our state,” Ray said during a recent news conference. “The road to recovery will be long, but North Carolinians are strong and resilient, and together we will recover.”

At the same conference, Kody Kinsley, secretary of the N.C. Department of Health and Human Services, said more than 10,000 cases of baby formula had been delivered to the region. The department, he said, had also increased the flexibility of its Supplemental Nutrition Assistance Program, allowing recipients to buy hot food, which is ordinarily not covered, from participating vendors through Nov. 3.

On Oct. 6, NCDHHS reissued 70 percent of the previous month’s SNAP benefits to help people in the disaster area replace food that had been lost or was no longer safe to eat. More than 227,000 beneficiaries across a 23-county swathe of western North Carolina automatically received the reimbursement, totaling $24 million in benefits. 

Beginning Tuesday, storm victims who are not currently enrolled in SNAP can pre-register for a one-time stipend to buy food through the Disaster Supplemental Nutrition Assistance Program, or D-SNAP. The program is open to people who “suffered losses/damages related to Hurricane Helene,” according to NCDHHS. 

Pre-registration can be completed online through the state’s ePass service. Registration will be available by phone and in-person at designated offices in the affected counties beginning Friday. 

“Much is underway, and there will be much more to do,” Kinsley said. “We all remain committed to the health and well-being of everyone in the region, in mind and body, for the long haul.”

The post Food bank bounces back from Helene to tackle hunger crisis in western NC appeared first on North Carolina Health News.

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Applying for FEMA aid in NC after Tropical Storm Helene is a story from Carolina Public Press, an award-winning independent newsroom. Our breakthrough journalism shines a light on the critical overlooked and under-reported issues facing North Carolina’s 10.4 million residents. Please consider making a contribution to support our journalism.