ARMED WITH COURAGE, TENACITY AND A NOBLE CAUSE, THEY FIGHT FOR CHANGE—AND PROVE THAT ONE PERSON CAN MAKE A DIFFERENCE

EULA HALL GREW UP poor as there was on Joe Boner Hollow off Greasy Creek in Eastern Kentucky's Appalachian Mountains. She dropped out of school in the eighth grade, had five children delivered at home without ever seeing a doctor. (A daughter died in infancy; a son was born premature and deaf.) Prenatal care? "Never had none," says Hall, who is 63. Doctors? "There was none. I didn't even know what kind of blood I had until I was 41." She lived next door to a woman who fell on a rusty nail and died days later from tetanus. ("Five children was left without a mother for something that could've been fixed with a shot.") She saw children infested with parasites die from malnourishment. ("I seen the worms come out of their noses and mouths.")

All her adult life, Eula Hall had a vision that seemed odd and impossible for a poor woman who never took a high school science course: to open a medical clinic for the poor.

But she did—18 years ago in little more than a shack that she rented for $40 a month. Now, each day, up to 75 people spill over from the waiting room into Hall's tiny office at the modern, brick Mud Creek Clinic. There are six examining rooms and a staff of 17, including two doctors. The building is tucked along a winding remote road in Grethel, Ky.—so remote that if you press the scan button on the car radio, the numbers keep going round without finding a station.

The clinic has won praise from congressmen, editorial writers, civic leaders and the people it serves. "Eula's a worker," says Jay Blevins, one of many Mud Creek residents who owes his life to Hall. "She'll invite you to dinner at 5:30. So you come over at 7, and she's home from the clinic at 9." "I stay until the last one's taken care of," explains Hall, who makes $22,000 a year and last took a vacation four years ago.

To the poor, Hall is a legend, and yet a mountain person like themselves. "There ain't nowhere they've been I hardly haven't been," she says. On a recent visit to Mud Creek, a man applying for benefits tells her he has a spotty work history because he spent 11 years at Kentucky State Reformatory at LaGrange for murder. "I bet you know my oldest boy," says Hall. "He was at LaGrange too."

Hall toils in one of the poorest, most isolated sections of America, a place where people give their address by the nearest creek. In the nearly three decades since President Johnson traveled to Appalachia before proposing his antipoverty program, the region has made gains. But for most of the 15,000 people who live off the dirt roads and creek beds of Mud Creek, life is little changed. Eighty-three percent of the clinic's patients live below the poverty level; 40 percent are so poor they pay a token fee of $5 a visit. Because it is one of the few pay-what-you-can clinics in this depressed, coal-producing region, people journey across the mountains from Virginia and West Virginia.

Starting it wasn't easy. Early on, doctors came two days a week; people lined up in the yard for appointments. Physicians have always been hard to recruit to Appalachia, partly because of a shortage of quality housing. (Hall put up one doctor in her house for a year.) In 1974, to handle more patients, she converted her three-bedroom house into the clinic; eight years later it burned down. The next day she reopened for business in a field, using a picnic bench and a phone hooked up to a willow tree. "At first," says Hall, "the phone company said, 'You can't put a phone on a tree. It's a big responsibility, a phone on a tree—anyone could use it.' I said, 'You put phones in the coal mines on poles, it ain't no different, a tree and a pole. You get us a phone out here!' I'd say in four hours we had a phone." Same number, too.

Hall fought with everyone necessary to keep Mud Creek going. The most powerful politician in the region for nearly two decades, the late U.S. Rep. Carl D. Perkins, once told her, "I wish you'd been a little easier on me, Eula." In a softer moment he called her "one of the most dedicated people I have ever known to stay on the job."

She does practically everything, although she has the credentials to do none of it. "I'm not a licensed anything," she says. And so a sign in her office reads, simply, Social Director. This is like describing Florence Nightingale as a visiting nurse.

The sign should also say Fundraiser. After the fire, she raised $80,000 in seed money within 90 days to secure a federal grant for a new clinic—going on the radio, buttonholing the small and the mighty, hosting chicken dumpling dinners.

The sign could also read Emergency Ambulance Driver. When Jay Blevins's lung filled with fluid and he was near death, she loaded him into the clinic's secondhand van—donated by a funeral home—and covered the two-and-a-half hour drive to a Lexington hospital in one hour and 45 minutes. "That includes stopping for gas," she says.

She routinely wins difficult government-disability claims that elsewhere would be handled by lawyers. She won black-lung benefits for Ida Gayheart's coal-miner husband and Social Security disability for both Ida's retarded son and her grandson who suffers seizures. Hall's savvy is so well known that when she was hospitalized a few years back, the office for Social Security appeals in West Virginia sent her a get-well card.

She is Water Commissioner, too. After health survey showed that 90 percent of local drinking wells were contaminated, Hall reorganized the Mud Creek Water District with a slate grant, pumping clean water to 800 families. She runs it from a trailer behind the clinic. Commissioner Hall collects overdue bills and, during one emergency, flagged traffic around Mud Creek at 2 A.M.

She is also a human safety net, the local social worker. "When a family member dies on Mud Creek, there are people who call Eula first," says Chris Salisbury, the clinic's X-ray technician. Hall's files are stuffed with thank-yous. "This is Melissa Lawson," she says, holding a photo. "Melissa had the worst crossed eyes you ever seen. I got the Lions to pay for the surgery."

The clinic, which relies on federal aid and contributions, is overseen by Big Sandy Health Care, a nonprofit agency. Big Sandy handles the billing, paperwork and salaries. In the early 1970s, says executive director Jim Stewart, Big Sandy had so many problems that the federal government suspended funding. Hall went to work and in time won majority control of Big Sandy's board, or, as she says, "I stacked it."

With Stewart, she scours the region for doctors. Recently, they hired a physician who was convicted of a federal tax charge related to Medicare fraud in Virginia. He was given a license in Kentucky on the condition that, according to the state, he work in a "protective environment." "At his other job someone else was handling the paperwork and got him in trouble," says Hall. "Here, he'll just be taking patients. He's a good doctor. He don't mumble and jumble about being overworked."

Neither does Hall. "Eula, 2200! Eula, 2209!" All day her phone rings. "Where do you live, James? Uh-huh. You're hemorrhaging from the bowels? Uh-huh. We'll have to come and get you." She drives up hollows daily to pick up patients, deliver medicine or surplus government food. These dirt roads, creek beds and hillside farms are all she knows. The daughter of a sharecropper and his wife, she is one of seven children, most of whom are disabled.

There has long been a tradition of leftist political activism in the mountains, and Hall embraced it early. "My dad was real outgoing, he was a Good Samaritan, she says. "It's instilled in me. I can't watch suffering." Married since 1978 to second husband Oliver, 60, a retired miner, she has seven grandchildren and two great-grandchildren. She suffers from arthritis and heart disease, and people wonder what Mud Creek might be without her. "When she went into the hospital a few years back," says Jay Blevins, "I said to my wife, 'There goes my Social Security claim.' "

All Hall says on this is, "Hard work don't kill people." She has new goals, including opening a shelter for battered women. In a place where unemployment is high and the best job—mining—often maims men, frustration is common and abuse is a serious problem. She was abused by her first husband, now deceased. ("Stabbed me in the face when I asked for a divorce.") She has saved many women and children from raging men, once hiding a wife in the clinic bathroom.

Each task invigorates her, for she has that rare sense of making progress. "I ain't saying we're not far horn where we want to be, but we've come far," she says, excusing herself to take a heart pill. Then she climbs into her van and drives alongside the Big Branch of Little Mud Creek for a visit to Mary Ann Tackett. The 7-year-old almost died from stomach cancer but, with Hall's help, got first-rate medical care, and on this sun-filled afternoon was in her mommy's garden hunting cucumbers for pickling.