Treating Tangier Island

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david b. nichols health centerThe clinic is where Dr. Kemp is heading today. Once Sharon Kay III docks, the doctor is greeted by Inez Pruitt, a 53-year-old physician assistant who was born on Tangier—in fact, inside the house right next door to the clinic. Inez greets Dr. Kemp and Kim with warm hugs; she smiles upon noticing that she and Kim are wearing matching helicopter pins on their jackets. The three pile on a golf cart and head to the clinic, where Inez has prepared a breakfast casserole.

The pristine clinic features three exam rooms, a digital X-ray machine and a lab. There’s a room set up for a dental chair, but they’re still waiting for a dentist to come to the island. Then there’s the waiting room, which as Dr. Kemp says, is “almost like a social hall.”

Prescriptions come by mail boat through a pharmacy on the Eastern Shore, so if Dr. Kemp sees a patient in the morning, they can have their prescription by the afternoon boat.

In major medical emergencies, like a heart attack, residents can be brought to a hospital in Crisfield or Salisbury, Md., via the Maryland State Police medevac helicopter, at no charge.

Health Issues on Tangier

Most residents on Tangier either work in the summer tourism industry or as a waterman, equaling a tough life—long hours, increasing regulations, an ever-rising cost of fishing supplies and fuel and declining profits.

tangier island crab shanties

“When you’re a waterman, you work ‘til you drop on your boat,” says Gerald Wheatley, who was mayor of Tangier for 11 months. “A lot of ’em would have pains in their chest and all that, but they’d never go to a doctor because they had to go to Crisfield (Maryland), so they’d drop dead on their boats.”

Some of the island’s older residents have significant illnesses, including diabetes, heart disease, hypertension, cardiovascular disease and hypothyroidism. “The people out here work long into their 70s,” Dr. Kemp explains. And because they work such long hours with the sun beating down on them all day, many of them have skin cancer, or as they call it, barnacles.

Due to the island’s small genetic population, there is a high incidence of a rare genetic disorder called Tangier Disease, characterized by a severe reduction in the amount of high density lipoprotein in the bloodstream.

Even with all of these health issues, for years, doctor visits to the island were inconsistent, and residents would jump at the chance to get medical attention when it was available. Outside an outdated and dilapidated building, lines would form, consisting of folks with anything from colds and cuts to broken bones and pneumonia. Leaving the island to seek medical care is no easy task; the closest healthcare facility is an hour boat ride, plus additional drive time, so islanders would avoid going to the doctor, often having their conditions escalate because of it.

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