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Students will be traveling to the remote area of Williamson, West Virginia, USA. Williamson is a town of about 3000 inhabitants deep in the beautiful Appalachian mountains. These rugged inhabitants have been devastated by natural disasters and economic hardship. Only recently has the city been protected by a floodwall in response to deadly flooding along the Tug Fork River in 1977 and again in 1984. The local economy is largely fueled by coal mining, an industry that is challenged.  The primary patients are the uninsured and those covered by government poverty programs, including those who are unable to leave their home due to lack of transportation in Southwestern West Virginia and Southeastern Kentucky. Activities will include educational programming with local schools, home visits and working at the local clinic.  For their clinical service, students are divided into teams led by trained college students (premeds from Duke, Hopkins or similar universities) or faculty. Students learn to facilitate several medical interventions and screenings (measuring infant height and weight, measuring blood glucose, blood pressure, heart rate, incentive spirometry, pulse oximetry, etc.) and complete an important introductory cultural training.