Skip links
Return to The Rural Voice


Sharma Vaughn, RN, MPA
Executive Director, Community Care Alliance
Western Healthcare Alliance
June 03, 2020


For the first time in my life, my knees buckled. Luckily, there was a couch just behind me to catch my nine-month pregnant, bloated frame. That had never happened before or since. I would tell myself years later that it was probably because I was only twenty-one years old, nine months pregnant, and scared to death. It was probably that my husband’s job had moved us to the big city, promising no shortage of new threats and worry.

It was probably because at that very moment, I watched the first of the Twin Towers fall and knew that in addition to the regular fears of being a new parent, I would be raising the baby now safely tucked in my tummy in a world where something like this could happen.

As a toddler, her personality bloomed full force, and I began to feel better about her future. Her outright obstinance might serve her well in this world at war. She was forged among the fires and pits of 9/11 and learned her colors from the flags dug out of storage as our nation began to fly Old Glory once again.

Years later we would visit the 9/11 site, before the memorial was built and before the new tower was made. As the subway sped in the dark from New Jersey to the World Trade Center station, blinding brightness suddenly streamed into the windows. When my eyes focused, I realized we were racing along the on the edge of a massive crater, the pit of the disaster rubble of the Twin Towers. The scale of the footprint and the depth of the damage made it hard to breathe.

Last weekend I lowered myself onto the grass just outside the high school. Along with 26 other families, all appropriately socially distanced, we watched the babies born under September 11, 2001, receive their high school diplomas and turn their tassels.

Settled into a small town, where doors aren’t locked and parents know their kids have ditched school before the little culprits get home, this graduating class still enters a dangerous world. The danger is more subtle, though no less potent.

While the COVID-19 has killed more Americans than 9/11, it’s not the particular danger I’m worried about. My worry is that for generations Americans have reaped the benefits of old hands now at rest. Now, we are responsible to maintain or improve upon what they built, but few remember how and even fewer care why.

The togetherness required to fund the building of dams, roads, tunnels, water treatment plants, hospitals, health departments, and schools in cities across America isn’t emphasized in history books. Yet it was the critical cultural ingredient that made it possible.

How do I know this? I know this because, even in America today there are places without critical pieces of infrastructure. Or those pieces are so newly earned that even the young generations are taught to value the collaboration, compromise, investment, and sometimes outright arguments required to build them.
Why is rural America so culturally different? Because, knowing no one is coming to help them when things get tough, they continue the struggle of building it for themselves. They know that the survival of their friends and family is not up to anyone else.

So, their recent societal memory includes the funding and construction of dams, roads, tunnels, water treatment plants, hospitals, health departments, and schools.

Why would they go to all the trouble? Equity. Their people deserved to survive too.

When you don’t remember the cost of these things and the hard-won battle of putting them there, it’s easy to forget how precious they are. It is easy to take them for granted.

It’s easy when you have always had a dam to forget that unregulated rivers in the West flood wildly; that flooding leads to water contamination, and water contamination leads to children dehydrated from nausea, vomiting, and diarrhea. Even to death. It’s easy when you’ve always had paved roads to forget that dirt roads falling off the side of the mountain make a perilous journey for a two-wheel drive station-wagon ambulance headed to pick up a father, who while hunting with his son, had sudden and crushing chest pain. It’s easy to forget when you have always had a hospital that people died often from the simple, preventable things.

These things are taken for granted in the city. See? Equity.

As I watched the graduates receive their diploma off of a table, a safe six feet away from their principal who genuinely wanted to shake their hand and tell them how proud he was of them, I couldn’t help but think of the rubble that lay before them.

There is a healthcare system in rural Colorado in crisis. It was in crisis before COVID-19 hit. Now, they are laying people off, desperate to keep afloat to serve the towns they exist for.

Will these newly minted adults see the build before them? What about their parents and grandparents, many of whom also spent their whole lives enjoying dams, roads, tunnels, water treatment plants, hospitals, health departments, and schools already in place for them?

As hospitals enter an age where Americans believe they should carry the financial responsibility of the poor health outcomes of a generation raised on Cheetos and video games, will we gather our toolbelts of collaboration, compromise, investment, and sometimes outright argument for the benefit of communities for which no help is coming in the midst of crisis?

The WWII generation accomplished more by the time they were in their forties than the next three generations would in their lifetime. They’re called “the joiners.” They used collaboration across disagreements and outright obstacles to build up vital infrastructure. While so revered, many of us who knew them would also say they were downright obstinate.

I watched my daughter turn her tassel, toss her cap, and smile at her classmates. She is strong, but too smart to be fearless. She was forged among the fires and pits of 9/11 and learned her colors from a nation flying Old Glory.
“All men are created equal.” We will live without tyranny, without fear, or we will not live at all. The pursuit of happiness is not the guarantee of happiness. It is the right to build for ourselves the critical infrastructure and supports we deem appropriate for our children to enjoy.

This graduation, on the heels of Memorial Day, reminds us that our liberties must be re-earned with each generation.

She has seen the cost of equity in our town. She knows that for our town to have access to healthcare, holidays and vacations are often sacrificed. She has seen the reverberations of trauma and loss, shaking a town that refuses to rattle. She’s watched her elders wield tools like stubbornness and solidarity, sharpened by use in a community with no one coming to help, and will use them to build for tomorrow what was hard bought today.

She turns her tassel and turns to face a future that requires solidarity, selflessness, and wisdom… Oh, and the outright obstinance of a generation that will demand nothing less than equity for rural people. She and her classmates will come together to face their rebuild. Yeah, she’ll be fine.

Return to The Rural Voice