Evergreen AIDS Foundation Faces  the Challenges of Small-Town Outreach

by Claire Swedberg

In the mid-1980s, Bellingham, Washington, had yet to be touched by AIDS. So residents were shocked when Barney Wood, a popular young fisherman, came out on the local radio station and proclaimed, “I have AIDS and I’m dying.” AIDS had found the town of 40,000, perched in the wooded hills above Puget Sound, between Seattle and Vancouver, British Columbia. Longtime friend of Wood, Marybeth Brom, recalled those days in 1985 when she discovered Wood was sick and she was unable to provide the care that he needed. “I walked into Rumors [a local gay bar] and said ‘I need help’.” In that instant, Barney’s friends decided to rally around him.

HIV-positive individuals in small towns have a unique set of challenges—less understanding about the disease, fewer services, and less funding for those services. But many small towns are finding fruitful options such as the Evergreen AIDS Foundation (EAF), which has evolved from four buddies who came to Barney Wood’s side to multiple case workers and volunteers and has become the heart of northwestern Washington’s HIV-positive community.

Wide diversity here in the northwestern tip of the United States makes this area distinct. Included in the territory are several Indian reservations, dozens of small rural towns, the college community of Western Washington University, and trendy artist communities and resort areas for the well-to-do. Thousands of migrant laborers traverse the region for the agricultural jobs.

None of the region, though, is completely without social services. Ryan White CARE Act funding provides care services and case management. In fact, the majority of EAF’s funding comes from Ryan White. Evergreen has a partnership through the North County HIV/AIDS consortium to cover the needs of all people affected by HIV/AIDS over a 4,200 square-mile area. Despite that, mere financial survival is a constant EAF challenge. “We’re always on the razor’s edge,” said Director Edward Wilhoute, Jr. Evergreen also administers additional services that are not funded. The agency relies on private contributions and fundraising events for these.

The services provide for people like Rick A. (who preferred not to release his last name) of Bellingham, who learned he was HIV-positive in 2001. “I was so sick, run down, dehydrated, and couldn’t afford a doctor,” he said. The health department gave him an HIV test and sent him to EAF. “According to doctors, I wouldn’t have survived a year if I hadn’t gone,” he said. And what did they do for him? Everything, he says. “I owe them my life.”

Larry Feyko, an HIV-positive commercial fisherman, trolled the cold Pacific coast, usually hundreds of miles from medical assistance. As his health deteriorated he left his work and moved into a mobile home. But there his health took a turn for the worse. With the help of a case manager at EAF, he discovered the mobile home’s water was contaminated with Cryptosporidium, a parasite that can devastate the weakened immune system. Eventually Evergreen was able to help Feyko relocate and restore his health.

This kind of advocacy is not unusual for EAF, an agency that must take many roles to respond to its small but widely diverse and widely spread client base. Without social services that most urban residents take for granted, EAF must handle everything from AIDS-related health issues to poverty, drug addiction, and even ensuring an HIV-positive client’s child is still functioning well in school.

There are about 200 HIV-positive residents of the three-county area that encompasses northwestern Washington. EAF has all of them on their clientele list in addition to serving family members, including thirty-five children of HIV-positive parents.  Many of the clients are mentally ill, often suffer from substance abuse, and many are migrant workers who do not speak English.

The smaller and more remote the town, the greater the prejudice. Many live on Indian reservations and others are in tiny communities where a visit from an EAF case worker can mean disastrous stigma. For that reason, case workers such as Michelle Dever have been known to make visits at night when no one recognizes “the AIDS lady” paying a visit. Working in such an environment makes for a job that can be intensive and exhausting. For each client, Dever says, she has separate challenges. “I let [each new client] explain their life. I want to hear their voice. I need to learn who I need to be for each client.”

“Poverty is one of our biggest problems,” Wilhoite said. “[And yet addressing that is] not [even part of] the mission of the agency.” But case workers take the problems as they come. Putting their clients to work is another mission that they must try to realize. The case workers’ latest plan is a thrift store that would employ clients and offer used items to the public. They noted the success of Out of The Closet, a popular thrift shop that contributes its profits to HIV causes in numerous cities. EAF’s recent Krispy Kreme Doughnut sale netted the agency $160, an accomplishment even though it did require footwork by the caseworkers just to pick up and deliver the donuts.

With all that agencies try to offer, rural individuals need to be resourceful, too. Hamen Ides, a former professional dancer and commercial fisherman from the Makah Nation near Port Angeles, Washington, suffered AIDS-related paralysis on one side of his body in 1996 and moved in with his mother in Bellingham to find better medical help. He was successful in stopping the progression of the brain viral infection progressive multifocal leukoencephalopathy (PML) thanks to a protease-inhibitor regimen but never restored his mobility on that side.

Unlike Ides, Martin Durham came to Bellingham from a more urban environment. Dallas native Durham and his partner were drawn to Bellingham because of the affordable cost of housing. Evergreen helped Durham find group health and make medication decisions. “Larger cities have advantages,” Durham commented. Durham uses a physician in Seattle and still travels an hour and a half to the larger city for medical assistance. But for Ides, Bellingham has been an improvement. “In Port Angeles [where he lived] there were no HIV doctors, there was no knowledge of [HIV]. They put me on AZT and kept me on that through 1996. The AZT made me anemic.”

The agency has inspired at least some of its clients to do more for their fellow HIV clients. Rick A., who mans the EAF front desk, greets new clients and often sees the fear in their eyes, fear he once felt as well. Rick says he will dedicate his life to assisting Evergreen in its mission. Feyko, also a metal sculptor and whose wife recently had a baby, is continuing on with his own life, trying to bring art work as a source of healing for other AIDS clients by launching a program he calls AIDSart. With the group he intends to draw artists together for the annual art auction that benefits Evergreen.

“[Evergreen] is a voice when you don’t know what to do,” Martin Durham said. While today’s clients know Barney Wood, who died in 1997, only as a banner on the office wall, the foundation that he inspired has become his legacy, quietly rescuing and restoring lives.

Claire Swedberg is a freelance journalist based in Skagit County, Washington, and Somerset, New Jersey.

July 2004