Robotics in rural Alabama obstetrics care gets mixed reviews

36 of Alabama's 54 counties lack any obstetrics care.
(Photo by Volodymyr Hryshchenko, Unsplash)

People are conflicted about part of the Alabama Rural Health Transformation Program, which aims to add robotic ultrasound machines in rural areas of the state, reports Liz Carey for The Daily Yonder. Many experts agree that the state's biggest obstacles to ensuring healthy pregnancies, babies and moms is access.

Alabama has the highest maternal mortality rate in the U.S., with 41 of its 54 counties lacking labor and delivery services and 36 counties without any obstetrics care.

While the new robots address a lack of technical support in rural healthcare, the real issue, medical care access, isn't addressed by robot-providing ultrasounds, according to an OB/GYN in Jasper, Alabama.

“There may be a case where a mom may have low fluid, and that patient needs to go to a hospital,”  LoRissa Autery told Fox54 News. “But if you’re in a part of the county that doesn’t have a hospital that has obstetrical services, now you have to drive an hour to an hour and a half to receive those services from a physician that did not do the ultrasound.”

New technology can help provide access to care, but to do so, it requires basic healthcare infrastructure and reliable broadband internet access, Katy Kozhimannil, a professor and co-director of a rural health research center at the University of Minnesota, told the Yonder.

The Alabama's plan also outlines programs to supply emergency labor and delivery carts to rural hospitals, pair patients with specialty providers, and distribute equipment upgrades and minor building renovations, reports Carey.

Some state and federal officials have praised the plan, while others have given it mixed reviews, Carey adds.

Small town of Muscle Shoals made Aretha Queen of Soul

Franklin helps open the 2017 Tribeca Film Festival
at Radio City Music Hall. (Photo: Rebecca Smeyne, NYT)

Aretha Franklin, who died today at 76 of pancreatic neuroendocrine cancer, may have been the greatest singer we ever heard. But in the music trade, talent does not guarantee success. You need good evaluators, collaborators and promoters. And she got the collaborators she needed in the small town of Muscle Shoals, Alabama, then less than 7,000 souls and now about 14,000. It was the career "pivot point" that sent her to stardom, says The New York Times:

"Jerry Wexler, the producer who brought Ms. Franklin to Atlantic [Records], persuaded her to record in the South. Ms. Franklin spent one night in January 1967 at Fame Studios in Muscle Shoals, Ala., recording with the Muscle Shoals Rhythm Section, the backup band behind dozens of 1960s soul hits. Ms. Franklin shaped the arrangements and played piano herself, as she had rarely done in the studio since her first gospel recordings," Jon Pareles writes. "The new songs were rooted in blues and gospel. And the combination finally ignited the passion in Ms. Franklin’s voice, the spirit that was only glimpsed in many of her Columbia recordings." Franklin was born in Memphis and was living in Detroit.

Rick Hall's studio in Muscle Shoals (Photo by Carol M. Highsmith)

"The Muscle Shoals session broke down, with just one song complete and another half-finished, in a drunken dispute between a trumpet player" and Franklin's husband, Ted White, whom she would divorce two years later, Pareles writes. "But when the song completed in that session, 'I Never Loved a Man (the Way I Love You),' was released as a single, it reached No. 1 on the R&B charts and No. 9 on the pop charts, eventually selling more than a million copies. Some of the Muscle Shoals musicians came north to complete the album in New York. And with that album, I Never Loved a Man the Way I Love You, the supper-club singer of Ms. Franklin’s Columbia [Records] years made way for the “Queen of Soul.”

For The Bitter Southerner, Chuck Reece recounts the Muscle Shoals sessions with the help of David Hood and Spooner Oldham, two of the musicians (all of whom were white). "Coming to Muscle Shoals probably resonated the Southern experience in her brain, even though she had been gone forever," Oldham said. "And then, when she was allowed to turn loose with all that Southern expression, we just played our hearts out, because we were used to that stuff."

Poynter Institute writing guru Roy Peter Clark recalls how Franklin helped him understand, as a musician and a young writer, "the rhythm of sentences and the voice of the writer," and how an artist can take over a song, just as Franklin seized Otis Redding's "Respect," much as Redding had turned the 1933 Bing Crosby standard "Try a Little Tenderness" into a whole 'nother thing: "The same text can be delivered to different audiences at the same time with different effects."

Auburn University architecture team makes tiny houses that are as chic as they are affordable

Co.Exist photo

Architecture students at Rural Studio, Auburn University's design-build program, have been working on a riddle of sorts for more than a decade: how do you design a home that someone living below the poverty line can afford, but that anyone would want, while also providing living wage construction jobs?

After years of building prototypes, the team finished their first pilot project in the real world in January, Adele Peters of Co.Exist reports. They partnered with a commercial developer in the tiny town of Serenbe, Georgia, southwest of Atlanta, to build two one-bedroom houses, with materials that cost just $14,000 each, making their goal of a $20,000 home feasible.

Their goal was simple: to figure out how to bring the ultra-low-cost homes, called the 20K Home, to a broader market. Many cohorts of architecture students and their advisers have spent more than 100,000 hours tweaking each detail of the house to optimize both the function and the price, Peters writes. But the bigger challenge is fitting a house that's completely different than normal into the existing system of zoning and codes, how contractors do their jobs and even mortgages.

For example, the foundation of the house uses cantilevers, seesaw-like joists that help save wood and concrete and actually make the house stronger than a typical foundation would. But the design isn't in the usual guides that code officials consult, so the architects had to go back and explain how it worked. The team realized that in order to make 20K Homes accessible they would have to create a detailed guide that explained everything from how to build each piece—with Ikea-like instructions—to how to educate local officials, Peters notes.

Another hurdle has been financing. The homes in the pilot project will be owned by the community and shared with artists as part of a residency program. But in a typical case, when someone is buying the house on a limited income and can't afford to pay $20,000 upfront, banks won't finance a mortgage for such a small amount of money; a $100,000 mortgage costs a bank about as much as a $20,000 mortgage, Peters explains.

The project originally aimed for a house that would cost $20,000 in total, including construction; however, the team now believes that more money may be needed to provide a living wage for builders. They've rejected the idea of using factory-made prefabricated parts because one of the main goals is to create jobs. Still, whatever the final cost, it will be inexpensive, Peters notes. And if someone wants to construct it together themselves, it would cost less than $20,000.

Rural editor wins national opinion award, again, and gets in line to be publisher of The Anniston Star

UPDATE: Davis, 47, has been named associate publisher in preparation to become publisher. He will remain editor. He is an Anniston native who has been at the Star since 2003. Read more here.

For the second year in a row, Bob Davis of The Anniston (Ala.) Star was named Opinion Journalist of the Year for newspapers with circulations less than 100,000 by the Association of Opinion Journalists (formerly the National Conference of Editorial Writers).

Davis is editor of the 20,000-circulation Anniston Star in rural northeastern Alabama, a paper that serves several small towns and rural counties along Interstate 20 between Birmingham and Atlanta, at the southern end of Appalachia near the Talladega National Forest.

Davis was praised for both the quality of his writing and for the breadth of issues he tackled in his columns and editorials (links to some examples are below). The judges wrote: "Bob Davis' columns have the best anchor any local newspaper could have -- a sense of place. Whether he's doing a devastating takedown of one state Sen. Scott Beason or advocating literacy programs (as opposed to absurd immigrant laws), the voice is always that of a thoughtful Alabama Southern gentleman who's considered all arguments."

When Davis won the award last year, the judges particularly praised his editorial campaign calling for reform of the Alabama constitution, which dates to 1901 and has a number of obsolete items in it, such as language making interracial marriage illegal and calling for the segregation of schools, both rendered moot by federal laws.

"His focus on issues that matter to all Alabamians (even if they don't know it yet) is clear, determined and precise," the 2011 judges wrote. "He even breathes a diverting life into the issue of Alabama's execrable 1901 constitution, the gift that keeps on giving to Alabama editorial writers and the problem that refuses to go away."

The Star is a storied community newspaper, made famous for its anti-segregation stances during the Civil Rights movement and its persistent watch-dogging of local and regional government agencies under publisher H. Brandt "Brandy" Ayers.

The AOJ's Opinion Journalist of the Year award for publications above 100,000 circulation went to Thomas Frank of Harper's magazine, who has written much about low-income rural people who vote against their economic interests by supporting candidates who stress religious and social issues (What's the Matter with Kansas?)

Here are some links to Davis' winning entries, which he provided to The Rural Blog:
"Reading into a real problem," Sept. 30, 2011; "Beason's gamble: State lawmaker walks thin 'wire'," June 16, 2011; "A 'band of brothers' for Bentley," Jan. 23, 2011; "Memories to warm us during the rebuilding," May 1, 2011.

Rural schools struggle to bridge the digital divide

Rural schools have long been leaders in distance-learning and online education. "To offer a full slate of courses to their students, they’ve had to be. Some states, fearing a divide between rural and urban communities, have developed statewide initiatives to provide technology to rural schools," Sarah Butrymowicz writes in The Hechinger Report. Maine, she points out, gives every student a laptop, and Alabama requires all school districts "to offer advanced placement courses through distance-learning technology, where students video-conference with teachers. (Edison School in Yoder, Colo.; Butrymowicz photo)

In 2010, only 57 percent of rural households had broadband Internet access, compared to 72 percent in urban areas, according to a November 2011 report by the U.S. Department of Commerce. Teachers in rural settings don't require students to go online to complete assignments and have to be flexible about staying after school so students can work on the computers. “The Internet can give them library resources that they might otherwise not have,” said Aimee Howley, senior associate dean in the College of Education at Ohio University, who studies technology integration in rural schools. Technology can also be used for simulations of things, she said, that “you just can’t do on site."

For schools facing shrinking budgets and consolidation, technology could be rural schools’ saving grace, said Bob Wise, a former governor of West Virginia who now serves as president of the Alliance for Excellent Education, a national advocacy organization in Washington, D.C., that has studied the challenges facing rural schools. “We’re encouraging every district to develop a systematic strategy for employing technology,” he said. “My guess is you will see a number of rural schools actually saved and renewed as learning centers.”
  

Alabama legislature adds public-notice feature to immigration law, keeping its core in face of U.S. suit

The Alabama legislature on Wednesday tinkered with the state’s controversial immigration law, keeping certain portions intact and adding a new provision that would require publication of the names of undocumented immigrants who appear in court, even if they are eventually acquitted of the crime, reports Bryan Lyman of the Montgomery Advertiser. The bill now goes to Republican Gov. Robert Bentley to sign.

The bill kept in place the measure that has generated the most controversy: the requirement that police verify the immigration status of anyone they suspect of being in the country illegally. The law drew a suit from the U.S. Justice Department last year. Politico's Tim Mak provides the legal lay-of-the-land since: "In October, a federal appeals court temporarily blocked parts of the law that would require schools to verify the immigration status of students. The U.S. Supreme Court is currently waiting to rule on a case challenging a similar immigration law in Arizona. That case was heard in April. It was not immediately clear what the legal impact of the tweaks to Alabama’s law will be in regard to the legal action underway against the state."

Alabama electronic bingo facilities spark debate about what kind of jobs rural areas need

An attempt by Alabama Gov. Bob Riley to rid the state of electronic bingo has put rural county officials on the defensive for one of the few industries they say has created jobs in their jurisdictions. "This fight might have its roots in the legality of electronic bingo, but the tussle also has taken on an economic development angle in areas that see gaming establishments ... in the same light as the state's Mercedes-Benz and Honda factories," Michael Tomberlin of The Birmingham News reports.

"It comes down to the fact that desperate people do desperate things," Larry Lee, a former economic developer in Covington County and other parts of the state, told Tomberlin. "Whatever it is we have called 'rural development' for years in Alabama has failed miserably. We've just not taken a meaningful approach to it, and those chickens are coming home to roost." Neal Wade, the executive director of the Alabama Development Office, disagrees telling Tomberlin the "state's economic development efforts must be attached to safer bets."

Proponents of the facilities say they account for nearly 5,000 jobs, while the Alabama Department of Industrial Relations reports the figure is fewer than 2,200. Local officials tell Tomberlin "by either measure, those are jobs those counties can't afford to lose." But one of the governor's spokespersons told Tomberlin the casinos have been no economic cure for those counties. Federal data shows the unemployment rate in December was 15.6 percent in Lowndes County, 15 percent in Greene County and 12 percent in Macon County. Houston County's 9 percent rate made it the only county with a large bingo facility and an unemployment rate less than the state's 11 percent average. (Read more)

Methamphetamine labs are on the rise in Alabama

Methamphetamine use is a cancer within many rural communities nationwide. Federal and state legislation has been implemented in recent years to curb the production of the drug, commonly known as meth, but this has not curtailed its existence.

Mike Cason writes in the Birmingham News that Alabama is facing a resurrection in meth labs. "More meth cooks in the past year have started using a simpler, 'one-pot' cooking method that takes fewer ingredients and can be mostly completed in a two-liter plastic soft drink bottle, authorities say."

The Talladega County Drug Task Force has "found 70 of the 'one-pot' or 'shake and bake' meth labs since October,' compared to 45 meth labs discovered by the task force in all of 2007.

Matt Germanowski, a supervisor in the federal Drug Administration's office in Birmingham told the News that, "the 'one-pot' labs have not emerged as a significant problem in Jefferson, Shelby and Tuscaloosa counties. 'Meth is still a rural drug.'"

Virginia makes a felony of cockfighting, so West Virginia could see more of the illegal fights

Recently, Virginia joined the 36 other states that make cockfighting a felony. Since cockfighting remains a misdemeanor in West Virginia, officials with the Humane Society of the United States warn that the crime could be on the rise there, reports Tom Searls of The Charleston Gazette.

"The national Humane Society rates West Virginia's laws among the most lax, along with neighboring Ohio and Kentucky," Searls writes. John Goodwin, the national Humane Society's manager of animal fighting issues, told Searls that the majority of cockfighting goes on in rural areas — such as the mountainous region along the Virginia-West Virginia border — where locals know what's going on. Thus, there need to major deterrents, Goodwin said.

Two bills dealing with cockfighting failed to gain traction in the West Virginia Legislature, one of which would have made any participation in cockfighting a felony. Ohio and Tennessee have considered strengthening cockfighting laws, but Kentucky has not. (Read more)

This week, a bill making cockfighting a felony passed the Tennessee House Criminal Practice Subcommittee, reports Tom Humphrey of the Knoxville News-Sentinel. "The bill, HB2143, would increase the penalty for active participation in cockfighting from the current Class A misdemeanor, punishable by up to a year in jail and a $2,500 fine, to a Class E, punishable by up to a prison term of between one and six years and a fine of $3,000," Humphrey writes. "A spectator at a cockfight can now be punished for a Class C misdemeanor, which has a maximum penalty of up to 30 days in jail and a $50 fine. The bill would raise the crime of being a spectator to a Class A misdemeanor."

Leighann McCollum, Tennessee state director of the Humane Society, told Humphrey that supporters of cockfighting have been lobbying legislators to oppose the change. "We feel like they are cowering to the loud voices of the minority of people in this state who enjoy cockfighting," she said. (Read more)

The Humane Society ranks the states in order of cockfighting laws, with Arkansas, Kentucky, Idaho, Mississippi and Alabama at the bottom.

Biodiesel plants pose threat of water pollution

Biodiesel plants, touted as a largely non-polluting source of renewable energy, are causing water pollution in Iowa, Missouri, Alabama and probably other states, reports The New York Times.

"The discharges, which can be hazardous to birds and fish, have many people scratching their heads over the seeming incongruity of pollution from an industry that sells products with the promise of blue skies and clear streams," Brenda Goodman writes. But a Missouri official "said she was warned a year ago by colleagues in other states that biodiesel producers were dumping glycerin, the main byproduct of biodiesel production, contaminated with methanol, another waste product that is classified as hazardous. . . . In January, a grand jury indicted a Missouri businessman in the discharge, which killed at least 25,000 fish and wiped out the population of fat pocketbook mussels, an endangered species. "

An engineer for the National Biodiesel Board told Goodman that some producers of the fuel have had problems complying with environmental rules, "but says those violations have been infrequent in an industry that nearly doubled in size in one year, to 160 plants in the United States at the end of 2007 from 90 plants at the end of 2006," Goodman writes.

Alabama station's blackout of CBS report on ex-governor has some seeing another conspiracy

On Sunday night, the CBS News show "60 Minutes" aired a story suggesting that former Alabama Gov. Don Siegelman was wrongly convicted of corruption last year because of a politically driven agenda of the Bush administration. Instead of the segment, viewers of Huntsville's CBS affiliate, WHNT-19, "saw a blank screen . . . and the chance to declare yet another conspiracy," reports Patricia C. McCarter of The Huntsville Times.

The station's general manager said equipment problems caused the blackout and not the content of the report, called "The Prosecution of Dan Siegelman," which was favorable to the now-imprisoned Democrat. WHNT-TV has replayed the show in its entirety twice and posted links to the segment on its Web site, but the Alabama Democratic Party "is asking the Federal Communications Commission to seek a formal inquiry into the situation," McCarter writes.

"It has come to the attention of many Democrats in north Alabama and that the principal owners of WHNT are Bush Pioneers (people who have raised $100,000 or more for the President's election campaigns) and major Republican donors," Alabama Democratic Party Executive Director Jim Spearman said in a Monday press release."Many suspect that the enormous pressure was put on CBS to not air the Siegelman story. If CBS received political pressure to stifle the First Amendment rights of the network or affiliate, the FCC and Congress should take appropriate oversight into the matter." (Read more)

The New York Times, which once owned the Huntsville station, was skeptical in an editorial today. “After initially blaming the glitch on CBS in New York, the affiliate said it learned 'upon investigation,' and following a rebuke from the network, that 'the problem was on our end.' . . . If the blackout was intentional, it may also have been counterproductive. Rather than take attention away from allegations that Mr. Siegelman was the victim of a partisan campaign, WHNT’s technical glitch seems to lend support to the charge.” (Read more)

UPDATE, Feb. 28: The Press-Register of Mobile saw it differently, in an editorial today. The paper said the story "failed to present convincing evidence of corruption. The CBS program's descent into tabloid journalism consisted of uncorroborated and mostly repackaged charges about the prosecution . . . by career federal prosecutors who were spurred on by stories in the Press-Register." (Read more)

Parched Georgia wants to tap into Tennessee River by correcting error in states' boundary

Georgia, withering from drought, wants to correct a 190-year-old mistake and move its border with Tennessee a mile north so it can freely draw water from Nickajack Lake. A Georgia legislative committee approved a bill this week calling for creation of a boundary line commission, but officials in Tennessee scoffed at the idea, reports the Chattanooga Times Free Press: "They have criticized the effort as a veiled attempt by a thirsty Atlanta, unwilling to control reckless sprawl, to get access to the bountiful Tennessee River," which the Tennessee Valley Authority impounded to create the lake in the 1930s.

Georgia state Sen. David Shafer, R-Duluth, "said he believes resolution of the border issue will open the way to discussions about water sharing," the Times Free Press said in a staff report this week. Last fall, Tennessee Gov. Phil Bredesen "said he has no interest in seeing Tennessee River water diverted to relieve drought-parched metro Atlanta and northern Florida," wrote TFP Nashville reporter Andy Sher. "I would have a real problem ... with a wholesale transfer of water out of the Tennessee watershed into Florida," Bredesen told him. "I just think it's one of the very important natural resources that we have in Tennessee, and (we) should be very, very cautious about allowing it to be degraded in any way." (Read more)

Atlanta's situation became more dire this month, with a federal appeals-court decision "curtailing Georgia's access to Lake Lanier – metro Atlanta's primary water source — in the future," wrote Dan Chapman of the Atlanta Journal-Constitution. The suit was filed by interests downstream on the Chattahoochee River, as far as Florida.

The border between Georgia and Tennessee is supposed to be 35 degrees north latitude, the horizontal gray line on this Encarta map, centered on the aptly named (from Georgia's viewpoint) community of New Hope, Tenn. The shallows of Nickajack Lake are tantalizingly close to the northern border of Georgia -- about 150 feet, by our reckoning of a satellite photo. A major water intake would probably require deeper water, but no more than 1,000 feet north of the border. The Journal-Constitution used this satellite photo and red lines to show its somewhat different concept of the current and proposed border.

Seems to us there are other ways to solve the problem than moving a long-established border. In another story, Chapman said a 2004 TVA study found "Metro Atlanta could receive 264 million gallons a day — triple the average amount used daily by the city of Atlanta last December — with minimal impact on the river."

C. Bart Crattie, a surveyor who lives on the Georgia part of Lookout Mountain, told Pam Sohn of the Times Free Press that most of Tennessee's borders were incorrectly drawn to the state's advantage. “Tennessee made out like a bandit on all of its surveys,” he said. “On the Kentucky line, it’s off in some places by as much as 9 miles in Tennessee’s favor.” (Read more) The two states settled that error in the 1830s by allowing Kentucky to make land grants in the slice of Tennessee that should have been in Kentucky.

Drought continues in Southeast, and rural areas' private wells feel the strain

As extreme drought conditions persist in the Southeast, predictions of a dry winter present a grim forecast for parts of Alabama, the Carolinas, Georgia, Kentucky, Tennessee and Virginia. Little of the reporting about the problem has mentioned private water supplies, but the drought is putting heavy pressure on wells around Charlotte, N.C., which suffered through its driest summer since 1948, reports The Charlotte Observer.

The biggest problem is with old-fashioned, shallow wells. "Commonly known as 2-inch wells, these typically consist of a 2-inch pipe that goes less than 100 feet down -- about one-third the depth of modern wells," Mark Price reports for the Observer. "Most were drilled prior to the '60s, and they are the least productive and most vulnerable to groundwater changes."

Now, homeowners who depend on those wells are hoping for rain but preparing for the worst. When those wells go dry, homeowners must drill new, deeper wells, Price reports. Homeowners whose wells still work are taking precautions to curb water use in hopes of squeezing more time out of those wells. That includes adding "flow restrictors on faucets" and enforcing "strict rules against car washing, lawn watering and lazy showers," Price writes. (Read more)

According to the latest projections from the National Weather Service, the drought conditions likely will continue in Alabama, the Carolinas and Georgia, but should improve elsewhere over the next few months. The NWS has created the Drought Information Center, which has up-to-date conditions and seasonal outlooks. In the last few hours, Chattanooga, Tenn., has received more than 2 inches of rain, while Rome, Ga., has receive 1 inch, The Weather Channel reports. More rain is predicted for Alabama and Georgia, but it is not expected to offer much relief.

Rural school enrollment up 15 percent last year, with a 55 percent jump in minority students

Enrollment in rural schools is up 15 percent since last year, and minority enrollment is up 55 percent, says the latest report from the Rural School and Community Trust. The jump in enrollment reverses year-by-year trends, yet rural schools, specifically in the South, continue to receive less funding per pupil.

The report also highlights what it calls the "priority states where rural schools produce the worst student achievement outcomes." The report, called "Why Rural Matters 2007: The Realities of Rural Education Growth," was written by Jerry Johnson, the trust's policy research and analysis manager, and Marty Strange, the trust's policy director.

The report ranked states according to 23 factors in five gauges: importance of rural education, socioeconomic challenges, student diversity, policy context and educational outcomes. Based on that, the report found 13 priority states that rank low across these factors: Alabama, Arizona, Florida, Georgia, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee and Texas. These states "serve student populations with the severest socio-economic challenges — especially high poverty levels — and they operate with less money than rural schools in other states," the report says.

The lack of funding and a rise in English Language Learner students, who require more teaching resources, have made difficult situations worse. The report concludes that in those priority states, "poverty, fiscal incapacity, low levels of adult education, and low levels of student achievement run in the same mutually reinforcing circles in states in these regions, many of which are as fiscally challenged as their citizens and schools."

Not surprisingly, one of the report's policy recommendations is a priority for the trust: "Keep schools small. Research shows there are academic benefits for students attending small schools in small districts." Other recommendations:

• Keep schools small. Concentrate resources in high poverty areas. The cost of teaching low-income children rises disproportionately as the poverty rate increases; more student support per pupil in schools with high poverty rates is needed.
• Maximize rural school effectiveness and efficiency with technology. Distance learning has been proven to be effective in meeting needs of rural communities.

To download the full report, go here. (Free subscription required.) To read the report overview, see summaries and compare state-by-state results on a clickable map, go here.