Who Are Those People?

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“Through my time in Eastern Kentucky, I began to undergo a radical consciousness shift that has since changed my life.”


Nancy Reinhart is a proud parent to two feisty daughters, Anjali and Maitreya, and a partner of fifteen years to David Mitchell. She graduated from Washington and Lee with a double major in journalism and political science in 2000. She served in Peace Corps Armenia as a Health Volunteer and attained her Master’s Degree in Public Health from University of Louisville after returning to the U.S., doing her capstone project in under resourced communities in Mysore, India. Nancy then worked in Eastern Kentucky for ten years, first as a social justice organizer and health researcher with Kentuckians For The Commonwealth and then as the Courier Program Coordinator for Frontier Nursing University. Since 2010, Nancy has also worked as a birth doula and yoga teacher. She has just finished her RN degree and is pursuing a Master’s of Nurse Midwifery at FNU starting this fall.

The memory of my interview with what was then called the Shepherd Poverty Program is still fresh in my memory after twenty years. My poverty professor had recruited me to apply for an internship in the Appalachian region of my home state, Kentucky, with a healthcare organization called the Frontier Nursing Service. I had never heard of it, but I trusted his recommendation.

Iconic image of a Frontier Nursing Service (FNS) nurse midwife traveling to her district on horseback.

Iconic image of a Frontier Nursing Service (FNS) nurse midwife traveling to her district on horseback.


During the interview, I recall describing how much I wanted to help “them” and “those poor people.” I can see the face of the interviewer in my mind now, looking at me with a slightly raised eyebrow, like something wasn’t quite right. I remember feeling like there was something deep and rich I didn’t understand about the exchange, but I wasn’t sure what it was at the time. Luckily, I was chosen for the internship with FNS despite my lack of clarity.

I was raised in a middle class family and was attending Washington and Lee on scholarship at that time. Having spent two years on campus, I had already had a very personal experience of “examining privilege,” as I came from a less privileged home than most of my peers. Yet, I was thoroughly unsophisticated in my personal framework and analysis for privilege and poverty, their causations and the power structures that both promote and sustain them. I didn’t have words to describe my own experience.

My summer serving as a Courier with the Frontier Nursing Service began to change this. Through my time in Eastern Kentucky, I began to undergo a radical consciousness shift that has since changed my life.

During that summer, I learned things I had in common with the people I met, celebrated and at times remained in awe of our differences, and gained perspective on my own life and heritage. I came to love the mountainous region of my state and value all that it brings to our American consciousness – and not just because people there are poor. I birthed the words and constructs I needed to begin to build my own consciousness around race, class, and privilege.

In my role as a Courier, I performed volunteer duties that ranged from filing papers to shadowing nurse midwives catching babies to helping adults learn how to read. I was invited into people’s homes, ate squirrel stew, danced the jig at weddings and enjoyed wonderful back hills bluegrass music jams. It was my first rich, challenging and deep cross-cultural experience, and, as I wrote in my journal at the time, my first glimpse of what some would call the “shared humanity” that transcends race, class, and geography. As one fellow Courier said so eloquently, I left with the colorful threads of Appalachian life “stitched into my heart.”

After graduation, in large part motivated by my time with FNS, I joined the Peace Corps as a health volunteer. I served in Armenia and was able to deepen my investigation of so many of the lessons learned in Eastern Kentucky. After my return from there, I obtained a Master’s in Public Health and continued to work in the Appalachian region in our state for the next decade.

In one of life’s strange circles, in 2012, I was offered the opportunity to return to Frontier Nursing and to run the internship Courier service learning program in which I had participated. I gladly accepted and had the chance to work with the internship director of the Shepherd Consortium as well. I accepted Shepherd interns each year I directed the Courier Program.

When preparing the Couriers for their summer experience, I incorporated class and poverty analyses, health equity framework exploration, and group discussions about the changing healthcare landscape and what it means for people and places like Appalachia. We intentionally explored the impacts of a coal-based extractive economy in the region and its relationship to the health, wellbeing, and the future of our entire country. I invited the students to make these discussions personal, to be uncomfortable, and to give words to how their own inner landscape shaped their view–and not just to think about “them” and “those poor people.”

Through this intellectual work and throughout their summer experiences, I encouraged students to explore the application of newly forming lenses and constructs to both the painful and joyous realities they confronted in Appalachia and within themselves. I invited them to investigate for themselves, as I had during my time with FNS, what they believed were the causes and potential solutions for BIG issues such as these. The seeds the Shepherd program planted so many years ago bore fruit in me and planted new seeds in my students.

I’ve only recently left that job to pursue training as a nurse midwife – another step in my professional path that began to be birthed during my time as an intern. Frontier Nursing was the first school of nurse midwifery in the United State and is now the top ranked program of its kind nationally. The mission is to train highly skilled practitioners to serve rural and underserved communities, and they do it well.

For all of these turns and twists in my path, I am grateful that my poverty professor first sought me out and encouraged me to attend to FNS and the communities it serves. The echoes of those trips down the rocky hollers in FNS home health jeeps twenty years ago and of the paths the Shepherd internship carved inside of me continue to reverberate across the decades of my life as they unfold in front of me today.

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