“Few will have the greatness to bend history itself, but each of us can work to change a small portion of events. It is from numberless diverse acts of courage and belief that human history is shaped. Each time a man stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, he sends forth a tiny ripple of hope, and crossing each other from a million different centers of energy and daring those ripples build a current which can sweep down the mightiest walls of oppression and resistance.”
~ Robert F. Kennedy

“Out in the Rural: A Mississippi Health Center and Its War on Poverty” is a historical account of the birth of the nation’s community health care program and gives readers a proper introduction to Dr. H. Jack Geiger, founder of the Tufts-Delta Health Center in rural Mississippi.

It is a story one man’s vision of health care and how it led to the opening of the first rural community health center (CHC) in America. Set during the civil rights movement, author Thomas J. Ward Jr. takes a look back in time to when America was not so great. A time in America’s history when separate and unequal treatment was the norm. A time when the poorest among us were those who for generations had provided free labor to this country’s economy. A time when many African-Americans in the south had lived beyond their usefulness on farms and plantations and were victims of their circumstances.

The book includes many compelling photos, but perhaps the most telling of the times is the one selected for the cover. It provides a haunting glimpse into the living conditions and the plight of the people who were all but invisible.

Dr. Geiger saw health and human rights as inseparable, stemming from his experiences as a visiting medical student in South Africa in the 1950s. He used this knowledge to bring health care to impoverished people in Mound Bayou, Mississippi. In Dr. Geiger’s mind, the concept of community health was a merger of public health and clinical medicine, teaching the people how to take a more active role in their own health.

War was indeed waged on poverty through this Mississippi Health Center via the approach taken to improve the quality of life of the many sharecroppers in the region. The health center was not only concerned about the health of the people, but it was a launching pad for economic development.

The center utilized health services as the route of entry to social change and addressed issues such as environmental (living) conditions, nutrition, economic attainment and self-sufficiency. Not quite a rags-to-riches story, but Out in the Rural chronicles the development of how a cooperative was formed which empowered the people by giving them the opportunity to earn a living for themselves by teaching them new skills or showing them how to utilize the ones they already possessed.

There are now over 9,000 CHC’s in America and it is amazing to think it all started with this one. Out in the Rural is a must read for health professionals and history buffs alike.

Thomas J. Ward is the chair of the History Department at Spring Hill College in Mobile, Alabama. He is the author of numerous works on both African-American history and the history of health care, including his first book, Black Physicians in the Jim Crow South. He lives in Spanish Fort, Alabama with his wife and three sons.