The land as medicine

HALE COUNTY, Ala. — Small, cramped trailer homes and old farmhouses can be glimpsed through patches of towering trees as an old SUV barrels down a bumpy, gravel road. Marlo Paul, the only Black female doctor within three neighboring counties in the heart of the Alabama Black Belt, is making a house call. 

“It has been a very trying year and a half,” she said. “People don’t have insurance, and there is a big lack of trust with the hospitals and the doctors. A lot of people will refuse to go to the hospital because family members, those that they love, that went to the hospital didn’t make it back. If they don’t get the treatment, the support, and help they need, they will die in their homes.” 

Over a decade ago, Paul and her botanist husband, Anthony, felt compelled to move her practice and work in medically underserved Hale County, historically known for its fertile soil, cotton production, and legacy of slavery. The couple run an organic, medicinal herb farm and wellness center on over 100 acres of land in Sawyerville. But lush greenery and rolling farmland belie the extreme poverty, high unemployment rates, and food insecurity in the area.

Since the pandemic hit, she and her husband have been driving to the homes of Covid-19 patients, many of them extremely isolated with limited internet access or no means of transportation. Paul checks their temperature and oxygen saturation, listens to their lungs, and gives advice, all at no cost to the patients.

“I ask myself all the time what would I have done without them,” Shelanda Hare says while sitting on her front porch. She struggled to get medical care when she came down with Covid, and has now recovered. Paul presents her with information about the vaccine. But Hare sounds unconvinced. “I don’t trust the vaccine. I spoke with the Lord about it, I always speak with him, if he leads me to take the vaccine, then I will take the vaccine,” she says. 

According to data from the Centers for Disease Control and Prevention, in August, just 34.8% of Alabama’s total population was fully vaccinated — the lowest percentage of any state in the country.

“This is the Bible Belt area, so a lot of people rely heavily on their spiritual upbringing, and on God, and so we just have to encourage them to pray about it but here are the facts,” said Paul. “There is a lot of misinformation. … The big thing is educating them on what the vaccines are, what they do, and what the benefits are vs. what could happen if you catch the Covid-19 virus.” 

Despite the steep challenges she and her community face, Paul says she has never been happier in her work: “I absolutely love my patients here, and they teach me to be positive.”