“He Thinks Our People Are Idiots” Trump has betrayed the people of coal country. They love him anyway.

Christy Ratliff is sitting in a folding chair in a public school gym in Grundy, Virginia, waiting for her number to be called.

- Stephanie Mencimer

She arrived at 4 a.m. on this October Saturday to secure her position in line to have eight teeth pulled. Genetic gum disease, she explains, has left most of them rotten or broken. She hooks a finger to pull down her lip and show me gruesome damage—the kind most dentists see only in textbooks.

Grundy, the seat of Buchanan County, sits deep in the Appalachian Mountains of Southwest Virginia. This weekend, it's hosting a free clinic courtesy of Remote Area Medical, a nonprofit like Doctors Without Borders, but for places in the United States where the health outcomes are as grim as those in many developing countries. RAM founder Stan Brock once suggested that because Grundy is so inaccessible, his volunteers should literally parachute into town, as he once did while working in rural Africa.

Buchanan County borders West Virginia and Kentucky. The nearest (tiny) airport is in Bristol, Tennessee, about two hours south. Nothing around Grundy is flat. The roads can be perilous and slow going. But the topography doesn’t deter hundreds of people from traveling to the RAM clinic from all over the region. Ratliff’s friend drove her about 30 minutes from her home in Haysi, population 537, in neighboring Dickenson County. Grundy, an isolated coal country outpost, has only one or two dentists, and even if Ratliff could get in to see them, she can’t afford to. A mother of two small children, with her ex-husband in prison, she earns $13.47 an hour working part time at Food City. Along with about a quarter of the residents of Buchanan and Dickenson counties, Ratliff is covered by Medicaid, but she hasn't been able to find a dentist to go to. That's why she’s here in this gym, where RAM offers free dental work.