Rural Hospital in Greene County Struggles to Deliver Modern Care Amid Broadband Gaps
Leroy Walker, a 65-year-old with chronic high blood pressure, arrived at Greene County Health System short of breath. One of only two working ambulances in the rural Alabama county brought him in. Nurses quickly began treatment: an ECG, X-rays, and magnesium via IV. As the machines beeped, Walker whispered, “I feel better.” But behind the scenes, a critical limitation remained—one that technology couldn’t fix fast enough.
Greene County Health System, a small 20-bed hospital with just three doctors and no ICU or surgical unit, serves a community among the sickest in the nation. According to CDC data, Greene County ranks near the top in stroke, obesity, and hypertension rates.
The hospital’s visible wear and tear—chipped floor tiles, an abandoned front desk—reflects deeper systemic issues. The most pressing: its painfully slow internet. In an era when modern medicine depends on electronic health records, remote monitoring, and telehealth, Greene’s outdated broadband infrastructure puts lives at risk.
Despite multiple federal promises over the years—including executive orders by former President Trump and broadband investment pledges by President Biden—rural areas like Greene remain digitally disconnected. Greene County is one of more than 200 counties identified in a KFF Health News analysis as lacking both high-speed internet and sufficient healthcare providers.
Nearly 60% of such counties don’t even have a hospital, and at least nine lost theirs in the past 20 years. Residents in these areas, often in the rural South, Appalachia, and the remote West, tend to suffer worse health outcomes and die younger due to a lack of access to care.
Stephen Katsinas of the University of Alabama’s Education Policy Center called it a case of systemic neglect: “Rural areas with low population and high poverty always get help last.”
President Biden’s $42 billion Broadband Equity Access and Deployment (BEAD) program was expected to help, but implementation has stalled. New commerce secretary Howard Lutnick has ordered a full review of the program, slowing rollout just as states prepared to begin fiber-optic construction. Arielle Roth, Trump’s nominee to lead the overseeing agency, promised to act “expeditiously” but gave no clear timeline during her confirmation hearings.
Meanwhile, Greene County’s problems persist. Only half of its homes have high-speed internet, and 36% of the population lives below the poverty line. The hospital’s internet is so slow that nurses must rely on handheld devices and listen manually for IV alarms. “Our system isn’t strong enough. There are many days you sit here and wait,” said nurse Jittaun Williams.
With no centralized patient monitoring system, nurses like Teresa Kendrick carry portable pulse oximeters and rely on continuous spot-checks. In Room 122, where Walker lay, his dialysis port bulged under his skin—he undergoes treatment three times a week. Despite his condition, only a single IV monitor beeped as the nurses moved between patient rooms, unsupported by a digital network.
Aaron Brooks, the hospital’s tech consultant, said Greene can’t afford a central monitoring system, let alone the high-speed internet needed to support it. The hospital reported a $2 million loss on patient care last year.
Despite decades of federal programs—more than 133 across 15 agencies, according to a 2023 government report—rural broadband gaps remain. Alabama has been distributing funds from the American Rescue Plan Act (ARPA), and Greene County Hospital is on the list for upgrades. But progress has been slow.
State Sen. Bobby Singleton, who represents Greene, said red tape and resistance from internet providers delayed broadband construction. He said the fiber lines are now visible across the district, and he’s hopeful Greene County Hospital will be connected soon. “It’s taking too long, but I’m patient,” Singleton said.
The Alabama Fiber Network (AFN), a group of electric cooperatives, won $45.7 million in ARPA funds to bring fiber to Greene and neighboring counties. AFN says it’s ahead of schedule and aims to connect the hospital by year’s end. Still, Greene CEO Marcia Pugh remains cautiously optimistic. “You want to believe,” she said.
Until then, patients like Walker—and the nurses who care for them—must rely on outdated equipment, personal dedication, and hope. In Greene County, modern healthcare remains just out of reach.
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