A scratchy newsreel dating from the 1960s depicts a bleak Beaufort County where rural, poor blacks could be mistaken for current news video of depravation in Somalia or Ethiopia: Adults crippled with untreated ills; children lethargic and wide-eyed from malnutrition; drinking murky water tainted with bacteria and worms.

The news footage shocked a national audience and led the federal government to interject itself while the state of South Carolina did little. Federal money paid for a medical clinic in Beaufort to provide free or reduced-cost service to the poor.

That was in 1969, and it continues today as the Beaufort-Jasper-Hampton Comprehensive Health Services. As the name implies, the medical system provides care for the poor in three counties. It is one of 18 such federally financed health services around the state.

Rural poverty still runs deep in Beaufort County, with Hispanics making up an increasing part of that number. Many come to the county as migrant farm workers or laborers for the booming coastal developments.

Rafael Romero could compete as an Ernest Hemingway look-alike. He's burly with a full white beard. His eyes speak of kindness. His bearing, noble.

Yet his beef-jerky hands and soiled clothes tell you he toils for a living.

Romero arrived in this country in 1980 as part of the Mariel boatlift when Fidel Castro allowed 125,000 people to leave Cuba, most for economic or political reasons, but many criminals and mental patients were dumped from Cuban jails and institutions.

Since then, Romero has not seen his family in Cuba as he travels each year from Florida to South Carolina to Virginia following the crops. He spends six months in Florida and three each in South Carolina and Virginia.

The 54-year-old tells of witnessing years of rough treatment for migrant farm workers in many places that don't accept them as equals but want their cheap labor.

He receives better treatment than most because the federal government allows Cubans who arrive here to remain legally. Still, he said, “It's been hard. I cannot say it's been easy.”

On a hot August morning, Romero took time from his job at a Beaufort tomato packinghouse to represent many of his fellow migrants at an opening ceremony for a new medical clinic run by Beaufort-Jasper-Hampton Comprehensive Health Services, which operates eight medical clinics and nine school-based clinics in the three counties.

The clinics primarily serve the poor but take anyone who comes.

Normally, it's hard for migrants to get medical assistance, Romero said. “In Florida we can't get this kind of help. ... We're blessed here. It's beautiful to come to a place where we get help.”

He said most of the migrants he works with came from Mexico, some from Guatemala, and many arrived illegally. In most places they're on constant edge, but not in Beaufort. “When they come here, they are not scared,” Romero said.

He encourages them to go to the clinic for treatment, and to prevent controllable ills from becoming major, diabetes in particular. “They are hard-working people. If I can do anything to make the people I work with better, I try.”

Roland Gardner, chief executive of Comprehensive Health, said the service runs on a $16 million budget, $6 million a year from the federal government and the rest in grants and fees charged to patients on a variable scale depending on ability to pay.

Because of the federally financed health service and the upscale growth in Hilton Head and Blufton, Beaufort County ranked in a recent national study as the state's healthiest.
The state provides the three-county health service the same amount of money it has each year since the center opened more than 40 years ago — next to nothing, Gardner said.

That's not all that surprising, considering that the state also provides very little of its own money to its own state health department.

Dr. Lisa F. Waddell, deputy director of preventive services at the Department of Health and Environmental Control, said most of health service's programs operate on federal money, usually for specific programs.

Just 16 percent of the health department's more than $300 million budget comes from the state. The federal government puts up most of the money.

If the federal money went away, the state's health services would face “big challenges,” Waddell said.