Appalachian Figures
On a summer morning in 1982, patients arrived at Mud Creek Clinic and found only ashes. The small community clinic in Grethel, Floyd County, had burned during the night in a suspected arson fire. Instead of closing the doors, Eula Hall dragged a picnic table under a willow tree, called the doctor, and started seeing patients in the yard. When the staff realized they had no telephone, she convinced the phone company to wire a line straight to the tree so the clinic could keep calling in prescriptions.
That image of a phone nailed to a tree captures why neighbors, journalists, and scholars have spent fifty years trying to explain Hall. Born poor in Pike County in 1927, she called herself a “hillbilly activist,” a woman who would fight strip mines one week, Medicaid bureaucracy the next, and domestic violence whenever it crossed her path. She is best remembered as founder of the Mud Creek Clinic, now the Eula Hall Health Center, but her life threads through the War on Poverty, the welfare rights movement, black lung struggles, and the rise of community-controlled health care in Central Appalachia.
What follows is an attempt to tell her story in the spirit of Appalachian public history, leaning first on her own voice and on contemporary documentation, then on later scholarship that has made sense of her work.
“You Ain’t Got No Life”
Eula Riley was born on October 29, 1927, in Joe Boner Hollow near Greasy Creek in Pike County, Kentucky, the daughter of tenant farmers Lee D. and Nanny Elizabeth Riley. Her parents raised a large blended family in a rough coalfield economy. Childhood meant farm work, hauling water, and watching neighbors get sick in houses far from medical care. In later interviews she remembered children whose skin peeled from untreated staph infections and neighbors who died for lack of a simple shot.
Formal schooling ended early. Eula finished eighth grade at Greasy Creek Elementary, but the nearest high school was more than twenty miles away over difficult mountain roads. The family could not afford the time or travel, so she went to work. At fifteen she left the mountains for a wartime canning plant in Ontario, New York. When she complained about dangerous conditions and pushed co-workers to demand better, management accused her of “inciting a labor riot” and sent her home.
Back in eastern Kentucky she worked as a domestic servant in Floyd County for families that boarded miners and oilfield workers. There she met her first husband, coal miner McKinley Hall, and married at seventeen. All five of their children were born at home. One baby died in infancy and another was born premature and deaf, experiences that sharpened her anger about the lack of basic health care.
In later life she described nights walking home past company houses where miners with black lung sat on porches, coughing in the dark, too short of breath to sleep inside. That sensory memory of fear and untreated disease, more than any policy paper, was her first education in public health.
War on Poverty and “Hillbilly Activism”
When President Lyndon Johnson’s War on Poverty reached eastern Kentucky in the mid nineteen sixties, Eula was ready. She joined VISTA, then became one of two local workers for the Appalachian Volunteers, a controversial anti-poverty group that moved from tutoring and home repair toward grassroots organizing.
From there she helped build Highway 979 Community Action Council and the Eastern Kentucky Welfare Rights Organization, which linked poor white families on Mud Creek with a wider welfare rights movement that was often led by Black women in Kentucky’s cities. Oral histories collected by the Student Health Coalition and Council of the Southern Mountains show her learning to file appeals, confront local officials, and turn personal knowledge of food stamps, Social Security, and public assistance into a kind of lay law practice for her neighbors.
She also stepped into coalfield politics. In the late nineteen sixties and early nineteen seventies Hall joined the Kentucky Black Lung Association, eventually serving as its president, and marched with miners and their families as they demanded recognition of coal dust disease. Appalshop’s memorial later recalled that she had already been charged with inciting a labor riot as a teenager and never stopped confronting power on behalf of workers and their children.
These years forged the persona that People magazine and regional journalists would later popularize as “Kentucky’s Godmother to the Poor,” the plain spoken woman who would sit with a neighbor at a welfare hearing one day and host national civil rights leaders the next.
“Sick for Clinics” on Mud Creek
The health work that made Hall famous grew directly out of those welfare rights battles. In Floyd County the federal Office of Economic Opportunity funded a “comprehensive health services” program that mainly paid private doctors to see poor patients and provided transportation, but offered little real care on Mud Creek itself. Hall and her allies in the Eastern Kentucky Welfare Rights Organization argued that the program was top down and unresponsive. They pushed for a clinic that their community would control.
The struggle is documented in a 1978 Southern Exposure article, “Mud Creek, Kentucky: Sick for Clinics,” which prints a long interview with Hall and clinic administrator Pat Little. They explain how Welfare Rights activists worked to cut off funding for the old program, fought for representation on new health boards, and began to imagine a clinic that would be accountable to local people rather than distant professionals.
At the same time, Hall was building ties with young medical activists. In 1970, as president of the Eastern Kentucky Welfare Rights Organization, she invited the Student Health Coalition, a project linking southern communities with medical students, to bring a health fair to Mud Creek. They came in the summer of 1971 and saw roughly five hundred people in a week, documenting high rates of untreated chronic illness and teaching residents how to read their own lab results. Student Health Coalition participants later remembered her as the driving force who turned that temporary health fair into something permanent.
Building the Mud Creek Clinic
In 1973 Hall and other community leaders finally opened the Mud Creek Clinic in a rented house trailer on Tinker Fork. The project grew from a fourteen hundred dollar donation and the volunteer labor of two local physicians from Our Lady of the Way Hospital in nearby Martin. As “Sick for Clinics” describes, the trailer was small, supplies were precarious, and staff had to fight constantly to recruit doctors willing to work with poor patients and to obtain reimbursements from federal programs.
When the clinic outgrew the trailer, Hall made a characteristic decision. She moved her husband and five children into a two bedroom mobile home and converted their three bedroom house into a six exam room clinic. The building sat within sight of the family’s original homeplace, but now people came from across county lines for care. Some traveled from West Virginia and Ohio after hearing through the grapevine that Mud Creek would not turn them away.
In 1977 the clinic joined Big Sandy Health Care, a nonprofit that operated clinics in neighboring Magoffin County and beyond. The partnership brought access to federal community health center funds and a larger network of providers while preserving the community governed spirit of Mud Creek. Over time the site grew into a full service primary care facility with dental, behavioral health, optometry, and pharmacy services, feeding into what is now a cluster of Big Sandy clinics across five counties.
Fire, Rebuilding, and the Tree with a Telephone
On a February night in 1982, fire destroyed the clinic building. The cause was widely believed to be arson. Wikipedia’s summary, supported by oral histories and local reporting, notes that her response was immediate. The next morning Hall and the clinic doctor set up a picnic table under a willow tree and saw every patient who showed up.
The Appalshop memorial captures the story of what happened next. When staff realized they needed a telephone to call prescriptions into town, Hall phoned the company and asked them to install a line at the tree. When the workers hesitated, she pointed out that they ran phone lines to mine sites on poles all the time and insisted that a health clinic deserved no less. The company wired the tree.
Rebuilding required new money. The Appalachian Regional Commission offered three hundred twenty thousand dollars for a new clinic if the community could raise eighty thousand as a local match. Hall organized radiothons, raffles, and endless soup bean and chicken and dumpling dinners, and she stood in the road with a collection bucket. According to later accounts, the community eventually raised one hundred twenty thousand dollars, enough to meet the match and equip a new lab and x ray suite.
The rebuilt brick clinic opened in 1984 and remains the heart of the complex that now bears her name.
“Citizen Caregivers” in the Coalfields
For historians like Jessica Wilkerson, Hall’s story illustrates what she calls “citizen caregivers,” working class Appalachian women whose caregiving roles pushed them into public life. Hall’s understanding of herself as a mother and neighbor never stayed inside the home. It shaped how she confronted strip mine operators, hospital administrators, and senators.
A review of Wilkerson’s To Live Here, You Have to Fight sketches the arc. It notes that Hall, the daughter of tenant farmers, endured marriage to a violent alcoholic, learned to navigate meager welfare programs, and became deeply involved in local anti poverty councils. Organizing for city water and better health care on Mud Creek, she and other women broadened ideas about who counted as a worker and what women were supposed to do.
In her own writing Hall pushed back against stereotypes of Appalachian people as passive and of Appalachian women as accepting abuse. In her essay “If there’s one thing you can tell them, it’s that you’re free,” published in Back Talk from Appalachia, she ties her activism to her decision to leave an abusive marriage, insisting that poor women in the mountains had both the right and the capacity to fight back. When she referred to herself as a hillbilly activist, she was reclaiming a label often used to mock her community and turning it into a badge of resistance.
Everyday Work at the Clinic
Day to day, Hall’s title at the clinic was social worker or social director, but those words hardly cover it. She helped patients file disability claims, applied for food assistance on their behalf, argued with utility companies, and represented people informally in court when they could not afford lawyers. Southern Exposure’s “Sick for Clinics” captures her deep knowledge of black lung benefits and Medicaid rules and the way she moved easily from exam rooms to county courthouses.
A 2019 profile in 100 Days in Appalachia found her still sitting at the clinic’s front desk at ninety one, directing staff and greeting patients. She told reporter Taylor Sisk that memories of preventable deaths from her childhood never left her and that if you live every day in fear that a sibling or child will be the next to die, “it is not living.”
That same piece ends with a simple line that Hall used over and over. Asked how she summed up the clinic’s mission, she answered, “We are just people that help people.”
Honors, Hallways, and Highways
Recognition eventually caught up to the work. In 1999 the Kentucky Women Remembered exhibit in the state capitol added her portrait, describing her as an Appalachian activist and health care pioneer who founded the Mud Creek Clinic and helped lead regional War on Poverty programs.
Over the years she received honorary doctorates from Berea College, Midway College, Pikeville College, and Trinity College, often sharing stages with national figures such as Archbishop Desmond Tutu. In 2010 the University of Kentucky’s College of Public Health inducted her into its Hall of Fame, praising her as a “living legend” who had devoted more than seventy years to improving health in eastern Kentucky.
In 2006 the Kentucky General Assembly renamed Highway 979, the road that runs through Mud Creek, as the Eula Hall Highway, formally attaching her name to the landscape she had spent a lifetime serving. Big Sandy Health Care now operates the Eula Hall Health Center as part of its network, and recent investments have built a new, expanded facility on the same hillside while keeping the original mission that Hall planted.
When she died at home in Floyd County on May 8, 2021, at the age of ninety three, obituaries from local stations like WYMT to national outlets such as the New York Times emphasized that she “never stopped” working and that people across the region felt they had lost a one woman relief agency.
Remembering Eula in Her Own Voice
For future researchers, the richest sources on Hall are recordings where she speaks for herself. The Louie B. Nunn Center for Oral History at the University of Kentucky holds a 1988 interview recorded for the “Appalachia: Family and Gender in the Coal Community” project, where she talks about childhood, gender roles, and early organizing, and a major 2020 interview in the “Health Care Advocates in Eastern Kentucky” series that covers the arc of her health justice work.
Berea College’s Council of the Southern Mountains collection includes an oral history titled simply “Eula Hall Interview,” along with a media reference collection that gathers clippings and recordings of her public talks. Richard Couto’s Southern Exposure article “Mud Creek, Kentucky: Sick for Clinics,” built around a 1970s interview with Hall and Pat Little, offers a contemporaneous window into the early years of the Mud Creek Health Project.
On film, Anne Lewis’s Appalshop documentary Mud Creek Clinic portrays Hall at mid career, juggling phone calls, listening to patients, and explaining why she believes good health care is a right rather than a privilege. Appalshop’s earlier Five Conversations about Violence and the short Ted Kennedy and Eula Hall also feature her reflections on poverty, power, and the day Senator Kennedy brought a Senate field hearing to Mud Creek.
Together with her essay in Back Talk from Appalachia and the many oral histories assembled by the Student Health Coalition, these primary sources let us hear not only her policy arguments but also her humor, stubbornness, and deep affection for her neighbors.
For historians of Appalachia, Hall stands at the intersection of several stories at once. She is a witness to the transition from company doctor medicine to community health centers, a key figure in Appalachian welfare rights and black lung activism, and a central example in Wilkerson’s argument that working class women in the mountain South reshaped both feminism and social policy through what they did in their own communities.
Mud Creek Clinic and the Eula Hall Health Center continue to treat patients every weekday on the hillside above Route 979. Every chart in its files, every black lung claim she helped file, and every child who grew up with a family doctor in Grethel instead of an emergency room in Pikeville is part of the legacy she left behind.
Sources & Further Reading
Interview with Eula Hall, June 14, 1988, “Appalachia: Family and Gender in the Coal Community,” Louie B. Nunn Center for Oral History, University of Kentucky Libraries.
Interview with Eula Hall, November 4, 2020, “Health Care Advocates in Eastern Kentucky,” Louie B. Nunn Center for Oral History, University of Kentucky Libraries.
“Eula Hall Interview,” Council of the Southern Mountains Oral History Collection (BCA 0110 SAA 110), Berea College Special Collections and Archives.
Richard Couto, “Mud Creek, Kentucky: Sick for Clinics,” Southern Exposure 6, no. 2 (1978), reprinted at Facing South.Facing South
Anne Lewis, Mud Creek Clinic (Appalshop, 1986).Mud Creek Medicine+1
Five Conversations about Violence (Appalshop, 1983) and Ted Kennedy and Eula Hall (Appalshop, 1983).AbeBooks+1
Eula Hall, “If there’s one thing you can tell them, it’s that you’re free,” in Back Talk from Appalachia: Confronting Stereotypes, ed. Dwight Billings, Gurney Norman, and Katherine Ledford (Lexington: University Press of Kentucky, 1999).WorldCat+1
“Eula Hall,” Student Health Coalition Archive Project, person page and “SHC in Mud Creek, Kentucky” narrative.Student Health Coalition Archive+1
Kiran Bhatraju, Mud Creek Medicine: The Life of Eula Hall and the Fight for Appalachia (Louisville: Butler Books, 2013).Wikipedia+1
Jessica Wilkerson, To Live Here, You Have to Fight: How Women Led Appalachian Movements for Social Justice (Urbana: University of Illinois Press, 2019), especially chapters on welfare rights and community health.JSTOR+1
Lane Windham, review of To Live Here, You Have to Fight, Journal of Working-Class Studies 4, no. 1 (2019).University of Wyoming Journals+1
Taylor Sisk, “Eula Hall’s Mud Creek Clinic: Kentucky’s ‘People That Help People’,” 100 Days in Appalachia, April 15, 2019.100 Days in Appalachia
“We mourn the passing of Appalshop’s longtime friend, Eula Hall,” Appalshop News, May 11, 2021.Appalshop
“Eula Hall,” Wikipedia entry, including references to People magazine’s “Kentucky’s Godmother to the Poor” and Seelye’s New York Times obituary.Wikipedia+1
“‘Hillbilly activist’ and healthcare pioneer Eula Hall dies at 93; founded Mud Creek Clinic,” Northern Kentucky Tribune, May 2021, and related regional obituaries.NKyTribune+1
“Eula Hall,” Kentucky Women Remembered exhibit, Kentucky Commission on Women.Wikipedia+1
“Hall of Fame Former Inductees: Eula Hall,” University of Kentucky College of Public Health.UK College of Public Health+1
Big Sandy Health Care, site information for Mud Creek Clinic and Eula Hall Health Center.BSHC+1
Author Note: