If TriCounty Health Department director Joseph Shaffer had his way, the good people in his Uinta Basin area — and, indeed, in other small towns and rural areas — would invest their charitable dollars in their own community first, before giving to statewide or national charities. There's a lot of need in their own backyards.

And he's noticed, he says, that "once it's donated to a national organization, it has a tendency to leave the area and not come back."

It's not something I think much about; I'm a big-town girl. But when I called several direct-service programs in small communities across the state, I found the same sentiment and frustration repeatedly. They're struggling to take care of their own dramatic needs, on a smaller but no less important scale, and it's not easy to do.

Recently, Shaffer and I were chatting about the big hearts you find in small towns. His community not long ago raised a whopping $200,000 for the American Cancer Society's Relay for Life program, and he's proud of that commitment to giving. That one community alone raised a big chunk of what ACS says it gave Utah in the way of research grants last year.

ACS is just one of many statewide and national organizations that benefit from community fundraisers held in smaller towns. But the truth is, most of the money that comes back to Utah from any national charity will mostly go to the bigger communities along the Wasatch Front. Small-town folks may get little or nothing in the way of direct services. Still, as the organizations point out, researchers tend to be in those urban areas, and everyone benefits from research.

Shaffer recognizes all that. But he also knows the serious and personal needs his neighbors have, too. So while he wishes all the organizations the best in their funding efforts, he'd like to see neighbor take care of neighbor first.

A project that pointed the issue out to Shaffer is the Radiation Vacation van, a shuttle service administered by his department that provides transportation so that TriCounty residents who need to see a doctor at the University of Utah can get there. It started as a way to help cancer patients traveling to the Huntsman Cancer Institute or cancer hospital, who might be too sick to drive the distance. It has since expanded, recognizing that others have legitimate need for a ride and barriers to driving. All they require is a note from a physician showing an appointment at the U.

It's not a cheap program to run, although the administration costs are low. Record-high gas prices and the distance from Vernal and nearby communities to Salt Lake add up considerably. But as far as meeting a very concrete need, with direct impact on people you know, it's really hard to top, he notes. The program is providing needed transportation to 15 people a week who would be hard-pressed to make appointments without it. If it runs out of funds, a lot of people will be impacted.

It's just an example of neighbor helping neighbor. Other small towns statewide are offering their own helping hands to each other.

There are also opportunities for small-town programs and larger organizations to work together. Joel Kincart, regional vice president of ACS of Utah, recently told the me the ACS is going to list the Uinta Basin program with its National Cancer Information Center, although he said it will take some time to make that happen. That will help residents who know about the big cancer program but not the van service. There also may be grant opportunities for the smaller program with the national organization, as well, he said.

That kind of cooperation would go a long way toward boosting the real value of big advocacy programs to small-town fundraisers.

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