The uninterrupted corn stalks that line Interstate 65 north from Louisville and south from Indianapolis are bleak sentinels for Austin, a lost town surrounded by a lost county.
Austin is haunted and hurting and filled with heartless hustles.
This is the state’s far southeastern underbelly. Indiana mostly forgot Scott County, although it’s not the only place.
About the same time Indiana lost interest in Scott County and its 23,000 souls, easy drugs came to town. It was a plague.
In Austin, 30 bucks buys an Opana tablet that can be liquefied and injected. It’s an opiate. Drug couriers on I-65 relish the market. The drug is worse — or better — than heroin, depending on your reference point.
Austin has 4,300 residents. Few make more than $20,000 a year. Not many jobs. Not much health insurance, even if there were health care to buy. People are poor and unlikely ever to be otherwise.
You’d leave Austin if you had somewhere to go.
Indiana has a dozen or so left-in-the-rear-view-mirror counties like Scott. Whatever prosperity ever existed has blown away. This is the dark, often desperate Indiana of 2015. No cheery television marketing for Austin.
But the 160-and-counting active HIV cases there constitute a shocking epidemic inflicted on people who have little else but their addictions. One quarter of residents live below the poverty line. Another quarter is close to the precipice.
But Austin was not as helpless four years ago. That’s when the state General Assembly declared culture war on Planned Parenthood and made Austin a casualty of that combat.
Conservative political forces in Indiana were driven by religious fervor to gut all public funding from Planned Parenthood. They led the nation in demonizing the organization because 3 percent of its services involved reproductive services — abortion.
To sterilize that contagion, the remaining 97 percent of Planned Parenthood services would be expunged as necessary collateral damage. Private interest became public mandate.
The people of Austin bore that burden for Indiana’s War on Planned Parenthood.
In 2011, Planned Parenthood ran five rural clinics in Indiana. They tested for HIV and offered prevention, intervention and counseling for better health. The one in Scott County performed no abortions.
Mothers-to-be in Scott County must drive 50 miles to visit a gynecologist or an obstetrician. That’s not an isolated insight. Of Indiana’s 92 counties, Scott County has ranked 92nd in unhealthiness for five straight years.
Fewer high school kids there go to college than anywhere else in the state. There is one mental health provider for every 3,500 residents.
There is one physician in town. He saw the HIV outbreak coming and begged the state for help.
The General Assembly was too preoccupied before 2013 trying to defund Planned Parenthood and finally succeeded despite court objections.
Scott County has been without an HIV testing center for two years. That’s how long it took the epidemic to flourish.
Now the Centers for Disease Control and Prevention and anti-AIDS medical forces and foundations have descended there with $1 million in support, counseling and medical treatment. That gives the town a fighting chance to face the plague.
Though Gov. Mike Pence belatedly recognized Scott County’s fate and agreed to a free needle-exchange program to stop the wildfire, few have come to grips with what happened there and more particularly why.
And why it might happen elsewhere. Scott County is not unique in Indiana.
Health services in rural Indiana always have leaned on good luck rather than resources. Poor patients avoid the doctor’s office, but rural HIV outbreaks often result from missing “infrastructure:” counselors, nurses, testing.
Austin was a deep ditch of poverty just waiting for opioids to arrive. Users can illegally purchase drugs such as Opana in liquid form and reuse needles to save money. The risk of HIV infection multiplies. It did there.
The number of opioid-related deaths in Indiana spiraled from 200 in 2002 to 700 in 2012, according to the Indiana State Department of Health.
That’s what happens when a state pays no attention.
The public’s HIV treatment bill for Austin will run $200 million once the epidemic peaks — at least $1 million to save each uninsured patient, health experts say.
It’s the price of inattention and indifference.
For at least once in its life, Scott County will be remembered.
David Rutter is a writer for the (Merrillville) Post-Tribune. Send comments to [email protected].