To illustrate the dire need for better health care, David Toland holds up an item familiar to anyone who has visited a gas station or grocery store in rural America: an empty pickle jar.

Those jars collect money for all manner of medical problems: neighbors with cancer, pastors with kidney disease, families with insurmountable medical bills.

“We pay for healthcare in the richest society in the world by putting nickels in a pickle jar,” Toland, the CEO of Thrive Allen County in Kansas, told participants at the National Rural Assembly in Durham, North Carolina, this week.

One of the biggest obstacles to effecting positive change in a rural community is the notion — often promoted in coffee klatches at those same gas stations and grocery stores — that most efforts will fail.

Toland has a sort of formula for combating those notions: Ask community members what changes they would like to see; start small if necessary; build on what community members suggest.

In other words: Tackle one problem at a time. Small successes, like mowing some troublesome ditches or putting up a stop sign, breed larger ones, like building a new critical access hospital, as they did in Allen County.

“Action removes doubt,” he said.

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