This summer, 5 million tourists will descend on 200 miles of remote North Carolina coastline. The Outer Banks are idyllic — and popular. But for both those visitors and the area’s 38,000 year-round residents, the vacation paradise has one serious problem: health care access.

Dare County Emergency Management Services evacuates about one person a day by helicopter. In the summer, that number can reach four or five.

Outer Banks Health Hospital in Nags Head, with its 21 beds, is the region’s lone hospital, and its capabilities and equipment are limited. The hospital evacuates another 15 to 30 people per month.
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On the island of Ocracoke in nearby Hyde County, for example, a ride in a helicopter or ferry is required to reach any kind of specialty, intensive or emergency care. Travel time to the mainland in a ferry can reach three hours, and that’s if weather permits

On the island of Ocracoke in nearby Hyde County, for example, a ride in a helicopter or ferry is required to reach any kind of specialty, intensive or emergency care. Travel time to the mainland in a ferry can reach three hours, and that’s if weather permits.

Some parts of the Outer Banks are more well-connected, but even there, travel times, and staffing shortages keep people from getting the care they need.

In an emergency, these limitations can result in life-threatening crises. It can take up to six hours for EMS services to respond to a call.

“We’re a rural area that deals with nonrural problems because of the amount of visitors we have,” Dare County EMS chief Jennie Collins told Carolina Public Press. “The population swells from 38,000 to 300,000 in the summer. Everyone that’s coming on vacation brings their problems with them.”

Tropical weather systems and storm surges create a further threat. The region’s singular artery, Highway 12, can flood, leaving residents completely cut off. Traveling over bridges in high winds poses its own dangers. And for a number of populated islands like Ocracoke, no road connects them to the rest of the world.

In the event of a storm surge, Hatteras residents rely on emergency ferries to transport them to beaches farther north, Roanoke Island or to the mainland.

The last time that happened was nearly 10 years ago, noted Sheila Davies, director of Dare County Health Department. But Atlantic hurricanes are getting more and more severe, due in part to warming ocean temperatures.

The area is popular with retirees, many of whom have cardiovascular diseases, lung cancer or other conditions that can cause moments of acute emergency.

Medical calls from people over 50 are the most common form of emergency calls to Dare County EMS, said Collins.

“A lot of times, someone’s doctor back home will say, ‘you need to go on vacation and rest and relax,’” Collins said. “So those people will come to the Outer Banks. And then they want to go for a walk on the beach. Well, that’s very much like a stress test.” And if it doesn’t go well, help is rarely at hand.