YANCEY COUNTY, N.C. (WBTV) — Up a mountain dirt road inside one of Yancey County’s worst stretches of devastation, two paramedics check on a cancer patient on Monday.

The patient’s delicate medication stays cool thanks to a generator; many parts of the county still don’t have power, running water or cell service.

Maintaining the patient’s access to medication and health care is just one of hundreds of similar jobs that have kept Evan Carroll and Nicole McKinney working at a breakneck pace since Hurricane Helene passed through the county two and a half weeks ago.

“There’s so many needs,” Carroll said. “It’s a blur at this point.”

Carroll founded the county’s community paramedic program, a resource that had just expanded a few weeks before Helene with the addition of McKinney.

Together, their patient list has doubled since September 27. Across the county, it’s McKinney’s personal side-by-side that carts the two over unstable makeshift bridges and around road blockages.

“We’ll go pick [prescriptions] up, get them to the pharmacy to get them filled, get them back out to them,” Carroll said.

“If they have other needs when we get there we’ll address those; we’ll triage whatever acute illness they may have. Call in an ambulance; medivac if needed.”

Carroll has called Yancey County home since his birth; McKinney has lived in neighboring Mitchell County for the past eight years. Helene upended their own lives; McKinney’s toddler went thirteen days without a hot bath.

“This isn’t a job that’s done for money,” McKinney said. A pastor’s wife, the little time she’s had off since Helene has been filled with volunteering and cooking meals for others. Her job the past two weeks has taken its toll.

“You’re not just holding on to what your needs are, you’re also holding on to what everyone else needs.”

At the USPS’s last update a few days ago, 15% of the county’s post officers were still closed, with the same percentage of deliveries not made. The gap in postal service has been particularly acute for patients who rely on it for mailed medications.

“There’s a good percentage that rely on the post for that,” Carroll said.

Perhaps more acutely, the lack of power and water for many means fresh hurdles for their health care. Medications that need refrigeration or have to be taken alongside special foods are a challenge; getting patients the gas needed to keep their generators running is its own challenge given the state of the roads.

“It’s like bombs have went off,” Carroll said. “Complete and utter devastation.”

Running water has medical officials concerned about new health risks. Water can become contaminated with bacteria that can cause gastrointestinal illness, Dr. Zach Moore said, the North Carolina Department of Health and Human Services state epidemiologist.

“A very serious concern,” Moore said, “Especially with the flood water that unfortunately does contain a lot of things, including human and animal waste.”

According to The North Carolina Department of Environmental Quality, 9 counties still have water system failures, with some towns reporting that it will take at least several weeks to restore their water systems.

Bottled water is being distributed in most communities with water system failures. Dr. Moore encouraged people without access to bottled water to boil water to remove bacteria that can risk infection – not just for drinking, but also cooking, washing dishes and preparing infant formula.

Even wells aren’t necessarily safe.

“It’s really important if you’re in an area that’s had flooding that you disinfect your well and get it tested before you start using it again,” Dr. Moore said.

Carroll and McKinney have been displaced from their normal office and temporarily work out of the field hospital at the Burnsville Fire Department.

That hospital has been a vital resource since it was established by local nurses the Saturday after Helene hit, particularly when pharmacies were still closed.

“They were able to get doctors in to write those prescriptions,” Carroll said of the hospital. “[They] had medications with them that were able to fill those prescriptions.”

The long days have worn on the two paramedics. A sudden storm Sunday night startled Carroll to his feet, flashbacks in his head of Helene as he thought: “Who do I need to help?”

The storm triggered trauma across the county; McKinney’s phone flooded with notifications as gusts of wind and a torrential downpour blazed across a county still reeling from the storm that took the lives of at least a dozen and leveled scores’ more homes.

One of their pre-Helene patients still hasn’t been accounted for. Search and rescue efforts in the county have shifted towards recovery of remains.

“We drive by this house and this little old man‘s always sittin’ on his front porch,” McKinney said. “Then you drive by there and that house doesn’t even exist. So then you start down the whole path of, ‘Well did he get out? Is he okay? Has he been found? It’s a lot.’”

Carroll has talked little about his own loss.

One of his closest high school friends, one who was ‘always there’ when Carroll needed him, is among the lives gone.

He’s quiet when asked about it.

“I’m still in ‘help others’ mode.”

Maggie McCabe contributed reporting.

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