Live in Eastport, Maine, and you are the first in the US to see the sun rise, among the fortunate few to watch whales or witness the largest whirlpool in the Western hemisphere, and—if you love mustard—able to savor a sample produced by the last remaining stoneground mustard mill in America. And Eastport’s harbor, the deepest natural one on the Eastern Seaboard, never freezes over.

Eastport’s people are hardy and resilient, some say. But they are not hale. Indeed, Washington County, where Eastport is situated, ranks the lowest of Maine’s 16 counties in health outcomes, from length of life to quality of life. Not surprisingly, the county also ranks lowest in the state in social and economic factors, including poverty, income inequality, and violent crime. Its population has declined from more than 5,000 in the early 1900s to 1,331 in 2010, mostly the result of the death of a once-burgeoning sardine processing industry.

But Eastport has a critical community asset: Eastport Health Care, a 40-year-old nonprofit community health center with the mission of providing access to high quality healthcare regardless of a person’s ability to pay. This clinic provides a true range of services to its nearly 6,000 patients, including primary, dental, psychiatric, and nephrology care. The clinic is able to make health care available to all because it is a Federally Qualified Health Center (FQHC), one of 1,400 in the country serving more than 28 million people.

Here’s where the creativity, persistence, longevity, and even flexibility of a true community-based institution like EHC comes in:

Community Circles. Since 2011, Eastport’s clinics have convened nearly one hundred community circles, a model that honors and empowers the peer voice, demands attentive and responsive listening, and promotes community engagement.

Making Access Easier. Transportation is a problem for many rural residents, and EHC has “patient-navigators” who manage the many pieces involved in accessing health care.

Attracting Staff. EHC believes that an awareness of eastern Maine’s distinctive local culture is key to both attracting and retaining personnel.

The median age in Eastport is 54, compared with 45 for Maine, which has the highest median age in the US. EHC installs grab bars and smoke detectors in homes with elderly residents, registers caregivers with the police and EMS to facilitate quick responses during emergencies, and has worked with the city to improve sidewalks, install street lighting, put safety rails along steep inclines and place benches for people to stop and rest.

These are not high-tech, complex responses to a rural community’s deep-seated challenges, but remedies that emerge from deep community engagement, cultural respect, longstanding partnerships, a viable business model and transparency—the marks of a respected and effective community-based institution like Eastport Health Care.

Read the full article about simple rural healthcare solutions by Debby Warren at Nonprofit Quarterly.