On March 14, 2020, after several restless nights of seeing news about COVID-19 and personal protective equipment shortages, Edie Culberson woke up at 5 a.m. to start working on a cloth mask pattern that has led to the creation of about 425 masks.
Culberson lives in Johnson City, Tennessee, in Southern Appalachia — a region known for its health disparities as an underserved region of the United States. As of Aug. 1, 2020, Appalachia has had a total of 233,631 positive COVID-19 cases and 5,197 deaths, according to the Appalachian Regional Commission and data from John Hopkins University.
Culberson began sewing with her identical twin sister at 11 years old, and has pursued the hobby ever since. Although she loves to embroider clothes for her grandchildren, she has now added sewing face masks to her daily routine.
“When I sew, I get kind of happy and makes me think I am helping some people out,” Culberson said. “I shudder to think how many masks have been thrown out. I see all these people in these white suits and I know they throw it all away.”
Culberson gave away the first 300 to places like nursing homes and churches, the rest to neighbors and other acquaintances. She makes these masks from her kitchen table, using a unique pattern based off a disposable mask she already had at her house.
“I was telling my husband today, I think I am getting addicted to it,” said Culberson. “I have just come in here in the dining room and I cut out 8 by 8 inch squares and put him aside and I just seem to be working on them at every spare moment.”
Culberson sews masks knowing the need is not going to disappear, and as a retired Science Hill High School math teacher, she also looks to find light in the midst of the novel coronavirus situation.
“I really feel like we are going to be wearing masks for a good while,” said Culberson. “I wonder if women will get to the place where it will be just an accessory like a purse or scarf, and you want to match your outfit? Who knows. You have got to find some humor in all of it.”
While people like Culberson are making masks, there are others like Wendy Welch, the Executive Director of the Southwest Virginia Graduate Medical Education Consortium, who are distributing them. In March of 2020, Welch began hiring local mask-makers and distributing homemade cloth masks to rural health clinics to protect patients from COVID-19.
Welch said clinics reached out to the Virginia Rural Health Association, whose director contacted her, saying they needed masks to give their patients. The clinics could not afford to give patients their surgical masks, and they did not have the resources to purchase cloth masks themselves. Welch’s organization decided to help.
“What I do is work to ensure that those programs get homemade masks because they have a lot of people coming into the clinic who are either fairly poor and because they are poor, they are really busy working,” Welch said. “Like, they work two jobs or they work all the time, or they are just—they are running to keep up and they cannot afford to shell out five bucks for their own mask which is kind of the going rate.”
Welch said about $10,000 of her budget was put toward the collection of all masks, including both cloth masks and N95's, with around $3,000 put solely toward cloth masks. Her organization has distributed a total of about 2000 masks—250 of which they acquired for free—into four health districts: LENOWISCO, Cumberland Plateau, Mount Rogers and New River Valley, which combined covers 21 counties in Virginia.
Welch pays the mask-makers from her budget, distributes the masks to the clinics for free and the clinics give the masks to their patients. She said she bought cloth masks from 10 different mask-makers across the region.
Bonnie Proudfoot, one of the mask-makers, is an author and semi-retired English professor from Athens, Ohio. Proudfoot was on the Appalachian Studies Association list-serve when Wendy put out the call for masks in March.
“I mean, immediately I thought everybody needs to do something if they can,” Proudfoot said. “And I am not a healthcare worker, and I am a schoolteacher and a writer. My book stuff was all cancelled. I had the time, and I thought I can maybe help people, especially when the call first went out. I mean, people were desperate for masks.”
Proudfoot began making masks by hand, but later transitioned to using a sewing machine she received from her son. She described the experience of transitioning from sewing by hand to using the machine as one that helped her realize what goes into making a mask and why people need them.
“I started thinking more about the material,” said Proudfoot. “I wore this mask I made, and I was on a bike path riding my bike, and I could smell people's colognes through the mask. I thought, ‘That is way too permeable.’ Then I realized, ‘Oh, I need to use this other mask that when you breathe in the whole mask sucks in.’ You know, and you realize, ‘Oh, that one's really sealing to your face.’ So, I started to realize what makes a better mask and the extent of the protection they can get from one, and I didn't want to take any chances.”
Proudfoot adopted the Deaconess face mask pattern, featuring a double-sided, pleated and cloth material. As the need for face masks increased, she also had to be creative in what resources she used after running out.
“A friend of a friend sent me elastic,” Proudfoot said. “I got through some orders with elastic from just the neighborhood network kind of thing and then I was using like whatever – rags and things around the house and like old PJ's and all that I didn't need the elastic, whatever I could strip elastic out of.”
Another one of Wendy’s mask-makers, Margaret Crites from North Carolina, had experience with crisis and recovery in local communities before the pandemic. Her hometown of Lumberton was hit by Hurricane Matthew in 2016 and again by Hurricane Florence in 2018.
For the last year, Crites has been doing research on hurricane recovery and community resilience with North Carolina State University. Something she learned from that research that she has been able to apply to the COVID-19 pandemic is the need to be ready to do tangible things during a crisis.
“Money is not always the thing a community needs,” Crites said. “I think that those kinds of acts help reassure people they live in a community that cares, or that there is at least a sense of community. Where I live, because we had Hurricane Matthew and Florence, the community was able to mobilize to help each other out. In the interviews, one of the things that we found that people really appreciated was that some of those normal barriers to helping a person in need fell away. We no longer cared if you were ‘deserving poor’. Everyone had been hit by the hurricane, everyone needed something. I think this pandemic is very different because I think there’s still very much an issue of haves and have-nots.”
Crites began making masks in early March 2020. She said she has made about 500 masks for Wendy’s organizations and about 150 more for family and friends – who she has asked to donate money to charities instead of paying her for masks.
Instead of donating money to charitable organizations, independent mask-maker Tricia Nguyen has donated masks to organizations like the Ronald McDonald House and Dawn of Hope, as well as the Neonatal Intensive Care Unit at the Johnson City Medical Center. Nguyen started crafting masks after feeling the need to contribute to Johnson City in a way that was bigger than just staying at home.
“The people I have given the masks to have been awesome because they needed them,” said Nguyen. “I donated about 30 to a friend who works at the [VA Medical Center] who heard her team were given one mask and needed to wear it over and over. For people like that, it is a huge blessing to have something you can at least wash, and it is hopefully a little more comfortable.”
Nguyen recollected a day where she gave someone a mask, and in return they gave her thread, which she happened to need at the time. She described this as a divine force that pushed her to continue to make masks.
“Everything that I was about to run out of somebody would give me,” Nguyen said. “I believe in God. Maybe it is coincidence, I do not know, but like every time I spent $20, I would get $20. Every time I needed to get some fabric, I would get fabric.”
Wearing masks has become a subject of debate within the United States. Nguyen has associated this conflict of interest with her own “let us not pee on each other” concept.
“If a naked person pees on you, you are going to get pee on you,” Nguyen said. “If you have on pants, you will get a little less pee on you. If you both have on pants, you will not get pee on you at all. So, this is kind of my philosophy right now is let us just try to keep as much pee off of each other as we possibly can.”
Nguyen said although she loves crafts, she does not actually enjoy sewing. However, her mother taught her how to sew a straight line, she knew how to use her grandmother’s sewing machine and she felt like she needed to do her part. Since starting to make masks, she said her lines have gotten straighter, and she plans to continue making them until she runs out of supplies.
“I feel like I have a role in keeping the people around me safe,” Nguyen said. “And so that is my motivation. I am going to make masks and hope other people that take them actually wear them, and I am going to wear one when I go around people.”
Nguyen, Crites, Proudfoot and Culberson all said they started making masks because they wanted to contribute to their communities in some way. While Appalachia is known for its health disparities, it is also known for its people’s resilience. Proudfoot said that Appalachians are the do-it-yourself type—artisans, artists, makers—which is why she thinks so many people she knows are making masks as well.
“I think it is a certain kind of person,” Proudfoot said. “The maker. The maker-spirit, right? And that is big in Appalachia, right? We are the independent type. So we try to figure out how to do everything.”
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