I watched disease and despair grip Austin. Now hope is breaking it free

A hard rain had just ended. Austin’s streets were still wet as I walked alongside residents marching to protest the drugs that overwhelmed their tiny rural town.

Some held hands. Some draped arms around each other. Some pushed strollers. All walked with purpose past Morgan Foods, the ice cream cone-shaped sign for the Dairy Queen and the “recovery wall” of names outside H2O Church on Mann Avenue.

I knew many of the 200 marchers from more than three years of covering their town of just over 4,000 people, epicenter of rural America's worst HIV outbreak caused by IV drug use. I met some during their struggles with addiction. But on the late-August evening of the Fed Up! march, everyone was celebrating recovery.

Austin Rising:Explore our coverage of a devastated town that found hope

My tears fell as I felt Austin's hope rising.

Almost on cue, a faint rainbow appeared in the still-threatening sky. We marched toward it, and the woman next to me, Sabina Adams, said: “God’s promise.”

Never again, it seemed to portend, would their world be devastated like it was in 2015.

That's when I first visited Austin. In February of that year, I learned that Indiana state health officials were alarmed about tests showing 26 confirmed and four “preliminary positive” cases of HIV, the virus that causes AIDS. Most had been caused by shooting up Opana, an opioid painkiller. Before that, the county had never had more than a handful of cases.

I wrote a story about the crisis for The Courier Journal and USA TODAY and followed up with others.

You may like: Read Laura's award-winning Healing Austin stories

As a longtime health reporter, I knew this would only get worse.

And it did.

The number of patients skyrocketed. In less than a month, cases more than doubled. Eventually, HIV would sicken 235 people, and Austin's HIV rate would be comparable to countries in sub-Saharan Africa.

In those first few months after the outbreak, despair was palpable. I remember watching haggard-looking young men walk past rundown homes on Rural Street, the most notorious stretch for drugs. Locals told me about women who sold their bodies to get money for drugs, sometimes to truckers who made a quick stop off the I-65 Austin exit.

Longtime residents pined for better days. They described growing up in a close-knit manufacturing town full of salt-of-the-earth people, a safe place where kids could ride their bikes without concern, where everyone kept a friendly eye on neighbors.

I could see the faded remnants of those Norman Rockwell days. Outside of the sketchy areas, Austin was still that picture of rural America, with stubble-filled cornfields and a one-stoplight Main Street lined by churches, shops and sidewalks. There were plenty of tidy, well-kept houses, some not far from dilapidated ones. Lots of people pitched in to help their neighbors. I sensed a deep love among many for their hometown.

Seeing that small-town soul trapped in such chaos resonated with me because I, too, grew up in a small town in my home state of Connecticut.

Of course some of the things that make small towns so wonderful can make disease outbreaks worse. When everyone knows one another, stigma can fester, discouraging people from getting tested or treated for HIV or seeking help for addiction. Disease can spread quickly when people share needles in close-knit groups.

In some Austin families, three generations shared needles — young adults, their parents and their grandparents.

During the early months of the outbreak, national and even international news outlets flew journalists in to do stories. Austin quickly became known for the outbreak — which hurt residents deeply. For the most part, the national attention faded before things started to get better. People in Austin grew leery of the press.

At the same time, some residents didn’t want to focus on the outbreak, clinging to what some in town called a longstanding reluctance to deal with such problems. As addiction took hold before the outbreak, Austin native Staci Mullins told me, “We turned a blind eye, willingly.”

Part one:An angel of Austin, music teacher lifts kids amid town's drug recovery

All this contributed to the skepticism I faced when I began reporting what would eventually become a three-part series called “Healing Austin,” which chronicled the outbreak and response through the lens of Austin physician Will Cooke. But over more than six months in 2016 and 2017, I gained the trust of many more residents. I reminded them I wasn’t one of those journalists jetting into their town for a day or two; I live about 45 minutes away. This is part of my community, too.

During those years, I described Austin as a place at the intersection of hope and despair.

And I saw plenty of both.

Addiction ripped apart the lives of hundreds of people, such as Johnathon Clark, an HIV patient whose head is caved in where his grandfather shot him with a .38 special when he tried to steal money for drugs.

And Polly Polly, who watched three sons fall into addiction. One died in a car accident, another overdosed on heroin but survived, and a third narrowly escaped HIV before going into recovery.

But the desperate needs of the community — laid bare so starkly by the outbreak — seemed to strengthen others' generosity, love, and faith. It reminded me of what happens during natural disasters when neighbors share food and electricity and help one another rebuild homes. For many in Austin, reclaiming their hometown from addiction and disease brought out their best.

Part two:Once a heroin addict, Austin pastor finds love greater than temptation

Paul and Becky Thomas were prime examples, running a dinner program for needy residents called Food 4R Souls at the Church of the New Covenant every Thursday. People from churches throughout town pitched in to serve chicken, chili, lemonade, love and prayers to anyone who showed up.

Cooke, who I'm now helping with a book about Austin, was another, doing everything he could to care for his patients, advocate for them with state and federal governments and help with community efforts like Food 4R Souls. Cooke closes every email with a quote from the book of Galatians that could be a mantra for all the helpers in Austin: "And let us not grow weary of doing good, for in due season we will reap, if we do not give up."

I could sense the spirit of goodness grow as I spent more time in Austin this year. And I began to see more and more signs of hope. There are the statistics: Most cases of HIV are well-controlled. More than 380 participants used the county’s syringe services program through late November this year. High school graduation rates are up, now exceeding 90 percent. The number of recovery groups has risen from three before the outbreak to 18 today, and membership in these groups has risen more than tenfold.

Then there are the people nurturing hope and inspiring it in others. We found people working to improve Austin by educating its youth, spreading a compassionate faith and building a culture of recovery. We figured they could be examples for all of the nation’s struggling, drug-plagued rural communities.

Covering the addiction crisis intensively since 2011, I know that any of these places could easily suffer a similar HIV outbreak.

About a year ago, I wrote a story on counties deemed by the federal government as most vulnerable. Kentucky contains more than any other state — 54 of 220 nationally — with Wolfe County in Appalachia topping the list.

Hopefully, Austin can provide a road map for all of these places on how to avoid a similar public health disaster and move past addiction.

Part three:After the crush of a meth arrest, an Austin teacher finds her light

Spending so much time in Austin, I’ve marveled at all of the connections between people. As our team reported this series, two stories intersected in an incredible way as a pastor we wrote about about in one came to the aid of a former teacher we wrote about in another as she tried to convince her son to go into recovery.

This reminded me how, in a much larger sense, we are all connected. It’s very clear when you cover health and disease: When one community suffers, the risk extends to other communities. So does the burden and the responsibility.

We’re all in this together. If our neighbors suffer, we suffer too.

For Austin, the suffering isn’t over. On the day of that Fed Up! march, the rain started tapping on my windshield as I pulled out of Austin for the drive back to Louisville.

Like every community in Kentucky and Indiana, Austin still faces formidable challenges.

There is still addiction.

There are still deaths caused by the scourge of opioids.

There’s still poverty and despair.

But at that intersection of despair and hope, Austin is now taking a different direction.

It is moving down the path of hope.

Laura Ungar: 502-582-7190; lungar@courier-journal.com; Twitter: @laura_ungar; Support strong local journalism by subscribing today: courier-journal.com/laurau.