When Notre Dame de Namur Sr. Kathleen O'Hagan and St. Joseph Sr. Gretchen Shaffer arrived in Mingo County in 1976, nearly everyone was economically poor. Though four decades have passed since the pastoral letter by the Appalachian bishops, the region's underlying problem has not changed. Standards of living are higher, regulations have made coal mining cleaner, and unions have turned coal mining into safer, well-paying jobs, but the people still have little voice.