Rural Area Broadband and DSL Access

One of my most important tasks over the past 10 years has been coordinating rural community Internet access. Over the years we've had to development Community Technology Literacy Skills curriculum and GIS tools that rural area residents can actually work with.

What is the reality of bandwidth in your rural areas? Is DSL available throughout your entire region? I have found that most of the rural communities I work with, including the one where I live, still have no DSL or broadband available. For a price we can use satallite access but why, with all the technology in America, do we still have rural communities using dial up to get to education, telemedicine and community emergency management information?

If you have experience with rural bandwith and rural Internet access let us know what you have learned.