For the past 29 years, a Sumter couple, husband-and-wife physicians Joseph and Brenda Williams, have signed up their patients to vote.
"You come to the office to be examined, we register you to vote and tell you why it's important," Brenda Williams said.
So when the two read about a new state law requiring S.C. citizens to have a photo ID before voting, they knew they needed to get to work.
"I said, 'Oh my God, do we know so many people who don't have photo IDs, thousands of people who've come through our practice,' " Williams said. "These are decent, honest people."
Now, the two find themselves in the midst of a new voting-rights movement - one that seeks to ensure that the elderly are not turned away from the polls in November.
According to the S.C. Election Commission, 178,175 registered voters do not have photo IDs. Before now, pollworkers did not - in fact, could not, in recent decades - require one.
Joseph and Brenda Williams, born in Georgia in the 1950s, take the right and responsibility to vote seriously. They came up during a time in America when people of color were often blocked from voting.
So when they opened their Excelsior Medical Clinic in Sumter, they made conversations about voting a part of the medical exam. Brenda Williams estimates the couple has registered "well over 1,000" people to vote.
Joseph Williams has a practice focused on geriatrics. His wife has a general practice.
Between them, they began a nonprofit organization to renovate run-down housing, provide cellphones to senior citizens - and, now, help those without birth certificates get a photo ID. To sort through the birth certificate issue, they have enlisted the help of a retired family court judge, Ruben Gray, who has taken on 10 cases.
At first, Brenda Williams mistakenly thought they could just pre-pay for a passel of state-issued IDs.
She thought money would be the deterrent.
She put $200 into a checking account and headed down to her local S.C. Department of Motor Vehicles office to work out a system for sending patients by. "I thought all people needed was $5, go down to the DMV, and they'll take your photo. I was in for the education of my life."
Turned out, birth certificates were the problem.
For those who don't have a birth certificate, getting a state-issued ID is no easy task, although a spokeswoman for the S.C. Department of Motor Vehicles said there are a variety of records the agency accepts as proof of identification. (Also, the IDs are free for anyone 17 and older.)
Still, since the Legislature passed the new voter law this year, there has not been a surge in requests for state-issued ID cards. Spokeswoman Jean Smolen said 15,163 cards were issued over a five-week period ending June 30 of this year, compared with 15,026 during the same period in 2010.
The problem is this: Before the 1970s, many women in rural South Carolina didn't go to hospitals at childbirth. They used midwives. Often, though, midwives did not file birth certificates. Or their information might be wrong, or incomplete.
Going back to correct a name or collect the documents needed to get a delayed birth certificate is time-consuming and expensive.
Joseph and Brenda Williams have plenty of stories about people's birth records: The midwife who tried to sound out the name "Naomi," spelling it "Llnoie"; the child named "Baby Girl Kennedy" because her folks couldn't come up with a first name right away.
Other patients don't have birth certificates at all, simply using the year of their birth, said Joseph Williams, himself delivered by a midwife.
"It's a very common thing," he said, noting that such problems and practices were common throughout the South and involved black and white families alike.
Sure enough, 64 percent of S.C. voters without an ID are white, according to the S.C. Election Commission. About 53 percent are age 45 or older.
Nowadays, midwives are required to submit birth certificates within five days of a birth, said Tavish Brinton of Batesburg-Leesville, a long-time certified professional midwife.
"There was a shift in the training of midwives, and they required every midwife to be able to read and write," she said. "Before that time, births would be recorded in a family Bible ... but not every family had such a thing."