My nephew lives in a very isolated rural area on the east coast and I think you're overselling the "people in the community learn emergency medicine" part - he has no idea how to handle much more than stopping bleeding for a cut (his answer to any size cut is to slather it with antibiotic ointment, which the doctors then have to scrub out before they can suture) or maybe stabilizing a broken leg enough to move someone to the pickup truck.

Likewise, while he does repair things, I wouldn't say they are done well -- his electrical panel is a mess, I spent a couple weekends trying to help bring things up to code (and I'm not even an electrician), like replacing taped hand-twisted wire splices with junction boxes - the tape was melted on one of them from overheating.

He does own an impressive set of guns, but his car has a hole in it after accidentally shooting it while cleaning a loaded gun, so gun safety is not his strong suit.

He has a 4WD, but it's been a 2WD for the past couple years because he can't afford the parts needed to fix it, he cruises junkyards when he can to try to find what he needs.

His closest neighbor is a half mile away and lives in a glorified shed where the water comes in on a hose and electricity comes from a generator when he can afford to fuel it.

I can believe that there are well trained survival handymen out there who are well equipped to survive on their own, but I doubt that most isolated rural people are that well trained.