St. Jude Hospital serves the southern third of St. Lucia, which is the more rural and economically challenged area of the island. Housed in an 8,000 seat stadium since 2009 after a fire destroyed everything surgical and killed 3 patients, the institution gets by on government funding of salaries for local health care professionals, donations from off island and, partially, by patient payments.
I will bring donated supplies, attend orthopedic clinic, cover the emergency room, perform elective and emergency surgery, do consultations and teach house officers during my visit.
There is a long tradition of volunteer health care provision at this hospital, creating an elevated standard of care. The local staff is well trained and eager for the experience to interact with physicians from abroad.
The most significant operation I've performed in my 37 years doing orthopedics stemmed from an accident that occurred the first day I ever volunteered in St Lucia on 2002. It pushed my envelope way beyond my expectations, I had to "make do" and I maintained contact with the patient who has become a true friend over the years.
The 12th experience, like all the previous, was unlike all the previous. It was a combination of connecting and re-connecting. Here are some snippets:
It was great to hook up with the patient who had the most significant operation I’ve performed in my 36 year orthopedic career on the first day of my first day ever volunteering (2002). I was forced to repair a hip fracture/dislocation with a socket in multiple fragments. I had always referred an injury like this to the level one trauma center and always have since then. I had no experience with the injury, no pre-op planning and no intraoperative imaging. His name is Gibson and I was all he had. Ten years after the injury, we climbed the 2,600 foot Gros Pion St Lucian icon. He had never done that and he had no problems with the rigorous climb. The picture we took at the summit was at what has been the best moment of my career.
We spent a lot of time with 68 year old “Sissy” who was also a patient of mine in 2002 after a van backed into her as she sat on a wall and broke both her femur and tibia. I had to rod her femur without imaging in the OR and, as a consequence of flying blind, had to supplement her rod fixation with an improvised augment. Her x-ray shows something no one has seen before or since! She makes the most unbelievable roasty, toasty coconut oil by hand with nuts that she drags from her mountain side stash. It takes her all day to make 8 750ml bottles of oil. Great for cooking and just look at her skin!
The challenge of treating a severely crushed hand bone involving the joint is daunting no matter where one is. This trip, I met Ras whose car accident injuries resulted in a pneumothorax and 4 broken ribs, a hip socket fracture (not unlike Gibson’s but not as bad), a ruptured spleen requiring an emergency splenectomy, a clavicle fracture and a hand fracture. I had seen a technique as a resident which used bone cement to make a home made external fixator. Again, without x-ray in the operating room, we fashioned a device which gave him a better chance that his grip would be strong, functional and, hopefully, pain free.
We celebrated with 11 year old Kimberly who drew my attention in 2009 when she was 4 years old and had a very obvious case of Blount’s Disease, affecting the growth plates of both legs just below the knees. After several unsuccessful attempts to correct the problem surgically in St Lucia, we facilitated her having corrective surgery at the Shiners Hospital in Philadelphia in 2015. She and her mom visited us in Maine over Christmas that year and, though her left leg needs a little adjusting this year, she’s doing fabulously well.
Seeing our growing Kimberly whose life is now more “normal” and her family, creating ways to help people in need just for the pleasure of it, connecting with “old friends” who warm our hearts with memories and their happy presence reinforces that I get more than I give when we go to volunteer in St. Lucia.
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Health Volunteers Overseas is a nonprofit organization working to improve global health through the education, training and professional development of the local health workforce in resource-scarce countries. Visit www.hvousa.org to learn more
