St Jude Hospital

St. Jude Hospital, managed by Mercy Hospital Medical Centre, Des Moines, Iowa, is about four miles northwest of the coastal town of Vieux Fort, in southern St. Lucia. It is owned by the St. Lucian Government and until 1992 was managed by the Sisters of the Sorrowful Mother.

The 110-bed hospital has medical, surgical, maternity and pediatric wards, two operating rooms, recovery room, intensive care, emergency room, pharmacy, laboratory, x-ray, ultrasound and physical therapy.

In 1998, the hospital admitted 4,851 patients, recorded 932 live births and conducted 1,025 operative procedures. There was a total of 31,452 outpatient visits.

Outpatient clinics include general medical and maxillo facial. Specialty clinics for general surgery, orthopedics, ENT, OB-GYN, dermatology, cardiology, rheumatology, internal medicine, pediatrics, diabetic and psychiatric care are also held regularly.

St. Judes provides high-quality primary care for the largely rural southern half of the island but its specialty care services the entire island. The hospital employs about 200 local staff, including 14 full-time physicians.

The St Jude Hospital is partly government funded and partly funded by patients paying up-front (in advance) for each item of service and consultation that they receive. Many patients do not pay for these services (eg 'paupers', government workers, hospital workers, police, prisoners). In addition to this, many people who are expected to pay may default on considerable parts of their bill.

The health service provided at St Jude Hospital is therefore cash-limited. This means money that is spent on one patient is unavailable for another patient and this has considerable implications. The concept is quite foreign to many volunteers, and so, whilst you are working at St Jude please remember the five following points:

For those patients who pay, the cost of their health care can be a considerable personal burden to them, with a visit to hospital easily adding up to 10 or 20% of their monthly wage.

For those who don't pay, the cost is borne by the hospital who of course pass that cost on to the patients who do pay!

St Jude is not the only source of health advice and care on the island. As well as facilities in Castries, each village has its own private general practitioner and each district has a government run health centre which is 'manned' mainly by nurses but also intermittently by well trained local general practitioners. These health centres provide diabetes advice, insulin, act as the family planning and sexually transmitted disease clinics (where HIV testing is done) and also run a very efficient Pap smear programme.

Vieux Fort also has a private clinic where many of the hospital practitioners hold private clinics. Bush Medicine is often the first type of treatment many St Lucians may resort to and it varies from mild herbal infusions to potent purgatives..

English is the official language of St Lucia but some of the older people may not speak it well, or at all in some cases. Most people, however, speak English as their first language. Because of St Lucia's colourful past, there are many idiosyncracies which derive from Spanish, English, French and American influences over the years.

English	St Lucian
Chest	stomak/lestomak
Low Back	waist
Cough	spit
Allergy	"have you ever had any pills from a doctor that have made you sick?"
Stomach	chest
Ill	sick
take (pills)	drink
medicine	pills
tendons/ligaments	veins
any intractable pain	gas
stool/faeces	poop/pooh/kaka
it helps the pain	it gives me a chance
cross	vexed
wait a while	just now

St. Lucia is a delightful little island in the southern Caribbean. It has a population of 151,000 on an area of about 238 square miles. The climate is ideal, with year-round temperatures ranging from 80 - 88 F (28 - 32 C). In the rainy season, between May and November, there are frequent showers and occasional torrential downpours, although the average rainfall during the 'dry' months of February, March and April is 9 cm per month. There is almost always a pleasant breeze. The hurricane season lasts from August to November but St Lucia has not had a serious hurricane since 1980.

In order to enter the island, a return ticket is required. There are direct air services from London, the U.S., and Canada with BWIA, British Airways, American Airlines and Air Canada. (Volunteers are required to pay their own transportation if staying fewer than 3 months).

Most international flights land at Hewanorra Airport, which is conveniently located only five miles from St. Jude Hospital. Landing at the other island airport, in the capital, Castries, is not recommended. A taxi to St. Jude from this airport costs $55 U.S. and takes about one hour.

Getting Around the Island: Public transport is available at reasonable cost. Cars may be rented but a local driver's licence (U.S. $12) is necessary if the person does not have an international licence (usually less expensive). Volunteers may use their own bicycles, provided they are equipped with brakes, light, horn and reflector. The terrain is hilly and the roads somewhat narrow and often in poor condition, although many roads are currently being resurfaced.

Currency: The monetary unit is the Eastern Caribbean Dollar (EC). One dollar U.S. is worth about $2.65 E.C. Exchange at the hospital or local banks is readily available and rates are comparable. Cash or travellers cheques may be exchanged, but there is a slight charge for the latter. For volunteers staying for longer periods, there is a Barclays and a Scotia Bank in Vieux Fort. Accounts can be opened here and for those people who are to receive a salary, the money can be automatically credited to you account each month.

Electrical Current: The hospital is on 110 volt, 50 cycle (U.S. is 110, 60 cycle). The rest of the island is on 220 volts. All appliances work well at the hospital, with the exception of electric clocks.

Immunisation: None required. Current tetanus shots and hepatitis B shots recommended. Malaria prohylaxis is not required.

Accommodation: Dormitory-style units are available on the hospital grounds for volunteers and short-term full-time staff. Four or more people share bathroom facilities and some units have hot plates and refrigerators. There are a few hospital-owned apartments available and there are several small hotels in the area which offer rental units. Housing on the hospital grounds is provided, as are the meals served in the hospital cafeteria. Some volunteers may wish to bring relatives and friends who are not in their immediate and dependent family. In these circumstances, accommodation is dependent on availability. A nominal charge is payable by volunteers to the hospital to cover hotel expenses. Further details are available from the administrator regarding charges levied for family and non-dependent relatives.

Schools: Children of volunteers may attend local schools which operate on the British system. Eighty per cent are Roman Catholic and uniforms are worn. Between ages five and 12, most students choose to attend the elementary school in the local community of Augier. Secondary schooling for ages 12 - 16 is available at the Vieux Fort Comprehensive School in nearby Vieux Fort. (Anyone wishing to contact volunteers who have had children in the school system should e-mail Dr. Don Fockler or Dr. Tim Coker. (Both of these doctors had children in the local school but both left the island in 2000)

Pets: Not permitted. There are dogs on the compound, but feeding them is discouraged so as to not attract the many other local wild dogs.

Mail and Telephone Services: Mail service is slow. It takes 10 - 14 days for mail from the U.S. to arrive and up to three weeks, in the other direction. Most people send letters and cards with departing volunteers so it is a good idea to have a supply of U.S. or Canadian stamps on hand.

St. Jude Hospital is well equipped with telephone services. Outside calls can be transferred to living quarters as well as to hospital departments between 7:30 a.m. and 11:30 p.m. AT&T. Sprint, Global, British Telecom, and Cable and Wireless telephone credit cards are honoured on the island. Canada Direct service is available.

Clothing: Light-weight, casual, washable, non-iron clothing and swimwear is recommended. Shorts may be worn off-duty but pants and skirts are required in the hospital. Laundry dropped off before 8 a.m. can be picked up that afternoon Monday to Friday.

Essentials: Insect repellent, sun screen, a flashlight and ear plugs, if you are bothered at night by barking dogs and loud music. Also, for professional use, you should bring an ophthalmoscope, oto (auro) scope, ball point pens, name badge and stethoscope.

Recreation: St. Lucia has beautiful beaches and water sports of all kind are available not far from the hospital. Sandy Beach, only 20 minutes by public transport or 25 minutes by bike, offers scuba diving, windsurfing, parakiting, sailing and water skiing. It is advisable to bring mask, snorkel and flippers for diving, but all these can be bought locally at low cost in Anse Chastenet.

At the hospital, a library, TV, games and informal social interactions provide entertainment and relaxation.

In the first place, if you are interested in working at St Jude's, or wish to have more information, please e-mail or write to the administrator, and include your resume or curriculum vitae.

With your reply from St Jude's, you will receive a 'volunteer application form', an application to join the medical staff, and a form with Schedules A and B. There will also be a request for you to provide copies of other personal and professional documents.

Applications for registration must be on file at the Ministry of Health two months before the doctor expects to arrive in St. Lucia to allow time for processing. This means that the documents must arrive at St. Jude a few weeks earlier than this so they may be reviewed and passed to the Ministry by the required deadline.

You will need to enclose the following when you return the three completed forms mentioned above:

Re-registration: Copy of current licence to practise (medicine) should be sent to St. Jude prior to arrival.

Nurses must apply for licensure directly to the General Nursing Council
Box 1443
Castries, St. Lucia

Non-medical volunteers: A variety of tasks are performed by spouses and other family members who accompany the medical volunteers. Some people work in clerical or administrative support positions, others in laboratories, as gardeners, in patient service positions or the gift shop. Volunteer service by family members is not required, but is encouraged.

As soon as the paperwork is completed, please try to give a date on which you will be able to commence work. Please also state the date at which you intend to finish work in St Jude's.

Life in St. Lucia