Dr. founds St. Lucia health nonprofit

By CANDACE CHASE

The Daily Inter Lake

Dr. Lisa Fleischer has stepped beyond collecting shoes for the impoverished island of St. Lucia to founding a nonprofit health organization to round up money and more volunteers for the island's hospital.

"We've got a lot of lofty goals but no money yet," she said.

Fleischer, a family practice physician at Big Sky Family Medicine, recently returned from a month-long trip volunteering her medical services at St. Jude's Hospital on the tiny Caribbean island.

For six years, she and her contractor husband and two children have spent their vacation as hospital volunteers. Before their third trip to St. Lucia, the Daily Inter Lake wrote about Fleischer's shoe-collecting efforts after her family had given away their own shoes during their second trip.

"When you're desperately poor, you have no trouble asking," she said in that article.

According to Fleischer, physicians working at the hospital make only about $16,000 a year. But that's big money compared to the islander's average income of about $3,500 U.S.

Even though people make little money, nearly everything, including water, is expensive on St. Lucia. Most items arrive by air or sea.

"Some things are cheap like coconuts," she said.

The physician described the island as about the size of Flathead Lake. A windward island about 1,300 miles southeast of Florida, St. Lucia is one of the lesser antilles of the Caribbean.

Surrounding islands include Martinique to the north, Grenada to the south, St. Vincent and the Grenadines to the west, and Barbados to the east.

The hospital resides in Vieux-Fort, a town on the south end of the island, sort of like Polson if Flathead Lake was an island.

"But it reminds me more of Ronan and St. Ignatius," Fleischer said.

The population consists of 90 percent black, 9 percent mixed races and 1 percent white. They speak Patois, a creole language she described as a combination of French and English with a little African thrown in.

"A lot of people speak English, but it's not the English we speak here," she said.

Tourism, slow to take over after the collapse of the banana industry, has finally begun to develop. Another less desirable trade, drugs, has also discovered St. Lucia.

With drugs, the hospital has begun to see occasional gun shot wounds. But most crime still involves nonviolent thefts.

"It's the poverty issue," Fleischer said. "As a lot of people get access to consumerism and its trapping see all the stuff and they want it. It's a sad thing."

Working mainly in the outpatient clinic, Fleischer said she sees infectious diseases, hook worm, trauma, high blood pressure and diabetes. Many diabetics end up with amputations due to their high carb diet and lack of medications.

The clinic also treats many cases sexually transmitted diseases like syphilis and gonorrhea. Medical officials fear a coming explosion of AIDS on the island.

"I had one patient die," Fleischer said. "He was very end stage."

Because of the stigma, people fear getting tested. Fleischer said a Peace Corps worker reported 250 cases with 53 in the last year in women 14 to 34.

The physician said the actual number of cases is at least double the number reported.

For this year's trip to St. Lucia, the physician rounded up HIV meds, baby blankets, hospital gowns, needles, syringes, sterile gloves and diabetic supplies. The very expensive Glucometer strips she bought herself.

She also hauled donated clothes and shoes along with tools her husband uses to make repairs then leaves with the maintenance people.

"A teacher from the high school brought in 30 pairs of running shoes," Fleischer said.

In order to get the goods to the island, Fleischer, her husband and daughters take a bare minimum of clothing with them. Some friends from Columbia Falls traveled with them, expanding their suitcase freight capability.

Just before leaving, she opened a bank account for the new nonprofit organization which Whitefish attorney Randy Schwickert set up for no charge. The final paperwork allowing for tax deductibility of donations is pending.

"It's called Hewanorra Health Volunteers," Fleischer said. "That's the pre-colonial name for the island. It means land of iguanas."

An employee suggested the name because the hospital may change it's name in the near future.

The hospital made a major shift about three years ago when the government took control. It was originally a Catholic charity hospital.

"In that change, the volunteer program lost a lot of its focus and some of its support," Fleischer said.

She said the hospital's CEO asked her help in building a framework to recruit and organize volunteers as well as to raise dollars. Fleischer said there's a need for internists and primary physicians to supervise hospital interns.

"There's a lot more teaching now," she said. "They've got interns that are St. Lucia residents who went to medical school in Cuba."

As a condition of admission to medical school in Cuba, St. Lucia students have to learn Spanish.

"It's interesting because everything medical is spoken in Spanish," she said with a laugh. "But that worked out because I speak Spanish."

Fleischer said the hospital also needs emergency room doctors, ophthalmologists, anesthesiologists and general surgeons to give the local staff a break.

"For six months in the E.R., they had two guys covering 24-7," Fleischer said.

She hopes to tackle the problem of too many volunteers arriving January to March but then very few in the less popular rainy and hurricane seasons.

"I'm guilty of that as well," she said with a laugh. "It just works out for my practice. My patients are used to it because I haven't been here in March since 2000."

Fleischer gives the lion's share of credit to Northwest Healthcare as well as Big Sky Family Medicine for donations as well as accommodating her the time to travel to St. Lucia.

During those visits in the last six years, she has adapted to a whole different way of practicing medicine. She said taxes her brain much harder without medications and only basic lab tests and x-rays.

"People work really hard here because it's harder to work here," Fleischer said. "But the people are so grateful."

She described the islanders' outlook as rather fatalistic as opposed to her patients in the United States. Absent miracles of modern medicine, they maintain firm grip on their own mortality and give thanks for any help they receive.

Through the new Hewanorra Health Volunteers, Fleischer hopes to create an infusion of capital to bring a few more of those modern miracles to the residents of St. Lucia or at least take the residents to the miracles.

"There's a kid there with congestive heart failure," Fleischer said.

She described the operation needed to fix the child's heart as "not super complicated." But organizing a trip to the United States takes both time, manpower and money.

In spite of frustrations like these, Fleischer keeps a positive attitude as she and her family spend their vacation making life better in St. Lucia. A balmy 65 degrees at night and 85 in the day with a tropical breeze blowing make the work less taxing.

"I'd done overseas work while in medical school. That was part of why I became a doctor," she said. "I've just kept going back. It's been great."

People interested in helping may contact Fleischer or send donations to 210 Weaver Lane, Kalispell 59901. The organization also has a new Website at www.Hewanorrahv.org.

Reporter Candace Chase may be reached at 758-4436 or by e-mail at cchase@dailyinterlake.com.