How does healthcare work in Sint Eustatius, and what travel insurance, health insurance or expat insurance do you need?

How does the healthcare system work in Sint Eustatius?

What is the quality of healthcare in Sint Eustatius?

• There is a joint health care system for the three Dutch Caribbean islands of Bonaire, Sint Eustatius and Saba (the BES islands). Health care is good, but limited. There is also a lot of effort to get health care to European level.
• There is more poverty on the BES islands than in the Netherlands. This also causes health problems among the population (for example, a lot of alcohol and tobacco use and little physical activity). This is also the reason why the Dutch government has organized the health care system on the BES islands differently.
• Nevertheless, the life expectancy of residents on the BES islands is about one year longer than that of residents in the European part of the Netherlands.
• Bonaire has a hospital, Sint Eustatius and Saba have medical clinics.
• A triage system applies on all three islands. This means that nurses provide primary care, secondary care is available with a referral and for tertiary care with a medical transfer, approval must be given by medical advisors of the ZJCN.
• The health care facilities are generally non-profit or private companies. Some are contracted to the government and thus provide the public healthcare system.
• There are also mental health facilities on all three islands, organized by Mental Health Caribbean (MHC).
• Bonaire has two pharmacies, Sint Eustatius has The Golden Rock pharmacy and Saba the Saba Wellness Pharmacy. There is not always a pharmacist present due to a shortage of staff.
• In case of medical emergencies, there is a medical helicopter that transports people from Sint Eustatius and Saba.

How does the public healthcare system work in Sint Eustatius?

• The public healthcare system is run by the Ministry of Health, Welfare and Sport in the European Netherlands and works differently than the European Dutch healthcare system.
• There's a mandatory health insurance for residents of the BES islands provided by the Department of Care and Youth Caribbean Netherlands (ZJCN). This is paid from taxes and covers approximately 0.5% of people's salary.
• Because healthcare is limited, this insurance also covers the costs of care when you are referred to contracted healthcare providers outside the archipelago. More than 80% of referrals go to Sint Maarten, Aruba or Curaçao.
• A challenge in healthcare is retaining staff, which can sometimes lead to shortages.
• The mandatory health insurance covers general practitioner care, specialist medical care, hospital care, paramedical care, dental visits, medicines, aids, obstetric care, patient transport, maternity care and long-term care.
• For some medical services and resources, a personal contribution must be paid. For example, glasses, orthopedic shoes, physiotherapy and dental care.
• There is no deductible and all services covered by the insurance are free.
• Fundashon Mariadal is the main healthcare provider on Bonaire. It offers secondary care, also at people's homes, and runs two of the three pharmacies on the island.
• On Sint Eustatius, the St Eustatius Health Care Foundation runs the medical clinics, and on Saba, Saba Cares. Both islands have a pharmacy. Sometimes specialists come to the islands, but usually they go to Sint Maarten or other islands.
• Problems in the healthcare system are the limited choice of healthcare providers, the limitations in care and quality of care on the small islands and the risk of too few staff.

How does the private healthcare system work in Sint Eustatius?

• Most healthcare providers are private providers or non-profits. If you are not insured, you can receive care if you pay for it.
• The care is therefore, as described in the section on public care, limited and medical evacuation is necessary for more serious illnesses and medical emergencies. If you are not insured, the costs are high.
• You often have to pay in advance if you don’t have public insurance.

How is the general practitioner arranged in Sint Eustatius?

• The general practitioner is the first point of contact, a kind of gatekeeper, for care and can refer you to a specialist if necessary.
• Several private general practitioners work on Bonaire. On Saba and Sint Eustatius, the general practitioners work at medical clinics and the supply of general practitioners is very limited.

How is the dentist arranged in Sint Eustatius?

• Dental care is free for young people under the age of 18. For those over the age of 18, free dental care is limited to basic care.
• There are three dental practices and a dental clinic on Bonaire.
• There is a dentist on Sint Eustatius, but not on Saba. A dentist from Bonaire does come three times a week to provide dental care to people on Saba. An orthodontist also comes once a month.
• The dental practices are private healthcare institutions.

How is pregnancy care arranged in Sint Eustatius?

• Sint Eustatius has a private clinic for gynecological care that cooperates with SEHCF so that pregnancy care can also be provided here.
• Fundashon Mariadal offers pregnancy care on Bonaire. Care is also available on Sint Eustatius and Saba, but limited.
• In case of complications or a high-risk pregnancy, a referral to Curacao or the Netherlands may be necessary.
• Breastfeeding in public is generally accepted.
• On the BES islands you are entitled to 16 weeks of maternity leave.
• Abortion is allowed up to 22 weeks, or 24 weeks with advice from a doctor.

How safe or unsafe is a trip or stay in Sint Eustatius?

What should you pay attention to in terms of safety in Sint Eustatius?

• Bonaire, Sint Eustatius and Saba are generally safe. There is little crime, except sometimes theft from hotel rooms and cars or pickpocketing.
• Hurricanes can visit the islands. Keep an eye on the weather forecast and the advice of the local government.
• Be careful with swimming, because there can sometimes be strong currents.

What should you look out for in terms of diseases in Sint Eustatius?

• Zika, Chikungunya and Dengue pose a risk of Sint Eustatius. So protect yourself well against mosquitoes!
• The sun is intense. So use good (coral -friendly) sunscreen and make sure you drink enough.
• Tap water is safe to drink.

What should you pay attention to when it comes to traffic in Sint Eustatius?

• Renting a car is the best way to discover the BES islands, but it will come with some challenges!
• The quality of the roads on Saba and Sint Eustatius varies. There is often little lighting and road designation and it is also not unusual that cattle suddenly run for your car.
• Helmets and belts must be worn by both driver and passenger.
• Scooters are also a popular means of transport, but it may take some getting used to because the roads are not always in the best.
• There are limited bus and taxi services. These are reliable, but agree on a price with taxis.
• Water taxis are a popular means of transport between the islands.

What work and travel insurance policies are suitable for short and long stays in Sint Eustatius?

• Is the trip to and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

What emigration and expat insurance can you take out for Sint Eustatius if you are going to live there for a while?

• As a resident of Sint Eustatius, in most cases public health insurance is an obligation. This insurance covers a lot and it might be enough, but it does not cover everything. It may therefore be wise to purchase international health insurance so that you are fully covered.
• Make sure your insurance covers medical evacuation as well as coverage in neighboring countries. Read more about insurances for abroad on Expatinsurances.org.