ORANJESTAD/THE BOTTOM- While often quite some criticism can be heard on medical referrals to destinations outside of the island of the former Netherlands Antilles, statics show that the vast majority of medical referrals in Bonaire, St. Eustatius and Saba in the year 2023 were either to Curaçao and -in the case of St. Eustatius and Saba, to nearby St. Maarten. 

This can be read in the recently published ‘The Caribbean Netherlands Health system review’.

The report notes that as the providers on the BES islands themselves do not have full capacities to respond to the health needs of the population, facilitating care on other Dutch Caribbean islands, more broadly within the region, or beyond the region is a major task of Zorg en Jeugd Caribisch Nederland (ZJCN). 

“Over 90% of referrals from St. Eustatius and Saba were to nearby St. Maarten in the year 2023, while 81.3% of Bonaire’s referrals went to Aruba and Curaçao”, according to the report.

Other referral locations include primarily Colombia and the European Netherlands, or in the case of Sabans and Statians, sometimes Bonaire.

On average, 5,658 patients were referred annually for care off of the BES islands between 2017 and 2023, with notable declines seen in 2020 and 2021 and reflecting the impact of the COVID-19 pandemic on travel as well as suspended care. 

Referral costs

In 2023, the costs of logistical and medical costs of off-­‐ island referrals totalled US$ 43.7 million and averaged US$ 37.9 million between 2019 and 2022 (on average US$ 16.6 million for logistical costs and US$ 21.3 million for medical costs of referrals).