Health Care in the Windward Islands
By; Will Johnson
Now that there is so much discussion on health care in the Windward Islands it is good to take a look back on how it was in former times. As for Saba, Dr. Robert Mol wrote a wonderful book entitled “Doctor on Saba”. Dr. Howard Cyril Tjon-Sie-Fat who was born in Paramaribo on July 6th 1911 and died there September 20th, 1984 also did an extensive study on the health care in the islands back in the forties. The latter worked for a number of years on Saba and St. Maarten and also married one of the Carty girls from St. Maarten.
There are few sources which reflect the state of health care on Saba in the 18th century. Further research, including for example, an examination of ship’s logs, might shed further light on the subject.
“There it is healthy, cool, and fresh, and the fresh and pleasant food is prepared with one’s own hands, one flourishes, despite the lack of care in which one lives there. So wrote the French priest Guillaume Th. F. Raynal, the “enlightened” abbe who in his Histoire Philosophique, popularized and copied a great deal of true information but also a great deal of nonsense from Denis Diderot, the celebrated writer of encyclopedias. Neither Diederot nor Raynal had ever been on Saba or even in the area. With these reservations I record Raynal’s citation, as it is the oldest description of the living situation of the people of Saba.
Dr. Johan Hartog writes that, as far as it possible to ascertain, doctors and barber-surgeons were frequently present in the Windward Islands. Even Saba had its own barber-surgeon. In 1702, for example, Matthijs Koel from Monnikendam occupied this post. In 1790, Governor P.A. Godin wrote that the inhabitants of Saba were “strong, in general, and the women are beautiful,” but that almost always, scabies was common on the island. Almost all the inhabitants suffered from this disease. Sulfur, locally obtainable on Saba, was used as a remedy.
The following is a fragment from the letter written by John Simmons, a resident of Saba to Governor P.A. Godin on St. Eustatius on March 24th, 1790: “That Mr. Robert Stovall Coopman, who lived on the island of St. Eustatius since the year 1700 and eighty until, in the month of May of 1700 and eighty eight he, feeling himself unwell, proceeded to the Island of Saba, staying in the house of the Suppliant, planning to stay until he was recovered and could return to this island, is deceased. That the Suppliant by the appropriate opportunity gave to the said Robert Stovall not only Lodgings, maintenance, washing, care, and freshening, but even gave him (as on Saba, is the custom, as there are no expert doctors or barbers on the island) simple medicines , made up by the Suppliant himself, so that, after making a happy recovery several times, the said Robert Stovall finally on the twenty-sixth of May of the year 1700 Eighty Eight, came to decease at the home of the Suppliant as a result of complete exhaustion of his life forces.” The letter reproduced here gives an indication, that at the end of the 18th century, health care was administered on Saba without the assistance of doctors or barber-surgeons.
Somewhat more is known about medical care in the 19th century. Hartog writes that there were physicians on St. Euatatius and St. Maarten at most times during that century, as evidenced by the fact that a physician who also assisted private patients was assigned to the garrison. There was also a public health service of sorts. In 1830, the physician Philogene P. Maillard was assigned to it on St. Maarten. He by the way was married five times to daughters of prominent St. Maarten families.
In about 1818 the Commander of the island of St. Maarten and Saba wrote in a report, “generally the air on these islands and in particular on Saba is very clean and the climate is healthier than on the other islands of the Antilles.” Further, Teenstra, who was not a physician, noted in 1834 that “epidemic illnesses are virtually unknown on Saba, which is attributed to the freshening sea winds. There is no Doctor of Medicine on the entire island. A very small amount of Leprosy is found here, and jaws and elephantiasis is totally unknown here. “The first case of leprosy was seen on Saba in 1840. It was most probably imported from St. Kitts.
Pastor J.C. Gast, i n 1857 wrote, “The primary illnesses among the population are leprosy and elephantiasis, the latter of which they call “the Rose”, and of which very few families are completely free. In special cases, they call in the help of one or another of their friends, who have the knowledge of herbs and several drugs which they import from St. Thomas, where they are further known. There is also a man who knows the art of bleeding. This is the only medical therapy which is found here. Because of the lack of good rain barrels there is, when it has not recently rained, a lack of good drinking water. I do not see that anything is being done to stop the spread of leprosy.”
Because leprosy was also present on St. Eustatius, an institution known as Lazaretto was built at Diamond Rock in 1866. Patients from Saba were also cared for here. A previous leprosarium had been established as early as 1764 on a few small islands (“Five Islands” and “Hen and Chickens”) between St. Maarten and St. Barth’s.
In 1863, physicians in the pay of the government were installed on each of the three Windward Islands. This measure was probably as a result of the abolition of the slave trade. The physician on St. Maarten H.E. van Rigersma, carried out studies in biology and, in particular, on mollusks in addition to his medical practice. A doctoral thesis had been written about this man. Also the well-known local journalist and author Josiah Charles Waymouth was married to his daughter.
Mathias S. Voges also wrote a very informative book on the 100th anniversary of the Dominican Nuns of Voorschoten (1890-1990) in these Windward Islands which also gives a lot of information on their role in providing good health care to these islands.
Since the nuns established their congregation on St. Maarten in 1890, it was their quiet wish, besides what they were already successfully doing in education to do the same for healthcare. In 1908 Father J.B.A. Gijlswijk together with Prioress Regina decided to start a hospital. Already in 1906 the nuns had come into the ownership of two houses on the Backstreet which had been willed to them by someone. The two houses were connected to each other and were put at the disposal of Dr. C.A. Shaw. This small hospital had a sickroom and operating room and a drugstore. All patients of Saba, St. Eustatius and St. Maarten irrespective of their religious beliefs were allowed the use of the hospital. One hundred years later the country is drained of resources with people from all three islands having to go to all over the world but especially to Colombia in search of health care. Neither one of the islands has a Medical Center modern and equipped enough to provide the medical service required for the three islands.
Sister Agatha, who was a teacher by profession, was the first assistant nurse. She received instructions in preparing and serving medications and helped with operations and childbirth. She was assisted by some ladies in nursing and housekeeping. Installation costs were made possible by donations from residents on St. Maarten and through a fancy-fair and gifts from Holland. The amount collected was f. 2.715.—which was a sizable amount for 1908. In 1909 the government decided to give a subsidy of 25 cents per patient per day plans were made to expand the hospital. On January 2nd, 1910 a new wing was taken into use with a capacity of 18 beds.
In August of 1916 the hospital got a new operating room and a deep cistern was built alongside the building. If I am not mistaken that cistern is still there.
In the beginning things were tough but the Nuns carried on. In 1909 there was no government subsidy and the hospital dealt with 51 patients. By 1919 there were a total of 199 patients and the government subsidy was fls. 2.800,25 For that year.
On June 14th, 1934 a start was made with the new hospital on the Front street by the company Albetam. This was opened on January 16th 1935 in a ceremony presided over by Mgr. P.I. Verriet in the presence of Lt. Governor and Mrs. Meiners, Dr. Ricoux from the French side, Dr. Hans Spitzer, Mother Vicar and the nuns and priests and many other prominent people from the island.
The golden jubilee of the St. Rose hospital was celebrated on November 9th, 1958 with a solemn Holy Mass of thanksgiving. The Mass was followed by the official reception whereby Lt. Governor Walter Buncamper, Commissioner Milton Peters, island council member’s, J.C. Larmonie and William B. Peterson, Dr. Tjon Sie Fat and his wife, priests from both sides of the island were all present. Lt. Governor Buncamper spoke words of appreciation for Father J.B.A. van Gijlswijk who had the vision to start a hospital on St. Maarten for the three Dutch Windward Islands. Mr. Lionel Conner in his speech brought alive the history of the hospital since it was started fifty years before. At the same time the jubilee was celebrated of Nurse Angele Cagan’s twentieth anniversary as a nurse in the hospital. She was widely praised for her love of the patients. She used to call me Kennedy. I was rooting for him for President. Nurse Angele was from Grand Case. She was a frequent visitor at Capt. Hodge’s guesthouse. Seems like I was the only one in the house for Kennedy. Nurse Angele would roll with the laugh when questioning me in front of Capt. Hodge and Miss Bertha with: “But why it is so that you like this Kennedy so much?” I think that secretly she was a Kennedy supporter herself. I remember coming up Front street the day he was murdered. She shouted out to me from the verandah of the hospital with “ Woo Kennedy, Kennedy dead.” And we went on to discuss the sad case in detail.
I have fond and sad memories of the old St. Rose Hospital. Was in there twice myself , with the chicken pox, and the other time to cure some rum blossoms in my stomach. Dr. Levendag felt that I needed a rest in the hospital. My mother died there in 1977 and my father was dying in 1972 but the nurses worked on him and he was able to go home and die a few weeks later sitting under a tree watching his sheep. I have many wonderful memories of Frederick Froston, Angele Cagan, Nurse Ramona Illidge and Nurse Mavis Peterson. My mother was operated on for breast cancer there by Dr. Tjon Sie Fat in 1947 and went on to live until she died there in 1977. I remember going to see many patients from Saba and Statia and being helpful to them. It was this looking out for my people that later on got me elected on Saba. I remember going to see my old friend Commissioner Sadler of Statia. He told me a joke he planned to tell St. Peter when he saw him. Sadler was full of jokes. He looked so well that I walked back down to the Receivers Office where I worked feeling that Sadler would make it. A good half hour later the church bells started tolling. Someone, (I think Rosalie Carty) stuck her head in the office door and announced that a gentleman from Statia had just died in the hospital. I still cannot believe how quick he went and I hope that St. Peter liked the joke which Mr. Sadler had planned for him.
At the end of 1990 the new Medical Center was completed and the important role that the Dominican Nuns from Holland had played in Health Care had come to an end. The Medical Center also played an important role for the surrounding islands. Now people are talking about Medical tourism seemingly at the expense of the Medical Center. I think that from Saba and Statia alone millions of dollars could be diverted from Guadeloupe and Colombia to St. Maarten and the people would be among friends and closer to home. I for one prefer to deal with the Medical Center and I hope that quick action can be taken to upgrade it and encourage people from the neighboring islands to choose that option in preference to Colombia and Guadeloupe. There is no time for further delay.