Doctor on Saba

‘Doctor on Saba’ tells the true story of Dr. Dirk Kooy, a Dutch physician who arrived on the Caribbean island of Saba in the early 1950s. Written by R. Mol, the book captures the remarkable experiences of Kooy as the island’s only doctor, navigating medical emergencies, rugged terrain, and cultural nuances in a remote colonial setting.

Through vivid storytelling and personal anecdotes, the book offers a unique window into life on Saba during the mid-twentieth century. It highlights both the challenges of rural healthcare and the resilience of small island communities.

Contents

List of abbreviations
Introduction

Part A – The Island of Saba

1. An overview of Saba’s history
2. The Island of Saba and its population
   • Location, geography, climate, vegetation, and environment
   • Government and politics
   • Population
   • Housing
   • Religion
   • Education
   • Free-time activities
   • Tourism
   • Business and industry
   • Agriculture and horticulture
   • Animal husbandry
   • Fishing
   • Commerce
   • Traffic and transport, mail, and telecommunications
   • Mass media: radio, television, newspapers, and magazines
   • Public finance
   • Judiciary and police.

Part B – Health care on the Island of Saba

3. The history of health care on Saba
   • General
     • Introduction
     • Sources: archives and libraries
     • The period before 1884
     • The period after 1884
   • Health care
     • Personnel
       • Government physicians and specialists
       • Dentists
       • Midwives
       • Nurses
     • Institutions
       • Hospitals
       • Drug supply
       • Blood transfusion service
       • Laboratory and x-ray examination
       • Care for the aged
     • Morbidity in the past
     • Further education
     • Medical research
     • Miscellaneous
       • The physician and his transportation problem
       • The physician and Island politics
       • Some notable incidents
     • Model Annual Report
4. The current state of health care on Saba
   • Introduction
   • Formal aspects of health care on Saba: government and laws, social assistance and health insurance, national inspectorates
   • Facilities: the hospital, nursing home, and out-patient clinic
   • Personnel involved in health care on Saba
   • The activities in general
   • Science, post-graduate education, and training.

Part C – The study

5. Objectives of the study
6. Two days in general practice on Saba
   • A day in the clinic in The Bottom
   • A day in the clinic in Windwardside
   • Discussion
7. Morbidity and transition on Saba
   • Introduction
   • The goal and questions to be examined in the study
   • Background of the concepts and instruments used in the study
   • Available morbidity-data
   • The International Classification of Primary Care (ICPC)
   • The Transition Project
   • Organization, materials, and reliability
   • Results:
     • General data on the utilization of health care on Saba
     • Utilization of health care by sex, age, ethnic background, socio-economic status, location, and form of insurance
     • Results in relation to components and chapters of the ICPC
     • Further analysis of the episodes
     • Consideration of the chapters
     • The reasons for encounter, diagnoses, and interventions
     • The most frequent episodes in detail
     • Referrals within and outside of primary health care
     • Disability declaration (unable to work= utw, able to work= atw) in relation to reason for encounter and diagnosis
   • Glossary of terms related to the International Classification of Primary Care (ICPC)
8. Referrals over a one year period
   • Introduction
   • Literature concerning referrals
   • Considerations in, indications for, and practicalities of referrals
   • Use of the facilities available for primary health care
   • Referral to medical specialists
   • Material and methods
   • Results
9. Mortality and causes of death in the period 1944-1986
   • Introduction
   • Material and methods
   • Results
   • Discussion
10. Skin tumors on Saba
    • Introduction
    • Etiology and treatment
    • Material and methods
    • Results
    • Discussion
11. The growth and development of the Saban child
    • Introduction
    • The study of Saban babies (0-12 months old):
      • General aspects
      • Organization and methods of examination
      • Results
      • Discussion
    • The study of Saban school children (6-18 years old):
      • General aspects
      • Organization and methods of examination
      • Results
      • Discussion

Part D – Conclusions, summaries and references

12. Conclusions and recommendations
13. Summaries in English and Dutch
14. References and appendices
15. Literature about Saba

About the author
Picture credits