Pregnant and without papers in Curaçao. And then? Clinic Salú Pu Tur helps thousands of undocumented people every year

Yes, she eats healthy, the Colombian Jessica says softly to the Dutch doctor. Or at least, she tries: a sandwich in the morning, rice with chicken in the afternoon, an apple in between and hardly any more in the evening. Yet her blood sugar values are still quite high, but as much lower than they were that the doctor mainly compliments her.

Because that, Arts Nathalja Knijnenburg knows, often works better than being too strict. The patients she sees in the clinic Salú Pa Tur, which in Papiamento means ‘health for everyone’, are often vulnerable. Here, in Landhuis Cas Chikitu on the east side of Willemstad, people without residence papers are seen by doctors for free. Life is not easy for this group, which tries to remain invisible to official authorities in daily life. Nobody is waiting here on a sermon.

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But the clinic itself is also vulnerable. Salú Pa Tur is dependent on donors and receives money from, among others, the Vluchteling and UNHCR Foundation, the UN refugee organization. When President Donald Trump closed the money tap for foreign help at the beginning of this year, at the beginning of this year, The financial support of the American Development Foundation (PADF) Pan was in one fell swoopwith 35 percent of the total budget the largest donor of the Curaçao clinic.

“That was a shock,” says Knijnenburg in one of the three simply furnished consultation rooms. There are white tiles on the floor, the air conditioning is looking – it’s hot outside. “It is already helping, with the limited resources we have, but suddenly everything was on loose.” There is still a poster of the Padf on the wall. “Would contracts be extended? Could we stay open?”

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That turned out, for the time being. The Curaçao government promised to close the financial gap that has arisen in 2025. A few weeks later, employees of Salú Pa Tur on Facebook read a message from the Minister of Finance Javier Silvania that the clinic will be included in the multi -year budget from next year. After a lot of thumb turning, the confirmation followed on 31 July that Salú Pa Tur will be insured for the next three years of 478,000 Curaçao guilders (around 234,000 euros) per year. Sealed again Via a message on Facebooka widely used communication channel from the government. Although the Dutch Ministry of the Interior granted a one -off subsidy last year, State Secretary Zolt Szabó (Home Affairs, PVV) explicitly announced this spring to explicitly do not want to provide extra financial support to the clinic.

Jules Pieters, chairman of the Salú Pa Tur Foundation, counted on it that it would be okay, but nevertheless brought a sigh of lighting with that news. “This is very important for our continuation,” he says, referring that UNHCR also announced that it would halve the budget from next year. “We also save the government money. Because of our work, many people do not end up in the already overburdened Curaçao care system.”

Men in construction

Jessica (31) also does not have the right papers to stay on Curaçao, so she does not want her last name in the newspaper – she thinks a photo is good. A year and a half ago, together with her husband and two daughters of eleven and five years, she came from the Colombian city of Barranquilla to Curaçao, her mother, who has been living in Willemstad for twenty years. In particular for economic reasons, looking for a better life. Her husband works at a welding company, Jessica is cleaning. On weekends she cooks in a hotel.

When she arrived, she was pregnant with the third, Jessica says, a long thin braid loosely over her shoulder. Salú Pa Tur did not know them yet and she ended up at a private clinic with market -based prizes. There, she now thinks, her diabetes was not properly checked. Her baby was born lifeless. Untreated maternity diabetes can entail major risks for mother and child.

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In Curaçao, an estimated fifteen thousand people are staying without valid residence papers – probably the real number is higher. With that, Curaçao catches according to UNHCR After Lebanon and Aruba, most migrants per head of the population in the world. They are not entitled to social services and cannot take out health insurance, so they often remain deprived of necessary health care. The men often work in construction, the women often clean. Many work under poor or exploiting circumstances, sometimes women, also forced, prostitution.

Venezuelans were the largest group, especially between 2015 and 2019, tens of thousands fled their country, because of the iron grip of President Nicolás Maduro and the economic and humanitarian crisis in which the country is located. Curaçao is only 65 kilometers from the Venezuelan coast, Aruba even only 24 kilometers. Curaçao has not ratified the UN Refugee Convention. This means that the island is not bound by the provisions that are included therein, such as that refugees can rely on the asylum procedure and enforce protection, and that a refugee cannot be sent back to the country where she or he cannot live in freedom.

Alarm amnesty

Curaçao is an autonomous country within the Kingdom of the Netherlands, but is dependent on the Netherlands for a number of tasks, such as in the field of Foreign Affairs and Defense. The Netherlands has signed and ratified the Refugee Convention, but there has never been a territorial expansion for Curaçao and there is political restraint on both the island and in the Netherlands.

Amnesty International raised the alarm about the way Curaçao deals with Venezuelans and noted in 2021 and 2023 that people were fixed and deported on improper grounds – last Friday, August 1, the Court of Justice ruled on Curaçao that this is a common detention policy is unlawful. This has led to harrowing situations for years and in 2019 the Dutch doctor Elisa Janszen Salú Pa Tur decided to set up. To make it accessible to this vulnerable group of basic care. There are often Dutch doctors; The director, doctor’s assistants, nurses and interpreters come from the island.

We have psychologists, but also provide psychosocial help ourselves. We are sometimes the only ones who look after these people

Six years later, more than eight thousand patients are registered, new people register every week. The clinic employs several doctors, a midwife and a psychologist. There is an own ultrasound device, especially for pregnancies, and a bus, with which a nurse enters the neighborhoods, to people who can hardly come to the clinic themselves.

“We see a lot of disrupted diabetes here and, often as a result, relatively many kidney patients. Many people with high blood pressure and adhesive wounds or metal splinters in their eyes, who in particular suffer men when working in construction,” says Arts Knijnenburg. “And many women, around pregnancy, delivery and everything that is related to it.”

At Salú Pa Tur, the care that GPs provide goes beyond the physical. “This population often lives in the margin, people have experienced a lot, there is a lot of tension and trauma,” says Knijnenburg. “We have psychologists, but also provide psychosocial help ourselves. We are sometimes the only ones who look after these people.”

Eye condition

When she looks at her phone screen, the letters start dancing, says the Venezuelan Jacqueline, after she has sat down to general practitioner Esther van de Scheur-Easting. And if she is stressed, her eye turns red. Her right leg vibrates continuously, she looks at the interpreter, which translates from Spanish. Van de Scheur-Easting takes an ophthalmoscope and looks. “I can’t treat this,” she says.

Jacqueline, who does not want to be recognizable because of her residence status, has Pterygium, judges the doctor, a condition in which a piece of conjunctiva grows slowly over the cornea, which hinders the vision. Treatment is only possible in the hospital, but the crack-east will contact a friendly ophthalmologist, she promises. At Salú Pa Tur they have an extensive network of specialists on the island, she says later, so that they can also arrange second -line care for patients faster and cheaper.

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Many undocumented people have no money for medical care. They work as a day laborer, without being a contract and being sick means no income. “We can also help people to a certain extent, I find that really difficult about this work,” says Van de Scheur-Easting. “Recently a man with advanced pneumonia came here. He really couldn’t work. He lost his house, asked me for money, if he was like Poolman My swimming pool could maintain. We don’t do that, but it sometimes gnaws. “

More often people go home satisfied. Such as the Venezuelan Rusmelly (29). She comes for a check -up, after the birth of her youngest daughter Aurora, five days ago. The placenta was at the front, she lost a lot of blood and got a caesarean section. With the help of Salú Pa Tur, she was able to conclude a payment arrangement with the hospital. “Otherwise I would not have made it,” she says. The girl in her lap sleeps undisturbed.

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