Sint Maarten: Health Care Is Reaching New Heights

This past year marked a turning point for health care in Sint Maarten on two fronts: construction of the new St. Maarten General Hospital (SMGH) rose to its highest point, and upgrades to the existing St. Maarten Medical Center (SMMC) facility brought improved, more accessible patient care to the island today. From the Ground Up With financing support from the Sint Maarten Trust Fund’s Hospital Resiliency and Preparedness Project and private investors, SMGH construction advanced to the upper floors. In March 2026, construction reached its highest point, a milestone in the building trade known as "topping out." "Structural works are nearly complete, and finishing works have already begun," says Erika van der Horst, SMGH Contract Manager. "This is bringing us closer to the moment when the hospital will be ready for use." The new facility is a major step toward strengthening the health care system and reducing vulnerability to shocks. Beyond expanded bed capacity, SMGH is being built for long-term resilience: reinforced structures to withstand Category 5 hurricanes, 108 seismic base isolators to absorb earthquake shocks, and independent power and water systems to keep operations running during extreme weather events. So when the next disaster strikes, the new hospital is designed to stay standing and keep treating patients, serving as a critical lifeline for the wider Caribbean region in the immediate aftermath. This approach reflects a broader shift toward “build back better” principles, strengthening infrastructure not only to withstand shocks but to maintain essential care when communities need it most. Better Patient Care, Available Now While the new hospital took shape, targeted upgrades to the current facility improved care in the short term. These included installation of new generators to increase power reliability, construction of a new operating room to expand surgical capacity, expansion of dialysis services to reach more patients, and updates for 12 clinical guidelines to address the most prevalent health conditions on the island. Together, these improvements increased the island’s capacity to treat patients locally and maintain essential services without interruption. Overseas medical referrals were reduced by 88 percent in 2025, and newly instituted emergency disaster preparedness and evacuation plans helped hospital operations remain unaffected when Hurricane Erin struck in August 2025. Quality of care also advanced alongside capacity. Under the leadership of a newly hired Quality and Safety Officer, patient satisfaction surveys were streamlined and made more frequent—they now take under one minute to complete and provide feedback for continuous improvement. Patient satisfaction rose to 85 percent in 2025, a 25 percent increase from only three years ago, reflecting growing confidence in local health care. Building a Complete Team, Not Just a Structure Strengthening institutional capacity is central to long-term resilience and this project’s objectives. For the first time, SMMC conducted a comprehensive technical audit of service quality and delivery preparedness entirely in-house. The hospital also completed a demanding internal documentation effort linked to COVID-19, strengthening its project management capability and procurement systems—capabilities critical for future emergency response and efficient service delivery. Training programs that align with Joint Commission International standards continue to build human resources: 238 SMMC staff were trained in 2025 alone, bringing the total to 648 since the project began. This sustained investment in human capital reflects a broader approach promoted by the World Bank: resilient health systems depend not only on stronger buildings, but on skilled personnel capable of maintaining high-quality care under both routine and crisis conditions. “Continuous learning and leadership development are critical to ensuring our teams are ready to operate the new facility effectively,” says van der Horst. “We are not only building a hospital—we are preparing our staff for the future.”