The Journal of Radiation Oncology A Brief Overview of Recent Neurosurgery Developments in the Netherlands Antilles Klian Bos Jubio MD Mind and Brain, Department of Neurosurgery, Curaçao Medical Center and Erasmus Medical Center Corresponding Author: Klian Bos Jubio, Mind and Brain, Department of Neurosurgery, Curaçao Medical Center and Erasmus Medical Center Email : klianbosjubio@erasmusmc.nl Received Date : July 15, 2023 Accepted Date : July 19, 2023 Published Date : Aug 23, 2023 Introduction Curaçao is Associate in Nursing island within the Southern sea, that shaped a part of the Dutch Antilles along with Aruba, Bonaire, a part of island, Saba, and Statia. Aruba was the primary country of the Dutch Antilles to profligate in 1986 (1). On Gregorian calendar month tenth of 2010, Curaçao and island conjointly became a constituent country among the Dutch kingdom. Bonaire, Saba, and Statia became “special municipalities,” conjointly referred to as body divisions, among the Dutch state (2). Curaçao is that the biggest of the six islands, with a district of 444 km2/ 171.4 sq.mi, settled sixty five kilometer (40mi) north of the Venezuelan coast (3). Curaçao is of multi-cultural composition (mainly Afro-Caribbean) and has 3 official languages: Papiamentu, Dutch, and English. Spanish is wide spoken on the island likewise (3). it’s a touch less the a hundred and sixty,000 inhabitants (4). 2 surgery ON CURACAO Aruba and Curaçao square measure the {sole} 2 islands that give Neurosurgical services within the Kingdom of the Dutch Antilles and are doing so for many decades. The neurosurgical department of every island consists of 1 sawbones. till 2016 each neurosurgeons were native of their island and had completed their neurosurgical instructional formation within the Netherlands. till that amount, a gradual decline in advanced neurosurgical procedures were performed on Curaçao with at the same time increasing money difficulties for its former hospital (Stichting Elisabeth Hospital, SEHOS). Neurosurgical medical referrals to neighboring countries like Republic of Colombia, European country, and Aruba reached a staggering height when the retirement of the previous sawbones in 2016 and absence of a successor. In that same year, a positive development within the neurologic department occurred, wherever till then, a player personal apply of Neurology was reworked into a four-person neurologic department contracted by the hospital. In 2017, a successor, the primary feminine sawbones of the dominion of the Dutch Antilles, born within the {netherlands|Netherlands|The Netherlands|Kingdom of The Netherlands|Holland|European country|European nation} of Angolan folks and trained within the Netherlands and Brazil, was contracted by SEHOS to offer rise to a replacement neurosurgical department with the most goal of providing high- level neurosurgical care, saving lives and decreasing medical referrals to alternative countries. Current western neurosurgical care is more and more being centralized to be able to give ranking care. the requirement for excellent quality of care, patient-reported outcome measurements, and purposeful outcomes of surgery is progressively} turning into vital (5); this has given rise to the usage of more technical power- assisted surgery and minimally invasive procedures. Resources on the islands square measure restricted, and thus, we have a tendency to were Janus-faced with challenges to ascertain a high western quality level of care (6). This doesn’t solely apply to the provision of surgery, and its’ resources on the island, however conjointly the upkeep and development of the array of surgical https://www.directivepublications.org/ 1 Copyright © Klian Bos Jubio MD Original Article

skills required domestically, establishing applicable labor hours, partnership and collaborations with educational neurosurgical centers development specialised nursing wards and supporting departments, research project departments, and generate future successors (6,7). a replacement ERA Since 2017 the Neurosurgical department has slowly evolved into a ranking care unit thanks to money, personnel, and academic investments. Currently, there’s a cooperation contract with 2 educational neurosurgical centers within the Netherlands (Erasmus middle in metropolis and therefore the University Neurosurgical Center European nation, The Hague, and Leiden) to confirm a broad advanced neurosurgical palette with reverse medical referralswhereone of those neurosurgeons frequently involves Curaçao to perform and teach specific neurosurgical procedures and conjointly partakes within the regular neurosurgical practices (i.e., on-call duties, patient clinic, and clinical practices). The authorities has set to take a position in neurosurgical care and several other medical devices and instrumentation were purchased like (cranial and spine navigation, 3D C-arm, fashionable magnifier, high-speed drills, spine OR table, ventriculoscope, intracranial watching devices, and every one instruments are upgraded)as have the consumables. With these investments we’ve been able to decrease medical referrals regarding ninetieth and ensuing at the same time in money advantage for the country. Most of the neurosurgical care consists of advanced spine, peripheral nerve, bone medical specialty, and traumatic brain injury surgeries. Furthermore, a replacement middle (Curaçao Medical Center) has been inaugurated in November 2019, beginning a replacement era in excellence of care. With progressive instrumentation, electronic medical charts and reorganization of the medical system, as an example fewer personal practices and additional hospital contracted physicians, Curaçao has elevated the treatment on the island normally and has taken on a outstanding role within the Dutch Kingdom relating to neurosurgical care domestically and regionally. Since the COVID-19 eruption, the vulnerability of our islands has become apparent. Reorganization of treatment and its’ referrals has occurred. Curaçao currently receives elective and semi-urgent referrals for island, Saba, Statia, and Bonaire. Extreme pressing care, i.e., brain trauma, remains a challenge thanks to the distances between the islands, sadly. The islands of the Dutch kingdom are operating along closely to secure additional harmonious treatment.Recentlythe Dutch Caribbean Hospital Alliance (DCHA) has been shaped to confirm continuity in care and a healthy money, economic state (8); this suggests that steps are going to be taken to bolster the neurosurgical care in Aruba and Curaçao in a very cooperative manner. There square measure still several challenges ourneurosurgical department faces several challenges as we have a tendency to lack the whole neurosurgical palette, like endovascular treatment, that remains one thing that we would like to realize shortly. we have a tendency to square measure operating laborious to realize a nonstop research project cluster to publish our work and increase our visibility within the world. Currently, the neurologic department has magnified to five neurologists, an extra retired brain doctor supports the education of Dutch medical students throughout their rotations, 2 native physicians square measure presently {in a|during a|in Associate in Nursing exceedingly|in a very} residency program (one neurology and one neurosurgery) to become an addition to our department shortly. Finally, we have a tendency to belief that the Islands ought to {join forces|collaborate|cooperate|get along|work} to assure a stronger future together. (6,7). References 1. History of Kingdom and Aruba. https://www.overheid. aw/bestuur-organisatie/historie-van-het-koninkrijk-en- aruba_41237/. 2. Central government of the Netherlands. https:// www.rijksoverheid.nl/onderwerpen/caribische-deel-van- het- koninkrijk/vraag-en-antwoord/waaruit-bestaat-het- koninkrijk-der-nederlanden. 3. Central Bureau of Statistics Curaçao. http://www.cbs.cw/ website/general-facts-curacao_3169/ 4. Central Bureau of Statistics Curacao. January 1st, 2020. https://www.cbs.cw/population-of-curacao-january- 1st-2020. 5. Ghimire P, Hasegawa H, Kalyal N, Hurwitz V, Ashkan K. Patient-Reported Outcome Measures in Neurosurgery: A Review of the Current Literature. Neurosurgery 2018; 83(4): 622-30. https://www.directivepublications.org/ The Journal of Radiation Oncology 2 Copyright © Klian Bos Jubio MD

6. Almeida JP, Velásquez C, Karekezi C, et al. Global neurosurgery: models for international surgical education and collaboration at one university. Neurosurgical focus 2018; 45(4): E5. 7. Barthélemy EJ, Park KB, Johnson W. Neurosurgery and Sustainable Development Goals. World neurosurgery 2018; 120: 143-52. 8. Uitbreidingtopzorgeilanden. AntilliaansDagblad. 2021 10- 02-2021 https://www.directivepublications.org/ The Journal of Radiation Oncology 3 Copyright © Klian Bos Jubio MD