How Robert Borst flew to Bonaire out of his own pocket and ended up rethinking health equity in the Dutch Caribbean with a Veni Grant.
The invitation came from a former student in Bonaire, a small island in the Dutch Caribbean who needed research guidance. Robert had previously been advised not to focus on these islands. "No one is interested in small islands," he was told. "It's just 20,000 people. So what's the academic relevance of it all?" Colleagues argued. Intrigued, he flew anyway, paying out of pocket.
What he found on the island stayed with him. Despite Bonaire being part of the Kingdom of the Netherlands, the people he spoke with described feeling overlooked in ways that went well beyond research. Their health issues were not taken seriously, and their context was not understood. The distance between the islands and the European Netherlands, it turned out, was not just geographic.
A turning point
That trip became a turning point. Robert had long been uncomfortable with the normativity of his field and had already spent his PhD years questioning how knowledge moves from research into practice and why conventional pathways so often fail. Now he had a place and a community where those questions felt urgent and personal.
Robert is now a health system ethnographer at Erasmus School of Health Policy & Management (ESHPM) and a recipient of a Veni grant from the Netherlands Organisation for Scientific Research (NWO), one of the most competitive early-career grants in Dutch academia. The question driving his current work is why the European Netherlands and the Caribbean Netherlands have such different health systems, and what those differences reveal about their relationship.
Three Dutch Caribbean islands, Aruba, Curaçao, and Sint Maarten in the south, are autonomous, while Bonaire, Saba, and Sint Eustatius in the north are integrated into the Kingdom of the Netherlands. Robert is examining the healthcare relations between the two regions and the Netherlands, how those relations are structured, and how they play out in practice. He calls this lens "caring entanglements."
"By acknowledging these differences, we might also be able to establish a new perspective on caring, a dignified way of caring for each other. We live in the same world, and we can't escape that."
Robert Borst
Ethnographer at ESHPM
Part of what makes his approach distinctive is his insistence on working within communities rather than above them. For example, advice from local colleagues early on reshaped how he thinks about dissemination. They recommended carefully crafting stories to capture the attention of healthcare actors. He has taken that advice seriously, reviewing how he presents findings to ensure they reach local decision-makers.
He is equally direct about the assumptions researchers bring to geographically close communities. Proximity, he argues, does not mean similarity. You cannot assume that what applies in one island applies in another, or that Caribbean contexts map onto European ones. Each community deserves to be approached on its own terms, with the effort to understand lived experience rather than generalize from it.
The Veni grant has also broadened the curriculum. “The Dutch Health System”, an undergraduate course at ESHPM, now includes a module on health systems in the Dutch Caribbean islands, a small but deliberate step toward what Robert calls a "responsibility to care." He is building collaborations with other universities and using new speaking platforms to draw sustained attention to what has long been a neglected set of questions.
For those working in resource-constrained or marginalized communities, he offers one more piece of advice: trust the discomfort. "Whenever it feels wrong, it probably is. Don't ignore that feeling. Talk about it. If there's no role for your position, you leave."
His article, "And when will you install the new water pump?": disconcerted reflections on how to be a 'good' Global Health scholar, is a useful starting point for anyone grappling with similar questions about what it truly means to do global health work well.
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About RGHI
Rotterdam Global Health Initiative (RGHI) is the academic interdisciplinary network initiated and sponsored by the Erasmus University Rotterdam, The Netherlands, which has evolved into a vibrant community of global partners across more than 30 low- and middle-income countries.
