St. Barts approaches do give a whole new meaning to the phrase "join the traffic pattern."
Terrain requires a steepish approach, the runway runs downhill, and is not overlong. The usual accident scenario is an overrun, as lpatrick notes.
I haven't landed at TFFJ myself, but have flown into TJCP on Puerto Rico's Culebra Island. A similar but much less extreme approach through a "saddle" between higher hills, and the high ground either side can cause low-level turbulence on short final.
Also, if one becomes used to the prevailing easterly trade breezes, the occasional change in wind direction can mess with one's "picture" of how the approach should go.