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Dominican Republic - Health Service
The current healthcare system has three different tiers:
- Subsidized regime, which is financed by the government for unemployed, poor, disabled and indigent people.
- Contributive regime, which is financed by workers and employers
- Contributive subsidized regime, which is financed by independent workers, technical workers, and self-employed people, but subsidized by the state
Expats who work in the Dominican Republic are mostly part of the contributive regime, but it is wise to check out your options with your employer. Private health insurance or complementary insurance is very important to obtain in order to avoid huge gaps in costs when going for a treatment or even just visiting a doctor. The reforms still have a long way to go when it comes to the public healthcare system. Four years ago, even though reforms started in 2001, just 60% of workers were contributing to the public healthcare.
The phone number for emergency medical assistance in the Dominican Republic is 911. It's wise to have emergency numbers of the local police station, clinic, ambulance and fire department on hand too. The standard of healthcare in this country largely depends on the chosen clinic. If expats have to visit a doctor for non-urgent reasons, then the services in are fine. However, in an emergency, things can be quite complicated. The emergency number can often be offline and there are very few ambulances available. When people need emergency help due to an accident or similar situation, they can expect to be transferred to a hospital by any means, such as car, police car or even motorbike.
Movimed, Santo Domingo
809 532 0000
Promed, Santon Domingo
809 948 7200
Santiago, Puerta Plata, La Romana
1 200 0911
Apart from in public hospitals where the healthcare is mostly free, insurance is crucial in this country. Many hospitals do not treat expats without proof that they can pay for it. Expats need to show cash or proof of insurance. Hospitals in the Dominican Republic do not all accept the same kinds of insurance, so it is best to check with a local hospital or clinic to see which insurance type is accepted before you are admitted. Emergency treatment is not free and it can cost quite a lot. In general, there are no particular problems with healthcare for foreigners, but the costs can be significantly higher than for Dominican citizens.
Diet and common health problems
The percentage of diabetes and high blood pressure among the Dominican population is higher than in other countries. The reason for that can be found in a diet which includes a lot of salt, sugar and oil. The average diet in the Dominican Republic largely lacks vitamins and fresh vegetables. It has a high carbohydrate level, mostly because of the rice which is eaten almost on daily basis. In the last ten years, there has been an increase in obesity and heart disease problems in this country.
The attitude of this country towards smoking can be seen as quite relaxed. There are very few restaurants and bars that forbid smoking in the Dominican Republic. Air-conditioned restaurants sometimes have a ban on smoking, but this is never the case when it comes to open-air restaurants. Smoking among Dominicans is not so common, largely because of the high price of cigarettes. However, the vast majority of expats are smokers, probably due to the country's relaxed attitude towards it and the prices that are still lower than in many other countries.
Health risks and vaccinations
As the Dominican Republic is a tropical country, there are some health risks that cannot be found in Europe and North America. Due to high temperatures and quite intense sunshine, it is advised to wear sunscreen. It is interesting to know that most expats who live here rarely sunbathe.
There are a number of insects that people should be aware of, even though they do not bring fatal consequences. Numerous mosquitoes in the Dominican Republic can bring you dengue fever or malaria. As dengue fever is widespread in this country, it is best to prevent bites by using a repellent, fumigating the home and garden, to ensure that there's no standing water which may be inviting for them. Long trousers are also a good idea. The mosquitoes that carry dengue are known as "patas blancas", meaning that they have white feet, which makes them easily recognizable compared to other insects.
The water in the Dominican Republic is not safe to drink, but 5 gallon containers of drinking water can be bought for just one dollar. The tap water is considered to be safe for cooking and brushing teeth, but it is still smart to double check, depending on the area. The water comes from either a central water system or a well, which then goes to the cistern.
Other health problems
Most tourists and expats have stomach troubles while spending time in the Dominican Republic. This happens mostly due to food poisoning or infections caused by amoebas and parasites. They can be all easily dealt with by taking proper medications, but it's better to visit a doctor first, in order to find out which infection it is and determine which medications are best for it. All areas of this country have testing facilities. In order to avoid health issues, it's smart to wash fruit and vegetables with bottled water before eating them. Hands should be also washed frequently.
There are also some other diseases that are frequent in this country, such as Hepatitis, Typhoid, Aids and Cholera. Even though it's not necessary to be vaccinated before entering the country, expats should be aware that they are contractable here.
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