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Wondering about healthcare services available in the Dominican Republic and how to access them? Find out in this article.
If you are moving to the Dominican Republic, one of your major concerns is likely to be what the healthcare system is like and what services are available. The country does have an excellent healthcare service, but only in some places, so you should take this into account when deciding where to live.
Basically, there are four different types of health care available: the public hospitals, tourist area clinics, private clinics, and major public/private hospitals.
There is a public hospital available in every large town, and the medical treatment is free, but usually medication, x-rays, stitches, etc. have to be paid for. Some hospitals do not charge for x-rays and stitches. The standard of care is average at best and they should only be used in dire emergencies. The in-patient has to provide their own sheets, pillows, toilet paper, food, etc., and they are basically looked after by members of their family. It is very unlikely that any English will be spoken here.
The second type of hospital is the major world-class hospitals which are located in the two major cities of Santo Domingo and Santiago. These hospitals have the latest equipment and top medical professional staff. They have private facilities along with public facilities but they are not free although all take medical insurance. Nonetheless, they are still significantly cheaper than the United States, or Europe for example. These hospitals will carry out everything including heart operations and organ transplants and some, although not all of the staff can speak English.
In the tourist and heavy expat areas there are private clinics where all or most of the staff speaks English and although they do not have the same high standards as the hospitals in Santo Domingo and Santiago, they are usually high quality with a good standard of patient care in private rooms, with operating facilities and intensive care units. They will usually be more expensive than the private clinics mentioned below.
The final type of hospital is the private clinic, used by the local people who do not want to go to the public hospital. There are usually 3 to 5 in each town and they are of a higher standard than public hospitals but usually unable to deal with anything overly complex.
All of the different types of hospital offer consultations, usually by specialists rather than General Practitioners. Most do not keep files on patients, and rarely is a consultation made without analysis of blood, x-rays, and other tests.
All Dominican hospitals will always put patients on a saline drip immediately, and will almost always administer IV antibiotics, whatever the problem is, even if it might not require saline drips or antibiotics. In addition, the nursing staff do not perform the same duties as in the USA, Canada or Europe, in that they only administer the injections, change dressings, etc. The family is supposed to look after the patient, bathe them and provide food, and most family members will stay with the patient around the clock.
Pharmacies are called farmacias in Spanish and are available everywhere with even a small town having around 20. They have long opening hours and many also have delivery services. In addition most convenience stores, colmados will also have some basic medicines such as antibiotics, cold and flu aids, and painkillers.
Almost all medicines are available over the counter including strong painkillers, antibiotics, steroids, anti-inflammatory drugs, and sleeping pills. The only drugs which require a prescription are narcotics such as morphine, although some pharmacies will also provide this without a prescription even though it is against the law. Most pharmacies will also prescribe medication simply upon you telling them or showing them the problem, which saves a trip to the doctor.
It is not necessary to buy a whole packet of tablets. They are all sold singly. A typical antibiotic, or anti-inflammatory or blood pressure pill will cost RD$10 (US$0.20). Most pharmacies will give discounts for cash as opposed to credit card payment, so it is always worth asking for that as they may ‘forget’ when they see a foreigner.
As well as brand names, there is also a wide range of generic drugs but it is thought that around 30% of all medicines in the country are fake so you should take care to check what you are buying.
In recent years the government has introduced a social security system whereby workers and employers contribute to providing basic levels of health insurance, although they do not cover the cost of treatment in full. For expats and those who do not have social security, there is a wide range of health insurance policies from different providers.
It is first worth checking which policies are accepted by the clinic you are most likely to use as not all clinics accept all policies. Then you can choose your provider and the level of cover you require. Insurance is very reasonable, starting at around US$100 every three months per person, for an average level of cover.
This is a fast-growing area especially for dentistry, laser treatment, and cosmetic surgery, as well as other procedures, given that the price is so much less than in some neighbouring countries, and the level of expertise is of high standard, especially in dentistry.
Foreigners wishing to settle in the Dominican Republic are strongly advised to be vaccinated against Hepatitis A and B and typhoid. Malaria is only present usually along the border with Haiti, and anti-malaria pills are not normally needed. Rabies is present but there are on average only one human rabies case every few years. Cholera and the mosquito-borne illnesses of dengue, chikungunya, and zika have sporadic outbursts but usually mostly in the poorer areas where there is a lot of stagnant water in the streets and yards, and a lack of sewage collection and regulation.
Over the last couple of years, a 911 emergency system has been rolled out throughout the country. At the time of writing it is available in Santo Domingo, east to Boca Chica, and west to San Cristobal. It is also now in Santiago and Puerto Plata and will eventually be available in the whole country.