Living in the Dominican Republic?
Dominican Republic: Health and Safety
The Healthcare System
The Dominican healthcare system has been undergoing reforms since 2001, which is good news for everyone involved. The old system was underfunded, inefficient, low quality, and resulted in a lot of out-of-pocket expenses for the patients — even the poorest of Dominican society. The new system is split into three clear tiers:
- contributive regime — financed by workers and their employers
- subsidized regime — financed by the state for the poor, unemployed, disabled, and indigent
- contributive subsidized regime — financed by independent professionals, technical workers, and self-employed persons themselves, but subsidized by the state (instead of an employer)
As an expat working in the Dominican Republic, you are likely to be part of the contributive regime, but it is worth clearing up the details with your employer. Private health insurance or complementary insurance is essential to avoid excessive gaps in coverage costs, i.e. what you have to pay for each visit or treatment. The reforms of the public healthcare system still have a long way to go. In fact, in 2013 only 58% of workers were contributing to the public healthcare system, even though the reforms had begun twelve years earlier.
In terms of medical services, the Dominican Republic is not far behind other developed countries and even offers far better services than other Caribbean nations in some areas. Its excellent reputation in the field of laparoscopic laser surgery and dentistry, for instance, attracts patients from the Virgin Islands, the Lesser Antilles, and other Caribbean countries who wish to take advantage of the high-quality care. However, most of these high-quality services are offered by private clinics which are well staffed and have the newest equipment. Fees range from DOP 400 to DOP 3,000 — around 65 USD — for the first visit, depending on the clinic. Make sure that your insurance covers treatments at these hospitals.
One thing you should keep in mind is that general practitioners and family doctors are, in fact, very rare in the Dominican Republic. This is why you should choose an internist, instead of a general practitioner, who tends to your basic needs and refers you to specialists if needed. You can turn to doctors’ practices or local clinics for basic care; if you are unsure which doctor or clinic to choose, contact your insurance company for help or ask your friends and co-workers for recommendations.
Necessary Vaccinations and Precautions
As is always the case when you move to a Caribbean country, living in the Dominican Republic requires expats to take care of vaccinations and immunizations if they want to stay healthy. Aside from routine vaccinations like measles, mumps, and rubella, as well as diphtheria, pertussis, and tetanus, there are other health precautions you need to keep in mind. Hepatitis A and B should by now be a standard vaccination for expats who travel abroad a lot to lesser developed countries. If you also plan on spending a decent amount of time outside the cities exploring rural areas and smaller towns of the Dominican Republic, typhoid and rabies vaccinations are definitely recommended.
On top of that, malaria is prevalent in almost all areas of the Dominican Republic, except for the cities of Santo Domingo and Santiago. As an expat who plans on spending months or even years in the DR, it is likely that you will visit places in the Dominican Republic where the risk of an infection is particularly high. Thus, you should talk to your doctor about taking antimalarial drugs such as Atovaquone-proguanil, Chloroquine, Doxycycline, or Mefloquine. However, taking precautions can also be an effective way of preventing a malaria infection: make sure to use insect repellent, wear long sleeves and pants, and sleep in well-screened rooms or under bed nets.
Also, as of 2016, there is a warning issued against the Zika virus. This virus can be dangerous for pregnant women and is also transmitted by mosquitoes. It is therefore recommended to take the same precautions as for preventing a malaria infection and to contact your embassy for more information.
Tropical Storms in the Dominican Republic
Tropical storms and hurricanes are a serious concern for those living in the Caribbean. These storms can cause serious damage and injury and are a threat which is not to be taken lightly. The main hurricane season is from June to November, with peak times from late August to the end of September. The last hurricane that hit the country was Hurricane Sandy in 2014. It was very powerful and deadly, and it is advised to be always prepared for a storm warning. Generally, you should find out if a tropical storm is approaching via different news media. Keep your eyes open for alerts (alerta) and approaching storms (aviso).
You should be able to receive information about a target area and whether it is necessary to evacuate your home. If you are not living in the evacuation zone and are sure that your building can withstand a storm, you may stay there until the storm is over. However, make sure to make your home “disaster ready” and to have a “disaster kit” with plenty of canned food and water. The good news is that 90% of all buildings in the country are completely storm-resistant. More people are killed through injuries after, rather than during, the storm. Make sure, therefore, to avoid fallen wires and potentially dangerous situations once the storm is over.
Safety in the Dominican Republic
When you think of the Dominican Republic, you may associate it with relatively unsafe countries in the region, like Jamaica, Venezuela, or Colombia. Even though the DR is safer than those countries, the threat of crimes remains high, so make sure to be aware of the most common crimes.
The most common crime is drive-by robbery, and criminality is shifting from firearm violence to robbery and theft. However, the Dominican Republic is in the top 20 countries with the highest murder rate worldwide, but violent crime mostly affects poor areas of the country, and it is important to mention that the situation is indeed safer in the capital.
In Santo Domingo most of the criminal activities take the form of thefts at ATMs, drive-by robbery, real estate scams, or credit card frauds.
Most of the armed assaults happen at night. As a consequence, if you don’t have a car, it is better to book a taxi at night — Apolo, for example, is a trustworthy company. If you do have a car, it is recommended to park it close to other cars to minimize the risk of theft by glass breakage, which happens frequently in the Dominican Republic.
Finally, if you have an emergency, call 911. However, this number only works in Greater Santo Domingo, thus if you are elsewhere in the country, they will redirect your call to the unit in charge.
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