 |
|
|
|
| |
Dominica: Healthcare System
|
|
|
|
|
| |
 The Caribbean
island nation of the Commonwealth of Dominica was named after the
Latin word for Sunday, which was the day of the week it was first
observed by explorer Christopher Columbus in 1493. The tiny island
has a population of only 72,000, but boasts varied terrain
including lush forests, pristine beaches and even arid desert-like
parts of the west coast. Although Dominica was ceded to the
British in 1763 and remained a possession of the crown until 1978,
its location and French colonial history mean that while English
is the official language, French and various Creole dialects are
widely spoken and understood, especially among the older
generations. Dominica’s mix of cultures includes a black majority,
native Carib tribes, as well a few Europeans. The cuisine, music
and art are a reflection of this, and are quite similar to
neighbouring Caribbean islands.
Although it is a middle-income developing country, Dominican life
expectancy is in line with that of wealthier countries at 72 years
for men and 76 for women. Total annual health expenditure per
capita in Dominica is USD626, which is only a small fraction of
the Americas regional average; this figure represents 6.4 percent
of GDP. Most health care is administered through the state-run
Ministry of Health, although private health care is available and
usually offered as an employee benefit for expatriate staff.
Dominica’s rates of infectious disease are extremely low. For
example, tuberculosis affects only 13 Dominicans per 100,000
people, or about one third of the regional average. Utilisation of
basic antenatal, birth and infant health care services are nearly
universal in Dominica. All births are attended by skilled health
personnel, compared to 93 percent of births throughout the
Americas. Public health investment is relatively high. Over 90
percent of Dominicans have access to improved drinking water
sources, and about 80 percent have access to improved sanitation
facilities, although these toilets might not all measure up to
developed world standards.
As a tropical island nation, Dominica is a very attractive if
often overlooked tourist destination. But like many tropical
regions, it is also especially prone to insect borne diseases,
including malaria and dengue fever. The US Center for Disease
Control has issued a number of guidelines to prevent and treat
such cases. Using insect repellent with 30 – 50 percent DEET
content, wearing long-sleeved clothing and broad-brimmed hats, and
sleeping with a mosquito net are all recommended.
The CDC recommends visiting a travel health clinic four to six
weeks before travelling to ensure that routine vaccinations are up
to date. It should be noted that the Dominican government requires
travellers from areas at risk of yellow fever transmission are
required to show proof of vaccination upon entering the country.
Hepatitis and typhoid vaccinations are strongly recommended,
especially for those planning to visit more remote parts of the
island. Rabies is only suggested for travellers expecting to come
into contact with bats, usually on spelunking expeditions.
Travellers to Caribbean islands may also be at risk for
leptospiros, ciguatera poisoning and histoplasmosis. These may be
prevalent in areas with fresh surface water and from reef fish.
Tropical sun can have several negative effects, especially on
travellers from more temperate climes. To avoid risk of sunburn or
heatstroke, midday sun should be avoided. Sunblock, long sleeved
clothing and plenty of drinking water can prevent unnecessary
discomfort. Tropical storms, hurricanes and other natural
disasters are also fairly common to the region; the aftermath of
these storms can have serious negative public health consequences
as flooding can pollute drinking water and affect sanitation.
For most travellers, the most common medical problem is
gastrointestinal distress and Dominica is no exception. Drink only
bottled water and avoid raw and undercooked foods to reduce risk.
Acute cases can be treated with over the counter medicine,
although persistent diarrhea or vomiting should be treated by a
physician.
In Dominica, there is only one major health centre, Princess
Margaret Hospital, in the capital city of Roseau. There are seven
health centres and 44 clinics throughout the island. The Ministry
of Health of Dominica is responsible for the provision and
financing of health services on the island. For the purposes of
administering health care, Dominica has been divided into seven
districts. The ministry is organised into eight units, responsible
for: central policy formulation, primary health care, the Princess
Margaret Hospital, Environmental Health Department, Drug Abuse
Prevention Unit, Dominica Solid Waste Management Corporation,
Health Information Unit and the National Aids Response Program.
Each of these dedicated teams also cooperates with the Pan
American Health Organisation (PAHO) and various intergovernmental
and NGO agencies to provide universal health care to Dominicans.
Although Dominica is not a poor country and it does provide
universal health care, the standard of treatment is far below what
can be expected in the developed world. Given the limitations of
local health care resources and the prevalence of natural
disasters, extra precautions should be made before visiting
Dominica. Bear in mind that given its relative isolation, travel
to Dominica is more risky than trips to other more popular
Caribbean destinations. Emergency evacuation may be required for
situations requiring serious medical attention; this may even
require air transport and treatment in the United States where
health care costs are the highest in the world.
Fortunately, the Globalsurance team can help with any of your
travel health insurance needs. Globalsurance offers free
consultations 24 hours a day, with plans for solo travellers,
families and tour groups. The range of policies on offer from
Globalsurance cover everything from dental, maternity, specialist
consultation, transportation, inpatient services and more. Please
contact a Globalsurance adviser today for further international
health insurance details.
|
|
|
|
|
