Dominican Republic

Located in the Caribbean, this nation occupies the eastern end of the island of Hispaniola, and was a Spanish colony until gaining its independence on February 27, 1844. It has a population of 8,834,000 (2004) and there are 216 doctors and 30 nurses per 100,000 people. There are also 516 dentists in the country. Until relatively recently, the health services in much of the Dominican Republic were fairly rudimentary.

It is believed that Christopher Columbus, on his first voyage in 1492, may have landed on the Samaná peninsula which was then a separate island off the north coast of the Dominican Republic. On his second voyage in 1493, he built a base at what is now Santo Domingo, and it was during this visit that he and his sailors noticed the local Taino people smoking rolled leaves of tobacco. Some tobacco leaves were then brought back to Europe, with a major effect on the healthcare around the world to the present day.

The major health problems facing people in the Dominican Republic include malaria, especially in rural parts of the country; heat exhaustion and heat stroke, and schistosomiasis (bilharzia). The latter comes from parasitic worms which live in infected freshwater snails and are commonly found in rivers, lakes and especially near dams. Tourists are thus advised not to swim except in chlorinated swimming pools. There have also been cases of dengue fever, and a prevalence of human T-cell leukemia [Page 553]lymphona virus in some black former slave communities in the country. By 1988, there had been 701 cases of the acquired immune deficiency syndrome (AIDS), of which 65 had died. Subsequently, AIDS increased dramatically, and HIV and AIDS are now widespread.

Healthcare in the Dominican Republic is run by the Secretariat of State for Public Health and Social Welfare, with the Secretary of State having a position in the cabinet. The Asociatión Médica Dominicana (Dominican Medical Association), founded in 1941, operates from Santo Domingo, the country's capital, and publishes the Revista Médica Dominicana. It has 1,550 members. Founded in the same year, the Asociatión Médica de Santiago (Santiago Medical Association) operates from the city of Santiago de los Cabelleros, in the north of the country, and publishes Boletin Médico, and has 65 members. Mention should also be made of the Dominican Medical Congress which has been in operation since 1844.

There are a number of medical schools throughout the country, the main one being the Faculty of Medicine in the Universidad Autónoma de Santo Domingo, the university founded in 1538 making it the oldest university in the Americas. There is a Faculty of Health Sciences at the Pontificia Universidad Catolica Madre y Maestra; a Faculty of Medicine at the Universidad central del Este; a School of Public Health at the Universidad Eugenio Maria de Hostos, the Faculty of Health Sciences at the Universidad Nacional Pedro Henriquez Urena and at the Universidad Tencnológia de Santiago.

From the mid-1970s, there has been a major government attempt to improve healthcare throughout the country. As a result, by the early 1980s, there were some 5,000 rural health clinics, health subcenters and some satellite clinics. Pharmacies are now common throughout the country. Doctors were required to serve for one year in remote or poor districts, but there were complaints that some poorly trained local health workers were not sufficiently trained in how to teach about health problems and disease prevention. To alert the public to health care concerns, and raise money for charity, the postal authorities of the Dominican Republic have issued large numbers of postage stamps to raise money for medical charities.

...