Dominican Republic

DOMINICAN REPUBLIC

At-A-Glance

  • Among the most advanced EMS systems in the Americas — as long as you’re in a major city or popular tourist location
  • Strong political will to improve access to and establish quality standards for emergency care
  • Recognized in 2013 by World Health Organization as having the most dangerous roads in the world
  • Proximity to U.S. and strong support from medical diaspora has increased domain expertise and opened new commercial provider opportunities
  • Dominican baseball players have donated many ambulances, but local capacity to manage vehicle fleets is limited

SCOREBOARD

Overall score

49% of Population Covered by Public 911 System

[Our estimate based on current expansion of official 911 system vs. total population]

29.3 Road Traffic Injury Deaths per 100,000 population

[Source: 2015 Global Status Report on Road Safety, WHO]

Road Traffic Injury Deaths per 100,000

Road Traffic Injury Deaths per 100,000

Road Traffic Injury Deaths per 100,000

CAN I CALL AN AMBULANCE?
How do I call for help?

Dial 911*

*911 is the official public access number for the entire country and can be reached toll-free from any phone number originating in the Dominican Republic. Two call centers have been recently built in Santo Domingo (2014) and Santiago (2016) to coordinate police, fire and emergency medical services for their respective metropolitan areas. However, once leaving Santo Domingo, Santiago, San Cristobal, La Haina and parts of Puerto Plata and Punta Cana, emergency vehicles are difficult to summon.

Can I call it from anywhere?

Expansion of the government 911 system is expected in 2017 to Puerto Plata, Sosua, Cabarete, Luperón, and the roads in between and connecting to Santiago.

(From: Dominican Republic government transparency portal. Last accessed: Jan 15, 2017)

Are there other numbers I can call?

“The U.S. Citizens Services (ACS) Unit of the U.S. Embassy can provide a variety of services to U.S. citizens faced with medical emergencies while in the Dominican Republic. The ACS Unit maintains a List of Doctors and Hospitals in the Dominican Republic, (PDF – 199 KB), that might be of assistance to you. It is important to emphasize that solely the beneficiary of such services, and not the U.S. Government, is responsible for paying his/her own medical bills.”

(From: https://santodomingo.usembassy.gov/medical_assistance-e.html. Last accessed: Jan 15, 2017)

ADDITIONAL INFO
GOVERNMENT OVERSIGHT

Lead Agency – Provincial DOH

Government Oversight: – Medical oversight provided by Chief Medical Officer and Medical Advisory Committee. Includes treatment and hospital bypass protocols

Dispatch – ASNSW – 5 call centers to where all emergency calls are directed. Use of Computer Aided Dispatch (CAD) and vehicles equipped with Mobile Data Terminals (MDT) for messaging and Automatic Vehicle Location. Recent introduction of Medical Priority Dispatch System (MPDS)

REFERENCES

Boyle MJ, Smith EC, Archer FL: “Trauma incidents attended by emergency medical services in Victoria, Australia.” Prehospital and Disaster Medicine 2008;23(1):20-8.

Trevithick S, Flabouris A, Tall G, Webber CF: “International EMS systems: New South Wales, Australia.” Resuscitation 2003;59:165-70.

2015 Global Status Report on Road Safety, WHO

LINKS

Ambulance Service of NSW (ASNSW)
Metropolitan Ambulance Service (Victoria)
Rural Ambulance Victoria

HOW DOES IT COMPARE?
What are common medical emergencies?
Road Traffic Injuries

Infectious Disease

  • “Dengue is endemic in the Dominican Republic and outbreaks occur annually” (iamat.org, Last accessed: Jan 10, 2017)
  • Chikungunya in the Dominican Republic: lessons learned in the first six months [Abstract] (Rev Panam Salud Publica 36(5), 2014 español)
  • in 2016 there were 1069 cases and 18 deaths from cholera (ProMED, Last accessed Jan 10, 2017)

Hurricanes

Yes the Dominican Republic has a high vulnerability to hurricanes. Read: “The cyclones, hurricanes and storms in Dominican Republic” from dominican-republic-live.com to get a nearly exhaustive history of hurricanes in the Dominican Republic since 1615

How do I call for help?

911

Can I call it from anywhere?

*911 is the official public access number for the entire country and can be reached toll-free from any phone number originating in the Dominican Republic. Two call centers have been recently built in Santo Domingo (2014) and Santiago (2016) to coordinate police, fire and emergency medical services for their respective metropolitan areas. However, once leaving Santo Domingo, Santiago, San Cristobal, La Haina and parts of Puerto Plata and Punta Cana, emergency vehicles are difficult to summon.

How far will 911 coverage expand to?

Expansion is expected in 2017 to Puerto Plata, Sosua, Cabarete, Luperón, and the roads in between and connecting to Santiago.

(From: Dominican Republic government transparency portal. Last accessed: Jan 15, 2017)

Other Published Emergency Numbers in the D.R.

“The U.S. Citizens Services (ACS) Unit of the U.S. Embassy can provide a variety of services to U.S. citizens faced with medical emergencies while in the Dominican Republic.  The ACS Unit maintains a List of Doctors and Hospitals in the Dominican Republic, (PDF – 199 KB), that might be of assistance to you.  It is important to emphasize that solely the beneficiary of such services, and not the U.S. Government, is responsible for paying his/her own medical bills.”

(From: https://santodomingo.usembassy.gov/medical_assistance-e.html. Last accessed: Jan 15, 2017)

What about communications in disasters?

The emergency operations center (Centro de Operaciones de Emergencias) is the government agency mandated with coordinating disaster preparedness and response efforts. As of Jan. 2017, the website is still being completed, but you can sign up for the mailing list here (en español) or you can also follow them on Twitter at @COE_RD

For U.S. Citizens

“The U.S. Citizens Services (ACS) Unit of the U.S. Embassy can provide a variety of services to U.S. citizens faced with medical emergencies while in the Dominican Republic.  The ACS Unit maintains a List of Doctors and Hospitals in the Dominican Republic, (PDF – 199 KB), that might be of assistance to you.  It is important to emphasize that solely the beneficiary of such services, and not the U.S. Government, is responsible for paying his/her own medical bills.”

(From: https://santodomingo.usembassy.gov/medical_assistance-e.html. Last accessed: Jan 15, 2017)

Are there trained responders?
Santo Domingo

Yes, there are a number of training institutes for both private and public emergency providers, largely concentrated in Santo Domingo:

– Dirreción Nacional de Desastres y Emergencias

Universidad Nacional Pedro Henríquez Ureña has offered Advanced Trauma Life Support (ATLS) for both clinical and prehospital providers

How will they transport me?
Santo Domingo, Santiago and San Cristobal-La Haina

In 2015, the government of Taiwan donated 84 new ambulances and 480 motorcycles to the 911 development project, including:

  • 20 advanced life support (ALS )ambulances, including four with neonatal equipment (Hyunday, Model H1 2015)
  • 54 2×4 basic life support (BLS) ambulances (Hyundai, Model H1 2015)
  • 10 4×4 BLS ambulances (Volkswagen, Model Transporter T5 2015)
  • 480 motorcycles
    • 200 were given to the national police
    • 100 to the transport authority (AMET)
    • 80 to reinforce the ambulance system
    • 100 to the military.

The US government has also donated

  • Rescue equipment and tools to the Fire department of San Cristobal-Haina for a value of $50,000 (May, 2016)
  • Emergency and Rescue including vehicles, computers, extraction tools, and office supplies for a value of $300,000 to the Fire departments supporting the 911 system (February, 2016)
  • Equipment, mostly electronic equipment, video surveillance camaras, computers, servers, etc. ($6 Million)

Source: Dominican Republic government transparency portal

Where will they take me?
Existing Maps

Official Ministry of Health Map for all health centers in the country.

How will I pay?
For Dominican Citizens

In the Dominican Republic, health coverage is guaranteed by law and administered through Law 8701, The Family Health Insurance, under the responsibility of the National Social Security Council “which is aimed at providing comprehensive protection for the physical and mental health of affiliates and their families, as well as achieving universal coverage without exclusions for age, sex, social, work or territorial circumstances”

[Source: World Health Organization, 2010]

For U.S. Citizens

“Medical Insurance: The Department of State strongly urges U.S. citizens to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and if it will cover emergency expenses such as a medical evacuation. U.S. medical insurance plans seldom cover health costs incurred outside the United States unless supplemental coverage is purchased. Further, U.S. Medicare and Medicaid programs do not provide payment for medical services outside the United States. However, many travel agents and private companies offer insurance plans that will cover health care expenses incurred overseas, including emergency services such as medical evacuations.

Some of the health service providers that have accepted U.S. medical insurances in the past are:

  • Plaza de la Salud General Hospital – Assistcard, AXA Assistance, BUPA Medical Services, Claria Life, Delaware Life Insurance/Metlife, Emergency, Frontier Medex, Henner-GMC, Inter Mutuelle Assistance, MetLife, QHM, Redbridge, Worldwide Medical Assurance, Seven Corners, SunMed International, Vumi Group.
  • CEDIMAT – Amedex, Aetna Global Benefits, AXA Assistance Chicago, Accident and Health Travels, Best Doctor Inc., Careplus, Cigna International Expatria Benefits, Euro Center, Es-Ko International Inc., Global Assurance Group, Global Excel Management, Groupe Mutual Assistance, GMC Services International Adm., International SOS Assistance, Morgan White, Minustah, Medex Assistance Corp., Mondial Assistance, North American Commision of the IALE, Olympus Managed Health Care Inc., State Insurance Corporation, World Access, Travel Guard, USA Medical Services, Universal Assistance Inc., Worldwide Medical Assurance.

When making a decision regarding health insurance, U.S. citizens should consider that many foreign doctors and hospitals require payment in cash prior to providing service and that a medical evacuation to the United States may cost well in excess of $50,000. Uninsured travelers who require medical care overseas often face extreme difficulties. When consulting with your insurer prior to your trip, please ascertain whether payment will be made to the overseas healthcare provider or if you will be reimbursed later for expenses that you incur. Some insurance policies also include coverage for psychiatric treatment and for disposition of remains in the event of death.

Useful information on medical emergencies abroad, including overseas insurance programs, is provided in the Department of State’s Bureau of Consular Affairs brochure, Medical Information for U.S. Citizens Traveling Abroad, available via the Bureau of Consular Affairs home page or autofax: (202) 647-3000.”

(From: https://santodomingo.usembassy.gov/medical_assistance-e.html. Last accessed: Jan 15, 2017)

ADDITIONAL INFO
Useful Links
References

  • Arellano N, Mello MJ, Clark MA. “The role of motorcycle taxi drivers in the pre-hospital care of road traffic injury victims in rural Dominican Republic.” Inj Prev. 2010 Aug 9;16(4):272–4
  • Báez A, MsSc M, Giraldez E. “Knowledge and Attitudes of the Out-Of-Hospital Emergency Care Consumers in Santo Domingo, Dominican Republic.” Prehosp Disaster Med. 2008 May 28;27(4):273–6.
  • Báez AA, Lane P. “Emergency Medical Services Workforce in the City of Santo Domingo.” Prehosp Emerg Care. 2002;6(3):336–9.
  • Eaton D, U HMS. Determining Ambulance Deployment in Santo Domingo, Dominican Republic. J Oper Res Soc. 1986;37(2):113–26.
  • Tappero J, Tauxe R. Lessons Learned during Public Health Response to Cholera Epidemic in Haiti and the Dominican Republic. Emerg Infect Dis. 2011 Nov;17(11):2087–93.

EMS History

Baéz AA. “A history of EMS in the Dominican Republic”Energ Med Serv 2001 Jun;30(6):76.

Government Oversight
Directing Agencies

Lead Agency – Office of the Presidency

Medical Direction – Ministry of Public Health

Telecommunications Regulation
Official Partners

  • Ministerio de Interior y Policía (MIP)
  • Ministerio Público (MP)
  • Policía Nacional (PN)
  • Armada de República Dominicana
  • Ejército de República Dominicana
  • Fuerza Aérea de República Dominicana
  • Cuerpo de Bomberos
  • Ministerio de Salud Pública (MSP)
  • Centro de Operaciones de Emergencias (COE)
  • Defensa Civil
  • Agencia Metropolitana de Transporte (AMET)
  • Cruz Roja Dominicana
  • Hospitales y Clínicas
  • Compañías de servicios de Ambulancia privado
  • Corporación del Acueducto y Alcantarillado de Santo Domingo (CAASD)
  • Instituto Nacional de Recursos Hidráulicos (INDHRI)
  • Corporación Dominicana de Empresas Eléctricas Estatales (CDEEE)
  • EDESUR
  • EDENORTE
  • EDEESTE

Twitter Feeds
@911GobDo - Official 911
@CoE_RD - Official Emergency Operations Center (COE)
@DefensaCivilRD - Official Civil Defense
@PAHO - Official Pan American Health Organization
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