The Healthcare System in Guadeloupe: Hospitals, Emergencies, GP of Record, Medicines and Health Risks

Guadeloupe is an overseas department and region where laws and regulations apply as of right (Article 73 of the Constitution), and general social security legislation applies there (Article L751-1 of the Social Security Code). CLEISS (the French centre for European and international social security liaison) specifies that, in the overseas departments, benefits are paid by the general social security funds (CGSS) and not by the CPAM. The CGSS of Guadeloupe carries out locally the missions of the health, pension and collection branches of the general scheme; its Assurance Maladie branches receive visitors by appointment (ameli.fr or 36 46) in Basse-Terre, Capesterre-Belle-Eau, Les Abymes, Le Moule, Marie-Galante, Port-Louis, Saint-François, Sainte-Rose and Saint-Martin.

The Regional Health Agency (ARS) for Guadeloupe, Saint-Martin and Saint-Barthélemy, based on rue des Archives in Gourbeyre (05 90 80 94 94), is responsible for organising the care offering, health monitoring and prevention. Its 2023-2028 regional health project sets the framework for the care offering. The guide social security and health in Guadeloupe explains the legal framework and the affiliation procedures.

• Guadeloupe University Hospital (CHU) (route de Chauvel, 97159 Pointe-à-Pitre Cedex; switchboard 05 90 89 10 10, Monday to Friday from 8 a.m. to 6 p.m. according to the facility): the reference hospital, with its general divisions, a mother-and-child division at the Palais Royal site and a university consultation and research centre in Baie-Mahault. The Haute Autorité de santé publishes the facility’s certification on its page.
• New CHU: the CHU website presents a new facility on the Plaine aux Abymes, covering 19 hectares, with a programme of 558 beds and 82 places. The pages consulted do not detail the timetable for transferring services: the address of each consultation should be confirmed with the CHU.
• Basse-Terre hospital (avenue Gaston Feuillard, 97109 Basse-Terre Cedex; switchboard 05 90 80 54 54): public medicine, surgery and obstetrics facility with 237 beds and places, organised in two divisions (medicine and surgery), the only referral hospital of southern Basse-Terre, for a catchment area of more than 100,000 inhabitants that accounts for 90% of its activity. It is a member of the Guadeloupe hospital group.
• Marie-Galante (Sainte-Marie) and Capesterre-Belle-Eau hospitals: public facilities cited by the ARS among the archipelago’s public vaccination centres. Marie-Galante hospital is also among the emergency surveillance sources of Santé publique France.
• Louis-Constant Fleming hospital: public hospital of Saint-Martin, within the same ARS area, presented in the guide healthcare system in Saint-Martin.

The national emergency numbers (Ministry of the Interior) apply: 15 for the SAMU, 17 for police emergency, 18 for the fire brigade, 112 for the European emergency number, 114 for people who are deaf, deafblind, hard of hearing or aphasic, 196 for sea rescue, 31 14 for suicide prevention and 32 37 for the on-call pharmacy. The ARS specifies that hospital call-handling is provided by the SAMU - Centre 15 of the CHU.

For out-of-hours care in the community, the ARS describes, in a dedicated page, a division into 11 on-call sectors (6 for Guadeloupe and 5 for the outlying islands, Saint-Martin and Saint-Barthélemy) and 5 on-call medical centres, with private-practice call-handling entrusted to a departmental association for on-call duties, emergencies and out-of-hours care. Current contact details should be confirmed with the ARS. If in doubt about severity, dialling 15 gives medical advice and guidance.

As in mainland France, declaring a GP of record (médecin traitant) means being reimbursed at the normal rate. According to the Assurance Maladie page on Guadeloupe, Martinique, French Guiana and Réunion, a sector 1 general practitioner consultation costs €36: within the care pathway, 70% is reimbursed, i.e. €23.20 after the €2 flat-rate contribution, leaving about €12.80 to pay before supplementary cover. Outside the pathway, reimbursement falls to €12.60. A sector 1 specialist consulted within the pathway is billed €31.80 and reimbursed €20.26. Sector 2 doctors set free fees, reimbursed on the basis of the social security tariff. Minors, pregnant women from the 6th month to 12 days after delivery and recipients of the Complémentaire Santé Solidaire (C2S, supplementary solidarity health cover) do not pay the €2 contribution.

The guide healthcare reimbursement in Guadeloupe details each item (hospitalisation, dental, optical, maternity) and each status.

Medicine reimbursement rates are 65% for major or important medical benefit, 30% for moderate benefit and 15% for low benefit; irreplaceable and particularly expensive medicines are reimbursed at 100% (Assurance Maladie). A medical deductible of €1 is withheld on boxes of medicines. On-call pharmacies are reached on 32 37, and the ARS offers on its website a search service for on-call pharmacies. Pharmacies are among the places where you can be vaccinated, along with doctors and nurses on prescription.

Dengue. Dengue is monitored by Santé publique France (Antilles edition) as part of an epidemic surveillance, alert and management programme, which classifies the situation by phases. Guadeloupe experiences epidemic waves, and the ARS stresses that the virus continues to circulate even outside epidemic periods.

Chikungunya. Santé publique France recalls that the Aedes aegypti mosquito, established in the Antilles, is also competent to transmit the chikungunya virus, with a risk of importation and of local transmission chains becoming established during epidemics in other territories. The up-to-date situation should be confirmed with the ARS.

Prevention. The ARS recommends seeking care in case of high fever while avoiding aspirin and anti-inflammatories, protecting yourself from bites (mosquito nets, skin repellents, long clothing, household insecticides) and removing larval breeding sites (“empty, turn over, throw away”, cover water reserves).

Leptospirosis. Santé publique France tracks probable or confirmed cases for Guadeloupe, Saint-Martin and Saint-Barthélemy. It reports a seasonal upsurge during the rainy season and at-risk activities: gardening, green-space maintenance, hiking, walking barefoot outdoors, swimming in rivers and freshwater fishing.

Sargassum and chlordecone. Sargassum strandings release, as they decompose, hydrogen sulphide and ammonia, monitored by the ARS; the opinion of the Haut Conseil de la santé publique of July 2018 recommends moving away from affected areas and seeking care in case of irritation, with vulnerable people (pregnant women, young children, people over 65, asthmatics, people with cardiovascular disease) urged to take the greatest care. For chlordecone, Anses (the French food and health safety agency) indicates that diet is the main route of exposure and recommends limiting root vegetables and tubers from family gardens in contaminated areas to twice a week, and fishery products from short supply chains to four times a week.

Respiratory infections. Santé publique France publishes a regular bulletin for the Antilles on influenza, bronchiolitis and Covid-19, with seasonal upsurges.

According to the ARS, you can be vaccinated by any private-practice or hospital doctor, at the public vaccination centres (Institut Pasteur de la Guadeloupe, the Louis-Constant Fleming, Sainte-Marie, Capesterre-Belle-Eau and Basse-Terre hospitals, the CHU’s multipurpose and international vaccination centre), at a pharmacy, at the maternal and child health services for children under 7, by nurses on prescription and by midwives for certain vaccines. Before a trip, the ARS advises planning at least a month ahead and cites the airport medical centre among the facilities concerned.

Ageing weighs on demand for care: people aged 60 and over make up about a third of the population, one of the highest shares among French regions along with Martinique, with a negative natural balance and a negative migration balance, young adults leaving to study or work (Insee). Life expectancy reaches about 78 years for men and 85 years for women.

When care is not possible locally, the Assurance Maladie can fund transport subject to prior approval equivalent to a medical prescription, if the state of health justifies it and under certain conditions; a companion’s costs are covered under conditions, and medical costs in part or in full if the exemption conditions are met. During a hospital stay, the facility’s social service or the fund’s referent supports the procedures; one-off help from the health and social action fund is possible. An assistance policy remains useful for travel outside France.