The Saint Vincent and the Grenadines Healthcare System: Hospitals, Access for Foreigners, Emergencies and Health Risks

The Ministry of Health, Wellness, Environment and Energy organises community health, hospital, geriatric (Lewis Punnett Care Home), mental health, laboratory, environmental health and health safety services. Its list of facilities has 45 structures in nine districts: Northern and Southern Grenadines, Marriaqua, Pembroke, Kingstown, Georgetown, Chateaubelair, Cedars and Calliaqua. The hospitals are the Milton Cato Memorial Hospital in Kingstown (emergency unit), the Levi Latham Hospital (Marriaqua), the Chateaubelair Hospital, the Bequia Hospital and the Clifton Union Island Hospital; two polyclinics, at Buccament Bay (Pembroke) and Stubs (Calliaqua), and a medical and diagnostic centre in Georgetown complete the many health centres. France Diplomatie also mentions private facilities in Kingstown.

The budget address announces the continuation of the Arnos Vale hospital, which will bring together maternity, paediatrics and all the major services and become the country’s main hospital, as well as up to one million dollars of emergency repairs to the roof and operating theatres of the Milton Cato during the transition. It also provides for a patient support unit with one million dollars to coordinate radiotherapy abroad, screening for breast, cervical, prostate and colon cancer in primary care centres, a health information system funded by a six-million-dollar grant from Taiwan and the expansion of dental care.

It also mentions the hiring of two dental surgeons and two assistants, with more capacity at Calliaqua and Chateaubelair, standardisation of the training and protocols of the national emergency response system, the construction at Diamond of a centralised prefabricated warehouse worth 2.5 million dollars for medical supplies, which would remove 350,000 dollars of annual rent, the review of mental health policies and the strengthening of geriatric care at the Lewis Punnett Home, through updated admission criteria and staff training.

The World Bank records just over 3 hospital beds and fewer than 1 doctor per 1,000 inhabitants. The census reports more than 12,000 cases of hypertension and nearly 7,000 cases of diabetes: the budget address speaks of a silent epidemic of non-communicable diseases, with a health budget of around 120 million Eastern Caribbean dollars a year. According to the ministry’s list, Marriaqua and Georgetown each have seven structures, Pembroke and Chateaubelair six, Cedars and Calliaqua five, the Southern Grenadines four, the Northern Grenadines three and Kingstown, where the reference hospital is, two.

The same address announces a three-year phase-out of the use of Cuban district doctors, with the recruitment of local doctors, and wider access to community laboratories. These orders of magnitude describe a small archipelago state where each establishment counts for a lot, hence the value of a policy that includes evacuation. The full Saint Vincent and the Grenadines country page gathers the general benchmarks.

National Insurance Services pays cash benefits: sickness benefit at 65% of average insurable wage for up to 26 weeks (26 contributions including 8 in the last 13 weeks), maternity allowance at 65% for up to 13 weeks with an allowance of 660 dollars per live birth, and disability, old-age and survivors’ pensions. Only the employment injury branch mentions medical costs. The Ministry of Health publishes a patient guide, marked as expired on its website, which states that care is provided according to clinical need regardless of ability to pay and that the patient may ask for an itemised bill.

No official source read publishes a fee scale for care for non-residents or conditions for a foreign resident to join a public health scheme: these points should be confirmed with the Ministry of Health before settling. On the French side, the country does not appear in the CLEISS list of social security agreements; the carte Vitale (the French health insurance card) cannot be used locally and the arrangements by status are detailed in healthcare reimbursement in Saint Vincent and the Grenadines.

First-line consultations take place at a public health centre, found in every district, or at a private practice. France Diplomatie points out that several hospitals require payment in advance, hence the value of checking before departure that insurance covers this advance or provides for direct payment.

• Emergency services: 999 for the police, the fire brigade and the coast guard; local police (duty line): +1 784 457 12 11.
• Kingstown: emergency unit of the Milton Cato Memorial Hospital on +1 784 456 1955; public hospital on +1 784 456 11 85 (France Diplomatie).
• Other public hospitals: Georgetown +1 784 458 62 25, Troumaca +1 784 458 22 28, Bequia +1 784 458 32 94 (France Diplomatie); Clifton, on Union Island, +1 784 458 8339 (Ministry of Health).
• Air medical evacuation: +1 784 457 11 21 (France Diplomatie). French consular agency in Kingstown: +1 784 456 25 67; French embassy in Saint Lucia: +1 758 455 60 60 during working hours.

Keep your insurance certificate, the assistance number and the list of treatments. In a life-threatening emergency, the insurer’s assistance arranges referral and, if necessary, evacuation.

Before a non-urgent consultation, ask in writing for the fee, the accepted method of payment, the time to receive reports and the documents useful for a reimbursement. Keep prescriptions, paid invoices and proof of payment: they are used by the CFE, by the insurer or, for a posted employee, for form S 3125c. A person on chronic treatment asks their doctor for a medical summary in English, the list of molecules in international non-proprietary form and the quantities needed for the planned length of stay, and checks with the insurer the conditions for covering pre-existing conditions.

France Diplomatie reminds readers that the French embassy can pay neither medical costs nor repatriation and that the assistance contract or insurance must cover all costs, surgery and hospitalisation included. A policy providing for evacuation to the suitable establishment, and not only repatriation to France, answers this reality. See repatriation and assistance. Distances between islands also matter: a stay in the Grenadines means knowing the means of transport to Kingstown.

The country has no decompression chamber: the nearest are in Barbados, Grenada and Saint Lucia. Divers check that their policy covers diving.

France Diplomatie asks you to update the vaccines in the French schedule, in particular diphtheria, tetanus, polio, whooping cough and measles. Yellow fever is compulsory for travellers coming from an endemic zone; hepatitis A, typhoid, hepatitis B, chikungunya and dengue are discussed with a doctor or an international vaccination centre well before departure.

• Dengue: no curative treatment; avoid anti-inflammatory drugs and consult without delay.
• Chikungunya: symptomatic treatment; consult from the first symptoms.
• Zika: pregnant women or those planning a pregnancy consult before travelling.
• Typhoid: contaminated water and food; hygiene and vaccination.
• Protection against mosquitoes: covering clothing, repellents, mosquito nets or air conditioning, getting rid of standing water.
• Water and food: sealed drinks or water made safe to drink, hands washed often, fruit and vegetables peeled or washed, raw food avoided.

The most common combination pairs an assistance contract with evacuation and cover for routine care: the CFE (Caisse des Français de l’Étranger, the voluntary health insurance body for French people abroad) or international insurance. The CFE reimburses abroad according to rates or flat fees specific to the country of care, applied to the actual expense, with no waiting period if membership takes place before departure or within three months of settling. International insurance generally offers direct access to the private sector and a higher limit. See CFE or private insurance, expat health insurance and long-stay travel insurance. Expavy helps you weigh these options against your situation, for example through the online diagnostic.