The Healthcare System of Trinidad and Tobago: How to Get Care as a French National

The Ministry of Health steers health policy, and public care is delivered by five regional authorities: North West, North Central, Eastern, South West and Tobago. Each authority manages the hospitals, district facilities and health centres in its area. The Eric Williams Medical Sciences Complex, located at Champ Fleurs on the Uriah Butler Highway, comes under the North Central authority; it also includes, under its responsibility, the Mt. Hope Women’s Hospital and the Caura Hospital.

The ministry describes three levels of care. Health centres handle common illnesses and injuries, basic emergency care and referral to a hospital or a specialist, with chronic disease, tooth extraction, HIV testing and mental health services, generally from 8 am to 4 pm. District facilities, open 24 hours a day in Arima, Mayaro, Chaguanas, Couva, Princes Town and Siparia, offer emergencies and general medicine, pharmacy, X-ray and ultrasound, specialist consultations, prenatal and postnatal follow-up, family planning and child health, some with dental care. Hospitals provide emergencies and specialist care.

According to the profile of the Pan American Health Organization, public health expenditure represents about 3.3% of GDP and about 11% of total public expenditure, while household out-of-pocket payments reach nearly 46% of total health expenditure, a high level that underlines the importance of private cover. Life expectancy at birth is about 74 years, steadily rising, but remains below the average for the Americas region. The country’s “Vision 2030” aims at quality care for all and universal coverage.

The ministry asks people to use the emergency department (Accident and Emergency) only in the event of an accident or a life-threatening situation, for example heavy bleeding, severe chest pain or poisoning. Emergency services are located at the general hospitals of Port of Spain and San Fernando, at Sangre Grande, at Scarborough (Tobago) and at Point Fortin, at the paediatric department of the Eric Williams complex and in the district facilities.

• Ambulance: 811. Police: 999. Fire brigade: 990.
• Disaster management: 511 (ODPM); Tobago: 211 (TEMA).
• Ministry of Health: +1 868 217 4664; chronic diseases: 800-CDAP.
• French embassy (Port of Spain): +1 868 232 48 08; emergency during office hours: +1 868 628 1931; outside office hours, Saint Lucia embassy: +1 758 484 3167 (France Diplomatie).

Note these numbers on arrival and confirm them with the ministry, as details can change.

The Ministry of Health page on access to public care specifies neither the fees charged to patients nor the eligibility of non-nationals; this information should be requested from the ministry or the facility before any scheduled care. France Diplomatie warns that without insurance or an assistance contract, access to care may be refused, even in a life-threatening situation, and that the embassy cannot pay the costs.

A registered employee is affiliated to the National Insurance Board, which finances pensions and benefits but does not reimburse routine care. The detail is in the page on healthcare reimbursement in Trinidad and Tobago.

France Diplomatie indicates that the quality of healthcare infrastructure varies from country to country and recommends private facilities, described as expensive but of better quality. The names of private clinics are not repeated here: the insurer or assistance provider indicates its network, and direct payment avoids paying up front when the facility is a partner. Always ask for a written quote for a scheduled procedure and check that medical evacuation is in the contract: for serious accidents and illnesses, France Diplomatie mentions evacuation to Martinique, Guadeloupe or Miami.

• Mosquitoes: chikungunya, dengue and zika are transmitted by mosquitoes. Dengue has no curative treatment and anti-inflammatory drugs should be avoided; zika poses a risk in pregnancy. Protection relies on covering clothing, repellents, mosquito nets and the removal of standing water. The ministry runs a vector control line (612-IVCD).
• Water and food: typhoid fever is transmitted through water and food; drink bottled or treated water, and avoid unpeeled raw vegetables, shellfish and cold buffets.
• Rabies: vaccination advised for young children and for stays in rural or isolated areas; avoid any contact with stray or wild animals and seek medical advice immediately after an exposure.
• Vaccines: French schedule up to date; yellow fever is recommended and its certificate is required for travellers coming from an at-risk country; hepatitis A and B and typhoid depending on the stay; chikungunya and dengue depending on the epidemic situation.

See a doctor or an international vaccination centre well before departure, to leave time for boosters.

No social security agreement binds France and Trinidad and Tobago (CLEISS): the carte Vitale cannot be used. The options, depending on status, are the seconded employee’s retained scheme, the CFE (the French expatriates’ health fund) and international health insurance. For a tourist stay, bank cards sometimes include assistance whose ceilings should be read. The guide to healthcare systems around the world and the Trinidad and Tobago country page complete these benchmarks.

Zika poses a risk in pregnancy: a woman who is pregnant or planning a pregnancy sees a doctor before travelling, and any fever during or in the weeks after the stay warrants a consultation. For young children and for stays in rural or isolated areas, France Diplomatie advises rabies vaccination and avoiding any contact with stray animals; after a bite or a scratch, wash with soap and water and seek urgent medical attention.

For chronic diseases, the Ministry of Health runs a helpline (800-CDAP). Long-term treatment is prepared with the insurer: prior agreement, local availability of the medicine and a prescription written under the international non-proprietary name.

• Take out insurance covering care, hospitalisation, repatriation and evacuation to Martinique, Guadeloupe or Miami.
• Note the numbers 811 (ambulance), 999 (police), 990 (fire brigade), 511 (ODPM) and that of the embassy (+1 868 232 48 08).
• Check the vaccination schedule, yellow fever and boosters, several weeks before departure.
• Plan the necessary medicines in their original packaging, with a prescription under the international non-proprietary name.
• Register on Fil d’Ariane (the French foreign ministry’s alert service for travellers) and keep copies of your documents and insurance contract.