Health cannot become purely a business
Over two years without dengue deaths and 96% HPV vaccination coverage represent significant public health achievements in Santiago province. Private medical centers prioritize administrative and economic criteria over patient care, with excessive bureaucracy delaying treatment and reducing patients to economic indicators.
- Over two years without a single dengue death in Santiago province
- HPV vaccination coverage reached 96% among children aged 9-14
- Health minister took office in January 2024 during a dengue crisis
- Dairy factory temporarily suspended for production condition violations, not product quality issues
Santiago's provincial health director criticizes the dehumanization of medicine in Dominican healthcare, citing bureaucratic delays and profit-driven systems while highlighting successes in dengue control and HPV vaccination coverage.
Dr. Víctor Méndez sits in the provincial health director's office in Santiago, but he would rather be anywhere else—on the streets of Cienfuegos, in Gurabo, walking through Los Ciruelitos. He is, by his own admission, an enemy of offices. During a recent television interview, the director of Health for Santiago I province offered a candid assessment of Dominican healthcare: a system that has achieved remarkable victories against disease but has lost something essential in the process.
Méndez oversees a sprawling apparatus that most citizens never see. Provincial health directors function as watchdogs over hospital operations, coordinate vaccination campaigns, monitor disease outbreaks, and ensure that the National Health Service functions properly across their territory. When he speaks of his role, he frames it simply: "We are the guardians of good health function throughout the country." It is a job that requires presence, not paperwork. He spends his days moving through neighborhoods, checking on conditions, listening to what people need.
The numbers tell one part of the story. When the current minister of public health took office in January 2024, the country was in crisis. Dengue cases were climbing. Deaths were mounting. The situation had become one of the most serious health emergencies in recent memory. Méndez and his team implemented an aggressive response: community surveillance, systematic elimination of mosquito breeding sites, continuous fumigation, coordination with neighborhood associations and municipal leaders. The results have been striking. For more than two years now, Santiago has recorded zero deaths from dengue. The achievement has drawn international attention; the Dominican Republic is being cited as a regional model for disease control. The HPV vaccination campaign has reached nearly 96 percent coverage among children aged nine to fourteen—a figure Méndez describes as historic.
Yet these victories sit uneasily alongside a deeper concern that animated much of his recent interview. Méndez turned his attention to what he calls the dehumanization of medicine. He spoke from personal experience and observation: private medical centers have increasingly prioritized administrative procedures and profit margins over the actual care of patients. People wait for hours while bureaucratic protocols delay treatment. Patients are processed rather than treated. The system has begun to see them as economic indicators rather than human beings requiring help. "We have dehumanized medicine," he said flatly. "Health cannot become purely a business."
His criticism extended to the health insurance administrators, the ARS entities that manage coverage under the current system. While acknowledging their role in the existing structure, Méndez expressed concern about their overwhelming focus on financial returns. "Everyone has the right to earn money, but health must have a much stronger human component," he stated. The remark touches a debate that has divided healthcare specialists, patients, and system administrators for years.
Méndez also identified a structural problem that no regulation can fully solve: the absence of civic education around hygiene and community responsibility. People throw garbage in the streets. They leave standing water in patios and yards. They expect municipal authorities to solve environmental problems that also require individual accountability. "We don't have a community culture of preserving our spaces," he observed. Education matters, he argued, but so do consequences. The country needs to strengthen civic instruction in schools and establish enforcement mechanisms that actually change behavior.
When the conversation turned to food safety, Méndez described the recent temporary suspension of a major dairy factory in Santiago. The shutdown was not about the quality of the final product. The milk was fine. What was not fine were the conditions under which it was produced—infrastructure deficiencies, sanitation lapses in the production process itself. Once the company corrected the violations, operations resumed. The message, Méndez explained, was directed at every industry: standards exist and will be enforced.
Asked about the legacy he hopes to leave, Méndez rejected the language of monuments or recognition. He wants people to remember that a public official can act with honesty. He wants to model the understanding that government positions are temporary assignments in service to the population, not permanent perches above it. "We are here to serve the people, not to stand above them," he concluded. His vision—grounded in presence, skeptical of bureaucracy, insistent on the human dimension of healthcare—offers an unusual window into how at least one part of the Dominican health system sees its own contradictions and possibilities.
Notable Quotes
We have dehumanized medicine. Health cannot become purely a business.— Dr. Víctor Méndez, provincial health director
Everyone has the right to earn money, but health must have a much stronger human component.— Dr. Víctor Méndez, on health insurance administrators
The Hearth Conversation Another angle on the story
You mentioned spending most of your time outside the office, moving through neighborhoods. What do you actually see when you're out there that you wouldn't see from behind a desk?
You see what's broken. A health center with no supplies. A family waiting three hours to be seen. You hear directly from people about what the system is failing to do. You can't manage what you don't witness.
The dengue success is real—two years without deaths. But you seemed almost frustrated when discussing the private healthcare system. Why does that matter more to you right now?
Because we've solved the epidemic problem. Now the problem is that people who can afford care are being treated like transactions. They're waiting, being denied, being made to jump through hoops. That's a different kind of crisis—one that happens quietly, in clinics, not in the streets.
You criticized the ARS system but acknowledged it exists. What would you change if you could?
I would change the incentive structure. Right now, the system rewards denying care. It rewards keeping costs down. You need to flip that so that the incentive is to heal people efficiently, not to avoid paying for treatment.
The community education problem you described—people leaving standing water, throwing garbage—that sounds like it requires changing culture, not just policy. Is that even possible?
It has to be. You can fumigate forever, but if people keep creating breeding grounds, you're fighting the same battle endlessly. Schools have to teach it. There have to be real consequences for violations. It's slow work, but it's the only work that lasts.
When you say medicine has been dehumanized, what's the first image that comes to mind?
A patient sitting in a waiting room for hours while someone in an office decides whether the insurance will cover the procedure. The patient is suffering. The decision-maker has never met them. That's the image.