How does the healthcare system work in Eritrea?

What is the quality of healthcare in Eritrea?

• Despite the great poverty in the country, Eritrea has made great strides in the field of health care in recent years and is now one of the few countries in Africa that is actually on track to achieve the Millennium Development Goals.
• Good health care can be found in all major cities, but challenges remain in remote areas. If you are going to a remote area, it is therefore useful to bring your own medicines and first aid kit.
• Health care consists of both public and private providers and there is a lot of cooperation between the two.

How does the public healthcare system work in Eritrea?

• Public health care consists of hospitals and health centers spread across the country. Basic care and also some specialist care is provided here, but this is limited!
• The health centers or health stations are often staffed by nurses and focus on preventive care, maternity care and basic care.
• Regional hospitals offer general and obstetric care, laboratory tests and minor surgical procedures.
• Rural referral hospitals, located in Asmara, offer specialized medical services of reasonable quality. Healthcare is often free or cheap for residents. Expats usually have to pay.
• The quality of healthcare is reasonable and the government continues to invest in a better healthcare system, but do not expect care of international standards.

How does the private healthcare system work in Eritrea?

• Private healthcare may sound more chic than it is. In reality, it usually involves small clinics in Asmara where you will be helped faster than in the public sector.
• The quality is slightly better, but do not expect fancy equipment, wellness music or a cappuccino afterwards. The doctors are often the same as in public healthcare, only with a slightly fresher perspective and this work as a side job.
• The standard of care is low compared to Western standards. There are also few medical specialists available, and advanced treatments or equipment are rare.
• Cash payment is the norm - so bring some nakfa, and sometimes you have to bring your own materials - from bandages to injection needles.

How is the general practitioner arranged in Eritrea?

• Everybody can go to health centres or private clinics for general complaints, but do not expect extensive consultations or follow-up.
• For many public hospitals, you also need a referral from a general practitioner. Check this before you go to the hospital!
• Keep your own medical records. No GP also means no reminders of your vaccinations or that one allergy that gave you a rash in 2008.

How is the dentist arranged in Eritrea?

• Dental care is available in the cities, but here too the supply is limited and the standards are basic.
• You will mainly find dentists in Asmara.
• Some offer simple treatments such as extractions or fillings, but extensive dental procedures or aesthetic treatments are rare or of low quality.

How is pregnancy care arranged in Eritrea?

• Maternity care is largely accessible through public clinics, especially in urban areas. The government has tried to expand and improve this care, and more and more women are now giving birth under medical supervision. However, there are many challenges: lack of resources, poor hygiene, understaffing and a shortage of trained midwives are still commonplace — especially outside the cities.
• Private clinics sometimes offer slightly better care, but they too are limited in facilities.
• In rural areas, women often still give birth at home, with or without the help of a traditional midwife.
• If you are pregnant and staying in Eritrea, consider temporarily going to a neighboring country or back home for the birth — or at least to a better equipped clinic in Asmara.

How safe or unsafe is a trip or stay in Eritrea?

What should you pay attention to in terms of safety in Eritrea?

• Eritrea is a strictly regulated country with little press freedom and a strong authoritarian regime.
• It is relatively safe in terms of crime. Robberies are rare, even in cities, but caution is always wise. Do not carry valuables conspicuously and beware of pickpockets in busy markets.
• Political discussions, especially about human rights or the government, are better held at a coffee table in Europe than on a terrace in Asmara.
• Taking photos of government buildings, airports or military personnel is also a big no-go.
• To travel outside Asmara, you often need a special travel permit, even as a tourist. You can arrange this application at the Ministry of Tourism. Some areas are (temporarily) off-limits due to tensions with neighbouring countries or military zones — such as border areas with Ethiopia or Djibouti.
• The Red Sea is beautiful, but treacherous. There are hardly any lifeguards or warning systems, so only swim where it is safe, and ask local advice.
• Earthquakes are rare, but can occur in the eastern part of the country due to geological activity.

What should you look out for in terms of diseases in Eritrea?

• Malaria occurs in low-lying areas, especially around the coast. In Asmara (at altitude) the risk is small, but mosquitoes are like unwanted text messages: they will come anyway.
• Dengue and chikungunya can also occur, especially in the rainy season. There is no vaccination against it, so mosquito spray is your best friend.
• Diarrhoea, stomach flu and parasites are common.
• The risk of tuberculosis is still relatively widespread. The risk is especially higher if you are in contact with the local population for a long time in closed spaces (think: volunteer work, healthcare institutions, etc.).
• HIV/AIDS occurs.
• Stray dogs, cats or other rodents can transmit rabies.

What should you pay attention to when it comes to traffic in Eritrea?

• There are formal traffic rules, but on the streets, the law of the largest often prevails. Drivers do not always pay attention to pedestrians or cyclists, and traffic signs are sometimes more suggestive than obligatory.
• The main roads between Asmara, Massawa and Keren are reasonable (certainly for the region), but elsewhere roads are often unpaved, bumpy and unpredictable. 
• Driving at night is not recommended: potholes in the road + no street lighting = adventure with a capital A.
• There are minibuses (for those who like close-knit social contacts), and taxis are affordable, but do not have meters. Always agree on a price in advance.
• Rent a car? You can, but often only with a driver.

What work and travel insurance policies are suitable for short and long stays in Eritrea?

• Is the trip to Eritrea and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

What emigration and expat insurance can you take out for Eritrea if you are going to live there for a while?

• Although basic care is reasonable in Eritrea, the costs can be high. There is also a reasonable chance that you will need medical evacuation or repatriation. A good, international health insurance therefore offers reassurance so that you do not have to fear an empty savings account.
• Make sure your insurance covers medical evacuation as well as coverage in neighboring countries. Read more about insurances for abroad on Expatinsurances.org.