The Dominican Republic is the second poorest country in the Caribbean and the sixth poorest in the Western Hemisphere with a population of 8.5 millions inhabitants. 60% of the rural population exists without adequate health care. Health conditions among the poorer classes in both rural and urban zones are characterized by a generally unsanitary environment, inadequate health services, and poor nutrition. The situation is slightly better than in Haiti where there is one doctor for every 17,000 individuals.