Castle Bruce Health District

The Castle Bruce Health District serves the central eastern region of Dominica, covering agricultural and rural communities along the Atlantic slope and inland mountainous villages. Positioned between the La Plaine district and Marigot district, it acts as a mid-eastern corridor, encompassing villages like Castle Bruce, Sineku, Petite Soufrière, San Sauveur and Morpo. The population is sparser and communities are more dispersed, requiring robust outreach and reliable referral links to larger centres.

Facilities & Service Network

As a health district, Castle Bruce is anchored by a Type III health centre in Castle Bruce itself. This facility offers outpatient care, maternal and child health, immunizations, chronic disease monitoring, minor lab services, and referral coordination. Several Type I and Type II health clinics are distributed across the district, villages like Petite Soufrière, Morpo, and San Sauveur host clinics that focus on frontline services: consultations, health education, birth surveillance, and screening.

Because Castle Bruce is relatively remote, mobile outreach teams and periodic clinic days visit more isolated settlements. These visits support immunization drives, nutritional screening, and conditional NCD follow-up. Patients requiring advanced diagnostics or hospitalization travel to Marigot Hospital or Dominica-China Friendship Hospital depending on proximity and need.

Strategic Role & Challenges

Castle Bruce Health District plays a dual role: maintaining core primary health coverage in rural and agriculturally dependent zones, and acting as a buffer zone between the urban Roseau and coastal/eastern corridors. Its model is vital to ensuring no area is neglected.

However, the district grapples with:

• Topographic barriers: Steep terrain, river crossings, and landslide-prone roads make clinic access difficult, especially after heavy rains.
• Sparse staffing: Recruiting full-time nurses or doctors in remote clinics is difficult, leading to reliance on rotational staff or periodic visits.
• Supply logistics: Ensuring consistent delivery of medications, vaccines, and diagnostics across scattered clinics is resource-intensive.
• Referral burden: Because specialist services and inpatient care are not available locally, the district must maintain reliable referral pathways and stabilization protocols.
• Infrastructure fragility: Many facilities pre-date recent climate resilience upgrades and are vulnerable to storm damage and flooding.

Despite these constraints, Castle Bruce Health District remains a key component of Dominica’s health equity strategy, linking rural life with core services and helping to close access gaps across the island.