Tap water is safe to drink, but since it is sometimes drawn straight from Dominica's many rivers, it has a tendency to turn brown after heavy rainfall. It's better to drink the bottled water available almost anywhere.
Basic healthcare is available at Princess Margaret Hospital in Roseau.
North Americans moving to Dominica often experience boils for the first time and fingernail and toenail fungi. Stomach problems are rare among travellers.
Towns are sprayed with insecticides periodically to control the mosquitoes responsible for spreading Dengue fever. However, the spraying may not be done at the scheduled time and pesticides may drift into your home if the windows are open.
In the high lands and uninhabited central regions water is gathered at roadside springs. Sometimes the bus will stop and passengers will fill their water bottles. Locals prefer the taste of this water to bottled water.
Public water is bacterially safe to drink due to heavy chlorination and has the expected chlorine flavour.
LGBT travellers should be aware that "buggery" a term used for homosexual sex on the island is illegal in Dominica, as indicated by the 2012 arrest of two male Americans who were seen having mutually consensual sex on the balcony of their cruise ship while it was docked. The two men did not serve jail time, but paid a USD900 fine.
Nearly all Dominicans including the totality of people you are likely to encounter– taxi and minibus drivers, shopkeepers, restaurant and hotel personnel, and government employees speak serviceable English with a heavy Caribbean accent. It is understandable, though many travelers for whom English is a non-native language may have a difficult time navigating the native articulation. However, North American and British people generally have little to no problem understanding the local dialect. The native accent is less noticeable among the educated persons of Dominica, such as government employees and tourism industry personnel. The most widely spoken language, though somewhat frowned upon by the government and schools, is a creole of French origin. This creole is the primary language of Dominica and is the language of choice for interactions between natives. French, given Dominica's location between the French territories Guadeloupe and Martinique, is taught in schools and is a vital trade language for Dominicans. However, due to varying degrees of fluency, French is generally not considered a viable option outside of hotels and major cities such as Roseau and Portsmouth. Although the island is reasonably close to Venezuela, Puerto Rico, and Cuba, little to no Spanish is spoken on the island, though imported South American products do often bear Spanish text.
All those who are proficient in English should have no issues in Dominica. French speakers should expect to have to speak a little English or attempt to decipher the local creole, which is mostly French in its origin.