JARABACOA, Dominican Republic—The Dominican Republic is the Western hemisphere’s most dangerous place to drive, and 15th worst in the world, according to the World Health Organization. Each year, 29 out of every 100,000 people in this Caribbean nation die in road accidents, according to the2015 Global Status Report on Road Safety.

In 2013, the Dominican Republic saw more roads deaths per capita than any other country in the world, but it has since been eclipsed by nations including Libya, Thailand and several African nations. But that doesn’t mean things are improving: in fact, the death rate is still on the rise, up from 21.6 per 100,000 people in 2010.

The vast majority of the fatalities—63 percent—involved 2 and 3-wheeled vehicles, ie. motorcycles.

Francis Ortiz, a paramedic at the public hospital in the small mountain city of Jarabacoa, says hardly a night goes by that he doesn’t see at least one patient in the hospital for a motorcycle accident, and on the weekends he says the numbers become hard to fathom.

“Just last night a moto driver crashed into an older man,” said Ortiz one day in December. “The driver’s entire face was cut open. He had to have intensive surgery.”

Read the full story at the Pulitzer Center on Crisis Reporting.