The first recorded instance of people travelling to obtain medical treatment dates back thousands of years and refers to Greek pilgrims travelling from all over the Mediterranean to the small territory in the Saronic Gulf called Epidauria. This territory was the sanctuary of Asklepios – the Greek God of medicine . Asclepius represented the healing aspect of the medical arts; his daughters being Hygieia (“Hygiene”, the goddess/personification of health, cleanliness, and sanitation), Iaso (the goddess of recuperation from illness), Aceso (the goddess of the healing process), Aglæa/Ægle (the goddess of beauty, splendor, glory, magnificence, and adornment), and Panacea (the goddess of universal remedy).
In its most basic avatar, Medical Tourism refers to the act of visiting a foreign country to obtain medical treatment. It started when people from one country, allegedly patients from underdeveloped, third world countries sought medical succor in countries with highly advanced medical facilities, primarily in the West. However, over time, there was a distinct trend reversal, with the term coming to refer to patients from the developed countries seeking out low cost destinations where treatments are available at a fraction of the cost in their home countries. This was brought about by a variety of reasons including some treatments being illegal in their home countries, such as some fertility procedures, or for treatments that borders on ethicality and calls for organ transplants which are freely available in the seamy underbelly of the healthcare system, especially in developing and less developed economies. The desire to avoid the waiting period in many advanced countries (especially in those offering public health-care systems) for certain types of treatment, more so in view of the availability of treatment of similar standards at attractive price points, coupled with the ease of travelling has and continues to feed this phenomenon. Similar is the case of Circumvention tourism, like for example, tourism for abortion.
The steady growth of medical tourism around the world and the emergence of highly sought after destinations for the same, however, does not mean that there are no downsides. Some countries, especially those on the wrong side of the tropics have very different infectious disease-related epidemiology to Europe and North America. Exposure to diseases without having a natural immunity can be a hazard for weakened individuals, specifically with respect to gastrointestinal diseases which could weaken progress and expose the patient to mosquito-transmitted diseases, influenza, and tuberculosis among others. Again, as diseases run the entire gamut in economically challenged tropical nations, where concerns for sanitation in medical practices are not as stringent as in the west, doctors seem to be more open to the possibility of considering any infectious disease, including HIV, TB, and typhoid as possible threats. It will not be out of place to mention here that there have been cases in the West, where patients have been consistently misdiagnosed for years because such diseases are perceived to be rare, even generally unknown in the West.
The quality of post-operative care can also vary dramatically, depending on the hospital and country, and may be grossly different from US or European standards. Traveling long distances soon after surgery can also increase the risk of complications. Health facilities treating medical tourists may even lack an adequate complaints policy to deal appropriately and fairly with complaints made by dissatisfied patients, especially foreign ones.
Medical tourism in India is a growing sector, which was pegged at above US$ 3 billion in 2015 and is expected to go upward of US $ 8 billion by 2020. As a matter of fact, as one report pointed out, India offers one of the lowest cost and highest quality of all medical tourism destinations. She offers a wide variety of procedures at about one-tenth the cost of similar procedures in the United States. However, not all the inbound patients are from the states with a bulk of the people seeking medical help in India coming from countries where medical facilities are either conspicuous by their absence, or are prohibitively expensive. Patients from Bangladesh and Afghanistan make up a large part of this group, followed by patients from Russia and the CIS while the rest is made up of those seeking succor from Africa and the Middle East, especially the Persian Gulf countries.
However, it is wrong to believe that the medical tourism industry in India is dependent only on foreign patients. As a matter of fact, the medical tourism trails within India too, are getting more and more pronounced with every passing day. This is being brought about by the infrastructural disparities within the country which forces patients from states / regions with less advanced facilities to seek help and remedy in states where such facilities are available.
The city of Chennai for example has been termed as “India’s health capital”. Multi- and super-specialty hospitals across the city bring in an estimated 150 plus international patients every day. Chennai attracts about 45 percent of health tourists from abroad arriving in the country and 30 to 40 percent of domestic health tourists according to one study. Factors behind the tourist inflow in the city include low costs, little to no waiting period and state of the art facilities offered at the specialty hospitals in the city which are more often than not at par with those available in advanced countries. The city has an estimated 12,500 hospital beds, of which only half is used by the city’s population with the rest being shared by patients from other states of the country and foreigners. Kolkata too is fast emerging as a medical destination, especially in view of the fact that patients from the North Eastern parts of the country along with those from neighboring countries like Nepal, Bhutan and Bangladesh are increasingly looking at the city to provide them with the much needed medical support. This has been brought about to a very great extent by the legacy that the city has traditionally enjoyed from the time the British ruled the country as a premier destination for the study and practice of medical science and because of the fact that a number of multi and super specialty hospitals have come up which are expanding the city’s medical horizons.
There is one grave concern though. If current trends are to be believed, unscrupulous elements that were once involved in the running of pyramid money-management schemes are now increasingly turning their attention to medical tourism, especially in the relatively poorer states of eastern India, from where they are herding patients to locations in the south. With a variety of sleekly designed pay packages that are aimed at pulling the wool over the hapless and often helpless patients coming from the back of beyond, this is nothing but organised crime in another garb and often works in cohorts with the rackets involved in the illegal organ trade and human trafficking. As a matter of fact, if some reports are to be believed, medical tourism is often the legitimate face of these highly organised gangs and their tentacles have already spread to not only many Indian states, but also to many neighboring countries.
The piece was originally written for the Express Health Guide 2016.