Sending patients abroad now a lucrative trade

Sep 23, 2014

A salesman has been cajoling me to join what is arguably the most lucrative trade after narcotics — medical tourism.

In the past three months, I have been getting incessant international calls, almost three times everyday, from a sleek salesman with a thick Punjabi accent.

He has been cajoling me to join what is arguably the most lucrative cross-border trade after narcotics — medical tourism.

He tells to me that for every successful transaction, I will receive a 30% cut.

“Dr. Dan, if a person spends $30,000 you will receive $10,000. Clean. No question (sic) asked.

All we need is for you to send us the people. We shall do the rest. What do you think, my man?” he asked.
 
Medical tourism


It is by far the fastest growing global industry. Take India, for example. The trade was worth $825m five years ago. Now, the subcontinent rakes in more than $4b per year. India still remains the cheapest of all the hubs for general surgical procedures.

Thailand, Mexico, South Africa, Brazil, Singapore and the eastern European countries of Hungary and Poland are all in on the act.

The services that most exemplify medical tourism in Thailand are elective procedures such as routine check-ups and cosmetic surgery.

Singapore tends to be sold internationally as a hub, on the basis of skilled practitioners and modern technology.
Turkey is the newest entrant, having started late last year. By the middle of this year, it was already making half a billion dollars from foreign patients seeking health care.

The British media is also awash with the story of five-year-old Ashya King, whose parents decided to take him to the Czech Republic for what they deemed better care, despite protests from British doctors.

For Ugandans, Kenya, India and South Africa seem to be the destination of choice.
The recently formed Medical Tourist Association of South Africa is beginning to have a regular presence at international conferences, expos and exhibitions. It presents its services as a mix of “sun, sea, surgeon and safari”.

The Egyptians, not to be left behind, market themselves as “the land of pyramids, pharaohs and physicians.”
The medical cost in these destinations is usually 80% cheaper than that in developed countries. The price usually includes a recuperation stay at a 5-star resort hotel, extra activities and excursions.

For example, a typical package for surgery in South Africa will consist of consultation and surgery, services of a personal physical therapist and personal assistant during recovery in a spa and a safari tour afterwards.

As a result of this campaign, the Medical Association of South Africa boasts that 800,000 medical tourists have signed up this year alone, 85% of them coming from Africa. The average medical tourist spends two weeks in South Africa, and spends more than $20,000.


The medical tourism industry initially grew out of the need to cater for large numbers of people from developed countries, especially the United States, who were either uninsured or under-insured, or were on a waiting list for procedures that could be done immediately and cheaply in developing countries.

The growing trend in Africa, however, is of middle to upper class Africans fleeing poor quality care in their home countries for cheaper care in other developing countries.

Understanding the implication of this capital flight, the Rwandan government, for example, has recently embarked on making King Fahad Hospital the top medical destination on the continent, with a view of tapping into this lucrative market.

To prevent capital flight, Rwanda sends most of its heart patients not to India, not to South Africa, but to Sudan. There is a hospital in Sudan that provides free medical care to any African child who shows up at its door step.

It is funded by well-wishers in Italy. All one needs to do is catch a bus or plane to Khartoum. No safari, no pyramids, no spa, no commissions.  Very few doctors know about it. But that is largely because no one with a Punjabi accent will be calling them to ask them to refer their patients there.

The writer is a paediatrician at The Children’s Clinic in Kansanga and executive director of the Uganda Paediatrics Association
 

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