India: prime destination for medical tourism

Syed Zafar Mehdi

Little Medina, 4, of Turkemenistan, was diagnosed with a serious heart ailment recently. Not willing to take any chances with the slipshod healthcare system back in their country, her worried parents immediately flew her down to India and consulted doctors at Escorts Hospital. The little girl was operated last week and is recovering well now. Like Medina, thousands of overseas patients, also known as medical tourists, are increasingly flocking to India for treatment. And, they are returning back hail and hearty.

The capital’s premier hospitals are witnessing a rush of foreign patients coming in for various life-saving surgeries and other procedures. As per medical industry statistics, over 800, 000 foreign patients visited India last year, contributing to about 20 per cent of India’s hospital income. This year, the figures are likely to touch a new high, believe medical tourism experts. Notwithstanding the contentious reports about post-surgery superbugs in many hospitals here, the rush of patients hasn’t stopped. In fact “Patients who came over last few years have achieved good results and are now referring their friends and relatives requiring treatment,” says Dr Yash Gulati, Senior Consultant, Apollo Hospital.

Cheaper and better

According to a study by London-based Economist Intelligence Unit (EIU), the medical tourism has flourished in Asian countries like India because of the “lower cost, and to beat growing waiting lists for elective surgery”. Dr K.K. Aggarwal, Senior Consultant Cardiology at Moolchand Medcity and Padmashri awardee agrees. “Things have improved drastically in India now. The healthcare is cheaper and at par with anywhere in west, and more importantly as the study suggests there are no waiting lists.”

The quality of medical-care in some set-ups here is probably better than other medical tourism destinations, says Dr Anoop Misra, Director, Centre of Internal Medicine (CIM), Fortis Hospital, Vasant Kunj. “All the latest procedures are done here and all the support facilities and drugs are available. Further, the cost is nearly 1/5th of USA. Importantly, language of communication does not pose any problems, with translators being available for any language spoken in Middle East, Africa or CIS countries. The lodging and food during the stay of treatment is also within a reasonable budget.”

According to industry observers, the rush has intensified in last couple of month, as patients want to be in fine fettle before Christmas and New Year. Most of these patients are from UK, US, Australia as they find it difficult to get the requisite approval for such surgical procedures from health regulators in their country. Also, because they don’t want to stand in long queues, waiting for their turn. “I had to get the hip replacement surgery done but the irksome hassles and the annoying wait forced me to come here, after my friends suggested India and Thailand as ideal options,” says Jeff Clarke, a patient from Canberra, Australia. In India, things are mostly hassle-free. “Sometimes you cannot chose a particular specialist because of system does not allow you to do so or insurance does not pay you if you do so. In India, doctors are highly approachable, you can get in touch with them almost instantaneously,” says Dr. Misra.

On an over-drive

In a bid to promote the country as medical tourism hub, Indian government has been on an overdrive. Indian Medical Tourism Destination a mega event organized annually in various countries, with participation from all the premier 30 Indian hospitals including Apollo, Fortis, Max, Medanta etc was held in Oman and Kuwait last week. “The focus is on Middle east nations, besides Afghanistan and Africa as they don’t have advanced medical technology there. Earlier they used to go to UK, but now they are heading to India,” says Dr Amit Rastogi of AIIMS. “The idea is to convey to world that our healthcare system is at par with west. We have got English-speaking doctors, hospitality is better, technology has improved, and expenditure is less compared to west,” says Dr Aggarwal.

However some feel there is still work to be done. “We cannot really compare our healthcare system to developed countries because the difference in the services available and provided is very big between different socio-economic sectors. Like for example, the basic infrastructure at health care centers even in small cities in developed countries have a definite amount of medicines, equipment and personnel available which is not the case with our PHC or other health centers in small towns,” says Dr Abha Majumdar, Director, Center of IVF and Human Reproduction, Sir Ganga Ram Hospital. “But when we talk about foreign patients, they come to large urban institutional or corporate hospitals where state-of-the-art services can be provided, and India is one of them.”

Major ailments treated

The medical procedures that generally bring the foreign patients to India include bypass cardiac interventions, neurosurgeries, orthopedic surgeries, hip replacement, plastic surgery, infertility treatment, and dental implants among others. These procedures, according to Health Digital Systems report, costs half as much in India compared with the US, UK and Europe. “I attended a conference in Canada last week. A doctor from USA said that Bronchial Asthma treatment is the fifth most expensive treatment there. I was astonished because here it costs just a few thousands of rupees. I asked them to have a re-look at their treatment and policies,” says Dr Param Hans Mishra, Dean cum Administrator, Indian Spinal Injury Center. Many people are also coming for treatment of complications of diabetes, heart disease and kidney failure, for which experts in India are comparable to any developed country, says Dr Misra.

Many of these medical tourists are equally fascinated by the rich heritage in traditional and natural medicine as much by the advancements in modern medicine and health care techniques. Traditional alternative medicine like ayurveda, unani and yoga are also become increasingly popular with medical tourists.

Superbug scare

Ever since the International medical journal, Lancet, published a study on superbugs in and around Indian hospitals earlier this year, the foreign patients coming to country have been a tad wary. A recently released report by Delhi-based Gangaram Hospital only fueled the speculations further. But doctors here play down the apprehensions surrounding the superbug scare. “Superbug is a problem with low immunity patients and not healthy patients coming for surgeries, it does not look like to be a problem,” says Dr Aggarwal. Dr Misra feels, it may not affect the rush from Middle East and African nations, but patients from developed world will be reluctant to visit for fear of resistant infections.

However there are some who call it a conspiracy theory to discredit India of its ascendancy in medical tourism sector. “This is a malicious rumour spread by vested interests who do not want Indian health Industry to grow,” says Dr Param Hans Mishra. The superbug is an enzyme that is resistant to disinfectants.

Challenges ahead

The major challenge, according to experts in medical tourism, is to attract patients from Europe, Canada and US. Presently most of the patients coming from these countries are NRIs. Another challenge is medico legal issues in treating these patients, how malpractice suits will be handled. In one recent case an award of over 1.5 crore was awarded against a doctor and hospital.

Dr Kartikeya Bhargava, Senior Consultant Cardiologist, Medanta Heart Institute says it is important to maintain high standards. “It is mandatory that the Indian hospitals and doctors continue to provide good, ethical and updated medical care to these patients of foreign origin and take utmost care to prevent avoidable complications while treating these patients for medical tourism to sustain in this country for a longer time.”

At the same time, healthcare system needs to be made accessible to people from low-income groups also, feels Dr Gulati. “In our country also, there are limited number of hospitals offering high-end care. Most of people in our country do not get basic medical care. This also needs to be addressed.”

(First published in Hindustan Times)


Humayun Tomb – first ever garden-tomb


Syed Zafar Mehdi

Named after the revered Sufi saint Hazrat Nizamuddin Auliya, who lived here in the early fourteenth century, Nizamuddin is home to many popular heritage monuments, dotting the main road and the rickety lanes inside. Humayun Tomb, declared as the world heritage monument, is the prime attraction here. The first garden-tomb in the Indian subcontinent, Humayun’s Tomb is believed to have teased the architectural novelty that Taj Mahal finally gave shape to.

Mughal emperor Humayan could not rule for too long as he met an untimely death. This tomb was built by Haji Begum, the Persian widow of Humayun, at a cost of Rs 1.5 million, spanning eight long years.  According to legend, Sayyed Muhammad ibn Mirak Giyasuddin and his father Mirak Giyasuddin were roped in to design the tomb on the bank of the Yamuna River, adjacent to the shrine of Nizamuddin Auliya.

This tomb was built by Haji Begum, the Persian widow of Humayun, at a cost of Rs 1.5 million, spanning eight long years.

Humayun Tomb falls in Nizamuddin East, an upper-class residential locality. Locals here take pride in living in proximity of the heritage site. “It is indeed a special feeling to have a world heritage site in our backyard, which can mesmerize even the Obamas and Putins of world,” says Siddharth Trivedi, a resident. The Tomb holds great cultural significance, and for residents of Nizamuddin, it’s a status symbol and matter of prestige.

Besides Archeological Survey of India (ASI), many private players also have pitched in to give facelift to the monument. Most prominent being the Urban Renewal project – a collaborative effort of Archaeological Survey of India, Central Public Works Department, Municipal Corporation of Delhi, Aga Khan Foundation – which commenced with signing of the public-private partnership memorandum of understanding on July 11 2007.

Significant conservation works that have been undertaken include the careful removal of over one million kilos of twentieth century concrete from the roof and major repairs to the dome. Restoration of the stone paving on the lower plinth required the manual lifting of 12,000 square meters of stone blocks, most weighing over 1000 kilos. Now, the dome flashes a noticeable spark.

(First published in Hindustan Times)