1 August 2016

Africa: Is Medical Tourism Good or Bad?

Photo: Jacob Windham from Mobile, USA -Flickr
Emergency room in the U.S - Many African leaders are dying outside the country.

To some, this word "medical tourism" might sound strange or even new. But it simply means travelling abroad in search of healthcare that is either less expensive or more accessible.

The practice of medical tourism is indeed common in recent years in our country and the world at large but it began way back in ancient times.

Traditionally, people were travelling from poor to rich countries but recent trends show that people are also travelling from developed countries such as the United States, United Kingdom to developing country destinations like India, Thailand, Singapore and Malaysia, and south Africa.

In Africa, there is this movement pattern--people moving from one country to another in search of health care.

For example, Tanzanian citizens who live along the country boarders tend to travel to the nearby countries in search of medical treatment.

I have come across some people from Ngara, a district in Kagera Region bordering Rwanda and Burundi who travel to Bujumbura (a capital city of Burundi) just for medical treatment as they believe the cost of treatment is cheap and of good quality.

Recent statistics show that India earned about $2 billion in the year 2015. According to 2013 India medical tourism statistics, a total of twenty three thousands (23,000) patients were coming from Tanzania and among them; the leading top three African countries in medical tourism were Nigeria, Tanzania and Kenya.

Why are people travelling across the border in search for healthcare? Studies show that people travel far for medical surgeries like cardiac surgery, cosmetic surgery, knee and hip replacement; some go for other treatments like dental, fertility, psychiatry, alternative treatment and others.

What contributes to this growing trend of travelling across borders in search for health care? The response to this is indeed broad. Perceived cheap and quality healthcare in destination countries, lack of some important medical procedures in the home country ( for example major cardiac and kidney transplant surgeries); poor health infrastructure in our country; shortage of specialists in a given specialty, ( how many neurosurgeons do we have?); globalization has made it easy for people to travel for medical reasons; personal reasons like prestige also account.

Also there is good and attractive health marketing strategy by destination countries ( well packaged medical bill) and some treatment may not be legal in Tanzania but legal in other countries, for people travel just for an abortion. Lack of insurance coverage to many Tanzanians in one way contributes to this largely.

Implication on the health system

Medical tourism has implications on health system of the country from where foreign patients originate (i.e. the sending country) and the country that receive those patients.

For a sending country, people get access to quality and cheap healthcare services from destination countries. for circumstances where health system has long waiting lists, patients seeking care abroad may help to clear backlogs without difficulty, delay and expense of expanding local capacity.

On other hand if a large number of patients travel abroad, it will probably heighten competition among private-sector health providers in the sending countries, which could bring prices down.

Given global shortage of healthcare workers, one might deduce that the pressure on health workers would ease in the sending country; but is this always a case? I guess not.

In the receiving countries, Medical tourism contributes to creation of dual health delivery system, one for rich foreigners and one for poor locals. It leads also to draining of public sector funds and implementation of policies biased to commercial medicine.

The medical tourism industry brings in foreign currency, health global development race through importation of medical technology.

Are there risks linked to medical tourism?

There is lack of protection to patients and lack of legal assistance in case of a problem.

There is no uniform code that may help to determine what is medical negligence and malpractice in such scenarios. Poor post-surgical care in some reported cases, unethical issues and the continuum of care is often limited. There is lack of definitive regulations and standards amongst medical tourism brokerages. Anyone can become a broker and there is room for irresponsible business practices amongst medical tourism brokerages.


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