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Sun and surgery

July 13, 2014

Voices of medical tourism in high-tech Indian hospitals – by Orla Mulrooney

Forty years ago conditions and facilities at most Indian hospitals generally compelled rich Indian citizens to travel abroad for advanced surgeries where possible, while the poor simply did without. Today, however, quite the reverse is widely reported. Patients now travel from around the world to undergo advanced surgeries at high-tech hospitals in India. How did this happen? What has changed, who has driven these changes, and what is this burgeoning medical industry?

The term ‘medical tourism’ is, arguably, an oxymoron – even the name of the phenomenon my research explores is contested. As a concept in modern medical care it certainly remains hotly disputed. Yet since the expression first appeared in the last quarter of the 20th century, medical tourism has grown into a lucrative, increasingly organised, yet largely unregulated industry. Also referred to as ‘value medical travel’, it is a phenomenon associated with unprecedented changes in healthcare delivery. Social, political and economic factors – including access to travel, information and technologies, endorsements from states and insurance companies, promotion by various individuals and interest groups, and changed consumer behaviours – have all fuelled increased cross-border and international travel for health.

Indraprastha Apollo Hospital, New Delhi. Nadir Hashmi (nadircruise on Flickr)

Indraprastha Apollo Hospital, New Delhi. Nadir Hashmi (nadircruise on Flickr)

My research project explores the development of this industry through a study of medical tourism to high-tech hospitals in India. Although medical tourism can involve highly contested treatments, I have chosen to examine what are generally considered less controversial procedures: elective cardiac and orthopaedic surgeries. This allows me to focus on the development of the industry and on the people and processes involved in the phenomenon, rather than the overarching ethical debates embodied in the provision of surrogacy, IVF, cosmetic and transplant surgeries. My fieldwork seeks to discover the major drivers of this particular manifestation of travel for health purposes.

A key aim of my research is to create a sound archive: Voices of Medical Tourism. To this end, I am collecting oral histories in cities promoted as medical tourism destinations, including Hyderabad, Bangalore, Chennai, Mumbai and Delhi. To date I have recorded: doctors, nurses, hospital directors and medical tourism facilitators; executives in management, marketing, telemedicine, travel and insurance; entrepreneurs, academics, activists and – of course – medical tourists themselves. This ongoing public engagement activity allows those responsible for creating, using, sustaining, promoting or objecting to the medical tourism industry to tell their own stories. Eventually the archive will be available as a resource for medical historians and other researchers interested in examining this remarkable transition period in healthcare delivery.

The archive includes the voices of medical tourists like:

  • Sandhya, who, in 1975, flew from India to the UK for a CT scan. Facing a six-month delay there, she then flew to the USA for scan and surgery. One of a small minority of Indians rich enough to travel abroad for treatment not then available in India, Sandhya speaks of her healthcare options then and now, and her views on medical tourism.
  • Jim, who had hip replacement surgery, too expensive at home, in the USA.
  • Ghous, who spoke knowledgably about her mother’s lifesaving major surgery and eloquently told of desperate attempts, online and by phone, to secure affordable cancer treatment for her mother, with whom she travelled to India as interpreter and attendant. Ghous is 13 years old.
  • Judith, who spoke of her arduous two-day, multi-flight journey, carrying her desperately ill baby for lifesaving cardiac surgery, and of the daily struggles of being a ‘medical tourist’.
  • Suzanne, who came for a holiday and surgery for ‘bingo wings’ removal.

This is only a small selection of the oral histories collected so far. If you have experienced or helped shape medical tourism to India, particularly for cardiac or orthopaedic surgery, please do get in contact, so that your voice can be included too.

Orla Mulrooney is a doctoral student at the University of Warwick, supervised by Professor David Hardiman and Dr Roberta Bivins. Find out more about her project, funded by the Economic and Social Research Council. She is keen to hear from ‘medical tourists’ to India
 (o.mulrooney@warwick.ac.uk).

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