CHAPTER – III HISTORY OF MEDICAL TOURISM

CHAPTER –III HISTORY OF MEDICAL TOURISM 3.1

Introduction In this quickly developing medical world, it's troublesome to seek out a

promising and cheap treatment; medical tourism has emerged as the largest health care providing sector. The quicker the medical field is developing; the value of treatment is shooting sky high; all seeking treatment has to have enormous money or alternatively is forced to delay the treatment. During this state of affairs, medical tourism may be a ray of hope providing larger relief and cheap treatment. 3.2

Earliest medical tourism centres With several of the earliest civilizations, medical tourism typically took the

shape of sacred temple baths and hot springs. Written historical accounts of Mesopotamian, Indian, Egyptian, and Chinese cultures clearly document bathing and healing complexes erected around therapeutic springs. As way back the Bronze Age (2000 B.C.), hill tribes close to St. Moritz, Switzerland gathered around to drink and bathe within the iron wealthy mineral springs of the region. In 4000 B.C., the Sumerians made the earliest noted health complexes aboard drinking water springs that enclosed elevated temples and flowing pools. Though several post Sumerian civilizations understood and appreciated the healing effects of mineral wealthy water, it was the Greeks who initially arranged the inspiration for a comprehensive health tourism system (Health medical tourism, 2005).

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3.2.1

Greek medical tourism

3.2.1.1 Asclepius of Greece

According to Greek mythology, Asclepius was the god of medicine who, in his pre celestial days, had been mentored by Chiron, a master of medicine. The young Asclepius excelled within the healing arts and was visited by sufferers from all over Greece. Healing powers attributed to him bringing the dead back to life, reversing aging, and curing blindness. Among the foremost distressed was Pluto, lord of the underworld. As a result of Asclepius generous healing powers were proving to be unhealthy for business, Pluto complained bitterly to the nice Zeus who after slew Asclepius with a thunderbolt. The Greek people’s affinity for Asclepius, however, solely grew stronger, and by the fourth century B.C., Asclepian healing temples had been made throughout the length and breadth of the Balkan nation world, from Epidaurus to Tricca. 3.2.1.2 The Rise of Greek medical tourism The numerous Asclepia Temples that were made throughout this point were typically established in prime "healthful" locations, usually close to mineral springs. Most temple complexes conjointly enclosed snake nurseries where serpents were farmed for mystic, healing rituals. At Epidaurus, the longest preserved of the Asclepia Temples, the complicated enclosed bathing springs, a dream temple, gymnasium field (exercise area), and a snake farm massive enough to provide near villages. Patients at the temple were attended to by a suite of clergymen, stretcher carriers, and caretakers, before finally being granted an "appointment" with the mighty head priest, killing payments were created in step with the standing of the patient. The medical commercial enterprise treatment would culminate in a very dream, throughout that 75

Asclepius would allegedly visit the afflicted and suggest a remedy for the health problem or injury (Health medical tourism, 2007). The Asclepia Temples flourished well into the fourth century AD till treatments began to be less pattern and additional clinical. However, even at the peak of alchemy and herbal drugs, the old "sleep and dream" formula was still common in Mediterranean, alternative temple spas, just like the Sanctuary of Zeus at Olympia and the spa multiplex at the Temple of city, flourished throughout ancient Greece, though not on constant scale because the Asclepia Temples. 3.2.2

Ancient roman medical tourism In ancient Rome, hot water baths (called Thermae) weren't solely used for his

or her obvious healthful purposes, however they conjointly served as necessary social networking venues for a few of the Empires most privileged elite. The Romans were undoubtedly not believers in Spartan healing, and people who might afford to try paying lavish amounts of cash on gaining access to the various baths and hot springs that surfaced. Very similar to the swank health care centres of twenty first century medical tourism hot spots, these elaborate Roman complexes were classy institutions. Some treatment centres really enclosed theatre activities, lounges, art galleries, conference halls, brothels, and even the occasional bowl (Health medical tourism, 2007). During the early days of the Roman Empire, these Thermae might hardly are thought-about medical tourism spots since most guests were among one day’s journey. The Empire slowly dilated throughout its 1,000 year reign, pilgrims, diplomats, beggars, and kings from all corners of the "known" world flocked to the Mediterranean to hunt medical counsel and health treatments. As a result of active trade with several components of Persia, Africa, and Asia, these Roman baths essentially dilated the healing art sciences. Ayurvedic massage, Chinese drugs, and 76

varied aspects of Buddhist religious healing became common options at some Roman thermal (Health medical trade, 2005). 3.2.3

Persian, Arabian, and Islamic medical tourism Early Islamic civilization, renowned for its several contributions within the

fields of medication and healing, had a well established system in place for the treatment of foreigners. In all the foremost far-famed medical tourism facility was Mansuri Hospital in Cairo (erected: 1248 AD). With a complete patient capability of 8,000 people, Mansuri Hospital wasn't solely the biggest hospital of the time; however it had been conjointly the foremost advanced health care facility that the globe had ever seen. The complex enclosed separate wards for females, a pharmacy, a library, and diverse lecture halls. There have been conjointly facilities for surgery and separate departments for eye diseases, no patient was to be turned away on account of race or faith, and no limits were obligatory on a patients keep within the hospital. Progressive well sooner than its time, the organisation of the hospital (Waqf) with boldness secure the following: 

The hospital shall keep all patients, men and females, till they're fully recovered.

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All prices are to be borne by the hospital, whether or not the individuals return from a far or close to, whether or not they are residents or foreigners, sturdy or weak, low or high, wealthy or poor, working or not working, blind or sharpsighted, physically or unsound, learned or illiterate.

There are varied accounts of welfare driven hospitals in national capital and Asian nation that catered to weary travelers from abroad. Accommodations at these

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health care or Bimaristans as they were renowned domestically were off from incommodious. Furnishings were gilded, and these luxurious lodgings were offered to an endless stream of individuals from abroad (Health medical tourism, 2007). Endowments were the first supply of funding at several of those medical tourism facilities. 3.2.4

Japanese Onsen Medieval Japan discovered the healing powers of hot mineral springs (Onsen)

once hunters followed fleeing prey up to sparkling pools wherever the animals instinctively visited to relieve their pain and wounds. The healing property of the water enriched by the encompassing volcanic soil, attracted tourer from everywhere the country. Farmers, hunters, and fishermen discovered that the wealthy waters were effective for treating painful aches. It wasn’t long before members of the assorted individual clans began visiting favored hot springs to alleviate pain, heal wounds, recuperate, and increase lost energy levels (Health medical tourism, 2007). There is very little discussion encompassing the therapeutic properties of Japanese Onsen, and bathing rooms at Onsen still show lists of the numerous diseases and injuries that the drinking water will treat. Japanese Onsen still attract massive numbers of tourists, and due to fashionable plumbing, most Japanese homes have massive bathtubs specially designed to simulate the Onsen expertise. One thousand years when the Onsen became such a cultural development in Japan, be able to still see throngs of tourists, families, businessmen, and therefore the elderly frequenting these revered hot springs in places like Kyushu and alternative regions of Japan where volcanic activity continues to be present. Some Onsen even have mud pools or sulphur springs where bathers will receive rejuvenating mineral scrubs as they soak in hot, calming waters (Health medical tourism, 2007). 78

3.2.5

Indian medical tourism Some might have problem categorizing yoga retreats, Buddhist pilgrimages,

and meditation centres as medical tourism, however the unbelievable reach of India’s healing arts isn't to be neglected. Ever since yoga’s birth quite 5,000 years ago, India has enjoyed a continuing inflow of medical travelers and religious students hoping to master and like this most elementary and revered branch of alternative medicine. once Buddhism came on roughly a 2,500 years later, this solely value-added fuel to the fireplace and helped position India because the epicenter of Eastern cultural, spiritual, and healthful progress. Although Western clinical medicine eventually eclipsed India’s spiritually focused healing arts, the region has remained a veritable Mecca for all practitioners of different medicine. Within the Sixties, India received a brand new boost of support once the "New Age" movement began within America. India yet again became the destination of selection for thousands of Western pilgrims. This mass inflow of medical tourists was further helped by India’s deep commitment to technology and health care infrastructure. Not solely is India one amongst the world’s oldest medical tourism destinations, however it's become one amongst the world’s most well-liked one (Connell, 2006). 3.2.6

European medical tourism Although pilgrimages have remained central throughout abundant of Europe’s

history, leisure travel, recreational vacations, and medical tourism didn’t happen till the sixteenth century once Europeans rediscovered the Roman baths. Entire communities sprung up around spa cities like Baden, Aachen, and most notably, Bath. The emergence of bathtub or Aquae Sulis (Sulis derived from the water deity, Sulis Minerva) as a significant medical tourism destination is attributed to the significant royal patronage and involvement that the town enjoyed. With significant 79

endorsements from members of the upper crust, it wasn’t long before bathtub became anointed as a trendy wellbeing and recreation playground for the wealthy and farfamed. By the 1720s, aristocrats and gentlemen of leisure from alternative components of Europe were swarming to bathtub for cleansing and healing, whereas rubbing elbows with some of the continents elite. As a result of this attention, bathtub received an entire series of technological, financial, and social edges, like fashionable medical tourism destinations. As an example, bathtub was the primary town in England to receive a coated sewage system (years before London ever did). The roads were made-up, the streets received a lighting system, and designers disorganized to beautify the facades of the numerous hotels, pubs, mansions, and restaurants that cropped up due to enhanced tourism and disbursal (Health medical tourism, 2007). 3.2.7

Belgium medical tourism England wasn't the sole place in Europe where medical tourism flourished. In

1326, a sluggish little village in east Belgium gained nightlong fame when the invention of iron wealthy hot springs among its boundaries. Though the Romans knew regarding the therapeutic waters of Ville d Eaux (Town of Waters), it developed into a completely fledged health resort solely within the sixteenth century. Guests from everywhere Europe flocked to Ville d Eaux for relief from arthritis, rheumatism, and viscus disorders. Illustrious patients enclosed Peter the good and playwright. The word "spa," from the Roman "salude per aqua" (health through waters) was coined around this point, and it applied to any health and wellbeing resorts that didn’t follow typical clinical drugs.

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3.2.8

Health tourism within the new world Native Americans throughout the New World were adept in varied aspects of

the healing arts. In fact, their catalogue of therapeutic plants rivalled abundant of what was renowned back in Europe at that point. Sadly, several opportunities for sharing and learning were lost because the early settlers centered their efforts on securing land instead of on building relationships (Connell, 2006). In the 1600s, English and Dutch colonists within the new discovered Americas made log cabins close to mineral springs that were wealthy in healthful properties. By the nineteenth century, American reformists had developed a habit of traveling to remote Western springs, presumptively to drink and soak within the bubbly hot and cold springs whereas meditative the long run of recent civilization (Health medical tourism, 2007). 3.2.9

Other destination for attracting medical tourist Medical tourism has conjointly developed in African nation that has matured

in prominence in recent years, particularly for cosmetic surgery, since its prices are half those of the united states, from where most of its patients return. Hungary, as an example, declared 2003 to be the Year of Health tourism. Eastern European countries became necessary for dental care and cosmetic surgery. Jordan serves patients from some components of the Middle East whereas Israel caters Patients from Jewish and near countries, through specializing in feminine sterility, in vitro fertilization and high risk pregnancies. Argentina is noted for cosmetic surgery. The Caribbean has found it tougher to enter the medical tourism market since, despite its proximity to the United States; its races cannot strive with those in geographical area (Huff Rousselle et all, 1995).

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3.2.10 The rise of medical tourism in Asia The scope of this activity is stunning, with Asian countries of Thailand, Singapore, India, Republic of Korea, and Malaysia attracting 1.3 million medical tourists per annum from round the world, and increasing annually. Asia alone are projected to come up with quite US$4 billion by 2012 is proving a windfall for the travel and welcome sector (Gupta, 2007). Connell (2006) expressed that in1998 the Asian economic crisis and the need for economic diversification made Malaysia to concentrate in medical tourism. India thought to be the up to date international centre for medical tourism, and it advertises itself as providing everything from different Ayurvedic medical to coronary by-pass and cosmetic surgery. To become the foremost necessary international destination its upgraded technology, absorbed western medical protocols and stressed low value and prompt attention. Since economic relief within the mid1990s private hospitals have dilated and located it easier to import technology and alternative medical product, making infrastructure to the best of western levels. Moreover, as hospitals improved and specific salaries enhanced, doctors came back from overseas. Several had international qualifications and western expertise made exposed potential tourists better-off. Liberalisation brought new structures of corporation that made India wellknown and considerably improved administration. Singapore has late sought-after to contest with Malaysia and Asian country, deliberately set rates just under those in Asian country and even came upon a stand at the aerodrome with fliers, information and recommendation for transit passengers. Singapore claims to be Asias leading medical hub, with advanced research capabilities as well as 9 hospitals and 2 medical centres that have obtained Joint Commission International (JCI) certification. Many patients are from neighboring 82

countries, like Indonesia and Malaysia. Patient from Indochina, South Asia, the Middle East and China to Singapore are seeing quick growth. Patients from developed countries like the U.S. are getting down selecting Singapore as their medical travel destination for comparatively cheap health care services in a very clean cosmopolitan town. Singapore has created news for several complicated and innovative procedures, like the separation of conjoint twins and tooth in eye surgery. Philippines are becoming the "new hub of wellbeing and medical aid in Asia. They provide competitive costs, extremely trained physicians (most trained within the United States), who speak English. They advertise competent, compassionate, and caring people; world class, accredited health care facilities; and an opportunity to go to breathless tourer spots within the country (Wikipedia, 2007). It is seen by the very fact that Medical tourism could be a promising new trade in Asia, providing prospects for hospitals facing saturation in patient growth. It’s clear that available market potential, internal strengths and limitations, the level of external competition, might best move forward to comprehend this potential. Health care suppliers might think about the quality of their services, however non medical services are encouraging patient access, and marketing choices offered to them. A final thought towards implementing such reforms would be the partnerships that Stakeholders might establish. These embrace partnerships with universities, referring hospitals, agents, the government, accommodation and travel service suppliers, and even competitive hospitals. A sincere commitment to those alliances permits every stack holders to specialize in own competencies and should even alleviate the extent of competition providing higher revenues throughout the complete sector. The map of the medical tourism countries were shown below.

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Figure: 3.1 Medical tourism map

Source: indiameditrip.com

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3.2.11 Medical tourism in Middle East Dubai, Bahrain, Lebanon and Asian country, UAE (United Arab Emirates) has recently wanted to reverse this flow and develop its own medical tourism business. Dubai has built Health care city (DHCC) to capture the market and check out to divert it from Asia. The Bavaria Medical Group (BMG) has developed links with Qatar Airways and the Sultanate of Oman that have taken patients from Oman to European nation. In 2005 comparatively low value Jordan remained the most medical tourism destination within the Middle East (Holden, 2006). 3.3

Medical tourism today Throughout abundant of recorded history, health care travel was restricted

either to the rich or desperate, however in today’s world economy, the physical, economic, and cultural barriers have separated nations from each other dissolving as international travel, mass communication, and lenient trade policies build it attainable. For example nowadays, Americans who are suffering from grossly inflated health care prices typically flock to hospitals in medical tourism destinations like Asian nation for stylish procedures at a fraction of the value. In England, socialized medicine is the norm, long wait times and scarce health care personnel made medical tourists to travel to India, where an extremely evolved education system produces thousands of qualified doctors and nurses. Affordability and time are the reasons, quality of care and five star treatments are major factors why patients travel across borders for surgery. In fact, medical treatments in abroad are better than what you'd expect from health care centres at home country.

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3.4

Summary The idea of medical tourism isn't a replacement one. The primary recorded

instance of medical tourism dates back thousands of years to once Greek pilgrims traveled from everywhere the Mediterranean to the tiny territory within the Gulf known as Epidauria. Spa cities and sanitariums could also be thought of an early style of medical tourism. In eighteenth century England, patients visited spas for treating diseases from gout to liver disorders and respiratory disorder.

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