By Phillipa Sibanda
WHEN a person thinks of anything medical, it automatically suggests the dreary picture of being in a hospital or medical practice due to some form of illness. On the other hand, when a person thinks of tourism, they find themselves with a feeling of excitement about resting, being re-ignited and an overall sense of rejuvenation.
The truth is, there are definite parallels between the two fields in that both can evoke emotions of rebirth if the dreary feeling of illness is replaced by rest and relaxation. This is truly what fueled the growth of medical tourism globally. Prior to the Covid-19 pandemic and lockdowns, medical tourism was beginning to make traction.
According to projections the global medical tourism market size accounted for $104.68 billion in 2019 amid forecasts that it could reach $273.72 billion by 2027. (Gill, S & Sinha, S (2020). This would have been a 12.8% jump from 2019 to 2027. Unfortunately, the pandemic resulted in a decline as the models were designed around inbound travel of foreign patients into a host country.
The tourism sector, particularly the hotel industry, benchmarks the level of customer service and amenities by grading stars with five being the high-end resorts to the worst being the budget low end motels. Yet healthcare benchmarks quality of care with very little input from patients. In fact, wellbeing from the patient’s perspective is not accorded the importance it deserves.
This type of benchmarking while scientific leaves out cultural considerations and is embedded with historical systematic racial elements that have never been fully realised or addressed. If the community could have options of going to a medical tourism facility locally instead of the nearest public health facility, could that shift or raise the standards of the way healthcare is delivered? What would that sort of competitive landscape do to leap-frog health delivery systems to where patients truly feel a sense of healing through total care of body, mind and spirit?
It is wishful thinking in many parts of the western world to infuse the idea of medical tourism against the backdrop of healthcare delivery systems literally grid-locked with century old ideas around care. The places with the greatest potential for change are developing nations where their health systems have dire challenges and are looking to re-invent and redesign models of care that can be sustainable and futuristic. This could indeed be an opportunity to leapfrog healthcare systems.
Combining medicine and tourism together offers great advantages that each industry alone may never achieve without the partnership. The health industry can leverage vast experience from the hospitality sector by providing long-term extended stay housing post-surgery in an ecosystem that is combined with skilled nursing care and a healing environment that offers a sense of rebirth after a successful knee surgery or kidney transplant at a much lower cost. More importantly, this will take place in an environment embedded with care that speaks to each patient’s total health needs and is inclusive of cultural differences and expectations.
The partnerships that work best are those that offer a win-win outcome for both parties. What comes to mind is the media and sports partnership. I cannot imagine where the sporting industry would be without the media and the ability to broadcast globally. Things would be very different for sports today. The media has truly enabled the commercialisation of sports and created an exciting and extremely lucrative industry. In the same vein, the medical community can certainly get some much-needed positive posture from the tourism industry. As such, it is crucial to think beyond the surgery itself and to become more holistic in approach and consider the patient mind, body, and spirit in order to create a whole new patient experience while remaining sustainable.
How can this be done in a post Covid world? This is the million-dollar question, and my answer is to take a regional approach and embrace the medical tourism industry locally. Zimbabwe, for example, is blessed with many natural wonders and offers some of the greatest tourist sites and is the ideal home to great medical tourism facilities that allow even the local community to have options outside the nationalised health system. This will inspire a rebirth of the rest of the healthcare sector which is embedded with a deep-rooted culture of western medicine and models that are at times elusive to compassion, empathy and mindfulness.
There is a need for an awakening around the spirit and culture of a patient which is important to wellbeing and healing. Other advantages for Zimbabwe include a strong education system. If localised medical tourism became a national priority, it would be easy to catalyse an accelerated learning approach to empower those with certain basic requirements to quickly gain the necessary skills to achieve what is needed for a robust industry.
The reality is that the payroll of most healthcare systems is a large part of the cost of doing business and naturally this would be a necessary requirement to make this work. The Zimbabwean agriculture base provides an opportunity to bring farm to plate homegrown nutritious meals that aid in healing. In a sense, localised medical tourism has ripple effects on the economy which will benefit not only healthcare and tourism sectors but certainly the education and agriculture industries as well.
While this idea might be met with a lot of criticism, I truly believe in a vision of visiting the Victoria Falls as part of post-operative care after a knee surgery, or learning more about the ancient Shona tribes in the Great Zimbabwe area of Masvingo after getting fertility services. I can see some amazing mental rehabilitation centres in Inyanga that bring calm and peace to patients trying to overcome mental health challenges. Other services that can easily be established include dental services, hip and knee replacements which require extensive re-habilitation and post-operative care. Data offers the best opportunity for insights. Reviewing the insurance companies’ pay-outs for patients that were travelling to India and South Africa for care can also give insight into the services to provide.
Of great importance is establishing a common vision that inspires all stakeholders to participate in localised medical tourism. These stakeholders, particularly health insurance companies, the government, private health sector and health educational institutions, will need to see the value addition this new sector will bring for them to come on board and be fully committed in the creation of valuable partnerships. The Covid-19 pandemic halted cross-border travel around the world due to travel restrictions, and in turn had a real adverse impact on the medical tourism sector model throughout the world in countries like India, Singapore, Thailand, and other emerging economies.
This is the opportunity for localised medical tourism to emerge where the same main drivers for the growth can be used to create a new model with a local approach. What drove medical tourism -according to the World Health Organisation -included cost savings, better quality care for medically necessary procedures and more advanced technology. The re-birth of medical tourism that is localised can be a model that overcomes future pandemics and is a sustainable resilient one.
This vision requires the leadership of all the involved sectors to be agile and move to this new path. The leadership must be driven to execute and leapfrog by using the original idea of medical tourism to build upon this upgraded version of localised medical tourism. Challenging the process won’t be easy because of the colonial design of healthcare and some current rigidity in the structures in place. However, the coming together and building of enabling networks can spring this vision into motion and truly contribute to a middle-class income and 2030 national vision.
It is my belief that medical tourism can in fact have an impact in the way care is delivered in Zimbabwe because it can inspire the current health systems to do more to compete with these localised facilities. It is very difficult to see a faster way to accelerate and transform healthcare unless another way exists that inspires and models the way to a more holistic approach to healthcare delivery and speaks to the mind, body, and spirit of a patient at locations that feed the soul and have an effect of healing at the core. With the well-known African hospitality and well-executed medical service delivery, medical tourism can be the ideal answer to model and redesign a post-colonial health care system.
(Phillipa Sibanda is a respiratory care practitioner and managing director of Hwela Healthcare).
