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Go East!

Exotic tourism in the near future can give way to the priority of medical tourism, and one of the centers of attraction to the surprise of many has become India

Medical tourism, one of the most promising sectors of the modern technology market, is changing the vector of development before our very eyes: instead of Europe and the United States, potential clients are increasingly looking towards Asia and Latin America.

Go East!
Sixth grader Vika Ivanova came to the playground for the first time in two years. She covered the 200-meter path from the car to the swing in 10 minutes, and this is a real victory. Six months ago, her mother drove her in a wheelchair: Vika had a heart failure due to a rare disease - restrictive cardiomyopathy. Now she has a new heart - in September Vika underwent surgery in India.

“For the last two years, Vika literally sat within four walls, and all she saw was an oxygen concentrator, a TV, me and my grandmother,” says Yulia Ivanova, Vika’s mother. “The child was fading away, there was only one chance — a heart transplant. We tried to get a donor organ in Italy, at the Bergamo hospital, famous for just such operations, but a refusal came from there - there are no organs for foreigners and it is unlikely that there will be: there is low infant mortality in Europe, you can wait for years. And we didn't have time.

Then Julia herself suggested to the Russian Ministry of Health to send them to India. Unlike Russia, where pediatric transplantation is prohibited until January 2016, such operations have been performed there for a long time. Moreover, a year ago in India, a heart was transplanted to a three-year-old boy from Russia, Gleb Kudryavtsev, then the money for the operation - about 50 thousand dollars - was raised by charitable foundations. This time the government paid for the expenses - Yulia managed to get out of the quota, and the Russian company MedIndiya, the only one that regularly transports to India for treatment from the Russian Federation, helped to find a suitable hospital and a doctor.

- When I told my friends that we were going to India for a donor heart, everyone began to dissuade me, - Yulia Ivanova recalls, - they said that there is no medicine at all, cows wander everywhere, and on the streets they still cut their hair and pull out teeth ... After listening to all this, I signed a consent - there was no choice. So we got to the south of India - to Chennai.

Chennai

Chennai (formerly Madras) is the sixth largest city in India and the capital of the state of Tamil Nadu. Due to the fact that high-rise buildings are not very popular here, it is spreading to the sides, along the coast of the Bay of Bengal. Here is a large port, car factories, headquarters of the world's leading IT companies. But all this does not negate the cows on the streets - they walk here as they want, along with small, dark-haired hogs that are looking for food in the trash heaps.

India is a developing, tropical and overpopulated country, there are, as it were, two states: one is a beggar, with general unsanitary conditions, the other is civilized, which launches satellites into space, builds the most complex subway junctions in a few months and develops high-tech methods of treatment.

You will soon become convinced of all this: quite fashionable villas in Chennai, as elsewhere in India, alternate with slums - houses built from improvised material, with roofs made of poles or cardboard, where among piles of rubbish they wash clothes and cook food. In other areas, huge, city-like, whole medical quarters have been built. The hospitals were rebuilt by European architects and equipped with high-tech equipment - any Western clinic can envy them.

“Chennai was the first to become the capital of Indian healthcare,” says Anna Verbina, CEO of MedIndia. “World-class hospitals have appeared here, which have begun to develop two popular areas - cardiology and transplantology.

Donation is well developed here, in the south of India - this is connected with religion and the competent work of the authorities. It is to Chennai that 40 percent of all medical tourists arrive - about 150 new patients every day. In total, over the past year, India received about 270 thousand people from developed countries and promises to double this number in the near future.

Medical industry
Details

The EU countries, the USA and Israel are still the world leaders in the number of medical tourists. But a number of countries in Asia, Africa and Latin America are confidently catching up with them. Here are the new centers for medical tourism (data for 2014)

Thailand - 3,00 million

Malaysia - 0,88 million

Singapore - 0,63 million

Brazil - 0,60 million

India - 0,27 million

Turkey - 0,44 million

South Africa - 0,42 million

Source: Advantage HealthCare - India 2015

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The medical tourism market today is one of the fastest growing. Moreover, according to analysts, it will grow during the crisis. The scheme is simple: the treatment of its own citizens, by definition, is unprofitable for any state, and the treatment of foreigners is not just profitable, but super profitable. Last year, 8,5 million people went in search of health in the world - a migration comparable to the movement of an entire metropolis or a small state.

- IN 2014-m global medical tourism market was 38-48 Billion dollars, "says Dr. Didar Singh, general secretary of the Indian Federation of Chambers of Commerce." It's 15-18 percent of the total world tourist volume. And to 2020-mu it will already amount to $ 100 billion. At the same time, we are seeing a constant market growth in the countries of the East. So, in the last two years alone, the number of medical tourists in Thailand has increased by 17 percent, in India - by 26, and in Turkey - by all 30.

According to the Global Spa & Wellness Summit (GSWS), by 2017, half of the medical tourism market will come from Asia, Latin America and the Middle East. Today, tourists from Europe and North America most often come here: it is important to note that 63 percent of the flow is made up by citizens of five countries - the USA, Germany, Japan, France, Austria.

The main thing, experts say, is that demand is constantly growing. This is connected, firstly, with the general aging of the population, which needs a large amount of medical care, and secondly, with the fact that the health care systems of many countries cannot cope with the number of patients and they are increasingly forced to pay for their treatment on their own. For example, in the United States, according to GSWS, about 50 million citizens do not have insurance or their insurance does not cover the treatment of severe chronic diseases, so about 1,6 million Americans go to seek better medical fate a year. And when a person pays out of his pocket in full, he begins to choose where it is cheaper. Today, the average bill for treatment in Asia is from 7 to 15 thousand dollars, in Europe and the USA the price for the same services has to be multiplied by 10.

How to treat medicine

Most interesting is that 15-20 years ago, there was practically nothing of the current hospital system in India. The country spent only 1 percent of its national income on health care (up to 3 percent in most developing countries), and nearly 40 percent of the population had no access to health care at all. In the countryside, they were treated with traditional medicine - this is a cross between Ayurveda and sorcery. Russians still bring black pellets from India, which at best turn out to be mixed with sugar with peacock feathers or cremated owl meat, and at worst - burnt cow droppings, which are used in rural areas to treat baldness, bronchitis and cataracts. Then, 20 years ago, another government program for the development of health care failed, and the state decided to go the other way - to develop private medicine, attracting unprecedented investments (only in the last five years - $ 65 billion).

Then the Indians trained almost an entire generation of doctors in the West, paying the best students for internships at Harvard, and ran a program to return them from clinics in the United States and Europe. One of the first from the States to return was the famous doctor Pratapa Reddy. He founded the Apollo Clinic in India, which made him a millionaire in a few years. It turned out that India has its own fairly stable middle class, ready to pay for quality. Network clinics began to appear, uniting dozens of medical institutions throughout the country.

The next step was to attract foreigners. For this, the hospitals began to seek international accreditation by the Joint Commission International (JCI), which, according to medical tourism expert Nadezhda Menshova, is one of the main criteria for choosing a hospital for Western patients.

“Thus, 23 private hospitals received the quality mark,” explains Dr. Didar Singh, Secretary General of the Indian Federation of Chambers of Commerce and Industry, to Ogonyok. “Once in one of the most expensive hospitals by the standards of India, the patient receives treatment according to the same protocols as the rest the world. The only difference is that he is offered a choice of treatment with Indian generics or original drugs. As a result, private medicine has become a serious source of income for the budget - revenues from health care account for 5,2 percent of GDP, while health care provides jobs for 4 million people.

At the same time, public medicine in India is still in the last century: 16 rupees (that is, 16 rubles) per day are allocated for the maintenance of a patient in a municipal hospital, so patients lie on beds without bed linen, and eat what they bring with them. Interestingly, it was private companies, with the assistance of the state, that a few years ago, for the first time in India, organized a system of health insurance for poor families: thanks to this kind of micro-credit, poor patients can spend up to $ 700 per year on treatment. For a country where any more or less serious illness such as bronchial asthma completely ruined the family, this was a real salvation.

Doctors in India are popular as movie stars

Professor Christian Balakrishnan, head of the cardiology department at Fortis Malar Hospital in Chennai, is one of the physicians who made India a medical superpower. He has over 18 thousand heart surgeries on his account: he is recognized on the streets of his hometown, and cheerful photos are sent to him from all over the world, whose hearts he held in his hands.

And the hospital where he works performed 2014 organ transplants in 511 - one of the world's largest organ transplant programs outside the United States.

Delhi
Over the past 50 years, India's population has tripled to 1,2 billion. In any city, especially in Delhi, you feel this every second: there is always a crowd around, and there is always a traffic jam on the roads. The most realistic way to get to the hospital is by “tuk-tuk” - a tiny van on wheels driven by a rickshaw taxi driver. There are no doors in it, so you need to be vigilant: no one observes the rules of the road, they don't wear helmets, six people sit inside, and exactly on the place where a mini-iconostasis is placed in Russia, they attach the image of Shiva, Vishnu and Krishna.

“When I got into this thing for the first time, my heart sank into my heels,” Shamsiyat Kolosova from the village of Rylevo, Tula Region, admitted to Ogonyok. some meat, in the hospital the food is strictly vegetarian!

We are meeting with Shamsiyat and her 17-year-old son Maxim in Delhi, at Fortis Hospital. The building, to be honest, looks more like a shopping and entertainment center. In the middle of the large atrium there is a statue of a huge baby with a stethoscope, shops and cafes all around where you can drink coffee and eat traditional lentil soup. On the second floor, new entrants are registered, all staff speaks English. The patients are a complete international: we are assisted by coordinators from Russia and Ukraine, immigrants from post-Soviet Central Asia - Afghan and Uzbek translators, who are easily recognizable by their colorful trousers.

Maxim came to treat neuroblastoma recurrence. In Moscow, doctors admitted that they could not do anything, in Germany they promised to cure, however, for this it was necessary to collect 500 thousand euros.

- The charitable foundations explained to us that it was impossible and offered to consider India. Here the same treatment, including a bone marrow transplant, costs 129 thousand dollars, - says Shamsiyat. - Of course, we gladly agreed, although at first after our outback everything seemed strange and strange. However, as soon as we got to the hospital, everything changed - I have seen such well-coordinated and professional work in few places.

While patients from Western countries go to India most often to treat heart disease, Russians are treated with oncology. No less popular among Russians is treatment associated with joint prosthetics and infertility treatment. In addition, more and more of our tourists who come to India just to relax, simultaneously sign up for a check up - a general diagnosis, like a medical examination. The issue price is $ 80 and 4 hours. Is it worth doing a general blood test and an ultrasound scan 4 thousand kilometers from Russia? The issue is controversial. But judging by the fact that, according to polls by the Levada Center, 40 percent of Russians do not trust domestic health care very much, there will not be fewer people willing to go for treatment across the three seas in the near future.


The material was published in the journal Ogonyok No. 49 from 14.12.2015 

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