MEDICAL TOURISM IN INDIA: POSSIBILITIES and PROBLEMS OF ALTERNATIVE MEDICAL TREATMENT

Öz

This study aims to explore the problems and potential of medical tourism in India. India has become one of the destination countries for medical tourists from around the world. However, due to issues at both the policy and operational levels, India, like many other such countries, faces several problems in the development of its medical tourism industry. Indian medical tourism can be divided into four categories: surgical treatment, cosmetic surgery, alternative medical treatment, and wellness treatment. In this study, the authors focus on alternative medical treatment and wellness tourism and explore the possibilities and problems. Results of the current study show that India's medical tourism industry has potential, as international tourists can visit India at a relatively low cost, there is an easy visa process. India offers world-class and standardized medical services, services for alternative medical treatment, and more. Nonetheless, to realize this potential, the medical tourism industry in India must address with a variety of problems, including the absence of standardized herbal drugs and medicines as well as authentic raw materials, lagging processing technologies, the need for improved infrastructure, and lack of sufficient training for non-medical staff in cross-cultural sensitivity and language skills.

Anahtar Kelimeler

• alternative medicine
• AYUSH
• health tourism
• India
• medical tourism

Kaynakça

1. Addy, P. S. (1999). Food Security and Nutritional Status of Children in Fishing Community (Doctoral dissertation, University of Ghana).
2. Adu, E. (2014). Examining Effects of Voluntary Repatriation on Residual Liberian Refugees on Ghana (Doctoral dissertation, University of Ghana).
3. Alsharif, M., Labonte, R. and Zuxun, L. (2010). Patients beyond borders: a study of medical tourists in four countries .Global Social Policy, 10:315–335. available at http://www.acrc.org.hk/promotional/ promotional_ shownote .asp? caseref=86
4. Bookman, M. Z. and Bookman, K. R. (2007). Medical tourism in developing countries. New York: Palgrave Macmillan
5. Brink, J.G. and Hassoulas, J. (2009). The first human heart transplant and further advances in cardiac transplantation at Groote Schuur Hospital and the University of Cape
6. Town. Cardiovascular Journal of Africa, 20(1): 31–35.
7. Caballero-Danell, S. and Mugomba, C. (2007). Medical tourism and its entrepreneurial opportunities: A Conceptual framework for entry into the industry. Master Thesis,
8. Goteborg University. Retrieved from http://hdl.handle.net/20/03/17

9. Carscious, A. E. (2013). Conflict and Conflict Resolution in Ghana: The Case of the Dagbon Conflict (Doctoral dissertation, University of Ghana).
10. Cohen, E. (2012). Medical travel and the quality-of-life. In Handbook of Tourism and Quality-of-Life Research (pp. 169-191). Springer Netherlands.
11. Connell, J. (2006). Medical tourism: sea, sun, sand, and… surgery. Tourism Management, 27(6): 1093-1100
12. Connell, J. (2013). Contemporary medical tourism: conceptualization, culture and commodification. Tourism Management, 1-13.
13. Crozier, G. K. D. and Baylis, F. (2010), The ethical physician encounters international medical travel. Journal of Medical Ethics, 36, 297-301.
14. Crush, J. and Chikanda, A. (2015). South–south medical tourism and the quest for health in southern Africa. Social Science and Medicine, 124:313-320.
15. Crush, J., Chikanda, A. and Maswikwa, B. (2012). Patients without borders: Medical tourism and medical migration in southern Africa. Cape Town: Megadigital, 1-51.
16. Crush, J., Chikanda, A., Maswikwa, B., Labonté, R., Runnels, V., Packer, C. and Deonandan, R. (2013). South-south and north-south medical tourism: The case of South
17. Africa. Travelling well: Essays in medical tourism. Ottawa: Institute of Population Health, University of Ottawa, 43-61.
18. Delice, A. (2010). The sampling issues in quantitative research. Retrieved 24th August 2020 from website: https://files.eric.ed.gov/fulltext/EJ919871.pdf
19. Dondomeso-Soglo, F. (2012). Ministry Of Health/Ghana Health Service, Your High Indiscipline: Our Concern. Feature Article of Wednesday, 26 September 2012, Ghanaweb.
20. Glinos, I. A., R, B. and Boffin, N. (2006), Cross-border contracted care in Belgian hospitals. In: Rosenmöller, M., Baeten, R. and McKee, M. (eds.) Patient mobility in the European Union: learning from experience. Denmark: European Observatory on Health Systems and Policies.
21. Ghalley, P.& Twumasi, P. (2019). Refusal of trained medical doctors to accept postings to the northern regions. Retrieved, 4th April, 2019 from website: https://www.gbcghanaonline.com.
22. Ghana News Agency (2020). Tamale Teaching Hospital records 947 trauma cases in 2019. Retrieved 24th February 2020 from website: https://www.ghanaweb .com/GhanaHomePage/NewsArchive/Tamale-Teaching-Hospital-records-947-trauma-cases-in-2019-840229
23. Grail Research (2009). The Rise of Medical Tourism. Retrieved 20th May 2018 from website www. grail research.com.
24. Heale, R. & Twycross, A. (2015). Validity and reliability in quantitative studies. Retrieved 25th August 2020 from website: https://ebn.bmj.com/content/ebnurs /18 /3/66.full.pdf
25. Heung, V. C., Kucukusta, D. and Song, H. (2010). A conceptual model of medical tourism: implications for future research. Journal of Travel and Tourism Marketing, 27(3): 236-251.
26. Jeevan, R., Birch, J. and Armstrong, A. P. (2011). Travelling abroad for aesthetic surgery: Informing healthcare practitioners and providers while improving patient safety.
27. Journal of Plastic, Reconstructive and Aesthetic Surgery, 64, 143-147.
28. Kaminta, A. (2018). No doctor chose to work in the northern regions. Retrieved, 10th February 2018 from website: https//www.graphic.com.gh.
29. Kim, S., Lee, J., and Jung, J. (2013). Assessment of medical tourism development in Korea for the achievement of competitive advantages. Asia Pacific Journal of Tourism Research, 18(5), 421-445.
30. Lunt, N., and Carrera, P. (2010). Medical tourism: assessing the evidence on treatment abroad. Maturitas, 66(1), 27-32.
31. Ministry of Health (2018). Tamale Teaching Hospital. Retrieved 5th January 2018 from website http://www.moh.gov.gh/tamale-teaching-hospital/
32. Nicolaides, A. and Zigiriadis, E. (2011). Medical Tourism as an important niche of Tourism Development in South Africa. African journal on hospitality, Tourism and Leisure 1:3(2011): 1-11
33. PR Newswire Association LLC (2017). Kenya and Rwanda are competing to become East Africa's Medical Tourism hub, says Frost and Sullivan. Retrieved 20th May 2017 from website ttps://www.prnewswire.com/news-releases/kenya-and-rwanda-are-competing-to-become-east-africas-medical-tourism-hub-says-frost--sullivan-300070928.html
34. Smith, P. C. and Forgione, D. (2007). Global outsourcing of healthcare: a medical tourism model. Journal of Information Technology Case and Application Research, 9(3):19-30.
35. Tata, S. (2007). Medical travel in Asia and the Pacific: Challenges and opportunities. United National Economic and Social Commission for Asia and the Pacific.
36. Terzi, E., Kern, T. and Kohnen, T. (2008), Complications after refractive surgery abroad. Ophthalmologe, 105, 474-9
37. Treatment Abroad (2012) Medical tourism research:The Treatment Abroad Medical Tourism Survey. Available at http://www.treatmentabroad.com/medical-tourism/medical-tourist-research-2012 [Accessed 16/03/17].
38. Unti, J. A. (2009). Medical and surgical tourism: the new world of health care globalization and what it means for the practicing surgeon. Bulletin of the American College of Surgeons, 94, 18-25.
39. Ye, B., Qiu, H., and Yuen, P. (2011). Motivations and experiences of Mainland Chinese medical tourists in Hong Kong. Tourism Management, 32:1125-1127. Reuters (2017) Poor Egyptians seek better life with plastic surgery. Retrieved 29th July, 2017 from the website:http://www.reuters.com/article/us-egypt-plasticsurgery-idUSTRE6AN2Y720101124
40. International Medical Travel Journal [IMTJ] (2017). Medical tourism in West Africa - Nigeria, Ghana. Retrieved 29th July 2017 from website: https://www.imtj.com/news/medical-tourism-west-africa-nigeria-ghana/
41. Runckel, C. (2007). Why should you be a medical tourist? Retrieved 29th July 2017 from website: http://www.business-in-asia.com/asia/medical_tourism.html
42. Wible, P. (2014). Patient Profiling: Are You a Victim? Retrieved 29/07/2017 from website: http://www.idealmedicalcare.org/blog/patient-profiling-are-you-a-victim/
43. Ali, I. & Yadav, M. (2015). A Study of Consumer Perception of Herbal Products in Bhopal. International Journal of Management Studies, 2(1), 69-80.
44. Astin, J. (1998). Why Patients Use Alternative Medicine: Results of a National Study. JAMA, 279(19), 1548-1553. doi: 10.1001/jama.279.19.1548
45. Bhamra, S. (2016). Investigating the use and identity of traditional herbal remedies amongst South Asian communities using surveys and biomolecular techniques (pp. 19-21). De Montfort University.
46. Bhavanani, A. (2012). Yoga in Health Care. Patient First - Joint International Conference on Quality Assurance and Patient Safety. (pp. 1-14). Pondicherry, India.
47. Biswas, U., Allard, K., Pousette, A., & Härenstam, A. (2017). Understanding Attractive Work in a Globalized World. Singapore: Springer Singapore.
48. Bookman, M., & Bookman, K. (2007). Medical tourism in developing countries (1st ed., pp. 1-25). New York: Palgrave Macmillan.
49. Carrera, P., & Bridges, J. (2006). Globalization and healthcare: understanding health and medical tourism. Expert Review of Pharmacoeconomics & Outcomes Research, 6(4), 447-454. doi: 10.1586/14737167.6.4.447
50. Connell, J. (2006). Medical tourism: Sea, Sun, Sand and Surgery. Tourism Management, 27(6), 1093-1100. doi: 10.1016/j.tourman.2005.11.005
51. Crimmins, E. (2004). Trends in the Health of the Elderly. Annual Review of Public Health, 25(1), 79-98. doi: 10.1146/annurev.publhealth.25.102802.124401
52. Dawn, S., & Pal, S. (2011). Medical Tourism in India: Issues, Opportunities and Designing Strategies for Growth and Development. International Journal of Multidisciplinary Research, 1(3), 185-202.
53. European Environment Agency. (2013). Increasing divergence in global population trends: Analysis for update and improved assessment of this megatrend (pp. 9-11).
54. Fisher, P., & Ward, A. (1994). Medicine in Europe: Complementary medicine in Europe. BMJ, 309(6947), 107-111. doi: 10.1136/bmj.309.6947.107
55. Fontanarosa, P., & Lundberg, G. (1998). Alternative Medicine Meets Science. JAMA, 280(18), 1618-1619. doi: 10.1001/jama.280.18.1618
56. Ganguli, P. (2004). Patents and patent information in 1979 and 2004: a perspective from India. World Patent Information, 26(1), 61-62. doi: 10.1016/j.wpi.2003.10.015
57. Ghosh, A. (2010). A short history of the development of homeopathy in India. Homeopathy, 99(2), 130-136. doi: 10.1016/j.homp.2009.10.001
58. Global Wellness Institute. (2016). Retrieved 21 August 2019, from https://globalwellnessinstitute.org/press-room/press-releases/international-wellness-tourism-growing-much-faster-than-domestic/
59. Global Wellness Institute. (2017). Global Wellness Economy Monitor (pp. 3-20). Global Wellness Institute.
60. Global Wellness Institute. (2018). Global Wellness Economy Monitor (pp. 3-9). Global Wellness Institute.
61. Gupta, M., Rajachar, V., & Prabha, C. (2015). Medical tourism: a new growth factor for Indian healthcare industry. International Journal of Research in Medical Sciences, 2161-2163. doi: 10.18203/2320-6012.ijrms20150597
62. IANS. (2017). Ayush boosting medical tourism in India: Experts - ET HealthWorld. Retrieved 20 August 2019, from https://health.economictimes.indiatimes.com/news/industry/ayush-boosting-medical-tourism-in-india-experts/59725359
63. Jasani, S., & Heller, B. (2016). Impact of a Structured Yoga Program on Anxiety in Infertility Patients: A Feasibility Study. Journal of Fertilization: In Vitro - IVF-Worldwide, Reproductive Medicine, Genetics & Stem Cell Biology, 04(02). doi: 10.4172/2375-4508.1000183
64. Kumar, K., & Bharadwaj, A. (2016). Human consciousness and Yogic science (1st ed., pp. 10-27). Delhi: D K Print world.
65. Kumar, S. (2000). India's government promotes traditional healing practices. The Lancet, 355(9211), 1252. doi: 10.1016/s0140-6736(05)74695-x
66. Kunwar, R. (2019). Medical Tourism and Hospitality in Hospital. The Gaze: Journal of Tourism and Hospitality, 10(1), 67-123. doi: 10.3126/gaze.v10i1.22778
67. Linde, K., Clausius, N., Ramirez, G., Melchart, D., Eitel, F., Hedges, L., & Jonas, W. (1997). Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo-controlled trials. The Lancet, 350(9081), 834-843. doi: 10.1016/s0140-6736(97)02293-9
68. Manideep, A., Reddy, M., & Reddy, P. (2018). Competitiveness of Indian Wellness Industry A Conceptual Analysis. International Journal of Pure and Applied Mathematics, 118(24), 1-15.
69. Meštrović, T. (2014). Medical Tourism History. Retrieved 7 August 2019, from https://www.news-medical.net/health/Medical-Tourism-History.aspx
70. Ministry of AYUSH. (2015). Anual Report. Government of India Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha, And Homeopathy (AYUSH).
71. Ministry of AYUSH. (2019). Anual Report. Government of India Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha, Sowa-Rigpa, And Homeopathy (AYUSH).
72. Ministry of AYUSH. (2019). Retrieved 14 August 2019, from http://ayush.gov.in/about-us/about-the-ministry
73. Mishra, D., & Shailesh, K. (2012). Making Indian Healthcare Market a Global Medical Tourism Destination. IOSR Journal of Business and Management, 2(4), 23-28. doi: 10.9790/487x-0242328
74. PTI. (2018). AYUSH Ministry allocation in Budget increased by 13 per cent. Retrieved 3 September 2019, from https://timesofindia.indiatimes.com/business/india-business/ayush-ministry-allocation-in-budget-increased-by-13-per-cent/articleshow/62743094.cms
75. Patwardhan, B. (2007). Drug Discovery & Development: Traditional Medicine and Ethnopharmacology (pp. 1-63). New India Publishing.
76. Patwardhan, B., Warude, D., Pushpangadan, P., & Bhatt, N. (2005). Ayurveda and Traditional Chinese Medicine: A Comparative Overview. Evidence-Based Complementary and Alternative Medicine, 2(4), 465-473. doi: 10.1093/ecam/neh140
77. Poitevin, B. (1999). Integrating homoeopathy in health systems. Bulletin of the World Health Organization, 77(2), 160–166.
78. Ray, J., Chakrabarty, D., Paul, R., & Som, K. (2018). Prevalence of the use of complementary and alternative medicine in an eastern Indian population with emphasis on tribal/ethnic minority groups. Journal of Taibah University Medical Sciences, 13(4), 384-389. doi: 10.1016/j.jtumed.2018.04.001
79. Renckens, C. (2009). A Dutch View of the "Science" of CAM 1986—2003. Evaluation & The Health Professions, 32(4), 431-450. doi: 10.1177/0163278709346815 Research and markets (2017). AYUSH and Alternative Medicine Industry in India: Analysis of Growth, Trends and Progress 2017 - 2022. Retrieved 10 September 2019, from https://www.researchandmarkets.com/reports/4388820/ayush-and-alternative-medicine-industry-in-india
80. Rosen, L., French, A., & Sullivan, G. (2015). Complementary, Holistic, and Integrative Medicine: Yoga. Pediatrics in Review, 36(10), 468-474. doi: 10.1542/pir.36-10-468
81. Shakeel, M., Dilnawaz, P., Ziyaurrrahman, Safura, K., & Chanderprakash, B. (2011). Alternative System of Medicine in India: A Review. International Research Journal of Pharmacy,2(4), 29-37.
82. Sharma, E., Dubey, A., Malhotra, S., Manocha, S., & Handu, S. (2017). Use of complementary and alternative medicines in Indian elderly patients. National Journal of Physiology, Pharmacy and Pharmacology, 7(9), 1. doi: 10.5455/njppp.2017.7.0411401052017
83. Sivaraman, G., & Rajalakshmi, K. (2005). Concept of Siddha Nutraceuticals. Acta Horticulturae, 6, 153-159. doi: 10.17660/actahortic.2005.680.23
84. Song, P., Xia, J., Rezeng, C., Tong, L., & Tang, W. (2016). Traditional, complementary, and alternative medicine: Focusing on research into traditional Tibetan medicine in
85. China. Bioscience Trends, 10(3), 163-170. doi: 10.5582/bst.2016.01105
86. Suzuki, N. (2004). Complementary and Alternative Medicine: A Japanese Perspective. Evidence-Based Complementary and Alternative Medicine, 1(2), 113-118. doi: 10.1093/ecam/neh029
87. Turner, L. (2007). 'First World Health Care at Third World Prices': Globalization, Bioethics and Medical Tourism. Biosocieties, 2(3), 303-325. doi: 10.1017/s1745855207005765
88. World Health Organization. (2010). Benchmarks for training in traditional / complementary and alternative medicine Benchmarks for Training in Unani medicine (pp. 1-17).
89. World Tourism Organization. (2019). Implementation of the general programme of work for 2016-201. (UNWTOA) Specialized Agency of the United Nations.
90. Zysk, K. (2008). Siddha Medicine in Tamil Nadu (pp. 1-18). Nationalmuseets Tranquebar Initiativ.