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A perspective on Sri Lanka’s medical tourism and way forward




Introduction


Medical tourism is defined as ‘travelling across international borders to receive some kind of medical treatment such as dental care, cosmetic procedures, elective surgical care, fertility treatments, etc. (Kelly, 2013). The Medical Tourism Association describes it as people living in one country travelling to another country to access better quality medical, dental and surgical care than they are receiving in their own country (Medical Tourism Association, 2014).

The terms “medical tourism’ and ‘health tourism’ are used interchangeably in works of literature (Munro,2012). The term ‘health tourism’ has a broader concept than the term ‘medical tourism’, as it covers the three related domains are known as Medical tourism, Healthcare tourism and Wellness tourism (Chen et al., 2012).

The quality and cost of medical care, personal preferences (Personal experiences, Income, etc.) as well as the technological, economic, political,        socio-cultural and legal profiles of the destination country are aspects considered by medical travellers when selecting medical destinations. The primary aim of any medical traveller is to choose the best destination possible, to obtain the desired medical care in the highest quality at the lowest cost (Kara, et al., 2011).

This article will look into medical tourism in a global context, and explore where Sri Lanka stands in this field. The article will then discuss the country’s future prospects regarding the field as well as strategies that can be used to become the pioneers in the field of medical tourism in near future.

Medical tourism in a global context.

Globally, there is emerging competition among countries to promote medical tourism. In the past, rich people from developing countries travelled to developed countries aiming for high-quality medical care. However, trends have changed as there is a flow of medical tourism in both ways. Developing countries such as Thailand, India, Malaysia, Jordan, Turkey, Mexico, Cuba and Chile are becoming the most popular medical destinations (Hadi, 2009). Thailand has pioneered in medical tourism because of its flexibility in pricing; while India is offering medical care at the lowest cost due to its large pool of well trained medical practitioners, medical plurality and several accredited hospitals that cater to medical travellers (Herrick, 2007). Singapore plays a different role, as costs for medical care are comparatively higher than in other countries. Yet Singapore remains well reputed for its responsiveness and superior quality of medical facilities (Hadi,2009).

Where do we stand?

Sri Lanka has been a tourist destination for a long time due to its location and various attractions. In past years, Sri Lanka has drawn attention as a global health destination (Attygalle, 2015). The concept of medical tourism is not new to Sri Lanka, as Maldivian nationals have long-standing relations with Sri Lankan private healthcare institutions (Annon, 2014). At present, medical travellers from other countries also visit Sri Lanka for affordable high-quality medical care, particularly for organ transplants. However, the medical tourism industry in Sri Lanka is still in its early days of development. According to the Department of Immigration and Emigration sources, only 0.48% of tourists came to Sri Lanka for health purposes. The lack of government involvement in prioritizing medical tourism is one of the main drawbacks to achieving the status of the main medical tourism destination in the South Asian region. The private sector in Sri Lanka are pioneers of improving and promoting their medical and surgical treatment facilities and diagnostics which indicate that Sri Lanka is truly on its way to becoming a complete medical tourism destination in the future (Attygalle, 2015). Sri Lankan Private health care institutions are well equipped with modern technology and well-trained staff including medical specialists with international experience (Anon, 2014).

The Medical tourism industry creates a win-win situation between medical care and general tourism, which is beneficial to the country and its citizens. In many countries, medical tourism is now becoming the backbone of their tourism industry; because it interrelates with many other industries such as transport, accommodation, food, leisure and recreation. Thus, leading to the development of those supportive industries at the same time. Therefore, medical tourism will be one of the most lucrative industries, which would offer tremendous economic benefits to destination countries and promote their overall economic development and improve social benefits as well (Anon, 2014).

Where do we want to be?

Sri Lanka has the capacity to cater to more medical travellers. The country has several internationally accredited hospitals with new medical facilities and technologies alongside well qualified medical specialists and staff. However, information on socio-demographic characteristics of the travellers, types of services they are seeking, factors for them to choose their medical destination and their expectations are still lacking in Sri Lanka. 
Therefore,
  •        Sri Lanka still has no clear understanding of what medical travellers value the most, and what they are looking for when they come to Sri Lanka for medical care services. 
  •      Health care planners cannot get the policy decisions towards directing the expansion of medical tourism services.
  •      There is a lack of collaboration with other key stakeholders in tourism.

According to Koggalage, (2017), Sri Lanka is currently catering medical services to travellers mainly from Maldives, India and Seychelles. Majority of them sought care for surgical conditions, especially transplant surgery and orthopaedic surgery; while most of the medical conditions were respiratory, renal or neurological conditions. Most of them were either self-funded or were covered by health care insurance.
Out of these tourists, majority of them had previous experiences having medical treatments in Sri Lanka. But they were dependent on their family members and friends for information. Their flights, medical care and accommodations were arranged either by themselves or their family members in most instances. The majority had sought medical care out of their home country on recommendations by family members and friends. Non-availability of the required medical facility in their home countries was also the leading cause to travel abroad. (International Medical Travel Journal, 2018).

Among many reasons, the availability of high quality medical professionals, internationally accredited hospitals and superior customer care in hospitals were the leading medically related reasons to select Sri Lanka as their medical tourism destination (Koggalage, 2017).
Non- medical reasons include the availability of direct flights from their home countries, convenience in obtaining a visa from Sri Lanka, cultural similarities, political and security stability, good internal transport system and shopping facilities (Koggalage, 2017).

Ways to improve medical tourism in Sri Lanka.
To become the centre of excellence in medical tourism in future, health and non-health sectors of Sri Lanka should work together. The health sector of Sri Lanka should,
·   Improve and expand the training of medical professionals and develop the            sub-specialities demanded by medical travellers such as transplant surgery, orthopaedic surgery and nephrology.
·  Private hospitals should take measures to improve the promotional activities on medical tourism mainly targeting the countries in the region as evidenced by the study.

·  The private hospitals that engage in medical tourism in Sri Lanka should take necessary measures to improve hospitality and communication skills of their medical and non-medical staff through regular in-service training programmes.
·        The public-private partnership process should encourage the private sector and the government sector to minimize the idling times of medical equipment and operation theatres as well as minimize the rising health care burden.
· The private and government hospitals should be encouraged to obtain the international accreditation certificates by the Joint Commission International (JCI) as it’s the one of the key reason to travel for medical reasons.
The non- health sector of Sri Lanka,
·        Should encourage the formulation of friendly policies and laws in relation to tourism. (E.g. lesser tariffs, visa on arrival, etc…)
·        Should take adequate measures to improve transport and accommodation facilities to medical travellers and their families.
·        Should take adequate measures to support the private hospitals to acquire the latest medical technologies as demanded by medical travellers.

References
Anon., 2014. Medical Tourism in Sri Lanka. Available at; http;//www.flyingexotic.com/medical-tourism-in-Sri-Lanka/
Atygalle, R., 2015. The lure of local remedies. Available at http;//lmd.lk/health-and-wellness-2/
Chen, P.et al., 2012. ‘Exploring the medical tourism development barriers and participation willingness in Taiwan; An example of Mainland Tourist’. International science index,6(8), pp 1351-1356
Hadi, A.,2009. “Globalization, medical tourism and health equity.” In symposium on implications of Medical Tourism for Canadian Health and Health Policy, Ottawa, Canada, pp1-29, November, 2005.
Herrick, D., 2007. Medical Tourism; global competition in health care, Dallas, Texas; Institute of Policy Analysis
International Medical Travel Journal, volume 2, June 2018, pp 18-20
Kara, D. et al., 2011. ‘Consumer decision components for medical tourism: A stakeholder approach’. In 16th Graduate Student Research Conference in Hospitality and Tourism, January 2011, Houston.
Kelly, E.,2013. Medical Tourism, In WHO patient safety programme, October 2013. WHO
Munro,J , 2012. What is medical tourism? Medical Travel Quality Alliance
Koggalage, P.D., 2017.Medical Travellers’ perspectives in selecting in-patient services in private hospitals in Colombo, Sri Lanka, PGIM.

 Dr. K.Y.D Perera MBBS(Col), PGDCH(Col), PGDHQPS(Col), MSc (Medical Administration) is a Medical Officer and Medical Administrator. He was a former Medical Director at District General Hospital, Hambanthota and a former Deputy District Director of Health Services at Puttalam district. He is currently reading for his Doctorate in Medical Administration at Post Graduate Institute of Medicine, University of Colombo and is a student of the BIDTI.




      The opinions expressed in this article are the author’s own and not the institutional views of the BIDTI, nor do they necessarily reflect the position of any other institution or individual with which the author is


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