Botox in the bush
By Lisa Witepski
South Africa’s list of tourist attractions is impressive: beautiful beaches, pristine game reserves, cosmopolitan cities and…good hospitals? Absolutely. An astonishing number of international tourists are visiting the country specifically to take advantage of our skill with the scalpel.
Anne Lager is soaking up the South African sun – just like any visitor from Washington DC would. She’s already had some quintessentially South African experiences: she’s taken in Soweto’s vibe, browsed curio shops, and even cracked a nod to the bastion of Old Johannesburg, the Rand Club. What makes her different from other tourists, however, is that Anne has not come to South Africa to see lions. Instead, she has come to see a surgeon.
“A few years ago, my sister and I planned a trip on the Shongologo Express,” she says. “I’d always been rather self-conscious about my ‘Maggie Thatcher’ eyes, so when my sister pointed out that South Africa is well known for the quality of its medical practitioners, I thought why not kill two birds with one stone?”
So impressed was Anne with the procedure that she elected to return to the country when she required intensive dental work.
And she’s not alone in choosing a long-haul flight and a stint in customs control over a visit to a surgeon in her hometown. A recent report in the Mail & Guardian quotes Dr Tshepo Maaka, managing director of Serokolo Health Tourism, as saying that “South Africa currently earns about R270 million annually from medical tourism.”
Granted, not all of those millions are generated by elective procedures. The majority of medical tourists are African nationals – usually from countries such as Botswana, Ethiopia, Zambia, Angola, Nigeria, Ghana and other sub-equatorial states – who visit South Africa to avail themselves of medical facilities, equipment and skills not offered in their own countries.
Making the cut
These patients may make up the bulk of foreigners in our hospitals, but the number of tourists visiting for cosmetic reasons is by no means insignificant. Lorraine Melville, founder of Surgeon and Safari – a company that specialises in facilitating medical tours – reports that her company services up to 30 clients a month. Not bad, particularly when you consider that when Surgeon and Safari first opened its doors in 1999, it had just one client, hailing from California. Clientele had increased to 10 by the following year, and the company has enjoyed growth of almost 100% every year since.
But why would someone choose to undergo a procedure – and experience the pain and vulnerability that goes with it – far from home, especially if the same services are available in their own home town?
Cost, for one thing. According to Anne, medical treatment in the United States is prohibitively expensive. And because costs are so high, patients frequently have to skimp on aftercare. “If I’d had this treatment in the United States, it would have been performed in a day clinic and I would have been sent home shortly afterwards. As a single person, I would have had no one to look after me in case things went wrong.” As it turns out, something did go wrong after Anne’s surgery: she contracted a nasty case of gastric flu. “I was extremely impressed by the way the matter was handled by Surgeon and Safari – I was taken to an emergency clinic and given very considerate care. If I had fallen ill at home, the situation would have been vastly different – I would have had to phone medical services myself and there would have been a long debate about which medical facility I should go to. I would have waited hours for someone to attend to me, and paid hundreds of dollars for the entire experience.”
Diann Curtis, another Surgeon and Safari client, was also swayed by the value for money offered in South Africa. “I had been interested in having a face lift for many years. I had the money to have the procedure done on Harley Street, but I’d become aware of the South African option through my research on the subject. I found the idea of having the procedure done here, rather than in the UK, compelling due to the fact that the cost covered more than just the surgery; it included round the clock care and attention.”
That’s a major plus, Anne agrees. “The personal care I’ve received has made all the difference. Loraine’s local knowledge means that she knows which restaurants and activities to recommend – something I would never be able to access if I came here on my own.”
Diann and Anne admit that they received mixed reactions when they told friends and family they were heading to South Africa on a medical excursion. “My colleagues couldn’t understand my choice. The perception that Johannesburg is an unsophisticated, third world city still exists,” Anne admits.
Diann, meanwhile, received more positive feedback. “One of my friends told me that her sister had a procedure in South Africa, and that she had been very impressed with the doctors and standards of treatment.”
Both report that their doctors were less than charmed with the idea. “Mine asked me what I would do about aftercare – a silly question, I thought, since I have specifically purchased a package which emphasizes aftercare.”
Melville believes that international doctors are less than pleased by the thought that their patients are leaving them to undergo procedures in South Africa because of the loss in revenue – and she could be right. After all, the standard of our medical practices has never been in doubt, as borne out in a report on www.treatmentabroad.net.
The website, which showcases medical treatment offered beyond England’s borders as an alternative to the lengthy waits of the NHS or the high costs of private healthcare, poses the question, “why South Africa”, and answers it by saying that “…it has been firmly on the map as a leader in medicine since the first human heart transplant in Cape Town in 1967, and today the high standard of cosmetic surgery in South Africa is world renowned…Many of the private clinics and hospitals are located in the salubrious areas of Johannesburg and Cape Town. First class surgeons work to extremely high standards in clinics, yet offer procedures at a fraction of the cost in the UK…Combined with top class surgeons who spend 10 years in training, excellent clinics with state-of-the-art equipment and attractive savings, there’s little wonder that so many British people are choosing surgery and safari in South Africa.”
Fair enough…but the medical tourism craze is not unique to this country. India, Eastern Europe, South America and Thailand are also welcoming an increasing number of travelling patients – so what’s our big advantage? “The fact that South Africa is English-speaking,” says Diann. Anne adds that she finds the fact that the country is a democracy appealing. “It’s assuring to know that you have recourse should something go wrong.”
Melville reports that these sentiments are shared by most of her clients, the majority of whom hail from the United Kingdom with the United States following a close second. “The average client is aged between 45 and 65 and is usually single,” she says. And their most requested procedures? Face and eyelifts, tummy tucks, breast reductions and dental rehabilitation, including implants, crowns and periodontic work. That’s just a small selection of the procedures on the surgery menu, however: clients can also choose from hair transplants, liposuction, chin or calf augmentations, ear surgery, brow lifts, botox, ophthalmic procedures (such as cataract surgery) and orthopeadic procedures like knee and hip replacements.
Surgeon and Safari’s competitors - Evolution Cosmetics, Mediscapes, Surgical Attractions, the BodyContours Healthcare Group and Nu Look Surgery – offer a similar array of treatments.
And when clients want to recuperate, there’s always the option of doing so on safari or at the sea. “Generally, safaris take a back seat during the recuperation process, because the client must concentrate their energies on healing,” Melville says. “However, we do keep our patients occupied with day trips to Sandton City, cultural villages, Soweto, the Apartheid Museum and other unique experiences.” Although such excursions usually take up most of the average 10-day visit, trips to the Waterberg or Pilanesberg Game Reserve are also popular.
With so much in its favour, the medical tourism is certain to enjoy further growth – or is it? Melville maintains that the future definitely looks bright, but adds that the industry would benefit from greater cohesion. “Our biggest threat comes from doctors who try to organise tours themselves – but don’t have the contacts to facilitate a smooth-running package,” she says. Added to this, government has yet to lend its support to the growing industry, and will do so only once group consensus ends it fragmented nature. “That’s a pity, because the strength of other countries’ industries lies in the fact that government is behind them. Fortunately, we do have a Medical Tourism Association in place, and the industry has reached the stage where it is ready to start educating people in earnest.”
If that’s the case, we’d better prepare for an even greater influx of medical tourists. Scalpel, please.