“It is also the case that a number of key doctors linked to Surgeon & Safari (and other companies) regularly travel overseas to visit their patients for after- care or further consultation."

Financial Mail



Medical tourism has made SA a hot destination for face and boob lifts – not to mention the lions.

By Peter Wilhelm September, 2002

Increasing numbers of foreign tourists – mainly from the US and UK – are taking advantage of the low rand and SA's medical excellence to jet in for such pressing medical emergencies as excessive flab, wrinkles and the known ailments of age. Tourism based on the internal buying power of our currency is familiar. Less so is the surge of a subset of foreign visitors, medical tourists.

SA has become a magnet for those in search of (relatively) cheap elective procedures such as tummy tucks, lipo suction, laser eye surgery, rhinoplasty and breast enhancement. More critical surgical work – including hip and knee replacements, or, indeed, cardiac operations – are also on offer from a rising number of SA-based sources; but cosmetic surgery is the main drawcard.

There are no fixed prices for elective surgery and clients should beware of those that seem too low. As a bench mark, though, a breast augmentation operation that costs £3000-£5000 in the UK and US$10000 in the US, America is quoted by one SA company at £1800 ($2500). And local prices, listed in pounds or dollars, generally include some or all components of travel fares, food, hospital and hotel admission; even a game tour. A facelift in England costs £5000-£9000 (depending on where you have the surgery) and in the US, $20000; in SA, with some extras, it is priced costed at £2800 ($3900). A knee operation at a private hospital in the UK is priced atcosts £10000 – £7000 in SA. Patients can evaluate different packages for themselves; and since exchange rates and other costs can rise or fall, com parisons are inevitably fluid.

The trend towards "meditourism" is triggering new investment – a European group is funding a R200m cosmetic surgery hospital in the Western Cape's Winelands area, planned for 2004 and offering five-star hotel service. So, how many patients are being enticed?

Lorraine Melvill, CEO of Johannesburg- based Surgeon & Safari, says: "We have 20-30 clients here a month, in spread between Cape Town and Johannesburg. On average, each spends R80000, which goes directly into the following sectors: medical, hospitality and general tourism. The average stay is seven to 12 days."

Lorraine MelvillMelvill started Surgeon & Safari after she suggested that a visiting relative (a man) look no further than SA for his facelift. Making the arrangements, a light went on and a business was born.

Surgeon & Safari works with skilled surgeons, and has a business arrange ment with the Orient Express hotel group (The Westcliff in Johannesburg and Mount Nelson in Cape Town) to make recovery a delight. But, initially, the process is Internet-driven.

Melvill, a dynamic former marketing executive, founded Surgeon & Safari in 1999. Its primary focus is on the UK. Her first target audience was people in search of elective surgery, but she believes "medical insurers overseas are the next market". Earlier this month she spoke at SA House in London at a promotional press conference that drew considerable attention from the British media. She has set up a UK office.

There are broader aspects of the medi tourism trend. Some may feel they can not wait for (say) 18 months in Britain for a National Health Service booking, and may choose to travel here to shop around among SA's first-rate medical corps for a swift alternative. Or an Internet search could unveil the services offered by Surgeon & Safari, Health Hopper Holidays, Mediscapes, Far South Life, Safricare, Surgical Adventures – and a growing number of public com panies (Afrox and Netcare) and private doctors such as plastic surgeons, joint- replacement specialists, and dentists.

Any patient, naturally, must apply the caveat emptor rule. Since initial con ultations are conducted in cyberspace, critics feel that essential face-to-face evaluation cannot be up to scratch. Dr Tom Ford, president of the Association of Plastic & Reconstructive Surgeons of SA, comments: "Anyone seeking plastic surgery in SA should make sure they choose a surgeon who is subject to peer review and an accredited member of the association." He notes, too, that would- be patients should beware of the pressure to proceed with an operation if they arrive here and then have doubts.

Melvill rebuts any tacit accusation of unprofessionalism: "When you are innovative, you break new ground all the time. You have to keep your process liquid in order to benefit from opportunities, improve and be open to change – creating new standards and requirements." She adds: "The final decision for both client and surgeon is reserved for face-to-face consultation which fine- tunes the process – we offer consultation in London on a monthly basis, allowing pre- and follow-up consultations." She also has her eye on the US.

Then there is the boon of social concealment, as reflected in this com ment by "Dan" of the US, which Sur geon & Safari lists as not untypical: "Every person who has travelled to SA in the past year is suspect of having had some plastic work done. Indeed you may have blown my cover ... [If] Surgeon & Safari are all over the world news, where does that leave us– Actually, my two sons did not notice that I had had any surgery, so, in that respect, it was a complete success. I am happy."

The subtext here is that Dan – 14% of cosmetic surgery patients in the US are men – need not fear squiffy looks from his friends, family, neighbours or fellow workers; the medical care is good, the recuperation spent, if the patient so chooses, in a tranquil game lodge or classy hotels such as The Westcliff or the Mount Nelson. SAID THAT a classy hotel. No telltale bruises or scars give the game away on his return. Dan's fears about his "cover" arise because Surgeon & Safari has gained consid erable attention abroad – it has been the subject of reports on CNN and the BBC, and been profiled in Longevity, the Seattle Times, the Washington Post, the Wall St Journal and Forbes and Newsday. Among many others.The word is spreading. While

Though elective surgery in SA has been on the map since at least the Eighties, 1980s, the current upsurge in interest has been strongly promoted by Melvill. She and others in the field have had assistance not just from a falling rand, but from the escalation of medical costs generally – a development that has meant, according to one estimate, that at least some operations in SA cost one-third of what they do in England ALREADY GIVEN EXAMPLES .

On top of that, and of some significance, has been her carefully shep herded introduction of foreign patients to the more familiar reasons for visiting SA – the natural beauty, the lions – rather than allowing what she describes as "negative perceptions" of crime and Third-World conditions to sway choices.

So far as the FM can gauge, the reputable meditourist operators take care to play by the rules . Their doctors take assessments seriously, retaining the right to decline to perform procedures on those for whom, on closer inspection than an e-mail correspondence, surgery is not recommended.

Dr Michael Verrier of Knysna, for example, offers orthopaedic surgery, joint replacements, spinal surgery, arthroscopy and other treatments for ailments like arthritis. He bases his services on "the failure of most countries to provide an adequate and effective government-run medical sys tem". In a disclaimer, he asserts: "What is presented on this website is entirely my own approach and represents my own opinions, and therefore may differ from the approach or opinions of other orthopaedic surgeons ... I am happy to recommend other surgeons for second opinions when requested to do so ..."

That SA has also have failed to provide "an effective government-run medical system" speaks for itself. But the reputation of our medical profession is high and SA has many centres of excellence, such as the cardiac unit at Groote Schuur. The hospital has in fact set aside a ward for private patients – and is involved in negotiations with the UK National Health Service to refer patients for cardiac surgery to Cape Town. Meditourists in local beds are set to increase.

It is also the case that a number of key doctors linked to Surgeon & Safari (and other companies) regularly travel overseas to visit their patients for after- care or further consultation.

Such professionalism, of course, pays off: hotel-linked surgery bookings cur ently show a 200% annual increase. And doctors who are part of the medi tourist schemes report that up to 50% of their patients today are from abroad; it was 10% a few years ago.

Melvill says repeat clients are comments that "we are benefiting from repeat clients ... They are "now SA's best ambassadors for others at home – and so future tourism. This is why it's important to maintain the high standard of service."

Is the war against the consequences of age, rich food and gravity a little strange in our dislocated society– Probably: but that's the way that markets are supposed to work.


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