"Since I was a child, I've always wanted to come to Africa. The concept of combining medical treatment with a safari is amazing."


Travelling for Treatment

By Shoks Mzolo
8 February, 2008

Californian university professors Claudia Lowe and Barbara Weightman have returned to SA many times since their first visit seven years ago.

The trip back then was organised by Surgeon & Safari for medical purposes. This time the couple are wanting to retire in Johannesburg, where they recently bought a house.

Lowe, who flew in for a facelift in 2001 and a liposuction a year later, recommends SA because of the huge medical savings, safaris, good food, high level of professionalism and warm welcome. "What better way to do this away from home than getting to travel to Namibia and Cape Town as well? I paid a fraction [for the procedure] of what I would have at home. The food is good and the people nice and friendly," she says. The couple recently had a three-week summer vacation in SA.

Adds Weightman: "Since I was a child, I've always wanted to come to Africa. The concept of combining medical treatment with a safari is amazing."

Wildlife certainly features prominently for those hailing from the north.

Surgeon & Safari CE Lorraine Melvill cornered the market in 1999 and her business has grown significantly. But she has doubts about some of her rivals.

She is particularly critical of practitioners who double up as medical tourism operators, and argues that the state ought to play a proactive role in nurturing the R300m/year industry, termed "international health" by the Hospital Association of SA (Hasa).

Hasa CE Kurt Worrall-Clare says since SA doesn't issue "health visas", it's not easy to monitor the number of visitors coming in for medical reasons. However, Tshepo Maaka, founding MD of medical tourism operator Serokolo, pegs the number at almost 30 000 a year. Melvill estimates an average spend of R100 000 during the stay, which normally lasts 7-15 days.

Since setting up almost a decade ago, Melvill has experienced huge growth in the number of patients who choose to undergo surgery here.

Last year, 240 (out of a total of 400) of her clients hailed from the UK, and the trend is growing. It's easy to see why : SA offers world-class service at Third-World prices, she says, citing an example of a facelift and liposuction which cost double as much in the UK as in SA.

With runaway medical inflation in developed countries like the US, care is becoming extremely expensive, even for the well-heeled. An estimated 500 000 Americans travelled abroad for medical reasons in 2006. Total annual spend on medical services by residents of the UK, the US and the Middle East outside their home countries was estimated at US$20bn in 2005.

However, it's Costa Rica (whose prices are in line with those in SA) that is in the pound seats because of its proximity to the US. An estimated 14% of tourists to the tiny Central American country go there for medical reasons. Despite the US embargo, Cuba - thanks to world-class standards - is also becoming a player to be reckoned with.

As for promoting SA and enabling it to compete with nations like India, operators want government to do more than sit on the fence. But first, the sector needs to get its house in order. For one thing, several attempts to form an industry association have had no result.

That SA prices are relatively higher than in some other developing countries like India and Singapore is also now emerging as an obstacle (see graph).


Furthermore, says CE of Pretoria-based operator South Link, Ibukun Ogunsina, home affairs' red tape hampers the inflow of tourists from West Africa, so those travellers are going elsewhere. This is a big loss: according to research, Nigerians alone spend an estimated $1bn/ year on medical treatment, mostly in Europe and the US.

There's also a threat of operators with questionable standards; SA is not on the list of countries and organisations accredited by Joint Commission International. Being accredited is necessary for global benchmarking purposes.

But the biggest threat remains the Asian market. According to research by Maaka, it is not only established destinations like Singapore, Malaysia and the Philippines but also newcomers like India and Thailand that SA is up against. The five Asian countries are attracting an estimated 1m medical tourists a year.

Given the potential growth of the UK market, Surgeon & Safari has established a presence in London. Surgeons affiliated to the firm regularly travel to the city to host consultations for prospective clients.

Others have adopted a similar model but target different markets. For instance, Serokolo and South Link draw the majority of their clients from sub-Saharan Africa, where demand is driven by a general lack of resources. Travellers from these countries come here mostly for curative medical procedures.

Having already opened shop in Nigeria, Serokolo is setting up offices elsewhere on the continent. Maaka feels medical aid firms there should pay for treatment for patients who can't get the necessary medical treatment at home.

"Most of our patients come from sub-Saharan Africa, followed by the UK and the Middle East, with a few from the US. It's mainly for cardiac, oncology and gynaecology cases and the like, but that's not to say we don't handle cosmetic surgery," Maaka explains.

But Worrall-Clare warns against a pitfall, namely that foreigners are coming here to have operations they couldn't get at home or were advised not to have by their doctors.

"Let's ensure that patients who enter SA do so out of legitimate clinical need and have valid requests. Patients who have been denied treatment at home [for clinical reasons] should not be allowed to come here for treatment," Worrall-Clare says.


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