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Medical Tourism In India Is Booming But At What Cost?

The modern healthcare industry revolves around accessibility and affordability. In countries like the United States of America, healthcare services are quite expensive especially when it comes to detailed procedures like bypass surgery or transplants. Besides cost, long waiting lists and limited treatment options are major hindrances in most western countries. Whereas in developing or least developed countries, factors like domestic policy reform, political instability, travel restrictions, availability of modern healthcare infrastructure, and medical personnel all contribute to the demand for affordable healthcare. This is where medical tourism as a niche has emerged.

Medical tourism, not only provides growth opportunities for the medical sector of the host country but also helps in tourism development. According to a recent market research report on medical tourism, “global medical tourism market was valued at approximately USD 15.5 billion in 2017 and is expected to generate revenue of around USD 28.0 billion by the end of 2024, growing at a CAGR of around 8.8% between 2018 and 2024”. Emerging economies with medical expertise and facilities with tourism resources are pushing for medical tourism. Hence, some of the popular destinations for medical tourism are emerging economies like India, Mexico, Malaysia, and Turkey among others.

Historically, India has always been famous for its spiritual and natural healing image, which has brought people in search of tranquillity to our country. But for the past decade, international tourists are coming to India for modern medical procedures. The Indian healthcare sector, particularly the private entities, boast state-of-the-art infrastructure along with well-qualified practitioners. This has led to foreign tourists coming in for affordable treatment, while eventually allowing for tourism at other sites of the country. India’s medical facilities are famous for fertility, oncology, heart bypass surgery, orthopaedic and spine treatment. The number of foreign tourists coming to India for medical treatments has increased considerably in the past few years. The estimated number of Foreign Tourist Arrivals (FTAs) in India for the medical purpose was Rs 2.34 lakh in 2015 which almost doubled to Rs 4.27 lakh in 2016.

According to the Ministry of Tourism, the provisional estimates of total Foreign Exchange Earnings (FEE) through medical tourism during 2015, 2016 and 2017 were INR 1,35,193 crore, INR 1,54,146 crore, and INR 1,77,874 crore, respectively. Furthermore, NITI Aayog in its report has identified medical value travel (MVT) as a major source of FEE. India currently has around 18 per cent of the global medical tourism market.  It has been estimated that by 2020, India’s medical tourism industry could be worth USD 9 billion, and account for 20% of the global market share. Based on these projections, the Indian government has taken considerable steps to boost the medical tourism niche.

Accessibility has been made easier through the Medical and Medical attendant visa which is processed within 72 hours. Medical tourism facilitation centres have been set up along with separate counters at major airports of Delhi, Mumbai, Chennai, Kolkata, Hyderabad and Bengaluru for tourists arriving on Medical Visas. For better promotion and dissemination of medical tourism for potential patients/tourists, the Department of Commerce along with Services Export Promotion Council (SEPC) has set up an online platform listing the top healthcare institutions in the country with comprehensive supplementary information on each. For better outreach and making the process comprehensive for the tourists, the portal is in four different languages.

For better accountability, and efficacy of the medical tourism sector, a National Medical and Wellness Tourism Board has been constituted. The role of the board is not only to provide a dedicated institutional framework of the medical tourism sector but also promote other forms of Indian medicine and wellness practices like Ayurveda, Yoga and Homeopathy among others. The Ministry of Tourism has also taken up the responsibility of providing financial and technical support for individuals or organisations through marketing development and assistance programs as well as through workshop/events/seminars. The future of medical tourism looks solid, and India may yet emerge as an important medical tourism destination.

Yet, there is an ethical aspect that just cannot be ignored. Approximately 22% of the Indian population lives below the poverty line, and many do not have access to healthcare services. Despite being a fundamental right under Article 21, primary healthcare remains in shambles. The under-investment in the primary healthcare sector is evident from the fact that public health expenditure from 2008 – 2015 was approximately 1.3 % of GDP whereas, in 2016-17, it was approximately 1.4 %. This is way below the world average of 6%.

Furthermore, healthcare in India is considered the most affordable across the globe, yet for most Indians it is expensive. Additionally, the rate of Indian’s out-of-pocket spending on healthcare is one the world’s highest since the health insurance penetration rate in India is approximately only 20%[5]. World Banks’s 2017 report on ‘Tracking Universal Health Coverage’ also points out the “catastrophic spending on health” by Indians, illustrating that out-of-pocket medical expenditure exceeds “10 and 25% of household total income or consumption”. These are only some of the problems in the Indian healthcare system.

To conclude, the government has taken some major steps in resuscitating the healthcare sector. In 2018-19 approximately INR 56,600 Crore has been allocated to the Ministry of Health and Family Welfare which is a 2% increase from 2017-18. Moreover, the National Health Mission (NHM) received its highest allocation of INR 30,130 Crore which is roughly 55% of total allocation. More concrete reforms and policies are required for making healthcare more affordable for Indians. It would be a shame to see India thrive as a medical tourism destination, while Indians cannot afford primary healthcare services.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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