Why patients are flocking to India for surgery

Juan Francisco Paladines knew something was wrong when he started seeing double.

Doctors told him his symptoms – including double vision – which first appeared ten years ago were caused by a brain tumour.

“It was a very tough moment in my life. Fortunately, I have many friends and family who have been my backbone,” says the 56-year-old industrial engineer from Santiago, Chile.

Surgeons told him the unusual shape of his tumor meant it wasn’t possible to completely destroy it. But after radiation therapy, his symptoms disappeared.

Over the next four years, scans showed the tumor was not growing. “Everything went well. I forgot about the whole business,” he says.

In 2019, however, the double vision came back. “I knew what it was… I started looking for alternatives to radiation therapy.”

In recent years, a new cancer treatment called proton beam therapy has emerged – a form of radiation treatment used to get rid of malignant tumors.

It uses a beam of high-energy protons, which are small parts of atoms, instead of high-energy X-rays.

Proton beams easily pass through the body on their way to the tumor and are very effective in destroying it when they arrive.

They can also be controlled in a very targeted manner, which makes proton beam therapy useful for the treatment of sensitive body regions such as the brain, neck and spine.

After some research, Mr Paladines decided this was the treatment for him. But proton beam therapy was not available in Chile or neighboring countries.

“I did extensive research to find hospitals from different countries that could offer proton treatment,” he explains.

Many options were too expensive or not suitable for him. But eventually he found the Apollo Hospital center in Chennai, India.

“It has cutting-edge technology at very affordable prices compared to Western countries,” he says.

The hospital also helped him find accommodation and transportation for his trip in November 2021.

“These factors play a very important role mentally. I was miles away from home for fear, in a new country, a completely different culture and language,” says Mr. Paladines.

Mr Paladines is one of thousands of people who visit India for medical treatment each year.

Between 2016 and 2019, the number of foreign patients traveling to India increased from 430,000 to 700,000. The sector was valued at US$9bn (£6.7bn) by 2019.

But travel restrictions during the pandemic nearly brought the sector to a standstill. According to the Ministry of Tourism, nearly 183,000 tourists arrived for medical reasons in 2021, down 73% from 2019.

The picture is similar elsewhere in the world, including in other nations popular for medical tourism, including Thailand, Singapore and Malaysia.

“India has the largest pool of physicians in South Asia,” said Dinesh Madhavan, President of Group Oncology at International Apollo Hospital Enterprises.

“Thanks to our hospitality and rich culture, combined with modern and traditional medicine and therapy, we are uniquely positioned,” he says.

And it’s not just treating diseases like cancer. There has also been a sharp increase in patients coming to India for cosmetic surgeries such as liposuction (removal of body fat) or hair transplants for balding.

“We get patients from the US, Africa and the Gulf regions,” says Dr. Satish Bhatia, dermatologist and skin surgeon in Mumbai. dr Bhatia says he sees many flight attendants looking for quick, non-invasive cosmetic procedures like dermal fillers or Botox.

dr Bhatia says the cost of most cosmetic procedures in the US, Europe and the Middle East is, on average, at least 50% higher than in India.

Like many travel, medical tourism ground to a halt during the pandemic, but Dr. Bhatia says business is picking up again and he’s confident it will continue to grow.

However, this boom in foreign patients has its downsides.

“Across India, new beauty clinics are springing up like mushrooms. Unfortunately, this also attracts unqualified and untrained doctors who want to make easy money,” says Dr. Bhatia.

Always check your doctor’s testimonials and experiences before making an appointment, he advises.

Patients should also make sure that proper arrangements are made for follow-up care, says Dr. Shankar Vangipuram, Senior Consultant, Radiation Oncology at Apollo Cancer Center in Chennai.

“In follow-up in India — sometimes due to the lack of skilled clinicians and diagnostic tools — we struggle to track reactions and toxicities,” he says.

The government, meanwhile, acknowledges that the sector needs tighter regulation.

“Indian medical tourism lacks effective regulations to regulate the sector, resulting in it being disorganized and unmonitored,” says Rakesh Kumar Verma, Associate Secretary at India’s Ministry of Tourism.

While doctors have been shown to complete years of training at university, this does not apply to the brokers who take care of the placement of doctors with foreign patients, he explains.

The intermediaries or intermediaries can be considered travel agencies for medical tourists. “[They] play an important role, but they are not well organised,” says Mr Verma.

He warns that the quality of services these agents provide is unregulated, adding that pricing is not uniform across hospitals either, making it easy for some agents to overcharge unsuspecting patients.

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Some in this industry would welcome a lot more oversight.

“There is an urgent need for specific guidelines to be set by the government and to be followed by the hospitals, facilitators and other support services…to bring professionalism into MVT (Medical Value Tourism),” says Garima Magu, a Director at Medsurge, a medical travel agency.

A recurring problem for the hospitals is that patients change their minds and transfer to another, cheaper hospital upon arrival in India, wasting their time and resources.

Ms Magu says this could be easily solved by having the government set standard rates for treatments and sending patients a deposit to the hospital before they arrive in the country.

However, back in Santigao, Mr. Paladines is satisfied with his treatment and is being monitored by his doctor from Chennai.

“I’m fine at the moment. I’m feeling better to some extent,” he says.