India Cashes in on Cosmetic Holiday Boom

If you need your hip fixed, your sagging jowls tautened or help with infertility, then the search for low-cost medical treatment could lead you to India. But first you'll have to deal with family and friends who'll likely say you're crazy. That's what happened to Bradley Thayer, a retired American apple farmer, who has become part of an increasing crowd of foreigners - medical tourists, they're sometimes called - who come to India in search of high-quality, low-cost medical care. Thayer badly twisted his leg after falling four metres to the ground from his boat - then secured to a trailer - near his summer home in Canada's British Columbia. Thayer, 60, who has not been covered by health insurance since he retired 13 years ago, strapped up his swollen leg, surfed the net and worked the phones.

He learned it could take six months and cost $US35,000 ($NZ49,650) in hospital bills, tests and surgery to reconstruct his badly torn knee ligament in the United States. Six weeks and dozens of emails and phone calls later, he was in India.

After the surgery, a two-week hospital stay and airfare, Thayer had spent just one-third what it would have cost in the United States. "Flying halfway around the world is cheaper," said Thayer beaming from his Bombay hospital bed.

"I came straight to India. It's a long way to come without tests, but I feel great." Like most Westerners coming here for medical treatment, Thayer was not a frequent traveller and had never visited India.

His family was stunned by his decision. "My friends and relatives said I was crazy. They said they'll cremate you along the Ganges," he said. Thayer disagreed. He said his confidence stemmed from the visibility of Indian doctors in the United States.

Many Indians return home after working in top US and British hospitals. "In Canada and America when you read the names of doctors in hospitals, every third or fourth doctor is Indian," he said. Since the mid-1970s, hospitals in Bombay, Delhi and Bangalore have attracted patients from neighbouring countries and the Middle East, and the 1990s saw a stream of patients from Africa.

The past year, more Americans and Europeans have come, fleeing staggering costs and long waits at home.

The biggest demand is for orthopaedic surgery, followed by plastic surgery, infertility treatment and cardiology. Many patients come to India because they don't have health insurance, while others don't want to wait months for specialised surgery.

Some want cosmetic surgery or infertility treatment - procedures that are often not covered by insurance. So far, news has spread largely by word of mouth or web sites from a few satisfied patients.

Hoping for more business, the Indian government has organised exhibitions abroad to tout the quality and low costs of health care here.

It also has introduced one-year medical visas, which can be extended for another year, and is planning a list of recommended hospitals. Recommendations are important because while India has top-notch doctors, it is still a nation notorious for filth and poverty, and most Indians still get substandard medical care.

Even at some top hospitals, nursing care can be poor and hygiene standards dramatically lower than in the West. Cosmetic surgeon Dr Mohan Thomas, a member of the government's council for medical tourism, says foreign patients need to be careful about choosing their care. "My advice is check the doctor's credentials, the hospitals he is attached to and most important see some work he has done," said Thomas, who said 25 per cent of his patients are from overseas, primarily from Britain, the United States and Africa. "Check how much effort the hospital takes with cleanliness, starting with the bathroom," he said. While India's medical care has dramatically changed in recent years as its economy has boomed, it's still in its early days for medical tourism.

India attracted 150,000 foreign patients last year, Singapore got 200,000 and Thailand - the favoured destination - 600,000. But the numbers are increasing in India. One stretch in June found three Americans recovering from orthopaedic surgery in Jaslok, one of Bombay's top hospitals. Texas-born businessman Robert Carson, 46, says he pulled out of hip replacement surgery the evening before it was scheduled in a Bangkok hospital.

A television program about a new treatment - hip resurfacing - convinced him the procedure was less invasive and promised more mobility since the bone was shaved and not cut as in a traditional hip replacement. The trail led to orthopaedic surgeon Dr Ameet Pispati, an Indian doctor trained in Britain under a pioneer in the procedure. Carson had his operation in Bombay three days after he cancelled his Bangkok surgery.

Now, he says India is his first choice for medical treatment. "I'd come back in a minute even if costs were equal to the US I would come because of the personal care," he said. Carson complained about American doctors being incommunicative and said Pispati, his Indian surgeon, was completely open - "He told me what could go wrong and what he's done before." Other patients also cited rapport with Indian doctors as a reason for coming here.

A Briton working in Ireland, who asked that his name not be used, pointed to a doctor's kindness as the reason he thought infertility treatment for his wife would work in India after failing in Dublin.

He said the doctor answered emails, gave out her mobile phone number and even responded while on vacation. Belgian Jaequet Robert wrote an emotional note in the record book of Bangalore's Manipal Hospital where his nine-year-old son had heart surgery.

"I am delighted with the way we were received here, the way people understood our problem, the way they are very sensitive to the suffering of especially the poor people and children. I find this an exceptional experience." The absence of long waiting lists also draws patients. "I could have had total hip replacement done in the States for nothing because I have a health plan. But I found it worth it to come here. I didn't want to stand in line," said Gordon Deboo, 73, a retired NASA research scientist from Walnut Creek, California. Couples from the United States, Ireland and South East Asia also head to India for infertility treatment - with some women carrying frozen sperm in liquid nitrogen containers. Dr Firuza Parikh, a leading infertility specialist, said she generally asks women to plan to stay for two in-vitro fertilisation cycles, or two months.

They stay in hotels or rent apartments. "The husbands usually come for a shorter period and we freeze the sperm," she said. In-vitro fertilisation can cost $US20,000 ($NZ28,400) in the United States and $US15,000 ($NZ21,300) in Europe - opposed to about $US2,500 ($NZ3,500) in India. Even after adding hotel costs and airfare, India is far cheaper.