Chapter I

INTRODUCTION
1.1 The Conceptual Framework
The chapter deals with the concept of Medical Tourism which has vast economic
potential in Indian and international scenario. The services sector is contributing up to 60%
in India GDP and also 70% in international marketplace in the era of economic recession.
This sector is one of the leading sector of Indian and global economy and earning
maximum foreign exchange. The name medical tourism itself states that it is a combination
of two booming services sector i.e. medical service sector and tourism services sector. The
third service industry which is newly formed by joining this two sectors is also growing in
leaps n bounds .The medical tourism industry which is earning in multimillions foreign
dollars ’industry in India and also in a global terrain.

 Worldwide growth of Service Sector

 Booming world Tourism Sector

 Golden Era of Indian Tourism

 Types of Tourism Products

 Emerging Medical Tourism in globe and India.

 History of Medical Tourism.

 Definition of Medical Tourism

 Growth of Medical tourism in Tourism Sector

 Changing Faces of Indian Hospitals.

 Advantage India in Medical Tourism

 India ideal Medical tourism Destination (SWOT India)

 Madhya Pradesh Profile: Medical Tourism.

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 This chapter is discussion of growing service sectors and tourism sectors in world
and in India. The Chapter also confer various types of tourism products available in India,
and about the emerging Niche Tourism concept of medical tourism developing in Indian
and international regional markets, and also talk about particularly on the, applicability of
medical tourism concept in various states of India like Madhya Pradesh .

Definition of medical services: The proposed amendment redefines medical services

to include preventive health care and provides continuing treatment eligibility for certain
persons disabled as a result of treatment.

Tourism Services: “A Tourism service is traveling for predominantly recreational or

leisure purposes or the provision of services to support this leisure travel. All the services
provided to a tourist are known as tourism services.”

Both the services are joined together to form Medical tourism.

Medical travel is the act of traveling to the other countries to obtain medical, dental
and surgical care. In year 1987 for the Goodrich & Goodrich (1987) gave the initial
definition of Health care tourism was as “the attempt on the part of a tourist facility (a
hotel) or destination to attract tourist by deliberately promoting its health care services and
facilities in addition to its tourist amenities”.

1.1.1 Worldwide Emergence Of Service Sector

Today Service sector all over the world is growing very fast. In all developed
countries like England, China, America and Europe, are the major destinations and this
sector contributes the major market share to the tune of 60-70% of total earning. Service
sector covers a larger canvas and is the fastest growing sector in the economy with huge
source of employment. This study is dealing with the concept of Medical Tourism, which is
a part of Service Sector which is growing very fast in the international scenario.

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 The service sector consists of the "soft" parts of the economy, i.e. activities where
people offer their knowledge and time to improve productivity, performance, potential, and
sustainability. The basic characteristic of this sector is the production of services instead of
end products.

Definition of Service Industry: An industry made up of companies that primarily

earn revenue through providing intangible products and services. Service industry
companies are involved in retail, tourism transport, distribution, food services, as well as
other service-dominated businesses.

Service sector constitutes a very heterogeneous economic category. It encompasses

trade, finance, insurance, communication, public transportation, government administration,
healthcare, education, business, and tourism services.

In Services the Consumer markets are becoming increasingly mature with growing
information input. As a result, consumer expectation are changing vary fast and creating
challenges for business. These challenges make tourism as an emerging area for attraction
and exploration of India. It is boom time for world and India’s Tourism and hospitality
sector to show its presence in global map. The emergence of India as one of the fastest
growing economies in the world during the 1990s is attributable to the rapid growth of its
services sector to a great extent.

1.1.2 Booming World Tourism Sector

The service sector is a major contributor in economy in the era of economic
recession. The study is discussing in detail a very important and potential area of service
sector i.e. the tourism services.

Definition of Tourism: Tourism comprises the activities of persons traveling and

staying outside their usual environment not more than one year for leisure, business or
other reasons not related to the excise of the activity remunerated from the place.

Tourism is traveling predominantly for recreational or leisure purposes or the

provision of services to support this leisure travel. A prime factor in the tourism industry is

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the "Tourist" a tourist by some is defined as people who travel and stay in places outside
their usual environment for more than twenty-four hours and not more than one consecutive
year for leisure, business etc.

The tourism industry is the different types of facilities provided within a country for
these "tourist". For example hotels, air transportation and accommodation, cafes, bars,
restaurants etc. All of which is used to boost the level of tourism within a country.

Travel and tourism is one of the fastest-growing industries and a significant source
of employment in many countries. It is expected to have generated around 9.4% of world
GDP and 8.2% of total employment in 2009. The contribution of the industry to the global
economy remains high despite a 4.38% decline in 2009. During this year, travel and
tourism investment too declined by more than 12%.

International tourist arrivals grew by over 4% in 2011 to 980 million, according to

the latest UNWTO World Tourism Barometer. With growth expected to continue in 2012,
at a somewhat slower rate due to World Economic Recession, international tourist arrivals
are on track to reach the milestone one billion mark later this year.

According to the UNWTO World Tourism Barometer 2012 the top ten tourist
destinations, receipts were up significantly in the USA (+12%), Spain (+9%), Hong Kong
(China) (+25%) and the UK (+7%). The top spenders were led by emerging source markets
– China (+38%), Russia (+21%), Brazil (+32%) and India (+32%) – followed by traditional
markets, with the growth in expenditure of travelers from Germany (+4%) and the USA
(+5%) above the levels of previous years.

1.1.3 Golden era of Indian Tourism

It is boom time for India's Tourism and Hospitality sector. Ever since India has
taken up the initiatives of globalization way back in 90s. Driven by a surge in business
traveler arrivals and a soaring interest in India as a tourist destination, the year 2011 has
been the best year till date, with foreign visitor arrivals reaching record revenue in dollars,
resulting in international tourism receipts of Rs. 5724 Crore. It’s a golden time for Indian
Tourism Sector according to global hotel and hospitality consulting firm,HVS International,
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the strong performance in tourist arrivals in last years can be attributed to a strong sense of
business and investment confidence in India inspired by-

 India's strong GDP performance

 Strengthening of ties with the developed world, and

 Opening of sectors of the economy to private sector/ foreign investment.

India: Foreign Tourist Arrivals

Indian tourism is catering most diverse products globally. The country’s rich
history, cultural heritage, beauty, diversity of religion and medicine fascinate budget and
luxury travelers. Tourism in India has registered significant growth over the years. This has
been led by growth in both leisure and business tourism. Rising incomes, increasing
affordability, growing aspirations, increasing globalisation, and a growing airline industry
along with improvement in travel-related infrastructure have supported industry growth.
Tourism holds immense potential for the Indian economy. It can provide impetus to other
industries through backward and forward linkages and can contribute significantly to GDP.

Table No. 1.1: Performance Of Travel And Tourism Industry in India 2009

Parameter Value
Foreign Tourist Arrival In India 5.11 millions no’s (P)
Indian National Departures from India 11.07 Millions no’s (P)
Domestic tourist visits to all states/UTS 650.04 millions no’s (P)
Foreign Exchange earnings from Tourism
NRI Terms 549.6 bn
US$ terms 11.39 bn $

India’s travel and tourism industry is expected to generate revenue of Rs. 1,970 bn
(US$ 42 bn) in 2010, according to the World Travel & Tourism Council (WTTC). This
would be around 3.1% of total GDP. However, since travel and tourism touches all sectors
of the economy, its real impact is greater and the travel and tourism economy directly and
indirectly accounts for ` 5,533 bn (US$ 118 bn), equivalent to 8.6% of total GDP.

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Rising online sales

Online travel sales have increased drastically in recent years. Greater proliferation
of the Internet, growth in low-cost air carriers, secure payment mechanisms, and coming-up
of the Indian railways portal have led to rise in online sales in the travel industry. A number
of low-cost carriers operate on certain routes, and hence online booking offers choice of air
carriers to customers. Airline ticket booking constitutes more than 70% of online travel
sales. However, a shift is being seen from air to non-air segments in the online travel
market. This shift is due to the non-air ticket booking segment growing swiftly with launch
of the Indian Railways online portal and many online travel agencies providing bus tickets.
Indian Railway Catering and Tourism Corporation is the largest travel website in the APAC
in terms of transaction volumes. A number of hotels also use the Internet for booking of
rooms. The online booking of railway tickets through IRCTC has gone up to 35% of the
total ticket booked.

1.1.4 Types Of Tourism Products In India

India has registered phenomenal growth in the last decade so the Indian government
decided to boost revenues from the tourism sector by projecting India as the ultimate tourist
destination. India is providing variety of Tourism products. The reason why India has been
doing well in all types of tourism is practiced in India. Then country has always been
known for its, unique culture of hospitality which helps in entertaining the foreigners. This
is the major reason why India is attracting foreign travelers to India. In order to boost
tourism of various kinds in India, The Indian government, has set up the Ministry of
Tourism and Culture. This ministry recently launched a campaign called ‘Incredible India!’
in order to encourage different types of tourism in India.

The result was that in 2004, foreign tourists spent around US$ 15.4 billion during
their trips to India. Being a country with tremendous diversity, India has a lot to offer in
terms of tourism and related activities. The diversity that India is famous for ensures that
there is something to do for all tourists in India, no matter what their interests are.

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Eco Tourism

Beach Tourism

Adventure tourism

The various kinds of adventure tourism in India are:

 Rock climbing

 Skiing

 Camel safari

 Para gliding

 Mountaineering

 White Water Rafting

 Trekking

As a kind of adventure Sports tourism in India, rock climbing is relatively new. Due to
the presence of climbing rocks in large numbers throughout the country, rock climbing as a
kind of adventure tourism in India is taking off in a big way. Whitewater rafting in India is
a relative newcomer in the domain of adventure tourism in India. This has been increasing
due to the presence of a number of rivers, water falls, and rapids. The places where a tourist
can go for whitewater rafting in India are Ganga, Alaknanda, and Bhagirathi rivers.
Trekking as a part of adventure tourism India has grown recently. Many tourists are coming
to India in order to go trekking in the various rugged mountains present in India.

As a kind of tourism in India, adventure tourism has recently grown in India. This involves
exploration of remote areas and exotic locales and engaging in various activities. For
adventure tourism in India, tourists prefer to go for trekking to places like Ladakh, Sikkim,
and Himalaya. Himachal Pradesh and Jammu and Kashmir are popular for the skiing
facilities they offer. Whitewater rafting is also catching on in India and tourists flock to
places such as Uttranchal, Assam, and Arunachal Pradesh for this adrenalin-packed activity.

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Wildlife tourism

India has a rich forest cover which has some beautiful and exotic species of wildlife–some
of which that are even endangered and very rare. This has boosted wildlife tourism in India.
The places where a foreign tourist can go for wildlife tourism in India are the Sariska
Wildlife Sanctuary, Keoladeo Ghana National Park, and Corbett National Park. Out of total
60% of area of the Madhya Pradesh state is covered with dense forest. So Kanha Tiger
Reserve of Madhya Pradesh is very popular amongst Foreign Visitors.

Pilgrimage tourism

India is famous for its temples and that is the reason that among the different kinds
of tourism in India, pilgrimage tourism is increasing most rapidly. The various places for
tourists to visit in India for pilgrimage are Vaishno Devi, Golden temple, Char Dham, and
Mathura Vrindavan.

Eco tourism the main motto of Eco Tourism is to create local employment .Among
the types of tourism in India, ecotourism has grown recently. Ecotourism entails the
sustainable preservation of a naturally endowed area or region. This is becoming more and
more significant for the ecological development of all regions that have tourist value. For
ecotourism in India, tourists can go to places such as Kaziranga National Park, Gir National
Park, and Kanha National Park.

Gourmet Tourism is a Niche industry catering to the people who travel to food or
wine and visit restaurants for testing Indian delicacy.

Cultural tourism

India is known for its rich cultural heritage and an element of mysticism, which is
why tourists come to India to experience it for themselves. The various fairs and festivals
that tourists can visit in India are the Sindh Mahotsav, Boat races, Gwalior Mela, Pushkar
fair, Kalidas Mahaotsav, Taj Mahotsav, and Suraj Kund mela., Ellora Festival and more.
Instant Holidays

Instant Holidays are short-duration Indian and International travel packages to nearby
destinations, and countries that offer visa on arrival to Indian nationals. Perfect for last
minute travel deals.

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Romantic Getaways

If you have romance on your mind, opt for a Romantic Getaway, our compilation of short-
duration India holiday packages designed for the romantic at heart.

Europe Holidays

Europe is best explored by rail and a Rail Europe Holidays offer a flexible and economical
way to appreciate Europe's quaint towns and rich, enchanting culture.

Escorted Customize Tours

Luxury Escapades are a series of exclusive, International holidays custom-designed for the
tailor-made International Holidays and Travel Packages

Incredible India Campaign

Bharat Deko Tour packages offer group holidays in India, with a carefully selected itinerary
of essential sightseeing, buffet meals, tour managers and first class hotels.

Customized tours and International holiday packages with a wide range of sightseeing and
experiences to suit your individual taste and budget. One stay in 5 Star hotels, and travel in
private, air conditioned vehicles.

The different types of tourism in India are growing and this has boosted the Indian
economy. To make this growth of income in future also, efforts must be taken by the Indian
government, and that the tourism sector can contribute more substantially to the nation’s
GDP.

1.2.1 Emerging Medical tourism In Globe And India

Tourists from all over the world have been thronging India to avail themselves of cost-
effective but superior quality healthcare in terms of surgical procedures and general medical
attention. There are several medical institutes and corporate in the country that caters to
foreign patients and impart top-quality healthcare at a fraction of what it would have cost in
developed nations such as USA and UK. It is expected that medical tourism in India will
hold a value around US$ 2 billion by 2012. The city of Chennai attracts around 45% of
medical tourists from foreign countries.
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Two booming sectors of the world economy are joined and then a new sector is formed
called as medical tourism which is able to generate million dollar business.

Medical Sector now a days is treating patients with latest miraculous advance techniques,
less rates, backed by more latest pharma research, Stem Cell technology, so the treatment
is able to cure health complex problems like heart surgery, cancer, liver transplant , kidney
transplant etc.

Tourism is also a biggest sector of world economy. The world and Indian tourism Sector is
earning foreign currency, and also growing very soon, in turnover. The combination of
these two sectors is Medical Tourism which is started growing very fast in Indian and
International Scenario.

It can be stated that this combination sector of medical Tourism is a specific type of tourism
where tourist primarily is taking medical treatment and then exploring the tourism. Thus a
new product is created called Niche Tourism or medical tourism. In this original idea the
medical services are very nominal or uncomplicated and hence can be clubbed with
tourism. Example- Dental Treatment, minor surgeries. But now a days tourists are visiting
other countries for complicated surgeries like organ transplant etc.

Medical tourism is growing in world but Asian countries Ex-Singapore, Malaysia etc are
having a clear domination on these markets for the reason that most of the south and far
East Asian countries cheaper in terms of medical treatment and tourisms as well. Now a
day’s lots of countries are venturing in this medical tourism sector. The main reason for the
growth of Medical Tourism are long waiting lines for surgeries treatment ,costly healthcare
in developed countries , no insurance cover, open communication, globalised markets .
Asian countries are providing alternative medicine like yoga, naturopathy, ayurvedic etc
along with the Medical tourism package. India has also entered in Medical Tourism
Industry very aggressively and successively within a very short span of time this sector is
growing rapidly.

Medical Tourism occurs when international patients with visa travel across boundaries for
healthcare and their medical needs.

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1.2.2 History Of Medical Tourism
Although the word the Medical Tourism is gaining recognition in last decade or so but
actually this is as old phenomenon practice. The concept of medical tourism is almost as old
as medicine itself. A patient going to a different country for either urgent or elective
medical procedures is well established.

AS far as the Bronze Age (2000 B.C) tribes near St. Moritz Switzerland gathered to drink &
bathe in the iron rich mineral springs of the region. Votive drinking cups were found around
thermal springs

 In 4000 B.C., the Sumerians constructed the earliest known health complexes alongside
mineral water springs that included elevated temples and flowing pools. Although many
post-Sumerian civilizations probably understood and appreciated the healing effects of
mineral-rich water, it was the Greeks who first laid the foundation for a comprehensive
existence.

Greek

 Medical Tourism dates back to when Greek pilgrims traveled from all over the
Mediterranean to the small territory in the Sardonic Gulf (or Gulf of Aegina in Greece)
called Epiduria in Northeastern Peloponnese. This territory was the sanctuary of the
healing God Asclepius the god of medicine in ancient Greek mythology representing
healing aspects of the Medical Arts. The healing temples were called asclepiei on
Epidauria became the original travel destination for Medical Tourism.

 These temples flourished which included bathing springs, dream temple, Gymnasium
Palaestra (exercise area) and a snake farm were constructed all over Greece. Patents
were attended by priests, stretcher carriers and care takers, and finally patients were
given appointment of the priest. Expenses were made according to the capacity of the
family.

 Apart from this another famous “asclepieion” was on the island of Kos – a Greek island
in the south Sporades group of the Dodecanese, next to the Gulf of Gökova/Cos, where
Hippocrates, the legendary doctor, may have begun his career.

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Spa (Latin, Salus per Aquam meaning health by water) :

 Spa towns and sanitariums were considered an early form of medical tourism. In
eighteenth century England, for example, med trotters visited spas because there were
places with supposedly health-giving mineral waters, treating diseases from gout to
liver disorders and bronchitis.

 In Roman Britain, patients took the waters at a shrine at Bath, a practice that continued
for 2,000 years. Bath is world heritage city one of England’s most beautiful places to
visit and also visited Germany and Egypt.

 In 1326, a sleepy little village in East Belgium gained an overnight fame after the
discovery of iron-rich hot springs within its boundaries. Although the Romans knew
about the therapeutic waters of Ville d’Eaux (Town of Waters), it developed into a full-
fledged health resort only in the 16th century. Visitors from all over Europe flocked to
Ville d’Eaux for relief from gout, rheumatism, and intestinal disorders. The word “spa”
is created around this time, and it applied to any health and wellness resorts that
didn’t practice conventional clinical medicine.

 Hot water springs in India were destinations of mass public movements to get rid of
skin disorders due to probably therapeutic concentration of sulphur content in natural
water.

 Mineral springs in Japan called onsen have been popular for their healing properties
with travelers for 1000 years. Indian, Egyptian, and Chinese cultures clearly document
bathing and healing complexes erected around therapeutic springs.

 As far back as the Bronze Age (2000 B.C.) hill tribes near present-day St. Moritz,
Switzerland gathered around to drink and bathe in the iron-rich mineral springs of the
region. Bronze Age implements, including votive drinking cups, have also been found
around thermal springs in France and Germany, as well as in Celtic mineral wells.

China

The pattern of Chinese medical practice to stimulate Medical Tourism mainly includes the
use of herbs, dietary therapy, massage, and acupuncture. Chinese medicine is a wide subject

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and is practiced throughout China and East Asia by millions of people. The Chinese
traditional medicines are well recorded since 2700 BC. Acupuncture is considered to be the
most important old and new Chinese alternative medicine worldwide. It dates back as far as
4700 years. The members of the European ruling class, rich and famous personalities,
aristocrats and gentlemen of leisure and free-thinking American reformists had developed a
habit of traveling to remote Western springs for cleansing and healing.

MICHEL EYGUEM DE MONTAIGNE (1533-1592) a great French Renaissance thinker,

philosopher and French inventor of the essay traversed the continent for 9 years in search of
a cure for a troublesome gall bladder problem. He is said to be the most noteworthy medical
traveler.

PETER THE GREAT a Russian Emperor (1672-1725) is also an illustrious medical tourist.
He was a patient having problems with his urinary tract and bladder. VICTOR-MARIE
HUGO a great French poet (1802-1885) the most influential exponent of the Romantic
Movement in France is also a milestone medical tourist to get himself treated in Ville
d’Eaux (Town of Waters) in Belgium as he suffered from a mild stroke.

Ancient Roman Medical Tourism:

Hot water baths (Tharmae) were not only used for medicinal purpose but they also served
as important social networking venues for empires most privileged elites. Some

Treatment centers actually included theater or, Stadium, cathedral conference hall etc
accounting 3000 patients. Trade with different countries expanded art of healing and Ayur-
vedic massage, Chinese medicine also was provided.

Japan

Japanese Onsen: The healing powers of Mineral Springs to relive pain and heel their
wounds volcanic soil attracted lots of warriors all over the world. People went for treatment
in Japan. After lot of decades Kyushu a place in Japan is where lot of tourists visit for water
healing. Today they have sulfur springs and mud pools & mineral scrubs.

European medical tourism: The emergence of Bath or aqua sulies (named after goddess the
name of Aqua Sulis Minerva) as medical tourism in 1720’s .This received heavy royal
patronage and this bath become the latest thing in wellness & recreation playgrounds for the
13
rich & famous. Baths received a whole series of technological, financial, & social benefit.
This city was having covered sewer system. Adequate roads with pavements and architects
have beautified this place.

Islamic Medical: Tourism

(1248 AD) Throughout much of recorded history, health travel was restricted either to the
wealthy or truly desperate. But in today’s flattening global economy, the physical,
economic, and cultural barriers that once separated nations from one another are dissolving
as international travel, mass communication, and more lenient trade policies make it
possible for those with modest means to enjoy the benefits of world-class health care in the
form of Medical Tourism.(2007).

The idea of the health holiday is to offer an opportunity to get away from the daily routine
and come into a different relaxing surroundings. Here one can enjoy being close to the
beach and the mountains. At the same time is also able to receive an orientation that will
help to improve life in terms of health and general wellness. It is like rejuvenation and
cleanup process on all levels - physical, mental and emotional. This perspective has given
birth to a new dimension, known as Medical Tourism.

India

 Asia is also a historical Medical Tourism Destination. The practice of yoga (5000) years
ago was invented in India, Himalya Meditation centers; unbelievable reach of India’s
healing arts cannot be ignored. India has enjoyed influx of lots of travelers’ spiritual
students and also lots of visitors for alternative revered branch of treatment gained
popularity 5,000 years ago. India has been visited by a constant stream of health
travelers seeking to heal themselves through alternative medicine. The history of
indigenous Indian medical science is probably as old as the Indus Valley Civilization
dating back to 3000 BC.

 The art of India’s spiritual healing centers made India a Mecca for all alternative
treatment practitioners. So lot of experts in this area pooled their knowledge &
experience to provide best treatment.1960 India once again became a destination for
western tourist. A mass influx of Medical Tourist were helped by India’s deep
commitment to the technology and health care infrastructure. India is world’s oldest
destination and become world’s admired destination(Connell 2006)
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 Ayurveda has always been preserved by the people of India as a traditional “science of
life”. Ayurveda operates on the precept that various materials of vegetable, animal, and
mineral origin have some medicinal value.

The medicinal properties of these materials have been documented by the

practitioners and have been used for centuries to cure illness and/or help maintain good
health. Writers and compilers of Ayurvedic literature such as Charaka, Sushruta,
Vagabhatta, Bhav Mishra, Shaligram and others have written about the qualities,
characteristics and medicinal uses of the herbs, mineral, metals, chemicals, animal parts,
cooked food articles, natural foods, fruits. This great doctor in aurveda was doing
successfully very complex surgery and plastic surgeries of the patients. The authentic way
to benefit from this ancient medical methodology is to travel to the land where Ayurveda
was born.

India’s southernmost states, Kerala and Tamil Nadu, have particularly embraced the
spa industry’s hottest new phenomenon.

Fig No. 1.1 Susruta Surgeon India

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1.2.3 Definitions Of Medical Tourism
Medical tourism or medical travel is act of travelling to other countries to obtain dental,
physician or surgical Care.

Goodrich & Goodrich (1987) “The attempt on the part of tourist facility or destination to
attract tourist by deliberately promoting its health care services in addition to its regular
tourist amenities.” The Health care facilities were promoting Medical Tourism services.

This definition given 20 years back is mentioning about the medical and health services
spas, resorts hot springs were only mentioned this was only of those individuals who can
afford.

Connel l (2006) defined medical tourism as a mass culture “where people travel often long
distances to overseas destinations (India, Thailand Malaysia) to obtain medical dental and
surgical care while simultaneously being holiday makers in a more conventional sense”.
First time he has mentioned mass word which means Medical Tourism is always availed
in groups by people .This concept has seen in India in 2009-12 now a days in Medical
tourism ,Medical tourism travelers feel Cozy in their groups so they wish to come along
with their family and friends in India.

Many countries and states in Asia who are rich in natural resources are promoting
alternative treatment and conventional medicines which has led a recent natural progression
in the area of health from developed Countries.

(Jabbari 2007) Medical Tourism report (2005) Medical Tourism is described as any form
of travel from ones normal place of residence to destination at which medical treatments are
provided. The travel undertaken must involve more than one night away from the country
of residence.

Medical tourism can be broadly defined as provision of 'cost effective' private medical care
in collaboration with the tourism industry for patients needing surgical and other forms of
specialized treatment. This process is being facilitated by the corporate sector involved in
medical care as well as the tourism industry - both private and public. (India Medical Care
2007).

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It is correctly stated, “A definition is the envelope of ideas caught in the wall of words.”
The definition must serve the general purpose and betterment of the term. Though the term
“Medical Tourism” constitutes two words, the definition requires extensive understanding
of these words.

The word “Medical” means treatment of illness, disorder or injuries. In general, “Tourism”
means traveling for pleasure. According to World Tourism Organization (WTO), the word
“Tourism” compromises of “the activities of persons traveling to and staying in place
outside their usual environment for leisure, business and other purposes.” In this definition
going out of the usual environment is highlighted. Understanding of word medical and
tourism individually is not sufficient to define Medical Tourism. Medical Tourism is
combination of various and definite activities and clear understanding of such activities is
essential.

“Medical Tourism is a set of activities in which a person travels often long distances across
the borders to avail medical services with direct and indirect engagement in tourism
activities” Dr.Prem (2009)

“The person who travels to avail medical services is called Medical Tourist or Medical
Traveller.”

“The organization that provides health care services to the traveler or patients is called as
Global healthcare provider.”

“The company that provides support services to facilitate such arrangement is called
Medical Tourism provider”

In simple terms Medical Tourism is the process of travelling abroad to receive superior
medical, dental cosmetic care by highly skilled surgeons at some of the most modern and
state of the art medical facilities in the world where the cost of treatment is comparatively
very low then their home country.

According to Segen’s Medical Dictionary, medical tourism is defined as “A term coined by

travel agencies and the mass media for the practice of travelling across national borders to
obtain health care. It also refers to the practice of healthcare providers travelling
internationally to deliver healthcare, which is both pejorative and less common.”(2012)
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Alternative Medicine: All packages provided by Medical Tourism all over the world there
is always a word attached alternative medicine. Literally, alternative medicines means
alternative to “something else”, this “something else” is western medicine or allopathic or
orthodox medicine.

This term is casually used to cover all forms of medicine except allopathic. In 1973, the
Medical Faculty of the University of Rome convened the first world congress of alternative
Medicines, and the provisional program contained no less than 135 different therapies. The
experts of WHO have also identified and enlisted more than 100 types of practices and they
have termed these as traditional medicine.

These forms of medicine are known as traditional medicine (as most of these are practiced
from time immemorial), complementary medicine (as these medicines supplement
allopathic medicines in many-a-cases) (as it differs from the orthodox medicine), holistic
medicine (most of alternative medical systems consider the human body as a complete
being comprising of physical, mental, social and spiritual dimension), ethno medicine (as
these methods of treatment are based on the laws of nature and natural substances are used
to treat the patients).

There are more than 100 systems of alternative medicines still in practice all over the world.
Every country, region or area has its own traditional systems of health and medical care
such as for the chinese it is acupuncture, for the French, magnetic healing; for the Germans,
Heilpraxis; for the English-Herbalism; For India-Ayurveda; for the muslim countries-the
Unani; for the Southern part of the country- Siddha; for Japan-Shiatsu etc.

The most popular forms of alternative medicines are ayurveda, electro homoeopathy, unani,
siddha, naturopathy, yoga therapy, acupuncture, acupressure, magneto therapy, shiatsu,
herbalism, meditation, aroma therapy, bath flower remedies, gem therapy, chromo therapy,
hydro-therapy, diet therapy and reiki.

Complementary medicine is different than alternative treatment; it is used together with

conventional medicine. Example a special diet to treat cancer instead of radiation, surgery
etc. Alternative and complementary medicines are practices not generally recognized.

18
Medical Tourism is a Niche Tourism sector which has started and growing recently across
the globe. The Medical Tourism possesses mainly few subsets that draw focus of medical
travelers. Surgical Tourism, Reproductive Tourism, Dental Tourism, Cosmetic Tourism,
Organ Transplant, Aurveda, Sports Medicine ,Reproductive Tourism, Dental Care ,are
popular varieties of medical tourism.

Types of Medical Tourist: According to Tourist Arrival Destination.

1] Outbound Medical Tourist – Indian patients traveling to other countries to receive

medical care.

2] Inbound Medical Tourist - Medical Tourists from other countries traveling to the
India to receive medical care.

3] Intra Bound Medical Tourist : Indian patients traveling within the India to receive
medical care outside their geographic area, typically to a Center of Excellence in another
state/region/Process.

1.3.1 Growth of Medical Tourism Industry

Medical tourism sector or Industry is growing all over the world. More and more countries
are setting up to explore and enter in this sector. Now a globalization effect is observed in
all medical tourism services provided by hospitals of different countries.

The impact of globalisation- a consumerist culture is promoting, as a result there is

promotion of goods and services that can feed the aspirations arising from various cultures.
This has had its effect in the health sector too, with the emergence of a private sector that
thrives by servicing a small section of the population that has the ability to “buy” a medical
care at the rates at which the “high end” of the private medical sector provides such care.

Example: Bangkok’s Bumrundgrad hospital has more than 200 surgeons who are board-
certified in the United States, and one of Singapore’s major hospitals is a branch of the
prestigious Johns Hopkins University in Baltimore. In a field where experience is as
important as technology, Escorts Heart Institute and Research Center in Delhi and
Faridabad, India, performs nearly 10,0000 heart operations every year, and the death rate

19
among patients during surgery is only 0.8 percent--less than half that of most major
hospitals in the United States.

For many medical tourists, though, the real attraction is low price. The cost of surgery in
India, Thailand or South Africa can be one-tenth of what it is in the United States or
Western Europe, and sometimes even less. A heart-valve replacement that would cost
$200,000 or more in the U.S., for example, goes for $10,000 in India--and that includes
round-trip airfare and a brief vacation package as well. Similarly, a metal-free dental bridge
worth $5,500 in the U.S. costs $500 in India, a knee replacement in Thailand with six days
of physical therapy costs about one-fifth of what it would in the States, and Lasik eye
surgery worth $3,700 in the U.S. is available in many other countries for only $730.
Cosmetic surgery savings are even greater: A full facelift that would cost $20,000 in the
U.S. runs about $1,250 in South Africa.

Medical tourism could bring India as much as $2.2 billion per year by 2012. Argentina,
Costa Rica, Cuba, Jamaica, South Africa, Jordan, Malaysia, Hungary, Latvia and Estonia
all have broken into this lucrative market as well, or are trying to do so, and more countries
join the list every year. Argentina ranks high for plastic surgery, and Hungary draws large
numbers of patients from Western Europe and the U.S. for high-quality cosmetic and dental
procedures that cost half of what they would in Germany and America. Lastly, Dubai--a
destination already known as a luxury vacation paradise--is scheduled to open the Dubai
Healthcare City by 2010.

Indian Perspective:

Medical Tourism services is cocooning in India, There is a change in the character of the
medical care sector, with the entry of the corporate Hospitals ex. Fortis, Medanta etc . In
this background, corporate like Escorts, Apollo, Ranbaxy etc interests in the Medical Care
sector is increasing, who are looking for opportunities that go beyond the limited domestic
Indian “market” for economical medical care and they are thriving in foreign countries to
promote their services. This is the genesis of the “medical tourism” industry.

In many developing countries it is being actively promoted by the government’s official

policy. India’s National Health policy 2002, for example, says: “To capitalise on the

20
comparative cost advantage enjoyed by domestic health facilities in the secondary and
tertiary sector, the policy will encourage the supply of services to patients of foreign origin
on payment. The rendering of such services on payment in foreign exchange will be treated
as ‘deemed exports’ and will be made eligible for all fiscal incentives extended to export
earnings”. The formulation draws from recommendations that the corporate sector has been
making in India and specifically from the “Policy Framework for Reforms in Health Care”,
drafted by the prime minister’s advisory council on Trade and Industry, headed by Mukesh
Ambani and Kumaramangalam Birla.

But, things are going to change considerably in favor of India, especially in view of the
high quality expertise of medical professionals, backed by the fast improving equipment
and nursing facilities, and above all, the cost-effectiveness of the package.

Health Industry in India

Health Sector in India is developing fast; its turnover in India is 200000 crores rupees in FY
2011 and by 2012 it is expected to grow up to 300000 crores rupees. Out of all this medical
services 80% services are controlled by private sector. This is the only sector which is
untouched by economic downturn, and providing employment to 40 lacks individuals in
India in 2011.

Owing to above win - win condition huge investment projects are started by Hospitals and
corporate in India. Medanta for heart care is Rs.1000 crore. Kokilaben hospital in Bombay,
Mediciy lawasa (200) acres, Narayana is Rs.(3000) crore out of this 90% are multispecialty
hospitals. All corporate like Ambani’s, Wokhardt, Fortis etc are engaged very aggressively
in this sector.

Purchasing power of Indian patients and foreigners is increasing as well as maximum

patients are medically insured, so when they enter any hospital with their new expectations.
These patients are intelligent, rich, and also interested in availing various services
provided by hospitals. The hospitals are also investing a lot and providing services like:

 Robotic Surgery.

 MRI During Brain Surgery

21
 Flat panel Digital cathlab.

 Electronic keyboards hospital control

 Paperless Hospitals

 Air Ambulance

 Bar Coded opd card

 Presidential Suit

 Hospital Retail Clinic

 Butic Hospitals.

In the year 2011-Rupees 3415 Crores projects are designed to start the specialization center
to small places, cities, and Rural area so that patients there will be benefited by hospitals
experience. There is a huge demand in health sector and hence everybody will get their
share. India needs 100000 plus beds every year for next 20 years. So Max and fortis are
planning to move towards small cities.

1.3.2 Changing Face of Indian Hospitals

The Research student is personally visited Apollo and Wockhardt Hospital during the
study, hence like to share observations.

Apollo Hospital

If a visitor enters any hospitals the ambience & smell is not of hospital but now it is
converted in happening place, Massage parlors in waiting, Cyber café, CCD, Multi cuisine
canteen, so we can say now hospitals are more than just a hospital but it has added value to
it. These hospitals are providing yoga, alternative medicine in their treatment. Medical
Insurance in India is also growing at the pace of 20% in 2011. There is increase in Medical
Tourism sector in India, there are as good as 35 locations where The APOLLO HEALTH
CHECKS offered by the hospital is a comprehensive check up that screens each organ
closely to detect even the smallest symptom that could be an indication of a major disease.
In addition, the check also identifies the reason for minor ailments, which are constant
irritants. It also serves as a personal medical record for future reference. Once the check up
is completed, and if treatment is required it can begin without delay. Apollo's super

22
specialty departments cover all areas of medical science. For more information or to make
an appointment, call the hospital at 26925858 ext 1090, 1091.

Wockhardt Hospitals

Wockhardt Hospitals believe in giving our patients top priority. In order to treat patient's
illnesses in the most effective manner we have strived to continually improve on our
efforts.

This has put us in the news with some of the best newspapers and journals of our country
for a variety of reasons ranging from the first awake bypass surgery on a beating heart,
performing the first aortic aneurysm stent grafting, complicated laparoscopic obesity
surgery and helping cure spinal tumors to performing the first Maze cardiac procedure.

 Lung disease treated effectively by experts at Wockhardt Hospitals in Surat, (Gujarat)

India.

 A get-together for Cardiac patients – Wockhardt Hospital, Nagpur

 Click here to view Wockhardt Workshop Video on Difficult Rhinoplasty

 Congenital heart defect got corrected, in a unique heart surgery at wockhardt hospital

 Jyoti Amge makes way to the Guiness Book of World Records- Wockhardt Hospitals,
Nagpur

 High-risk bypass surgery (CABG) routinely performed at Wockhardt Hospitals, Nashik

 Cigna International ties up with Wockhardt Hospitals Group

 Transradial Angioplasty on a complex and rare Dextrocardia patient

 Health Talk on Osteoporosis – Rajkot

 Total Knee Replacement with no Blood Loss, Nashik

 SANDHICHHAYA-Wockhardts Initiative for Preventive Health Care, Nagpur

 Interventional Radiology Services now at Wockhardt, Nashik

 Critical Case-Spine Surgery on 105 year old

 Corporate Meet by Wockhardt, Nashik

23
 An unusual case of huge Fibroid Uterus at Wockhardt Hospitals,Rajkot

 Wockhardt's Campaign Against Drunken Driving, Nashik

 Quality of life and Neurosurgery: By Dr. Shailesh Kelkar

 Gall Bladder Stone Removal Surgery – Wockhardt Hospitals Innovates yet again!

The description of this hospitals states about the mentality of management of Indian
Hospitals to serve Patients with multi super specialty Hospitals .Hospitals are investing a lot
and also going out of way to plan to serve patients. They are providing all the alternatives
services to the patients’ weather it is infrastructure like machines, building or specialty
treatment.

1.3.3 Advantage India In Medical Tourism

India has emerged as a significant destination for Medical (treatment) Tourism. The country
offers great value for money in terms of medical treatment for both the visitors from
developed as well as developing countries. The bigger hospitals in India have state of art
medical facilities equipments and also highly experienced doctors. All this treatments is
offered in just half or one third cost of similar treatment in neighboring medical tourism
hot spots i.e. Singapore , Thailand. That’s why many patients started flocking to India
from various countries.

Singapore & Thailand are more expensive countries as compare to India and hence these
countries cannot be termed as a long term competitors where government is promoting
Medical Tourism. Government of India is not doing anything for growth of Medical
Tourism sector in India.

All Private players i.e. Hospitals, Agents, Chemists, Freelance agents are working in a
chain to build ecosystem that educates and facilitates and ferries Medical Tourists coming
across the world. In 2010 more than 600000 patients visited India for treatment and spent a
sum of Rupees 4500 Crores in getting treated. Private Max, Fortis, Apollo hospitals are
claiming 40% growth per annum in Medical Tourism in India. Due to this there is
employment growth and opportunities for a host of people connected to this business.

24
Max

 Medanta Medicity

 Apollo Group

 Fortis

All these hospitals are using strategies of Tie up with Ministers, Doctors- Medical Camp in
abroad, Brand Familiarization, Tie up with foreign clinics, starting medical colleges
abroad, entertaining Medical Interns in hospitals, Starting foreign bases in foreign lands can
stepping down on translators, food, Medicine ,etc.

Economics of Medical tourism:

Generally 20-30% additional is charged from Medical Tourism then Indian Patients. So
International patient is bringing additional revenue to the hospital. Medical tourism costs
are very reasonable compared to the developed world standard. Out of total Medical
Tourism tourists 55% are coming from west Asia and Africa sub continent.

1.4.1 India as Emerging Medical Tourism Destination

A SWOT Analysis of Medical tourism industry in India is given. According to the SWOT
of Medical tourism in India there is very huge demand for quality medical services in world
and Indian Hospitals are providing international quality medical services at very
economical rates. Indian doctors are knowledgeable, Specialized in their area and
experienced so patents all over the world are rushing to India for Medical Tourism
Services. Can different states of India Example : Madhya Pradesh state apply the input of
SWOT of Medical Tourism and plan accordingly to update , n develop introduce Medical
Tourism Services successively in near future.

Low Cost Treatment

The key “selling points” of the medical tourism industry are its “cost effectiveness” and its
combination with the attractions of tourism. The latter also uses the ploy of selling the
“exotica” of the countries involved as well as the packaging of health care with traditional
therapies and treatment methods.
25
Table No. 1.2 SWOT Analysis of Medical Tourism in India.

Strengths Weakness
 Quality services for affordable cost.  No Government support for promotion.
 Vast supply of Qualified doctors.  No coordination in different players’
 Strong presence in advance healthcare. airlines, hospitals.
Organ transplant.  Customer perception as unhygienic
 International character of hospitals & country.
Doctors.  No accreditation & regulations in
 Diversity in tourism destinations and hospitals.
experiences.  Lack of uniform pricing policies.
Opportunities Threats
 Increased demand of Healthcare  Strong competition exists within Asian
services in USA due to aging sub/continent.
population.  Lack of International Accreditation a
 Fast paced lifestyle increases demand major inhabitation.
for wellness & alternative treatment.  Overseas Medical Care not covered by
 Shortage in supply of national health insurance provider.
system in UK, Canada.  Inadequate investment in healthcare
 Demand from countries with infrastructure.
underdeveloped healthcare facilities.
 Demand for retire homes for age old
people in India.

The figures say it all. Check out the following information regarding the low cost super
specialty treatment in India.

 Total of around 1.5 million foreigners visited India for various medical treatments.

 The total worth of medical tourism industry is around $450 million and is estimated to
reach $2.2 billion by the year 2012.

26
 Foreign patients visiting India for various medical procedures last year marked a growth
of 15%.

 The cost of treatment in India starts as low as 1/10th of the total cost in US or UK.

 Over 150000 patients of over 55 countries visited India for various medical tourism
services.

 The medical expenses in India are 60 to 80% cheaper as compared to Thailand and
Singapore.

Table No. 1.3: Cost comparison in Asian Countries of Medical Tourism Services.

Country No of Patients From Money Strengths

Foreigners Earned
treated 2012
South Asia, 675 mn Cosmetic surgery,
Thailand 973532 Middle east, US organ
transplants, dental
treatment,
joint replacement.
Middle east, 600 mn Organ transplants,
Jordan 130000 America Fertility treatment
, cardiac care

150000 Middle Est., 33mn Cardiac Care, Joint

India Bangladesh, Transplant, Lasik
Europe, South
Africa
Indonesia, 27.63 mn Cosmetic Surgery
Malaysia 129381 Japan, West
Asia, Vietnam
US,UK NA Cosmetic surgery,
South Africa 50000 lasik,
Dental treatment

Cuba N.A Latin America 25-50 Specialist niche

MN treatment,
vitiligo, night
blindness,
cosmetic surgery

27
 Table No. 1.4: Procedure Comparative Charges in India and Leading countries

Procedure USA India Thailand Singapore Malaysia Mexico Cuba Poland Hungary UK
Heart 113000 10000 13000 20000 9000 3250 NA 7140 NA 13921
Bypass
CABG
Heart Valve 150000 9500 11000 13000 9000 18000 NA 9520 NA NA
Replacement
Angioplasty 47000 11000 10000 13000 11000 15000 NA 7300 NA 8000
Hip 47000 9000 12000 11000 10000 17300 NA 6120 7500 12000
Replacement
Knee 48000 8500 10000 13000 8000 14650 NA 6375 NA 10162
Replacement
Gastric 35000 11000 15000 20000 13000 8000 NA 11069 NA NA
Bypass
Hip 47000 8250 10000 12000 12500 12500 Na 7905 NA NA
resurfacing
Spinal 43000 5500 7000 9000 NA 15000 NA NA NA NA
Fusion
Mastectomy 17000 7500 9000 12400 NA 7500 NA NA NA NA
Rhino plasty 4500 2000 2500 4375 2083 3200 NA 1700 2858 3500
Tummy 6400 2900 3500 6250 3903 3000 1535 3500 3136 4810
Tuck
Brest 5200 2500 3750 8000 3343 3000 1831 3146 3490 5075
Reduction
Breast 6000 2200 2600 8000 3308 2500 1668 5243 3871 4350
implants
Crown 385 180 243 400 250 300 1248 246 322 330
Tooth 289 100 100 400 350 NA 174 350 500
Whitening
Dental 1188 1100 1429 1500 2636 950 NA 953 650 1600
Implants

Table Medical Tourism prices in selected Countries in US $

Source: DELSA/HEA/WD/Hwp(2011)3.

The price for surgery take into account Hospital and doctor charges only. Author compiled
from Medical tourism providers n brokers online.
The advantages of medical tourism in India is not only economical but beyond. You get the
benefits of getting high end medical attention and an opportunity to explore the rich
tradition and cultural heritage of India. The various tour packages available will be an
added advantage and will help you recover soon. The available Medical tourism India tour
packages are: (A comparative illustration).
28
Table No. 1.5 Table of Cost Comparison with U.S.A. & India 2010 .

Procedure USA INDIA Difference in price

Bone marrow transplant 250000 69200 28%

Liver transplant 300000 69350 23%
Heart surgery 30000 8700 29%
Orthopedic surgery 20000 6300 32%
Cataract
Cataract surgery 2000 1350 68%
Dental procedure
Metal free bridge 5500 600 11%
Dental implants 3500 900 26%
Porcelain metal bridge 3000 600 20%
Porcelain metal crown 100 100 10%
ROOT CANAL 1000 110 9.09%
TREATMENT
[email protected]

Table No. 1.6: Major players in Indian medical Tourism industry

No. of beds Turn over in % revenues from Major international markets
millions rupee international
patients
Escorts 326 2180 11.9% SAARC,CIS ,EAST AFRICAN
COUNTERIS,AFGANISTAN
Apollo 1500 2010 15% Middle east
Indarprasth 650 1650 7.3% NEPAL, BANGLADESH
Apollo SRILANKA, GULF AND
AFRICA
Hinduja 351 1350 3% AFRICAN AND SARC
COUNTRIES
Jaslok 376 1080 10% JAPAN, MIDDLEEAST AND
AFRICAN COUNTRIES
Source- business today 2001

29
Price advantage is, of course, a major selling point. The slogan, thus is, “First World
treatment’ at Third World prices”. The cost differential across the board is huge: only a
tenth and sometimes even a sixteenth of the cost in the West.

Indian Clinical Expertise

The price advantage is however offset today for patients from the developed countries by
concerns regarding standards, insurance coverage and other infrastructure. This is where the
tourism and medical industries are trying to pool resources, and also putting pressure on the
government.

The services are “cost effective” for those who can pay and in addition come from countries
where medical care costs are exorbitant - because of the failure of the government to
provide affordable medical care. It thus attracts only a small fraction that can pay for
medical care and leaves out large sections that are denied medical care but cannot afford to
pay. The demand for cost effective specialized care is coming from the developed countries
where there has been a decline in public spending and rise in life expectancy and non-
communicable diseases that requires specialist services.

 Medical Tourism concept can be practices and capitalized in future by different states of
India Example Madhya Pradesh, which is performing excellent in tourism sector, to
increase Madhya Pradesh states earnings.

 Health and medical tourism is perceived as one of the fastest growing segments in
marketing ‘Destination India’ today. While this area has so far been relatively
unexplored, we now find that not only the ministry of tourism, government of India, but
also the various state tourism boards and even the private sector consisting of travel
agents, tour operators, hotel companies and other accommodation providers are all
eyeing health and medical tourism as a segment with tremendous potential for future
growth

 When baby Noor Fatima, a two-and-a-half- year old Pakistani girl, successfully
underwent an open heart surgery in India, this movement has opened news vistas
reminding the potential of medical tourism. When Nargis Dutta travelled to U.S for
Cancer treatment that is the example of Medical Tourism.
30
 Medical tourism is the buzzword now. The government as well as private players are
keenly assessing the potential and means to tap the same. Indian tourism Ministry needs
to plan and prepare for developing this Niche Tourism concept of Medical Tourism.

India Attractive Tourist Destination

 India is an attractive tourism destination. It is a 5,000 year old civilization, renowned

for historical, cultural and religious diversity. From the global wonder Taj Mahal to the
colorful deserts of Rajasthan, silver sands of Goa, the pristine backwaters of Kerala, to
the towering and majestic Himalayas, India is incredible. It has diverse geographic
landmarks and vast coastline. It has rich traditional arts and crafts

Unique Indian Alternative Medicine

 India is unique as it offers holistic medicinal services. With yoga, meditation, ayurveda,
allopathic, and other systems of medicines, India offers a unique basket of services to an
individual that is difficult to match by other countries. Also, clinical outcomes in India
are at par with the world’s best centers, besides having internationally qualified and
experienced specialists.

 In India the strong tradition of traditional systems of health care in Kerala, for example,
is utilised. Kerala Ayurveda centres have been established at multiple locations in
various metro cities, thus highlighting the advantages of Ayurveda in health
management. The health tourism focus has seen Kerala participate in various trade
shows and etc

 It is advantage India in promoting medical tourism. According to CII, India has the
potential to attract 1 million tourists per annum, which could contribute up to US$ 5
billion to the economy. CII is of the opinion that India must leverage its competitive
edge, especially its cost advantage. It is only 1/5th of costs in the West, says CII due to
English speaking Doctors.

Good Indian Hospital – JCI Accreditation

 As Indian corporate hospitals are on par, if not better than the best hospitals in Thailand,
Singapore, etc there is scope for improvement, and the country may become a preferred

31
 medical destination. In addition to the increasingly top class medical care, a big draw
for foreign patients is also the very minimal or hardly any waitlist as is common in
European or American hospitals. In fact, priority treatment is provided today in Indian
hospitals.

 All medical investigations are conducted on the latest, technologically advanced

diagnostic equipment. Stringent quality assurance exercises ensure reliable and high
quality test results.

 India today has one of the most well developed private healthcare infrastructure,
consisting of super specialized private hospitals equivalent to some of the best hospitals
in USA, world class diagnostic facilities, government backed graduate and post
graduate medical colleges, research institutions, pharmaceutical industry, medical
equipment and devices industry. The infrastructure today is backed up by world class
telecommunication and information technology backbone.

The Apollo Group, Escorts Hospitals in New Delhi and Jaslok Hospitals in Mumbai are to
name a few which are established names even abroad. A list of corporate hospitals such as
Global Hospitals, CARE and Dr L.V. Prasad Eye Hospitals in Hyderabad, The Hindujas
and NM Excellence in Mumbai, also have built capabilities and are handling a steadily
increasing flow of foreign patients. India has much more expertise than say Thailand or
Malaysia. The infrastructure in some of India's hospitals is also very good. What is more
significant is that the costs are much less, almost one-third of those in other Asian
countries.

The government has woken up to realize the potential of medical tourism, with
tourism minister Renuka Chowdhury recently promising that she would put policies in
place to help hospitals promote medical tourism by seamless integration of healthcare
delivery with tourism and travel related facilities in the country.

In India, the Apollo group alone has so far treated 95,000 international patients,
many of whom are of Indian origin. Apollo has been a forerunner in medical tourism in
India and attracts patients from Southeast Asia, Africa, and the Middle East. The group has

32
tied up with hospitals in Mauritius, Tanzania, Bangladesh and Yemen besides running a
hospital in Sri Lanka, and managing a hospital in Dubai.

Escorts, claims it has doubled its number of overseas patients - from 675 in 2000 to
nearly 1,200 this year. Recently, the Ruby Hospital in Kolkata signed a contract with the
British insurance company, BUPA. The management hopes to get British patients from the
queue in the National Health Services soon. Some estimates say that foreigners account for
10 to 12 per cent of all patients in top Mumbai hospitals despite roadblocks like poor
aviation connectivity, poor road infrastructure and absence of uniform quality standards.

Medical Tourism is posing a very potential opportunity which can be utilized by

Indian hospitals & Different States Government to promote their Medical services to
foreign markets & generate huge foreign currency earning.

Conversion of Medical Cities Into Medical Tourism City

Often, medical cities will also incorporate substantial non-medical services to support the
staff, patients and visitors. These include retail, hotel and transportation systems. More
often than not, medical cities also include academic and research activities that draw upon
the large numbers of patients, the mix of learning opportunities and the access to high-tech
facilities.

These are two areas that medical cities are well positioned to excel in. With the
consolidation of services, including the co-location of diagnostic and physician activities,
medical cities create the opportunity for ‘one stop shopping’ and the ability to coordinate
care and offer package pricing.

Medical Tourism in India has developed a lot. Medical Tourism is a special type of tourism
where you can use many facilities in major hospitals in the world. If you want to know
about the areas of medical tourism in India, here you can see a lot of information on
different places for medical tourism in India. There are major medical tourism sites in India
such as Kolkata, Mumbai, Delhi, Chennai, Bangalore, Pune, Hyderabad, are the main areas
of India that offers exclusive and facilities for medical tourism. All these sites are
considered the best areas of medical tourism in India.

33
Medical tourism is going to result in a number of demands and changes in the areas of
financing and regulations. There will be a greater push for encouraging private insurance
tied to systems of accreditation of private hospitals. There is a huge concern in the
developed countries about the quality of care and clinical expertise in developing countries
and this will push for both insurance and regulatory regimes. The potential for earning
revenues through medical tourism will become an important argument for private hospitals
demanding more subsidies from the government in long run.

1.5.1 Madhya Pradesh Profile: Medical Tourism

Until now this chapter has discussed about development of Tourism, Health Sector in India,
Definition of Medical Tourism, What is advantage India in Medical Tourism. Now let study
the applicability of Medical Tourism Concept in states of India i.e. Madhya Pradesh.
Madhya Pradesh state is developing very fast in context of Infrastructure and faster road an
air connectivity, best hospitals providing treatment in advance technology. Can this state
may think for availing Medical Tourism Opportunity or not? In the same context this study
is trying to take an overview of Madhya Pradesh state resources and achievement which
may be complimenting in planning and providing Medical tourism services in the state.
Madhya Pradesh is a Centrally located state and so people of other states easily can reach
to Madhya Pradesh. There is dense Kanha and Bandhavgarh forests , the beautiful Satpura
ranges ,Rivers like Narmada makes the unique landscape of this state. So day by day it is
becoming favorite tourist destination of tourism in India . It is clear from the growing
figures of domestic as well as foreign tourists arrivals increasing in this happening state.

1.5.2 Climate And History

The Madhya Pradesh climate is characterized by very hot summer days and cold pleasant
winter nights. The monsoon however begins in the month of July and continues up to
September. This 8 Months are very pleasant; monsoon is a relief to the utterly hot weather
in Madhya Pradesh. The temperature remains moderate till September-October. Thereafter
it starts declining. This indicates the arrival of winter. Madhya Pradesh weather gets chilled
in winter which attains its height in the month of December and January. The average
temperature during winters is as low as 10 ºC in the north, while in the south it varies from
10 °-15 °C.

34
Table No. 1.7: Facts about Madhya Pradesh
Facts about Madhya Pradesh
Date of formation Nov 1, 1956
Size 3,08,000 sq km
Population 60,348,023
Capital Bhopal
Rivers Narmada, Tapti, Betwa, Son, Chambal
Forests Bandhavgarh NP, Kanha NP, Pench NP, Indrawati
National Park Tiger Reserve, Kheoni WS
Languages Hindi
Maharashtra, Gujarat, Rajasthan, Uttar Pradesh,
Neighboring State
Chhattisgarh
State Animal Swamp Deer
State Bird Paradise Fly-catcher

A rich history of Madhya Pradesh is as old as the time of Ashoka, the great Mauryan ruler.
A major portion of Central India was part of the Gupta Empire (300-550 AD). In the first
half of the seventh century the state was part of the domains of the famous emperor Harsha.
The close of tenth century was a period of confusion. In the early eleventh century the
Muslims entered central India, first Mahmud of Ghazni and then Mohammad Gori who
incorporated certain parts with Sultanate of Delhi. It also formed part of the Mughal Empire
with the rise of Maratha's. Till the death of Madhoji Shinde in 1794, Marathas ruled
supreme in Central India, but after that independent and smaller states came into being. The
disintegrated smaller states paved way for British sovereignty. Some great women rulers of
the region like Rani Ahilyabai Holkar of Indore, Gond queen Rani Kamla devi and Rani
Durgawati have carved a niche for themselves in history. The Caves, Stupas, Temples, rich
History and vivid tribal culture makes Madhya Pradesh a mysterious place to history
lovers.

1.5.3 Society and Culture

Madhya Pradesh has at least four agro-climatic zones, and thus, has the most interesting
mix of people and ways of life. It is home to about 40 percent of India's tribes. There are
three distinct tribal groups in the state. The largest chunk is formed by the Gonds, who once
ruled a major part of the state and after whom Gondwana, the central portion of the state is
35
known. Western Madhya Pradesh is inhabited by the Bhils, a colorful group of warriors and
huntsmen.

The state has several eminent annual cultural events, such as Kalidas Samaroh (for
performing and fine arts) in Ujjain, Tansen Samaroh (music) in Gwalior, and a dance
festival in Khajuraho, where artists from all over India participated. In Bhopal there is a
unique multifaceted cultural complex, the Bharat Bhavan, which functions as a meeting
ground for artists from various fields. Located along the Bhopal Lake, this sprawling
complex houses a museum, a library, an open-air theatre, and a number of conference halls.
The state has important yearly religious melas (gatherings) in Mandasor and Ujjain, as well
as religious festivals like Dashhera

1.5.4 Economy and Infrastructure

The state's Gross Domestic Product (GDP) during 2011-12 stands at 12 per cent, a jump of
4 per cent from last year. It is mainly agriculture that has pulled up the state's economy at a
time when the country is experiencing deceleration in growth. The agriculture growth rate
in the state is an exceptional 18 per cent. The area under irrigation has gone up from 7 lakh
hectares to 22 lakh hectares in the last year.

Madhya Pradesh has also seen an unprecedented promotion and growth of industries in
2011-12. During this period, the state has clocked close to 17 per cent in manufacturing and
8 per cent in industrial growth, augmenting job opportunities. The manufacturing sector has
seen a rise of nearly 12 per cent, and the services sector, which accounts for 48 per cent of
state's growth, has seen an increase of 9.4 per cent.

Agriculture

Agriculture is the base of Madhya Pradesh economy. Less than half of the land area is
cultivable, however, and its distribution is quite uneven because of variations in
topography, rainfall, and soils. The main cultivated areas are found in the Chambal River
valley and on the Malwa and Rewa plateaus. The magnificent Narmada valley, covered
with river-borne alluvium, is another fertile region. Agriculture in Madhya Pradesh is
characterized by low productivity and the use of no mechanized methods of cultivation.
Because only a portion of the sown area is irrigated, the state’s agriculture has remained
36
heavily dependent on rainfall; some regions often suffer from drought. Irrigation in Madhya
Pradesh is carried out primarily by means of canals, wells, and tanks (village lakes or
ponds).

Financial year 2011-12 was going to be a watershed for the economy of Madhya Pradesh,
the state government said on Friday, as revised estimates have put the economic growth rate
of the period at 12 percent.

The agriculture sector grew at an exceptional 18 percent, a government release said here.
Manufacuring sector clocked a close to 17 percent growth, while the industry grew 8
percent.The contribution of the industrial sector to the state's GDP increased to 29 percent,
it said, adding that this would herald a job growth and higher capital investment.
State's growth rate has ranked third in the country in the last four years, and remained above
the all-India average growth rate.

Madhya Pradesh, which topped the country in the overall foodgrain production in 2011-12,
has brought 5,01,980 hectares of land under horticulture in the past three years.

By this, the state has fulfilled one of the important resolves made during the special session
of the Assembly in 2009, it said.

According to point 21 of resolve 2013, there was a target of bringing five lakh hectares of
land under horticulture crops by 2012-13. However, the state surpassed the target by adding
another 1,980 hectares under it, an official release said here.

1.5.5 Resources Power, Manufacturing

Madhya Pradesh is rich in minerals, though these resources have yet to be fully exploited.
There are large reserves of coal and important deposits of iron ore, manganese ore, bauxite,
limestone, dolomite, copper, fireclay, and kaolin (china clay). At Panna, in the northeast,
there are diamond reserves.

The state is well endowed with hydroelectric power potential, and a number of
hydroelectric projects have been developed jointly with neighboring states. Madhya
Pradesh also draws a portion of its power from several thermal stations located within the
state. Most of these thermal plants are coal-fired. The ample and own developed power
37
supply assures unhindered development of various projects like Medical Tourism in
Madhya Pradesh.

Manufacturing

Overall, Madhya Pradesh has remained an industrially underdeveloped state. However,

there are several centers of large- and medium-scale manufacturing, most notably in Indore,
Gwalior, Bhopal, and Jabalpur, where industrial estates have been established as part of
planned development. The principal government-sponsored industries include paper
milling, cement production, and the manufacture of heavy electrical items,
microelectronics, and optical fibers. Cement works and paper mills also have been
established in the private sector, as have facilities for the production of sugar, textiles
(cotton, wool, silk, and jute), lumber, flour, and various seed and vegetable oils. Other
products of Madhya Pradesh include fertilizer, synthetic fibers, and chemicals.

Of the state’s small-scale enterprises, the hand-loom industry has flourished, with saris
(garments worn by Indian women) made in Chanderi, gold and silver thread embroidery
produced in Bhopal, and carpets woven in Gwalior. The artisans of Gwalior also produce
handmade pottery. Jabalpur and Sagar are well-known centers for the manufacture of bidis
(hand-rolled cigarettes).

Health and welfare

Every district in Madhya Pradesh has at least one hospital, typically in an urban centre, and
hundreds of community and primary health centre’s and subcentres spread across the rural
areas. The state also has several eye hospitals, mental hospitals, and other specialized
facilities for the prevention and treatment of tuberculosis, venereal disease, and rabies,
which, along with filariasis and leprosy, have remained major health concerns. Gwalior has
a cancer research centre. Malaria, which was formerly endemic throughout Madhya
Pradesh, has been virtually eradicated.

The government has implemented several social welfare programs, including adult literacy
classes and various schemes directed toward the special problems of rural youths, the
Scheduled Tribes, and members of other traditionally marginalized communities. There are
also a number of programs for women and girls, which include informal social service

38
clubs called mahila mandals, schemes for helping rural women with problems of
motherhood, and programs that make education available to girls from economically
disadvantaged families. Grants-in-aid are given to social welfare and physical welfare
institutions, while the government operates leprosy clinics, as well as homes for the
impoverished or otherwise needy citizens.

Education

Roughly two-thirds of the state’s population is literate. There are schools for primary,
middle, and high school education, as well as specialized schools for polytechnics,
industrial arts, and crafts. Madhya Pradesh has a number of state universities; among these,
the Dr. Harisingh Gour University (1946; formerly University of Saugar), located at Sagar,
and Vikram University (1957), in Ujjain, are the oldest and best-known, while the music
school at Khairagarh is one of the finest in India. Jabalpur has an agricultural university,
and there is an institute of journalism and public relations in Bhopal.

Madhya Pradesh is rich in minerals, though these resources have not yet been fully
exploited. There are large reserves of coal and important deposits of iron ore, manganese
ore, bauxite, limestone, dolomite, copper, fireclay, and china clay. Diamond reserves at
Panna are of particular interest. The major industries of the state are electronics,
telecommunications, petrochemicals, food processing and automobiles. The state has also
taken a lead in the production of cement.

The state is also famous for its traditional handicrafts and handlooms manufactured at
Chanderi and Maheshwar .The state is well endowed with potential hydroelectric power.
Main hydroelectric projects (jointly developed with other states) are the Babanthadi with
Maharashtra, the Ban Sagar with Bihar and Uttar Pradesh, the Chambal Valley with
Rajasthan, the Narmada Sagar with Gujarat and Rajasthan, and the Rajghat and Urmil with
Uttar Pradesh. The Hasdeo Bango, Bargi, and Birsinghapur thermal power projects are also
within the state. The Narmada Sagar project has been a source of controversy because of its
potential for damaging the environment. Important railway junctions include Bhopal,
Ratlam, Khandwa, Bilaspur, and Katni. Also connecting the state with other parts of India
are airports at Bhopal, Gwalior, Indore, Raipur, Jabalpur, Rewa, Bilaspur, and Khajuraho,
as well as several national highways.

39
Economic Activity: Manufacturing- 26%; Services- 28%; Agriculture-46%

Financial year 2011-12 was a watershed for the economy of Madhya Pradesh, the state
government said today, as revised estimates have put the economic growth rate of the
period at 12 per cent. The agriculture sector grew at an exceptional 18 per cent, as per
government sources. Manufacturing sector clocked a close to 17 per cent growth, while the
industry grew 8 per cent. The contribution of the industrial sector to the state's GDP
increased to 29 per cent, it said, adding that this would herald a job growth and higher
capital investment. State's growth rate has ranked third in the country in the last four years,
and remained above the all-India average growth rate. Madhya Pradesh had witnessed a
negative growth in 2000-01 (-7 per cent) and 2002-03 (-4 per cent), the release pointed out.
The ruling BJP government also claimed that the state's economy had grown in the last
seven years despite various odds, such as less-than-average rainfall for five years. Frost in
2010-11 had adversely impacted the farm output in the state, it added, saying that despite
this, Madhya Pradesh registered about 10 per cent growth in 2009-10 and close to 8 per
cent in 2010-11.

1.5.6 Tourism of Madhya Pradesh

Landlocked in the central part of the country, Madhya Pradesh is bordered by the states of
Rajasthan to the northwest, Uttar Pradesh to the north, Chhattisgarh to the east, Maharashtra
to the south, and Gujarat to the west.

Madhya Pradesh is one of India’s largest states and offers a variety of experiences to
tourists. It boasts of a rich history, a wealth of fauna and innumerable things to do.Tourism
is a priority sector with the Government of Madhya Pradesh. A dynamic mechanism being
put in place to remove all bottlenecks and the private sector is being encouraged to invest in
the sector. All roads linking major tourist centers have been taken up for up gradation. To
ensure an increase in employment generation and promote and market destination within
and outside India, the government is developing basic infrastructure at lesser known tourist
locations, developing eco-friendly and sustainable tourism facilities, promoting eco &
adventure tourism and converting old palaces in to heritage hotels under the public private
partnership scheme.
40
Transportation

In comparison with most other Indian states, Madhya Pradesh has a somewhat less
developed infrastructure and communication network. Although served by several national
highways, the state has a low density of roads, especially in remote rural areas. However,
the construction of bridges across the Narmada and other rivers has greatly helped the
development of all-weather traffic routes. The main railroads that pass through the state
were originally laid down to connect the ports of Chennai (Madras), Mumbai (Bombay),
and Kolkata (Calcutta) with their hinterlands. Important railway junctions include Bhopal,
Ratlam, Khandwa, and Katni. Airports at Bhopal, Gwalior, Indore, Jabalpur, and Khajuraho
offer domestic service.

Infrastructure

 Madhya Pradesh is a large State and it is well-connected to all major Indian metros.
Indore, Bhopal, Jabalpur, Gwalior, Khajuro have airports.

 Public transport is now easily accessible and faster & Cheaper option for all over
Madhya Pradesh. As the cities are far from each air Taxi services are started daily to all
major destination.

 Trains coming from various destinations are going through various important stations of
Madhya Pradesh.

 IBus Volvo Buses services with e reservations to major cities for faster connectivity.
Ex. Indore, Bhopal.

 Madhya Pradesh is going to become a WI-Fi state very soon.

Khajuraho temples

The Orchha Fort is one of India’s most spectacular. But what attracts people to Orchha in
millions is the Ram Raja Temple. The temple is supposed to have wish-fulfilling abilities
and it is the only place in the world where Rama is worshipped as a king and not a God.
Another city that speaks of royal splendour, even today, is Gwalior. Other than glimpses
into the splendors of Indian royalty, Madhya Pradesh also possesses a chapter, invaluable to
human history. One of the things to do in Madhya Pradesh is, without doubt, a trip to
Bhimbetka.

41
Panchmadhi – Healing Destination.

Due to the mesmerizing climate of this place before Indian Independence this place was
used to heal wounds of warriors of wars. The soothing atmosphere, Wind, Water and
medicine all jointly cure the warriors. Now Madhya Pradesh Government is planning to set
up a Health City which will not only providing allopath tic treatments but primarily
providing the alternative treatments like Ayurveda.

All over Madhya Pradesh there are many tribes who have their own treatment ways to heal.
Government of Madhya Pradesh is also working on designing programmers on this healing
technique. Jabalpur marble waterfall is also a very beautiful location which can be clubbed
with very advance treatment provided by many hospitals .The Medical tourism tourist will
share this unique experience of Jabalpur Falls.

All foreign tourist wish to visit places like Bhimbetka in Madhya Pradesh. Bhembetka is a
very popular tourist destination ,which is small city over 500 caves from the Neolithic age
were recently found. In these caves we can see paintings made by pre-historic man. The
paintings depict pre-historic life through scenes showing dancing, music, hunting, domestic
life and so much more, a chilling sight to behold. Another such location is in Pachmarhi. In
Pachmarhi’s Mahadeo Hills you can see a bounty of rock paintings. Many of these
creations date back to as far as 10,000 years.

Fig No. 1.2 Sanchi Wellness Spa

42
Sanchi Ayurvedic Spa and wellness

Comparatively close to Bhimbetka is Sanchi, a city famous world over for its treasure of
Buddhist monuments. Here, you can find a plethora of Buddhist monasteries, stupas and
architecture. A lot of these creations were built in the 3rd century B.C. and the most well
known amongst them is the Sanchi Stupa , which was built by Emperor Ashoka. A
sandstone pillar near the stupa bears Emperors Ashoka’s caveat against divisions in the
Buddhist community. In sanchi government is providing a Ayurvedic and Naturopathic
Relaxing Center.

Fig No. 1.3 Bandhavgarh And Kanha National Park

Visit of this unique national Park is a very unique experience. The Kanha and Bandhavgadh
National Park was created as a Tiger Reserve. Although Tiger spotting is rare here Kanha is
the sole sanctuary for the hardground Barasingha and a haven for bird lovers. One of the
most majestic natural wonders of the world is also located in Madhya Pradesh. This sight is
none other than the Marble Rocks of Bhedaghat. Rising high above the Earth and bisected
by River Narmada are these magnificent natural creations. The Marble cliffs, glittering
brightly are an unforgettable and incomparable sight.

43
From natural wealth to prehistoric treasures, Madhya Pradesh is one of the richest States in
India. Its vast array of wonders is nearly impossible to fit into a short trip and deserve at
least a week to soak in comfortably.

Craftsmanship

The exquisite taste for making handicrafts is an important trait of the trials of Madhya
Pradesh. The Murias and the Marias of Bastar are excellent wood carvers. They show their
art either on visible logs of wood pieces used in their dwelling hutments or on various
objects of daily use. Tobacco containers of the Murias will attract anyone for their tortoise
and the sun-moon motifs and designs.

Madhya Pradesh is having a rich culture and music art, or drama is pure reflection of this
culture. It is a unique experience to feel the touch of tribal culture.

The most popular among the Madhya Pradesh dances, is the Gaur dance of the Sing Marias
or Tallaguda Marias (bison-horn Marias) of South Bastar. This spectacular dance
symbolizes the hunting spirit of the tribe. The word 'Gaur' means a ferocious bison.

Culture

The Murias of North Bastar are trained in the Ghotul for all types of their community
dances. Before any dance is commenced at a wedding or a festive occasion, the Murias first
worship their drums. Very often they begin with an invocation to 'Lingo Pen', the phallic
deity of the tribe and the founder of the Ghotul institution. To a Muria, Lingo Pen was the
first musician who taught the art of drumming to the tribal boys.

Folk Entertainment and Drama

The Muria and Maria Gonds of Bastar enact the hobby-horse dance during festivals and
religious ceremonies. The Gonds of Mandla district perform the horse-ride mainly as an
entertainment. The Adivasis of Chhattisgarh are music-minded but they do not have
anything like the traditional theatre in their society. Only some sort of rural farces serve the
purpose of their folk-theatrical needs.

The folk musical material of the state may be classified into three groups. The first being
the tribal music, which is undoubtedly very rich in content. The second group is of the

44
countryside music. It includes legendry narratives, ceremonial songs, work songs and the
songs linked with rituals, love longings and occupations. Its music survives in cross-cultural
traits of social relationships. Its structural shades vary from caste to caste and from region
to region.

In Madhya Pradesh the countryside woman makes interesting patterns of flowers, creepers,
trees and human figures. Verandahs and inner rooms of the houses are decorated with bold
designs. Small niches and alcove are elegantly outlined by wet clay carrying lace-like
impressions. Swirling designs are worked out on main entrances of the houses. In these
designs each line ends in stylistic swirl. Satiyas (Swastikas) are made and spirals are
relieved into empty spaces. All motifs bear local names. Those who are cultivators draw
Hal (plough) and Bakkhar (leveler) on the front walls of their houses.

Mandana is a decorative art. On festive occasions like Holi, Diwali, Dussehra and Nag-
panchami women first give a finish to the floors and mud walls with cow-dung, and then
draw traditional Mandana designs characteristic of the region. y The paint is prepared by
mixing Rati (colour made out of red earth) and Khadia (chalk) in water. Haematite is
employed to heighten the effect wherever necessary. Symbols like Keri ( unripe mango),
Jowar Ka Bhutta (millet flower) and Chauk (square) are made with many interwoven
variations and polygonous figures, hexagrams, pagliya (foot marks) Chhi Phulya (six-
flower pattern) etc are drawn with skill. All these designs are embellished by Bharvan
(space-filling) devices. The figures employed to this effect are Laddu (ball), Tipki (dot)
and Laharia (waving lines).

This is not only entertainment but it is different ways to earn the livelihood to this tribal
people as well. All foreigners are willing to purchase following reflections of culture.

Wood Carving and Brass Work

Wood carving is one of the main industries of the tribes of Madhya Pradesh. Various
objects of daily use, hut dwellings etc are finely carved. Tobacco containers with tortoise
and the sun-moon motifs and designs, Combs depicted with animal motifs, intensely carved
wooden spears and utensils, carved boxes, panels, furniture and funerary pillars carved with
figures are some of the products.

45
Textiles
Textile weaving is one of the main crafts of Madhya Pradesh. Sarees in subtle
shades are woven in places like Chanderi, a village near Gwalior and Maheshwar.
These sarees include a wide variety of checks with traditional gold borders.
Madhya Pradesh’s craftsmen are equally adept at producing tassar silk.

Carpet Weaving

Carpet weaving has become popular in Gwalior. The fine quality of weaving in imaginative
designs has earned Gwalior’s carpet industry an excellent reputation. Today, more than a
thousand looms are in operation in and around the city.

This is how tribal people live, earn. In this chapter details of infrastructure and
tourism of Madhya Pradesh is discussed .Now the description of Health
services of Madhya Pradesh will be discussed.

1.5.7 Private And Public Medical Services

Government Health Department

The Department of Health and Family Welfare Madhya Pradeh will ensure that the
population has access to a range of affordable essential health promotion and preventive
services, and simple curative and emergency services of acceptable quality.

 Promote appropriate health seeking behavior by all citizens.

 Ensure that the poor have access to a safety net to cope with adverse,

 Economic and social impacts of serious illness.

 Promote partnerships with civil society groups, Panchayati Raj Institutions.

 NGOs, donor agencies, the private sector and other development partners to achieve its
aims.

 Improve accountability and cost effectiveness of the public sector.

Like the rest of the country, the state of Madhya Pradesh has also tended to focus more on
selective vertical programs aimed at specific diseases, rather than comprehensive health

46
care at the Primary level. The state has focused on Protecting child fetus, Reproductive and
Child Health and other National Programs aimed at controlling TB, Blindness, Malaria etc.
However, there is a growing realization at the national as well as state level, that such an
approach, though successful interns of specific diseases such as Polio and Leprosy, has not
yielded desired results in many cases. It has also kept the community involvement away
from health care. The National Rural Health Mission aims at integrating the vertical
programs and providing horizontal linkages that will strengthen the health delivery system
and lead to greater involvement of the community. The state of Madhya Pradesh is also
moving in a similar direction.

Health care services options are available in the public sector as well as the private sector.
These include allopathic, Indian system of medicine (Ayurvedic, Unani) and Homeopathy.
However, Allopathy is the dominant system in both

Public Sector Health Care

The allopathic health care delivery system in rural areas is based on a network of 8835 sub
health centers, 1194 private health centers and 227 community healths in whole Madhya
Pradesh. The Sub Health Center is envisaged to cater to a population of 5000 (3000 in hilly
areas), provide limited primary care and act as a stock point for basic medical and family
welfare supplies.

In MP, a population of 5000 could be scattered across 6 villages. There is minimal curative
service at the Sub Health Center.

 Primary Health Centre (PHC): is envisaged to have a qualified medical officer, cater to
a population of 30,000 (20,000 in hilly areas), provide in patient services (6 beds) and
act as a referral unit for 6 SHCs.

 Community Health Centre (CHC): is envisaged to have 4 medical specialists (including

surgeon, physician, gynecologist, pediatrician), 30 beds, operating theatre, laboratory
facilities and act as a referral centre for 4 PHCs. In urban areas there are 48 districts and
57 civil hospitals, which are also expected as well as hospitals attached to medical

47
 colleges. Tertiary health care is provided almost exclusively by specialist and medical
school teaching hospitals and by the district and civil hospitals in the larger cities.

Private sector - The private sector health care delivery system consists of:

 Traditional Practitioners including herbalists who are based in the village and provide
low cost alternative treatment for minor ailments; payment is quite often in kind and can
be deferred.

 Dais (traditional birth attendant) are also based in the village and are normally the most
experienced person available for assistance during child birth. They provide a personal
touch and offer a convenient and affordable method of payment.

 Registered Medical Practitioners (RMPs)/unqualified practitioners are again accessible

since they would be based in the same or nearby village. Quite often, they are the only
help available during emergencies especially for those who cannot travel large
distances.

 Qualified Private Practitioners, both allopathic and ISM&H (ayurvedic, unani and
homeopathy);

 Private nursing homes and hospitals including those for profit and nonprofit;

 Private tertiary health care establishments.

In addition, there are a number of pathological laboratories/diagnostic centers.

Pharmaceutical chemists would also quite often provide diagnostic/prescriptive services.

Public sector doctors also practice privately.

Qualified private practitioners, nursing homes/hospitals and tertiary health care

establishments are based in urban areas, while traditional practitioners, dais and RMPs are
present in both rural and urban areas.

48
Table No. 1.8 : Health / Medical Care Infrastructure in Madhya Pradesh.

Allopathic ISM & H Total beds Total Number

Rural 9300 1125
Urban
Civil Dispensaries 00 97
Post partum 00 96
Civil Hospital 2700 57
District Hospital 7700 39
ISM Hospitals 30 34
Specialized Hospital 600 11
Disease Specific Unit 00 90
Teaching Hospital 5600 6
Rural Alternative–Ayur, Homeo etc 00 1622

Specialized hospitals (allopathic) includes TB hospitals(7), TB sanatoriums(1), mental

hospitals(2). Disease specific units include malaria control units (34), blindness (51), and
leprosy treatment clinics (5). Rural family welfare centers, which will typically be a part of
PHC/CHC have not been shown above.

In Madhya Pradesh Medical Care is provided by public as well as private sector .Public
sector is successfully completed all rural health programs, like Eradication of malaria,
Child heath etc and also successfully educating on Health education. But now day’s patients
are going to private hospitals. So they are dominant in Madhya Pradesh state. These
hospitals are charging but providing good quality care to patients. The demand is more for
private hospitals and increasing competitions so services are upgraded.

Emergence of Internet and e-Medical Treatment facility is available for hospitals so that
they can root in expert services for their patients

“The Mission of the Department of Health and Family Welfare is to improve health
outcomes of the population, especially the disadvantaged and marginalized including poor
families, women and children in Madhya Pradesh.”

Recent changes in medical Services is that now maximum patients are Medically Insured
patients due to which they are seeking for best treatment and hospitals , as they are not
bothered about the funds.. Now the purchasing power of all patients is increasing so they
49
private hospitals are dominating in medical/Health industry. Huge Investment by Private
and Public Hospitals to provide Excellent Medical Services. Newer research is there is
pharmacy & treatments of various advanced Technology for treatment.

Madhya Pradesh is having best quality hospitals and they are providing best health care
and so there are lot of patients visiting Indore, Bhopal for there complex treatment. From
different states. As Doctors are learned and experienced & hospitals here are having
equipped operation theaters and instruments, so they are able to go for complex surgeries,
Ex. United twins were separated in Indore hospital. So the hospitals in Madhya Pradesh are
boosting on the achievement of surgeries for major organ transplant, complex heart
surgeries, in Madhya Pradesh.

1.5.8 Achievements of Health Sector MP

AIMS Bhopal has started a huge hospital in Bhopal Madhya Pradesh to extend the quality
services to Madhya Pradesh. All latest variety of medical services are available for
patients in Madhya Pradesh.

A Huge project of a establishing a Medical Hub in near future in Indore by Indore Vikas
Pradhikaran . This is unique project of 500 acers for Indore City spending thousands of
crores . The project assures that best corporate hospitals which promise all variety o
treatment and super specialization treatments will be available near to Airport. All those
treatments for which patients in Indore visit metro cities .Corporate hospitals s are
interested in being a part of this hub. Medanta Medicity.,Max,, Apollo Hospitals Group
have approached for the same.

Conjoined twins Stuti and Aradhna were successfully separated after a day-long complex
surgery conducted by a team of 34 medical experts, including 23 doctors, drawn from India
and abroad. The complicated surgical procedure was carried out at Missionary Hospital in
Padhar Madhya Pradesh here. In a four-phase operation, the twins were first given
anesthesia. After nearly two hours, a team of surgeons separated their heart which was
again transplanted into them in two pieces.

50
The state is marked with a complex social structure, a predominantly agrarian economy, a
difficult and inaccessible terrain, and scattered settlements over vast area that together pose
several formidable problems to health service delivery systems. According to the
2001census, Madhya Pradesh has a population of about 60 million, which is around 6% per
cent of the country’s population. Ranking 7th in terms of population size and 23rd in terms
of population density among the 35 states and union territories, it is a large state with a
widely dispersed population and relatively low density. From the point of view of per capita
income, literacy, urbanization, infrastructure facilities and other development indicators,
Madhya Pradesh belongs to the category of less developed states of the country

Though not specifically known for medical facilities, Bhopal has recently been developing
as a good Medicare center in central India. Now the town boasts of many rare, so far
unavailable advanced health care facilities in field of Cardiology, Nephrology, Oncology,
Chest Diseases, Gastroenterology, Pediatrics and other disciplines. Apart from big
multispecialty government and semi-government Hospitals like Hamidia Hospital, Bhopal
Memorial Hospital, scores of large and low scale hospitals and nursing homes have come
up in the city, catering to various super specialties.

A Cancer Treatment Hub is started in Indore, due to this all advance treatments of different
types of Cancers are available in Indore . Now patients will gate treatment in their City.

AIIMS Bhopal

The AIIMS, likewise New Delhi model will be adopted and adapted. Unlike the
Postgraduate Institutes which lack the basic departments like Anatomy, Physiology,
Pharmacology etc and General medicine, Surgery, Obstetrics and Gynecology; etc will be
added. In addition there will be all the sub-specialty departments for example Accident &
Emergency, Biostatistics, Medical Engineering, Hospital administration, Genetics, Physical
Medicine & Rehabilitation, Telemedicine, Clinical Epidemiology and Medical Education
Cell etc. This institution should also provide a good opportunity to promote basic scientists
and biotechnologists and studies in genomics, proteomics and metabonomics providing
opportunity to work in close proximity of rich clinical material. A lot of effort would go
into locating, enticing, appointing and retaining talented faculty as it is the faculty that

51
makes an institution great. Heads of Department would be strengthened by having a say in
faculty appointments and promotions and writing annual confidential reports. Annual self
assessment by faculty would be updated as e-portfolio. Each department shall have a 5-year
development plan. The entire. A Purchase department will facilitate purchases in all
departments. E-tender policy is likely to be followed with maximum transparency and
efficiency.

Bombay Hospital Indore

Bombay Hospital, Indore is a multi-specialty 600 bedded hospital coming up in Indore. It

will have state of the art facilities, in terms of medical equipment & computerization. It will
be the tallest structure in the entire state of Madhya Pradesh & will be run by the Bombay
Hospital Trust, along lines similar to the principles of Bombay Hospital, Bombay. A
significant proportion of patients would be treated free, both OPD and inpatients.

Location And Infrastructure

The hospital is located in the eastern part of the city of Indore on the Bombay-Agra Road,
adjacent to the industrial complex of Dewas. It will consist of 2 tower buildings of 12 stores
each and a podium block of basement, ground floor and 2 other floors. There are plans to
build a school of nursing on the premises and the hospital will apply for recognition to the
National Board of Examinations, New Delhi, so that we will be able to offer postgraduate
degree (DNB) in as many subjects as possible.

Indore is considered to be a mini Bombay and is widely regarded as the commercial capital
of MP. It is well connected to Bombay and Delhi by air and rail, and the flight time from
Bombay to Indore is only 50 minutes. There is a facility of landing a helicopter at the top of
Bombay Hospital so that patients and doctors from various destinations may come for the
patients treatment.

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