Wednesday, May 20, 2009

Emerging Medical Tourism in Turkey










Turkey's Belly Dancers


Turkey's Dervishers





Seems like the Europeans find Turkey’s healthcare facilities attractive.

Research group RNCOS says in its new report, Emerging Medical Tourism in Turkey, that despite the sluggish world economy, the industry witnessed impressive growth of around 40 percent in 2008 over the same period in 2007. Last year, the country received around 200,000 foreign medical tourists

The study provides an in-depth analysis of the present and future prospects of the country in the medical travel arena, delving into the operations of key players such as The World Eye Hospital, Memorial Hospital, Anadolu Medical Center and Sanatolia Care.

Growth has been fuelled by a cost advantage. In Turkey, fees for treatments range from one-half to as little as one-fifth the price in Europe and other developed countries. Its strategic location between Asia and Europe makes it accessible to travellers, and the capital Istanbul boasts good air connectivity.

Turkey has proven especially attractive to European medical visitors, who are avid patrons of its spas. To promote these further, the tourism ministry has listed 17 registered thermal spa resorts with mud bath facilities, but there are an estimated thousand more unregistered.

Istanbul Memorial Hospital was the first hospitals in the country to receive JCI accreditation.

Sex Change Surgery



Male to Female Surgery





Female to Male Surgery

Let's face it...transsexualism exists and that treating transsexual patients can be regarded as a justifiable medical activity. In 1997, the medical guidelines for transgender persons were issued by the Japanese Society of Psychiatry and Neurology, with some modifications of the Standards of Care of the Harry Benjamin International Gender Dysphoria Association.

Before a sex change operation or sex reassignment surgery (SRS) is carried out, a medical team composed of psychiatrists, a sexologist, endocrinologists, gynecologists, urologists, and plastic surgeons must first be assembled and a unanymous decision is reached.

Diagnosis, preparatory psychotherapy, and hormonal therapy were carried out according to the above-mentioned guidelines.

Meanwhile in Bangkok, the world's sex capital, Thailand’s recent ban on sex-change operations for boys under 16 years has, once again, brought the whole Thai sex scene into prominence. Hospitals and clinics are now barred from castrating would be “ladyboys” - “katoeys” to give them their Thai name. It was feared that the operation was being seen as a cheap and quick alternative to a full sex-change.

In letters to private health units doctors have been told that such operations performed outside formal sex-change therapy, would result in up to six months in jail. Policing this ban may be difficult as cosmetic removal of the testicles takes no longer than 15-20 minutes surgery, and is easy to conduct in secret. At the lower end of the market, Internet advertisements offer castration at clinics for as little as 4,000 baht ($125, £62.50).

The procedure, technique and result for Male to Female change:

1.“Penile inversion technique”vaginoplasty (not recommended for body weight of more than 200 lbs. and those seeking more vaginal depth)

Surgeon uses the "Penile Inversion Vaginoplasty" technique which turns the penile skin "inside out" and uses it to line a vaginal cavity. The penis and testes are removed. A pure penile inversion limits the size of the vagina that can be created depends on the amount of penile skin available,also the vaginal depth is to depend on penile skin on the resting state not from your erectile state.This technique is called SRS with penile inversion vaginoplasty. You should know the depth has been gained from your penile skin but not from your whole shaft of penis in resting stage not from your erectile stage. This technique offers fast recovery and better healing.

2."Scrotal Graft Technique" Vaginoplasty
Some patient's penile tissue limit because the length of penis or the Peno - scrotal junction stays in high position, which will limit the vaginal lining or meaning that vaginal depth is limited.The surgeon will use "Scrotal Graft Technique" combination with penile skin to form the vaginal lining to create the new vaginal depth or new vagina, which is a better technique compared to the penile inversion technique.You will get the depth of your new vagina between 5-7 inches owning to your body structure. This is better choice for those with limited penile skin but with more scrotal sac tissue to use.

Most surgeons currently prefer Scrotal skin graft much more than penile inversion and colon graft.

3."Sigmoid Colon-Vaginoplasty Technique" Vaginoplasty( it is not for those weighing over 200 lbs or with larger abdomen.)

You will have two choices to do this surgery: delayed or immediate “ Sigmoid Colon-Vaginoplasty Technique”.

Check the above pictures.

Bitter Lesson: Beware Medical Tourism Agency




London's Big Ben

Hiding a botched facial lift?



Here is a lesson that Medical Tourism Agencies anywhere in the world ought to consider very seriously. One agent in the UK had been sued for recommending a facial plastic surgery in Belgium which allegedly turned out nasty for the patient and now she is suing the company rather than the Plastic Surgeon.

Europe certainly lags behind the US in promoting insurance covering medical negligence. Many agencies, involved in arranging medical travel, don’t think they need protection or have the funds to buy a policy. Underwriters are reluctant to insure them because some are not licensed, appear to be new at the game or cannot present a professional way of selecting its roster of specialists.

A woman from Wales is suing a cosmetic surgery clinic in Belgium after she underwent cosmetic surgery a facelift.

Mrs X, who is in her 40s, is taking the UK-based Cosmetic Surgery Agency Group to court for personal injury, following a botched facelift and upper and lower eye procedure in 2005. The woman is now too embarrassed to be seen in public, claiming that she has been left with prominent scarring around the eyes and the ears.

She adds that she suffers numbness and a “lack of symmetry” on the left side of her face. To hide the scarring, she has had to grow her hair long.

Although the surgery was performed in Belgium, she is pressing charges in the UK. If she succeeds, it could pave the way for other patients, who may have received below standard healthcare abroad, but want to go to court in the UK where they can expect bigger payouts.

The agency, which has offices in London and Manchester, denies any liability, saying the procedure took place in Belgium, and thus, Belgian law should prevail. In that context, it is the attending surgeon who is legally responsible for any personal injury, not the firm he works for.

A spokeswoman said they did not accept responsibility for the case, however, they did feel they had a moral responsibility to try to put things right. “We are providing aftercare to correct errors. But generally patients are not reimbursed.”

The agency has offices in Paris, Utrecht, Manchester, London and Brussels.

Malaysia medical tourism figures for 2008




Prince Court Medical Centre, Kuala Lumpur



National medical tourism figures for 2008 revealed

About 370,000 foreigners sought medical treatment in Malaysia in 2008, according to health minister Datuk Seri Liow Tiong Lai.

Over the years, the country’s medical tourism industry has registered annual growth of 30 percent.

The minister spoke at the awarding of the Joint Commission International's (JCI) hospital accreditation to the Prince Court Medical Centre (PCMC) in Kuala Lumpur.

"Being accredited, especially by an international body, would certainly help in benchmarking the quality services provided by the hospitals. The rapid uptake of accreditation activities by hospitals in Malaysia is testimony to the ministry's commitment to ensure that healthcare is provided in a safe and effective manner to all our clients, local or from overseas.

“Our own home-grown hospital accreditation body, the Malaysian Society for Quality in Health (MSQH), has been awarded this coveted international accreditation by ISQua. Thus, the standards set by both JCI and MSQH are of international stature."

Besides PCMC, the Penang Adventist Hospital and the International Eye Specialist Centre in Kuala Lumpur also have JCI accreditation.

The Institut Jantung Negara is also working towards it.

For the MSQH, 113 hospitals have been surveyed. Sixty five government and 18 private hospitals have received the accreditation. MSQH was formed by the Ministry of Health Malaysia (MOH), Association of Private Hospitals of Malaysia (APHM) and the Malaysian Medical Association (MMA).

Only 35 of APHM’s 111 member hospitals are involved in medical tourism and they are the source of Malaysia’s medical tourism figures. APHM offers a range of medical tourism packages and sets recommended fees for medical tourism hospitals

Rhe PCMC expects health tourism to contribute 30 percent of its revenue for the financial year ending March 31, 2010

Said PCMC chief executive Stuart Rowley: "Overseas patients can save up to 60 percent [in their medical cost]. We have 300 beds but only use 85.It does not make sense to use all, but we aim to do so within the next 12 months."

Dr Mubbashir Iftikhar, chief executive of Malaysian medical tourism agency Wellness Visit, noted: “Malaysia’s excellently maintained healthcare providers are certainly as good as their counterparts in Singapore and Thailand.

“Malaysia is as competitive in cost as Thailand and much superior in terms of healthcare providers, healthcare infrastructure, English-speaking staff, foreign trained specialist doctors, and strict government rulings on maintaining high standards of healthcare delivery systems. Malaysia is as competitive as Singapore in the quality of healthcare with its world-class hospitals and clinics, world-class renowned surgeons and doctors. Furthermore, Malaysia is offering services at costs less than Singapore. Singapore is no match to Malaysian costs for healthcare.”

Tuesday, May 19, 2009

What about Costa Rica Medicine?




San Jose fat lady statue

Downtown San Jose, Costa Rica







In the past, agricultural exports, like bananas, have been the staple of the Costa Rican economy. However, tourism has always played an ever increasing role, and now it has become the dominant economic force. Ecotourism travel is the most preferred for expansion because it will provide a sustainable resource for tourism for generations of Costa Ricans to come.

But with traditional tourism hit hard by the global recession, Costa Rica is seeking to draw foreign visitors by offering reasonably priced, high-quality healthcare. A combination of proximity to the US, excellent air connections, political and social stability and low crime stats make it an attractive proposition. San Jose, the capital of Costa Rica, is home to an entire third of Costa Rica's population. Like other Central America capital cities, San Jose is dirty and chaotic in some parts, but is remarkably cosmopolitan in others.

A 2008 study by Deloitte identified Brazil, Costa Rica and Mexico, boasting professional costs ranging from 25 to 50 percent of the US average, as countries in Latin America with the greatest potential for inbound medical tourism. Other contenders were Argentina, Colombia, Brazil and Chile whose dental and cosmetic treatments are about 20 percent off prices in the US.

Officials regularly quote the figure of 100,000 medical visitors to the country, but this may only be an estimate – 20,000 a year is a much more realistic sum.

To stimulate demand overseas, the government is enlisting the help of its tourism, health and trade ministries and planning a big publicity campaign.

The Association for the Promotion of Costa Rican Medicine (PROMED) has also been established, consisting of six health consortiums, three private hospitals and several local universities and hotels. But how about the weather?

The high season in Costa Rica, December through April, is the dry season. The rainy season, which lasts from May to November, usually sees sunny mornings, with rain showers in late afternoon and evening. Secondary roads can become rutted during those months, and four-wheeldrive vehicles are strongly recommended. Overall, the climate is tropical, with an average temperature of 72°F (22°C). It can be much hotter along the coastal areas of the country, and much cooler in the mountains.

Jordan the Arab Medical Tourism Champion



..ancient wall city of Petra

Jordan, officially the Hashemite Kingdom of Jordan, is an Arab country in Southwest Asia spanning the southern part of the Syrian Desert down to the Gulf of Aqaba. It shares borders with Syria to the north, Iraq to the north-east, the West Bank and Israel to the west, and Saudi Arabia to the east and south. It shares control of the Dead Sea with Israel, and the coastline of the Gulf of Aqaba with the State of Israel, Saudi Arabia, and Egypt. Much of Jordan is covered by desert. The capital city of Amman is in the north-west.

So what do we know about Jordan besides maybe the ancient wall city of Petra sometimes claimed as 'Petra, Jordan, the place in the desert that is prepared by God for the Jewish people'?.

How about medical tourists? Really.

Private Hospital Association (PHA) president Fawzi Hammouri contends the World Bank places Jordan as first among the Arab countries and among the top 10 in the world when it concerns medical travel.

A study by Jordan’s Private Hospital Association (PHA) reports that last year, 210,000 patients from 48 countries received treatment in local medical facilities. This was an increase compared with the 190,000 patients in the previous year.

Most of the patients come from Iraq, Palestine, Sudan and Yemen.

“In order to maintain this ranking, we have to keep the current markets in the Arab world and find new ones in Africa, Europe and the US,” he said. “We have already marketed in Chad, Nigeria, Russia, Azerbaijan and Kazakhstan.”

PHA is a private, voluntary, non-profit organisation established in1984 to represent the interests of 48 private hospitals in Jordan. It seeks to raise medical standards, supports national and international accreditation and promotes the Hashemite Kingdom as a medical tourism destination. To enable these ambitions to be fulfilled more quickly, it is planning to allow public and university hospitals to join its ranks. The new grouping will eventually be named Jordan Hospital Association.

PHA is working with member hospitals to promote specially designed healthcare offers to Americans and Europeans. Hammouri explains: “ We will provide them with packages that are 25 percent below market prices. This includes the plane ticket, accommodation and a visit to Petra to encourage local tourism as well.”

Really.

Indonesians seeking treatment overseas


..the famed ancient Borobudur complex in Yogyakarta, Indonesia

About a million Indonesians go overseas annually seeking treatment, an exercise that amounts to well over US$1 billion, research by analysts Frost and Sullivan shows.

The study, presented at a health forum in Singapore in April, indicates that despite the huge potential and spending power of Indonesia’s large population, the domestic healthcare industry has proven incapable of meeting their needs. Instead, countries such as Singapore, Australia, Malaysia and the US have been benefiting from the visits of wealthy local residents.

Frost and Sullivan contend that Malaysia has been gaining over Singapore in attracting Indonesian patients. It said: “Indonesian medical tourists going to Malaysia comprise around 70 percent of its total (inventory of) international patients, while those going to Singapore are only around 65 percent.”

Last year, Malaysian hospitals treated 288,000 Indonesian patients, up from 221,538 in 2007 and 170,414 in 2006.

In 2007, Singapore hospitals treated 226,200 Indonesian patients, a drop from the 266,500 recorded in 2006. However, its revenue in 2007 from this market was recorded to have increased.

Affordable pricing was Malaysia’s edge over Singapore, while political stability put it ahead of another rival Thailand.

With Singapore’s healthcare infrastructure being world class, its treatment costs are higher than Malaysia’s as are accommodation and incidentals. This reality has led it emphasise quality, and focus on the highly affluent Middle East sector.

A Muslim country, Malaysia has also decided to go for an Arab clientele, as well as those from destinations within the eight-hour flight range including China, Japan, Korea and the Asean.

Medical Tourists are Reluctant to come to Malaysia because the Nurses wear Headscarves?



A Malay Muslim Nurse



Student Nurses


Pity the Malaysian.
Actually only slightly more than half of the nurses in this beautiful country wear head scarves. The country had been accused to be associated so often with Islamic aggression and Al Qaeda connection that tourists formed pre-conceived ideas even before touching down at the Kuala Lumpur International Airport which itself consistently voted the world's top three airports.

So what's all this about the frightening Islamic headscarves?

Queens University, Kingston, Ontario, Canada:
The veil or the head cover is considered in the West as the greatest symbol of women's oppression and servitude.
Is it true that there is no such thing as the veil in the Judaeo-Christian tradition?
According to Rabbi Dr. Menachem M. Brayer (Professor of Biblical Literature at Yeshiva University) in his book, The Jewish woman in Rabbinic literature, it was the custom of Jewish women to go out in public with a head covering which, sometimes, even covered the whole face leaving one eye free. He quotes some famous ancient Rabbis saying," It is not like the daughters of Israel to walk out with heads uncovered" and "Cursed be the man who lets the hair of his wife be seen....a woman who exposes her hair for self-adornment brings poverty." Rabbinic law forbids the recitation of blessings or prayers in the presence of a bareheaded married woman since uncovering the woman's hair is considered "nudity". Dr. Brayer also mentions that "During the Tannaitic period the Jewish woman's failure to cover her head was considered an affront to her modesty. When her head was uncovered she might be fined four hundred zuzim for this offense." Dr. Brayer also explains that veil of the Jewish woman was not always considered a sign of modesty. Sometimes, the veil symbolized a state of distinction and luxury rather than modesty. The veil personified the dignity and superiority of noble women. It also represented a woman's inaccessibility as a sanctified possession of her husband.

The veil signified a woman's self-respect and social status. Women of lower classes would often wear the veil to give the impression of a higher standing. The fact that the veil was the sign of nobility was the reason why prostitutes were not permitted to cover their hair in the old Jewish society. However, prostitutes often wore a special headscarf in order to look respectable. Jewish women in Europe continued to wear veils until the nineteenth century when their lives became more intermingled with the surrounding secular culture. The external pressures of the European life in the nineteenth century forced many of them to go out bare-headed. Some Jewish women found it more convenient to replace their traditional veil with a wig as another form of hair covering. Today, most pious Jewish women do not cover their hair except in the synagogue.Some of them, such as the Hasidic sects, still use the wig.

What about the Christian tradition?
It is well known that Catholic Nuns have been covering their heads for hundreds of years, but that is not all. St. Paul in the New Testament made some very interesting statements about the veil:
"Now I want you to realize that the head of every man is Christ, and the head of the woman is man, and the head of Christ is God. Every man who prays or prophesies with his head covered dishonours his head. And every woman who prays or prophesies with her head uncovered dishonours her head - it is just as though her head were shaved. If a woman does not cover her head, she should have her hair cut off; and if it is a disgrace for a woman to have her hair cut off or shaved off, she should cover her head. A man ought not to cover his head, since he is the image and glory of God; but the woman is the glory of man. For man did not come from woman, but woman from man; neither was man created for woman, but woman for man. For this reason, and because of the angels, the woman ought to have a sign of authority on her head" (I Corinthians 11:3-10).
St. Paul's rationale for veiling women is that the veil represents a sign of the authority of the man, who is the image and glory of God, over the woman who was created from and for man.
St. Tertullian in his famous treatise 'On The Veiling Of Virgins' wrote, "Young women, you wear your veils out on the streets, so you should wear them in the church, you wear them when you are among strangers, then wear them among your brothers..." Among the Canon laws of the Catholic church today, there is a law that requires women to cover their heads in church. Some Christian denominations, such as the Amish and the Mennonites for example, keep their women veiled to the present day. The reason for the veil, as offered by their Church leaders, is that "The head covering is a symbol of woman's subjection to the man and to God", which is the same logic introduced by St. Paul in the New Testament.
It is obvious that Islam did not invent the head cover. However, Islam did endorse it. The Quran urges the believing men and women to lower their gaze and guard their modesty and then urges the believing women to extend their head covers to cover the neck and the bosom:
"Say to the believing men that they should lower their gaze and guard their modesty......And say to the believing women that they should lower their gaze and guard their modesty; that they should not display their beauty and ornaments except what ordinarily appear thereof; that they should draw their veils over their bosoms...." (Quran 24:30,31).

Some people, especially in the West, would tend to ridicule the whole argument of modesty for protection. Their argument is that the best protection is the spread of education, civilised behaviour, and self restraint. We would say: fine but not enough. If 'civilization' is enough protection, then why is it that women in North America dare not walk alone in a dark street - or even across an empty parking lot ? If Education is the solution, then why is it that a respected university like Queen's has a 'walk home service' mainly for female students on campus? If self restraint is the answer, then why are cases of sexual harassment in the workplace reported on the news media every day? A sample of those accused of sexual harassment, in the last few years, includes: Navy officers, Managers, University professors, Senators, Supreme Court Justices, and the President of the United States!
The following statistics, written in a pamphlet issued by the Dean of Women's office at Queen's University:
* In Canada, a woman is sexually assaulted every 6 minutes,
* 1 in 3 women in Canada will be sexually assaulted at some time in their lives,
* 1 in 4 women are at the risk of rape or attempted rape in her lifetime,
* 1 in 8 women will be sexually assaulted while attending college or university, and
* A study found 60% of Canadian university-aged males said they would commit sexual assault if they were certain they wouldn't get caught.

Something is fundamentally wrong in the society we live in. A culture of modesty is badly needed, modesty in dress, in speech, and in manners of both men and women. Otherwise, the grim statistics will grow even worse day after day and, unfortunately, women alone will be paying the price. Actually, we all suffer but as K. Gibran has said, "...for the person who receives the blows is not like the one who counts them." Therefore, a society like France which expels young women from schools because of their modest dress is, in the end, simply harming itself.

It is one of the great ironies of our world today that the very same headscarf revered as a sign of 'holiness' when worn for the purpose of showing the authority of man by Catholic Nuns, is reviled as a sign of 'oppression' and possible 'suicidal attackers' when worn for the purpose of protection by Muslim women.

Sherif A A, Ph.D.