http://portal.telegraph.co.uk/global/main.jhtml?xml=/global/2005/08/20/etnewsmedical20.xml
Medical tourism By Dr Richard Dawood (Filed: 20/08/2005) When 14-year-old Elliot Knott, from Dorset, flies to India for medical treatment this month, he joins a long list of patients who have opted to go abroad in search of low-cost back surgery, rather than face a long wait on the NHS or a large bill for private treatment. Medical tourism has been with us for many decades. Indeed, in many parts of the world, hospitals now vie with each other to attract foreign visitors. In South Africa, for example, low-cost plastic surgery can be followed by recuperation on safari, away from friends or family who might disapprove, or stare at your bruises. India receives 150,000 medical tourists annually, and, as reported by Telegraph Travel last month, is now introducing a system of medical visas to streamline the process. Elliot has my full sympathy, not least because I have back problems of my own, but other than for the most compelling medical reasons, surgery abroad is ill-advised and media coverage of his case has glossed over the numerous reasons for avoiding it. All surgery carries an element of risk. It is not enough that a surgeon, or hospital facility, is adequate for the operation being contemplated; they must be proficient enough to cope with worst-case complications as well, and to be able to offer, for example, swift access to state-of-the-art intensive care as and when required. Blood loss is a routine surgical risk. In Britain blood donations are carefully screened and drawn from a population with a low carriage rate of infections such as hepatitis B and C, HIV and malaria. In addition to the risk of disease, other local hazards include the presence of counterfeit drugs and medicines. The journey home may also be troublesome: surgery increases the risk of deep-vein thrombosis, and other emergencies in the air are more likely, and difficult to deal with, on long-haul flights. There's little chance of good continuity of care; should you have a problem, you can't nip back for a quick check-up with your surgeon if he is thousands of miles away. If anything goes badly wrong, costs can escalate. Insurance cover may not apply and legal liability can be impossible to resolve. I've looked after many people who are unwell, in pain, or needing surgery in foreign countries. It is bad enough to be ill at all, but away from the support network of family and friends, in a different cultural and ethical environment and far from those who speak your language, it can be a miserable experience. It can also be bad for your health. Generally, wherever in the world you come from, and whatever the local shortcomings may be, the best medical care is nearly always found at home. # Dr Richard Dawood is a specialist in travel medicine at the Fleet Street Travel Clinic (020 7353 5678) -- Cheers, Gabe Menezes. London, England
