In the beginning there was tourism. Tourism being getting out of the usual rut of things and going away from your home base for some rest and recreation. It was about meeting new people, seeing new places, having new experiences and the likes. Things have come a long way from there. Now tourism is no longer a singular activity, it is not about simply having a good time goofing off. These days it is thematic tourism.

Now it is sports tourism, eco-tourism, bio tourism, aqua tourism, heritage tourism, beach tourism and so on. Fast jumping on to the thematic tourism bandwagon is Medical Tourism or Health Tourism. Medical tourism, or more broadly, health tourism, refers to the increasing tendency among people living where medical services are either very expensive or not available to travel overseas in search of more affordable health options, often packaged with tourist attractions.

The World Tourism Organization includes the following in its definition of medical tourism: medical care, sickness and well-being, rehabilitation and recuperation. The concept of Medical Tourism is not entirely new. As a matter of fact as far back as 3,000 BC, people with eye problems made pilgrimage to Tell Brak, Syria, where healing deities were said to perform miracles. Ancient Roman spas that were believed to cure an endless list of ailments still offer hope and relief to bathers today. As people travelled to these destinations to seek the sure they had inadvertently embarked on Medical Tourism.

According to the International Trade Centre, Geneva, the global demand for clinical services is estimated at US$804 billion in the year 2000. That is a large market and everybody seems to want a piece of the pie. Traditionally, the western countries were considered the leaders and front runners in good healthcare. Times have changed and these days developing nations too are able to offer the same if not better services in terms of healthcare, technology, comfort during recuperation and most importantly at affordable prices. As a matter of fact, healthcare costs in some of these developing countries are less than one-third of that in non-European or US facilities. This has cause many a person to seek alternate destination to cure their ills.

In addition to the ever increasing cost of healthcare in developed nations, there is also the problem of waiting time. The wait list, especially in the UK, for both inpatients and outpatients is anything between three weeks to one year. For example, there is a backlog of about 1.2 million patients in major hospitals in Britain alone, according to figures provided by the National Health Survey in UK. The number and wait period increases in non-elective surgery. Non-essential surgery and cosmetic surgery performed by private medical practitioners are so expensive that they border of prohibitive. Nevertheless, people are clearly interested in image and appearance enhancement medical alternatives. Clearly with more and more women interested in enhancing their endowments at a reasonable cost, many medical practitioners in these developing countries want to get abreast of the problem.

In view of all these issues, medical tourism has blossomed in many countries as yet another opportunity to get better, look better, feel better, have a good time, see a new place and still have some money left over and most importantly have it happen within this lifetime. As a matter of fact many Europeans visited South Africa for their healthcare requirements to overcome the difficulties identified above. The main reason for this was that South African doctors, often educated abroad, are widely regarded as among the world's finest — South African Christiaan Barnard performed the world's first successful human heart transplant in 1967. With a more consolidated and committed governance, South Africa began to enjoy its new foray into this industry, that is Scalpel Safaris.

The scenario has changed with more and more countries getting in to the game, especially Asian and in particular South East Asian countries. India, Hong Kong, Singapore, Thailand and most definitely Malaysia and now definite players in the game and all of them are here to stay. In these countries tourism is a big contributor to the Gross Domestic Product (GDP). For these countries, the new theme for tourism, would most likely be, Sun, Sea, Sands and Surgery (or Scalpel).

The Medical Tourism initiative in Malaysia actually garnered speed in the late nineties. As a matter of fact, the concept of health tourism was initially introduced in 1998 by the Malaysian government, as a response to the Asian economic crisis in search of new and sustainable growth areas. The Health Ministry of Malaysia by definition declares that all activities by virtue of health and tourism that generate wealth for the country are considered Medical Tourism. In other words, medical tourism can also be defined as travels for the purpose of enhancing the well-being of the mind, body and spirit of the individual, families and groups.

The healthcare facilities and the ability of our healthcare professionals are comparable to some of the best in the world in many areas. This coupled with a stable government with moderate outlooks in many areas and a multitude of holiday destinations make Malaysia an ideal address for medical tourists.

According to 'PricewaterhouseCoopers', Malaysia's health tourism sector saw a total revenue, for the whole of 2002, as RM35.88 million (USD $9.4 million). During the first nine months of 2003, health tourism generated RM40.9 million (USD $10.8 million) revenue from 73,573 foreign patients. The Malaysian Government expects health tourism to be among the top contributors to total tourist expenditure, reaching RM540 million (USD $142 million) by 2005 and RM2.2 billion (USD $0.6 billion) in 2010. This is indeed a sizeable contribution to the economy of the country.

According to the same source approximately 60% of foreigners who seek treatment are from Indonesia, another 10% are from Brunei, Vietnam, Singapore and Thailand. The rest are from West Asia, South Asia (Bangladesh and India) and Japan. In view of this huge market and its propensity for tremendous growth, hotels and private medical institutions are teaming up to provide interesting packages.

The Malaysian Medical Tourism industry although extremely lucrative, faces tremendous challenges from our neighbours, i.e. Thailand and Singapore. A sustained effort in needed by the Tourism Board and the Ministry of Health to overwhelm these challenges as soon as they appear. With the pie being as big as it is Malaysia must acknowledge that the competition will mobilise all avenues within its means to garner as much as is possible.

Perhaps we have a distinct advantage in terms of our currency exchange rates. With the Sterling beings as high as it is and the US Dollar having being pegged for several years now, we are definitely in an advantageous position. The other advantage is our cost factor. For example, based on figures by the Association of Private Hospitals of Malaysia, a cardiac bypass surgery at a top-notch private hospital in Malaysia costs an average of US$6,300 as opposed to US$10,400 charged in Singapore. This is already showing when you observe the increase in the number of Singaporeans seeking healthcare in Malaysia.

In terms of facilities we are not in short supply either. Malaysia has the right infrastructure, especially when we have comprehensive network of hospitals and clinics. Statistically, 88.5% of the population are within 5 km of a public health clinic or private practitioner. Further, our healthcare professionals are conversant in the English Language allowing us to better communicate with the tourists.

Yet another advantage is our position as a moderate and modern Muslim nation. Malaysia offers a culture that would certainly appeal to the sensibilities of the Islamic population. This in turn offers us a tremendous advantage to explore the global Muslim market for Medical Tourism. A more concerted effort to extensively and aggressively market the available avenues for healthcare in the Middle East region would undoubtedly prove to be a distinct push for the industry.

We need to understand, that in order to prepare ourselves for the challenge and be seen as force to be reckoned with, there is a need to prepare ourselves. We must ensure that the image and reputation is maintained at all cost. Malaysian private healthcare service providers should strive to maintain high standards of service and professionalism. Continuing professional development and education of healthcare personnel is also important in order to keep pace with the latest developments in the medical and healthcare sector. To further enhance credibility in the promotion of healthcare services abroad, Malaysian healthcare service providers should seek internationally recognised accreditations such as Quality Management Systems (ISO 9001) certification and Hospital Accreditation.

We must be prepared to take the challenges that come with this tremendous opportunity. The clarion call has sounded, are we ready to face the challenges that come with this opportunity?