Rwanda turns to medical tourism, eyes regional dominance

As efforts to boost the budding tourism sector that registered high foreign exchange receipts last year gather momentum, Rwanda is looking at medical tourism, mainly in the region, as another option that could further enhance tourism earnings, a move that could see the country leapfrog its economy.The tourism sector collected $210.5m (about Rwf133b) between January and September in 2012, up from $184.4m over the same period in 2011, indicating a 14 per cent increase.A positive outlook for the future of the fast-growing sector, experts say, will depend on the efforts to increase tourism products, including medical tourism.Medical tourism, also called medical travel, is a term initially coined by travel agencies to describe the rapidly-growing practice of travelling across international borders to obtain health care.“The government is courting investors to set up advanced medical facilities in the country; we believe this will help make our country a regional tourism hub,” said Rica Rwigamba, the head of tourism at Rwanda Development Board.Rwigamba was optimistic that tapping into medical tourism would improve the foreign exchange receipts needed to bridge the current trade deficit the country is facing. Rwanda’s trade deficit stands at over $1.2b.“Medical tourism is something that requires a different approach if one is to attract world class health investment like Dr. Agarwal’s Eye Hospital in Kimironko, Gasabo district. It is also about wooing people to provide quality medical services at affordable rates,” she says.She adds: “Rwanda is in a good location in terms of climate, the security and quiet environment, which patients need when going through the process of healing.”“Early last year, I had blood clot complication around my neck, which doctors here failed to handle, so I ended up paying a return ticket of $1,200 (about Rwf 760,000) to India, where I was treated at $2,500 (an estimated Rwf1.6 million). Actually, treatment abroad isn’t that costly. Transport and accommodation are the only costly items,” said Martin Nkuranga, a Rwandan, who received specialised medical care abroad.Such a story is heard almost every other day. Many patients with complications local doctors cannot handle are always referred for medical attention abroad. This is especially for people suffering from heart defects and health complications like blood cancer, brain tumour and plastic surgery for deformities or acid attack victims. It is important to note that this is a universal phenominon.This is what has come to be known as medical tourism, a relatively, new segment of tourism that countries with advanced medical facilities and highly qualified experts, have focused on to rake in millions of dollars.One would note that in spite of the rather huge benefits medical tourism could bring, including the establishment of world class medical facilities, pool of specialists and employment opportunities for the local people, it is an expensive venture for the government to undertake alone.This could, therefore, be the reason it is wooing investors into the medical tourism segment, where it is targeting regional dominance.Medical tourism, as many of us know, has always been a reserve of countries like India, Kenya or South Africa, which are earning a lot of money from it, making it a hugely successful tourism option. So, Rwanda, in taking a step to cement itself in this tourism market segment, is opening up the sector to more investment, business opportunities and jobs, experts say.“The government earmarked the School of Public Health under the National University of Rwanda to carry out the policy on medical tourism,” Arthur Asiimwe, the Ministry of Health communications chief, says.He, however, noted that statistics showing the number of people who fly in or out of the country for treatment or the amount of money the state loses in terms of foreign exchange would be hard to ascertain as many a tourist or Rwandan usually fly in or out on individual basis. But he said they would now pay keen interest and document such patients for planning purposes.“I don’t know if hospitals like King Faisal Hospital in Kigali don’t measure up to the required standards that would provide medical help to locals or foreigners because every day we hear of people flying to Nairobi Hospital or Aga Khan Hospital in Kenya to receive medical attention,” says Ndoli James, a Kigali Institute of Science and Technology (KIST) student, who lost his step mother last November in India to leukemia after local doctors here had failed to diagnose the ailment.This experience shows that for medical tourism to take root there must be huge investments in the health sector.We must have the right equipment and medical specialists, especially in those areas where patients have to be flown out for treatment, policy to encourage investment in the sector and other facilities and infrastructure.We need proper and enough accommodation and hotels, as well as a conducive and accessible transport system and lower cadre workers. There are over 50 countries, including Mexico, Costa Rica, Germany, Seychelles, the UK, the US, Egypt and Israel, which have identified medical tourism as a national industry.However, accreditation and other measures of quality vary widely across the globe. Medical tourism is all about taking advantage of the numerous cost-saving opportunities that exist beyond ones country’s immediate neighbourhood, where there is quality and affordable healthcare.“Anybody going for treatment will have to spend a few more days at the different destinations, where they have to book hotels before seeking medical attention. Some may be accompanied by their family members and the fact that those people require accommodation and transport in one way or another sums it up as medical tourism,” says Chris Munyao, the general manager of Primate Safaris in Kigali.Munyao says the person seeking medical treatment abroad contacts the medical provider and a local tourism operator before travelling.The medical provider usually requires the patient to provide a medical report, including the nature of ailment, his or her previous doctor’s opinion, medical history and diagnosis.Certified medical doctors or consultants then advise on the medical treatment. The approximate expenditure, choice of hospitals and tourist destinations, and duration of stay are then discussed.After signing consent bonds and agreements, the patient is given recommendation letters for a medical visa, to be procured from the concerned recommended country’s embassy.When the patient travels to the country, the tourism operator assigns a case executive, who takes care of the patient’s accommodation, welfare and transport as he or she seeks medical help.With a pool of advanced researchers and specialists, medical tourism can be a success in Rwanda.“Rwandans usually fly out to get treatment for some diseases and disorders like heart complications and cancerous tumors,” says Bella Rukwavu, a Kigali resident, when asked about her views on medical tourism.“So, if they can get the same services at home, there would be no reason to go abroad. This is a great initiative, but it will need time to be well-established in Rwanda,” she added.Recently, Dr. Agarwal’s Eye Hospital opened its doors in Kigali, making it the first foreign specialist establishment, which is most likely to become a regional eye referral centre. This would mean that Rwanda would earn more foreign exchange from the patients and caretakers.“We have spent time with the ministry of health and Rwanda Development Board to see how we can expand this sector because it is quite vital,” said Farooq Siddiqui, the Indian Dr. Argarwal Eye Hospital head of business.The Asian giant eye facility has so far invested $6m (an estimated Rwf3.8b) with plans to invest more in the next few years.According to John Nkurikiye, the hospital’s medical director, the specialist hospital handles all complicated eye cases that were hitherto being referred abroad. This will help the country save its hard currency that would have been used abroad.“The aim of this hospital is to stop any referrals for eye treatment outside Rwanda. We have advanced eye investigational services and a network of over 59 hospitals and a pool of 350 specialists from where we can perform specialised care,” Nkurikiye says.Therefore, both locals and foreigners can receive medical assistance at the facility.If more medical tourism facilities are set up in the country and other tourism options are exploited, the figure will significantly rise.Other popular attractions in Rwanda include gorilla tracking, community and natural tourism, mountaineering, bird and sightseeing and kwita izina (young gorillas naming ceremony).The new Kigali master plan has earmarked some areas in Kimironko, Gasabo district for tourism activities.Experts say when medical tourism takes root; it will create thousands of jobs, improve the country’s foreign exchange receipts, boost the healthcare system and expertise and improve the lives of service providers.“We will need more health workers with specifics skills to handle given medical cases. Besides improving skilled personnel in the country, the move will create job opportunities for many nurses and doctors,” they say.