IMTA lobbies for relaxation of Indian Visa Procedures

The Indian Medical Travel Association has petitioned the government to ease restrictions on issuance of Visae to travellers who look to come to India specifically for Medical Treatment. This is a welcome move.

Recover Discover in the electronic press media

http://www.prlog.org/10512495-recover-discover-medical-tourism-tie-up-with-fortis-healthcare.html

A Brief History of the Medical Value Travel Industry in India

Medical Tourism is not a new phenomenon in India. It has been in existence in various avatars since the 1970’s. In the early days India was the favored destination for patients from right across the Middle East specifically Saudi Arabia and Kuwait. It was not an uncommon sight in Mumbai (erstwhile Bombay) to see Arab clients in their long flowing robes arrive at the airport and get transported to hospitals such as Breach Candy, Jaslok Hospital etc for medical treatment. In Kolkata (erstwhile Calcutta), each flight in carried a horde of people from Bangladesh looking for medical alternatives. A similar situation existed in Chennai (erstwhile Madras) that had people from Sri Lanka flocking to its hospitals in search of healthcare solutions.

In the new scenario there are many more people from different parts of the world that are looking at India for a range of healthcare solutions ranging from complicated surgeries to traditional healing practices like Ayurveda and Yoga. Patients access India for different reasons and ailments. People from the US, Canada and other developed nations look for Obesity or Bariatric Surgery, Joint Replacement Surgery, Spine related surgeries, Cosmetic and Dental Surgery among others. Patients from Africa, primarily from Nigeria look for Cancer therapies, cardiac care, pediatric care and orthopedic surgeries Over the last few years there has also been an influx of people from war ravaged regions e.g. Afghanistan, Iraq who come to India to have war related injuries treated like shrapnel and bullet injuries, artificial leg and arm prostheses.

In order to cope with rising demand of these medical travelers a range of quality healthcare facilities catering to all categories of patients have come up. Major hospital chains like Fortis Healthcare and Apollo Hospitals have their major facilities accredited by the Joint Commission International ( JCI - http://www.jointcommissioninternational.org/). JCI is the Gold Standard in Hospital Accreditation and is one of the few certification programs accepted internationally. Indian law now requires that every hospital facility be accredited to the National Accreditation Board for Hospital and Healthcare Providers (NABH - http://www.qcin.org/nabh/index.php ). NABH is the Indian equivalent of the JCI certification. It is not as robust a standard as JCI as it is a very young protocol and over the next few years is expected to be on par with International standards.

Traditional systems of Indian medicine and Wellness like Ayurveda, Ayurvedic massage therapies and Yoga have also seen a very rapid growth trajectory.

Recover Discover Healthcare ( www.recoverdiscover.com ) started its operations as one of the pioneers of the Medical Value Travel or Medical Tourism in India. It has an Exclusive tie up with the Fortis Healthcare Group ( www.fortishealthcare.com ) which is head quartered in Delhi, India. This physical proximity between Recover Discover and Fortis helps the both of them to co-ordinate all activities seamlessly and provide a high level of patient experience. Patients also have the huge added advantage to obtain multiple treatments with the same hospital chain. So whether a patient looks for a gastric Bypass at Wockhardt, Mumbai or a Cardiac Bypass to Escorts, Delhi or a Knee or Hip replacement at Fortis, Noida – all the top quality solutions are delivered by the same hospital chain Fortis Healthcare.

The exclusive agreement with Fortis also gives its clients access to treatment at 3 JCI accredited hospitals. The 4th hospital Escorts Heart Institute in Delhi is due to accredited by the summer of 2010. Recover Discover Healthcare aims to live by its motto – Care Beyond Boundaries.

Alternatives in Weight Loss or Bariatric Surgery

I just got this very informative article which was contributed by Dr. Randeep Wadhawan of Fortis Healthcare. I hope it is useful for readers--

OVERVIEW:

There are 2.1 billion obese people in the world. We in India have 97 million people with obesity,out of which 25 million(6% of our total population ) are morbidly obese. Urbanisation has been implicated as the strongest risk factor for obesity in India.

The incidence of obesity in children is also on the rise as shown by school surveys in Indian cities, where nearly 30% of adolescents from India’s higher socioeconomic groups are overweight.

Technology and globalization has gifted a new kind of disease to mankind i.e. obesity and diabetes.This new disease is called “DIABESITY”. This is a great challenge to all agencies including the government, NGO’s, & public at large.

OBESITY:

According to the National Institute of health(NIH) an increase of 20% or more of your ideal body weight is the point at which excess weight becomes a health risk. Obesity can be calculated by a parameter called BMI (body mass index). This is calculated by weight(kg) /height(m²).

Classification of Obesity:

BMI(Kg/m²) NIH IFSO

19-24.9 Normal Normal

25-29.9 Overweight Overweight

30-34.9 Class 1 Obese Moderate Obese

35-39.9 Class 2 Obese Severe Obese

>40 Class 3 Obese Morbid Obese

>50 Class 4 Obese Super Obese

Obesity does not come alone. It is just not a matter of looking ugly or asymmetrical, infact it is associated with number of life threatening co-morbid conditions.

Some of the common co-morbid conditions associated with obesity are:

· Diabetes type2.

· Hypertension and heart disease.

· Osteoarthritis of weight bearing joints.

· Sleep apnea and respiratory problems.

· Gastroesophageal reflux disease and heart burns.

· Depression.

· Infertility.

· Fatty liver and hepatic lipidosis.

· Skin breakdown.

· Swollen legs and skin ulcers.

· Urinary stress syndrome.

· Menstrual irregularities.

· Lower extremity venous stasis.

· Dyslipidemia.

· Pulmonary embolus

· Cancer.

MEDICAL TREATMENT:

Most nonsurgical weight loss programs are based on combination of diet , behaviour modification and regular exercise . Unfortunately, medical treatment has proven to be effective for only a small percentage of individuals. It is estimated that less than 5%, of individuals who participate in nonsurgical weight loss program will lose a significant amount of weight and maintain that loss for a long period of time. According to NIH most people in these programs regain their weight within one year called the

“yo-yo effect”.

WEIGHT LOSS SURGERY (BARIATRIC SURGERY):

Weight loss surgery (Bariatric surgery) has provided the longest period of sustained weight loss in patients for whom all other therapies have failed. Bariatric surgery is a major surgery and should be viewed first and foremost as a method for alleviating a debilitating disease. A meta-analysis of more than 22,000 patients who underwent bariatric surgical procedure showed a complete resolution or improvement of their co-morbid conditions along with weight loss .The indications for bariatric surgery are:

BMI >32.5 with atleast two co-morbid conditions

BMI > 37.5 with or without co-morbid conditions.

There are two basic approaches to bariatric surgery according to the mechanism of action.

Restrictive Procedures: It works on the principle of restricting the diet intake of the patient. The procedures are:

Gastric Banding

Sleeve Gastrectomy.

Malabsorptive Procedures: Malabsorptive procedures alter digestion, thus causing the food to be poorly digested and incompletely absorbed so that it is eliminated in stool. In addition to restriction , these techniques involve a bypass of the small intestine, limiting the absorption of calories. The commonly done malabsorptive procedure is

Roux en Y Gastric Bypass.

All the above mentioned procedures are being done routinely by LAPAROSCOPY (key hole surgery). The advantage of laparoscopy is:

· Faster recovery with reduced post-op pain

· Minimal blood loss ,

· Short hospital stay( 3-4 days)

· Better cosmetic results

· Early return to work.( within 7-10 days)

PROCEDURES:

LAGB (Laparoscopic Adjustable Gastric Banding): Purely restrictive procedure. In this a silicone band is placed around the uppermost part of the stomach. This band is adjustable by an access port kept under the skin. The band divides the stomach into two portions: one small and one large. The small pouch gives early satiety hence patient eats very small amount of food, gets satisfied with it, and ultimately gains its goal of dieting voluntarily. This is a reversible procedure but it requires follow up in OPD for band adjustment.

Laparoscopic Sleeve Gastrectomy: Essentially a restrictive procedure. It involves cutting and stapling 75% of the stomach and leaving in place 25%(100ml) of gastric tube along the lesser curvature of the stomach. It also decreases appetite as with the removal of fundus of stomach ,the appetite stimulating Ghrelin hormone is also removed. This is an irreversible procedure but it does not require frequent followup in the OPD.

Laparoscopic Gastric By-Pass : This is a combination of restrictive and malabsorptive procedure. In this procedure a small stomach pouch(30cc) is created by stapling and then a large length of small intestine is bypassed to join with the stomach pouch. It therefore restricts the intake of food and also produces higher levels of malabsorption . Compared to the other two procedures long term weight loss is more in this procedure. It is a major surgery and therefore has more complication rate along with certain nutritional deficiencies eg. Iron deficiency, Vitamin B12 deficiency and Calcium deficiency.

Metabolic Surgery : Today bariatric surgery is also known as metabolic surgery as it treats ”DIABESITY”.i.e. diabetes and obesity. Recent evidence suggests that a small amount of weight loss reduces the effects of Type 2 diabetes, infact many patients have completely eliminated their blood sugar problems after losing a significant amount of body weight.

LIFE AFTER SURGERY:

Diet: Some of the generally accepted post surgical guidelines are:

· Chew thoroughly

· Not to drink fluids while eating.

· Omit desserts.

· Omit carbonated drinks.

· Avoid alcohol.

· Limit snacking between meals.

Going back to work: Most patients return to full presurgery levels of activity within two weeks.

In conclusion surgery combined with behavioural modification, is currently the only proven method of achieving long-term weight loss for the obese.

Exclusive tie up to help clients better - Fortis Healthcare

In the past few years there has been a profusion of companies and individuals who have decided to jump onto the medical tourism bandwagon. Hospitals too want a piece of the pie (Though not to many people know what is the size of the pie) as everyone feels this is the next biggest thing after the IT and BPO outsourcing wave of the past decade. 2010-2020 might be the decade for Medical outsourcing.

There are very little differences between facilitators and it becomes difficult for patients to corroborate information on doctors, facilities etc. Most individuals still spend a lot of time searching through the web to locate information on the best facilities or the best doctors. All facilitators tie up with multiple hospitals to enable their patients get a choice. But often it confuses prospective clients as it is difficult to understand why one facilitator pushes one doctor or hospital more than the other (possible monetary temptations here).

Realizing this, after 3 years of working as a company that dealt with a chain of various hospitals, I decided in 2010 to work alongside Fortis Healthcare on an exclusive basis. The benefits Recover Discover gets is that its clients get preferred care and they have access to the entire range of healthcare services available right across Delhi/NCR. An additional advantage is that with the Fortis takeover of Wockhardt Hospitals, now the Fortis network has 3 JCI Accredited ( http://www.jointcommissioninternational.org/) facilities. JCI Accreditation is the Gold Standard for Global Recognition of Patient care and Best in Class Healthcare Practices.

I am very confident that this new partnership will open up a higher level of care for my clients.

Indian Hospital Voted Worlds No. ! Hospital for Medical Tourists

The Wockhardt Hospital at Bangalore, was Voted as the World's No. 1 Hospital for Medical Tourists World wide by the MTQUA (http://community.mtqua.org/page/medical-travel-quality-1). Fortis Healthcare recently took over the Wockhardt Hospital and the Bangalore facility is now a part of the Fortis Healthcare Network. Recover Discover eorkd exclusively with the Fortis group and provides access to 3 JCI accredited facilities for its patients from North America.