Bangladesh loses a substantial amount of its foreign currencies to medical tourism abroad. Why is the middle class and the upper class of Bangladesh hurrying abroad for medical purpose?
The rise of medical tourism originating from Bangladesh has emerged as a noteworthy economic and social development, indicative of wider international patterns and distinct regional factors. An approximate 400,000 Bangladeshis participated in medical tourism in 2019 (Pre-COVID). The majority of these individuals travelled to Thailand, Singapore, Malaysia, and adjacent India. The substantial outflow is motivated by the desire for superior medical services, perceived or actual deficiencies in the domestic healthcare system, and occasionally more economical alternatives overseas.
The economic ramifications of medical tourism in Bangladesh are undeniably complex, shedding light on the potential advantages and disadvantages linked to this expanding phenomenon. An annual expenditure by Bangladeshis exceeding $2 billion on medical treatment overseas signifies a significant depletion of foreign currency, which could have been utilized to bolster the domestic economy. The substantial outflow of funds highlights the possible economic consequences that may arise from failing to allocate these funds towards local healthcare and associated industries.
Growing Medical Tourism Abroad
The vast majority of medical tourists who visited India last year were from Bangladesh, according to a report published by the Times of India on July 24, 2021. Bangladesh supplied 54.3% of the visitors, followed by Iraq with 9.0%, Afghanistan with 8.0 percent, the Maldives with 6.0 percent, and a group of African nations with 4.5 percent. The report also stated, citing data from the Indian Union Tourism Ministry, that Bangladesh sent 23.6 percent of medical tourists to India in 2009, with the Maldives sending the largest proportion at 57.5 percent the same year. Over one decade, Bangladesh’s share increased two-folds where Maldives’ share decreased manyfolds.
54.3% from Bangladesh | 6.0% from the Maldives
of the Total Medical Tourists to India in 2021
23.6% from Bangladesh | 57.7% from the Maldives
of the Total Medical Tourists to India in 2009
According to a recent survey report by the Bangladesh Bureau of Statistics (BBS), a significant proportion of individuals from Bangladesh travel abroad primarily for medical treatment. Around 60.41 percent of outbound tourists from Bangladesh during the 2018-19 fiscal year travelled exclusively to India. Furthermore, 29% of all Bangladeshi tourists traveling abroad spent money on medical treatment in foreign countries.
Bangladeshis spent a total of BDT 99.33 billion on medical treatment abroad during the 2018-19 fiscal year, compared to BDT 336.80 billion spent by outbound tourists. Based on data from the Bangladesh Outbound Tour Operators Forum, an estimated eight lakh individuals from Bangladesh seek medical treatment abroad annually, with India being their preferred destination. Additional prominent medical tourism destinations for Bangladeshis include Singapore, Thailand, and Malaysia. The United States, the United Kingdom, and Dubai are also frequented by numerous wealthy individuals seeking medical procedures.
Prominent Destination for Medical Tourists
Bangladeshis visit mostly India, Singapore and Thailand for medical purposes. India’s appeal as a principal medical tourism destination for Bangladeshis can be ascribed to a multitude of factors, encompassing cultural familiarity, advanced medical technology, and cost-effectiveness. The fact that an estimated 1,000 Bangladeshis travel to India daily for medical treatment demonstrates the magnitude of the cross-border medical movement, which has become an integral component of many Bangladeshis’ healthcare consumption.
60.41% Patients Went to India
In 2019
10% Patients Went to Thailand
4300 Bangladeshis contributed 6.7 billion Thai Baht
15% Patients Went to Other Countries in 2019
Singapore, Malaysia, UK, US, China etc.
A substantial economic contribution was made by the 10% of outbound Bangladeshi patients who received treatment in Thailand; in the year 2019, alone, an estimated 4,300 Bangladeshis contributed approximately 6.7 billion Thai baht to the Thai economy. In contrast, the 15% remaining proportion of patients who did not travel to India is individuals from Singapore, Malaysia, the United Kingdom, the United States, and China, with Singapore-specific figures not explicitly specified but included.
Reasons to seek treatment abroad
Geographic Proximity
Due to its close proximity to Bangladesh, travel time and expenses are drastically reduced, rendering India a practical choice for numerous individuals. Additionally, the geographical proximity facilitates the logistical complexities associated with seeking medical attention while travelling, a critical factor for patients who necessitate recurrent consultations or extended care.
Sophisticated Medical Technology
India is widely recognized for its cutting-edge medical technology and rigorous medical education standards. International organisations such as the National Accreditation Board for Hospitals & Healthcare Providers (NABH) and the Joint Commission International (JCI) accredit a number of its hospitals, ensuring that they adhere to global standards.
On another note, hospitals in Thailand are renowned for their proficiency in orthopedic procedures, dental care, and cosmetic surgery. Furthermore, the nation has made substantial investments in fostering an environment that is hospitable to medical tourism by, among other things, facilitating visa requirements for medical visits and offering specialized services to international clients.
In terms of Singapore, niche fields such as oncology, cardiology, and neurology contribute significantly to the nation’s reputation. Preferred by individuals in search of sophisticated therapies, it is characterized by its cutting-edge medical technology and high standard of care. In addition, medical travelers are susceptible to the confidence and dependability that Singapore’s organized and effective healthcare system engenders.
Effectiveness in Cost
Medical treatments in India are frequently more affordable than those in other Asian countries and can be considerably less expensive than in the West. The combination of this cost disparity and the provision of superior healthcare creates an attractive value proposition for patients from Bangladesh who may lack the financial means to obtain comparable treatment in their country of origin or in more costly global. The combination of competitive pricing and high-quality healthcare services in Thailand renders it an appealing medical tourism destination, particularly for Bangladeshi middle income patients who are in search of cost-effective alternatives that do not compromise on quality.
Liaison Offices and Information Centers
The substantial level of engagement in the domain of healthcare has facilitated the development of more profound partnerships and collaborations among medical establishments in both nations. Numerous Indian, Thai, Singapore medical facilities have established liaison offices and information centers in Bangladesh with the aim of facilitating medical visits, optimizing appointment processes, and offering logistical assistance. This initiative serves to deepen the integration of medical tourism within the healthcare domain of Bangladesh.
Healthcare Quality Concerns in Bangladesh
Inadequate Medical Facilities Beyond Dhaka
The concentration of high-quality healthcare facilities in Dhaka presents a substantial obstacle for inhabitants residing in other regions of Bangladesh. Due to this geographical discrepancy in healthcare quality, patients residing in rural or less urbanized regions frequently encounter barriers in accessing medical services of equivalent quality to those available in the capital. Inequitable allocation of healthcare resources, as stated in a report by the World Health Organization, is a substantial factor in the divergent health outcomes that exist between regions of Bangladesh. The inadequate provision of specialized personnel, shortages of medical apparatus, and outdated facilities frequently plague hospitals located outside of Dhaka, thereby compromising the quality of care delivered.
Preventable Medical Procedures
Widespread apprehension exists regarding superfluous medical procedures prevalent in Bangladesh. This encompasses the inappropriate prescription of medications and the suggestion of superfluous diagnostic examinations. According to a study published in the Journal of Pharmaceutical Policy and Practice, the presence of commercial incentives embedded in the healthcare system in addition to the absence of regulatory supervision directly contribute to such practices. In addition to imposing an additional financial strain on patients, these superfluous procedures also subject them to potential health hazards stemming from unwarranted interventions.
Communication Deficits with Patients
In Bangladesh, the communication quality between healthcare providers and patients is frequently cited as a significant problem. Patients frequently report feeling hurried during consultations and that physicians fail to provide sufficient information or engage in meaningful dialogue regarding their treatment options, according to a PatientView survey. Insufficient communication has the potential to give rise to misinterpretations regarding medical conditions and treatments, which may have an adverse impact on patient satisfaction and outcomes.
Factors of Prestige
Treatment received abroad is frequently regarded as a symbol of social standing by the wealthy in Bangladesh. The media frequently reports on the decision of public figures and high-net-worth individuals to seek medical treatment abroad, thereby reinforcing this perception. This trend elevates the prestige associated with foreign medical treatment and affects public perceptions regarding the quality of local healthcare, according to a sociological analysis published in Health Sociology Review.
Insufficient Personnel in Local Healthcare
A persistent challenge in Bangladesh pertains to the scarcity of medical personnel, specifically in fields such as cardiology and oncology. As reported in the Bangladesh Journal of Medical Science, the healthcare provider-to-patient ratio is only 5.26 doctors, nurses, and midwives per 10,000 population which is substantially below the standards recommended by the World Health Organization. This situation results in an inadequate number of personnel to attend to patients, further impeding the efficiency and efficacy of healthcare provision.
Least Favourable Experience with Local Hospital Services
Widespread discontentment exists regarding the services provided by local hospitals, which is influenced by various factors including protracted waiting periods, allegations of corruption, inadequate communication, and superfluous medical interventions. Constantly, the healthcare sector in Bangladesh is identified by the Transparency International Corruption Perceptions Index as being susceptible to corrupt practices, which erodes confidence in domestic healthcare delivery and compels patients to seek medical attention overseas.
Recommendations for Medical Industry
In order to enhance patient satisfaction and health outcomes, as well as to meet the rising demand for foreign medical treatment, Bangladesh’s healthcare system requires substantial reforms. This entails-
- Invest in healthcare infrastructure, such as modernizing and expanding facilities, particularly in underserved areas. Foster public-private (PPP) collaborations in the realm of infrastructure development.
- Improve the standard of medical training and education, such as by incorporating digital medicine into the curriculum. Healthcare professionals must complete continuing education.
- Strengthen policies and regulations in healthcare by establishing rigorous accreditation protocols for healthcare establishments as well as standards and regulations for treatment costs to prevent overcharging.
- Establish specialized medical facilities by concentrating on specialized areas such as oncology and cardiology and forming alliances with international institutions to implement advanced practices.
- Enhance patient satisfaction and care by strengthening the communication abilities of providers to increase patient satisfaction. Also advocating for patient-centered care by ensuring that treatments are in accordance with the requirements of the patients.
- Advocate for the expansion and improvement of insurance coverage to include a wider range of aspects and conditions. Provide government subsidies for expensive and life-threatening treatments.
- Capitalize on information technology opportunities in remote locations by investing in telemedicine. Construct integrated health information systems to optimize patient management processes.
Cover Photo: Trade Promotion Council of India
About the Author
A R Tahseen Jahan is a Research Associate at The Confluence and a student of Development Studies at the University of Dhaka. She is also serving as an Editor at Dhaka University Law and Politics Review.