Magazine 2017
International Peer-Reviewed Journal  
Meherjyoti Sangle  
The current paper is a review of medical tourism in India with special reference to Surrogacy. It describes  
how health tourism existed even in the early 19 century due to the expertise Indians possessed in herbs  
and medicines. Also the mineral rich soil in India acted as a magnet for international visitors. The paper  
describes the advantages and disadvantages of health tourism in India and also compares costs with the  
U.S.A. The article concludes with recommendations for the health tourism industry.  
Keywords : Medical tourism, India- Ancient Therapy, Ayurveda, Spas, Globalisation, Fertility Tourism,  
Surrogacy, Ethical Issues and Legal Control.  
Hunziker and Krapf in 1941 defined tourism as ‘the sum of phenomena and relationships arising from travel and  
stay of non-residents in; so far as they do not lead to permanent residence and are not connected with any  
earning activity.’  
But later this phase of tourism has undergone several changes. In today’s era we have know people to back up  
their lives and just travel across borders for years together. People travel across countries to attend just singular  
events, some to taste delicate red ant chutney from a corner of the Meghalaya forests, some travel across  
countries just for ayurvedic massages (Kerala) or travel across the world for thermal baths (Budapest). Well of  
course this is coupled with interesting conversations, learning about the other regions’ culture, lifestyle and  
food amongst several other things.  
Tourism was not always looked at from the perspective of leisure, but had great signification in various regions  
or geographies through the ages. If we deep dive into history, we will notice that geography and the geographical  
positioning of regions plays an important aspect in the evolution of that area’s tourism. For e.g. the tourism in  
Europe was faster advanced and tourist friendly compared to that of South Africa.  
Health Tourism  
Excessive stress at the work place and mechanics of life in big and crowded cities make people run to unknown  
places and unwind themselves. Health tourism was always existed but it was not until the eighteenth century  
that it became important. Ancient Indian medical texts were translated and this knowledge transposed to  
China, Greek and Europe.  
People often visited spas to unwind and relax. Some of them were orthodox like the natural reservoirs in India  
proved as rich sources of the sulphur where people used to visit and treated their skin diseases.  
The spas of the southern states of the USA in the 19th century served a rural market, whilst spas in the north  
were largely urban in characters. Leisure habits for the German bourgeoisie in the mid-1800s were often highly  
localized and this contributed to the lack of resort development on the north German coast until the early years  
of 20th century. In contrast, Italian’s indulged in local town, country spas and seaside resorts and limited  
international tourism and rarely extended beyond Switzerland and the South Tyrol.  
The period of spa growth in England (c. 1550-1820) was marked by a multitude of spa births and deaths, not  
a smooth projection of rise and decline. And, it is also too simplistic to see these English spas operating in  
isolation from a much wider urban leisure system.  
Medical tourism has served as a gateway for patients to receive affordable and quality medical care by crossing  
borders. The net worth of the health tourism industry is believed to be $40 billion. Savings from medical tourism  
can be 15 to 85 percent in some cases. Leading medical tourism hubs around the world include Brazil, Costa  
International Peer-Reviewed Journal  
Rica, India, Malaysia, Mexico, Singapore, South Korea, Taiwan, Thailand and Turkey. Estimates show that over  
million global citizens cross borders every year to appreciate the effects of medical tourism.  
Growth of medical tourism in India has been very rapid in the last 10 years and according to Confederation of  
Indian Industry over 1, 50, 000 patients travelled to India to seek health care services in 2005. And according to  
Ministry of Tourism, India, medical tourism growth in India is expected to see an exceptional growth rate of 30%  
by 2015 and set is to become a 2billion USD industry.  
Indigenous and Natural Health Tourism  
India has an ancient healing system called Ayurveda – knowledge of life – This system combines naturopathy  
with various natural therapies which include invigorating Yoga lessons added in these therapies. These have no  
side effects but very much rejuvenating. All around the World there is now a greater interest in this Indian  
Traditional Medicine System. Tourism Marketing teams have included Rejuvenation packages for travel to  
Kerala, Goa, Karnataka, Tamil Nadu etc., states which have developed quite a number of resorts with the aim of  
providing Ayurvedic therapies. These are now receiving worldwide attention.  
Treatments are provided for Allergy, Chest & Pulmonary, Cardiothoracic / Cardiovascular Surgeries, Vascular  
Surgery, Cosmetic Surgery, Pediatrics and Pediatric Surgery, Infertility / Reproductive Medicine and Obstetrics  
and Gynecology  
Globalization and Fertility Tourism  
With the onset of globalization, there has been a decline in fertility levels. This has led to what is known as  
reproductive tourism. Of the many options, surrogacy has caught the public-eye and so much so that visa  
regulations have been changed in line with the growing practice. With no legal regulation and easy availability  
of surrogate mothers at one-third the global cost, the practice proliferates in an unfettered manner in India. The  
rapid growth of the industry also poses various challenges to various familial notions and makes settled concepts  
like ‘motherhood’ look rather hazy.  
In the advanced technological era, there are many alternatives available for the couple who crave to have a  
child. Despite the fact that adoption and other options of the like nature exist to counteract the issue of  
childlessness, there is noted a great desire among couples to have a child of their own. That is to say that the  
infertile couples want a child genetically related to them. It is this yearning and aspiration of the infertile couples  
for a genetically related child that has fuelled the growth of assisted reproductive techniques, and more particularly,  
India’s booming commercial surrogacy tourism businesses face a bleak outlook. Official figures suggest 2,000  
children are born to surrogate mothers in India each year, and unofficial figures for the value of the industry  
range from $400 million to $2.3 billion. EY, a consultancy, published research in July 2015 suggesting that the  
market could grow by 20% a year.  
The government is planning legislation to ban most foreigners from hiring Indian surrogates.  
In October 2015, Indian embassies stopped issuing medical visas allowing foreigners to enter the country for  
the purposes of hiring a surrogate mother. The Indian Council of Medical Research has also banned clinics  
from offering such services to foreigners.  
What was a $2.3 billion industry will collapse. The government says that the lack of a legal framework has  
allowed surrogates to be underpaid and exploited by clinics, which charge between $25,000 and $50,000 for  
the safe delivery of a baby. Surrogates get between $4,000 and $6,500 from foreign couples and between  
3,000 and $5,000 from Indian couples.  
The new law aims to safeguard the rights of surrogate mothers, as surrogates are sometimes surreptitiously  
implanted with more than one embryo to improve the success rate, resulting in multiple births that could be  
International Peer-Reviewed Journal  
difficult for the mothers. Because the business is largely unregulated, there is little recourse if something goes  
Commercial surrogacy is allowed in a number of other countries, including Malaysia, Russia and Ukraine, and  
in some U.S. states. Most developed countries allow altruistic surrogacy, in which no payment changes hands,  
but ban commercial surrogacy. The industry was banned in Thailand in August 2015, and legislation is under  
discussion in Malaysia.  
Advantages of Medical Tourism in India  
The biggest advantage of medical travel in India is the low cost health care service, Technological advancements  
and highly educated doctors, Availability of latest medical instruments, High health care standards offered, No  
language barrier as English is widely spoken across India. Moreover many hospitals in India hire native translators  
for patients from African countries so that they can communicate effectively, Relaxed visa rules, Visa on India  
arrival for patients from specific countries ( Just announced by P. M. Mr. Modiji in the SAARC, 2016), availability  
of low cost generic medicines.  
Disadvantages of Health Travel in India  
Medical practice has known as a noble profession but it changes its nature and became commercial. There are  
few disadvantages of medical travel in India. Medical malpractice has emerged most danger disadvantage.  
Misdiagnosis during the treatment can result in unforeseen damages even though hospitals provide malpractice  
insurance. And since travellers are not aware of the legal rules in India, this can cause further troubles.  
Second, Indian Insurance policies are very clumsy and hidden. Insurance coverage varies on the type of  
medical treatment. So before seeking any treatment it is important to understand all the facts to avoid any  
unnecessary expenses during your stay abroad. And since medical travellers are unaware of legal issues, it may  
cause problems to them since in countries like US & UK legal procedures are very transparent. Third is an  
expense raised in Post Operation Therapy and health check up. Issues arise when the recovery time of procedure  
is longer and in such cases medical tourists in India have to arrange stays outside the hospital on their own.  
Legal paperwork and permits are tedious and/ or serve as ahinderance to patients in medical tourism destinations.  
In foreign countries, it may be possible to unaware the legalities of medical care travel. and Last is Travel Cost  
is always recommended for medical tourists to accompany someone while travelling abroad for medical  
treatment. But this spurts the travel, accommodation and other bills.  
Health Care Cost – India Vs USA  
Here’s the summary of important heart surgical procedure in India compared to US. (Source: American Medical  
Tourism is the effective tools for building prosperous community economically, socially and culturally. Economics  
gains have been a major driving force the growth of tourism in developing countries. The World Travel and  
Tourism Council calculated that tourism generated $121 billion or 6.4% of the nation’s GDP in 2011. It was  
responsible for 39.3 million jobs, 7.9% of its total employment. The GDP of the tourism sector has expanded  
29% between 1990 and 2011. The sector is predicted to grow at an average annual rate of 7.7% in the next  
decade. In a 2011 forecast the World Travel and Tourism Council predicted the annual growth to be 8.8%  
between 2011 and 2021.  
India is ranked fifth among countries with the fastest growing tourism industry. India has a large medical tourism  
sector which is expected to grow at an estimated rate of 30% annually to reach about 9,500 crore by 2015. The  
Ministry of Tourism designs national policies for the development and promotion of tourism. In the process, the  
Ministry consults and collaborates with other stakeholders in the sector including various Central Ministries/  
agencies, state governments, Union Territories and the representatives of the private sector.  
International Peer-Reviewed Journal  
This sector must be environmentally sound and followed the regulations of Carrying capacity. Carrying capacity  
is a central principle in environmental protection and sustainable tourism development. Carrying capacity  
includes several elements Physical, Ecological, Cultural, and Tourist social, Host social Carrying capacity.  
Carrying capacity denotes how much tourism is sufficient to yield positive returns and avoid its blights.  
References :  
Hembry, P (1991), The English Spa, 1560-1815 Athlone Press, London  
Horowitz, Michael D.; Rosensweig, Jeffrey A.; Jones, Christopher A. (2007). ”Medical Tourism: Globalization  
of the Healthcare Marketplace”. MedGenMed. 9: 33. Accessed on  
Hughes, C G (1991), ‘Conceiving of tourism” Area 23 (3) 236-267.  
Hughes EG, Dejean D (June 2010). ”Cross-border fertility services in North America: a survey of Canadian  
and American providers”. Fertility and Sterility. 94 (1): e16–9.  
Kannan, Shilpa (2009) “Regulators eye India’s surrogacy sector”.India Business Report, BBC World.  
Retrieved on 23 Mars, 2009  
Walton, J.K. (2000) The British Seaside: Holidays and Resorts in the Twentieth Century. Manchester:  
Wecbsberg, J. (1979), The Lost Worm of the Great Spas Weidenfeld and Nicolson. London.  
Tourism and History 19, © Goodfellow Publishers Ltd( G) University Press.  
Walton, J.K. (ed.) (2005a) Histories of Tourism: Representation, Identity and Conflict. Clevedon: Channel  
View Press. ;  
Assistant Professor, Department of History, S. N. D. T. Women’s University, Mumbai.  
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