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The Development, Nature, and Impact of Medical Tourism in Bangladesh

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Chapter 21
The Development, Nature,
and Impact of Medical
Tourism in Bangladesh
Azizul Hassan
Tourism Consultants Network, the Tourism Society, UK

Mojib Uddin Ahamed

University of Dhaka, Bangladesh

Muhammad Shoeb-Ur-Rahman
University of Dhaka, Bangladesh

ABSTRACT
Medical tourism is recent phenomenon. All such tourism is based on three main factors (tourists, service
providers and facilities, and the policy frameworks required to put these together), that contribute to its
development. Bangladesh has put these main factors in place for medical tourism, and now wishes to
make better use of available service providers and facilities. The country is believed to have the capacity
to become a major medical tourism destination, if its development is properly orchestrated. Bangladesh
produces a considerable number of medical tourists, however the country has in recent years witnessed
huge investment in public and private medical services, and health infrastructure development. This
chapter is an analytical study that aims to explore the existing patterns of medical tourism in Bangladesh,
while offering suggestions that would allow the country to gain a competitive edge.

INTRODUCTION

Tourism as a practice engages travelers with diverse activities and in many instances these evolve into
basic demands rather than mere leisurely inclinations. This becomes particularly evident when tourists
are sick and vulnerable but have lower access of treatment within their own country. Medical tourists
tend to modify their travel in order to receive medical treatments. ‘Medical Tourism’, also known as
‘Health Tourism’ or ‘Wellness Tourism’, is a newer type of niche market in tourism (Smith & Kelly,

DOI: 10.4018/978-1-4666-8574-1.ch021

Copyright © 2015, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited.

The Development, Nature, and Impact of Medical Tourism in Bangladesh

2006; Erfurt-Cooper & Cooper, 2009; Connell, 2013). All such new niche tourism is based on a chain
reaction of three main factors (the tourists, the service providers and facilities, and the policy frameworks
required to put these two together), who each contribute individually to this collective phenomenon in
their diversified roles. Bangladesh has the 2 of the 3 main factors, and wishes to attract tourists who
might seek to make use of the available service providers and facilities.
This chapter particularly focuses on the emerging role of Bangladesh in terms of both inbound and
outbound trends in medical tourism. The country is believed to have the capacity to turn into a major
destination of medical tourism interest if its development is properly orchestrated. At present, Bangladesh
produces a considerable number of medical tourists, who find their ultimate destination not only in the
neighboring countries of South Asia, but also across the entire world. However, the country has on the
one hand witnessed huge investment in medical services and health infrastructure development from
both the public and private sector in recent years. While on the other, alternative medical practices such
as Ayurveda (herbal remedies and massage) are a well-established in-country resource. The primary
purpose that this form of tourism normally serves is to obtain treatment in areas of medical, surgical,
cosmetic, dental, orthopedic or related. Medical tourism offers treatments during the time of tour, vaca-
tion or visit and is widely growing as a popular concept across the World. This type of tourism enables
tourists from one country to go to another to meet and access specific offers in areas of healthcare or
treatment. The basic fact is that, healthcare or medical facilities differ in countries across the world, and
there is a constant shift towards consumers demanding better treatment at lower cost. Characteristically,
the development of medical tourism in a specific destination relies on certain factors such as industry
focused information sharing, easier transportation, the existence of ancillary tourism facilities, and in
general higher quality of service offers.
Medical tourism is generally popular in both developed and developing countries and gradually tak-
ing shape as a valid branch of tourism (Brown, 2008; Gray & Poland, 2008; Waikar, Cappel, & Tate,
2011). This chapter specifically concentrates on Bangladesh as a destination for both outbound and
inbound medical tourists. Medical tourism is still a niche market in Bangladesh with immense potential
and obviously with limited capacities. However, this type of tourism is receiving attention in terms of
existing facilities, and possible areas of investment. The interrelations between medical and other forms
of tourism are thus becoming noticeable. The growth of this kind of tourism is necessarily intertwined
with the development of related areas with examples like sustainable tourism, urban tourism and many
more (Hassan & Forhad, 2013). It is obvious that the acceptability of medical tourism by travelers is
unquestionable where, seemingly, they are more willing to visit destinations across the world that can
offer medical or healthcare and tourism facilities in an appropriate similar manner than stay at home. The
objective of this conceptual discussion is to analyze the development of medical tourism in Bangladesh
with particular reference to its current nature and probable impacts. The study also makes some key
suggestions to help policy construction in the acceleration of the development of this sector.

MEDICAL TOURISM: CONCEPT AND PRACTICE

The simplistic definition of medical tourism is travelling for medical purposes (Ninian, 2008). As iden-
tified by Lee & Spisto (2006), medical tourism has four components: ‘Medical’ through treatment of
illness, ‘Enhancement’ through cosmetic surgery, ‘Wellness’ through spa or alternative therapies, and
‘Reproduction’ through IVF and associated therapies. Medical tourism typically covers areas of treat-

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The Development, Nature, and Impact of Medical Tourism in Bangladesh

ment ranging from bone marrow transplants, cosmetic surgery, hip and knee replacement, pediatric
heart surgery, open-heart surgery, and dentistry, to cancer therapy and IVF, with the latest electronic and
medical diagnostic procedures available (English, Mussell, Sheather, & Sommerville, 2006; George &
Nedelia, 2014). The general view is that only articulated or sophisticated medical or healthcare facilities
can promote such tourism activities even though these cannot be always granted in every single situa-
tion and at reasonable cost/time. To make sure of this, there should be specific frameworks regarding
the development and promotion of tourism facilities in destinations that are considered able to support
medical tourism activities.
Medical tourism has spread into areas that are also linked with general ancillary tourism facilities,
and these are regarded as essential for service offerings to both general (Table 1) and medical tourists
(Oxford Analytica, 2014). Experts and practitioners in medical tourism believe that medical tourism is
a product that is creating enormous enthusiasm among general tourists across the world for both tourism
and healthcare (Carrera, 2006). Zinkewicz (2008) argues that the onsite experiences that medical tourists
normally gain are as important as those of general tourists, and their past visit experiences. These all are
beneficial for further visits and recommending the destination to others. Of course, the backgrounds and
needs of tourists and their characters are as important as their capacities to spend to avail themselves of
better services or facilities. The basic needs of tourists normally vary from one to another geographical
destination, and these are also attached with their aspirations to demand better industry performance.
Positive outcome generation from medical tourism is related to similar considerations but is also viewed
as an inseparable part of wellness. These considerations mean that marketing activities in the medical
tourism context are linked with general tourism promotion and facilities offered. It is important to offer
general information simultaneously and to share details about available facilities and services to medical
tourists. Together, these can help them to decide and create imperative impressions for potential visits.
Thus, information sharing for marketing purposes can simply be identified as a way to promote medical
tourism to diverse consumer bases in many destinations.
The resources of a medical tourism destination also need to be well analyzed and documented. Tour-
ists need to know what facilities are being made available to them, and to what degree they will be able
to get access to these resources. This is crucial as in many cases, the scope of medical resources in a

Table 1. Regional Tourist Arrivals in South Asia

Destination International Tourist Arrivals (000s) International Tourism Receipts (US$Million)

2010 2011 2012 2013 2010 2011 2012 2013
Afghanistan - - - - 55 71 56 -
Bangladesh 303 - - - 81 87 108 -
Bhutan 41 66 105 - 35 418 63 63
India 5776 6309 6578 6848 14490 17707 17971 18397
Iran 2938 33654 3834 - 2438 2381 1114 -
Maldives 792 931 958 1125 1713 1868 1877 2031
Nepal 603 736 803 798 344 386 352 436
Pakistan 907 1161 966 - 305 373 339 288
Sri Lanka 654 856 1006 1275 576 830 1039 1715
Source: World Tourism Organization, 2014.

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The Development, Nature, and Impact of Medical Tourism in Bangladesh

particular destination is very limited and services may not be widely available. Sobo (2009) states that
the image of a medical tourism destination relies on some specific points, and these are the availability
of resources both of a natural and man-made type. The demand for common conveniences along with
leisure or recreation facilities for medical tourists is also basic where the socio-political and economic
situations are required to be kept congenial and harmonized. The general background and history of
medical tourism destinations is also important for the entire purpose of tourism promotion and marketing
activities. The normal requirements and their fulfilment are beneficial for improved service offerings
for medical tourists, and these also allow them to view and thus to experience the available services or
facilities in a destination, and to recommend them to potential visitors.

MEDICAL TOURISM IN BANGLADESH

Tourism for medical and healthcare reasons has always been frequent but mainly outbound with re-
spect to Bangladesh. Medical tourism in this region existed both before and after the independence of
Bangladesh. The country has numerous areas that are currently in use as medical tourism destinations.
There are also potential areas that might be turned into popular medical tourism destinations (Figure 1).
In comparison to neighboring countries, the level of international tourism in Bangladesh is less than
satisfactory. However, the ability to attract them is diverse. There are numerous destinations that are
left undeveloped, and the possible benefits of such destinations are worthy of consideration. All these
potential destinations, varying from small to medium or large can prospectively change the entire country
of Bangladesh into a global hub for medical tourism. Medical tourism destinations in Bangladesh are
scattered throughout the entire country but, the communication network between them sometimes appears
to be a basic obstacle. It is critical that there be improvement in the communication and transportation
network otherwise there will be a very nominal outcome from any endeavor aimed towards promoting
medical tourism in the country.
In Bangladesh, several destinations like Sylhet, Mymensingh, Dhaka, Chittagong Hill Tracts (Bandar-
ban, Rangamati, and Khagrachari), and many more are famous for medical activities (mainly for Ayurveda
or herbal treatments), while major cities like Dhaka and Chittagong are famous for surgical procedures.
Other medical tourism destinations in Bangladesh are not always well known, and their promotion is
also subject to intensive interest from the entire nation. This is why medical tourism in Bangladesh needs
proper and effective marketing activities in order to support and promote this initiative in that country.
Medical tourism in Bangladesh thus mainly concentrates on relatively more developed cities like
Dhaka and Chittagong. Dhaka as the capital city of Bangladesh is the hub for national administration.
On the other hand, Chittagong as the most commercially prominent port city of the country has its own
international sea and airport. Despite Chittagong having this access advantage, Dhaka is relatively more
advanced and well equipped for medical or healthcare facilities through the numerous contributions of
both public and private sector entrepreneurs. The city also enjoys the influx of tourists from all over the
world due to the availability of transportation facilities to the world and to rest of the country. These two
cities are well known and famous for surgical procedures, however they are less equipped with alterna-
tive medicinal or healthcare facilities, which are mostly regarded as archaic by nature and usage. Unani,
homeopathy, Ayurveda and all other alternative medical or healthcare facilities are available in rural
areas, and through the intense practices of devoted peoples.

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The Development, Nature, and Impact of Medical Tourism in Bangladesh

Figure 1. Structure of health care offered in Bangladesh

Source: Adopted from Ara (2008).

Medical tourism in Bangladesh, is in need of an effective and reliable set of marketing policy frame-
works, and the country needs to meet this demand that is crucial and deserves full attention (Islam &
Akhter, 2011; Hassan & Burns, 2014). The history of medical tourism in Bangladesh characteristically
resembles a weaker healthcare sector that has created a wider gap between peoples’ status and spending
capacities. The trend of travel to countries like India, Singapore, Malaysia, the United States of America,
the United Kingdom or Thailand became phenomenal during the decades of the 1980s and 90s, when
these countries witnessed a massive boom in medical tourism facilities (Lagace, 2014). However, the
reasons for such movements were more necessity than luxury, because Bangladesh seriously lacked
experts and instruments to serve the demands of patients.
On the basis of such trends, Ali and Medhekar (2012) have identified both push and pull factors for
the outbound medical and healthcare patterns of Bangladesh. According to them, the push factors are the
unavailability of experts and specialized treatment facilities, coupled with soaring costs in Bangladesh.
On the other side, the pull factors are the state of the art medical and healthcare technologies and prac-
tices, easier access to facilities, quicker transportation, better nursing quality, and relatively lower costs

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The Development, Nature, and Impact of Medical Tourism in Bangladesh

in comparison to American or European countries. A surge of private sector investments in the medical
and healthcare sector followed by the favorable policies of the government helped to bring some sort of
revolution in the country during the latter part of the twentieth century.

Medical Tourism in Bangladesh: A Shift

The involvement of private sector medical and healthcare service providers has actually started devel-
oping this sector in Bangladesh. On the other side, the government with support of international donor
agencies has also been playing a crucial role in building medical and healthcare infrastructure across the
country. Apart from specialized medical institutions and hospitals, a total of 39 private medical facilities,
including 8 dental and 15 government medical facilities and 1 dental college, are currently accessible and
in operation in Bangladesh (Figure 1), covering both public and private sector investments (Bangladesh
Medical and Dental Council, 2014). These are creating health professionals and the supporting medical
and healthcare services of the country.
It is very often claimed that public medical and healthcare sectors enjoy relatively less freedom
compared to that of the private sector, in terms of resource allocation and expertise. On the other side, it
is also believed that the private sector can bring dynamism to the entire medical and healthcare market
where more investment can ensure better capacity increases (Andaleeb, 2000). It is thus evident that keen
competition between the public and private sector would surely help to develop this sector to a certain
standard. However, a more congenial development of both the public and private sectors could help to
formulate and accelerate market strategies more conveniently and effectively.
The promotion of medical tourism in any specific country needs more attention from both the public
and private sector (McCallum & Jacoby, 2007). It is also important that responsible agencies are more
prepared to offer services and products for medical tourists. Medical tourism in a country like Bangladesh
thus deserves more attention from the responsible parties and authorities. The country has the capacity
to support distinctive forms of services, products or offers for medical tourists, and all of these tend to
be beneficial for the advancement of medical tourism as a comprehensive sector in the years to follow.
Bangladesh has considerable number of medical colleges, and recently experienced huge investment
both in the medical and healthcare sectors from domestic and international sources. This investment as
expected and intended will enrich the sources and capacities of healthcare and medical facilities that
should enrich the image of Bangladesh as a medical tourism destination.
While it is natural that general tourists will seek treatment if necessary while they are on vacation,
it is also normal that tourists will choose destinations those are more accessible, resourceful and offer
better value for money. Bangladesh as a tourist destination is already established in the travelling world
for its pristine natural beauties but, as medical tourism covers a completely different travel niche, be-
ing more intent on greater technology and skill support and a demand for well-recognized manmade
facilities and services (George & Henthome, 2009). This particular feature is in fact the basic differ-
ence between natural tourism and medical tourism in terms of specialties and skills sharing. However,
technological infrastructure and the development of medical related establishments are yet to be fully
secured in Bangladesh. There is a demand from patients from across the world for destinations to sup-
ply a comprehensive range of medical and healthcare facilities that establish a general understanding
of a medical tourism destination, as medical tourists are those who typically move from one country

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The Development, Nature, and Impact of Medical Tourism in Bangladesh

to another to seek required medical or healthcare facilities. Until recently, the movement of people was
mainly from underdeveloped countries like Bangladesh to developed countries with an ability to meet
the required demand for treatment (Figure 2).
In Bangladesh, medical tourism has yet to create a stable and solid position from which it can be per-
formed, or add the required diversity in order to meet the demands of numerous types of medical tourist
from across the world. One good point though, is that medical tourism is not necessarily restricted to
medical or surgical procedures; rather it is a unique combination of both medical and leisure activities.
Thus traditional Ayurveda or similar wellness offerings can make up for some at least of the shortfall
(Figure 3). While the main cities of the country where most of the medical facilities are situated in most
cases cannot produce and offer the best patterns of leisure activities, which is a critical failing, they can
be part of a wider network within the country for those tourists who demand leisure activities as well as
medical or surgical procedures. It is important therefore to initially restrict the capacities and potentials
of medical tourism destinations to those able to offer best value benefits in relation to their costs and
locations, while creating a network of supporting wellness attractions and facilities for their repeated
visits (Connell, 2006; McCallum & Jacoby, 2007; Erfurt-Cooper & Cooper, 2009; Hall, 2013).

Figure 2. Treatments attracting outbound medical tourism from Bangladesh

Source: Author.

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The Development, Nature, and Impact of Medical Tourism in Bangladesh

Figure 3. Treatments that could attract inbound medical tourism to Bangladesh

Source: Author.

Any form of under provision of facilities as against claims of being able to provide treatments can
lead to loss of interest by tourists, and thus mean a drawback to a destination’s intention to facilities for
this form of tourism (George & Henthome, 2009). Again, the popularity of an identified medical tour-
ism destination also relies on completeness, and any lack in one or more of the above critical factors can
also jeopardize the reputation of that destination. Thus, the image and reputation of a medical tourism
destination is not limited only to tourism settings, but expands to represent the entire country itself.
Medical tourism destinations help to create a positive image in the global arena of the specific country
or destination. In Bangladesh, while this particular need is not necessarily addressed in an organized or
coherent format, there are plenty of medical tourism destinations equipped with the capacity and potential
to represent the entire country or nation before global audiences. And the capacity and potential to do
this has increased over the years with the inclusion of well-developed private facilities.

Medical Tourism in Bangladesh: The Features

It is evident that the nature of medical tourism is global and cannot be viewed as local or narrow (Smith
& Puczko, 2013). Medical tourism offers lucrative opportunities for investors and entrepreneurs. It
is thus necessary to acknowledge that medical tourism is gaining acceptance across the world and in
different market settings. However, this also means that what was domestic in terms of healthcare or
medical facilities at the start of this phenomenon cannot now be generalized as domestic; rather, these
facilities early start to embrace international patterns or shapes. Bangladesh is an unlikely popular name
in the global medical tourism market. In comparison, neighboring countries like India or Thailand have
advanced greatly in areas of medical tourism, and have managed to attract a considerable number of
tourists from almost all over the world.

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The Development, Nature, and Impact of Medical Tourism in Bangladesh

However, there is now constant demand for the offering of existing medical and healthcare facilities in
Bangladesh to tourists because the country wishes to grow its international tourist arrivals. Nevertheless,
it cannot be claimed that this country has already established itself as a medical tourism destination; the
position and familiarity of Bangladesh is the point under consideration. Having said this, it is natural
that investors or entrepreneurs will be attracted to those sectors which are relatively more rewarding and
profit generating. Bangladesh possesses the capacity to become established mainly in areas of alternative
medicinal or healthcare facilities as noted earlier but, the limitations are immense given the unavail-
ability of support for the entire medical tourism sector. Dhaka and Chittagong are well facilitated with
entertainment amenities aimed towards promoting the culture and tourism in the country before global
audiences or tourists. Their medical facilities are also concentrated, and modern transportation has made
access to these from abroad more convenient and easier. In the area of ancillary tourism facilities, both
of these cities are well designed and have world class accommodation facilities regarded as beneficial
for the promotion of tourism (Rahim, 2014). Their catering facilities are also noteworthy, and in many
cases normally tend to create specific sub-interests among tourists. The rural areas are less developed
but nurture the authenticity of alternative medical facilities. These areas are the breeding grounds for
almost all of the alternative medicinal or healthcare facilities like herbal or Ayurveda (Bushell & Shel-
don, 2009). One particular issue that needs to be well addressed is the pattern of quality control of and
access to such facilities by international tourists. In addition, rural transportation and communication
networks deserve more updates and development.

Medical Tourism in Bangladesh: Impact Analysis

Bangladesh is yet to reach an international standard in medical tourism however. The provision of both
general and specialized form or medical and healthcare facilities involve unexpected issues concerned
with ethical practices that are also acute in many other developing countries (Borman, 2004; Bezruchka,
2000; Bishop & Litch, 2000; Hall, 2013). In Bangladesh, it has already been established that the medical
and healthcare services are more or less subject to corruption, bureaucratic complexities and serious
lack of service offers. Both politicization and commercialization in turn are seen to having negative
effects on the provision of medical and healthcare services where, the ‘Dalals’ (middlemen) become
a common facade for exploitation (Ali, 2012). The availability of facilities and the offer of services or
products are crucial in allowing outsiders to view the country’s potential as investors or entrepreneurs.
Tourists like to enjoy holidays and obtain medical services at the same time and in the same manner.
Also, transparent pricing and transparent services become important where tourists are seeking the
maximum return with reasonable pricing and cost-effectiveness. The middleman systems obscures and
distorts these relationships.
Medical tourism is a fast growing niche market. The increasing number of aged people in origin
markets creates demands to expand medical tourism market very sharply (Connell, 2013). It is important
that medical tourism is able to meet the requirements of consumers with quality service offerings. In a
country like Bangladesh, medical tourism represents an opportunity for both outbound and inbound tour-
ism. The basic reason for out bound medical tourism results from the critical circumstances of patients
that the country’s existing medical and healthcare systems cannot support. Infertility is another reason,
because it is enmeshed in socio-religious perspectives that are responsible for triggering medical tourism

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The Development, Nature, and Impact of Medical Tourism in Bangladesh

to destinations not so affected. This is helping the country to become a medical tourist generating area in
global terms. However this form of tourism normally restricted to middle to high income sectors of the
population. Destinations for outbound tourism are mainly India and Thailand, together with European
countries and North American.
Medical tourists who visit Bangladesh have more or less suffered from rising costs for medical and
healthcare services, along with longer waiting times in their countries of origin. The globalization of
medical and tourism technology has allowed local medical and healthcare practitioners to become more
able to offer better and advanced services within Bangladesh. Bangladesh is thus both generating and
attracting a considerable number of tourists who can be identified as medical tourists from their motives
and aims for visitation. While no reliable figures exist as yet, these medical tourists will help to make
tourism and related industries in the country more active and better positioned.
It is also important to restate that the country is not yet well advanced in terms of offering interna-
tional standards of services and facilities for tourists in all areas of medical tourism. However, it is able
to bring dynamism and acceleration to medical tourism as a niche market. The country also needs to
adopt marketing activities to highlight, promote and thus to make existing facilities widely available to
global medical tourists. Unfortunately, it is unclear which marketing strategies the country is adopting
to promote medical tourism (Rahman & Hashem, 2000). The demand for a well-executed outline of
medical tourism promotion in the country should support all related marketing activities before global
audiences. Bangladesh should adopt those strategies and policies for marketing that can generate com-
petitive benefits with their proven abilities to create positive impacts in the general tourism market
place. Marketing activities should be realistic and rewarding, in terms of their application and affectiv-
ity. These should also be able to generate considerable impact on the entire process of marketing, and
help to make the country popular in the global tourism market overall, and the medical tourism niche
market. Bangladesh needs to emphasize branding that identifies the country and its popular medical
tourism sites to global tourist markets.

Medical Tourism in Bangladesh: The Potentials Ahead

As a developing nation with an emerging economy, the development of medical tourism in Bangladesh
could be important, in terms of capacities and offerings (Bookman & Bookman, 2007). As a developing
country, the unavailability of current data and information on tourism or related areas is conventional.
However, as part of an intensive search, unpublished demographic data provided to the author by the
Special Branch of the Bangladesh Bank revealed that the country has witnessed a surge of international
tourists, with an average growth of 15% during the period of 2006-2010. Total arrivals were 303,386
in 2010. With a 5.04% earnings growth rate during the same period, in 2010 net earnings from tourism
reached 5562.94 million BDTK.
According to projections made by the World Travel and Tourism Council (WTTC, 2014), in 2013
the direct contribution of travel and tourism to Bangladesh GDP was BDTK 222.6bn (2.1% of GDP),
forecast to rise by 7.9% to BDTK 239.8bn in 2014, and to rise by 6.1% to BDTK434.7bn by 2024. The
total contribution of travel and tourism to GDP in 2013 was BDTK 460.3 billion (4.4% of total GDP),
and is forecast to rise by 7.9% in 2014, and to rise by 6.5% per annum by 2024, to BDTK 935.5 billion.
As a new contributor to this growth, medical tourism in Bangladesh deserves attention from all of the
parties involved, followed by their guidance and follow up suggestions. There are considerable number
of patterns of development within which medical tourism in Bangladesh would flourish and become

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The Development, Nature, and Impact of Medical Tourism in Bangladesh

more capable as a contributing sector in the national economy (Hossen, 2001). There should also be
a set of proper guidelines and suggested outlines within which medical tourism can move forward. In
this regard, surgical facilities in the country have recently witnessed massive expansion, in terms of
capacities and standards. In many cases where, private sector investors are involved, medical tourism
facilities have enabled to reach a certain standard and level of capacities. Thus, medical tourism facilities
in Bangladesh can be subsequent and substantial, in terms of their offers and capacities. To make this
happen, it is necessary to relate this tourism niche to the mainstream tourism sector. There also have to
be extensive publicity and promotion thus to retain the interest of international medical tourists.
The availability of medical facilities in countries across the world is clearly dissimilar (UNWTO,
2014). In a country like Bangladesh, the existing gap between government and the private sector bodies is
narrowing as the contributions from them are becoming more thoughtful. The best resources and facilities
are almost at an international standard. However, these are still to reach within the general population,
and are largely restricted within the upper middle or higher level of the society. Alternative medical and
medicine facilities are becoming popular among general populations as the costs are relatively much
lower than the traditional or mainstream facilities. In alternative medical systems, patients do not neces-
sarily have to go to hospitals or highly expert medical practitioners. Rather, they go to local alternative
medical practitioners who charge a very low rate or in many cases, almost nothing in comparison to
mainstream medical practitioners. Alternative medical or healthcare facilities are also attracting medical
tourists from many parts of the world, but mainly from developed countries.
The world is getting smaller over the time through the invention and interaction of technological
advancement. It is very common in recent times that people are moving from one country to another
for medical purposes. However, the patterns and features have changed gradually over time with the
increased intervention of technologies. Patients used to rely on their personally limited capacities to avail
themselves of the efficient and useful medical facilities within reach, and while this trend in fact has
pushed medical tourism to a certain level, its further enrichment is contingent on a wider penetration of
the market. The facilities and features of medical tourism vary from culture to culture and from coun-
tries to countries. This happens mainly due to differences in cultures, beliefs or geographical settings.
In recent times, medical tourism is more attached to global tourism business than the general well-being
of the patients. Thus it has turned out to be a vital niche in the entire tourism industry. The trends and
patterns of medical tourism are presently adopting diversities and extended features where, in the past,
such tourists normally looked for cheaper medical services. This is one feature that Bangladesh can
take advantage of, and the other active feature is the need to look for leisure activities. Both of these
features have further expanded the medical tourism industry to a more accessible state for countries like
Bangladesh, in terms of generating economic outcomes.
Many countries in the world are becoming popular as medical tourism destinations. Other than North
and South American destinations, countries in Asia are also becoming attractions within medical tour-
ism, and are getting enormous responses from international medical tourists even where the facilities
still require huge improvement (Whittaker, 2008). Medical tourism is believed to offer a massive boom
to tourism industry through the generation of more interest in the vast mass of general tourists. This is
often termed ‘health or wellness tourism’ and as such has appeal to tourists. The nature of medical tour-
ism can be of numerous types. However, in the specific context of the Indian subcontinent, the features
are Yoga, massage of different types, Ayurveda and so on. However, more complex types of medical or
surgical procedures are also becoming popular in this region, mainly for better quality and lower costs.

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The Development, Nature, and Impact of Medical Tourism in Bangladesh

In Bangladesh, medical tourism has been developing as a niche over several decades mainly in the
areas of non-surgery and non-mainstream treatment procedures. Conversely, for centuries the country has
been well known in the areas of Ayurveda and herbal medicines. Bangladesh has a traditional reputation
in areas of medical tourism that covers herbal, Unani or Ayurveda medicines. In recent years, the country
has advanced in specialized treatment and healthcare facilities for medical treatment, but it has yet to
manage the expected position upon which it can be viewed as an independent economic sector because
there is serious lack of strategically viable policies (Nath, 2010). Still, the contribution of this sector is
not as yet enormous, and the opportunities that it is creating look exciting. However, the tourism world
is still mostly unaware about the services, benefits and offering of medical tourism in Bangladesh. Once,
medical tourism was considered as a myth in the Bangladesh context but those days have passed and
the country is becoming well known for its capacity and establishments able to offer medical tourism
products or services. The country can also boast world class human resources in the areas of surgical and
healthcare facilities. Bangladesh also holds the academic settings for alternative medicinal or healthcare
procedures like herbal, homeopathy, Unani or Ayurveda (Mahmud, 2004).

CONCLUSION

In comparison to neighboring nations, the country still stays far behind but is gradually emerging as a
medical tourism destination. However, Bangladesh relies more at present on non-surgical procedures
and alternative healthcare than medical facilities as offerings to medical tourists. Due to the nature of
these complexities, medical tourists are less likely to select this country as their ultimate destination,
but what facilities there are in many cases are world class. Bangladesh, mainly due to the benefits of
geographical location and non-resident Bangladeshis is becoming known as a key destination for medical
tourism in South Asia. In addition, many expatriates, when visiting friends or relatives, frequently utilize
medical tourism facilities. These visitors normally do not only rely on herbal or alternative medicinal
or healthcare facilities, but rather are more interested in both surgical and non-surgical procedures. This
helps to brand and promote medical tourism in Bangladesh to global audiences, and these people can
recommend Bangladesh to other peoples who later on may turn into potential tourists to Bangladesh.
In the meantime, the country has yet to experience an abundance of medical tourists from all over the
world. It is a matter of hope that the number is increasing gradually day by day. Visibly, the enthusiasm
is great and the attention of medical tourists from almost every part of the world is also encouraging.
There are some basic benefits which Bangladesh can offer to medical tourists and these appear in
areas of relatively cheap costs for medical, surgical or healthcare procedures. On the other side, there
are also relatively very low or no waiting times to see a physician, or to avail themselves of the desired
medical or healthcare facilities. The private sector has flourished over the years, and within this the
healthcare sector has witnessed a kind of revolution through the enormous investment and expert en-
gagement of these entrepreneurs (Mahmud, 2008). Bangladesh was listed as an international medical
tourism service provider destination in 2006, along with a few other countries in the world identified as
having the capacity to offer products or services in certain areas of medical tourism. These are mainly
consumed by international tourists, but domestic tourists who can afford them are also catered for. The
infrastructure building and capacity enhancement in medical tourism that is occurring is shared by both
the governmental and non-governmental sectors (TRAM, 2006).

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With a clear focus on access and the availability of medical facilities in Bangladesh, the objective of
this chapter were to explore the key issues related to medical tourism in this country. Also, understanding
the current trends of this sector can help to lay down some suggestions for potential marketing purposes.
Medical tourism in Bangladesh needs to be given reasonable importance in national and local policy,
and this is important in the creation of a strong position in the global tourism market. It is also crucial
that medical tourism in Bangladesh develops the ability to learn from examples in the global tourism
industry. As part of the international tourism industry, medical tourism in Bangladesh is in need of a set
of marketing strategies and policy frameworks for promotion and for this purpose, the setting and appli-
cation of effective marketing policies and strategies are very important (Goodrich, 1994). The country,
at present does not visibly and evidently have a set of medical tourism promotion policies which can be
identified as beneficial for developing this tourism niche.
Traditionally, Bangladesh is famous for the abundance of natural resources such as trees, herbs, shrubs
and so on. These resources are becoming elements in medical tourism. The ways are manifold but are a
well-known as a subject of tourism development (Smith & Kelly, 2006; Erfurt-Cooper & Cooper, 2009;
Bushell & Sheldon, 2009). Medical tourism in Bangladesh thus relies on both natural and non-natural
elements, and is capable of attracting the interest of both tourists and scientists, in this pattern. Within
the country, there are many places and destinations that can be viewed as important and popular for
medical tourism activities. There are thus capacities and interests in medical tourism in Bangladesh, and
the country needs to nurture these interests, promote them in almost all cases, and make sure that the
tourism niche is well attended and has a proper position in national development policies.
A demand for effective and more appropriate strategic policies is made on the basis of expected
government policy support. A harmonized and more proportionate interrelationship between the pri-
vate and public sector that is promoted by such policy can help to facilitate the process of advancement
towards the establishment of medical and healthcare as an economically viable and rewarding sector in
Bangladesh. Medical tourism in Bangladesh still needs to develop a strong position, and thus represent
the entire nation and the country itself. There are potentials and prospects to add further benefits to those
medical tourism establishments that support the demands of medical tourists.

REFERENCES

Ali, M. M. (2012). Outbound medical tourism: The case of Bangladesh. World Review of Business
Research, 2(4), 50–70.
Ali, M. M., & Medhekar, A. (2012). A cross-border trade in healthcare services: Bangladesh to India.
Presidency University Journal, 1(1).
Andaleeb, S. S. (2000). Public and private hospitals in Bangladesh: Service quality and predictors of
hospital choice. Health Policy and Planning, 15(1), 95–102. doi:10.1093/heapol/15.1.95 PMID:10731240
Ara, F. (2008 December 15-16). Key issues to health governance in Bangladesh. Paper presented to the
International Conference on Challenges of Governance in South Asia. Kathmandu.
Bangladesh Medical & Dental Council. (2014). List of Recognized Medical and Dental Colleges. Re-
trieved from http://bit.ly/1u3hHgb

306

The Development, Nature, and Impact of Medical Tourism in Bangladesh

Bezruchka, S. (2000). Medical tourism as medical harm in the third world: Why, for whom? Wilder-
ness & Environmental Medicine, 11(2), 77–78. doi:10.1580/1080-6032(2000)011[0077:MTAMHT]2.
3.CO;2 PMID:10921355
Bishop, R., & Litch, J. (2000). Medical tourism can do harm (personal view). British Medical Journal,
320(7240), 1017. doi:10.1136/bmj.320.7240.1017 PMID:10753174
Bookman, M., & Bookman, K. (2007). Medical Tourism in Developing Countries. New York: Palgrave
Macmillan. doi:10.1057/9780230605657
Borman, E. (2004). Health tourism: Where healthcare, ethics, and the state collide. British Medical
Journal, 328(7431), 60–61. doi:10.1136/bmj.328.7431.60 PMID:14715577
Brown, S. (2008). Medical tourism: Nations vie for health dollars. Hospitals & Health Networks, 82(12),
49. PMID:19209504
Bushell, R., & Sheldon, P. (Eds.). (2009). Wellness and Tourism: Mind, Body, Spirit, Place. New York:
Cognizant Communication Books.
Carrera, P. M., & Bridges, J. F. P. (2006). Globalisation and healthcare: understanding health and medical
tourism. Expert review of Pharmacoeconomics and Outcomes Research, 6(4), 447-454.
Connell, J. (2006). Medical tourism: Sea, sun, sun and ...surgery. Tourism Management, 27(6), 1093–1100.
doi:10.1016/j.tourman.2005.11.005
Connell, J. (2013). Contemporary Medical Tourism: Conceptualization, Culture and Commodification.
Tourism Management, 34, 1–13. doi:10.1016/j.tourman.2012.05.009
English, V., Mussell, R., Sheather, J., & Sommerville, A. (2006). Medical Tourism. Journal of Medical
Ethics, 32(4), 248–248.
Erfurt-Cooper, P., & Cooper, M. (2009). Health and Wellness Tourism: Spas and Hot Springs. Bristol,
UK: Channel View Publications.
George, B., & Henthome, T. (2009). The incorporation of telemedicine with medical tourism. Journal
of Hospitality Marketing & Management, 18(5), 512-5-22.
George, B., & Nedelea, A. (2014). Medical tourism: the next big thing to come. Retrieved from http://
bit.ly/1nQKD9m
Goodrich, J. (1994). Health Tourism: A new positioning strategy for tourist destinations. Journal of
International Consumer Marketing, 6(3), 227–238. doi:10.1300/J046v06n03_12
Gray, H., & Poland, S. (2008). Medical tourism: Crossing borders to access health care. Kennedy Institute
of Ethics Journal, 18(2), 193–201. doi:10.1353/ken.0.0006 PMID:18610785
Hall, C. M. (2013). Medical and Health Tourism: the development and implications of health mobility.
In C. M. Hall (Ed.), Medical Tourism: the ethics, regulation, and marketing of health mobility (p. 3).
Oxford: Routledge.

307
 
The Development, Nature, and Impact of Medical Tourism in Bangladesh

Hassan, A., & Burns, P. (2014). Tourism Policies of Bangladesh – a contextual analysis. Tourism Plan-
ning & Development, 1–4. doi:10.1080/21568316.2013.874366
Hassan, A., & Forhad, A. (2013). The Role of NGOs in the Sustainable Development of Bangladesh.
Present Environment & Sustainable Development, 7(2), 59–72.
Hossen, M. A. (2001). Beliefs and practices relating to health care in developing countries [The Dhaka
university Studies]. Social Science Review, 22(1), 247–256.
Islam, A., & Akhter, S. (2011). Introducing user charges in government health facilities in Bangladesh:
Policy and implementation. [The Dhaka University Studies]. Social Science Review, 28(1), 43–56.
Lagace, M. (2014). The Rise of Medical Tourism. Retrieved from http://bit.ly/1m1K8VI
Lee, C., & Spisto, M. (2008). Medical tourism, an emerging international business. Going for Gold ~
Best Practices in Ed. &. Public Paper, 7(7), 1–7.
Mahmud, S. (2004). Citizen participation in the health sector in rural Bangladesh: Perceptions and real-
ity. IDS Bulletin, 35(2), 11–18. doi:10.1111/j.1759-5436.2004.tb00116.x
Mahmud, S. (2008). Health care provision and consumption in Bangladesh. In R. Sobhan. (Ed.). Emerging
issues in Bangladesh economy-a review of Bangladesh’s development 2005-06 (pp. 323-359). Dhaka:
Center for Policy Dialogue and The University press Limited.
McCallum, B. T., & Jacoby, P. F. (2007). Medical outsourcing: Reducing clients’ health care risks.
Journal of Financial Planning, 20(10), 60.
Nath, D. K. (2010). Urban health strategy: Needs and priorities. Bangladesh Journal of Political Economy,
26(1), 147–162.
Ninian, A. (2008). Medical Tourism. Contemporary Review (London, England), 290, 486–492.
Oxford Analytica. (2014). Medical tourism industry grows rapidly. Retrieved from http://onforb.es/19l9POP
Rahim, S. (2014). Q&A: preparing for a surgery abroad. Retrieved from http://n.pr/1hnphAh
Rahman, R. M., & Hashem, F. (2000). The state of health determinants in Bangladesh. The International
Journal of Sociology and Social Policy, 20(8), 33–54. doi:10.1108/01443330010789034
Smith, M., & Kelly, C. (2006). Wellness tourism. Tourism Recreation Research, 31(1), 1–4. doi:10.10
80/02508281.2006.11081241
Smith, M., & Puczko, L. (2014). Health, Tourism and Hospitality: Spas, Wellness and Medical Travel.
Oxford: Routledge.
Sobo, E. (2009). Medical travel: What it means, why it matters. Medical Anthropology, 28(4), 326–335.
doi:10.1080/01459740903303894 PMID:20182968
Tourism Research and Marketing (TRAM). (2006). Medical tourism: a global analysis: a report by
Tourism Research and Marketing. Arnhem: ATLAS.

308
 
The Development, Nature, and Impact of Medical Tourism in Bangladesh

UNWTO Tourism Highlights 2014 Edition. (2014). UN World Tourism Organization (UNWTO). Re-
trieved from http://bit.ly/1mxuIYQ
Waikar, A. M., Cappel, S. D., & Tate, U. S. (2011). Challenges and opportunities for developing countries
from medical tourism. Journal of Business and Economics, 2(5), 325–331.
Whittaker, A. (2008). Pleasure and pain: Medical travel in Asia. Global Public Health: An International
Journal for Research, Policy and Practice, 3(3), 271–290. doi:10.1080/17441690701463936
World Travel and Tourism Council (WTTC). (2014). Travel & tourism economic impact 2014 – Ban-
gladesh. Retrieved from http://bit.ly/1kw97E9
Zinkewicz, P. (2008). Medical tourism on the rise. Rough Notes, 151(8), 88.

KEY TERMS AND DEFINITIONS

Ayurveda: A system of Hindu traditional medicine of Vedic tradition including medicinal prepara-
tions and surgical procedures based in the 5 traditional elements (earth, fire, water, air and ether), three
elemental Doshas, and 7 basic tissues. Balance in the 3 Doshas equals health and imbalance equals ill-
ness. Plant based medicines are used.
Niche Markets: Is a subset of a market on which a specific product is focused. The market niche
defines the product features aimed at satisfying specific market needs as well as the price range, produc-
tion quality, and the demographics that is intended to impact.
Policy Frameworks: A policy framework is a logical structure that is established to organize policy
documentation into relevant groupings and categories that make it easier for employees to carry out
tasks. A set of principles and long term goals that form the basis of making rules and guidelines, and to
give overall direction to planning.
Private Sector: There is a growing trend to incorporate private sector expertise into infrastructure
projects that have traditionally been carried out as public projects. This is occurring in the hospital sector
in many countries in response to the demands of medical tourism.
Service Provider: Is a company that provides organizations with consulting, legal, real estate, educa-
tion, communications, strategies, processing, and many other services.

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