Understanding Iran’s medical travel sector

Iran is often in the headlines, but rarely for medical travel. Ian Youngman reviews a recently published academic study by Iranian and Romanian universities that offers new ways to compare medical tourism destinations, understand what medical tourists actually want, and where countries can improve.

Despite tough economic sanctions and being unable to use most debit and credit cards, Iran still manages to attract large numbers of medical tourists. Should Iran’s relations with Europe and the USA be normalised, there is significant potential to increase its medical travel sector.

Political context

The political context is important for medical tourism in Iran. There are many reasons why Iran triggers hostile reactions from US politicians. It is a potential rival to US-backed countries in the Middle East, it is a global leader in science and medicine, and claims a healthcare system that puts the USA to shame.

Politically Iran is supported by countries that have provoked the anger of the USA in recent years, including China, Russia and Turkey. The UN and EU have also pushed back at the USA on demands for sanctions. However, there are signs that President Biden will take a more sensible view on Iran.

Iran has already withstood sanctions for three years without caving into the demands of the Trump administration. It has given Biden a short time frame to agree a new nuclear and political deal.

Healthcare in Iran

Medical facilities are very good in the major cities in Iran but poor in remote areas. Iran offers a wide range of state-of-the-art treatment at reasonable prices, through an extensive network of modern hospitals, comprising approximately 850 hospitals, and rehabilitation centres. Iranian researchers have made many medical advances and Iran is one of the most progressive countries in the region. There is no need for foreign doctors, as Iranian doctors are reported to be among the best qualified in the world.

An extensive network of public clinics offers basic care at low cost, and general and specialty hospitals operated by the Ministry of Health provide higher levels of care. In most large cities, wealthier citizens use private clinics and hospitals that charge higher fees.

Iran national brand for tourism

Once the pandemic is under control globally and billions of people vaccinated, Iran expects to see a tourism boom.

The United Nations World Tourism Organisation (UNWTO) has registered “Majestic Iran: A Different Experience” as the national brand for the Islamic Republic of Iran. The slogan aims to promote the message of diversity and richness in recreational, cultural, and medical tourism.

Under the 2025 Tourism Vision Plan, Iran aims to increase the number of tourist arrivals from 4.8 million in 2014 to 20 million in 2025. The latest available data show eight million tourists visited the Islamic Republic during the first ten months of the past Iranian calendar year (ended March 2020). According to the tourism ministry, two million Iraqi nationals visited Iran during the first seven months of the Iranian calendar year 1397, 1397 (March 2018 – March 2019) turning the country into Iran’s largest source of tourists.

Iran’s medical travel sector

Even in the current situation where travel is heavily restricted by the pandemic, a significant number of Iraqis are still travelling to Iran for medical treatment. Most seek cosmetic surgery such as rhinoplasty and hair transplants.

Iranian hospitals admitted 70,000 foreign patients over the Iranian calendar year 1397 (March 2018 – March 2019) and it made an economic contribution of around US$1.2 billion to the country, according to the medical tourism department at the Ministry of Health.

New academic study of medical tourism in Iran

A recent detailed academic study by Iranian and Romanian universities looked at the problems faced in Iran’s medical tourism sector; and analysed how many Iranians go abroad, where they go and why.

The study also looked at complex scientific models to compare medical tourism destinations.

Iranian inbound medical tourism

Although medical tourism in Iran has long been the focus of tourists and foreign patients entering the country, the study finds it is facing challenges including:

• Lack of a clear strategy and agency for medical tourism at the international, national, and regional levels. Despite the introduction of tourism in the laws of the Islamic Republic of Iran as one of the pillars of economic development, the share and position of this sector in the economy is not fully understood and lacks a clear long-term strategy in dealing with domestic and foreign tourism applicants. Medical tourism in Iran has more than 60 institutions and stakeholders, all of which, based on their organisational duties and powers in the field of tourism and health tourism, claim to participate in management and do not have a proper response.
• Lack of a comprehensive medical tourism system, definition and formulation of laws, policies and programmes.
• Lack of infrastructure, including communication infrastructure, training infrastructure for medical tourism professionals, infrastructure of medical facilities and equipment, infrastructure for welfare and accommodation services of health tourists and their companions, legal infrastructure.
• Lack of a codified and strong monitoring system; different quality of public and private centres, especially in the field of service quality; and weaknesses and short-comings in the accreditation system.
• Weakness in process management and design of standard service packages that can be provided to medical tourists, such as: uncertain price of services, especially in the private sector; lack of a programme and system for alternative, traditional and herbal medicine; and lack of medical tourism insurance, and non-acceptance of medical tourism insurance cover.
• Lack of necessary private sector support from the government; lack of definition and explanation of the position of the private sector and the use of its potential; the tendency to governmentalise the issue despite previous unsuccessful experiences; and the weak role of private hospitals and trade unions.
• Lack of integrated information management systems; lack and delay in establishing a system of registration, control, and statistics of medical tourists; and lack of infrastructure and basic information of hospitals.
• Lack of a clear marketing system, the presence of brokers and intermediaries along with providing inappropriate services at different prices, lack of marketing institutions, lack of foreign marketing research, lack of overseas advertising system, insufficient knowledge of target markets, and poor marketing efforts.

Outbound Iranian medical tourism

The study finds that despite the various facilities inside the country, Iranians in some cases prefer to travel to different countries to for the following health and medical reasons:

• Medical Tourism: This type of trip is done to treat the disease, perform surgery, or check the health of the tourist in the clinics and hospitals of the destination country. The existence of experienced physicians, medical history, medical and supervisory infrastructures, standard hospitals and clinics, complete and up-to-date medical equipment, as well as laws and medical supervision are among the important medical infrastructures of the destination country.
• Curative Tourism: Travel to countries with natural healing resources such as hot springs, salt lakes, mud baths, a clean environment, and bright sunshine. On this type of trip, patients with skin, respiratory, rheumatology, and muscle ailments travel to these areas for medical massage, herbal baths, as well as to recover from treatment and surgery.
• Wellness Tourism: In wellness tourism, the tourist travels to get rid of the stresses of daily life and seek peace. Usually, these tourists do not have a specific physical illness and are more interested in enjoying the healing nature and avoiding stresses of urban life. Wellness tourists travel for a variety of services, including fitness and exercise, beauty treatments, healthy eating and weight management, relaxation and stress reduction, meditation, yoga, and health-related training.

Why Iranians go abroad and where

The study states there are many reasons why Iranians go abroad for medical treatment, the most important of which are:

• Disappointment with treatment in their home country.
• Lack of access to medical care at an appropriate time and cost.
• Insufficient insurance and income to cover the costs of local health services.
• High quality medical care in developing countries.
• Variety of treatment options.
• Desire to receive medical care away from a monotonous and permanent place (escapism).
• Lack of waiting list.
• Growing popularity for overseas medical services.
• Access to the latest technologies.
• Existence of oppressive sanctions that limit access to all kinds of drugs.

The options for most Iranians are Brazil, Costa Rica, India, Mexico, Panama, Singapore, Taiwan and Malaysia.

Numbers

In 2019, 13,232 trips were made from Iran for medical and health tourism, breaking down into:

• India – 4,398
• Malaysia – 3,425
• Panama – 2,178
• Mexico – 1,011
• Singapore – 938
• Taiwan – 755
• Brazil – 417
• Costa Rica – 110

Conclusion

The study is a fascinating look at how countries can assess what is good and bad about their offerings, and how it can be improved.

Looking at why people choose a destination, what they need and how the hype compares to reality is an area that more medical tourism destinations should look at. Nowhere is ‘low price’ even considered as a factor for inbound or outbound medical tourism.

Iran welcomes medical tourists from places like Iraq and Afghanistan, countries which have many reasons to be wary of USA, UK, European and many nearby Middle East destinations.

Although some figures promoted by Iranian politicians in the media may exaggerate, the inbound numbers achieved by Iran in what is an economic lockdown are impressive. If the sanctions are removed and Iran is able again to accept global debit and credit cards and online money transfer, the potential is massive.