South African medical tourism is about… Africa

A new research project reports that while South Africa is often portrayed as a cosmetic surgery destination for Europeans, the reality is that by numbers and value, 85% to 90% of medical tourism to South Africa is from the same continent, and is not related to cosmetic surgery.

The research does not use its own statistics but relies exclusively on official figures from a survey of samples of outgoing travellers at airports. These figures on purpose of visit are then statistically calculated using total tourism figures. This means that they are not ‘real‘ figures on medical tourists but a projection based on a relatively small sample. To be fair to the source and the research, the conclusions on who goes to South Africa, why and from where are robust, but their numbers on those from European countries are highly dubious when compared to other figures.

‘ Patients Without Borders – medical tourism and medical migration in Southern Africa’ is policy paper 57 from the Southern African Migration Programme; by Jonathan Crush, Abel Chikanda and Belinda Maswikwa.

It takes the premise that South Africa is most often marketed by medical tourism agencies as a cosmetic surgery destination for Europeans, and shows that much travel for surgery takes place without agency intervention from local African countries; so the European cosmetic surgery business is just one small segment.

The reality of medical tourism in South Africa by numbers and income is that it is dominated by medical travel from African countries – mostly middle-income Africans seeking specialist diagnosis and treatment. Total numbers grew from 327,000 in 2006 to 500,000 in 2009, but fell to 370,000 in 2010 and is now estimated at between 300,000 and 350,000 a year.

According to the research, the main sources are neighbouring Lesotho (140,000), Swaziland (47,000), Mozambique (38,000), Botswana (55,000) and Zimbabwe (17,000); where public and private health provision is in crisis; so people are traveling for availability of and quality of treatment, not for price reasons. African countries account for at least 90% of the total spend of rand 1.5 billion. While much of this is privately arranged, the South African government does have formal deals with 18 African countries where many pay for treatment for their citizens. South Africa even helps out with special funding mechanisms, but these are plagued by corruption on both sides of the border.

The average length of stay for Europeans is 8 nights as some do stay on as tourists. But the tourism element does not figure in medical travel from African countries; the average stay is 4 days, but only a day for Botswana and Lesotho. Most go to private hospitals and clinics, or for private treatment at public hospitals.

Cosmetic surgery is targeted at American, Dutch, British and German medical tourists.
The European and American tourism departure survey figures from Statistics South Africa and South Africa Tourism are highly suspect. According to the data, the annual average for medical tourists from 2003 to 2008 was 20,000 from the UK, 6,500 from the USA, 3,500 from the Netherlands, and 8,000 from Germany, with much smaller numbers from Australia, Canada, France, Italy and Sweden. Comparing the 20,000 figure for the UK with official outbound figures from the same period, shows that either these figures are hugely exaggerated or include holidaymakers, business travellers, expats, and people visiting family. For example, in the period 2003 to 2008, the total number of outbound UK medical travellers was between 40,000 and 70,000 (according to the UK’s International Passenger Survey); many of these went for dental treatment in Europe. That South Africa accounts for between one in two and one in three British medical tourists is unsustainable in the face of other evidence.

One of the problems on the European business is that there is a strong likelihood that after 2009, this cosmetic surgery tourism has fallen drastically due to the economy and price competition from nearer countries. This new research does a great service to the South African medical community as it shows clearly that the future of inbound medical tourism is about offering diagnostic and medical services to Africans. The report admits that few local hospitals take medical tourism seriously as it is a sideline when hospitals will be busier from the introduction of universal healthcare in South Africa.

It suggests that the revenue potential of medical tourism means that it needs government support and purpose built health and medical facilities targeting the medical tourist. It also suggests that in the future there is huge potential to attract middle class medical tourists from further away in East and North Africa.

The project has plans for other research looking at what drives people to become medical travellers, and why they choose South Africa.

The country has been involved in medical tourism since 1994. But has moved from mostly cosmetic surgery tourism to mostly medical travel for essential surgery. While rivals may shout louder, it is easy to forget that it is regularly the 5th or 6th biggest global medical tourism destination, despite very little official support.