For the Ozigi family, Dubai has become a one-stop shop for tourism and healthcare. Soon after London-based Nigerians Charles Ozigi and wife Zikechali completed their honeymoon here last year, Charles’ 73-year-old father, Albert Ozigi, was encouraged to visit the city and dovetail it with a routine medical checkup. They liked the arrangement so much so that Albert’s wife, Abigail, last month chose the local American Hospital for knee replacement surgery. While she recuperated, Albert roamed around Dubai, promising to take his wife shopping as soon as she was able to walk.

The Ozigis’ experience may give the impression that Dubai is a classic treatment destination, but they’re the exception, not the rule. As far as serious growth in the industry is concerned, the prognosis isn’t good. The city, which is keen on the idea but lacks a sectoral policy on medical tourism, is learning the hard way that its reach has exceeded its grasp. The logistics are daunting and investment in human capital so far has been scant.

Although the authorities claim that the sector is growing by 15 percent a year and will bring in 7 billion dirhams ($1.9 billion) annually to the UAE by 2010, those who know the field disagree. “It will take another 15-20 years before Dubai will have sufficient infrastructure – physical and human capital – needed to provide advanced medical care services for receiving international patients on a competitive level with countries such as Singapore, Thailand and Germany,” says Mahatma Davis, the chief executive officer of ArabMedicare.com, a provider of online information and educational services for Arab healthcare professionals.

“The tourism side of the equation can be achieved much quicker but establishing medical centers of excellence requires time. There are no shortcuts in this process,” he says. In October 2004, ArabMedicare.com launched its online medical tourism center, aimed squarely at the medical tourism market.

Ground rules. According to Davis, a national policy on how medical tourism will be organized, structured, regulated and promoted in the UAE must be established. “This will create synergies between the various emirates, as well as coordination of key local medical services that will complement each other, as well as support the advancement of the local healthcare system as a whole. It will also allow for the international marketing and coordination of activities between the various stakeholders in medical tourism. Medical tourism is developing as an industry and needs to be approached as such,” says Davis.
Dubai Healthcare City (DHCC) was launched in 2002 with the aim of filling the gap between the European and Southeast Asian healthcare hubs. Although it is still in its infancy, it envisages becoming a full-service healthcare center offering everything from primary care to spas, weight programs and alternative medicine.

“We have dedicated marketing programs which will promote specific services and facilities within DHCC to cater to a broad array of visitors,” the company told TRENDS in a statement. “We are working at various levels to ensure a continued flow of regional and international patients to the city. While there still remains more to be done, we are determined,” the company said.

A senior doctor at a leading hospital in Dubai says he doubts the industry will develop much in the near future. “Developing medical tourism destination is very different from building a tourist center. There are no compromises when it comes to healthcare and a city has to give the best of both tourism and healthcare and then build a reputation over it. I have been approached by intermediary companies that promote medical tourism in the UK and other European countries,” he says. “The UAE will first have to plug this outflow before it starts to think of building the city as a medical tourism destination.”

He cites as an example that the DHCC does not yet have an orthopedic center, which is one of the most sought-after treatments by medical tourists. However, he remains optimistic, saying the infrastructure can be built in less than ten years. The DHCC says that by 2010 the city will have nine hospitals and more than 300 outpatient facilities. “With our strong focus on quality healthcare and the numerous specialized services that the DHCC strives to provide, we are confident the DHCC will attract patients from the region and further afield,” the DHCC said.

Worth it. Medical tourist Albert Ozigi says when you are combining tourism with treatment, a slightly expensive option is worth taking. “My son works in London but knee replacement surgery in Dubai is slightly cheaper.” He paid about $19,000 for the surgery, which costs about $10,000 in Thailand and $13,000 in Singapore.
“Tunisia would have been nearer but we did not trust the doctors there. So we had to choose between Saudi Arabia and Dubai. We learnt that Dr. Sameh Tarabishi [the joint replacement orthopedic surgeon at the American Hospital in Dubai] does most of the knee-replacement surgery in the region,” says Ozigi. According to Ozigi, the tourist attractions of Dubai, its infrastructure and some other minor but important factors lured them here. “Dubai is like a welfare state and the people are friendly. Even the heat of Dubai is not alien to me. I don’t speak Arabic, so Saudi Arabia would have been a little difficult. We hope to come back every year to tour as well as to get our regular checkups done. I just hope that the hospitals will maintain the present standards,” he says.

Traditionally, medical tourists from the region have gone to Jordan, Egypt or Tunisia. Jordan receives more than 100,000 patients from Arab countries each year. Medical-related investments from Kuwait are pouring into Jordan, and a new medical city, said to be bigger than DHCC, is being built in Amman. Egypt is developing a national sectoral policy on medical tourism under the guidance of the European Union.
Too early. Davis of ArabMedicare.com says it is too early to even say whether Dubai is in a position to challenge any of these. “Once it is at a state to compete, it would compete against Amman, Cairo and Sharm El-Sheikh and probably Tunis. I don’t foresee Dubai competing against major medical tourism markets like Thailand, Singapore, India and Germany in the immediate future. As a matter of fact, these countries are still increasing their share of attracting patients from the UAE market, and are quite active in the local UAE market,” says Davis.

Bangkok’s Bumrungrad Hospital – which has built a reputation as a cost-effective medical tourism destination – receives 65,000-70,000 patients a year from Arab countries. The hospital treats more than 400,000 foreign patients each year, about 50,000 of whom are from GCC countries, with 15-20 percent of those coming from the UAE. The hospital used to get only about 5,000 Arab patients a year, but admissions have grown since 9/11.

To make sure that they don’t lose any market share to local Arab hospitals, Bumrungrad last year entered into a joint venture with Istithmar PJSC, a major investment house based in the UAE. As part of this venture, its first hospital in the region will open in Dubai. The new facility, with a phase-one capacity of 125 beds, at a total investment of 300 million dirhams for the first phase, is scheduled for completion at the end of this year. The Dubai unit will serve as Bumrungrad’s own referral center for receiving local and international patients from the region and for sending the more advanced cases to Bangkok.

Announcing the joint venture, Muneef Tarmoom, the chief executive officer of Istithmar, said, “This agreement will help us catapult Dubai in particular as an emerging medical and healthcare destination. Investment in the new hospital project and tie-up with a leading name like Bumrungrad International Limited is in line with our objective of offering world-class healthcare services and attracting healthcare professionals to Dubai.”

Missing the boat. Davis says the advantage for Dubai is that it can maximize its exposure from other mega projects that have been launched in the market. “So name recognition and market ‘buzz’ about Dubai is very high. It is on the map. The disadvantage is that Dubai is not ready to seize the medical tourism opportunities, and possibly by the time it is ready, the other markets will have already secured a significant share of the market that would have been available for healthcare facilities in Dubai, making it extremely costly for those healthcare facilities in Dubai to compete at a later stage,” he says.

DHCC also sees the Dubai buzz as a positive that can be used to good effect. “Dubai already has the reputation of a place for good governance, efficiency, convenience and high service standards. This is in addition to being a renowned tourist destination. All these features will greatly favor Dubai Healthcare City in its efforts to project itself as a leading destination for medical tourism in the region,” it says, adding that besides a comprehensive range of healthcare services, Dubai Healthcare City will focus on certain medical specialties.
“This will be based on a ‘whole system’ approach to service packages and delivery setup to provide seamless, integrated patient journeys in and out of the respective elements within the city. The planning and design elements also target an international network of clinical partners, referral and assessment centers to establish and enhance its market presence and potential,” it says.

Countries in Southeast Asia see their relatively lower cost of healthcare and favorable foreign exchange rates as bargaining chips to attract people from the Middle East. Hospitals in Thailand, Singapore and Malaysia have been offering packages to potential medical tourists from the region. The Tourism Authority of Thailand aggressively promotes medical tourism under its theme-based campaigns and its healthcare services industry has established representation in the region to attract travelers.

Can’t beat ’em. Some of these campaigns are taking the form of cooperation. Dubai’s Department of Health and Medical Services (DOHMS) and Singapore’s Ministry of Health in January signed a memorandum of understanding to promote cooperation in healthcare. On the issue of promoting medical tourism, DOHMS maintains it is focusing “on massive projects and participation in international conferences to make Dubai a medical hub.” The department says it received a total of 741 overseas patients in 2004, 792 in 2005 and 787 in 2006 while the total number of patients during the first quarter of this year has been 220. However, there is no evidence to suggest that these overseas patients arrived as a result of the initiatives taken by the department.

Davis says most of the recent medical tourists are coming to Dubai for cosmetic surgery. “This may actually be a by-product of the crisis that occurred in Lebanon last year. Lebanon used to be the main destination for Arabs seeking cosmetic surgery. There are also similar reports of patients seeking cosmetic surgery in markets like Oman and Tunisia, which, in the past would have gone to Beirut. Medical tourists have started to come to Dubai for spa treatments. However, there are no hard numbers to determine how significant these numbers are,” he says.

Interestingly, Arab investments in Tunisian tourism projects comprise 12 percent of the total foreign investment in the sector and the UAE is one of the biggest Arab investors in Tunisia, along with Egypt, Kuwait and Saudi Arabia.
But the real trouble is a lack of any coordinated marketing campaigns to attract these patients or for any other medical specialty procedures or treatments. “Entities like Dubai Healthcare City still have to engage in ‘soft’ marketing activities – primarily seeking tenants – because its infrastructure is not at a level to engage in any ‘hard’ marketing campaigns for attracting large patient flows from abroad. It is also still trying to define what role it can play globally and what type of management structure is needed to facilitate that role. At the moment, Dubai Healthcare City is a non-factor in the global medical tourism market,” Davis says.

That means losing out on a goodly slice of the estimated $56 billion spent by medical tourists last year alone. According to a study by the Abu Dhabi Chamber of Commerce, the UAE’s realizable goal is comparable to India’s projected revenue earnings of $2 billion by 2012, but most of the medical facilities in Dubai have not yet developed the type of infrastructure needed to support medical tourism as a “business unit.” Much medical infrastructure is devoted to servicing the UAE’s young population. The medical tourism industry has a lot of growing up to do.

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