By: Anthony Sedzro
Edward Banson was seeing me off at the hospital entrance when his phone rang. The caller was speaking French so he had to return and give the phone to the hospital’s bilingual secretary to answer the client’s queries. The caller was calling about cancer treatment at the Sweden Ghana Medical Centre (SGMC), the only private cancer treatment centre in Ghana, where Banson works as the Marketing Manager.
That was just one of the many clients from the West African sub-region who make trips to the SGMC for cancer treatment, in what is known as Medical Tourism. Oncology (branch of medicine devoted to the treatment of cancer and tumours) treatment is a specialist treatment not available in many African countries.
What is medical tourism?
Medical tourism (also called health tourism) is the term commonly used to describe people traveling outside their home country for medical treatment in another country. The treatment could be medical, surgical, dental, alternative (wellness) and other types of care.
‘Domestic medical tourism’ is another type where people who live in one country travel to another city in the same country for treatment, as defined by the USA-based Medical Tourism Association (MTA).
Worldwide health tourism facts
There are hard facts to support the growing trend of medical tourism. Globally, some approximately 11million patients spend an estimated US$40 – US$55 billion for health care outside of their home country every year. According to Patient’s Beyond Borders, the international healthcare market is growing at a rate of 15 to 25 percent a year, mainly due to increasing wealth, people living much longer and a shortage of quality healthcare facilities to support it. The United States, the world’s leader in medical tourism, alone, serves approximately 1.2 million international patients each year.
Ghana situation on medical tourism
Ghana, a country with an average life expectancy of 62.5 years, is no different from other African countries, in terms of health challenges. Each year, many Ghanaians who can afford it, travel abroad to seek medical treatment. The country became a lower middle income country in July 2012, meaning a lot of citizens have disposable incomes to spend on better health care. Ghana’s health system is better by sub-regional standards. The country has in place a much-praised National Health Insurance Scheme (NHIS) although it has its challenges. Despite an oversupply of nurses in the last few years, the exodus of the country’s doctors to seek greener pastures abroad has not stopped, making the doctor-to-patient ratio a high one.
The country has three cancer treatment centers-Korle-Bu Teaching hospital, Komfo Anokye Teaching hospital and the Sweden Ghana Medical Centre (SGMC) in East Legon, the only private one. Ghana thus has more cancer treatment hospitals than most West African countries and this attracts a lot of tourists seeking cancer treatment.
Banson of SGMC, the only private cancer treatment centre in West Africa, agrees.
“SGMC is an oncology facility. It is the only private one in the whole of West Africa and this attracts mainly people with cancer-related problems from the whole sub-region. It was strategically sited here by the investors because Ghana happens to be the hub of West Africa. What I mean by this is that it takes you between 40 and 45 minutes to fly from Lagos or Abuja in Nigeria to Accra, it takes 45 minutes to fly from Cote d’Ivoire to Accra, one hour fifteen minutes from Burkina Faso, 40 and 45 minutes from Togo and Benin. We also have people coming from Sierra Leone, Liberia and a host of other countries”.
Treatment for cancer can be expensive for ordinary people, but Banson explained what made the SGMC unique unlike any other.
“…when it comes to radiotherapy which is the premium service that we deliver, we use the latest technology. The equipment SGMC uses for this is called the Linear Accelerator, shortly called the ‘Linac’, and this machine comes out with precision in treatment. Currently, in the entire West Africa there are about five only. There are four in Nigeria owned by the state and one here at SGMC. Korle-Bu and Komfo Anokye teaching hospitals [the only other two cancer treatment centers in Ghana] have what we call the ‘Cobalt’ machine.”
Alternative (or palliative) care is also increasing in Ghana and this is led by the Holy Trinity Spa and Health Farm in Sogakope. Dr. Felix Anyah, the founder of Holy Trinity Spa, explained the importance of palliative care in an interview with the media some time ago.
“Health Tourism will receive a boost should it be captured and supported by the Ghana Tourist Board. It will also be enhanced with a committed public-private partnership….Ghana, therefore, could have an edge over India in terms of distance, and an edge over Thailand, Bolivia, Peru, Colombia, Ukraine, China, and Brazil,” Dr. Anyah said at a mid-year review of the Holy Trinity Spa in 2011.
Yet, another area of Ghana’s health care that can attract patients, especially from West Africa, is fertility tourism. This involves traveling to another country for fertility or reproductive treatments such as In-Vitro Fertilisation (IVF), surrogacy and others.
Ghana has very good private fertility hospitals which, when well marketed, could attract patrons from the West African sub-region.
These include Lister Hospital and Fertility Centre on the Spintex road, Del International hospital in East Legon, Provita hospital in Tema, Lapaz Community hospital, Medifem hospital and Fertility Centre in Dzorwulu.
The growth in medical tourism industry is always led by the private sector. In February 2016, the Daily Graphic newspaper carried a story which said that a new medical village with a 380 bed hospital, specifically targeting health tourism is soon to be built in Achimota. It will be called ECO-Medical Village (EMV) and will be “a state of the art international hospital Complex for citizens and residents of the West Africa sub-region, who usually travel to South Africa, North America, Europe, Cuba and India for medical care. The EMV will be built on a 40-acre land and with satellite units in all the West African Countries in the sub-region”.
Ghana Tourism so far
Tourism used to be the third highest foreign exchange earner for Ghana until the country discovered oil and the sector was pushed to fourth. Despite this, tourists’ arrivals into the country continue to increase. Figures released by JOVAGO, a tourism and travel company, revealed that the total contribution of Travel and Tourism to Ghana’s Gross Domestic Product (GDP) in 2015 was around GHS10.5billion (US$2.7billion), representing 7.8 percent of the GDP. This figure was forecast to rise by 2.4 percent in 2016. Directly, the industry contributed GHS4.5 billion (US$1.15 billion) in 2015, representing 3.3 percent of total GDP.
YEAR TOURISM ARRIVALS IN GH
Source: World Bank
Despite this yearly increase in tourism arrivals, there are no figures to determine how many of these come for medical or health tourism. According to Dr. Felix Anyah of Holy Trinity Spa and Health Farm, in an interview he granted in 2011, the Ghana Tourist Authority (GTA) currently captures only six tourism products such as Ecotourism, Historical tourism, Cultural tourism and Conference tourism. The remaining two are Recreational tourism and Community–based Ecotourism projects. It does not classify medical tourism as a tourism product yet.
In a careful look at the website of both the Ministry of Tourism, Culture and Creative Arts, and the GTA, Medical or Health tourism is not classified as a tourism product.
Ben Anane Nsiah is the Manager for Special Events at the Ghana Tourism Authority (GTA). Speaking to me in his office, he gave reasons why medical tourism is not classified as a tourism product by the GTA.
“When we say tourism, you could go to the classic definition, the one the professors like to talk about. There are always certain elements that make what tourism is. It has to be a voluntary movement, so, a refugee is not a tourist, the immigrants crossing the Mediterranean [to get to Europe] are not tourists. You move from where you are normally resident to another place for certain activities that are not remunerated from where you are for a period more than a day but less than a year,” Ben Nsiah says.
“So, if you look at it that way, certain people cannot be classified as tourists although they may come into the statistics that are captured. But you also have people whose primary reason for moving is business say, a consultant comes to Ghana for business and whilst here, he undertakes some primary activity so, although his primary motivation might be to work…
“If you stretch the definition of medical tourism, it might be a misnomer in a certain way. In fact, we should ask ourselves if we can genuinely consider anything as medical tourism,” he continues.
“In the current context, however…what you find is that certain people develop their health system quite well, or a certain aspect of it quite well, and they are able to offer certain good quality services at a more competitive rate. Good places fitting this example are India, and now Turkey…they specialise in a certain [medical] area and that kind of thing. Now, the primary motivation for the patient going there is not tourism. The man is sick and is looking for a solution. So, can you call that voluntary?” Nsiah explains.
Nsiah gave other reasons why medical tourism has not attained the status of India and other countries yet.
“…We haven’t gone around using our health care facilities as a tourist attraction for good reason. We, ourselves have issues with our health system sometimes-how many times haven’t people complained that there are no hospital beds in Korle-Bu? In this business, you don’t promise and don’t deliver as you will run into credibility problems, to recover from that takes a lot of time. So, let the people (tourists) experience it themselves and then we move on with that,” he adds.
Despite medical tourism not being considered a tourism product in the country, Nsiah believes it is a possibility provided the infrastructure is in place.