Medical tourism’s magic formula

Travellers discover that taking time out for a medical while on holiday in Thailand pays off.

Terri Roamer

If you are looking for Thailand’s most resilient tourists the chances are they are enjoying a coffee, or a green tea, in a hospital reception lounge.

This is not the usual hospital waiting room by any means. The department’s brass plate will probably identify the plush five-star environment as a wellness or life and health centre.

Inside, the scent of jasmine, or some other soothing fragrance, is more likely to catch your attention than the customary antiseptic odour associated with hospitals.  Background music helps to enhance the calming atmosphere replacing the harsh announcements that order you queue for your medicine or wait for a number.

Welcome to the world of Thailand’s highly successful medical tourism business. In less than 10 years, medical visits have reached an annual 1.8 million and are rising by an impressive 10% a year. It has turned Thailand into a remarkably successful centre for a variety of medical treatments and heath checks.

Medical tourists travel year round and often take their families in tow for support. They recuperate after treatments by booking post-medical holidays and they apparently are unshaken by economic downturns, or political upheavals that worry the rest of us.

Many of them are in perfect health. They subscribe to preventative medicine, the annual check-up, or they want to improve their lifestyle through wellness programmes that will tweak diet or introduce exercises and spa treatments into their daily life.

They visit Thailand’s hospitals for annual check-ups, dental and corrective eye surgery as well as skin care. They may attend a hospital’s “life centre” to improve their diet, lose weight, or tone up their physique under the watchful eye of experts.

Even as other tourism segments faced challenges from global recession, or perceived security worries in Thailand, since 2008 medical tourism flourished, expanding to the point it now contributes revenue exceeding Bt150 billion annually for the country’s economy.

Not a bad performance for a sector that was largely unknown a decade ago. Today, medical tourism and the associated spa industry are probably the fastest growing segments in Thailand’s varied tourism business.

Let’s face it, medical tourism is surrounded by contradictory emotions. The last place most of us want to be on holiday is in a hospital.  But even that traditional argument weakens when hospitals create a relaxing, plush environment that has us all wondering whatever happened to the glaring white walls and drab green floor tiles?

Medical tourism brochures tell us how we can combine health care and travel. It might include a comprehensive annual check-up followed by a holiday in a luxury resort on one of Thailand’s white sandy beaches, well below the cost of just a health check back home.

Those who are heading for more serious corrective medicine can save 20 to 50% off the procedure costs by checking in one of Thailand’s 30 international hospitals, mostly located near major tourist destinations.

The savings are substantial. The bill for dental and eye care drops by 70%. Cardiac procedures such as heart by-pass surgery (US$130,000 in a US hospital) are a good 50 to 70% cheaper in Thailand (US$15,000 for a by-pass).

For ex-rugby or football players, a knee replacement procedure in the US costs US44,000, compared to US$10,000 in Thailand. Margin enough to combine the treatment with a week-long recuperation at the beach and still come out of it financially smiling.

Thailand’s medical tourism boom started with this tangible cost incentive, but it also embraces other advantages such as the gracious service of nursing staff on par to what guests enjoy in five-star hotels.

Treatments are executed without delay for both day patients and those admitted. Wait-lists are rare for most treatments and queues are short, a fact that always amazes medical tourists from the UK.

Bangkok’s top hospitals have centres for international visitors with language specific staff to assist in explaining the diagnosis and treatment.

Most international hospitals have specialised diagnostic and treatment centres such as heart, skin, oncology, orthopaedic and paediatric. Beyond the main stream international hospitals, there are specialised, smaller hospitals that concentrate on dermatology, eye care, gender realignment and plastic surgery.

At the top of the medical tourism tree are 15 international hospitals that have been accredited by the US-based Joint Commission International. Founded in the 1950s to raise the standard of US hospitals and healthcare services, it accredited 15,000 institutions before expanding into international accreditation in the 1990s. Worldwide there are now 140 hospitals that have met its stringent conditions.

JCI accredited hospitals are located in Bangkok, Nonthaburi province (adjacent to the Thai capital), Phuket, Pattaya and Chiang Mai. These international hospitals are the backbone of Thailand’s medical tourism and have successfully outpaced competition to gain an enviable lead in what is a very competitive business.

Overall, there are 200 hospitals in Thailand that have gained accreditation with various agencies other than JCI. The JCI hospitals are listed on the commission website with links to the individual hospital’s websites.

Thailand’s medical tourism success is based on three distinct advantages – cost incentives, high quality service and the support of sophisticated tourism industry offering an attractive recuperation options in destinations across the country.

Destinations that can support medical tourism with full travel services, air services, sophisticated shopping and a variety of accommodation options are Bangkok, Pattaya, Phuket, Samui and Chiang Mai.

Apart from quality hotels located close to international hospitals these destinations offer self-catering apartments rented, on short one-week options,  or long-stay for a month or more at rates starting at Bt10,000 a week to Bt30,000 for a month. Usually, they are located within walking distances of international hospitals.

There are also clusters of boutique hotel specifically catering to medical tourists, while there are five-star hotels that offer promotional rates for medical tourists usually in the off peak months June to September.

These features have been successfully positioned as the country’s “health travel brand” giving Thailand a strong competitive edge to claim the accolade Asia’s leading medical tourism destination.

One of Thailand’s leading international hospitals calls medical tourists the “intentional travellers.”

They are not popping into a hospital as accidental visitors with an emergency on their plate. They plan their medical visits well in advance, check their insurance cover and tag on a holiday experience as a bonus.

But the fact is you could pop by unannounced if that was your inclination. The system works equally well for travellers who are already visiting the country. Perhaps on the spur of the moment they decide they have the time and cash to sign up for a bargain physical check-up, or to get their enamel tapped and prodded in a dental chair.

We hear it all the time: “Savings on dental work paid for this trip; unbelievable.” Or they tap a new pair of classy bifocals: “Got the eyes checked for a fraction of the cost back home. My holiday is a bonus.

There are also plenty of examples that show how speed and timely treatment is worth its weight in gold.

In the UK a resident notices a wonky mole; sensitive, itchy and changing colour. What will all the alarm bells on the dangers of tanning they worry it could be cancer. They make a doctor’s appointment and wait a month.  Their GP (general practitioner) refers them to a skin specialist at a nearby hospital. They wait another six months for an appointment.

Eventually, diagnosed with a common skin cancer the patient joins a queue for a minor operation that is ultimately scheduled eight months after the initial doctor’s appointment.

As this drama unfolds, a close friend is on a long-stay holiday in Thailand. Coincidentally, they too are worried about a suspect mole and they pop by the skin centre of one Bangkok’s top international hospitals.

It’s 0900 on a Tuesday, and not much to do other than go shopping in the rain. By 1000, the English speaking doctor examines the mole runs some tests and gives him the news that he has the identical cancer that afflicted his mate back in the UK.

The difference is that the long-stay tourist in Bangkok is all smiles on Wednesday of the same week after undergoing a successful minor operation. Three weeks later he returns to the UK and asks his mate if the appointment with the skin specialist has arrived in the mail. It hasn’t.

“You lucky so and so,” his mate declares when he hears that an unintentional medical traveller was treated speedily in Thailand and sent on his way to continue his holiday all within 48 hours.

“Done and dust in two days, and cost next to nothing; great service friendly nurses, what more can you ask. It’s magic,”   the happy traveller exclaims.

What more can you say, except to do the sums and work it out that if you have insurance cover, visiting a hospital while on holiday in Thailand is not such a bad gig after all.  

Loy Krathong heralds recovery

This year’s Loy Krathong has special significance for residents as it heralds a fresh start after months of battling floods.

Terri Roamer

Monsoon rains are over, the cool season beckons and millions of Thais across the nation celebrate the Loy Krathong Festival.

This year there is a difference. Thais from every walk of life are facing unprecedented flooding that threatens the economy across the vast central plains and even touches the capital, the commercial lifeline to a global economy.

On the full-moon night of the 12th lunar month, families and families gather on the banks of rivers and lakes to float miniature rafts crafted from banana tree trunks and leaves crafted in the shape of a lotus flower.

Decked out with candles, flowers and joss sticks, the delicate vessels are floated on the river currents or blown by the wind across still ponds.

This year, the 10 November festival has special meaning for Thai citizens. They are praying for a rebirth and the forgiveness of the water goddess for sins of omission and commission.

As they launch, these decorative, lotus shaped boats they will ponder over a devastating a flood unseen in the Land of Smiles for over 70 years.

Their thoughts will turn to the relatives and friends scattered throughout the country who sought refuge from the floods. Their prayers will be for a better future and a chance to rebuild their homes

They will touch the deeper significance of this festival. It conveys the hope that a simple gesture of floating a tiny raft guided by wind and water currents will cast aside past sins and herald a new beginning.

Celebrations in Bangkok and neighbouring provinces have been curtailed, or cancelled, as residents deal with a deep sadness, hidden behind smiles and a brave resolve that has been evident through the three-month crisis.

Out of respect for residents who are suffering the Tourism Authority of Thailand cancelled most of its Bangkok events related to the festival.

But there is always a silver lining to the worst tragedies and this is now evident in Ayutthaya, 70 km north of the capital, where the Loy Krathong festival literally opens the door to recovery and restoration.

For the residents of Ayutthaya the sight of hundreds of relief workers and supporters standing side-by-side to float Kratongs and mount a clean-up campaign indicates just one substantial heartening fact.

The water goddess has smiled and months of suffering will end soon.

Just a day ahead of the celebration the first tour group returned to the world heritage town to visit the historical temple sites. It was first credible indicator that better times are ahead for this former royal capital famed for its fabled temples and palace ruins. Protected and recognised as UNESCO World Heritage sites, teams from the Fine Arts Department will move in to begin restoration estimated to cost over Bt100 million.

With the arrival of the full moon night,10 November, town folk could mark the beginning of this massive clean-up that will continue for months to come to restore temples and historical ruins.

Tagged “We care for Ayutthaya” around 300 rolled up their sleeves to get the clean-up campaign rolling in earnest.

They face a monumental task over the next 12 months as over 500 temples will need to be restored as well as access roads. After seeing these priceless heritage sites inundated by metre deep water residents and relief workers are now committed to restoring their historical town brick-by-brick.

Loy Krathong has its roots in legend and references to another ancient royal capital, Sukhothai, 400 km north of Bangkok.

According to legend the festival was first celebrated in the 14^th century by members of the royal family resident in Sukhothai  as a gesture of worship to the water goddess, Phra Mae Khongkha .

They floated the decorative banana leaf boats to ask forgiveness for polluting life-sustaining rivers.

This act of floating the candle raft was symbolic of letting go of all grudges, anger and defilements, to allow for a fresh start to the new lunar year.

Today, Sukhothai remains one of the most popular venue to celebrate the festival against the backdrop of ancient temple ruins in the town’s World Heritage park.

 Sukhothai is a rewarding destination to visit anytime of the year, but shines with a romantic almost mystical ambience on special occasions such as Loy Krathong.

The town is close to two airports; the privately run airport of Bangkok Airways and the provincial airport in Phitsanulok.

There are two flights daily to Sukhothai’s airport and the visit can be combined with an interesting agro-tour at a site right next to the airport. Here, local residents show you how to plant rice, look after farm animals and tend to orchards. It is a valuable learning experience for visitors who want to understand rural life close-up as well as study Sukhothai’s heritage.

Venues to celebrate the festival.

Sukhothai Loy Krathong & Candle Festival 2011 Sukhothai province 8 to 10 November in Muang district;

Loy Krathong Sai Festival and Krathong Sai for the Kings Cup Contest 2011 will be held in Tak province 9 to 12 November;

Loy Krathong festival Mae Klong in Samut Songkram province,10 November at King Rama 2 Royal Garden, Amphawa district;

Lantern Festival, Colourful of Southern Cities in Songkhla province from 1 November to 28 February at Park of Hat Yai, Hat Yai district;

Yee Peng Festival Chiang Mai province, 8 to 11 November in Chang Klan Road, Chiang Mai Night Bazar and Muang district.

This is the northern version that has its origins in ancient Lanna heritage. One of its distinct features is the candle lanterns that rise in the sky on hot air trapped within the rice paper lantern. Thousands of them are launched during the full moon night.

Next year’s Loy Krathong Festival will be celebrated much later in the month, 28 November, 2012. Colour it in the diary now and plan details of a heritage tour that will take in world heritage towns with a memorable finale in Sukhothai to celebrate Loy Krathong on the full-moon night.

Winter in Thailand

Winter is just around the corner

Terri Roamer

What can you say about winter other than it is far away from Thailand’s shores. But is it?

One of the country’s tourism themes is an invitation to world roamers to sidle up to Thailand’s front door and ask if winter is playing this week.

It doesn’t take long to suss out the country’s weather patterns a media colleague once told me shortly after I landed in a sweltering, humid Bangkok for the first time. 

Initially I thought someone was steam ironing my shirt, on the go, as I walked to the airport’s taxi ranks.

“Is it like this all the time,” I asked.

“There are three seasons here; hot, very hot and scorching,” my gracious host explained over a cold beer a few hours later in an equally chilled hotel lobby. He was pretty close, too, but after decades of acclimatising to life in the Thai capital I concede there could be a case for arguing a winter of sorts exists after all.

It’s all very relative mind you. An office worker in Alaska would call winter in Thailand a heat wave. But as the years of residence pile up that seasonal slide of the mercury slither encased in my wall thermometer prompts a search party for a light winter jacket.

Speed is the essence to grasp a Thailand winter and wring out a great holiday experience. Bets are off on predicting how long the cold snap will last, so having your plans in place in October is vital.

An eye on the weather vane helps to judge the moment. There are usually a few tell-tale signs that winter is just around the corner. One is the change in direction of the prevailing wind that by late October swings from the southwest to settle into a steady refreshingly cool breeze from the Northeast.

It’s this seasonal wind that carries the cool air off China’s vast chilly plains. It brings with it cloudless blue skies, misty mornings and even a slight relief from the usual soaring midday temperatures.

As long as that the Northeast wind prevails, the morning temperatures even in sultry Bangkok will drop to 15 to 18 degree centigrade with a substantial decline in humidity to boot. The record for Bangkok residents is around 10 degrees on a very chilly morning that had us all shivering on our doorsteps wondering if this was global warming in reverse.

Based on past form, the cold snap should bear down on North Thailand slipping south to Bangkok by November. Then it is up to nature whether we are still donning our fashionable winter togs come December.

There is only one direction to take to appreciate Thailand’s soft and gentle version of winter.  North Thailand is the spot, a region that attracts less than 20% of all the visitors to the country. That should be enough to gain the attention of spirited roamers who seek new travel experiences.

Close to the northern borders with neighbouring Laos or Myanmar there are national parks spanning mountain ranges that rise to around 1,800 2,200 metres, their peaks covered in morning mist and cloud cover.  At camps sites at around 600 to 800 metres high you will find a light frost lingering on the leaves of trees and the grass around your tent.

In these hilly regions of North Thailand temperatures drop to single digits, just a notch or two from freezing and rising to 12 to 15 degrees as the day wears on towards noon. Evenings cool off quickly, making it an enjoyable experience to dine at al fresco on the terrace of a road side restaurant, or at a national park camp site.

Ask any office worker in Bangkok what winter means and they talk about a trip to the far north village of Pai in Mae Hong Son province where they can wander through quaint streets, lined with timber shop houses, in their North Face jackets edged by a designer scarves and topped off by equally bizarre fur-lined hats. Calf-high boots complete the pose. It’s a fashion statement, a chance to wear stuff that sits in the closet for 51 weeks of the year.

During the chilly months of December and January, Pai’s boutique hotels and quirky guest houses are packed with visitors. Evening entertainment focuses on the walking street that at dusk transforms into a wonderland of trinkets and a thousand ways to rhyme Pai on T-shirts and souvenirs. It’s the ultimate tinsel town, but it’s fun, Thai style. The trick is to blend in and go with the flow to enjoy a Pai in the sky experience.

Pai has its critics who say it is overdone, crowded and divorced from the real world of far north Thailand living. They are right, but it can also be charming and the fun young Thai travellers are having rubs off on the rest of us. It has a quality to fascinate and that makes lolling around a coffee shop with an Espresso and a chocolate brownie watching life go by very entertaining.

Pai town is set next to the fast flowing Pai river, the longest river in Mae Hong Son province that has its source in the Huay Nam Dang national park to the north of the village.  The river flows through Pai’s emerald green valley a patchwork of market gardening and paddy, surrounded by mountains some of them over 2,000 metres high.

Apart from the nightly winter fashion parade, Pai is good spot to go trekking or test your skills at white water rafting. You can explore waterfalls and hot springs and there riverside camp sites where you pitch your own or rent a tent for a couple of nights.

The 134 km trip from Chiang Mai takes about six hours by mini buses that ply the mountain road, 1095, through switch-back bends over forested ridges affording spectacular views of fast flowing rivers far below. Pai stands just 2 km off the highway, 111 km short of the province’s main town of Mae Hong Son.

The tiny village is also the proud of owner of an airport with a brand new terminal to welcome visitors who take the short 20-minute hop from Chiang Mai on a tiny commuter aircraft that operates under Nok Mini colours. There are three flights daily in the high season, but as long as the runway remains 700 metres long only a 12-seat aircraft can land safely.

Pai is a perfect fit for motor cycle enthusiasts who will love the challenging mountain route to test riding skills. During the winter season motor cycle clubs organise tours around Mae Hong Son province with a stop in Pai.

One option is to bike from Chiang Mai on a grand circular route that covers both Pai and Mae Hong Son returning via Khun Yuam on highway 108. At the village’s single junction there is a small resort overlooking a teak forest, where the tour turns off to follow the back road 1263 that eventually winds its way to Thailand’s highest mountain Doi Inthanon at 2565 metres.  There are alpine trees and wild flowers associated with a temperate climate growing on these steep mountain slopes.  Doi Inthanon has camp sites and chalet-style accommodation at a remarkable royal project that pioneers the cultivation of fruits and flowers that prosper in cool climates.

From here the circular tour of winter villages comes to a close in Chiang Mai entering the town via highway 108

Another of my favourites is Nan a provincial town that nestles in a valley surrounded by mountains close to the far northeast border with Laos and just the spot to enjoy a winter chill. It’s as remote as it gets for a Thailand destination. Sure it has a daily bus service and even daily flights from Bangkok’s on a partner airline of Nok Air.

But surrounded entirely by mountains, the Nan valley is a cul-de-sac unless you fancy a rough and ready four-wheel drive through the back door checkpoint to Laos and Luang Prabang.

If you are determined to chill out and pace yourself, Nan is just the ticket. The town stands on the picturesque Nan River, the scene of spectacular traditional boat races at the close of the Buddhist lent in October.

Nan surprised me with is exquisite temples all in walking distance in the town’s centre. You can spend hours photographing the various architectural details including older chapels and a temple library built from teak.

It’s easy to relax and sip a coffee and soak up the town’s atmosphere while you plan a motor cycle trip to Nan’s fascinating weaving villages or Si Nan National Park where you can camp on the edge of a ridge at 1,400 metres and experience a morning sea mist. It is quite eerie to wake up and peep out of your tent to see a vast valley covered in mist with just the blue peaks peeping through.

There is even a frost on the camp site grass and you will need your winter woollies for the first few hours of the day and evening.

It was the one time that I really loved camping in Thailand. The tent site commanded the best views I have seen in the land. It was a prime site, envy of those who booked the bungalows, close to the park’s single restaurant and very secure in earshot of the park’s headquarters.

Tents can be rented for a Bt300 a night. But this is one time when you can unroll your own lightweight tent, park your motor bike and enjoy a perfect camp site on the edge of the mist. That’s what winter is all about in Thailand. Capturing the moment to shiver, perhaps skipping a cold shower and sleeping under the stars to wake up to a sea of mist covering peaks all the way to Laos.