Discussion point: Travel health & medical tourism

Travel health is a burgeoning area of medical development. Why ? The numbers of individuals travelling overseas from their home countries increases year on year, and it is estimated at the time of writing (2007) that more than a billion human beings travel across international borders annually - this number is bound to keep growing.

The reasons why people travel are many and varied, including vacationing, business, military reasons, and missionary work. To this must be added medical tourism.

International travel can bring multiple problems in its wake. These include:

  • The epidemiology of different infectious diseases varies widely around the world (e.g. malaria, dengue, HIV, Japanese B encephalitis, chikungunya, viral hepatitis, MRSA)
  • Human beings can exacerbate pre-existing illness during travel, such as cardiac disease or respiratory disease
  • There are health problems strongly associated with long-distance air travel, such as deep venous thrombosis (DVT) and pneumothorax
  • Human beings can transport infectious diseases and antimicrobial
  • resistance around the world, by acting as vectors

Preventative medicine is vital - prevention is always better than cure - and this is a large part of the reason for the growth in the speciality of Travel Health. It is vital to remember that when it comes to Travel Health issues travelling as a medical tourist is no different to travelling for any other reason, except that medical tourism may be a reason why some very sick people will find themeselves undergoing a long plane trip to an unfamiliar place when they might otherwise not have done so. Examples of this might include:

  • A patient in renal failure requiring a kidney transplant may have to travel from the UK to Singapore, and this may involve overcoming a degree of frailty which will be heavily challenged by a very long air flight.
  • An immunosupressed patient travelling from South Africa to the Philippines for a sex-change operation may bring XDR-tuberculosis with them.
  • A patient travelling from Ireland to India for coronary artery surgery may acquire hepatitis B during the procedure if they receive an infected blood transfusion and have not previously been vaccinated against hepatitis B.
  • A patient having a "face-lift" in Thailand who then goes on to Chiang Mai for a holiday may be at risk of malaria or dengue unless appropriate precautions are taken.
  • The medical tourist develops an "unusual" surgical wound infection unresponsive to antibiotic therapy after returning home to Russia following treatment in Bahrain.

So, it is naive to think that you will never catch an infectious disease when you travel to an unfamiliar part of the world, whatever your reasons for travelling.   Such naiviety could cost a person their health, and even their life !

It is clear that there is a considerable overlap between Travel Health and Medical Tourism. This is an area of healthcare in which International Healthcare Accreditation can, and should, be interacting with specialists in Travel Health and taking a lead.

The latter paragraph is a bald statement - does anyone disagree ?