For about three months in 2019, Veronica Mwakatumbula, 25, endured poor health and often struggled to breathe while her fever remained high. Not much came out of the hospital visits she made in Dar es Salaam.

A distant relation learnt of her ailing and advised her to travel to Nairobi to one of the contact centres that connect the sick with Indian hospitals.

It is in Nairobi that she was referred to Jaipur National University Hospital, where she was admitted for two weeks after doctors ran a series of tests that revealed she had an inflammation on her throat, a low heart-rate and too much fluid in her chest cavity. The doctors then gave her the required treatment and she was back to Tanzania.

Ms Mwakatumbula joins thousands of people from the region—and the wider Africa—who are thronging India for medical treatment.

By June 2019, India’s medical tourism was said to earn the Asian subcontinent $9 billion, nearly a third of Kenya’s annual budgetary estimates.

According to “Medical Tourism in India,” a report by the Federation of Indian Chambers of Commerce, India is fifth in rank as far as global medical tourism is concerned.

But why India?

The Global Medical Tourism Index, which ranks top medical tourism destinations in the world, placed India fifth behind Singapore, the United Kingdom, Canada and Israel.
Kenya’s Ministry of Health had revealed in 2018 that more than half of the cancer patients (57.8 per cent) flock to India. Of those, 16.8 per cent sought renal disease treatment while 7.8 per cent were treated for cardiovascular diseases and skeletal disorders.

That points to India’s recent attractiveness to foreign patients.

India is popular for a variety of procedures—cancer, cosmetic, orthopaedic, cardiac, neurology, and organ transplant surgery and provides what experts term high-quality medical and surgical treatment services.

According to Dr Nidhi Gupta, a medical facilitator whose core duties are to recommend hospitals and doctors to patients, set up appointments as well as help others purchase the drugs they need, India is a hub for medical tourism from Africa and the Middle East mostly as the cost of treatment is cheaper compared to Western Europe, North America and some Southeast Asian countries.

The New Delhi-based Dr Gupta attributes this to the country’s world-class facilities and medical resources that it offers at nearly one-tenth the cost in the US and the UK.

“I have many patients from Kenya, Uganda, Zimbabwe, South Africa and Nigeria especially who pay upfront for drugs that will last them six months or so and I send them over.”

Akhil Dave, the general manager at Geetanjali Hospital in Rajasthan state, argues that what makes India tick goes beyond facilities to include the human element.

“What makes treatment in India unique is the human touch and care given by our doctors and paramedical, it makes us very attractive backed by highly skilled professionals and advanced technology doctors and other medical expert s are well trained to use the latest technology in modern medicine,” Mr Dave said.

Business partnerships

He adds that the hospitals are always ready to do business partnerships with accommodation and transport service providers to ensure the patients arrive and settle in with ease.

“We do not expect you to land from Uganda for the first time to a new culture and environment then start looking for accommodation all by yourself when we can make it easier by ensuring that you arrive to a fully furnished house of your choice.”

This almost-seamless way with which the hospitals handle patients in not by accident. In India, health is given priority through the training of healthcare workers.

For example, Rajasthan, one of the 28 states of India, has over 30 medical colleges. According to official statistics of the state government, one of its seven districts, Udaipur has six medical colleges, each producing about 1,000 doctors per year.

This system took long to build. Not so long ago, it was said that if a woman fell really sick, a man married another immediately and moved on.

“No one really cared because most families did not want to waste finances that had been saved for dowry to pay another man’s family on treating a woman who in their view was in a hopeless state as opposed to treating men,” explained Dr Manoj Mahajan, the lead medical oncologist at GBM Memorial Cancer Hospital in Udaipur.

It needed a radical attitude change.

Healthcare schemes

Prime Minister Narendra Modi is mentioned as the political figurehead who tinkered with that mentality. In power since 2014, Modi has put up 15 healthcare schemes, targeting the poor, women and other underprivileged groups.

In his campaigns ahead of elections last year, Premier Modi insisted that his focus was on the four main pillars; universal health, preventive health, affordable healthcare (supply side interventions) and mission-mode intervention.

For example, the flagship Ayushman Bharat scheme, offered through the government’s National Health Policy aims to provide free health coverage at the secondary and tertiary level to its bottom 40 per cent poor and vulnerable population.

The scheme has helped India innovate and upgrade the skills of the workforce to deliver value-based healthcare solutions, efficiencies in costs, increased patient access to healthcare through digital health models which also benefit foreign patients.

Ayushman Bharat is meant to provide affordable drugs to the poor. Some 500 million poor people could enjoy free treatment that costs the government $35 billion every year.

The government has also set up more than 5,000 public medicine centres fully stocked with more than 800 varieties of generic medicines that are available at affordable prices.

That has sort of opened space for foreign patients to get help as well.

“There are three types of Indian hospitals,” says Tribhuvun Ji, a journalist who has been covering health for more than three decades.

“We have totally private hospitals, government-funded hospitals then health trusts and societies,” he explained.

Trusts take money, but not too much and treat at a more affordable rate. Cancer treatment is super expensive but trusts and societies offer us much more economically viable rates.”

In the Indian system, national health policy makes the provision of healthcare a responsibility of the regional state administration, while the central government funds the many health programmes. In fact, government hospitals are often seen as suitable for the poor.

“I do not think there is anything unique with India’s healthcare system. Health is a right to life and medical services should be free not only in India but also in Kenya, Britain and the rest of the world,” Mr Ji argued.

Digital disruption

Peter Kimani, a Kenyan engineer who works at Tata Motors in Mumbai, believes that India is a developing country with so much African countries can learn from and its healthcare system is a combination of men, machines and materials.

“I think treatment in India compared to my experience in Kenya is a little better but the margin is very small. I had a medical issue when I was back home and approached four different doctors who couldn’t pinpoint the problem."

“When I moved to India, I was so shocked that getting a specialist is much easier than at my home country and she predicted my problem accurately within five minutes into consultation after which the tests confirmed it.”

According to Mr Kimani, his doctor listened to him and took an accurate guess at what he was suffering from, which was then confirmed by the tests compared with back home in Kenya where he has been a victim of misdiagnosis.

Those consultants are way cheaper to see too. In Kenya you could pay $50 to see a specialist. In India, the highest is $15.

Dr Manoj Mahajan, the lead medical oncologist at GBM Memorial Cancer Hospital in Udaipur says that digital disruption has played a major role in helping India make inroads into Africa.

Hospitals take patients’ photographs during all the stages treatment and must be submitted to the government that the service was actually offered.

“We have a digital healthcare system, where we upload all the information, documents, pre-operative approvals and all i’s are dotted,” Dr Mahajan told The EastAfrican.

Intensive networking

At the Indian High Commission in Nairobi, for example, patients seeking medical services can get visas during weekends or public holidays, as long as a local referral is presented to the Mission showing extreme emergency case.

In ordinary circumstances, an Indian medical visa of any type takes a maximum of three working days, but officials are under instruction to give the same day if situation is assessed to be extreme.

Then there is an alumni community. “We have African friends who have studied things like medical transcription and other short courses that bridge us to you,” Dr Mahajan explained.

“We basically work together, and the government has made it much easier for foreigners to travel over.”

The use of social media, global marketing and advertising agencies, partnerships with hospitals in Nairobi and other health projects within East Africa has cultivated trust and highlighted the fact that we are very affordable and ready to.

Medical diplomacy

While India’s medical diplomacy is older, strengthened by then Prime Minister Manmohan Singh, it is Premier Narendra Modi who is credited with implementing the friendly visa and medical schemes attractive to foreign patients. Indian consulates and missions abroad face a growing number of inquiries about “M” or medical visas.

The Indian Ministry of Tourism’s 13 overseas offices are stocked with information for those intending to travel to India for medical treatment. The new M-visas are valid for a year and are issued for companions too.

PM Manmohan Singh came up with this idea but PM Modi on coming into power has taken it to a whole new level and overseen implementation.

Those policies, argued Dr Mahajan, “have inspired trust in our healthcare system, our welcoming nature as Indians coupled with states like Rajasthan which is a top tourist destination gets the word out pretty quickly.”

Ms Mwakatumbula, now enjoying a new lease on life, does not hesitate to recommend India but insists on first getting the correct referral.