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Last Updated: Friday, 6 August, 2004, 23:27 GMT 00:27 UK
India woos Africans for medical cure

By Soutik Biswas
BBC News Online correspondent in Madras

Magreth has been given new hope
Back home in Tanzania, doctors had ruled out any treatment for 11-year-old Magreth's cardiac problem.

For the past four years, the frail daughter of farm worker parents had been sick because of a congenital heart disease.

She suffered from searing pain, breathlessness and swollen legs.

That was then.

These days, Magreth is recuperating in a room in a hospital in southern India, over 5,000km (3,125 miles) away from home, after successful surgery to fix her defective heart valves.

"I have never felt better," she told BBC News Online. "I am ready to go back and join school again."

Outsourcing treatment

How did Magreth from a country far away in East Africa land up in a hospital in southern Madras (also known as Chennai) for surgery?

As India becomes a preferred destination for cheap and good quality medical treatment, foreign governments are tying up with hospitals to send their patients who cannot be treated at home.

African patients at the Madras Medical Mission
Tanzanian patients are sent for quality care at the right price

The Tanzanian government, for example, has tied up with three private Indian hospitals to sponsor and send their patients for operations and treatment.

One of them is the Madras Medical Mission, a 200-bed, state-of-the-art hospital well known for its cardiac care.

This is where Magreth has been sent for surgery along with 31 other patients, mostly with cardiac problems. They are accompanied by two nurses.

India was chosen as the place where Tanzania's direly sick could be sent for treatment after its government did a comparative analysis of health facilities in South Africa, India and western European countries.


"We found India offered better services at a cheaper cost. We had begun sending a few patients as early as 1999, but not on this scale," Tanzania's permanent secretary for health, MJ Mwaffisi, told BBC News Online from Dar es Salaam.

Heart operations are comparatively inexpensive in India compared to the West. Open heart surgery in a private Indian hospital typically costs around $4,000, compared to $30,000 abroad.

Salvatamushi, 14
I feel at home because I am part of a big group

Despite relative peace, Tanzania remains one of the poorest countries in the world, heavily reliant on foreign aid, with many of its people living below the World Bank poverty line.

Anna Hunjula, one of the nurses accompanying the group of patients, says that her country does not have any paediatric heart surgery facilities, and many of the suffering children have to be sent to India for treatment.

The 12-hour air journey to Madras with a break in Bombay (Mumbai) is arduous, but for most of the patients successful treatment in India gives them a fresh lease of life.

Like 14-year-old Salvatamushi, daughter of a policeman, who will soon be operated on to fix a leaky heart valve. "I feel at home because I am part of a big group," she says.

Or three-year-old Benedict and 17-month-old Marie Kwige, who are both accompanied by their mothers and have undergone heart surgery.

"I can feel my baby getting better every day. Her heart is beating so much more normally now. Her pallor has changed," says Marie's mother, Ivona.

In the spanking clean corridors of the hospital, recuperating Tanzanian children roam around. In their rooms they are glued to Indian music videos and children's programmes on cable television.

'Resilient and strong'

The hospital's top paediatric cardiac surgeon, Roberto Coelho, who does most of the operations, says that 24 of the 32 Tanzanian patients are children, aged between seven months and 18 years.

Tanzanian patients
Most of the Tanzanian patients are children
"Most of them seem to be poor, and suffering from congenital heart problems of various kinds. Some have rheumatic heart diseases," Dr Coelho says.

Hospital doctors marvel at the "resilient and unfussy" little patients from Africa.

"They recover very fast. They are resilient, adaptive strong and never throw tantrums," says paediatric cardiologist Anpon Bhagyavathy.

Hospitals like Madras Medical Mission are now aggressively hard-selling their core competencies and competitive costs to woo patients from abroad.

The 17-year-old hospital has already treated patients from 32 countries, including the United Kingdom, US, Australia and Italy. Some 10% of foreign patients are from Africa.

The hospital takes pride in its cardiac care: governing board member Verghese Eapan claims a "zero mortality" rate for some 300 paediatric heart operations in the past six months.

The hospital has now tied up with the Seychelles government for a similar transfer of patients from that country.

Verghese Eapan says the hospital also "offered its services" to the UK's National Health Service (NHS) to outsource patients for surgery last year. "But they declined saying they were not sending their patients abroad as yet."


Madras Medical Mission is among a growing number of private Indian hospitals who pride themselves on good doctors, state-of-the-art equipment and a clean environment to treat the most complicated ailments.

India's health indicators are among the worst in the world
Economist Jean Dreze

The private Apollo chain of hospitals, in fact, claims to be treating some 20,000 foreign patients a year.

Analysts find India becoming a health destination for African patients a bit of an irony, and point to the fact that public spending on health in Tanzania - 1.3% of GDP - is actually a tad more than India's.

They also point out that half of all Indian children are undernourished and half of all adult women suffer from anaemia.

They say most of these private islands of medical excellence which woo foreign patients are out of reach of the average Indian, and their runaway growth points to the abject failure of the public health system.

"India's health indicators are among the worst in the world," says eminent economist Jean Dreze.

"Health is virtually absent from public debates and democratic politics in India."

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