Vol.6 | Issue No.4 |Apr - Jun 2022 (English) by Lalfx

ISSN 2582-452X Vol.6 | Issue No.4 |Apr - Jun 2022

Travel Facilitators

UPBEAT ON PROSPECTS

Expert say how to

BREATH EASY

The Psyche and

THE PANDEMIC

Kerala's

HEALTH BATTLE Cover Story

MEDICAL VALUE TRAVEL

BACK WITH A BANG A Complete Magazine on Healthcare in Asia

Medical Tourism Apr - Jun 2022

cancer couldn’t take away her happiness

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A Complete Magazine on Healthcare in Asia

Vol. 6 | Issue No. 4 |April - June 2022

TO HORIZONS NEW

RNI No. KERBIL/2016/68979 Editor & Publisher BENNY THOMAS

One sphere of human activity that was hit hard by the pandemic was tourism, particularly health tourism. While travel for pleasure is something that a person can defer, travel for medical care is not something that be postponed indefinitely. At stake here is the life and well-being of persons who must reach the best healthcare destination. Like everyone else, we at Medical Tourism were also hurt grievously by the Covid-19 malady. And, like everyone else, we too are commandeering all our energies and resources to bounce back. This is a battle we must all win together.

Group Editor C GOURIDASAN NAIR Editorial Co-ordinators VINOD NEDUMUDY* KRISHNA KUMAR K. E.

This issue of Medical Tourism is naturally focused on that battle. We wish to bring back to focus the importance of medical value travel—for both those who seek the best medical care at affordable prices and those who have the facilities and expertise to offer to the world. Our cover story is, therefore, on some prime players in the medical value tourism sector reflecting on the battle against Covid-19, the current state of the industry and how it can forge ahead in the days to come. We also have a related story, featuring key medical value tourism facilitators, on the challenges ahead and ways to overcome them.

Marketing & Promotion GEO PAMPACKAL Layout & Design LAL JOSEPH Arabic Translation Prof. Dr. A. ABOOBACKER (Retired Professor of Arabic)

We also have two special articles on Kerala’s fight against Covid-19, Nipah, Zika and Black Fungus putting to good use its army of sterling healthcare professionals and the spectacular healthcare infrastructure it has built over the years.

BUSINESS ASSOCIATES Overseas USA

: CHICAGO: Vincent Joseph

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: Houston:

Shaju Joseph, Mob: 847 899 2232 USA

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Vincent Sebastian, Mob: 917 992 9629 USA

The Covid-19 pandemic has disruption on a scale unknown to humanity after World War II. Every sphere of life was affected by the malady which claimed millions of lives, devastated businesses, and rendered hundreds of thousands of people jobless. The malady has now subsided, but its variants are making their appearance in different parts of the world, leaving nations, populations and businesses on tenterhooks. The message is clear: the world needs to remain alert to similar disruptions anytime in future.

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Wilson Nechikat, Ph: 408 903 8997 Canada

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BUSINESS ASSOCIATES India Mumbai

: Mohan Iyer, Mob: +91 22 6450 5111

Eastern India

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: Kuriyan K. Raju, Mob: +91 944 610 6644

Focus further on Covid-19 and its aftermath, we have included in this issue articles by specialists in diverse fields. Thus, we have an insightful article by an eminent psychiatrist on the importance of mental well-being in the post-Covid phase. We also have two experts weighing in on tackling the impact of Covid-19 on the lungs. There are sections on Yoga and the use of Ayurveda in the fight against Covid-19, apart from the regular features such as a listing of the major upcoming medical events, prominent hospitals, and major medical news of interest. Covid-19 presented each of us with a grave challenge. We have overcome that, though paying a heavy price in terms of lives and livelihoods lost. Humanity must forge ahead. India has shown how best to tackle the huge challenge that an unfamiliar malady such as Covid-19 posed. The national economy has shown its resilience by remaining on the growth path despite the disruption of the last two years. The healthcare and wellness sectors of the economy have also bounced back with confidence. This is the time to pack your bags to leave for your chosen healthcare destination in different parts of India. We are here to welcome you with the promise that we will be there at every step as your truly high value medical travel partner.

Vinod Nedumudy Editorial co-ordinator

*Responsible for selection of news under the PRB Act CORPORATE OFFICE FM Media Technologies PVT Ltd, Penta Square, Opp.Kavitha, MG Road, Cochin -682016, Kerala, India. Tel: +91 484 403 4055 Email: director@asianmeditour.com www. asianmeditour.com

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Printed, published and owned by Benny Thomas FM Media Technologies Pvt. Ltd, Penta Square, Opp.Kavitha, MG Road, Cochin -682016, Kerala, India. Editor: Benny Thomas

Printed at Sterling Print House Pvt Ltd, Door No. 49/1849, PonekkaraCheranellur Road,Aims, Ponekkara P.O, Cochin-682041, Ph: 0484 2800406.

Disclaimer: The statements in this magazine have not been evaluated by the Food and Drug Administratin of USA or any other country. Information provided in this magazine are not intended to diagnose, treat, cure or prevent any disease. If you have a medical condition, consult your physician. All information is provided for research and education purpose only.

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Your Reliable High Value Medical Travel Partner Your health is your most precious asset. And we value your health. Allow us to hold hands with you to ease your way through Visa clearances, transport arrangements, hospitalisation, recuperation and rejuvenation and timely follow-up at the best medical facilities in India.

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Contents 08

News

Events

Cover Story: Medical value travel back with a bang

A beacon of hope

Facilitators upbeat on prospects

Equipment World

The psyche and the pandemic

Rare Surgeries

Breathing easy

Yoga in the post-Covid phase

Kerala goose-stepping as global Ayurveda hub

34 38 41 6

Medical Tourism Apr - Jun 2022

Kerala’s battles on the health front You Name It, We Have It Medical Mall to grace Thalassery

Hospitals

Wellness Centers

NEW DAWN IN ROBOTIC-ASSISTED KNEE REPLACEMENT One of most performed surgeries in the world is knee replacement and this is a segment that’s getting evolved with advanced implants to surgical methods. Stryker, one of the world’s leading medical technology companies, has introduced the Mako Smart Robotics for knee replacements ( partial and total). Dr.Madan Mohan Reddy, Senior Consultant Joint Replacement Surgeon from Apollo Hospitals, Chennai, answers questions on the role of robotics in knee replacements.

Q: Dr Madan, with over two-and-a-half decade’s experience in joint replacements, how do you the see robotics changing the knee replacement scenario? A: Well, at Apollo Hospitals, Chennai, we have the state-of-theart orthopedics and joint replacement unit. We have been in the forefront of brining advanced care for our patients, and we are the first in South-East Asia to introduce the Mako Smart Robotics System. A distinct, prospective, consecutive series, single-surgeon study comparing patients undergoing conventional jig-based total knee replacement versus Mako Total Knee surgery concluded that Mako Total Knee with Triathlon was associated with less need for opiate analgesics (p<0.001), less time to hospital discharge (26% reduction in LOS), less need for in-patient physical therapy sessions (p<0.001), and less postoperative pain (p<0.001). Essentially, the system ensures better outcomes and success rate than conventional knee replacement surgery. Q: Who is a candidate for robotic knee replacement?

is fed into the system with which the robotic system creates a 3D model and this model gives guidance to the surgeons to accurately place the implants. During the operation, the robotic arm uses data from the 3D model to create a predefined space for the surgeon to work in, preventing him from accidentally damaging surrounding soft tissues. Q-5: How good is the knee robotic system for the patient? A: With robotics, there is greater surgical precision, this means that less bone and soft tissues are disturbed, and this increases the body’s natural healing process. In a conventional knee replacement surgery, some amount of soft tissue release and / or sacrifice is needed. While this doesn’t impact pain after surgery, it can impact how an artificial knee feels after recovery. The robotics will help soft tissue sparing and this is very important for patients who are highly active. For more details and free second medical opinion, you can connect with our relationship manager Mr.Ragil Raghunath at ragil_r@apollohospitals.com

A: Any patient who is advised for a total knee replacement is a candidate for robotic assisted knee replacement. Q: Is surgery performed by the ROBOT? A: This is one of the most repeated questions when it comes to robotic surgeries. Keep in mind that today robotics is used for guidance, better access, lesser incision, increased dexterity, less blood loss, faster healing etc. In robotic knee surgery, the Mako Robotic system is used to assist the surgeon through its robotic arm and the surgeon is the one who performs the procedure. Q-4: How does the robotic system for knee surgery work? A: The Mako Robotic System has a specially designed software. Prior to the knee surgery, the patient’s CT scan image

About Apollo Hospitals Enterprise Ltd. (AHEL) It was in 1983, that Dr. Prathap Reddy made a pioneering endeavor by launching India’s first corporate hospital - Apollo Hospital in Chennai. Now, as Asia’s largest and most trusted healthcare group, its presence includes over 1000 beds across 72 Hospitals, over 3000 retail pharmacies, 100 primary care and diagnostic clinics, 100 telemedicine units across 9 countries, medical business process outsourcing services, health insurance services, global projects consultancy, 15 colleges of nursing and hospital management and a research foundation with a focus on global clinical trials, epidemiological studies, stem cell and genetic research. A Complete Magazine on Healthcare in Asia

MEDICAL TOURISM NEWS

27 PROTEINS TO PREDICT HEART DISEASE RISK

cientists have come out with a finding that a blood test can be used to predict Cardio Vascular Diseases (CVD). Published in ‘Science Translation Medicine’ the study open vistas for individualised treatment plans for CVD while speeding up the process of identifying and developing new CVD drugs. Surrogate biomarkers being used as a predictor of risk helps in speeding up and reducing the cost of drug development without sacrificing efficacy or safety. According to Dr. Stephen Williams, Chief Medical Officer at SomaLogic, and the corresponding author of the study, after analysing blood plasma samples from 22,849

people, they studied 5,000 proteins from these samples, and using machine learning identified 27 proteins that together could predict the risk of stroke, myocardial infarction, heart failure, or death over a 4-year period. The 27 protein markers are an improvement over current risk score calculators like high cholesterol which do not predict when a cardiovascular event is likely to occur. The markers help doctors to know what is going to happen with enough advance notice to be able to change the outcome.

NEW PROMISING DRUG IN MULTIPLE SCLEROSIS TREATMENT

study published early this year has found that contracting the Epstein-Barr virus (EBV), a herpes virus, increases a person’s risk of Multiple Sclerosis (MS) significantly. Studies have also found EBV-infected immune B cells in patients with MS. Multiple sclerosis (MS) is a chronic condition that affects the central nervous system of human body and is characterized by the immune system attacking myelin sheaths — fatty layers that surround nerve fibers and enable them to communicate. Though researchers are unclear how EBV increases MS risk, one study throws a possibility of EBV proteins mimicking human myelin proteins and induce an immune reaction against myelin by CNS antigens. Atara Biotherapeutics, Inc., an allogeneic T-cell immunotherapy company, recently began an ongoing Phase 1 clinical trial to examine an experimental T-cell immunotherapy drug called ATA118 that targets EBV-infected 8

Medical Tourism Apr - Jun 2022

cells in people with MS. Of the trials in 24 volunteers, 20 showed improvement or a halt in progression after a year of treatment. The researchers say their findings demonstrate the potential to halt or reverse disability progression by targeting what may be the root cause of MS.

MEDICAL TOURISM NEWS

LEARN AFTER YOU SLEEP FOR BETTER RETENTION

urther evidence has come out on the correlation between sleep and learning with researchers from Brown University and the RIKEN Center for Brain Science going deep into the subject. They have found that sitting awake late into night for study doesn’t help. Sleep helps a person absorb what they learn while awake through a process that is specifically centered on learning. This means that the more sleep a person gets, the more time their brain has to process knowledge and skills learned while they are awake. The use-dependent model that the scientists used finds that the amount a person learns while

sleeping is the result of how the brain functions when awake. On the other hand, the learning-dependent model states that what a person retains during sleep is directly connected to a neural process specifically related to learning. The research suggests that learning after sleep is beneficial for learning to be enhanced and protected. The results from the study appear in ‘The Journal of Neuroscience.’ This is good news for those who sleep early and wake up early in the morning to study.

IS BEER HEALTHY? HOW MUCH SHOULD PEOPLE DRINK?

eer decreases risk of heart disease and osteoporosis, however, its heavy drinking can lead to cancer, liver disease and cardiovascular diseases. The minerals in beer include calcium, copper, iron, magnesium, manganese, silicon, selenium, fluoride, phosphorus, potassium, sodium and zinc and the Vitamins include Vitamin B1, or

thiamin, Vitamin B2, or riboflavin, Vitamin B3, or niacin, Vitamin B5, or pantothenic acid, Vitamin B6, folate, choline, Vitamin B12, or cobalamine, Vitamin A, Vitamin E, Vitamin D and Vitamin K. Beer also contains the amino acids alanine, aspartic acid, glutamic acid, glycine and proline. A recent review artcile concludes that people who consume beer in moderate amounts have higher high-density lipoprotein cholesterol — or “good” cholesterol, better vascular elasticity, and higher apolipoprotein A1 levels. It decreases the risk of neurodegenerative diseases such as Alzheimer’s disease and may control blood sugar levels. However, heavy or excessive drinking may lead to cancer, liver failure, cardiovascular disease, diabetes, pancreatic disease, infectious diseases, neuropsychiatric diseases, weight gain and depression. Experts say even though beer contains a variety of nutrients, people should not turn to beer for its nutritional value. Eating a diet full of fruits, vegetables, whole grains, and lean proteins should be more of a priority.

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MEDICAL TOURISM EVENTS

KERALA TRAVEL MART

he inauguration of one of the biggest tourism events in India, the Kerala Travel Mart, will be held at Hotel Grand Hyatt in Bolgatty in Kochi on May 5, 2022. It will be followed by business meets on May 6 and 7 at Sagara and Samudrika convention centres at Willingdon Island, Kochi. The event is positioned as a common ground for travel agents from across the globe and the service providers in Kerala to connect. Alongside its focus on Malabar, Kerala Tourism is going ahead with giving worldwide publicity to its renewed post-pandemic activities such as Caravan Tourism, Champions Boat League, Responsible Tourism, Ayurveda, adventure, plantation, and backwater resorts besides positioning Kerala as wedding destination and MICE (meetings, incentives, conferences and exhibitions) destination. Several attractive schemes and packages will be featured in the business meets of KTM, aiming to attract both international and domestic tourists. The public will have access to the pa-

vilions in Sagara and Samudrika on the concluding day of May 8 from 1 pm. The green-compliant conclave at the 100,000-sqft venue will host more than 2,000 delegates, including buyers, sellers and policymakers from within the country and abroad. https://www.keralatravelmart.org/ Home

ARABIAN TRAVEL MARKET

he Arabian Travel Market is the market-leading international travel and tourism event being hosted in Dubai unlocking business potential within the Middle East for inbound and outbound tourism professionals. Tourism destinations from around the world will be showcasing their brands and exhibit side by side with the biggest names in accommodation and hospitality including innovative travel technology providers and airlines. The show to be held both online and offline at Dubai International Convention and Exhibition Centre (DICEC) on the Sheikh Zayed Road will focus on the future of international travel and tourism. The event will explore new tourism trends, opportunities for growth, innovation, and of course effective recovery. ATM 2022 offline event will take place in Dubai on 9-12 May, 2022 and the online event will be held a week after from 17-18 May. https://www.wtm.com/atm/en-gb. html

10 Medical Tourism Apr - Jun 2022

TY & QUAL

PAT

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MEDICAL TOURISM EVENTS

OMAN HEALTH EXHIBITION AND CONFERENCE

man Health Exhibition and Conference is an international annual event that showcases the continued development of the health and medical sector in Oman, the industry’s market potential, and emerging opportunities. It will be held from September 20-28, 2022, at Oman Convention Centre, Muscat. The exhibition provides a platform for medical professionals, traders, manufacturers, suppliers, service providers and stakeholders of the healthcare industry to explore new opportunities, showcase the latest technologies, services and facilities, and leverage potential for trade and investment. It has a healthcare exhibition and medical tourism exhibition. Close to 4500 trade vis-

itors and 100 companies from ten countries will participate in the expo. Medical tourism associations and trade promotions bodies, international hospitals and medical centers, airlines and travel agents, medical tour operators, hotels and health resorts and wellness centers will be part of the medical tourism exhibition while

INDIA INTERNATIONAL TRAVEL MART, HYDERABAD

he India International Travel Mart Hyderabad to be held from December 2 to 4, 2022, in Hyderbad, is a pioneer in travel-trade exhibitions and strives to foster a vibrant environment for business and business client organizations across the most prominent feeder cities of India to network and contract. IITM events provide a unique opportunity for professionals from the tourism industry to meet and connect with people interested in travel and other related business. IITM events showcase a diverse range of destinations and industry sectors to Indian and International travel professionals. It is a unique opportunity for the travel trade to meet, network, negotiate and conduct business. Over 1500 exhibitors and 10,000 visitors are expected for the event. https://10times.com/iitm-hyderabad

12 Medical Tourism Apr - Jun 2022

healthcare products and services, medical products and services, infrastructure enablers, medical equipment suppliers and pharmaceuticals will be part of the healthcare exhibition. https://www.omanhealthexpo.com/

HOSPEX JAPAN

OSPEX Japan is a comprehensive exhibition of equipment and devices for medical and welfare facilities. Many exhibitors, visitors, institutions and agencies have been supporting HOSPEX Japan for a long time, and this is why HOSPEX Japan has a high reputation. The event will display medical equipment, nursing products, infection control and welfare equipment, medical information technology and system, construction equipment and much more. https://10times.com/hospex-japan?

from QRS wellness QRSadevice fromproduct Germany Germany it is now available in India it now available in India

Cellular Effects Of QRS • Improves Intercellular Fluid and Blood Flow, Stimulates the Production of ATP, Increases Cellular Energy Levels, Increases Cellular Oxygen Levels. Promotes Cellular Healing, Stimulates Inter-Cellular Communication, Stimulates Electron Transport In Cells.

or Hospitals, physiotherapy centers,

lf Idea

QRS (Quantum Resonance System) is a Pulsed Electro Magnetic Field (PEMF) therapy equipment manufactured in Germany and marketed and serviced by Doctor M Company Pvt Ltd,

wellness centers, or to doctors, physiotherapists

Another business model is open the franchisee center of Dr M QRS wellness Physio center using QRS technology Dr M QRS wellness physio center is the master franchisee to set up franchisee centers using QRS device for pain management and wellness It is being installed at All India Institute of Medical science New Delhi and in Dr M QRS wellness Physio center at Karunagappally, Kerala

Enquiries for QRS product and franchisee center are invited

a Kerala based wellness company in association with QRS India Pvt Ltd the Haryana based company. •

It is a revolutionary cure against

chronic pain and diseases. QRS is a German technology having 3 international patents. Very effective for all type of pain, such as knee pain, shoulder pain, back pain etc, and other conditions such as

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Parkinsonism , Glaucoma, Alzheimer's disease, Diabetic Polyneuropathy, Arthritis Symptoms, Atopic Dermatitis, Heal Ulcer, Wound Healing, Muscle Stiffness, Muscular Disorders, Osteoporosis, Migraines, Fibromyalgia, Sleep Disorders etc.

Bldg. No. 7/873, Doctor M Institute Building, Near AM Pharmacy College, Vavvakkavu, Karunagappally, Kollam 690 528 Ph : +91 99 47 333 888, 0476 2640688 drm.qrs@gmail.com www.doctorm.in/qrs

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MEDICAL TOURISM COVER STORY

MEDICAL VALUE TRAVEL

BACK WITH A BANG Vinod Nedumudy

The global medical value travel (MVT) market which accounted for US$ 54.4* billion in 2020 is projected to reach US$200 billion by 2027. The pandemic may have interrupted the smooth progress of the sector, but experts feel that by the end of this year it will return to the pre-Covid pattern and then make a surge in 2023. However, India’s share in the global market was at US$ 5-6 billion pre-Covid, which shows that there is a huge potential to be tapped and the players in the sector, recovering from the pandemic, are optimistic about making a surge, reports Vinod Nedumudy

Source: statista.com

14 Medical Tourism Apr - Jun 2022

hile India’s medical value travel sector was projected to reach US$ 13 billion by 2022, the Covid-19 outbreak seems to have delayed achieving this milestone. With flight services being restored, the Metro destinations including the medical capital of Chennai and Kerala are revving up to welcome more and more foreign nationals desiring to get quality care at affordable costs.

pandemic from which we are slowly recovering, has once again established the common denominator for human life, which is ‘good health’. “The most affected industry which is taking its baby steps is global tourism. The impact of tourism revenue losses has changed the landscape of many countries,” said Jithu.

E M Najeeb

Global studies say that the Asia-Pacific region is poised to witness humungous growth in the sector in the coming days as it remains lucrative in terms of high-quality care at a reasonable cost. While Thailand, Singapore, and South Korea give us a run for our money, the opportunities are enormous if private players join hands with both Central and State Governments to offer the best packages and best care along with the best publicity. “While our metro cities offer top class care and facilities, Kerala is also in the vanguard having excellent private hospitals and topclass professionals. Our major hospitals have received both national and international accreditations and have the coverage of international insurance companies which enable a smooth flow of medical value tourists. With flight operations turning normal, we will have a steady flow of medical value tourists. Already we are witnessing good arrivals from our two prime clients, that’s Maldives and Oman and we are sure to attract more from the Middle East, West Africa, Europe and the US,” said Mr E M Najeeb, Executive Director of KIMS Health, Thiruvananthapuram. Mr Najeeb said that the brilliant handling of the pandemic by India has caught worldwide attention and a renewed interest in India’s healthcare sector. “Many more people overseas now find our healthcare system reliable and they will flow to the key hospitals in the coming days to get ex-

Executive Director,KIMS Health

cellent care at affordable rates. There is no medical cost change in the postCovid period from the pre-Covid period in India and Kerala’s edge is in giving homely care,” Mr Najeeb said. Mr Najeeb said that elective treatments have also picked up pace in the post-Covid-19 phase. “The Central Government has simplified rules regarding medical visas and it’s now easy for bystanders and others to accompany the patients,” he said. Mr Najeeb said that in Kerala the State Government should come out with a policy initiative to promote medical value tourism. “A public-private partnership should be evolved and the state health and tourism department should take the lead for it,” he said. According to Jithu Jose, Vice-President of International Business Development at Apollo Hospitals, the

Jithu Jose Vice-President-IBD, Apollo Hospitals

“To reboot MVT for a country like India, we may need a refined approach, the efforts by the Central Government on this front are worth appreciating and the states should also support the providers,” said Jithu. “If we consider MVT as just a subset of global tourism, the recovery can take at least a year or more to reach the 2019-20 FY scenario. On a positive note, we should look at the MVT segment to take the lead in kickstarting normal tourism too. For India, the opportunity would be to project more super-specialty services and the immediate approach should be value-based and not volume-based,” said Jithu. “The opportunity for MVT should not be assessed based on deferred care statistics and should be based on ‘ value for money’ and clinical bandwidth; only such an approach can facilitate the MVT segment growth,” said Jithu. “We have definite reasons to be optimistic and to see India evolving as a global healthcare destination and the re-boot needs a lot of handholding from the government to hospitality providers to airlines. The pandemic may bounce back, another wave or ripple effect, but MVT can be nurtured and has to be... call it shared responsibility beyond geographical boundaries,” said Jithu Jose. Farhan Yasin, Director, Aster DM Healthcare, said that 10-12 per cent of our total revenue of the group came from medical tourism in pre-Covid times. “During the first wave, revenue came to nearly zero because the air traffic had come to a halt. SubseA Complete Magazine on Healthcare in Asia

1200 robotic-assisted surgeries by transplant surgeons, urologists, and gynaecologists. The hospital also is one of the very few in the region to offer full-fledged Extra Corporeal Membrane Oxygenation (ECMO) facilities reviving critically ill patients,” he said. Farhan said that the exotic travel destinations in Kerala are within 3-4 hour reach of Aster which has a dedicated travel desk to assist. Farhan Yasin Director, Aster DM Healthcare

According to Harish Manian, CEO, MGM Healthcare Pvt Ltd, though the loss from the pandemic was unimag-

quently, we revived a little bit. In the last quarter we were at 50-60 per cent of the pre-Covid levels. Patients were coming to us through an air-bubble arrangement. We have recovered up to 6-7 per cent now. By the Q1 of the current financial year, we hope that we will reach the pre-Covid level of 10-11 percent, and from there on, we can expect some growth,” said Farhan Yasin. “Now we should be seeing the bulk of the patients coming from Oman, Maldives, Saudi Arabia, and UAE. Kerala gets approximately 60% of its medical travelers from GCC. We have four hospitals in Kerala which cater to international patients which are Aster Medcity Kochi, Aster MIMS Calicut, Kottakkal and Kannur. Aster Medcity is Kerala’s first quaternary care hospital and accredited by JCI, NABH, received NABH certification for nursing excellence, Green OT (Green Operation Theatres) Certification by Bureau Veritas all within a year of opening its door to the world,” said Farhan. Farhan said that Bone Marrow Transplant, Liver Transplant, Kidney Transplant, Parkinson and Movement Disorders treatment including Deep Brain Stimulation (DBS), Spine Surgery, Epilepsy Surgery, Cardiac Electrophysiology offered by Aster has already benefited hundreds of people across the world. “Aster Minimal Access Robotic Surgery (MARS) program has successfully performed over 16 Medical Tourism Apr - Jun 2022

Harish Manian CEO, MGM Healthcare Pvt Ltd

inable, the ineffable contribution and sacrifice of the frontline workers underpinned where we are now. Frontline workers at MGM Healthcare experienced high work volume, personal risk and societal pressure to meet extraordinary demands for healthcare. The hospital also faced challenges in performing elective surgeries since patients were reluctant to visit the hospital due to the fear of Covid. “The pandemic had a major impact on MGM Healthcare when the OPD number dropped from 400 patients a day to below 150 patients. Surgeries dropped from 20 to 5 a day. Before Covid, there was a steady inflow of over 7500 international patients from over 54 countries. These numbers dropped significantly during the pandemic,” says Harish Manian According to Harish Manian, the

trust of patients coming from different parts of the country and the rest of the world for electives and emergency surgeries helped the firm to bounce back. Regular follow-ups with patients while continuously being the watchdog during Covid enabled the hospital to maintain a subtle balance. Besides, the collaborations from different countries and networks nudged patients back. He said that MGM Healthcare during the pandemic ran the largest ECMO programme in the country to help the patients to recover from Covid-affected lungs and performed the first lung transplant on a Covid-affected patient. He said that the hospital expects a major inflow of MV tourists from the MENA sector, SAARC, Africa, CIS countries, and parts of Europe. “Chennai being the gateway to the cultural heritage of Tamil Nadu we can direct the guests to many tourist spots across the state,” he said. Yes, the operators in the MVT sector are gung-ho about future prospects. Let’s take off!

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MEDICAL TOURISM STAKEHOLDER TAKE

FACILITATORS UPBEAT ON PROSPECTS Our Correspondent

he facilitators are the backbone of any industry and the medical value travel (MVT) sector is no exception. With Covid-19 playing mayhem across the world for the past two years, along with the medical value travel operators, the facilitators too were at the receiving end. Even as the sector limps back to normalcy, the facilitators are optimistic that order will be restored in the sector by the end of the year. “The MVT Sector had a huge setback because of Covid-19 and the resultant flight restrictions. India also lost to some other key medical tourism destinations which did not close their borders for treatment. However, now our sector is bouncing back sharply and all pending patients have started traveling. Hospitals have started getting aggressive in their marketing and so has travel started for medical tourism companies,” said Mihir Vora, Founder & CEO, Magnus Medi, an MVT facilitator based at Mumbai.

18 Medical Tourism Apr - Jun 2022

Govt boost needed

When asked how he, as an MVT facilitator, would assure travellers on costs post-pandemic, Mr Mihir Vora said that hotel expenses may have gone up, but across the world it is the same. “India is still best in terms of quality treatment at the most affordable prices,” he underlined. Dr Savad said that India is still a favorite destination of not only nationals of GCC countries, Bangladesh, Maldives and Sri Lanka, but also African, Central Asian and European nations. “We have competitive rates and low waiting period,” he said and added that the country is in the league of Thailand and Singapore in drawing medical value tourists. According to Mr Mihir Vora, Bangladesh would be our best customer in the coming days while Afghanistan which had been sending a number of patients is in limbo now. “The other

mar-

kets

Dr. SAVAD

Chairman, Global Healthcare Services Ltd.

Dr Savad said that the pandemic restrictions hit both patients and hospitals in the same measure. “Hospitals over the years had added infrastructure including logistics and manpower to cater to foreign patients incurring a lot of expenses but they had to suffer losses,” said Dr Savad.

same.

The

govern-

ment

should

processing and other as-

Concurring with the sentiment, Chairman of Kochi-based Global Healthcare Services Pvt Ltd, Dr Savad, said that at the height of the pandemic, healthcare institutions, including top medical travel destinations, cut back on treatments they offered, suspending elective procedures and channelling healthcare resources to combat the virus.

Mr Mihir Vora said that the priority now before MVT facilitators is to reactivate partners and resume the business. “We had already started the process from last year and companies are working hard to reestablish their lost or stopped offices/partners. Facilitators like us have started travelling and doing marketing in the offline offices and also started digital campaigns which were on hold,” Mr Mihir Vora said.

the

make the visa

On the revival path

“Now, as travel is slowly returning to normal, medical travellers have new expectations from a medical tourist destination - these patients now not only seek quality and affordability of medical care but also a medical travel destination that has put in place adequate measures to safeguard their health, given the COVID-19 pandemic,” said Dr Savad.

remain

pects

easier

in such a way as to help the growth of MVT industry which is

emerging

from the setback

Mihir Vora,

caused

by Covid-19,” Mr Mihir Vora

Founder & CEO, Magnus Medi

said. Mr Savad said

that official promotionals by government agencies for the Ayruveda, Sidha, Unani, Yoga and Naturopathy sectors at this hour would immensely boost the MVT sector. Traditional segments like cardiovascular, orthopedic, dental and cosmetic treatments should also get the desired help to get back to the track. “We are in discussions with established players in the industry to offer quality service to tourists across various budgets and needs. With the resumption of travel, medical tourism is set to see growth by the end of 2022 at pre-pandemic levels with demand being restored,” said Dr Savad. A Complete Magazine on Healthcare in Asia

MEDICAL TOURISM COVID AND AFTER

THE PSYCHE AND THE PANDEMIC

Dr. C. J. John

Consultant Psychiatrist, Medical Trust Hospital, Kochi

ovid-19 pandemic has dealt a ‘body and mind blow’ to entire humanity in one fell swoop and many parts of the world are yet to recover from it. Being a psychosomatic disease, its ramifications are unprecedented and from pre-covid to covid to post-covid, it has shaken several frames and many victims are not with us now. In the psychological and psychiatric realms, the three phases of pre-covid, covid and post-covid have been extremely traumatic for several people. The Medical Tourism Magazine has caught up with one of the most eminent psychiatrists of our times Dr C J John, Consultant Psychiatrist with Medical Trust Hospital, Kochi, to identify the various psychological as well as psychiatric dimensions of Covid-19 and how to overcome the same in the days to come.

20 Medical Tourism Apr - Jun 2022

The very common issues in all the three phases of Covid start with anxiety, stress, fear, low mood, sleep and appetite disturbance, headache, fatigue and general weakness. They can worsen to psychiatric disorders, anxiety disorders, depressive disorders, stress-related disorders, suicidal thoughts, and even psychosis. Delirium is also common during the acute stage of Covid-19 while brain haemorrhage cases have gone up during the pandemic. “In some persons, many of the above initial symptoms resolve on their own with adequate coping. But with certain others, when such symptoms persist for longer, and significantly disrupt his or her day-to-day functioning, it becomes clinically relevant and must be taken care of by a medical expert,” says Dr. C J John. The fundamental approach, in most cases, is to help people understand it is normal to feel overwhelmed during such phases. “But don’t ignore such stress, but acknowledge and validate all your concerns. Connect with your existing support network, including your family members and friends, and convey to them your emotions and thoughts. Maintaining a daily diary and learning relaxation techniques like deep breathing and diaphragmatic breathing and indulging in positive self-talk, engaging in self-soothing activities like reading, cooking, singing, and gardening, helps one overcome grief and stress. Don’t remain bitter about any loss. All these are important in the three phases of Covid-19, including the ongoing post-Covid-19 phase,” adds Dr. C. J. John. Quarantine and social distancing, too, make their own impacts. People experience emotional disturbance, irritability, insomnia, depression and post-traumatic stress symptoms immediately after the quarantine period too. The psychological effects in such cases can last for up to three years. Social distancing can lead to increased loneliness, anxiety, depression, domestic violence, child abuse, and substance abuse. Prolonged social isolation can lead to social withdrawal.

Bereavement crisis

“One of the major issues during Covid-19 is bereavement over the loss of a relative or friend. In several cases, it’s a Covid-19 affected person witnessing the death of another Covid affected relative. It could be his/her mother, daughter, brother, or father. This is extremely painful, especially when two Covid affected-kin are admitted to hospitals or their ICUs. The shock that it makes to the survivor is beyond description. Its impact is immeasurable and systematically dealing with it is a priority,” points out Dr. John. Dr. John says that healthcare providers, while dealing with post-Covid issues, should actively and empathetically listen to the bereaving family members. “Allow them to ventilate their emotions. Help them understand that grieving is a process that is very subjective to each person. There is no right and wrong way of grieving. Grief takes time for its processing and people should allow themselves this time to process grief,” he says. “Help people identify what gives them hope and courage, encourage them to involve in activities that help them gain strength, help them reconnect with their lives in meaningful ways again, let them know it is okay if they are not being able to handle the grief now, encourage them to try. However, do spread awareness that sometimes a psychotherapist can help them in the process. Provide a few local services available and encourage them to seek help when required,” says Dr John. A Complete Magazine on Healthcare in Asia

Lancet Covid-19 study

A Lancet study post Covid-19 outbreak released last year revealed that people who had to be hospitalised, especially in ICUs, suffered in terms of psychiatric and neurological issues. Increased risk for strokes in Covid-19 patients was reported. The study reported preliminary evidence for an association between Covid-19 and dementia. In the Lancet study among 2,36,379 patients diagnosed with Covid-19, the estimated incidence of a neurological or psychiatric diagnosis in the following six months was 33·62%, with 12·84% receiving their first such diagnosis. For patients who had been admitted to an ICU, the estimated incidence of a diagnosis of the same was 46·42%.

The socio-economic crisis

Unemployment, insecure job situation, and very low or nil incomes as a result of the economic recession arising from Covid-induced lockdowns and collapse of business activities have also led to psychological distress, anxiety, depression, substance abuse disorders, and suicide and suicidal behavior. In the initial stages, stigma attached to Covid-19 had resulted in emotional disturbance and other issues in the victims.

What helps in such crises?

Dr. John says that while one manages negative emotions, one should also 22 Medical Tourism Apr - Jun 2022

strive to achieve resilience and well-being. Resilience is defined as the ability of people to bounce back after adversities. “Cultivate emotions of gratitude and forgiveness for the past, practice mindfulness by slowing down, connecting with your immediate surroundings, refocusing, and engaging with the present. Use your five senses to experience the moment that you are in now. Listen to the sounds of nature, observe your surroundings, and feel the touch. It can be practiced anywhere and anytime, build hope and optimism for the future,” Dr. John says. Getting in touch with people you have not seen in a while and choosing the appropriate activity for you, based on your health and preference, helps. Taking care of the ‘fence’ Dr. John says that healthcare providers who helped us fight the battle against Covid-19 with their back to the wall are a key concern. Psychological symptoms including anxiety, depression, insomnia have been prevalent in up to 60% of physicians, nurses and medical residents concerned during the Covid-19 pandemic. “Their mental and physical health too is a concern during the pandemic and post-pandemic period. Healthcare providers should practice Yoga, aerobics, muscle-building exercises and play a sport or game to keep them in fine fettle. They should compensate for sleep loss and have an eye on balanced nutrition,” says Dr. John.

Brain fog caused by Covid-19

Dr. John points out that some people who’ve had Covid-19 have reported brain fog that lasts weeks or even months after their other symptoms — like cough, fatigue, or fever — have fad-

ed. Brain fog is a term used to describe the feeling of being mentally slow, fuzzy, or spaced out. It leads to memory problems, lack of mental clarity, poor concentration, feeling ‘out of it', headaches and confusion. Both physiological and psychological factors play a role in this. Inflammation in and around your brain may contribute to brain fog. Poor sleep quality, the feeling of loneliness, depression, increased stress or anxiety, dietary changes, decreased physical activity, and side effects of certain medications during Covid-19 contraction can lead to brain fog. People with severe Covid-19 will be at a higher risk for brain fog. As of now, the best treatment for brain fog caused by Covid-19 is to adopt healthy habits. • Get plenty of sleep: Getting good quality sleep can help your body repair and recover. • Get regular exercise: Physical activity isn’t only beneficial to your heart and lungs, it’s also a great way to boost your brain function. • Eat well: Try to eat a well-balanced, healthy diet to give your body the nourishment it needs to return to good health. • Avoid tobacco and alcohol: Staying away from tobacco products and alcohol can help minimize inflammation in your brain.

Long-term solutions needed

“The mental health impact of Covid-19 can last for several years to come. Increases in the prevalence of common psychiatric disorders and suicide are expected during the post-pandemic period. Enhancing access to mental health services, including tele psychiatry, early assessment, treatment and psycho-social support, screening and support for specific groups is needed to tide over the crisis. Long-term measures to mitigate the impact of economic recession on mental health is another priority area,” says Dr. C. J. John.

A Complete Magazine on Healthcare in Asia

SANGHAMAM CHICAGO | NEW YORK | TEXAS | TORONTO A Popular Tabloid In Malayalam, Published From

Penta Square, Opp. Kavitha Theatre, M.G Road, Kochi-35, Kerala, India, Tel: +91 484 4034055 Email: marketing@ayurvedamagazine.org www.ayurvedamagazine.org

ISSN 2582-452X Vol.4 | Issue No.3 | Jan - Mar 2020

COVER STORY

DIAGNOSIS GOES DIGITAL

SPECIAL FEATURE

CORONA VIRUS

THE VIRAL CHALLENGE

asianmeditour.com

HIGH HOPES FOR AI in Cancer detection

Beware of DIABESITY!

STRESSED OUT?

Blame social media

FORGET HARVESTING

Let’s make organs!

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MEDICAL TOURISM COVID AND AFTER

A pulmonologist and a surgeon advise how to

BREATH EASY

ung infection and it aggravating to pneumonia have been major issues during the Covid-19 times leading to many persons losing their lives. Both surgical and non-surgical managements were employed to save many lives too when the pandemic raged. While Dr Praveen Valsalan, Pulmonologist at Aster Medcity, Kochi, has been at the forefront of the fight, Dr Nasser Yusuf, Cardiothoracic Surgeon with Chest Hospital, Calicut and Sunrise Hospital, Kochi, went one step further exploring newer surgical possibilities in providing relief to the patients. Insightful views emerging from them are important in Covid-19 management and leading a healthy post-Covid life too.

Dr Praveen Valsalan highlights pulmonary rehabilitation Dr Praveen Valsalan says that pneumonia can be caused by various organisms including viruses. “So Covid by itself can cause pneumonia which can sometimes be severe and can cause difficulties with breathing needing ICU and ventilatory requirements. The chance of Covid patients developing secondary infections and subsequent pneumonia due to other bacteria and viruses is also very high, as this disease by itself and some drugs will reduce the immunity. Secondary pneumonia which usually happens a few days after developing Covid, can also be severe enough to cause significant morbidity needing ICU admission and ventilation,” says Dr Praveen. Dr Praveen says that pneumonia that the Covid disease causes will heal by scarring. “This healing process causes fibrosis. The percentage of patients who have progressive fibrosis is less than 5%. Many patients can have residual fibrosis which will over time heals. We need to prevent secondary infections from happening to prevent the progression. Similarly graded supervised exercise called pulmonary rehabilitation helps these patients to overcome their difficulties in the long run. It will also help to reduce long-term complications,” Dr Praveen said. The secondary problems that happen to the lungs may require cardiothoracic management. “That includes problems like pneumothorax, presence of air leaks in lungs due to Covid and secondary infection sequels, etc. These patients will definitely benefit from pulmonary rehabilitation. Aster Medcity has a very good post-Covid pulmonary rehab program where a lot of Covid patients post-disease returned to normalcy. It helps in improving their physical and psychological well-being and helps to get back to normal life much faster.” The pulmonologist opined that Black Fungus, technically called mucormycosis, caused a threat only in a very small subset of the population during Covid-19 phase. “This fungus usually hap-

24 Medical Tourism Apr - Jun 2022

A Complete Magazine on Healthcare in Asia

pens in immunosuppressed populations. And Covid is one of these. So early detection is the rule. Earlier the detection, the faster the chance of improvement and the lesser the chance of complications including death. These patients require drug treatment and in certain cases surgical management also,” Dr Praveen Valsalan said.

Dr Nasser Yusuf unveils the surgical options

According to the surgeon Dr Nasser Yusuf, when Covid strikes and boils develop in the lungs leading to breaks and pus, it leaves a tsunami-like trail of destruction in the lungs, heart, and brain. “In fact, no

26 Medical Tourism Apr - Jun 2022

guidelines exist for patients who require surgery for post-Covid complications and there is a lack of evidence or precedent. But still, we, as part of a multi-center trial based in Italy, embarked and found that a group of patients benefited from surgery. And in a first in the country, a Rajasthan boy’s ruptured lung was repaired through surgery,” Dr Nasser Yusuf said. “Patients may have crippling fatigue, continued breathlessness, cough, hemoptysis, chest pain, recurrent infections for weeks and months, after Covid had left their body. These issues are not limited to patients who suffer from severe Covid, but having mild forms of infection. The more serious complications include lung fibrosis leading to breathlessness and clots in blood vessels. “In localized infection and pneumonia, removal of the diseased segment or lobe brings relief to the patients who have symptoms of cough, fever, chest pain, etc. Sometimes a cavity forms within the lung which can enlarge and cause bleeding and recurrent infection. At times fungus starts growing in the cavity and forms a ball leading to

Aspergilloma. Excision of this cures the problem,” Dr Nasser Yusuf said. “In some patients, after recovery from Covid infection, a portion of the lung is permanently destroyed by bronchiectasis (multiple number of small cavities which appear like the honeycomb). This can only be treated with surgery,” Dr. Nasser Yusuf said. On the benign side, on many occasions when a patient with Covid has been investigated, especially with CT scan, surprises have been thrown up such as early TB and its complications and cancerous and non-cancerous growth, which could otherwise have become serious in the future. On the surgery outcome, he said that the quality of lungs and life improves while patients can ambulate with minimal or no requirement of oxygen, thus converting them from respiratory cripples to productive humans. “They are relieved from symptoms like cough, breathlessness, hemoptysis, fever etc. Surgery may be done through a small scar in the chest with minimal pain leading to quick recovery and productive life,” Dr Nasser Yusuf added.

Inspiring Destinations...

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The Leading Travel Industry Service Provider

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MEDICAL TOURISM FITNESS

YOGA IN THE POST-COVID PHASE

he sage Patanjali, the greatest Yoga master of all times, talks about Soucha, which is included in Niyamas (observances) in his monumental work Yoga Sutras. Niyamas are recommended habits to be followed by Yoga sadhakas (practitioners) to achieve healthy and spiritual living.

Yogacharya Kaithapram Vasudevan Nampoothiri

Soucha means cleanliness. But Patanjali further defines Soucha as a tendency to hide or cover one's own organs and also the physical detachment from others. (Soucaat swaanga jugupsaa paraih asamsargah) You may remember, at the peak of Covid-19, the flight passengers needed to fully cover themselves with a gown supplied by the airport authorities, and mandatorily wear a multi-layer mask. The mask is still in use in most parts of the world as a disease preventive measure. Generally, Indians are alert when they travel, and also mingle with others. They take a bath upon returning home.

28 Medical Tourism Apr - Jun 2022

peaceful, which is essential for the wellness of the society. So Patanjali declares that this is a universal regulation (saarva bhoumaa mahaa vratam). Pratyaahaara, withdrawing the senses from its objects, will also amount to keeping aloof from internal and external disturbances. Senses are the gateways of all kinds of inputs into the body. In the post Covid scenario, the regular practice of Pranayama, the yogic practice focused on breath, is of utmost importance. Pranayama, the fourth limb of the eightfold path of Yoga, is primarily the regularization of breath. Whenever we are agitated, the rhythm of breath will be disturbed. This shows that mind and breath are very much connected. (Chale vaate chalecchittam). So, when breathing is made rhythmic, the mind will return to calmness.

Pancha Koshas - five different sheaths In Upanishads, especially in Tyttireeya, it's mentioned that man is the soul covered with five layers or sheaths namely, Annamaya, Pranamaya, Manomaya, Vijnanamaya and Aanandamaya. From the health point of view, the first three are vital. Annamaya refers to the physical body of flesh and blood, Pranamaya the vital energy and Manomaya the mind.

Aadhi and Vyaadhi

There will always be a pot full of water at the entrance of the house for visitors to wash their feet, legs, hands, and face. If the guest is a respectable one, the host himself will be waiting at the gate to wash the feet of the guest and dry them with fresh clothes. This is an example of our culture in sublimating the primary rituals connected with health care to spiritual heights. Yoga is an art and science of healthy living. It leads to perfect harmony between the mind and the body, the man and the nature, the individual consciousness and the universal consciousness. Nonviolence (Ahimsa), utterance of truth (Satyam), non-stealing (Asteyam), celibacy (Brahmacharyam), non-accumulation of wealth (Aparigraham) are the Yamas — the regulations connected with social life. If you look at it carefully, you understand that by observing the Yamas in personal life, the social life will become disciplined and

When the mind is agitated or disturbed or imbalanced, in other words, if Manomaya kosha is affected, it is called Aadhi, according to sage Vasishtha. So Aadhi is persistent, long-standing emotions (stress) in a Manomaya sheath. This may become a seed of a disease if suppressed for a long time. These types of diseases are called psychosomatic diseases, which are known in Yogavaasishtham as Aadhija Vyaadhi (Vyaadhi means disease). In fact, the word 'psycho somatic disease' is a direct translation of Aadhija Vyaadhi. If Manomaya kosha is affected, it gets reflected on the Pranamaya kosha. Here is how the manifestation occurs. Prana is the life energy which keeps every cell alive. When this flow of energy is disturbed, the functions of various organs will get affected. The body systems like digestion and blood circulation will not function well. Slowly, it percolates into the physical body, Annamaya kosha, made up of cells, tissues, organs etc. because the whole body is a conglomeration of atoms, quantum pockets of energy. Now the speed and violence started in the mind manifest in the body after affecting prana.

Pranayama Now we know that the mind is to be calmed in time, so that Aadhi won't get filtered out to Prana and then to body. How can we know Prana is affected? This we can figure out A Complete Magazine on Healthcare in Asia

by observing the speed of breath. If the breath is shallow or speedy, we can easily understand that Prana is imbalanced. If this continues for a long period, it will percolate in to body and one becomes sick. Here comes the role of Pranayama. Pranayama can regulate and regularise breath, which in turn will balance the mind. In fact, Pranayama is not meant for therapy, but for a higher purpose, yet we can make use of it for health care, too. Health or wellness is a precondition for advancement in the spiritual path. Anuloma - viloma or Naadi Suddhi Pranayama is the preliminary exercise done in Pranayama. Let us see how it is performed: •

Sit in vajrasana, padmasana or sukhasana. Keep the back and neck straight.

•

Place the left palm in chinmudra on the left knee.

•

Take two or three deep breaths. Keep the eyes closed.

•

Close the right nose with right thumb. Exhale completely through left nostril.

Now breath in slowly from left nostril - a long and deep breath. Close the left nostril with ring finger and small finger and open the right nostril and slowly breath out through right nostril completely. Now slowly inhale deeply through right and exhale completely through left. This is one cycle of Naadi Suddhi. No sound is produced while breathing in or out. Face is relaxed. Complete concentration is inwards. This is one round of Anuloma Viloma. Do it ten rounds and slowly bring down the hands. Feel the changes in the whole body and mind. Enjoy the inner peace. There are variations and improvisations for this practice, but this one can be tried by anybody without any fear. If the mind is calmed through balancing the breath, further filtering out of Pranic imbalance down to the body can be avoided. Prevention is better than cure. This is a famous proverb accepted everywhere in the world. In the medical field, the second one, cure is the highlight. In Ayurveda, both are discussed. But in Yoga, prevention is more important. Life is meant for Sadhana. For that, a sound body is the tool. Sareeramaadyam Khalu Dharma Saadhanam. Body is the primary tool for Dharma. So, in the traditional Yoga text, wellness is discussed in detail only to equip and maintain the body to do Sadhana. Six types of cleaning techniques (Shat kriyas) are given. The very aim is prevention of diseases. The techniques can be used for cure as well. Then we call it therapy, Yoga therapy, which is more acceptable nowadays. Having gone through the basics of Yoga therapy, we will look into what one should do to negate the after effects 30 Medical Tourism Apr - Jun 2022

of Covid. This disease is infectious and spreads easily and gives enough and more stress to patients and their near ones, and also the general public. Health care workers too are on a tightrope as there is no successful remedy. The psychological effects can further reduce immunity against infectious challenges and overstimulate host inflammatory responses, leading to tissue damage and even death. Yoga can naturally reduce mental stress and anxiety in patients or at the post recovery stage. The various Yoga routines, poses and breathing techniques can be a beneficial tool to increase immunity and get the strength back. According to AYUSH, the Yoga-based lifestyle can contribute to the society in three ways: •

Enhance general immunity among the population.

•

Pre-habilitation of vulnerable population (children, elderly and those with comorbid conditions, such as diabetes or hypertension).

•

Support Yoga-based interventions and meditation practices.

Each one of us can plan own Yoga protocol, for which the following can be a guideline. This is flexible, as you know.

Yoga protocol 1. Prayer You can start with a prayer. This may give a good and definite start.

2. Warming up You can do three or four quick Surya namaskars. Then all the joints of the body should be activated through loosening exercises or sukshma vyayam or yougika vyayam.

3. Yogasan

can be changed, but the four categories should be maintained.

4. Surya namaskar We can include 12 Surya namaskars in the module. It should be done in slow motion and also with rhythmic breathing.

5. Kapala bhathi, anuloma viloma pranayama and bhramari 6. Meditation 7. Santhi manthra Laziness has got no medicine. Eternal vigilance is the price of peace. We have to be vigilant in keeping our body intact. Through this, you are helping yourself as well as the society.

Two or three asanas each by standing, sitting, lying on the stomach and lying on the back can be practiced. Asanas A Complete Magazine on Healthcare in Asia

MEDICAL TOURISM UNIQUE KERALA

KERALA

GOOSE-STEPPING AS GLOBAL AYURVEDA HUB Our Correspondent Ayurveda, the world’s oldest holistic healing system, is steadily evoking a global interest post the pandemic, with people realizing its larger benefits, especially the immunity booster role. And the south Indian state of Kerala, which nurtured the indigenous medicinal system for centuries, is becoming the hub of authentic Ayurveda.

32 Medical Tourism Apr - Jun 2022

The state has captured the imagination of the global community when it comes to medical travel and wellness tourism. While the reasons are many – world-class medical facilities, excellent pre and post-care treatment, cost-effectiveness, trained para-medical staff, and technicians, scenic locations, and moderate climate throughout the year - its role as a perfect host to Ayurvedic treatment practices, with a wide range of treatment and research centres, tops the chart. The whole Ayurveda facilities in the state, including wellness treatment, have fully opened up in the postCovid era. In fact the authorities are planning to attract foreign tourist inflow in a big way by hosting two big international events–The Kerala Travel Mart and The Ayurveda Travel Mart. “The Ayurveda Travel Mart, planned for September this year, will exclusively showcase the state’s Ayurvedic capabilities to the world over. The event is held for the first time and is in line with the goal of turning the state into a global medical tourism destination. We’ve tied up with India Tourism and started active campaigning in foreign markets and are in touch with key players, including tour operators and buyers. The show-piece affair will be held in the cultural capital Thrissur,” said Sajeev Kurup V., President of Ayurvedic Promotion Society and also the General Secretary of the Confederation of Kerala Tourism Industry. The Ayurveda sector used to contribute a major chunk of the state’s tourism industry, which scaled up to Rs 45, 000 crore/ annum before the Covid outbreak. The spending on Ayurveda by an average tourist was around USD 100 a day then. “Certainly, the Covid outbreak, lockdowns, flight ban etc. broke the backbone of the sector. Even now, the deadly infection is peaking in many parts of the world and cases reporting again in Delhi in the country. But we expect the revival of the state’s

Ayurveda sector post-September this year. In fact, it may pick up after June. The KTM, to be held in May, is key for us, where we announce that the state is open and everything is ready. Our first goal is to revive the industry back to the pre-Covid level,” he said. The Malayalam month of ‘Karkidakam’ (July 17 onwards) is ideal for Ayurvedic remedies. It’s the time when monsoon rains keep the atmosphere cool. All pores in the human body will open, and the therapies prove most effective during this period. The authorities also expect more global takers for therapeutic Ayurveda in the post-Covid scenario, with a thrust on immunity-boost. This is especially after the state earned praise for successfully limiting the disease spread and casualties after the initial peaking, thanks to its integrated treatment initiative. The Ayurvedic medicines were found quite effective in resisting Covid-19. “The current situation presents the right time for Ayurveda and traditional medicines to become even more popular globally. There is growing interest in them. The world is seeing how modern and traditional medicines both are important to further wellness. People are realizing the benefits of Ayurveda and its role in boosting immunity,” a senior Tourism Department official in charge of the Kerala Travel Mart said. The 11th KTM will be held in Kochi from May 5 to 8. Ayurveda will also be the focus of the upcoming event. The authorities have included ‘Ayurveda tours’ across the state as part of KTM to provide an outline of the wide range of quality Ayurvedic treatment services available at affordable rates. “Wellness tourism has the potential of being the gamechanger for the growth of the Indian tourism industry. In a consistently growing economy, where the population is fast recovering from the pandemic jolt, people are facing a fast-changing life. Here

wellness tourism becomes even more important as it rejuvenates the body, mind, and soul by detoxification provided by various healthcare therapies. Kerala is one of the true spiritual homes of the modern wellness movement globally by incorporating Ayurveda, Yoga, meditation, acupuncture, naturopathy, panchakarma and holistic health. These are the experiences sought by wellness travellers in India and we have it,” the official said. Two types of Ayurveda treatment are being followed in Kerala – Beach Ayurveda, and Traditional and Authentic Ayurveda. Beach Ayurveda mostly focuses on leisure-based massages and treatments, while the Traditional and Authentic Ayurveda brings about a convergence of science and traditional medicines for therapeutic purposes. Around 60 percent of foreign tourists who reach here prefer Beach Ayurveda, while 40 percent prefer Traditional and Authentic Ayurveda. But the Traditional and Authentic Ayurveda segment has been growing over the years despite first-timers often preferring Beach Ayurveda as it is leisure-based therapeutics. There are around 100120 leading players, including the segment leaders, who mostly work as hospitals while others work as tourist wellness centres. There was around 95-100 percent occupancy in Beach Ayurveda centres until 2018, while the occupancy rate was around 82-90 percent in Traditional and Authentic Ayurveda centres during the peak period of October to March. If Europeans were the key clients of these centres earlier, now the state has the most clients from post-Soviet countries like Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan and Latvia and the West Asia.

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MEDICAL TOURISM UNIQUE KERALA

KERALA’S BATTLES ON THE HEALTH FRONT Our Correspondent

he Kerala Model in Health is known the world over for the high life expectancy rate of its population, highly improved access to healthcare, and low infant mortality and birth rates. Nearly 10,000 government and private medical institutions crisscross the state to form the backbone of its health infrastructure. An evenly distributed primary health centres and their sub-centres cater mainly to the rural population. The National Health Mission has found that the first twelve best primary health centres of India are in Kerala, while three of them have got the National Quality Assurance Standard (NQAS) Certification. Adding another golden feather in its cap, Kerala has topped Niti Ayog’s health index for the fourth year in a row this year, in recognition of its superior health system in both public and private sectors. Kerala achieved this scale of progress as compared to other states in India with consistent efforts by various sections of society, backed by the succeeding state governments irrespective of political colour. The Kerala model is marked by a rare combination of Marxist and Missionary work in parallel streams. No wonder then that the state has been able to tackle the Covid-19 pandemic and other threatening epidemics like Nipah, Zika, and Black Fungus in recent times. The state also successfully prevented any major outbreak of H1N1, Dengue, Hepatitis, Chikungunya in recent monsoons, further consolidating its position on the health front. Local bodies, too, have played a key role in making the state a place to live comfortably and lead a healthy life, and for tourists to visit fearlessly and bask in its natural beauty. Kerala stopping Nipah in its tracks in 2018 and 2019 were stories that attracted worldwide attention. The virus claimed 17 lives in the first phase in 2018, but was quickly restricted to Kozhikode and Malappuram districts. Kerala reined in the dreaded virus later in 2019 after an outbreak in Ernakulam district with no further casualties. This was at a time when 150 children had died of encephalitis in Bihar state. Nipah had claimed over a hundred lives when it reared its head for the first time in the Malaysian village of Sungai Nipah (hence the name) in 1998. Nipah has no known cure or vaccine. It

34 Medical Tourism Apr - Jun 2022

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phase leading up to May 2020 also came in for praise from across the world. UAE’s leading daily Gulf News observed that the three-tier health system of Kerala with primary health centres at the lowest level and medical college hospitals at the top level helped it to imaginatively tackle the crisis. It also patted the excellent pool of Kerala’s homegrown medical professionals. The Washington Post noted that “the state, where communists have held power for over 30 years in several different governments since the 1950s, has invested heavily in public education and universal health care.” UK’s vastly respected BBC News said: “Experts say, what really mattered, in the end, was Kerala's robust public health system, and a culture of thriving grassroots democracy with power devolving effectively to the village councils.”

gets to humans via fruits infected by Nipah-carrying bats. The 24-year-old person infected with the Nipah virus in Ernakulam in 2019 was brought under isolation and extended medical care in a private hospital while being monitored by a high-level team. Nearly 300 people who might have come into contact with him in 24 hours were brought under observation by different teams and it became another remarkable health victory. The efficient planning and quality healthcare system meant the deadly viral infection was erased out with no damage to any sector, including tourism. 36 Medical Tourism Apr - Jun 2022

Later, the Institute of Human Virology (IHV), Baltimore, in the United States, honoured Kerala Chief Minister Pinarayi Vijayan for effectively containing the spread of Nipah virus outbreak in Kerala. The bulk of the praise came in the way of then State Health Minister KK Shailaja, popularly known as Shailaja Teacher, for coordinating the efforts to contain the virus. The next major challenge came when Covid-19 was spotted in the state, also for the first time in the country, in January 2020, in university students returning from Wuhan in China. Kerala’s remarkable resilience in the first

A US tourist went to the extent of approaching the Kerala High Court with the plea that he be not sent across to his home country till the pandemic is over. The 74-year-old Terry John, who is a theatre director and writer, was all praise for the way Kerala tackled the crisis. Bulgarian football coach Dimitar Pantev who was home quarantined in Palakkad district’s Pattambi, scribbled on Facebook that it truly blessed him to be Kerala at the time of Covid-19 outbreak. No wonder then that the United Nations honoured Shailaja Teacher for her leadership role in flattening the curve with effective contact tracing while successfully maintaining low mortality rates. Though the second Covid-19 wave from the middle of 2021 gave some anxious moments to the state after the Assembly elections, with cases peaking, the steady vaccination programme conducted through the involvement of even Asha workers and local bodies helped it to survive the scare. A large section gained

herd immunity during the period and health workers and doctors in the state, both in the private and public sectors, toiled hard to battle the way forward. Tourism and other industries too began to open up and educational institutions started functioning. And when everything seemed to return to normal, Omicron came like a bolt from the blue by the end of 2021. But in December and early January, Kerala presented a picture different from the rest of the country with limited cases, steady vaccination and people conforming to Covid protocols. The resilience of the people, their awareness, herd immunity and adherence to hygiene and protocols and the robust health infrastructure give Kerala an edge in the battle and make it a safe place to live and travel. Kerala has performed in remarkable ways not only in these battles but also in fighting the Zika Virus, the Black Fungus, H1N1, Dengue, Hepatitis, and Chikungunya in recent times. The

Black Fungus reared its head during the Covid-19 spread, killing half a dozen people, but was soon wiped out. This was against the national death toll of over 4000 people at the hands of the disease. The Zika virus broke out last July amid the fight against Covid-19, with State Capital Thiruvananthapuram being the epicentre. At least 13 health workers in the city were tested positive for the virus apart from a pregnant woman in the first phase. Over 70 cases were reported from the state, but by August middle, the situation was brought under control, with zero prevalence after screening over nine lakh people. The highest number of dengue cases (21,993) and deaths (165) was reported in 2017 and ever since it was on the decline. The deaths were just five in 2020, while the total number of cases was 4399. Similar was the case with H1N1, Hepatitis and Chikungunya.

“We had a three-point agenda: government hospitals should be patient-friendly, high-tech, and out-ofpocket expenditure must reduce,” says Shailaja Teacher about the strategy since she took over. “Primary healthcare units are very important, especially in rural areas. They now have testing labs and are able to catch early signs of different diseases. Medical college hospitals have new equipment and good infrastructure. Our focus definitely strengthened the system to battle the crises. We’ve tried to create a feeling of ‘We’, as a team in this battle. It keeps the morale up of each healthcare warrior,” adds Shailaja Teacher. The state is today hale and healthy with lush green environs after a prolonged spell of southwest and northeast monsoons in months leading up to last December. It beckons every visitor to its lap with unparalleled warmth and new world-class infrastructure like the Kochi Metro.

A Complete Magazine on Healthcare in Asia

MEDICAL TOURISM UNIQUE KERALA

YOU NAME IT, WE HAVE IT

Our Correspondent

At affordable costs, excellent medical care is offered by brilliant professionals in state-of-theart hospitals. Step out, the magic of lush green nature will soothe you.

erala, perched at the fag end of India in the south, is popular across the world for its greenery, placid backwaters, and beaches. No wonder then that tourists from across the world make a beeline to bask in its natural bounty to relax and rejuvenate themselves. The myriad rejuvenation therapies from Ayurveda when offered in these pristine precincts assume a divine proposition and, hence, Ayurveda therapies have become a big draw of the land among tourists. It’s from this point that Kerala took off on the medical tourism map in a big way a few decades ago and now its offer-

38 Medical Tourism Apr - Jun 2022

queue to get care is so long in free schemes like the National Health Service (NHS). Outside NHS, the cost is very high. Kerala costs one-sixth of it and hence it’s the right destination for lower and middle-class people in the UK. In the US, a system of people taking insurance policies to cover their health expenses exists. Insurers are in the public and private sectors. Americans pay drastically different premiums monthly for health coverage, which scales up to very high levels. In reality, only 10 percent of the population can really afford the treatment there, while the Kerala healthcare cost is only one-tenth of it. In the Middle East, the facilities are only getting boosted now, ironically with the involvement of the Keralite diaspora, even so, there is a steady flow from there to God’s Own Country for expert treatment including surgeries. In most countries, procedures like cardiac surgery, ortho surgeries like knee replacement surgery, dentistry, and cosmetic surgery command exorbitant charges, but Kerala offers them at affordable rates. God’s Own Country offers at reasonable rates several elective procedures and dental surgeries, which are costly in different parts of the world. So, Kerala comes with a rare mix of expert professionals, top-class facilities, and top-class care at enormously affordable costs. Our doctors and nurses are accepted all over the world. In fact, they form the backbone of health systems in many countries. Back home, they excel in the most brilliant fashion. Kerala’s impeccable track record in the short span of a few decades in medical tourism is coming in its favour in its journey ahead. The compassionate attitude of the health professionals and the people, which even Thailand can’t claim, is any tourist’s delight. The state has identified that this soft aspect is crucial in its growth ahead. Kerala’s tertiary care hospitals have almost all medical departments under one roof, and comprehensive care is assured once a person from abroad is admitted to any of these hospitals. Effective coordination between various departments makes management easy for the patients and it is smooth sailing for the relatives too. People with multiple issues can sort them out without facing much fuss or pain in these hospitals. ings in modern medicine from the tertiary care hospitals too have become a great boon for the visiting tourists. Kerala has several advantages in every aspect of medical tourism, which makes it a favourite destination for people from the Middle East, Europe, the US, and many points of the world. Citizens of the Middle East and the Western World get quality and most advanced modern medical care comparable to the developed world in Kerala at rates lower than back home. Many countries lack expert personnel, while others don’t have the required facilities and, in several others, the cost is at prohibitive levels. In countries like England, the

Most hospitals pay attention to the ambiance. Some have captivating sylvan environs which offer a pleasant stay. It’s a soothing feeling not only for patients but also for the bystanders who will have tourism feel from the hospital campus itself. Keralites are spread across the world and are fondly called Non-Resident Keralites (NRKs) and they are the state’s envoys the world over. These include business executives, employees, health professionals, etc. Their interactions with the local population abroad and the information and the feel they share regarding various aspects of the state A Complete Magazine on Healthcare in Asia

trigger positive vibes for the state. They help attract people from far and wide to the state for availing of healthcare in the state.

did put in a word or two back home, which in turn brought more health-conscious tourists to the state. The growth of the sector underscores the fact.

Apart from Ayurveda, Kerala’s cultural heritage is another treat for visiting tourists. Classical art forms like Kathakali, Koodiyattom, Thullal, Theyyam etc are a treat to the eyes of any tourist. Classical music of the land has a healing touch too. The temple festivals from December to April offer a rich tapestry of the land’s tradition.

There are websites giving information on medical tourism in the state, and the Kerala Medical Value Travel Society website is the latest right step in this regard. The State Tourism Department and its websites also vigorously promote the Kerala Health Tourism Brand. “We are in tie-ups with external agencies to reach out to more and more people overseas. Road shows like the recent one in Muscat are also aimed at presenting a comprehensive picture of health tourism in the state,” the tourism official said.

In Ayurveda, neighbouring states or neighbouring Sri Lanka are competitors but Kerala has professionals with expertise apart from enough well-established reputed facilities which perk up the state above the rest. The cost also suits the pockets of middle-income tourists. Of late, the State Government has weeded out quacks and inferior quality or spurious massage centers from the scene. The availability of quality Ayurvedic decoctions within the state also makes Kerala a destination for quality-conscious Ayurveda seeking medical tourists. Both preventive and curative Ayurveda care get equal importance. Ayurveda-based food is best suited for the healthy living of tourists. Ayurveda’s holistic approach with equal emphasis on physical and psychological well-being without side effects is unique and hence can’t be missed. Kerala also offers Siddha, Unani, Panchakarma, Kalari, and Marma chikitsa. Tourists can make use of different branches according to their requirements. Those who accompany patients are equally important in tourism targeting. Mostly, they make enquiries and decide on the itinerary. Hence hospitals well liaison with them and decide on procedures in tandem with travel plans. There are dedicated personnel or travel desks to inform and direct patients and bystanders on tourism spots and decide on plans. The visits can be a relaxation after surgery or another procedure. They are well-versed in English, while some hospital staff has knowledge of Arabic. The doctors are also consulted on tour plans. It’s estimated that around 60,000 health tourists visit the state yearly before post-Covid-19 flight regulations arrived. Kerala has 33 hospitals with NABH accreditation, the highest quality certification in India, and hence, a lot more medical tourists can avail the of top-class facilities instead of heading to other states or metros. The state, in fact, is taken as a Metro. It today boasts four airports at Kannur, Kozhikode, Kochi, and Thiruvananthapuram with direct connectivity from the Far East and the Middle East. “Kerala can rival a place like Singapore in offering modern medicine with its cheaper rates and top-quality facilities and personnel," said a tourism industry player. Word of mouth publicity, which is the most potent publicity channel, has done a lot of service to Kerala. Almost all health tourists have returned a contented lot, and they 40 Medical Tourism Apr - Jun 2022

Ayurveda rejuvenation continues to be the big draw, but the news is that modern medicine branches offer excellent care in Kerala at much lesser costs. Medical visas are also issued fast, with no hassles. According to former Chief Secretary Dr. Biswas Mehta, the longest stay by a tourist coming to India is in Kerala. The major reason for this is the strengthening of health tourism. After all, who would turn their back on fresh air and lush green nature?

MEDICAL TOURISM MILESTONE

MEDICAL MALL TO GRACE THALASSERY

ndia’s first medical mall, Lifeonic Medical Mall, is being planned in Thalassery in Kerala which is known as the town of three Cs – Cricket, Cake and Circus. Lifeonic Medical Mall is the medical version of a shopping mall, a unique concept of bringing branded healthcare-related facilities under one roof. This will be a one-stop solution from prevention to palliative care through proper awareness and nursing care. The motto is to provide the best treatment and perfect health solutions at the right time at affordable rates for all. Lifeonic Medical Mall will provide integrated medical services through efficient and effective operation of multiple hospitals and clinics in the following disciplines: Allopathy, Ayurveda, Homeopathy, Physiotherapy, Dental, ENT and Unani along with an Infertility Clinic, Diabetic Clinic, Pharmacy, Medical Laborato-

ry, X-RAY and, CT/MRI Scan facilities, USG Scan/OPG facilities and a Health Club. These and many other such facilities are being planned in a luxurious 6-storey building (ground + 5 floors) with the below facilities: 3 lifts, 24/7 power backup, 200 plus car parking. The Lifeonic Medical Mall is easily accessible from all over the city and also well connected to Kannur, Irrity, Mattannur, Kuthuparamba, Mahe, Vatakara, Nadapuram and many other small towns by road and rail. The Kannur international airport establishes international and domestic flight connectivity bringing revenue in foreign currency through medical tourism. The project is managed by Lifeonic Healthcare Pvt Ltd which has a decade-long experience managing two hospitals. It is currently managing Royal Malabar Hospital (Thalassery).

Learning and development by continuous monitoring and up-gradation of technology and telemedical services through EDP are planned as part of the project. The interdisciplinary approach involving various specialties and paramedical and health services make the project comprehensive. The mall also plans to set apart a fund for patients from the economically backward section. This fund will be supported by contributions from the public/doctors/owners and other Samaritans. The ground floor of the facility will have sample collection units while samples will also be collected from various hospitals and from residences of patients. Online diagnosis and reporting and home delivery of medicines will also be available. Free medical camps outside the campus or at satellite places, sponsored by local clubs and social service will be a regular feature of the mall services. A Complete Magazine on Healthcare in Asia

MEDICAL TOURISM MILESTONE

WHO GLOBAL CENTRE FOR TRADITIONAL MEDICINE (GCTM)

A BEACON OF HOPE

The WHO Global Centre for Traditional Medicine (GCTM) seeks to blend ancient wisdom and advanced technology for global health and wellness.

historic agreement was signed between the World Health Organization (WHO) and the Government of India (GOI) on 19th April, 2022 to establish the Global Centre for Traditional Medicine (GCTM), the first of its kind in the world, at Jamnagar, Gujarat, India, that “aims to harness the potential of traditional medicine from across the world through modern science and technology to improve the health of people and the planet’. The Centre symbolises the hopes and aspirations of millions of people across the world, who are practitioners and beneficiaries of traditional systems of medicine. The historic decision, no doubt, will go a long way in promoting and protecting these systems to enable them to further global health and wellness.

S Jalaja IAS Former Secretary (AYUSH)

Status of traditional systems of medicine According to WHO, traditional medicine represents “the sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness”. Traditional systems were the predominant health systems in different parts of the world till late 19th and early 20th centuries. With the ascendance of modern medicine, traditional systems started facing stiff competition, and in the course of time, were marginalised. They were dismissed as ‘non-science’, despite the fact that they were used by people for generations for their healing and wellness and that many of the practices were recorded and tried over and over again. Today, with the advancement of technology, traditional systems are facing unprecedented challenges. Their practitioners are often accorded a second-class status, compared to modern medical practioners. Due to propaganda, or because of genuine concerns, even those among the educat-

42 Medical Tourism Apr - Jun 2022

ed look down on these systems with scepticism.

Indian Systems of Medicine Traditional Indian medicine is one of the oldest medical systems in the world, and Ayurveda is the most widely practised among them. The other systems of traditional medicine in India include Yoga, Siddha, and Homeopathy. Recognizing the importance of these systems, the government of India set up a separate department named AYUSH (Ayurveda, Yoga, Unani, Siddha and Homeopathy) in the year 1995 under the Ministry of Health and Family Welfare. It was upgraded to a full-fledged Ministry on 9 November 2014. Although these systems are used widely in India, their global acceptance is still very far of. I am, therefore, happy that the GOI has seized the opportunity and has committed an estimated $250 million (Rs 1910 crore) to support the establishment, infrastructure, and operations. This includes 35 acres of land in Jamnagar for a new building and premises, an interim office, and support for the GCTM operational costs with a 10year commitment.

Focus According to WHO, the GCTM ‘shall focus on four main strategic areas: evidence and learning; data and analytics; sustainability and equity; and innovation and technology to optimise the contribution of traditional medicine to global health. The Ministry of AYUSH will seek to set policies and standards on traditional medicine products and help countries create a comprehensive, safe, and high-quality health system.

Significance Traditional medicine has been a part of communities and cultures across the world for centuries and has been an integral part of our daily lives. “For many millions of people around the world, traditional medicine is the first

port of call to treat many diseases. Ensuring all people have access to safe and effective treatment is an essential part of WHO’s mission, and this new centre will help to harness the power of science to strengthen the evidence base for traditional medicines,” stated Dr. Tedros Ghebreyesus, Secretary General of WHO.  It is estimated that around 80 percent of the world’s population uses traditional medicine.  At least half of the world’s population cannot obtain essential health services, according to a new report from the World Bank and WHO. One of the objectives of setting up the Centre will be to make preventive and curative healthcare, affordable and accessible to all.  Around 40 per cent of approved pharmaceutical products in use today derive from natural substances.  Traditional medicine is also part of the growing trillion-dollar global health, wellness, beauty, and pharmaceutical industries.  170 of the 194 WHO member states have reported the use of traditional medicine, and their governments have requested the support of WHO in creating a body of data on traditional medicine practices and products.  The contribution of traditional medicine to national health systems is not yet fully realized as national health systems and strategies do not yet fully integrate the millions of traditional medicine workers, accredited courses, health facilities, and health expenditures.  Medicinal plants which naturally grow in waste and forest lands are facing the threat of extinction due to human activities, habitat loss, climate change and other factors. Therefore, focus will also be on conserving biodiversity and sustainability.  In the context of traditional medicines, digitalizing traditional knowledge systems is important. Other

countries could emulate the Indian experience in this area.  Setting up standard procedures for manufacture of drugs, and certifying the quality and safety of medicines are important for weeding out fake medicines to enhance the credibility of the traditional medicines.  Improving human resources in the area of TM globally will be an important task of the proposed centre.  Research in traditional medicines will receive a boost with the setting up of the centre. High end research could be taken up with the help of advanced technology. International collaboration could be sought for.  By systematic training of the workforce, youth from different countries could be gainfully engaged in the area of nursing (both hospital and home nursing), pharmacy, research, food technology, hospital management, wellness centres, medicinal plant cultivation, manufacture of drugs, thereby leading to large- scale job-creation.  Net- working with countries/ partners who are interested in TM will be will contribute to sharing of knowledge and innovation in areas identified  Although the new WHO centre will be established in Jamnagar, Gujarat, India and will serve as the hub, setting up regional centres in different parts of the world and designating some of the leading institutes as sub-centres within the country can benefit all regions of the country and the world. The proposed Global centre for Traditional Medicines is a beacon of hope for all those who repose faith in the systems. I do hope that the proposed Centre will help millions of people across the globe to access affordable and quality healthcare at their doorsteps in the near future. Ref: www.who.int/initiatives/ who-global-centre-for-traditional-medicine A Complete Magazine on Healthcare in Asia

MEDICAL TOURISM EQUIPMENT WORLD

INSPIRIS RESILIA AORTIC VALVE

ATEC® BREAST BIOPSY SYSTEM FOR MRI

The INSPIRIS RESILIA Aortic Valve, Model 11500A, is intended for use as a heart valve replacement. It is is indicated for patients who require replacement of their native or prosthetic aortic valve. Materials list Valve leaflets: Bovine pericardium Stent: Cobalt-chromium alloy, polyester Fabric covering stent: Polyester cloth Valve sewing ring: Silicone rubber Tissue platform Model 11500A features RESILIA tissue, bovine pericardial tissue transformed by a novel integrity preservation technology, which incorporates two new proprietary features that, virtually eliminate free aldehydes while protecting and preserving the tissue.

Our flagship ATEC vacuum-assisted breast biopsy system is an all-inone platform designed for use under ultrasound, MRI, stereotactic and 3D™-image guidance. It provides physicians a fast, safe and simple way to perform minimally invasive breast biopsy procedures. The ATEC MRI biopsy device enables physicians to treat patients who are at risk for breast disease under MRI-guidance, while reducing procedure time, minimizing costs and improving patient comfort.

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www.hologic.com/hologic-products/breast-skeletal/atec-breast-biopsy-system-mri

With the ATEC MRI biopsy device, physicians can treat a broad spectrum of patients such as women with thin breasts, implants, lesions near the medial wall or multiple lesions. With the ATEC system, physicians can reduce typical procedure time to under 40 minutes, allowing for multiple lesion targeting in one gadolinium session and optimizing costly magnet time.

PROBEAM 360° PROTON THERAPY SYSTEM

100% SILICONE DRAIN BAG FOLEY TRAYS

The ProBeam® 360° Proton Therapy System is designed for next-generation proton therapy, offering uncompromised clinical capabilities with ultra-high dose rates, a 360-degree gantry, and exceptional precision, all within a 30% smaller footprint. Proton therapy plays an increasingly important role in the fight against cancer, and the new ProBeam 360° System is designed not only for today’s most complex treatment techniques, but also to enable next-generation proton therapy. The ProBeam 360° System offers uncompromised proton therapy with: 50% smaller volume 30% smaller footprint 25% lower vault construction cost

The 100% silicone drainage bag Foley tray features a 5cc all-silicone BARDEX® Foley catheter pre-connected to a BARD® 2000ml drainage bag and includes the URO-PREP™ Tray. (8972xx, 8974xx, 9072xx) The 100% silicone drainage bag Foley tray is also available with the BARD® SAFTEYFLOW™ outlet device which helps eliminate urine splash when emptying the drainage bag. (9074xx). The URO-PREP™ Tray includes drape, underpad, powder-free exam gloves (not made with natural rubber latex), forceps, rayon balls, pre-filled inflation syringe, lubricant, povidone-iodine solution, specimen container and label.

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ANKYLOS

www.crbard.com/medical/en-US/Products/100-Silicone-Drain-Bag-Foley-Trays

DPTE® ALPHA

The Ankylos implant system is a dependable and well-designed dental implant system providing you with solutions that deliver long-term stability of hard and soft tissues, lasting aesthetics and reliable functionality, which your dental patients will appreciate and Dentsply Sirona Implants as manufacturer backs with a lifetime warranty. Dentsply Sirona Implants backs its implant systems with a lifetime warranty. The geometry of the Ankylos TissueCare connection moves the transition between implant and abutment to a central position. This integrated horizontal offset design establishes a broad basis for hard and soft tissue stability at the implant shoulder. In combination with the absence of micro-movement and the prevention of bacterial ingrowth, this enables long-term tissue maintenance. The unique friction-locked and keyed TissueCare connection ensures such a precise fit of the two components that it allows for subcrestal placement of the implant and positive bone response, thus enabling the desired emergence profile, and transgingival healing. Ankylos is therefore able to provide the flexibility of a two-piece system while ensuring hard and soft tissue remain healthy and free of irritation.

The core of the DPTE® transfer system is the Alpha port with its secure interlock enabling totally safe connections and disconnections. The DPTE® system enables material to be moved from one sterile zone to another through a non-sterile zone, with leak-tight, riskfree reconnection.

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Esteemed manufacturers of medical equipment /devices may forward details of new products for free featuring in Medical Tourism Magazine. The details can be forwarded to: director@asianmeditour.com For more information call: + 91 98461 21715

44 Medical Tourism Apr - Jun 2022

MEDICAL TOURISM RARE SURGERIES

47-YEAR-OLD SUCCESSFULLY TREATED WITH BONE MARROW TRANSPLANT Dr Rahul Bhargava, Director, Department of Clinical Hematology & Bone Marrow Transplant, Fortis Hospital in Gurugram with his team performed autologous bone marrow transplant where they used Mishra’s stem cells for transplant, thereby reducing the chances of rejection and infections.

n a ground-breaking procedure, Haematologists and Bone Marrow Transplant specialists successfully treated Anurag Mishra, a 47-year-old man from New Delhi, suffering from Multiple Sclerosis (MS) for the past seven years. Multiple sclerosis (MS) is a life-long condition, known to reduce life-expectancy. MS affects the brain and spinal cord that leads to serious disabilities. The most common symptoms of MS include loss of sensation and balance, restricted arm or leg movement and vision loss in one or both the eyes. Mishra, who was bedridden earlier and is back to his normal routines, was diagnosed with MS -- an autoimmune neuro degenerative disease, where the body’s own defence system starts attacking its nervous system without any specific reason. Unlike the current line of MS treatment, which mainly includes steroid therapy, physiotherapy and symptom management, doctors used Bone Marrow Transplant (BMT).

“In an autologous BMT procedure, the healthy stem cells from the patient are taken out and preserved. Chemotherapy is then administered to reset the body’s immunity and then the stem cells are injected back to rescue the person from the side effects of chemotherapy,” said Bhargava. After the surgery, the patient is kept under isolation for a few months to ensure he/she does not contract any infection. “In this case, when Anurag approached us, he was entirely dependent on others for his basic needs. But within six months of the treatment, he is back on his legs and is carrying on with his normal life,” Dr. Bhargava added. According to the patient, the attacks are sudden and may affect any part of your body, limiting your abilities. “Extreme pain and disabilities this disease gave was scary and left me depressed. I think I am very lucky to get to know about Dr Rahul Bhargava and team, who cured me miraculously,” Mishra said. “Too much delay in the procedure can considerably affect the clinical outcomes. In the case of Anurag, recovery is 90 per cent, which means he received the treatment within recovery time-frame,” Dr Bhargava said.

ONE-YEAR-OLD UNDERGOES RARE LIVER TRANSPLANT SURGERY

14-hour rare liver graft transplant surgery was performed on a one-year-old girl from Saudi Arabia at Artemis Hospital in Sector 51 in Gurugram in Delhi. Baby Fatima (name changed) underwent the living donor liver transplant, where only one out of eight portions of the liver was used to provide a new liver to her. The surgery called Monosegment (Segment 3) living donor liver transplant is the first such case reported in Delhi-NCR,

in which mono-segmented liver graft has been used, the hospital said. “Apart from this, the use of bovine jugular vein in liver transplant has been reported for the first time in the world, to provide an inflow of blood to the newly transplanted liver as the baby was born with absence of bile ducts and underdeveloped portal vein,” the hospital said. Managing the child during such a long surgery was a tedious and tricky task for the doctors. Born as the third child to her parents, Fatima suffered from unusually prolonged and deep jaundice for months after her birth. Doctors in Saudi Arabia diagnosed her with a rare disease called Biliary Atresia which is found in one in 16,000 live births. The developments of bile ducts in such children are absent. Fatima underwent biliary bypass surgery at a local hospital in Saudi Arabia before coming to India. A Complete Magazine on Healthcare in Asia

MEDICAL TOURISM HOSPITALS

ARMC IVF FERTILITY CENTRE

BELIEVERS CHURCH MEDICAL COLLEGE HOSPITAL Thiruvalla India Ph: +91 469 2703100 Email: info@bcmch.org

BMT Annex, Puthiyara, Kozhikode Kerala, India . Phone:+91 495 272 7376 Email: bdm@armcivf.com www.bcmch.org

www.armcivf.com

CHENNAI FERTILITY CENTER

CONTINENTAL HOSPITALS

Aminjikarai, Chennai India Phone : +91- 44 – 6458 2299 Email: cfcivf@gmail.com www.chennaifertilitycenter.com

APOLLO HOSPITALS CHENNAI

Hyderabad Ph: +91 40 67000000

www.continentalhospitals.com

SIR H.N. RELIANCE FOUNDATION HOSPITAL AND RESEARCH CENTRE

Chennai, India Ph: +91 40 4344 1066 Email: internationalcare@ apollohospitals.com

www.apollohospitals.com

Mumbai Ph: +91 22 6130 5005 Email: rfh.international@rfhospital.org

www.rfhospital.org

KIMS HOSPITAL

ASTER MIMS Kozhikode, India Ph: +918157880111 Email: mvt@asterhospital.com,

Thiruvananthapuram, India Ph: +91 471 294 1888 Email: ipr.tvm@kimsglobal.com

anvarhusain@asterhospital.com

astermims.com

https://trivandrum.kimsglobal.com/

SHARP SIGHT

MEITRA CALICUT Delhi, India Ph: +91 11 401 28881 Email: info@sharpsight.in, ceo@sharpsight.in

www.sharpsight.in

46 Medical Tourism Apr - Jun 2022

Kozhikode, India Ph: +91 495 7123456 Email: info@meitra.com

www.meitra.com

MEDICAL TOURISM HOSPITALS

ADK HOSPITAL

RAK HOSPITAL Sosun Magu Male', 20040 Maldives Phone: (+960) 331 3553 Email: info@adkhospital.com

www.adkhospital.mv

Al Qusaidat Ras Al Kaimah UAE Phone: +971 72074444 Email: mail@rakhospital.com www.rakhospital.com

HOSPITALS IN INDIA

MVR CANCER CENTRE & RESEARCH INSTITUTE

CIMAR COCHIN

Calicut, India Email: info@mvrccri.co

Ernakulam, Kerala India Phone : +91 484 4134444 Email : cimarcochin@gmail. com

www.mvrcancerhospital.com

cimarindia.org

BABY MEMORIAL HOSPITAL

NARAYANA HEALTHCARE Bangalore , Karnataka Ph: +91 99860 13353 Email: international@narayanahealth.org

Kozhikode, Kerala Phone: +91 - 495 – 2723272 Email: info@babymhospital.org

www.babymhospital.org

www.nhinternational.org

SRI RAMACHANDRA MEDICAL COLLEGE

ASTER MEDCITY Kochi Phone: +91 484 66-99999 Email: astermedcity@asterhospital.com www.astermedcity.com

Chennai India Ph: +91 984 096 9698 Email: ipcs@sriramachandra.edu.in

www.sriramachandra.edu.in/medical/

RAJAGIRI HOSPITAL

MANIPAL HOSPITALS Bangalore Ph: +91 80 2222 1111 Email: info@manipalhospitals.com

www.manipalhospitals.com

Cochin, India Ph: +91 484 290 5037 Email: international@rajagirihospital.com

http://www.rajagirihospital.com/ A Complete Magazine on Healthcare in Asia

MEDICAL TOURISM WELLNESS CENTERS

NIMBA NATURE CURE

KAIRALI AYURVEDIC GROUP Ahmedabad Gujarat India Phone: +91 276 228 3313

New Delhi Phone: +91 11 65028307 Email: info@kairali.com

www.kairali.com

www.nimba.in

SHATHAYU AYURVEDA YOGA RETREAT

KALARI KOVILAKAM

Bangalore Phone: +91 8884133300 Email: info@shathayuretreat. com

www.shathayuretreat.com

SWASWARA

Kollangode, Palakkad, Kerala Phone: +91 4923 305500 Email: admissions@cghearthayurveda.com

www.cghearthayurveda.com/kalari-kovilakom

DHATHRI AYURVEDA HOSPITAL Om Beach, Gokarna Phone: +91 484 4261751 Email: greswaswara@cghearth.co.in

www.cghearth.com/swaswara

SREEDHAREEYAM AYURVEDIC EYE HOSPITAL AND RESEARCH CENTRE

Kayamkulam, Kerala Phone: +91 90200 28888 Email: hospitals@dhathri.in

www.dhathriayurveda.com

RAHA CFAAR

Kadavathra, Ernakulam Phone: +91 484 2801235 Email: info@rahaayurveda.com

Koothattukulam, Kerala Phone: + 91 485 2253007 Email: mail@sreedhareeyam.com

www.sreedhareeyam.com

AYURGREEN HOSPITALS

www.rahaayurveda.com

SOMATHEERAM RESEARCH INSTITUTE AND AYURVEDA HOSPITAL

Malappuram, Kerala Phone: +91 494 305 5555 Email: info@ayurgreenhospitals.com

www.ayurgreeenhospitals.com 48 Medical Tourism Apr - Jun 2022

Kovalam, Thiruvananthapuram Phone: +91 471 2268101 Email: mail@somatheeram.in

somatheeram.in

Vol.6 | Issue No.4 |Apr - Jun 2022 (English)

Articles inside

Equipment World

Rare Surgeries

A beacon of hope

Facilitators upbeat on prospects

You Name It, We Have It

Medical Mall to grace Thalassery

Breathing easy

Yoga in the post-Covid phase

Kerala’s battles on the health front

Cover Story Medical value travel back with a bang

The psyche and the pandemic