Patients And Medicare Business Bear The Brunt As Bangladesh Crisis Hits ‘Medical Tourism’

Political unrest in Bangladesh, and the resultant protests and upheaval, have left medical tourists in the lurch as both the process of getting visas and travelling across the border has become complicated.

Jahanara’s desperation is shared by others from Bangladesh seeking medical treatment in India.

For long, Kolkata and other cities in India have been their preferred choice for medical consultations. But their wait is only getting longer now. This means huge losses for India's hospitals as more than half of the medical tourists to India are from the neighbouring country.

Leading healthcare facilities in Eastern India – Apollo Hospitals, Manipal Hospitals, Peerless Hospitals, Medica, Woodlands, and Narayana Hospitals, among others – cater to a significant share of patients from Bangladesh, estimated at around 2.5 to 3 lakhs annually. 

"Medical tourists" also make up a major source of revenue for these healthcare facilities, and have been part of project plans and business forecasts for years. That planning is on the back burner now.

Health Scare Unlikely To Get Resolved Soon

Bangladesh’s political unrest has seen travel between the two nations come to a grinding halt, with virtually no visas being issued over the past two weeks.

Hospitals in the Eastern region, which have borne the brunt of this hiatus, reported an almost 90-per cent drop in foreign patients. Worse, experts do not see this matter getting resolved anytime soon.

“We are faced with an unprecedented situation. The situation has led to a crisis that is unlikely to blow over quickly. It could be months if not longer, before normalcy is restored in medical and other travel between the two countries,” Rupak Barua, President of the Association of Hospitals of Eastern India (AHEI), told The Secretariat.

Over Half of India's Medical Tourists Come From Bangladesh

India witnessed a 48-per cent rise in medical tourists from Bangladesh in 2023, compared to 2022, according to Government estimates. In absolute numbers, nearly 4.5 lakh people from Bangladesh visited India in 2023 for medical treatment, with 60 per cent coming to West Bengal.

Of the remaining, 30 per cent chose healthcare facilities in South Indian cities like Bangalore, Chennai, and Hyderabad, while 10 per cent opted for Delhi.

In 2022, Bangladeshi ‘tourists’ made up nearly 68.66 per cent of total patient arrivals in India. This is in stark contrast to the modest influx from neighbouring countries such as the Maldives, Sri Lanka, Pakistan and Myanmar.

The bulk of the patients from Bangladesh visiting India seek medical consultation in outpatient departments (OPD) of hospitals, or laboratory and follow-up tests. Only a fraction stay back for admission and surgery.

The key segments where patients seek medical treatment are oncology, neurology, including neurosurgery, IVF (a significant patient base), gastroenterology, and cardiology.

The availability of skilled doctors and affordable healthcare, in addition to familiarity with the language and food habits, spurs the inflow.

‘Mini-Bangladesh’ Helps Other Businesses Too

This steady rise in medical tourists has created what is often referred to as a ‘Mini Bangladesh’ in and around Kolkata’s iconic New Market area.

Some 400 restaurants, hotels, and lodges have sprouted to cater to the flood of tourists, in adjoining localities like Free School Street, Marquis Street, Colin Street, Sudder Street, and Rafi Ahmed Kidwai Road.

Typically, it takes 30-45 days to get a medical visa. That’s because, on any given day, the Indian High Commission in Dhaka receives around 20,000 visa applications.

“Of these, around 9,000 visas are approved each day, by far the largest number processed by any embassy, anywhere in the world,” according to Prashant Sharma, Chairman, the National Healthcare Committee, Indian Chamber of Commerce.

The growing count of medical tourists has also given birth to a travel industry boom. With equal numbers coming in by land and the air route from Bangladesh, flights to India from Chittagong and Dhaka are chock-a-block, as are bookings on buses and other road travel options.

The road-travellers, mostly from west or north Bangladesh, enter India from Siliguri, Barasat, Benapole, or Barishat in West Bengal, while those living in southern or eastern Bangladesh prefer to come through Tripura's Akhaura.

However, with Indian visa application centres in Bangladesh shut since August 8 and no new tourists coming in since the fall of the Sheikh Hasina regime on August 5, appointment books have been all but torn asunder in Indian hospitals.

For instance, in Kolkata alone, nearly 80 per cent of hospital appointments have had to be cancelled.

Hospitals such as those at Manipal Group have felt the pinch, with the normal footfall of nearly 2,500 patients now slowing down to near nothing.

Doctors are also worried that critically ill patients from Bangladesh may face health complications without their prescribed treatment in Indian hospitals. “Many cancer patients scheduled for treatment haven’t come, which is detrimental to their health,” Dr Sayan Paul, Consultant, Radiation Oncology, Apollo Cancer Centre, Kolkata, said.

Business Impact And Learning to Adapt

Patients from Bangladesh constitute around 10 per cent of the total number seeking medical care in India’s Eastern region, and this naturally impacts admissions at hospitals.

While the total revenue fall is unlikely to be catastrophic, it will nonetheless be a blow, as patients and their caregivers also make up a large part of the earnings of smaller ancillary businesses.

Those analysing the hospital industry insisted that it would manage to tide over the crisis as the bulk of its revenues come from domestic patients.

“Medical tourism forms around 8-10 per cent of hospital revenues, of which Bangladesh contributes 50-60 per cent. Thus, while the crisis will have an impact on medical tourism, the impact will be a maximum of 4-6 per cent of hospital revenues", Kinjal Shah, Senior V-P at ICRA, said.

Necessity leads to inventions, it is said, and the ongoing crisis is no different. After the internet was restored in Bangladesh, Kolkata hospitals have been increasingly offering online consultations.

On average, hospitals are conducting 8-10 online consultations daily – while that is a far cry from erstwhile physical numbers, it is a lifesaver in many critical cases.

Medical Options: Singapore, Malaysia and Bangkok

With travel to India uncertain, Bangladesh patients are eyeing healthcare options in Singapore, Malaysia and Bangkok.

The first signs of a ‘patient flight’ to hospitals in Southeast Asia were apparent in the first week of the stir itself, but the numbers have been restricted as expenses for treatment in these countries are significantly higher than in Eastern India.

This necessity has led to the beginning of a second invention too, forcing Indian healthcare providers to look at other geographies to sustain business. “The Bangladesh situation has given us reason to conduct a review and identify ways to reduce our dependence on one country,” ICC’s Prashant Sharma said.

Indian hospitals are learnt to be focusing their energies on alternative ‘target countries’ such as Africa and those in the Gulf, or closer home, Nepal and Myanmar.

In all these cases, though, there is the proverbial slip between the medical cup and the patient’s lip – travel and other logistics. Indian businesses’ innate ability to manage in the face of adversity, however, may see that hurdle resolved by new flights to other destinations being launched.