Medical and Wellness Tourism : Studies from Asia and Europe

Objectives

Tourism has long been regarded by social scientists as a rather ‘soft’ topic of enquiry. It has, however, become the world’s largest industry over the last two decades and anthropologists have responded by raising the theoretical importance of so-called ‘tourism studies’. The expression “health tourism” was coined in 1987 by Goodrich and Goodrich, with respect to domestic tourism. Researchers later briefly offered some avenues for research into the new, emerging forms of “travel health care services”. Tourism studies alone do not, however, suffice to unpack the complex nature of this phenomenon. The approaches developed in medical anthropology / geography and the social studies of medicine help to revisit and go beyond conventional studies of health tourism. The analytic lens of the proposed panel will shift from one approach to the other, so as to add to the heuristic potential of the project. This panel will examine medical and wellness tourism in four different contexts, pertaining to India, Thailand and Germany. The participants are interested in exploring the rise of neo-oriental spas in Europe and in Asia, as well as the transnational flows of medical patients from Europe to Asia and among Asian countries. Attention will be given to the positive and negative effects of health tourism on Asia’s health care systems, particularly in terms of disparities of access.

Organisers

• French Institute of Pondicherry (UMIFRE 21 CNRS-MAEE)
• Cluster of Excellence ‘Asia & Europe’, University of Heidelberg

Coordinator

Dr. Laurent Pordié (IFP / Heidelberg)

Venue

Room S (210 + 211), Daejeon Convention Center, Daejeon, South Korea

Participants

• Audrey Bochaton (University Paris 10 – Nanterre / IRD)
• Harish Naraindas (Jawaharlal Nehru University, New Delhi)
• Laurent Pordié (IFP / Heidelberg)
• Caroline Wilson (University of Sussex)

Programme

Introduction : The New Global Healthcare Destinations : A Research Agenda
Laurent Pordié

Paper 1 : Panchakarma in the time of Lent : Glocalizing the Ayurvedic Spa in Germany
Harish Naraindas (Jawaharlal Nehru University, New Delhi)

Not far from the “last” Roman outpost of Cologne, home to the grand carnival celebrated by the Catholics on the banks of the Rhine, is the city of Bad Ems on the River Lahn. It houses a posh Ayurvedic resort in a historic former palace on the river front and invites its clients to retrofit themselves soon after the carnival through an Ayurvedic panchakarma instead of the traditional Lenten fasting. This localizing of the latest globalising Asian medical system, within a “religious” European Calendar, may be seen as a perfect Post-festive purging of the plethoric brought about by the excess of the winter carnival. Under the soothing notion of detoxification (quite like getting rid of the accumulated toxic assets that has led to the financial meltdown brought about by speculative excess), and under watchful medical supervision, the Asian panchakarma (5 fold “purificatory” therapy), promises a “genuine cure” instead of a problematic and dicey fasting that may both disturb the circulation and is full of sacrificial intent. In this paper, I hope to ethnographically explore through examples like the above, the growth and translation of Ayurvedic panchakarma as spa therapy in a European context, in terms of the cognitive translations, accommodations and negotiations that an Asian system makes as it globalises itself in the European context. This dialogue is simultaneously framed by German culture, by Catholic and Protestant religious sensibilities, by biomedicine, by insurance companies, and by a rainbow of alternative therapies with a long history, including that of the European spa, within which Ayurveda is the latest entrant.

Paper 2 : Degrees of Relatedness : Medical Tourism and the Local Health Care System in Kerala, South India
Caroline Wilson (University of Sussex)

In the last two years, the leading corporate hospitals from Kerala, South India are working in conjunction with the government tourism department to brand the state as an international hub for medical tourism. Although the industry is still in its infancy, recent development within the health care sector is increasingly being designed to cater to this market. This paper examines the complex ways in which medical tourism is both integrated within and separated from the local health care system. It explores the role of medical tourism as an important framing device through which the local health care system is further imagined and integrated within the global marketplace for medical care. It examines the ways in which the norms, values, priorities, and practices of private hospitals are being transformed as institutions respond to the distinct needs of local and global patients and as institutions seek accreditation from national and international standards organisation. The paper analyses how medical tourism is redefining the hospital, medical work, patient care, and conceptualisations of health care costs. It therefore uses medical tourism as a trope through which to explore the emerging paradoxes of neo-liberal transformation in contemporary India.

Paper 3 : Tibetan Medical Knowledge on the Market. Encounters between Amchi and Health Tourists in Ladakh
Laurent Pordié (IFP / Heidelberg)

Tibetan medicine plays an increasing role in the international market for alternative therapies and its popularity has been extending far beyond its original cultural area becoming a global phenomenon. In the Himalayan region of Ladakh, however, medicine production is directed towards the local market and the global circulation of Ladakh-made drugs and practitioners is a very new and limited phenomenon. The international scope of Tibetan medicine in Ladakh is exemplified by the clientele of some urban practitioners (amchi). The fascination the West has for the Tibetan world and the interest that has been shown over the last three decades in Asian medicine have led to an increasing number of seasonal tourists seeking Tibetan medical care during the Ladakh summers. Over the past decade, a few clinics operated by English-speaking amchi have explicitly directed their services toward this new category of patients, hoping to add to their regular, local clientele. In this paper, I examine the meaning of local knowledge in this context, and the way it is discursively constructed and sold on the market. I am interested in the local appropriations of global discourse on ‘natural medicine’, which do not mean that medical practice itself is undergoing stringent transformations, as it is sometimes read. These appropriations mainly aim at facilitating communication, so as to better explain what the practitioners do and what they hope to sell to their foreign clients. The last part of this paper explores important marketing arguments for Tibetan medicine pertaining to the scientific character of medicine and its religious framework. It shows that such contemporary articulation of distinct domains of knowledge is to be found in the Tibetan architecture of learned knowledge and not to be explained, in the case of medicine, by the sole influence of the market and the discourse of health tourists.

Paper 4 : Health Mobility of Laotian Patients towards Thailand
Audrey Bochaton (University Paris 10 – Nanterre / IRD)

While mobility across borders is mostly studied from economic, trade and migration points of views, this paper studies border movements from a health perspective. Specialist research already showed in the beginning of the 1970’s that Lao people living close to the eastern border of the country crossed the Mekong river to seek health care in Thailand. Does this form of transnational health seeking behavior still exist today ? What is, for example, the role of the development of transport infrastructure on both sides of the border ? More significantly, how does Thailand’s leading medical tourism industry in Asia affect the therapeutic itineraries of Lao people ? Over the last ten years indeed, Thailand has been a pioneer in medical tourism in Asia and currently leads the way in terms of the number of foreign patients treated each year. The country has gained a reputation for offering high standards of care at an affordable price : “First World Treatment at Third World prices”. Bangkok is now ‘the health care hub’ for South-East Asia. The objective of this paper, therefore, is to explore the relationships between health mobilities of Laotian patients and Thai medical tourism.