South Africa is increasingly looked to by Africa’s elites and middle-classes as a place where quality private care is available for non-elective treatments such as surgery after accidents, heart surgery and cancer treatment.

However, the greatest growth in medical travel to South Africa in recent years is from neighbouring countries whose public healthcare systems are in a state of crisis.

South Africa’s own public healthcare system is itself overburdened and under-resourced but it can still deliver a quality of treatment that is often unavailable elsewhere on the continet.

The Southern African Migration Project, an international network of organisations that promotes awareness of migration-development linkages in the Southern African Development Community (SADC), has embarked on a major project to study the dimensions and impact of medical travel. Although the number of global medical tourism destinations is multiplying rapidly, a recent overview of the global medical tourism industry identified three major hubs (Thailand, India and Singapore) and three minor hubs (Costa Rica, Hungary and South Africa) for north-south medical tourists.

The competitive success of the three major hubs is attributed to a number of factors. India, for example, is the cheapest of all the hubs with prices for surgical procedures averaging only a fifth of those in the US. The services that most exemplify medical tourism in Thailand are elective procedures such as routine check-ups and cosmetic surgery. Singapore tends to be sold internationally as a hub, on the basis of skilled practitioners and state-of-the-art technology.

South Africa’s strength lies in the packaging of its tours, rather than the outright price of its medical capabilities. A cosmetic surgery package in South Africa will consist of a consultation and surgery, personal physical therapist and personal assistant during your recovery in a spa and a safari tour afterwards.

Any of these components can be found in other tourism hubs for far less and some travel agents will even bundle them, but the professionalism and polish of the South African package cannot be matched.

Our research shows that the “surgeon and safari” medical tourism experience is only one small segment of the industry in South Africa. Indeed, the evidence suggests that a great deal of so-called medical tourism to South Africa is not from the north at all, but from other African countries.

Two major forms of south-south medical migration to South Africa from the rest of Africa are identified. The first is the growth in medical travel from east and west Africa to South Africa. These travellers spend more in South Africa than any other traveller (including those from the Northern hemisphere) and are generally middle-class Africans seeking specialist diagnosis and treatment.

The second, making up more than 80% of the total medical travel flow to South Africa, are formal and informal movements from countries neighbouring South Africa (especially Lesotho, Swaziland, Mozambique and Zimbabwe).

The number of medical travellers increased from 327000 in 2006 to more than 500000 in 2009 but dropped again to under 400000 in 2010, probably as a result of the global recession. The proportion of entrants who said they had come to South Africa for medical reasons in the period 2006-10 is well below those who came to shop, on holiday, to visit family and friends, and on business.

The global north generated a total of 281000 medical travellers over this period while the global south was the source of more than 2million. In terms of the regional breakdown, Asia and Australia were the least important source of medical travellers at 29000 (only 2.5% of total visitors) and Africa the most important at 2196000. What is most striking is that 85% of South Africa’s medical visitors are from other African countries.

In general, medical travellers tend to stay in the country for shorter periods than other visitors. The average length of stay of all tourists in 2010, for example, was around 8.5 nights while medical travellers stayed for around 5.5 nights on average. The main reason for the discrepancy is that the former tend to engage in a wider variety of activities in several destinations whereas medical travel is generally restricted to a single destination and purpose.

However, the average length of stay of medical travellers did increase from 4.5 nights in 2007 to 5.6 nights in 2010. This could be associated with a greater demand for more specialised treatment and advanced medical procedures by patients.

When length-of-stay data is broken down by source country, interesting differences emerge. The average length of stay for medical travellers from Europe, for example, was eight nights in 2010 (compared with 13 nights for all European tourists). The average length of stay for South-South medical travellers from countries neighbouring South Africa, on the other hand, was four nights and as low as one night in the case of Botswana and Lesotho.

Medical travellers from African countries further away actually spend more time in South Africa than European medical travellers: for example, 20 nights for medical travellers from Angola; 14 nights for those from the DRC and 13 nights for those from Nigeria.

South Africa’s own public healthcare system is itself overburdened and under-resourced but it can still deliver a quality of treatment that is often unavailable elsewhere on the continet.
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