A STUDY ABOUT MEDICAL TOURISM IN KERALA

PROJECT SUBMITTED TO KERALA UNIVERSITY FOR THE

PARTIAL FULFILLMENT OF THE REQUIREMENT FOR THE
AWARD OF BMS IN HOTEL MANAGEMENT

SUBMITTED BY

AKHIL.N
UNDER THE GUIDANCE OF
REJI RAJESH

SANKAR INSTITUTE OF SCIENCE TECHNOLOGY AND

MANAGEMENT , CHATHANOOR
KOLLAM
2017-2020

1
 CERTIFICATE
This is to certify that project entitled ‘A study about medical tourism in Kerala’ is a
bonafied record of project work done by the student Akhil.N In partial fulfillment for the
award of BMS Hotel Management in the academic year 2017-2020

External Examiner

Sreeraj.S
(Lecturer)
Dr.Manu Kamaljith
(Principal)

Place : Kollam
Date :

2
 ACKNOWLEDGEMENT
This research report has proved to be an overall extremely learning experiance. I am
thankful to my Prof. Mr. Reji Rajesh for guiding me throughout of this research in the light of
their experience.

I am also very greatful to Prof. Sreeraj.S and Nimish S.D for giving valuable
comments .

The guidance of all faculty members was very valuable during my reasearch stage
.This support was not only a source of encouragement for me but also made me realized the
truth implications of beign a researcher and made it possible for me to apply my subject
theory into a practical research project

3
 DECLARATION

I here by declare that the project entitled ”Housekeeping in A Study about medical
tourism in kerala” submitted by me to Kerala University for the year 2017-2020 for the
completion of BMS Hotel Management at Sankar institute of science and technology .

Akhil.N

Place : Kollam

Date :

4
 LIST OF CONTENTS

CHAPTERS TITLE PAGE NO.

I Introduction:
a) Importance of the topic
b) Statement of the problem
c) Need and significance of the study
d) Reason for selecting the topic
e) Objectives
II Review of literature
a) What is medical tourism
b) Advantages of medical tourism in Kerala
c) Medical tourism and its trends

III Methodology
1) Experimental Procedure
a) Selection Of area
b) Selection of subject
c) Selection tools to collect data
i)Questionnaire Method

IV Data analysis and interpretation

V Findings and conclusion
a) Findings from data analysis
b) Recommendations
c) Conclusion
d) Appendix

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6
 CHAPTER-1

INTRODUCTION

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INTRODUCTION
Tourism is traveling for predominantly recreational or leisure purposes or the
provision of services to support this leisure travel. The World Tourism
Organization defines tourists as people who "travel to and stay in places outside
their usual environment for not more than one consecutive year for leisure,
business and other purposes not related to the exercise of an activity remunerated
from within the place visited". Globally, Tourism has become a popular global
leisure activity. In 2006, there were over 842 million international tourist arrivals.
Tourism is subdivided into:

Leisure Tourism
Pilgrimage Health Tourism Winter Tourism Mass Tourism

Tourism is further subdivided into 31 sub divisions as follows:

Accessible tourism · Adventure tourism—Hiking, Tramping,

Mountaineering · Agritourism · Archaeological tourism · Backpacker
Tourism · Bicycle touring · Bookstore tourism · Cultural tourism · Dark
tourism · Disaster tourism · Drug tourism · Ecotourism · Extreme tourism
· Female sex tourism · Free Independent Traveller · Garden tourism ·
Heritage tourism · Literary tourism · Medical tourism · Music tourism ·
Naked hiking · Pop-culture tourism · Perpetual tourism · Pilgrimage ·
Sacred travel · Safaris · Sex tourism · Space tourism · Sustainable tourism.

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Medical Tourism

Medical tourism (also called medical travel or health tourism) is a term

initially coined by travel agencies and the mass media to describe the
rapidly-growing practice of traveling to another country to obtain health
care. According to Mary Tabacchi, Health Tourism is any kind of travel to
make yourself or a member of your family healthier. More recently the
phrase "Global Healthcare" has emerged, and may replace the earlier
terms. Such services typically include elective procedures as well as
complex specialized surgeries such as joint replacement (knee/hip),
cardiac surgery, dental surgery, and cosmetic surgeries. The provider and
customer use informal channels of communication-connection-contract,
with less regulatory or legal oversight to assure quality and less formal
recourse to reimbursement or redress, if needed. Leisure aspects typically
associated with travel and tourism may be included on such medical travel
trips.

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Medical Tourism in Kerala

Kerala has established itself as a prominent Destination of world leisure

tourism for its natural beauty and cultural assets. The growth of Tourism
in Kerala has been induced by the buyer driven factors. The collective
marketing effort through the tourism department has been limited. The
scenario of Medical Tourism is also not much different from leisure
tourism. Medical tourism in Kerala grew without much wilful collective
effort. It was recognized as an opportunity by some sectors, particularly
the Ayurveda sector who took some collective effort to convert Kerala as
source for Ayurveda treatment. Then came Dentistry and Modern
Medicine. A combination of many factors has led to the increase in
popularity of medical tourism in Kerala:
 Traditional systems of medicine like Ayurveda and
Siddha are widely popular in the state, and draws increasing numbers
of tourists
 High costs of healthcare in industrialised nations
 Ease and affordability of international travel
 Improving technology and standards of care.

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NEED AND SIGNIFICANCE OF THE STUDY

Kerala has become the global health leader and is renowned as the most popular
destination for the medical tourists. Medical Tourism is Kerala growing at the rate
of 30 percent each year. Kerala offer high quality, world class health treatment at
only 20 percent of the cost of treatment in USA, UK and other European countries.
The quality of medical treatment here is of world class with many of the doctors
holding western qualifications. The trend of medical tourism is fast getting popular
in Kerala with the number of medical tourists increasing by about 20 to 30 percent
each year.

Kerala is been growing as a tourists destination of choice for health and holidays
because of our world class team of professionals, modern advanced technology and
the distinct warmth of hospitality. Kerala is a home to some of the best hospitals
and stand alone specialty clinics in the world, offering world-class expertise and
state-of-the-art facilities at the economical rates. Several hospitals in Kerala have
carved out outstanding reputation for themselves that health tourism has become a
major money spinner. The state also boosts of some of the best Ayurveda resorts
and Yoga centers to pamper the tourists physically, mentally and emotionally

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With the best infrastructure, the best possible health care facilities accompanied
with the most competitive prises, you can get the treatment done in Kerala at the
lowest rates.
Even the ordinary medical check ups costs low in Kerala as compared to the
other European countries.
The tropical climate of Kerala is best suited for any medical treatment and
rejuvenation therapy.
The Competent doctors, highly qualified surgeons and supportive staff.
Internationally accredited medical facilities
No waiting lists
Cost of health care treatments is 60 -80% low
Fluent English Speaking Staff
24 hours round the clock service
Availability of budget friendly accommodation options near to the best
hospitals for the family members accompanying you
Availability of Naturatherapy in the purest form makes Kerala the most
sought after health destination.
Availability of natural and herbal rejuvenation therapies , through Ayurveda
and Yoga.

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OBJECTIVE OF THE STUDY

 Major treatment taken by the guest

 Guest satisfaction for the taken treatment
 Main package included to medical tourism

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14
 CHAPTER 2

REVIEW OF LITERATURE

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 REVIEW OF LITERATURE

In the topic selected for in the importance of medical tourism in

Trivandrum and Kollam. In the review collected from the book general
knowledge, internet, and the information getted from this source are
discussed under the following headings.

 What is medical tourism

 Advantages of medical
tourism in Kerala
 Medical tourism and its
trends

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 What is Medical Tourism

Factors that have led to the increasing popularity of medical travel include the high cost of health
care, long wait times for certain procedures, the ease and affordability of international travel, and
improvements in both technology and standards of care in many countries.[6][7] The avoidance of
waiting times is the leading factor for medical tourism from the UK, whereas in the US, the main
reason is cheaper prices abroad. Furthermore, death rates even in the developed countries differ
extremely, i.e. UK versus seven other leading countries, including the US.[8]
Many surgical procedures performed in medical tourism destinations cost a fraction of the price
they do in other countries. For example, in the United States, a liver transplant that may cost
$300,000 USD, would generally cost about $91,000 USD in Taiwan.[9] A large draw to medical
travel is convenience and speed. Countries that operate public health-care systems often have
long wait times for certain operations, for example, an estimated 782,936 Canadian patients
spent an average waiting time of 9.4 weeks on medical waiting lists in 2005.[10] Canada has also
set waiting time benchmarks for non-urgent medical procedures, including a 26-week waiting
period for a hip replacement and a 16-week wait for cataract surgery.[11]
In First World countries such as the United States, medical tourism has large growth prospects
and potentially destabilizing implications. A forecast by Deloitte Consulting published in August
2008 projected that medical tourism originating in the US could jump by a factor of ten over the
next decade. An estimated 750,000 Americans went abroad for health care in 2007, and the
report estimated that 1.5 million would seek health care outside the US in 2008. The growth in
medical tourism has the potential to cost US health care providers billions of dollars in lost
revenue.[12]
An authority at the Harvard Business School stated that "medical tourism is promoted much
more heavily in the United Kingdom than in the United States".[13]

17
Additionally, some patients in some First World countries are finding that insurance either does
not cover orthopedic surgery (such as knee or hip replacement) or limits the choice of the
facility, surgeon, or prosthetics to be used.
Popular medical travel worldwide destinations include: Canada, Cuba, Costa
Rica, Ecuador, India, Israel, Jordan, Malaysia, Mexico, Singapore, South
Korea, Taiwan, Thailand, Turkey, United States.[14]
Popular destinations for cosmetic surgery include: Argentina, Bolivia, Brazil, Colombia, Costa
Rica, Cuba, Ecuador, Mexico, Turkey, Thailand and Ukraine. According to the "Sociedad
Boliviana de Cirugia Plastica y Reconstructiva", more than 70% of middle and upper class
women in the country have had some form of plastic surgery. Other destination countries
include Belgium, Poland, Slovakia and South Africa.[15]
Some people travel for assisted pregnancy, such as in-vitro fertilization, or surrogacy,[16] or
freezing embryos for retro-production.[17]
However, perceptions of medical tourism are not always positive. In places like the US, which
has high standards of quality, medical tourism is viewed as risky. In some parts of the world,
wider political issues can influence where medical tourists will choose to seek out health care.
Medical tourism providers have developed as intermediaries which unite potential medical
tourists with surgeons, provider hospitals and other organizations. In some cases, surgeons from
the United States have signed up with medical tourism providers to travel to Mexico to treat
American patients. The hope is that using an American surgeon may alleviate concerns about
going outside the country, and persuade self-insured American employers to offer this cost-
effective option to their workers as a way to save money while still provide high-quality
care.[18] Companies that focus on medical value travel typically provide nurse case managers to
assist patients with pre- and post-travel medical issues. They may also help provide resources for
follow-up care upon the patient's return.
Circumvention tourism is also an area of medical tourism that has grown. Circumvention tourism
is travel in order to access medical services that are legal in the destination country but illegal in
the home country. This can include travel for fertility treatments that aren’t yet approved in the
home country, abortion, and doctor-assisted suicide.[19] Abortion tourism can be found most
commonly in Europe, where travel between countries is relatively simple. Ireland and Poland,
two European countries with highly restrictive abortion laws, have the highest rates of
circumvention tourism. In Poland especially, it is estimated that each year nearly 7,000 women
travel to the UK, where abortion services are free through the National Health Service.[20] There
are also efforts being made by independent organizations and doctors, such as with Women on
Waves, to help women circumvent draconian laws in order to access medical services. With
Women on Waves, the organization uses a mobile clinic aboard a ship to provide medical
abortions in international waters, where the law of the country whose flag is flown applies.[21]

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 Advantages of medical tourism in Kerala :

Kerala, popularly known as the ‘God’s Own Country’ is fast becoming a renowned destination
for Medical Tourism. Many people considered this South Indian state as a great destination to
relax and unwind. Now it is also a wonderful place for achieving health, mainly in the field of
Ayurveda, Allopathy and Dentistry. A lot of travelers from different parts of the world take
advantages of different medical packages in the above mentioned fields. The presence of highly
trained doctors and medical practitioners and excellent medical facilities make it an ideal
destination for medical tourism. Most of the hospitals in the state maintain international
standards but at the same time they provide cost-effective treatments. Get more details about
medical tourism in Kerala and know how to choose the best packages by visiting tour website
www.KSU.in.

Kerala For Quality Medical Care

Kerala is mainly famous for the alternative and traditional medical system like Ayurveda. Many
people from different parts of the world visit India to seek fine treatments for various diseases.
The medical tourism in the country has been attaining a boost and plenty of people visit India in
order to get quality medical care at affordable rates. Medical and dental tourism are the new
trends in Kerala where travelers can find excellent medical care at reasonable rates. The Tourism
Department of Kerala has taken several initiatives to encourage medical tourism in the state.
People who seek better treatments in Kerala can get an idea about the medical visa through the
website of KSU.

A Booming Industry

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Medical tourism is a booming industry in Kerala that attracts many people from different parts of
the world. Even if it is relatively a new concept, it can be an effort from the part of government
to draw patients in order to seek medical treatment through tourism. It is an attractive way to
promote tourism as it can combine the joy of traveling to some particular places while enjoying
the health benefits.

The Kerala Medical Tourism helps travelers to this South Indian state to have leisure and
relaxation along with wellness and healthcare. In fact, people who come to Kerala through
medical tourism can go back with a rejuvenated body and mind. People who opt for medical
tourism can stay in a relaxed environment away from the stress and chaos of the daily life. They
can spend their time in some of the exotic places of the state and revitalize physically, mentally
and emotionally.

Perfect Place To Meet Medical And Travel Needs

One of the great advantages of Kerala medical tourism is that it offers many job opportunities.
The health providers in this state have to play different roles to utilize them. Kerala has so many
favorable elements so improve medical tourism such as immediate availability of treatments,
excellent treatment facilities and low cost. The growing popularity of this state as a great medical
and health tourism destination is also a factor to attract travelers from different parts of the globe
to get medical and dental treatments. The treatment cost is also relatively very cheap compared
to many other countries in the world. For so many reasons, Kerala is a wonderful tourist place in
the world when it comes to medical tourism where people can meet both travel and medical
needs perfectly.

Low Cost Of Treatments

Since Kerala Medical Tourism combines the services of superlative hospitals and outstanding
tour operators in the state, travelers can enjoy complete medical care while enjoying a
memorable holiday experience. Kerala offers the service of experienced and best qualified
doctors along with excellent medical facilities. Travelers can enjoy medical treatments at very
cheap rates. The low cost of treatment can be a relief for many patients who seek first-rate
medical treatment and care in Kerala. The cost of treatments in this state can be nearly 1/10 th of
what they get in some other countries like US or Europe. The excellent infrastructure of Kerala is
also competitive globally.

English-Speaking Medical Professionals

The proficiency of English for the health professionals and travel agents in Kerala can be a
reason for the popularity of medical tourism in Kerala. So, foreign travelers can get in touch with
the people in the state without any difficulty. Kerala is also a hub of several other alternative
medicines like Ayurvedic, homeopathic, Sidha and Unani. Many Indians and foreigners visit this
state to get treatments in different ailments through the natural health system of Ayurveda. This
state has rich culture and heritage and each visitor to this state also admire its varied history.
Travelers can find many things to enjoy in this destination such as its unique lifestyle,

20
spectacular beaches, vibrant cultural festival, delectable cuisine, exotic wildlife and breathtaking
Western Ghats.

Support From KTDC

Kerala, the southernmost Indian state is one of the first few states in India that realized the
possibilities and importance of Medical tourism. The Government of Kerala has performed a
commendable role for the promotion of medical tourism in the state. With the support of them, a
patient from a foreign country can reach the state for treatment without any difficulty. KTDC or
the Kerala Tourism Development Corporation planned a few comprehensive packages for the
medical tourism. They gave equal importance for medical treatments and leisure options. The
Kerala Tourism department coordinates with many multi-specialty hospitals, health insurance
companies, policy makers and international institutions to promote health tourism in the state.

A Chief Source Of Income

Not many people know that medical tourism has a great source of income in India especially
some states like Kerala after information technology. The State Government of Kerala provides
all support for the growth of Medical Tourism in the state. The availability of highly experienced
and best qualified health professionals in different areas like dental, oncology, Orthopedics,
Kidney transplant treatments and dialysis is certainly a great feature. Kerala Medical tourism
ensures patients from different parts of the globe to get world-class treatment and care along with
an opportunity to explore some great tourist destinations in the state.

Popular Hospitals In Collaboration

Kerala Medical Tourism industry is in collaboration with some of the major hospitals in the state
such as Amrita Hospital, Medical Trust hospital, Jubilee hospital and Lakeshore hospital. The
advanced medical skills backed by modern treatment in these hospitals help patients to seek
treatments in different areas like cardiology, neurology, cancer, spine and joint replacements,
pediatric specialties and cosmetic reconstructive surgery in Kerala. They can enjoy world-class
treatments in this state at cheap rates under the supervision of best qualified health professionals.
An attractive feature of Kerala Medical tourism is the next-day appointment. Kerala has a
pleasant climate throughout the year that also encourage travelers to visit this state anytime for
getting treatment.

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 Medical tourism and its trends :

The concept of medical tourism have undergone many changes in recent times and there is a
change in the trends like people from developed countries moving to developing countries for
medical procedures for the difference in the cost. The global medical standards and regulations
have been implemented in different countries and this in turn raises the number of people
seeking cost advantage and best treatment in their preferred destination. The market of medical
tourism depends on awareness and application of significant issues such as social diversities,
consumer benefits, branding of products, legal frame work infrastructure, target markets, the
actual product and communication channels (Dannell & Mugumba).Therefore it is understood
that the people from developed countries choose their destination after analysing various features
and therefore there exist high competition between the countries to promote medical tourism.

The one more key component in this medical tourism is the medical concierge services. These
are medical travel companies that provide service to the traveller and they act as a link between
tourist and the destination (Lagiewski, 2007).They have a vital role in the tourist experience from
planning, stay, and post stages of the trip. The medical travel guide meets the tourist at the
airport and he is the local agent who works as interpreter, guide and assists the tourist to stay in
communication with his loved ones in his home. (Smith and Forgione, 2007).

According to Connell (2006) the ability to the countries to ensure the medical tourist that
healthcare is of safe quality is a vital factor and this will be the main barrier for a destination to
promote itself as most favourite destination In order to combat this concern, international
accrediting agencies are in the process of certifying the quality and safety of global healthcare

22
delivery. The tourist decides to engage in medical tourism on the basis of five a factor identified
by Lagieweskii.Her study identifies the first and foremost as the alternative healthcare facility to
their country’s facility which should be of high standard and at affordable cost. This factor is the
main factor and when the tourist is satisfied with first factor the next will be cost of treatment
and travel of great importance. The tourist may seek other country because of the e big waiting
list in their home country. There may be some reasons like remote destination for tourist for
certain cosmetic procedures. The nature of the country is also an important factor because tourist
seeks a country free from risk factors associated with safety, security and actability. (
Lagiewski,2007).

The country trying to make itself as most preferred destination for medical tourism it should
emphasize on the fact that its overall appeal and the experiences offered to the other competing
destinations. (Dwyer and Kim 2003).Dwyer and Kim insists that the destination should have the
competitive advantage to become successful in the medical tourism industry. According to
Dwyer and Kim the existence of two type of resource group may lead to achieve competitive
advantage. They are the endowed resources and created resources. Endowed resources are
natural heritage and cultural attributes to a specific destination and created resources are services
associated with the tourist such as accommodation, food and beverage establishments, and
manmade attraction. There can be created resources such as special events entertainment and
shopping which adds extra value to he destination. There can be supporting factors such as
general infrastructure; quality of service; accessibility of the destination; hospitality of the host
population; and market ties.

Growth has been facilitated by the rise of the Internet, and the emergence of new companies, that
are not health specialists, but brokers between international patients and hospital networks. It has
also grown because of rapidly improving health care systems in some key countries, where new
technologies have been adopted. Above all it has followed the deliberate marketing of health
care (in association with tourism) as medical care has gradually moved away from the public
sector to the private sector, ensuring that a growing majority of people, especially in the richest
countries, and particularly in the United States, must pay-often considerably-for health care

Finally, the factors like growth in medical tourism is done by the changing life style where
people are ready to undergo cosmetic surgery, involving such elective procedures as rhinoplasty,
liposuction, breast enhancement or reduction, LASIK eye surgery and so on, or more simply the
removal of tattoos, have created new demands. Various forms of dental surgery, especially
cosmetic dental surgery, are not covered by insurance in countries like the UK and Australia;
hence dental tourism has become particularly common. In Asia these trends are ‘the unlikely
child of new global realities: the fallout of terrorism, the Asian economic downturn, internet
access to price information, and the globalisation of health services’ (Levett, 2005)

India and medical tourism

India is a country of rich culture and heritage and one of the most favorite destinations for
tourism. It is one of the existing oldest civilizations in the world for a period of more than 4000
years and it has fusion of traditions, customs and diversity. (myindia).The survey conducted by
lonely planet about the world’s favourite tourist destination among 134 countries ranks India as
one among the world’s top 5 tourist destination.(lonelyplanet)

23
There are similar surveys and rankings for India as National Geographic describes India as
“Land of mystery and majesty”. The company i – explore also ranks India as one of the tp 5
destinations in world. The Forbes traveller states India as one the fast growing travel markets.
(ICRImedical tourism)

A number of destinations within India developed as havens for rest and recuperation such as hill
stations at Darjeeling and the lakes in Kashmir where during the colonial era members of British
era would retreat for cool breeze and a change of scenery. Late during the 19th century people
began travelling India in search of alternative life style often focusing on yoga or meditation and
following the footsteps of celebrities. India is building on these traditions as a wellness
destination by a developing expertise in medical tourism (Garcia Altes 2005: conell 2006a).

The main marketing segments for medical tourism in India are patients from USA and European
and middle east nations, while growing niche is formed by Indian expatriates ,particularly those
live in USA and the UK.(Conell 2006), who combine medical treatment with visits to family and
friends.

Medical tourism as a niche has emerged from the rapid growth of what has become an industry,
where people travel often long distances to overseas countries to obtain medical, dental and
surgical care while simultaneously being holidaymakers, in a more conventional sense. It has
grown dramatically in recent years primarily because of the high costs of treatment in rich world
countries, long waiting lists (for what is not always seen institutionally as priority surgery), the
relative affordability of international air travel and favorable economic exchange rates, and the
ageing of the often affluent post-war baby-boom generation. Growth has been facilitated by the
rise of the Internet, and the emergence of new companies, that are not health specialists, but
brokers between international patients and hospital networks. It has also grown because of
rapidly improving health care systems in some key countries, where new technologies have been
adopted. Above all it has followed the deliberate marketing of health care (in association with
tourism) as medical care has gradually moved away from the public sector to the private sector,
ensuring that a growing majority of people, especially in the richest countries, and particularly in
the United States, must pay-often considerably-for health care

“Medical tourism” is an important part of the Indian tourism industry and holds immense growth
potential. The medical tourism sector had experienced a phenomenal growth in the flow of
medical tourists – from10,000 patients in 2000 to stupendous 180,000 by 2005. (Source: RNCOS
report on ‘Indian Tourism Industry Forecast (2007-2011)

The Indian government takes meticulous steps in promoting medical tourism and it tries to
increase the growth of foreign medical tourist by providing medical visas called M visas. These
M visas are valid for one year and it is issued for the accompanies and Indian ministry of tourism
has stocked its 13 overseas offices with information regarding these visas.( Meleigy)

In 2002,2.2 million foreigners visited India :those numbers increased by 20 percent the following
year(Mathew 2004).The tourist literature produced by the Indian government portrays India as a
country rooted in tradition and also sufficiently modern to offer western style amenities
(Bandyoupdhay and Morais 2005) A study by McKinsey and Confederation of Indian Industry

24
says that at its current pace of growth, healthcare tourism alone can rake over 8,000 crore
additional revenue by 2012.(cii mckinsey study)

There are several states in India and the private hospitals in India target for the medical tourist
other than the home patients. The southern state of Kerala which is very rich in culture and
heritage and ancient medical practice like Ayurvediac ,Siddha and Yoga leads in attracting the
foreign tourist for medical health and leisure tourism.

Kerala

Kerala is a bizarre anomaly among developing nations, a place that offers real hope for the future
of the Third World. Consider: This small state in India, though not much larger than Maryland,
has a population as big as California’s and a per capita annual income of less than $300. But its
infant mortality rate is low, its literacy rate among the highest on Earth, and its birthrate below
America’s and falling faster. Kerala’s citizens live nearly as long as Americans or Europeans.
Though mostly a land of paddy-covered plains, statistically Kerala stands out as the Mount
Everest of social development; there’s truly no place like it. The National Geographic Traveler,
which once made Kerala the cynosure of all eyes in the world travel circuit by describing it as
one of the 50 paradises in the world. (National Geographic)

Kerala is one of the most visited tourists destination of India. It is globally famous for its
enchanting tourists’ attractions that are off beat than any other tourists’ places in the world.
Every year hundred and thousands of tourists from all over the world come to Kerala to enjoy
holidays in splendor. The state is endowed with palm fringed beaches, verdant hill stations,
captivating beaches, emerald paddy fields, historical churches and more of all picturesque
backwaters. This makes the marketing medical tourism easier in Kerala.

Accreditation of health centers

The quality of the medical care is the first and foremost factor considered by the medical tourist.
According to the medical tourism association the accreditation is the means of way to attain
safety and overall positive results to the patients who travel from one country to another for
treatment purposes. The medical tourist can look into the accreditation to ensure the safety of the
treatment in the hospital. The accreditation program is very essential to help patients, employers
and insurance companies who can look into the accreditation status and thereby can find the
hospitals with highest quality of care during their entire patient experience. The medical tourism
industry grows day by day and therefore there is a necessity to ensure that hospitals, clinic and
rehabilitation centers entering medical tourism posses proper infrastructure to meet the medical
tourist. There is a need to certify that the center has proper communication facilities,
transparency in quality and pricing, informed consent, proper medical care and further follow up
facilities. The accreditation is focused on the fact that international patients have special needs
and requirements than domestic patients. The accreditation is usually given by bodies which may
by government or non government with the panel of expert members to examine and find
whether the organization meets the requirements.(medical tourism association)

25
The accreditation to the allopathic medical practice in Trivandrum is provided by the
international accreditation bodies such as Joint Commission International (JCI), ISO 9001 –
2000 etc. Other than the international bodies Trivandrum city has hospitals certified by NABH, a
board set up by government of India. (See appendix).These are the major accreditations of
medical service in India. The ayurvedic practice is the unique specialty and most popular
medical practice in India and they have accreditation done by Body set up by Government of
Kerala as “Green leaf” and “Olive leaf” and green leaf is the highest degree of accreditation and
its followed by olive leaf and these accreditation ensures the quality of ayurvedic treatment in
Kerala. (expresshealthcare)

Ayurvedic tourism in Kerala

Kerala is usually marketed as a health destination for its ayurveda packages. Medical tourism is
marketed along with ayurveda and other health packages. Kerala ayurveda tourism has becoming
a huge selling point for Kerala tourism industry. State promotes Kerala ayurveda tourism as a
part of medical tourism to the world. Today popularity of Kerala ayurvedic treatment has gained
such a momentum that tourist from across the world come to Kerala to rejuvenate and for
therapeutic treatment.

Ayurvedic medical practice is the most ancient medical system originated in India before 10,000
years ago and in India the ayurvedic practice is more popular in kerala where it is practiced in
traditional way. As per ayurveda specialists, the rainy season (June – August) is the best time for
ayurvedic treatments as the atmosphere remains dust free and cool, which helps open the pores
of the body to the maximum.(Messerli and Oyama 2004)

Ayurveda believes in the treatment of not just the affected part, but the individual as a whole.
Kerala ayurvedic treatments and rejuvenation therapies are natural way to refresh and eliminate
all toxic imbalances from the body and to regain resistance and good health. Most of the
ayurvedictherapies help to strengthening the immune system, preventing and curing diseases
without any side effects.

There are number of resorts and hospitals throughout state which are integral parts of Kerala
ayurveda tourism and offering customized ayurveda holiday packages which help you to
rejuvenate the body and soul and to start a fresh life. Kerala ayurveda provides number of
treatments ranging from de-stressing, anti-ageing, weight loss, joint pains and general
rejuvenation

26
 Chapter 3

Research methodology

27
1.Selection of area :

1.1) Kollam :

Kollam is a coastal city on the banks of Ashtamudi Lake that took the title God's Own Country. The
Ashtamudi Lake lie about 71 kilometres (44 mi) north of the state capital, Thiruvananthapuram. The city
hosts the administrative offices of Kollam district and is a prominent trading city for the state. The
proportion of females to males in Kollam city is second highest among the 500 most populous cities in
India. Kollam is one of the least polluted cities in India.Four major trading centers around Kollam are
Kottarakara, Punalur, Paravur and Karunagapally.

Kollam is an ancient trading town – trading with Romans, Chinese, Arabs and other Orientals
mentioned in historical citations dating back to Biblical times and the reign of Solomon,
connecting with Red Sea ports of the Arabian Sea (supported by a find of ancient Roman coins).
There was also internal trade through the Punalur Pass connecting the ancient town to Tamil
Nadu. The overland trade in pepper by bullock cart and the trade over the waterways connecting
Allepey and Cochin established trade linkages that enabled it to grow into one of the earliest
Indian industrial townships. The rail links later established to Tamil Nadu supported still stronger
trade links. The factories processing marine exports and the processing and packaging of
cashewnuts extended its trade across the globe

28
Major characteristics

Kollam is the fourth largest city in Kerala and the fifth largest in terms of corporation area. It is
known for cashew processing and coir manufacturing. Ashtamudi Lake is considered the
southern gateway to the backwaters of Kerala and is a prominent tourist destination at Kollam.
The Kollam urban area includes suburban towns such as Paravur in the south, Kundara in the
east and Karunagapally in the north of the city. Other important towns in the city suburbs are
Eravipuram, Kottiyam, Kannanallur and Chavara.

Kollam appeared as Palombe in Mandeville's Travels, where he claimed it contained a Fountain

of Youth.During the later stages of the rule of the Chera monarchy in Kerala, Kollam emerged as
the focal point of trade and politics. Kollam continues to be a major business and commercial
centre in the Southern Kerala.

1.2) Thiruvananthapuram :

Commonly known by its former name Trivandrum, is the capital of the Indian
state of Kerala. It is the most populous city in Kerala with a population of 957,730 as of
2011.[2] The encompassing urban agglomeration population is around 1.68 million.[4] Located on
the west coast of India near the extreme south of the mainland, Thiruvananthapuram is a
major Information Technology hub in Kerala and contributes 55% of the state's software exports
as of 2016.[7][8] Referred to by Mahatma Gandhi as the "Evergreen city of India",[9][1] the city is
characterised by its undulating terrain of low coastal hills.[10]
The Ays ruled the present region of Thiruvananthapuram until the 10th century. With their fall in
the 10th century, the city was taken over by the Chera dynasty.[11] The city was later taken over
by the Kingdom of Venad in the 12th century.[11] In the 17th century the king Marthanda
Varma expanded the territory and founded the princely state of Travancore and
Thiruvananthapuram was made capital of Travancore.[12] Following India's independence in
1947, Thiruvananthapuram became the capital of Travancore-Cochin state and remained capital
when the new Indian state of Kerala was formed in 1956.[13]
Thiruvananthapuram is a notable academic and research hub and is home to the University of
Kerala, Kerala Technological University the regional headquarters of Indira Gandhi National
Open University, and many other schools and colleges. Thiruvananthapuram is also home to
research centres such as the National Institute for Interdisciplinary Science and

29
Technology, Indian Space Research Organisation's Vikram Sarabhai Space Centre, the Indian
Institute of Space Science and Technology, and a campus of the Indian Institutes of Science
Education and Research.[14] The city is home to media institutions like Toonz India Ltd and Tata
Elxsi Ltd, and is also home to Chitranjali Film Studio, one of the first film studios in Malayalam
Cinema, and Kinfra Film and Video Park at Kazhakoottom, which is India's first Infotainment
industrial park.[15]
Being India's largest city in the deep south, it is strategically prominent and hosts the Southern
Air Command headquarters of the Indian Air Force, the Thumba Equatorial Rocket Launching
Station and the upcoming Vizhinjam International Seaport. Thiruvananthapuram is a major
tourist centre, known for the Padmanabhaswamy Temple, the beaches of Kovalam and Varkala,
the backwaters of Poovar and Anchuthengu and its Western Ghats tracts of Ponmudi and
the Agastyamala. In 2012, Thiruvananthapuram was named the best Kerala city to live in, by a
field survey conducted by The Times of India.[16] In 2013, the city was ranked the fifteenth best
city to live in India, in a survey conducted by India Today.[17][18] The city was also selected as the
best-governed city in India in the survey conducted by Janaagraha Centre for citizenship and
democracy in 2017.[

30
2)Selection of subject :
The subjects selected for the research
is staff working in KIMS Hospital Thiruvananthapuram and vaidhyadharma ayurveda
hospital, Kollam

31
3. Selection of tools to collect data :

A)Questionnaire Method :

It is a set of statement to be answered by the respondant in a face to face interview and

fill by interviewer or by the respondant in writing. It is a device for securing answer to wish him
by using a farm which usually filled by the respondant himself. There are main points to a
member to draft the questionnaire.
1. The success of the questionnaire method of collecting information deepends largely on the
proper drafting of questionnaire.

2. There should be a covering letters the person conducting the survey must introduce himself
and state the objectives or the survey on interview.

3. The number of questions should be less and the questions should not be very lengthy.

4. Questions should be logically arranged.

5. Questions should be short and simple.

6. Question sensitive should be avoided.

7. Question should be capable of objective.

8. Answer to question should not require calculation.

32
9. Yes or No questions can be added but other choices can also be introduced in the
questionnaire format.
10. Questionnaire was filled which include 12 questions. The 12 questions based on the
Housekeeping in Hospitality industry. They were given to the 20 selected subject and received
the answer for the question.

CHAPTER 4
Data analysis and interpretation

33
 Section a

1.General background information of the selected subjects :

The general background information on sex, age and monthly income was taken
and the information is discussed under the following heading .

Age :

AGE
20-25 26-30 31-35 36-40

7.894736842,
8%
21.05263158,
21% 44.73684211,
45%

26.31578947,
26%

34
The result shows that majority of the selected subjects were in the age group between 20-25 .

Gender :

The informtion was collected about the sex of people who collected for the selected subject

Gender

0, 0%

Male
47.36842105,
47% 52.63157895, Female
53%
Others

35
 The results shows that majority of the selected subjects were Males

Monthly income :

Monthly income

21.05263158,
21% 26.31578947,
26%
1000-10000
10000-20000
Above 20000

52.63157895,
53%

The result shows that Majority of h selected subjects were having monthly income in the range of
10000-20000 .

36
 Section B

1. Do you think medical tourism is benefited in hospital revenue ?

a) Yes
b) No

21%

Yes
No

79%

The result shows that majority of the selected subjects answered that medical tourism is benefited
in the revenue of the hotel .

37
2.Are you maintaining guest records for the further treatments ?

A)Yes
B)No

120

100

80

60

40

20

0
Yes No

The result shows that whole of the selected subjects answered that they are maintaining a record

38
 for the further treatment of the guests .

3.Do you think the government gives support for the medical tourism >?

A)Yes
B)No

Yes
47%
53% No

39
 The result shows that majority of the selected subjects responded that the government gives
support for the medical tourism .

4. Are facing any problem from the side of government in the field of medical tourism ?
A) yes
B) No

8%

Yes
No

92%

40
The result shows that majority of the selected subjects answered that they are not facing any
problems from the side of the government .

5.Which type of patients are visiting commonly in the hospital ?

A)Indian .
B)Foreign .

18%

Indian
Foreign

82%

The result shows that majority of the selected subjects answered that most commonly foreigners
are visiting the hospital .

41
6.Are you providing any package for the treatment ?

A)Yes
B)No

120

100

80

60

40

20

0
Yes No

42
The result shows that majority of the selected subjects responded that they are providing packages
for the treatment .

7.By which mean are you collecting the payment ?

A)Cash
B)Medical resources

39%
Cash
Medical Resources
61%

43
 The result show that majority of the selected subjects responded that they are collecting the
payment by the mean of Medical resource .

8.What type of treatment are you providing the most ?

A)Obisity
B)Bone related
C)Fertility

21%

40% Obisity
Bone related
Fertility

39%

44
 The result shows that majority of the selected subjects responded that majority of the selected
subjects answered that they are providing the treatment for obisity the most .

9.What is the duration of treatment taken by patient in a hospital ?

A)1-7 Days
B)7-14 Days
C)14-21 Days
D)More than one month

8%
26%
1-7 Days
7-14 Days
37% 14-21 Days
More than one month
29%

45
 The result shows that majority of the selected subjects answered that 14-21 days is the duration
of treatment taken by the patients .

SECTION C

1.Do you recommend this hospital for your friends and relatives ?

A)Yes
B)No

46
 Yes No

The result shows that majority of the customers visited the hospital responded that they will
recommend the hospital to their friends and relatives .

2.Is the hospital maintaining cleanliness and higher standards of hygiene ?

A)Yes
B)No

47
 40%
Yes
No
60%

The result shows that majority of the selected subjects answered that the hospital is maintaining
cleanliness and higher standards of hygiene .

3.Do you have any changes in your conditions after starting the treatment ?

A)Yes
B)No

48
 20%

Yes
No

80%

The result shows that majority of the selected subjects answered that they have change in their
condition after the treatment .

4.How much money is spend for the treatment ?

A)1000-2000
B)2000-5000
C)5000-10000
D)More than 10000

49
 0%
20%
1000-2000
40%
2000-5000
5000-10000
More than 10000
40%

The result shows that majority of the selected subjects answered that they spend 2000-10000 for the
treatment

50
 Chapter 5
Findings and conclusion

Findings from data analysis :

From the analysis the following are the findings about the medical tourism

>The staffs working in the hospital responded that medical tourism is providing benefits to the
income of the hospital

51
 >The majority of the staffs working in the hospital answered that they are maintaining a
record for the further treatment.

>The staffs working in the hospital responded that the government is providing support for
the medical tourism .

>Most part of the staffs responded that they are not facing any problems or difficulties from
the side of the government
.
>The most part of the staffs working in the hospital answered that foreigners are most
commonly visiting the hospital .

>The majority of the staffs working in the hospital responded that they are providing
packages for the treatment .

>The majority of the staffs working in the hospital responded that they are collecting
payment by the mean of Medical resource
.
>The most part of the staffs working in the hospital responded that they are providing the
treatment for obesity the most .

>The majority of the staffs working in the hospital responded that the the duration of the
treatment given is 14 to 21 days .

Recommendations :

>The hospitals in Trivandrum and kollam areas has to give more importance in health tourism to
atrract foreigners so that the economy to kerala can be developed.

>The good transportation facility like good roads and air ambulance have to be introduced all
over the kerala.This will attract more nationals as well as foreigners for the treatment in kerala .

52
 CONCLUSION
From the reasearch project I came to the conclusion that medical tourism or health tourism
play an important role in promoting tourism in Kerala ,Globalization and economy
liberalization have given a boost to the medical service sector especially in Kerala .The
medical treatment for various packages from part of packages in International level . Airport
pickup ,Accommodation Transportation ,Food ,Etc are offered along with medical treatment

53
 at these hospitals in Trivandrum KIMS having class international facilities are treatments
provided for both national and foreign patients . In kollam vaidhyadharma ayurveda
hospital have so many medical treatment packaging provided at high standard. Tourism
department have played an important role in promoting Kerala especially (Trivandrum and
kollam)as a major destination in medical tourism in the international market .

APPENDIX

Questionnaire :

54
 SECTION A

1.General background information about the Gender , Age and monthly income of the selected
subjects

SECTION B
2. Do you think medical tourism is benefited in hospital revenue ?
c) Yes
d) No

2.Are you maintaining guest records for the further treatments ?

A)Yes
B)No

3.Do you think the government gives support for the medical tourism >?

A)Yes
B)No

5. Are facing any problem from the side of government in the field of medical tourism ?
C) yes
D) No

5.Which type of patients are visiting commonly in the hospital ?

A)Indian .
B)Foreig

6.Are you providing any package for the treatment ?

A)Yes
B)No

7.By which mean are you collecting the payment ?

A)Cash
B)Medical resources

55
 8.What type of treatment are you providing the most ?

A)Obisity
B)Bone related
C)Fertility

9.What is the duration of treatment taken by patient in a hospital ?

A)1-7 Days
B)7-14 Days
C)14-21 Days
D)More than one month

SECTION C

1.Do you recommend this hospital for your friends and relatives ?

A)Yes
B)No

2.Is the hospital maintaining cleanliness and higher standards of hygiene ?

A)Yes
B)No
3.Do you have any changes in your conditions after starting the treatment ?

A)Yes
B)N

4.How much money is spend for the treatment ?

A)1000-2000
B)2000-5000
C)5000-10000
D)More than 10000

56