'Goa Tourism Targeting Beach Shacks': Father Fernandes

The social wing of the influential Roman Catholic Church in Goa has accused the state government of corporatising tourism spaces like beach shacks and taxi services while pushing resident entrepreneurs out of business.

Beach shacks, the temporary thatched eateries, are licenced annually by the tourism ministry. They are synonymous with Goa's beaches and enormously popular with the hundreds of thousands of tourists visiting the state every year.

India: Untapped potential in the medical tourism market

By M H Ahssan

The Indian healthcare market is Rs 15 billion and growing at over 30 per cent every year. Indian private hospitals are increasingly finding a mention in the travel itineraries of foreigners, with the trend of medical tourism catching up in the country. If industry estimates are to be believed, the size of the medical tourism industry stands at Rs 1,200 - Rs 1,500 crore (Rs 12-15 billion).

A recent CII-McKinsey study on healthcare says medical tourism alone can contribute Rs 5,000- Rs 10,000 crore (Rs 50-100 billion) additional revenue for upmarket tertiary hospitals by 2012, and will account for 3-5 per cent of the total healthcare delivery market. Compared to countries like the UK or the US, procedures like heart bypass surgery or angioplasty come at a fraction of the cost in India, even though the quality of doctors and medical equipment is comparable to the best in the world.

A heart bypass surgery in India costs USD 3,000-6,000, while in the US it costs between USD 15,000 and USD 40,000. The Indian Health Care Federation (IHCF), an association of the healthcare delivery sector that includes the Escorts Heart Institute, Apollo Hospitals Group, Fortis Healthcare among others and CII, under the leadership of Dr Naresh Trehan, executive director, Escorts Heart Institute and Research Centre (EHIRC), New Delhi have also decided to project India as a major healthcare destination. Even travel agents are aggressively promoting India as a destination for medical tourism. This is a huge, untapped market, not just for therapeutic medical tourism like ayurveda, but also for curative treatment.

The benefit to tourism industry could be of the order of Rs 1,000 crore (Rs 10 billion). Indian NRIs, Asians and tourists from around the world are beginning to realise the potential of modern and traditional Indian medicine. Health and medical tourism is perceived to be one of the fastest growing segments in marketing ‘Destination Incredible India’ today. While this area has so far been relatively unexplored, we now find that not only the ministry of tourism, Government of India, but also the various state tourism boards are all promoting health and medical tourism as a segment with tremendous potential for future growth.

Indian hospitals have also realised the potential of this niche market and have begun to tailor their services for foreign visitors. Visitors, especially from the west and the middle-east, find Indian hospitals as an affordable and a viable option rather than grappling with health insurance and national medical systems in their native lands.

* Areas where Indian healthcare excels
* Clinical outcomes being on par with the world’s best centres.
* Internationally qualified and experienced doctors.
* Technology edge.
* Competitive costs - 1/5th to 1/10th of costs in the west.
* Quality of service.
* No waiting time.
* Patient-centric care.
* Exotic experience, increasing popularity as a tourist destination.
* Eastern healthcare wisdom along with the expertise of western medicine.
* Areas where Indian healthcare has to focus
* Accreditation norms to be adopted by all major hospitals.
* Hospitals must conform to a code of ethics.
* Provision of a uniform price band for major specialities especially for health insurance majors.
* Handling of medico-legal issues.

Working with Indian tourism ministry and tour operators to promote medical tourism overseas. Cross-border travel for healthcare reasons is still a highly disorganised movement, but countries are slowly waking up to its potential. In some places, the governments have taken a lead. In others, travel agents specialising in medical tourism are driving the trend.

In India, private hospitals are trying to attract patients on their own and by showcasing Indian healthcare overseas through CII-IHCF led overseas missions. Developed nations will benefit majorly as costs and waiting time come down for a significant chunk of their population. Developing countries benefit through medical tourism as it brings in revenues and provides the right spur to improve their overall healthcare sector, apart from reducing brain drain in their medical fraternities. Least developed countries, too, benefit as they lack facilities for cutting-edge treatment.

The situation was so dismal that in 2002, the National Health Services(NHS) in UK started a pilot scheme for ‘overseas treatment’ to see if surgery services abroad could be bought to shorten the waiting lists. The project focused mainly on facilities available in the European Union.

Meanwhile, many British patients take the initiative to seek their own treatment abroad without waiting for the NHS to sort out its problems.

A Rs 15-billion-plus market growing at over 30 per cent per year throws up huge opportunities for anyone smart enough to tap it. Thus, India not only offers world class cardiac bypass surgery, hip replacements, organ transplants, but also cosmetic, dental surgery and vision correction etc and alternative healthcare which is a significant niche opportunity.

Healthcare insurers in the developed countries are aware of the fact that the option of medical treatment in countries like India could help them reduce premiums and offer options to people who are currently uninsured. Over the next few years, insurance firms are expected to provide a fillip to the medical tourism business in India.

Analysis: Why Is ‘Incredible India’ Such A Poor Show?

By M H Ahssan / INN Bureau

INN on why the world holidays elsewhere. India is spectacular. This fact has been impressed upon the world for a decade now by the slick ‘Incredible India’ advertising campaign. It’s all there on video, on billboards, on the sides of buses. The latest commercial features a smiling young woman practising yoga in the desert; boating on the Dal Lake; riding a vintage motorcycle in Ladakh; drinking fresh coconut water in Kerala; using one of our world-class airports; making earnest conversation at the Golden Temple; zorbing, paragliding, snowboarding, rock climbing and mountain biking; getting an oily massage at a luxury spa; drinking lassi in the blue city of Jodhpur; jostling onto a crowded bus in Kullu; swimming with an elephant; gawping at rhinos and tigers; playing chess in Varanasi; disappearing in clouds of coloured powder on Holi. All the while, during this hectic itinerary, she works on that most distinctive of Indian gestures: an ambiguous head-waggle.

Medical Tourism - Medical Tourism India - Healthcare Tourism

Medical tourism can be broadly defined as the provision of 'cost effective' private medical care in collaboration with the tourism industry for patients needing surgical and other forms of specialized treatment. The process of healthcare tourism is jointly facilitated by the corporate sector involved in medical and healthcare as well as the tourism industry - both private and public.

Medical tourism has become a common form of vacationing, and covers a broad spectrum of medical services. Medical tourism mixes leisure, fun and relaxation together with wellness and healthcare.

A combination of many factors has lead to the recent increase in popularity of medical tourism. Exorbitant cost of healthcare and medical facilities in advanced countries, ease and affordability of international travel, favorable currency exchange rates in the global economy, rapidly improving technology and high standards of medical care in the developing countries has all contributed their share to this rapid development of medical tourism.

India has originated as one of the most important hubs for medical toursim.Many people from the developed countries come to India for the rejuvenation promised by yoga and Ayurvedic massage however, a nice blend of top-class medical expertise at attractive prices is helping more and more Indian corporate hospitals to lure foreign patients, including patients from developed nations such as the UK and the US, for high end surgeries like Cardiac ByPass Surgery or a Knee/Hip Replacement.

As more and more patients from Europe, the USA and other affluent nations with high medical costs look for effective options, healthcare tourism in India is definitely on the cards for most of them and the fast growing Indian corporate health sector is fully geared to meet that need.

Not just cost savings or the high standard of medical care facility, but also the waiting time is much lower for any treatment in India than in any other country. Medical help is often an emergency and situations can turn worse if the treatment is delayed. While you might have to wait for several months to get a surgical operation done in the US, in India things can be arranged within a week.

Medical Tourism in India - at a glance
- Low cost medical treatment
- High quality medical care
- Low wait time for critical treatments
- Fluent English speaking staff

AP Govt To Step Into 'Marriage Tourism' Promotion

By Ramesh Reddy / Hyderabad

Marriage Tourism includes wide ranging services like match-making, astrological calculations, arranging the venue for the wedding, designing and printing of wedding cards and even shopping and accommodation of guests.

There is a frenzy surrounding Indian weddings that is almost unparalleled. Beginning from the selection of a bride or a groom to the destination of the couple's honeymoon, there is a tremendous amount of work that families undertake to make the wedding a memorable one.

Selling India To The World, The Great Indian Travel Crisis

By M H Ahssan & Kajol Singh

Home is not where the travel heartland is this summer. Footloose but pennywise, Indian travellers are packing their bags for overseas destinations, shunning domestic attractions. Flying abroad has always held more spell over travelling within India, but over the last decade, Indian tourism had been attracting visitors with well marketed heritage hotels, beaches and experience destinations like Kumarakom in Kerala and the more exotic North-East route. But an unhealthy combination of exploitative airfares and steep hotel tariffs is dissuading Indian tourists from travelling within the country. It is also stopping foreign tourists from flocking in. It’s less expensive for the Indian middle class traveller to fly to Dubai or even London than to fly to Kochi or the Andamans. England, Singapore, Dubai, Germany, Croatia, Spain, France and Thailand are the new hotspots where it is easier to bump into someone from India than in Leh.

'Desert Tourism' Will Be Saudi Arabia's Next Boom Industry

By Waleed Al Saba | Riyadh

The World Tourism Organization said the deserts is a good environment for tourism activities. And in a country like Saudi Arabia with its vast geographical area, investing in desert tourism sector can be very lucrative.

Despite the efforts the Supreme Commission for Tourism and Antiquities (SCTA) to encourage all types of activities, more need to be made so that large desert areas can start making money with opportunities to make them tourism resorts.

“Desert Tourism” can have many features including adventure, discovery, getting to know new animals and plants, in addition to off-roading, sand skiing, camping, etc. All this however requires investment.

Healthy Business: Will Medical Tourism Be India’s Next Big Industry?

No Other Choice: Why Medical Tourism Continues to Thrive: President of the United States Barack Obama recently urged Americans to seek medical treatment at domestic health care facilities, rather than traveling overseas. In India, where so-called "medical tourism" (known internationally as the global health care delivery system) is a booming industry, his statements have created quite a stir. In this opinion piece, Ravi Aron, a professor at Johns Hopkins University and a senior fellow at the Mack Center for Technological Innovation at the University of Pennsylvania, argues that people can't take advantage of something that doesn't exist. Until affordable universal care is a reality in the U.S., Aron says, Americans will continue to travel abroad for health care services.

President Barack Obama has asked Americans not go to India and Mexico for medical treatment. There are reasons why these appeals will have no impact on global health care delivery. Patients do not travel to India for health care services because they have a choice and they choose to go to India. They travel to India because they have no choice. They are either uninsured or grossly under insured and they cannot afford the cost of care in the U.S.
If a consumer exercises choice -- among comparable options -- then he or she can be asked to buy American. But the choice that these consumers of global health care services face is between care delivered overseas (Mexico, India or elsewhere) and no care at all. So asking them to stay in the U.S. is pointless. Until affordable universal care is a reality in the U.S. they will continue to travel abroad for health care services. This is not a discretionary spending that they can postpone or redirect.

Characteristics for Success
The globalization of health care services is inevitable in this environment. What are the characteristics needed for the industry to flourish? Look at it at the level of the multi-specialty hospital. The hospital needs to address the patients' sense of risk. If somebody in frail health is going to fly 12 hours to reach a point on the other side of the globe to get a bypass surgery or a hip replacement done in a country that they know very little about and one with a strange culture, they experience anxiety that stems from risk. Most of us weigh the choice of a vacation destination carefully; these people are literally entrusting their lives and well-being to a hospital and doctors that they do not know. So this is a decision that is characterized by a great deal of risk. Hospitals like Bumrungrad in Thailand go out of the way to address this risk. There are four levels at which they do this:

The Four Levels of Addressing Risk
The physical environment: The hospital lobby and the building feel like an excelsior hotel in a first world country. They go out of the way to showcase the sense of order and calm that prevails everywhere. The western patient would instantly feel at home with the Starbucks Café and Wi-Fi-enabled waiting lounges. The hospital and its lobby, lounges and wards gleam in their antiseptic cleanliness.

Process discipline: Bumrungrad hospital is pretty close to what we call a 360-degree automated hospital. From the point the patient has been admitted (from his overseas location) till discharge, all processes are centrally linked to the patient's records and care delivery, and support services are delivered and monitored at the level of each patient. They have extraordinary efficiency in the way they support clinical care with other services -- travel, hospitality (accommodation), transport within the city, billing and post-procedure follow-up.

Excellence in clinical care: Many of their doctors are board certified in the U.S. and in Thailand and Bumrungrad was the first hospital to get the JCI [Joint Commission International] accreditation in the region. On most parameters of medical care -- these statistics are available at the hospital site -- they compare more than favorably with the median hospital in U.S. and the E.U. (They were in the 90th percentile in patient satisfaction scores compared to similar hospitals in the U.S. and Europe).

Strategic use of IT: They use IT both to offer fine-grained information about the hospital, treatments and procedures at the hospital, and physician background to overseas patients, as well as information as a tool for monitoring and delivering clinical outcomes.

In terms of clinical information, they have been able to automate three crucial elements of clinical information flow: (i) Physician-level information from multiple physicians attending on the same patient; (ii) Information from clinical sources pertaining to a patient (tests, labs, nurses and clinical support services); and (iii) patient case history. This, in turn, has allowed them to implement a variety of innovations in care delivery that minimize medical errors, infection rates, etc. It also allows them to monitor patients and their progress in fine-grained detail. (Automating these three kinds of clinical information flows is very critical not only to deliver higher quality of care, but also to create "patient information portals" where the patient can constantly access his or her EHR (electronic health record) after the procedure from his or her country of origin, as well as schedule repeat check-up visits. Automating these three kinds of information flows is one of the reasons that Bumrungrad is referred to by some as the "gold standard" in global health care delivery).

First World Skills in Emerging Regions
So why is all of the above important? These are first-world institutions of skill and service excellence located in developing regions. The developing region economics makes these regions attractive from a cost (price) standpoint to overseas consumers. The first world skills and service excellence makes them attractive from the standpoint of actual care delivered to patients. For the paying patient, it is important to signal that the hospital is an island of calm and order founded on a reliable first world infrastructure and where care delivery is monitored with great precision and discipline. The patient needs to feel that this hospital has been insulated from its environment.

India is not lacking in clinical skill (quality of physicians). Traditionally, Indian hospitals were seen as weak in post-procedural care delivery (sometimes referred to as "post operative care"). But that, too, is changing. Some hospitals are beginning to get their acts together on post-procedural care in terms of significantly lowering medical errors and hospital infections, and improving nurse and support clinician hygiene standards. There is still much that can be done in this regard.

An area that is often overlooked by the Indian care delivery establishment is that of support services: travel, logistical support, accommodation and hospitality, transport within the destination city, billing, etc. Overseas patients are probably comfortable with the quality of Indian physicians; they are more concerned with clinical post-procedural care, support services and the infrastructure.

Medical services in India are where the IT-enabled services and the business process outsourcing (BPO) industries found themselves in the mid 1990s -- the challenge is to convince the customers that these hospitals are islands of excellence that have been insulated from the frailties of India, even as they draw upon its strengths. These services are not branded as "made in India" as much as "made in spite of India."

The Advantages of India
The one advantage the country has is that a doctor in India -- especially a surgeon -- would have acquired in 10 years' time more experience -- both in terms of scale of procedures done and the exposure to varying levels of complexity -- than what a surgeon in the U.S. would get in, say, 30 years of practice. So a doctor with about 15 years experience will probably be unrivalled in the scope and scale of his exposure.

In the well-run hospitals and multi-specialty centers, they have deep reservoirs of capability to treat patients who come in for a procedure with comorbidities [the presence of one or more disorders in addition to a primary ailment]. Not only can they perform the procedure, but they can also deliver related chronic care where necessary (procedure plus care for cardiovascular disease, diabetes, etc). Specialists are readily available to deliver care for comorbidities from a single location.

Almost all these institutions are private hospitals that cater to the needs of India's wealthy, powerful (Anglophone) elites. They are used to delivering services to a demanding clientele. This serves them well with overseas customers. A large number of physicians in the U.S. and the U.K. and in some Gulf countries are of Indian origin. So, overseas patients do not have the problem of entrusting themselves to Indian doctors.

The doctors of Indian origin can also serve as a distribution channel of sorts to hospitals in India. These institutions can tie up with these doctors to deliver some measures of post-procedure diagnostic care and ongoing care in the countries of origin of the patients.

The Low Cost Is a Given
The other advantage is, of course, cost. But there is no need to stress the difference in costs. The patient is usually acutely aware of the difference in the sticker price for care. The multiples range from eight to one to three to one, even after factoring in travel and other non-clinical costs. There is no reason to draw attention to this. It is far better to highlight capabilities and excellence for two reasons. First and less important, is that this will translate into "capabilities and excellence at an affordable cost" in the patient's mind. Second, and more important, the patient is worried about capabilities and support care and the risk of entrusting his life and well-being to a strange system far away from his home. So it is vital to address those concerns rather than emphasize "cheap." The patient is all too aware of the cost difference anyway.

Finally, the use of web-based channels to inform potential patients is key to running an efficient marketing operation. Hospitals should be able to offer information about JCI certification, physicians' experience and qualifications, the depth of their capabilities in performing specific medical procedures (coronary bypass, hip replacements, etc.) and give patients an accurate estimate of the costs.

Bumrungrad's use of electronic channels is a case in point in effective marketing. The hospital has developed a cost simulation where the patient can key in details of his or her condition and the simulation gives a clear estimate of the cost frontier that he or she will face: it gives the patient a distribution of costs that similar patients in the past faced -- including an average, a high percentile and a low percentile number -- allowing the patient to form his or her own estimate of the costs of care. This electronic estimate is based on actual costs of past patients and it is constantly updated from the hospital's database. Bumrungrad is able to do this because every element of the final cost the patient pays is itemized and categorized in the final invoice. This is yet another example of their strategic use of IT to both serve the customer and market their services effectively.

In the past, U.S. President Barack Obama has singled out India for what he sees as the country usurping American jobs and business. In May 2009, he removed some tax incentives for U.S. companies who allegedly preferred to outsource rather than create domestic jobs. "Buffalo before Bangalore" was his rallying call at the time. Now, India is back in his crosshairs. In April 2011, he told a town hall gathering in Virginia that Americans shouldn’t have to go to India or Mexico for “cheap” health care. "I would like you to get it right here in the U.S.," he said.

"It’s a 100% political statement," Gopal Dabade, convener of the All India Drug Action Network, told weekly newsmagazine India Today. Others in India were equally critical and dismissive. But some have taken more serious objection. "Not acceptable," says federal health minister Ghulam Nabi Azad. Affordable health care does not mean our medicine is inferior to any superpower’s. I would like to say our medicines are indigenous, they are superior, and superiority does not come by escalating costs."

The bone of contention is the word "cheap." Obama probably used the term in the sense of less expensive. But Indians have interpreted it as meaning "tawdry and inferior." Analysts don’t expect Obama’s political posturing to make any difference to the flow of U.S. medical tourists into India. But there is a lurking fear, nevertheless, that a nascent sector could be hamstrung at birth.

There Is No Choice
"Patients do not travel to India for health care services because they have a choice and they choose to go to India," says Ravi Aron, professor at the Johns Hopkins Carey Business School and a senior fellow at The Mack Center for Technological Innovation at Wharton. "They travel to India because they have no choice." Adds Rana Mehta, executive director, PricewaterhouseCoopers (PwC) India: "If patients see value in what India has to offer, they will continue to come."

Indians feel aggrieved that they have been singled out. In medical tourism, the country is still a bit player. According to a report by the Delhi-based RNCOS, which specializes in Industry intelligence and creative solutions for contemporary business segments, India’s share in the global medical tourism industry will reach around 3% by the end of 2013. The December 2010 report -- titled "Booming Medical Tourism in India" – says that the industry should generate revenues of around US$3 billion by 2013. "The Indian medical tourism industry is currently in its early growth stage," says RNCOS chief executive Shushmul Maheshwari.

Guess who’s the biggest beneficiary of medical tourism? It’s the U.S. "The largest segment, with 40% of all medical travelers, seeks the world’s most advanced technologies," says a McKinsey & Co paper titled "Mapping the market for medical travel." "These men and women take their search for high-quality medical care global, giving little attention to the proximity of potential destinations or the cost of care. Most such patients travel to the U.S." What worries the Indian industry is that this is not the first attack on Indian medical tourism. In August last year, leading medical journal The Lancet had published an article about a new superbug which it called the New Delhi metallo-beta-lactamase 1 (NDM-1). "The potential of NDM-1 to be a worldwide public health problem is great, and coordinated international surveillance is needed," said the article. Later, a co-author noted that some material had been inserted into the article without his knowledge; the editor of The Lancet had to apologize for naming the bug after New Delhi, and the Indian ministry of health had to weigh in. "The conclusions are loaded with the inference that these resistance genes/organism possibly originated in India and it may not be safe for U.K. patients to opt for surgery in India," said the ministry. "The medical journal's claim is not supported by any scientific data and thus tarnishes the reputation of the country." Rightly or wrongly, the government and many in India’s medical establishment believe that naming the superbug New Delhi was to keep U.K. medical tourists at home. "The superbug certainly garnered a lot of media attention given its name," says Preetha Reddy, managing director of Apollo Hospitals.

It won’t keep medical tourists at home, just as Obama’s appeal is likely to be ignored. "People will always weigh the cost and the benefit," says Reuben Abraham. "If there is a 10% saving and there is a danger of the superbug then chances are that people will not want to take it. But if you are offering an 80% discount, it is a different matter. If India continues to offer high quality health care at one-tenth the cost in the U.S. then these things will not make an impact."

The Next Big Thing
If all this is going to have limited impact, why is India getting so agitated? The answer lies in the potential of medical tourism. It could easily be the next big thing. Unlike business process outsourcing (BPO), which is on the whole very low-tech, health care -- particularly sophisticated procedures -- is very high-tech. India has not been able to set up an adequate health care infrastructure for its own citizens and it doesn’t have the money to do so. Creation of a sophisticated medical tourism structure will have a trickle-down effect.

"India has the highest potential in medical tourism in the world," says Maheshwari of RNCOS. "Factors such as low cost, scale and range of treatments differentiate it from other medical tourism destinations. Moreover, growth in India’s medical tourism market will be a boon for several associated industries, including the hospital industry, the medical equipment industry, and the pharmaceutical industry."His study shows that CAGR (compound annual growth rates) in revenue in 2011-13 will be 26%. In terms of medical tourists, the number would touch 1.3 million by 2013 at a CAGR of 19%. "Medical tourism can be considered one of the rapidly growing industries in the Indian economy on the back of various factors," he says. "However, the industry is at a nascent stage and requires a few years to reach the platform already established by the IT sector." "India has been ranked among the top five destinations for medical tourism," says Rana Kapoor, founder, managing director and CEO of Yes Bank, which has recently done a study on health and wellness tourism in India along with apex chamber of commerce FICCI.

The ranking by Nuwire Investors, an online source for news on alternative investments, puts Panama on top, followed by Brazil, Malaysia and Costa Rica. "India is looking at exponential growth as far as tourism is concerned," continues Kapoor. "Yes Bank forecasts that there will be an increase in domestic tourist movements over the period (2008-2020) by 118% and foreign tourist inflows over the same period will increase by 71.87%. What the potential for medical tourism from within this growth rate of 71.87% will be depends upon government policies, faith of the patients and many other external factors. We truly believe that this sector will play a significant role as a contributor towards the overall tourism growth in India."

"I strongly believe that many developments across the world will put India in a fantastic position," says Devi Shetty, cardiac surgeon and chairman of Narayana Hrudayalaya. "We produce the largest number of doctors, nurses and medical technicians in the world. Also, we have been traditionally linked with western health care because of the British influence on our medical education and the ability to speak English. This is extremely important for developing [global] health care. Our greatest asset is our ability to produce the largest number of technically-skilled individuals. We also have the largest number of USFDA (U.S. Food and Drugs Administration)-approved drug manufacturing units outside the U.S."

Differences over Terminology
Shetty doesn’t like the term medical tourism. "Medical care is something that is very stressful and people consider this under tremendous pressure," he says. "It is an event where people are scared of losing their lives. It may not be appropriate to call it tourism. Tourism is a different business altogether." Adds Mehta of PwC: "The tourism component is really very weak. Most foreign patients come to India for chronic and serious medical treatment and I would call it medical value travel." Aron of Johns Hopkins has yet another view. "The world over it is known as the global health care delivery system," he says. Reddy of Apollo agrees with Mehta. Says she: "At Apollo Hospitals, we prefer to term this business opportunity as ‘medical value travel’ as people travel to our hospitals for serious life threatening health conditions, which essentially need highly skilled doctors and medical infrastructure and not mere minor treatments like cosmetic enhancements, dental work or wellness which can be coupled with holidays, as the term ‘medical tourism’ implies."

The multiplicity of names is accompanied by a wide range of numbers. The confusion was started by the McKinsey study on Mapping the Market mentioned earlier. The May 2008 report said that "medical travel has captured the world’s attention and imagination". But it went on to explain that the McKinsey definition of medical traveler was very different from what many others thought him to be. The first to be knocked off were expats looking for health care in their country of stay. That accounted for 25-30% of the traditional medical tourist pool.

Then was the segment categorized under emergencies. These were ordinary tourists caught up in accidents. That eliminated another 30-35%. McKinsey estimated the remaining at "between 60,000 and 85,000 inpatients a year", much lower than generally accepted numbers. For instance, a 2008 Deloitte Center for Health Solutions report on "Medical Tourism: Consumers in Search of Value" put the number of Americans who had traveled abroad for medical care in 2007 at 750,000. McKinsey excludes "wellness" tourists (acupuncture, spas, yoga, aromatherapy and the like), patients from neighboring countries, and outpatients -- those who don’t need to check into hospital.

The Deloitte report says that India is stepping on the gas; the medical tourism sector is expected to grow 30% annually up to 2015. An update on the report says that the U.S. recession is driving more people out of the country for health care; U.S. outbound medical tourism is projected to increase 35% annually from 2010-2012. "Medical tourism [today] represents the maturation of a cottage industry," the report sums up.

Maheshwari of RNCOS agrees that economic problems are driving more Americans abroad for health care. "Under almost stagnant salary increments, the disposable income and saving considerations of U.S. citizens are still well below the pre-crisis levels," he says. "In this scenario, the low cost treatment and nearly zero waiting time coupled with its proven track record offer convenient procedures for tourist arrivals from various geographical locations including the U.S."

"Over the past few years, the medical tourism story has changed dramatically in India," says a recent Cover Story in weekly business magazine BusinessWorld. (That it made it to the Cover is a reflection of the growing importance of the sector.) "Not because the government has figured out the solution. But purely because of private enterprise -- with a few corporate hospitals, chemists and freelance agents all working in tandem to build a thriving ecosystem that educates, facilitates and ferries medical tourists from across the world. Last year, this ecosystem was responsible for about 600,000 patients travelling to India and spending US$1 billion in getting treated here. (The numbers are industry estimates as the government does not have any official statistics on the subject.) Corporate hospitals such as Apollo, Fortis Hospital and Max as well as business associations estimate that the business is growing by 40% year-on-year." (Obviously, the growth numbers vary depending on who you talk to.)

Other Markets Will Turn to India
"India’s potential is huge," says Mehta of PwC. "Some 80% of foreign patients coming to India are from the neighboring countries and from Iraq, Afghanistan, the former Soviet Union, etc and now increasingly from Africa. But now with India proving itself as a credible provider of value health care, the western population ageing, and health care becoming more difficult there, I expect more people to come from the U.S. and the U.K."

Mehta says that some things went wrong with the earlier planning. "We expected most patients to come from the U.S. and Europe. We expected people to come for cosmetic and regenerative treatment and this is where there is more potential for tourism. But the majority actually came for cardiac treatment, cancer treatment, knee replacement and other serious ailments. Therefore, tourism was not really of importance. We did not get the cost factor right. We thought that typically in India it costs one-tenth of that in the U.S., so we could cost at 5X. But hospitals have not been able to charge very much. At present, with a foreign patient, there is around 20% more earning."

Cost is, of course, being underplayed in the marketing efforts; this is why the word "cheap" rankles. "The patient is usually acutely aware of the difference in the sticker price for care," says Aron. "There is no reason to draw attention to this.”That’s an area where India enjoys an advantage over other countries too. According to the BusinessWorld report, a heart bypass surgery costs US$144,000 in the U.S., US$25,000 in Costa Rice, US$24,000 in Thailand, US$20,000 in Mexico, US$13,500 in Singapore, and US$8,500 in India. "The quality is excellent," says Maheshwari. In India, there is also less waiting time and personalized services.

Becoming an Industry
Medical tourism is also taking shape as an industry, though there are some who feel that it will eventually fall in many buckets. (The recent FICCI-Yes Bank study talks of wellness tourism, health tourism...) "There are over 3,371 hospitals and around 750,000 registered medical practitioners," says Maheshwari.

Shetty says it is easier to get loans these days. "Earlier, it was difficult for us to mobilize huge financial support to create large hospitals. However, things have changed now," he explains. Indian companies are also taking over hospital chains in Asia -- Fortis has gone on a shopping spree, though it’s not been entirely successful -- and setting up front-ends in other countries for marketing purposes. Apollo has facilitation centers in Oman, Nigeria and the U.S. Max is present in Nigeria, Afghanistan, Bangladesh and Nepal. Says Reddy of Apollo: "There are several key players. Apollo Hospitals continues to attract the largest numbers of international patients followed by Max, Fortis and Workhardt."

"Another opportunity that Indian operators are now seeing is that you don’t have to offer these health care services from India," says Abraham of ISB. "For instance you can offer it from say, Cayman Islands or the Bahamas. Ultimately, the innovation is in the process and as long as you can bring the same process innovation, even if the cost goes up a little as compared to offering it from India, it will still be a substantial saving for the patient."

This is one area where China is no threat. Foreigners in China still rush to Hong Kong when they need treatment because they cannot communicate with local doctors.

But what the budding sector will have to contend with is the Indian government. Take one example. With the intention of making things smoother, the government introduced a medical visa (M visa), which was faster and easier to get. In its wisdom, however, it added a peculiar clause -- "Foreigners coming on M visa will be required to get themselves registered mandatorily well within the period of 14 days of arrival with the concerned Foreigners Regional Registration Office." The end result: even patients who have to be carried into India on stretchers are coming on tourist visas. If the government wants medical tourism to be the next big thing, it has to put its house in order.

As for the immediate controversies, Shetty is very clear. "President Obama’s statement or the New Delhi superbug will not affect medical tourism development in India," he says. "First of all, he was not criticizing India. He was just trying to put his house in order."

Incredible India: When public sector advertising turned savvy

By M H Ahssan

If the recent Lok Sabha elections are any proof, then no matter how great an advertising agency is and how lavishly the client spends, there is always a sarkaari look to public sector advertising.

Small wonder when the Incredible India campaign was launched, it came as a welcome change from the fuddy-duddy public sector advertising.

The man at the centre of the campaign is Amitabh Kant, who was a joint secretary in the tourism ministry then. He is also the one to have steered the 'God's Own Country' campaign for Kerala for several years.

In his recent book, Branding India -- An Incredible Story, Kant chronicles the story of Incredible India, one of the most awarded and successful destination campaigns worldwide.

Kant begins with the domestic tourism scenario in the backdrop of the 9/11 attacks in the US in 2001. It was a time when tour operators thought there was nothing that could boost consumer demand.

"Global tourism saw a sharp decline... countries like Thailand, Singapore and Malaysia had sharply cut their advertising, promotion and marketing budgets," he writes.

Kant points out that till 2002, India had opened 18 tourism offices abroad, yet none of these gave a clear and singular positioning for India. "One foreign office called it 'Spiritual India', another termed it 'Cultural India', and the third termed it 'Unbelievable India'.

The cliched visuals, the saffron clad sadhus and rope tricks performed amidst crowds..." he laments, "did nothing to reflect the changes India was going through."
That's when a vision statement was drawn out to promote India as a "premier holiday destination for high-yielding tourists".Grey Worldwide and Wieden+Kennedy were roped in as key advertising agencies for the campaign.

Perhaps one of the best chapters in the book is the one where Kant draws from his experience in Kerala and describes the wrong flight of the state's tourism in the 90s, which was punctuated by high volume, low value tourism -- "A solitary ITDC hotel, mass tourist arrivals in the form of garbage collectors from Manchester and cobblers from London contributing not more £15 a night."

The tourism ministry then decided to do away with mass tourism and soon products exclusive to Kerala were promoted to the affluent traveller -- the backwaters, ayurveda, kettuvallams (houseboats), the tree house, butterfly holidays, and traditional cuisines became the rallying points.

"How can India's first communist state be called 'God's Own Country'? There was no end to criticism," he writes. The turning point came when after a series of familiarisation tours with tour operators and travel writers, the National Geographic Traveller featured Kerala among 'fifty destinations of a lifetime'.

In subsequent chapters, Kant describes other tourism makeovers -- Ajanta Ellora, Kumbalgarh, Mahabalipuram and Hardwar -- and also throws light on parallel growth stories such as low carrier airlines, enhanced air connectivity, online travel portals and growing macro-economic confidence about India.

Kant admits that branding a destination is a multi-sectoral challenge. "I was dealing with home ministry for visas, state governments for taxi drivers, there were challenges in customs and immigration, tour operators, ASI sites -- all of them have to become your brand ambassadors," the author states. This was the backdrop when a parallel campaign -- 'Atithi Devo Bhava' -- was conceived.

Indeed, the book effectively conveys the importance and greatness of the Incredible India campaign, but it also gives a feeling that the campaign was too dependent on the success of 'God's Own Country'.One may also feel that the book -- designed stylishly by Wieden+Kennedy's V Sunil -- underplays the role of advertising's contribution to the 'Incredible India' campaign.

Lines such as 'An island a day, keeps the doctor away. Vitamin Sea'for Andaman islands; 'Not all Indians are polite, hospitable and vegetarian,' to talk about the Royal Bengal tiger, and 'One day, man will travel at the speed of thought. Pity,' to describe a calm meditative journey through Kerala's backwaters, are indicative of not just the tourism ministry's welcome savviness as a client, but also of a bureaucracy agreeing to promote Brand India in a slick manner.

True, Incredible India is a rare instance of savvy public sector advertising, which dared to poke fun at the country's glorious self.

Earthquake Have Pushed Nepal’s Economy Back 20-Years!

Over the last days, Nepal has been rattled by its worst earthquakes since 1934. More than 3,000 people have lost their lives, and villages, roads, highways and ancient buildings have been devastated. The total economic losses from the damage could be between $1 billion and $10 billion, according to the US Geological Survey’s best estimate.

In all, the destruction could push the economy of Nepal—already one of the world’s poorest countries—back by a decade or more, significantly hurting the small Himalayan nation’s efforts to move from a “Least Developed Country” to a “Developing Country” by 2022.

Hospitality Education: Whom to blame for declining demand?

Blame it on lack of awareness in the society about career prospects in service sector, the image of the hotel industry as a bad employer, or ambiguity in programme nomenclatures offered across different institutions, there is a declining demand towards tourism-related courses in India. With admissions round the corner, institutes outside the National Council ambit are really facing student crunch this year around. P KRISHNA KUMAR finds out.

It is admission time in universities and technical institutes across the country. There is a mad scramble among parents and their wards to gain admissions to their desired institutes and courses. Traditionally, a university degree is still the first priority after schooling in India. People who opt for vocational courses are still meagre two per cent in India, as per the government figures. Among the vocational courses, obviously, Engineering, Medicine, etc., score over other streams and then comes the management courses. Here, also, management courses in tourism-related streams are still the last option for an Indian student. This is notwithstanding the fact that tourism industry is one of the biggest employment generators in the world today. It is a fact that the number of institutions that offer tourism and hospitality courses in the country has increased manifold in the last one decade. But at the same time, the career opportunities in the tourism industry also increased proportionally. If the figures by Ministry of Tourism (MoT), Government of India, are to be believed, the country requires almost two lakh skilled manpower to service the demands of the industry on an annual basis. A survey conducted by an agency, under the aegis of MoT few years ago, pointed out a huge demand and supply gap in the skilled jobs segment in the travel and hospitality industry in the country. Kumari Selja, Union Minister of Tourism, has recently declared that her ministry aims to train five million people in tourism-related disciplines by 2022, looking at the demand in the industry. While there is no denying on the fact that career opportunities are abundant and varied for those who pursue management degree or skill-oriented courses in the travel and hospitality disciplines, the industry as a whole is yet to catch the imagination of the people as a career industry in the country. What is the reason for that? What are the trends, which are being witnessed vis-à-vis enrolment to these courses are concerned? Is the industry responsible for this negative image? What should the government agencies do? Trends There is a palpable decline in terms of the interests being shown towards tourism-related courses in recent years, feels people in the academic field. “It appears that the trend is on the decline. We participated in four education fairs and had very poor response for the hospitality industry as a career,” comments Virender Datta, Chairman, International Institute of Culinary Arts (IICA), New Delhi. He felt that there is a lack of awareness about various skill-oriented programmes, including Chef programmes in the society. “The craze is still for popular career of engineering, technology or regular BBA etc. The reason is primarily on the lack of awareness, poor starting salaries, attitude of the employer as expecting the most but wanting to pay the least,” he informed. Agrees R K Bhandari, Principal, Banarsidas Chandiwala Institute of Hotel Management & Catering Technology, Delhi, “The sheen and glory associated with the hotel management what used to be there in earlier days seems to be loosing fast.” Commenting on this year’s enrolment trends, S C Bagri, Director, Centre for Mountain Tourism & Hospitality Studies, HNB Garhwal University said that the response is ‘poor’. “In government institutes, there are smooth admission procedures but in private colleges, the interest of students is little bit declining. Some of the private institutes who have made intensive marketing are getting positive results. Certainly, there is a lack of interest among students to pursue career in hospitality courses,” he said. Although career opportunities are increasing in the hospitality and tourism industry, the interest towards hospitality and travel related programmes is going down, says Vaskar Sen Gupta, Director, IEC IHM, Greater Noida. He feels that the traditional mindset that hospitality degrees are just about hotel jobs is still high on people’s minds. However, K V Simon, Regional Vice President, American Hotel & Lodging Educational Institute (AHLEI) has a different story to say. “I do not have authentic information or accurate statistics to confirm whether interest in hospitality and travel related courses is going up or down. One thing is for sure. Till nineties, the programmes were concentrated in cities. Now, we have an immense spread across the country, including rural areas. This to me is a good change,” he said analysing the trends. Simon refuses to accept that there is lack of interest towards these courses. “If at all there is, it is among the elite, educated, affluent class, which has far more other lucrative areas and opportunities. The poor and the needy will flock to hospitality, travel and tourism,” he argues. S K Saluja, Director, Amity School of Hospitality differs with the opinion that travel and hospitality related courses are not being preferred by people. The interest, according to Saluja, is ‘definitely up’. With the global economy opening up, people are looking at courses, which can fetch jobs in overseas markets. Hospitality courses are one of them, he contends. Whom to blame? Is industry the culprit? While we ponder the reasons, we must not ignore the feudal mindset of our society. We espouse the spirit of ‘Atiti Devo Bhava’ in public, at the same time, we look down upon the service sector, especially jobs in the hospitality sector. None other than Kapil Sibal, Union Human Resource Development Minister, said, “Our society still looks down upon people who opt for vocational courses. It is high time that we prepare our children for diversified occupations; everyone need not go to universities. Empowerment of children can come through vocational education as well,” he opines. People in the education sector blame it on the poor image of the industry for the ills. Long working hours, paltry salaries in the beginning, slow promotion avenues, etc. are cited as reasons. “The issue is students are getting disillusioned after passing out as they do not get the job they thought they shall be getting. This is leading to disillusionment and creating lesser intake of quality students into the industry,” observes Datta. The students are not fully conversant and aware about diverse opportunities in the hospitality sector. The reason for lack of interest can be low salary packages; long working hours and socially it is not considered as a respectable job, says Anand Kumar Singh, Director, MM Institute of Hotel Management, Mullana, Ambala. “No doubt, it is a largest employment generator, but, the industry opts for fresh graduates and trains them as per their needs. Even today, more than 50 per cent people in the industry are unskilled and without formal hospitality and tourism education,” he argues. “Certainly some of the archaic practices of the hospitality industry are detrimental to attracting the modern youth and the industry in general has a negative image from the point of being an employer of choice,” concedes Simon. The industry expects the institutes to supply fully trained personnel, but when it comes to salary and perks, it simply does not sync with what they spent to acquire the qualification. There is a huge mismatch between what the students aspire and what they get from the industry. This mismatch ultimately creates lot of disillusionment within a very short time after getting into the job. “Students are hardly getting the same what they have dreamt or learnt or what they should have got after graduating in Hospitality Management. What they are getting is nothing but situational exploitation which is due to non-uniform education, standards variation in curriculum standards and quality of education which creates large pool of mixed quality output and inefficient HR policies of some of the organisations,” Bhandari states. An ambiguous curriculum The ambiguity in terms of course curriculum is another major irritant in the travel and hospitality education. There are multiplicity of regulators and duplicity in relation to courses. Same courses are run under different nomenclatures across different institutions. While, there are only two formal programmes – one three-year degree programme approved by UGC and four-year degree programme by AICTE – the nomenclature of these programmes differ among institutes. Apart from these formal degrees, there are a number of other programmes in the country, run with affiliations from foreign universities as well as unapproved skill-oriented programmes run by end number of institutions. This, people in the educational sector feel, really creates confusion in the minds of the students and parents. There are voices that point fingers on the poor state of educational system in the country for the present state of affairs. Education has become a lucrative industry for investors, says Kapil Kumar, Chairperson, Faculty of History, School of Social Sciences, IGNOU. Lack of a single regulator is causing a lot of issues in the area of hospitality education. Institutes affiliated to AICTE are the real sufferers in the bargain. Questions are being raised on the folly of offering a four-year degree, when the same degree is offered by National Council and other universities across the country in three years. “There is no holistic view of the hospitality education across the county as a whole. Private colleges are the major sufferers since they are self financing institutions,” says Sen Gupta. Role of MoT While MoT is proactive in formulating policies to overcome the skill shortage in the tourism industry, these steps are more or less confined to institutes in the government sector. There is hardly anything being done to promote and streamline the hospitality education in the country by MoT. However, the recent initiative of the National Council for Hotel Management & Catering Technology (NCHMCT) to take the hospitality curriculum to the school level and the signing of the MoU with Central Board of Secondary Education (CBSE) has been applauded by many. “MoT and its agency, the National Council has a vital role to play if the hospitality courses across the country are to be streamlined. The major problem lies in the fact that although they are considered as pioneers and regulatory authorities in hospitality, the interest shown is only towards the government institutions and state education bodies,” laments Sen Gupta. However, there are differing voices against any interference from the government to streamline the educational system. Instead of government interference, Simon argues for proper interaction between educational entrepreneurs and employer industry to create ‘anticipatory and market responsive’ courses for the industry.

Even Poland, Morocco Have More Tourists Than India

By Alex Periera / INN Bureau

In the days of the British Raj, the colonial government used to flee to Shimla, a rickety Himalayan hill town, every three months. Now, India’s elite makes a similar migration, to London, or France or even Singapore. And not just Indians, people from all over the world have abandoned India, which was touted as one of the most ‘fascinating’ destinations in the world.

Despite our glorious Dal Lake, snow-covered Ladakh;  backwaters in Kerala, the adventures of swimming with an elephant; gawping at rhinos and tigers; disappearing in clouds of colours on Holi in Varanasi, the country has not been able to attract too many tourists last year.

Travel: Haiti Sees Big money Reviving Flagging Tourism

By Jenny Edwards / Haiti

The Club Indigo beach resort north of the Haiti capital was crowded with U.N. peacekeepers, aid workers, diplomats and missionaries. But the only real, live tourists seemed to be Anne Fournier and her husband. The government is pinning its hopes on a surge of private investment in hotels and resorts, plus a Venezuelan-financed $13.2 million airport and new infrastructure on the southern island of Ile-a-Vache, and an $8 million development of the historic coastal town of Jacmel.

Successful Budgeting For Your Medical Tourism Marketing Campaigns

By M H Ahssan

If marketing can be called the vehicle that brings dreams to reality, a marketing budget can certainly be referred to as the fuel that drives the vehicle. A marketing budget has long since outlived the traditional moniker of being a financial tool that helps an organization assign enough resources to achieve its marketing objectives.

Today, a marketing budget is a proud badge of recognition that demonstrates that an organization has purpose in its marketing. It says that an organization knows EXACTLY what marketing it intends to perform and how that marketing is going to help its bottom line.

In order to design a marketing budget, on organization first needs two things; an executive in charge of marketing and a manager in charge of executing the marketing plan. The former petitions the keeper of the funds for enough budget dollars to successfully help the organization, while the latter determines exactly how much resources the former should ask for.

The most successful budget style that I have encountered is the Cost Center Budget approach. With this approach, Medical Tourism is assigned what we call a cost center. This puts it on par with all the organization’s important strategic and operational departments such as Finance, Accounting, and Sales. More importantly, it means that your organization can now capture ALL the medical tourism costs in one place. This is a very important management tool that will enable senior management to assess the performance of the organization’s medical tourism operations.

Within this Cost Center, Medical Tourism Marketing is assigned a Cost Center Group. This means that all the marketing activities associated with medical tourism can be tracked from a financial perspective. Also, it isolates the marketing expenses from the other medical tourism efforts, such as Customer Service, Information Technology (IT), Sales, Public Relations (PR), Education and Training, and Business Processing (paperwork).

What are your marketing budget elements? In other words, what goes into your marketing budget? There’s the obvious; Salary and Fringe Benefits, IT Expense, Advertising, Event Marketing, and Promotional Merchandise. In addition however, your organization should budget for Professional Services, New Business Promotion, Purchased Services and Travel.

Professional Services will include any expenses that the organization incurs to solicit the services of professionals. Included in this line item are creative design, graphic design and website design. Website design, in my opinion, should always merit its own line item due to its importance and the need to isolate and, therefore, manage its expenses. Website marketing is rapidly becoming the most effective (and cost effective) way to attract customers. However, the costs associated with its design and maintenance can become very complex and easily lost with the other design costs that an organization may incur.

New Business Promotion costs are those costs incurred for new products, new markets or new customers. It’s very important for an organization to capture these costs separately from ongoing promotion. Most marketing professionals operate under a timeless adage that it costs seven times as much to capture a new customer as it costs to retain an already existing customer. In my opinion, anything that’s costing my organization seven times the cost of anything warrants its own specific attention. Plus, proper capture of these costs enables proper management of them and can provide guidance to actually reducing them, thereby becoming more efficient. ALL costs associated with new products, new markets or new customers should be captured in this bucket.

Purchased Services are those services that an organization elects to “buy” versus “build”. These costs can include printing, service measurement (customer surveys), project expenses, mail management, and special promotions not associated with any current product or service, nor with any new product or service, such as an organization’s community activities. The key to identifying which costs belong in this bucket is that they are for services (usually professional services) other than those included in the Professional Services bucket.

Travel costs might appear to be obvious and one might wonder why they warrant special attention. In one of my previous organizations, I have direct experience that suggests that excluding travel costs that are incurred because of marketing, from a marketing budget can skew the results of a marketing campaign. Imagine a campaign that involves travel to a particular conference where your organization is a sponsor and has a booth or other display space. The costs for travel, lodging, meals and other related expenses can be appreciable and should be included in the budget in order to determine how successful that event was for your organization. ALL expenses that are incurred to get people somewhere for a special reason, should be included in the marketing travel costs bucket.

While this article attempts to simplify the budgeting process somewhat, it should be clear that capturing all your marketing efforts is important for your organization. For a particular campaign like marketing to a specific U.S. state, or a particular U.S. ethnic sector, or for a specific purpose in the U.S., the campaign should be set up to capture all the aforementioned costs.

You can never have too many campaigns; each unique in its cost collection efforts so that the success of each can be uniquely and separately assessed. In order to accomplish this goal successfully, the marketing manager and marketing department should know EXACTLY what each campaign involves. This can be achieved by creating a communications plan for your campaign.

The Marketing Manager should be responsible to ensure that all the costs are properly captured and reported up to the executive responsible for marketing. Also, the marketing manager should be responsible for determining what results are expected. How many new customers? How many referrals? How much sales? What incremental sales are expected? By balancing the expected results against the cost, an organization can establish an expected Return on Investment (ROI). And, by balancing the actual results against the cost, an organization can establish an actual ROI. Does your actual medical tourism marketing campaign ROI meet or exceed your expected ROI?

When I was in charge of marketing at a previous employer, I created a campaign for every promotion. We tracked every campaign. We were able to identify and continue successful campaigns and actually improve them. We were also able to discontinue unsuccessful campaigns so they didn’t drain much needed resources. That particular product achieved $40 million in revenues in the first year and a retention ratio of almost 80% in the second year. Both achievements are considered excellent for the competitive market of the product. We are so committed to the concept of using marketing budgets, that we have created a presentation that demonstrates how to create a medical tourism marketing budget.

Make sure your organization has a budget method that enables it to capture all medical tourism marketing costs. Make sure that you establish expected results, against which actual results can be compared. Using a marketing budget for each campaign will help you achieve this. It will help you demonstrate the success of your Medical Tourism Marketing Program.

Are Travel Philanthropists Doing More Harm Than Good?

Tourists seeking to make voluntary work part of their holidays have helped build a sizeable industry which is now open to sharp criticism.

It seems like the best of both worlds. People using their hard-earned vacation time to give something back to those worse off than themselves. At its finest, travel philanthropy is seen as a form of direct development assistance – a benign initiative flowing from the travel industry and travellers into conservation initiatives, community projects and philanthropic organisations.

Tourism takes a hit in most Asia-Pacific nations

By M H Ahssan

India’s tourism industry may have suffered the double whammy of recession and the Mumbai terror attacks, but other countries in the Asia-Pacific region have not remained unscathed.

While growth of foreign tourist arrivals to India dropped from a high of 14% in 2007 to 5.6% in 2008, countries like Thailand, China and Singapore have registered a negative growth. The average growth for tourism in the world, according to United Nations World Tourism Organization (UNWTO), is 2% for 2009, down from 6% in 2008.

A Pacific Asia Travel Association (PATA) report on the Asia-Pacific region records India in the 8th position above China, but below smaller countries like Indonesia, Macau and Fiji in growth of foreign tourist arrivals.

While Indonesia tops the chart with the maximum growth of 15.4% in foreign tourist arrivals, Macau boasted an increase of 11.8% in times of global recession. Fiji (8%), Chile (7.7%) and Cambodia (7.1%) are part of the top 5 countries with the highest growth in the region followed by South Korea and Mexico. Though growth in India has dropped, the tourism industry has been reassured by the foreign tourist arrivals in February this year. Arrivals are up from 4.87 lakh in January 2009 to 5.02 lakh in February 2009.

While there is an increase in actual numbers in February 2009, a comparison with the tourist arrivals for the same period in 2008 shows a 10% drop. However, this is better than the 17% drop in arrivals for January 2009 as compared to January 2008.

The tourism ministry has, as part of its initiative to promote the Visit India 2009 campaign, added a component by which wellness resorts have been roped in to provide one free night stay for three nights booked by a tourist. “The ministry in partnership with hotels, airlines and tour operators has already announced various offers like an ecoholiday free for a tourist. We have recently put wellness resorts as an additional component,” Sujit Banerjee, tourism secretary, said.

At the same time, countries whose economies have been largely driven by tourism like Thailand and Singapore have shown a drop in growth. While China saw a drop of 1.4% in its growth, tourist arrivals in Singapore dropped by 1.6% while in Thailand the drop was at 5%.

'Tourist Visa On Arrival' To Boost Tourism In India

Tourist Visa On Arrival (TVOA) scheme should have a significant and positive impact on the decision to travel to India. Union Tourism Minister K.Chiranjeevi met Union Home Minister Sushil Kumar Shinde and submitted a proposal to extend Visa-on-arrivals to 16 countries. 
    
The ministry of tourism strongly felt that the "Tourist Visa - on - Arrival (TVOA)" facility for those countries, which are potential source markets to India and where there have been no security related issues in the past or likely to be in future can be taken up under this scheme. 
    
Accordingly, the ministry of Home Affairs accepted the proposal of the ministry of tourism and introduced "Tourist Visa - on - Arrival (TVOA)" scheme for the tourists from five countries viz. Singapore, New Zealand, Luxembourg, Japan & Finland on a pilot basis for a period of one year w.e.f. 01st January 2010. 
    
The TVOA scheme was extended by the ministry of Home Affairs on an experimental basis for one year for the nationals of six more countries - Cambodia,Vietnam,Laos, Philippines, Indonesia and Myanmar arriving at the airports of New Delhi, Mumbai, Chennai and Kolkata, with effect from 1st January 2011.Thus, the Tourist Visa - on - Arrival with a maximum validity of 30 days with single entry facility is being granted by Immigration Officers at Delhi, Mumbai, Chennai and Kolkata airports to the citizens of eleven countries - Singapore, New Zealand, Luxembourg, Japan, Finland, Cambodia, Vietnam, Laos, Philippines, Indonesia and Myanmar. 
    
An independent study conducted by the Indian Institute of Tourism and Travel Management (IITTM) has noted that TVOA scheme has a significant and positive impact on the decision to travel to India. This scheme needs to be expanded to cover more countries and more ports of entry. The ministry of tourism had proposed extension of TVOA to the following markets: 

(i) Germany, France, Spain, Poland, Sweden and Norway to cover the European and Scandinavian countries which are key inbound markets. 
(ii) Russia, Ukraine, Uzbekistan and Kazakhstan to cover the emerging markets from the CIS countries. 
(iii) Brazil and South Africa to cover foster IBSA Cooperation and Trinidad & Tobago to foster our historical links. 
(iv) Thailand, Malaysia and Brunei to cover all the ASEAN countries which will be consistent with our look east policy. 
    
The ministry of tourism had also proposed extension of TVOA to more airports namely Bengaluru, Hyderabad, Kochi, Goa,Bodhgaya and Trivandrum. 
    
Visa on Arrival is an attraction for potential tourists in key markets and at times also helps in tapping the people who make decisions at the last moment. The Ministry of Home Affairs (MHA) is considering this issue of extending TVOA to the 16 countries proposed by MOT earlier. 
    
Keeping in view the recent travel trends, the ministry of tourism now also proposes TVOA scheme for South Korea, which is a very important tourist generating market.

Insight: Why India Is Not So ‘Incredible’ For Tourists?

By Aeman Fatima / Hyderabad

On paper, India should be a tourist powerhouse. The country has all the right ingredients – good food, rich culture, beautiful historic monuments, spirituality, and diversity – to lure travellers from all over the world. Yet India lags behind Asian tourist hubs like Thailand, Malaysia, South Korea and China.

While tourism in India continues to increase, with 6.65 million tourists visiting the country in 2012, it grew just 5% over 2011. Bhutan and Sri Lanka — from the same south Asian region — recorded over 17% growth in the same year.

Election Tourism: The New Mantra For 'Varanasi' Travel

By Saraswat Sinha | INNLIVE

SPECIAL REPORT Foreigners keen on experiencing a slice of Indian elections are being treated to guided tours of this holy city and many of them have taken this opportunity to create awareness among voters urging them to exercise their franchise.    

As political decibels rise, Varanasi is turning into a tourist magnet. "These tours are part of 'Heart of India', designed by a US-based operator which takes them to different parts of the country before ending in Varanasi. And, as the city has riveted the attention of the entire country, I thought it was only fitting to show them the heart of Indian democracy too," Som Nath, who conducts the tour here, told INNLIVE.  

Andaman & Nicobar Islands, A Forgotten Paradise

During my two-week stay in the islands, this was one discussion constantly coming up no matter which island I went to. The beaches at Andaman and Nicobar islands are just as good. The waters here shimmer in a million shades of blue and the dive sites are one of the best all over the world. Everyone, from the tourism department to resort owners and private tour operators as well as the locals, talks about this.

They knew the answer lay in the lack of infrastructure. I can vouch for that. Having travelled to few remote islands in the Andaman group, I understood what they meant. My deep-rooted need to escape the crowd drove me to places as remote as Long Island and Little Andaman. I stayed in dingy places and stared alone, taking in the wondrous views. When my phone caught signal after a week, I called home. My family chided me because I didn’t take them with me to Andaman. I retorted saying they wouldn’t be able to stay at the places that I did and travel the way that I did. But in reality, I truly wished I could show them what I saw.

Port Blair and Havelock Island are the only places with good accommodation options. Elsewhere you are at the mercy of some enterprising locals who thought of setting up lodging facility. These places, mainly targeting the foreign backpacker, have put up extremely basic accommodation. Connectivity between the islands is a problem too, with ships running on limited schedules. While it sounds very exotic to stay in remote islands with absolutely no tourists and facilities, it doesn’t do much good to the locals.

Muthu, a migrant from Kovalam who now runs a surf board rental in Little Andaman, tells me the government decision to ban camping on the beaches has been good to the locals. “If everyone camps on the beach, then what do we get?” he asks. Indro’s family migrated to Andaman many years ago, even before he was born. Today, he lives in Kalipur with his wife and three children. Before the only private resort in Kalipur opened up, he couldn’t find much work and supporting his family wasn’t that easy. He tells me things have been much better since he got work at the resort. He now takes guests hiking up Saddle Peak among others.

In early 2000s, the three existing timber factories were shut down when the Supreme Court banned logging in the islands. This left the many migrant factory workers without a living. Today, they live off the island by fishing, few on pension and others take up small jobs here and there. But the youth still remains largely unemployed in most of these islands. Long Island is a remote island that can be reached by a six-hour boat ride from Havelock. Pawan, a teenager from this island, accompanied me on my three-hour trek to the pristine Lallaji Bay. When I asked him what he did for a living, spitting the tobacco, he answered very casually that he took up odd jobs on the island every now and then. Back at the resort in Long Island, a young girl named Soniya served me tea. Just about a month ago, having heard of this place, she convinced her parents in Rangat, a small town in Middle Andaman, to let her work here.

Tourism could be a key proponent in boosting the economy and solving the unemployment problem in the rising settler population. The islands have immense potential. But like any other place, this place is unique in its own right and tourism has to be managed carefully in a way not to disturb the delicate balance of the existing ecosystem. The forests are pristine and the marine life remarkable, lot of them endemic to these islands. In fact, the place is so remote and so pristine I have half a mind to not write anything about it and let it be the well-kept secret that it is today.

Havelock Island is already beginning to show effects of excess tourism. These islands survive on limited resources which makes it even more imperative to share the tourism load between different islands. In order to protect the islands, however, cutting down tourism at the roots is not the solution. The solution lies in managing tourism in collaboration with the locals to generate enough income and awareness.

Even before taking on tourism on a large scale, there are a few critical problems that have to be addressed first. The major one being that of power generation. Of the 572 islands, 38 are inhabited and almost all these islands depend on diesel for electricity! Considering diesel has to be imported from the mainland and electricity is provided at highly subsidised rates, the government incurs huge losses and I am scared to even consider the massive carbon footprint of the islands. Local resources such as solar, tidal, wind and bio-mass could be considered as alternative options for power generation. The second is that of solid waste management. I have seen parts of the pristine shore lines at Havelock and Neil filled with plastic waste that wash up from the sea.

When I was travelling from Port Blair to Neil by ship, many times the ship passed by plastic bottles floating in the blue waters. Apart from garbage generated by tourists, washed up plastic from the mainland also forms a bulk of the waste collected on the shore. As of now, most of the trash is either thrown into the sea or burnt. GreenLife Society, a local NGO, has tied up with several resorts in Havelock to collect and recycle the plastic waste and has seen some success. But steps have to be taken on a much higher level to deal with all the plastic in the islands.

Apart from these, the islands are also facing a lot of environmental issues, such as several endemic floras in the forests of Interview Island being destroyed by the abandoned elephants used for logging earlier or the introduced species of deer wreaking havoc on the growth of new forest or that of bleached corals. Despite all this, it is extremely sad that the only two occasions when Andaman & Nicobar was talked about was when Tsunami struck and the issue of Jarawas’ exploitation popped up.

About 1,200 km away from the mainland, we almost seem to have forgotten that this paradise is part of India too with its share of problems. These islands are too precious to be ignored and everyone deserves a chance to witness the extraordinary beauty here. The trick is in finding a balance between growing tourism and preserving the islands and that is a very delicate balance indeed.