Lessons from Erbil

Earlier this month, I was in Erbil in the Kurdistan region of Iraq. Erbil along with Dohuk and Sulemaniya have emerged as prominent cities sending patients to various Indian hospitals. Most Indian hospitals are actively wooing patients from these cities and I had traveled to Erbil for official meetings with our partners and government officials.

Erbil and Sulemaniya have International airports and are fairly well connected to the gulf countries as well as to Turkey and many European cities. Erbil is the administrative capital of the region and the seat of power of the regional government of Kurdistan, which is fairly autonomous. Kurdistan region, which suffered tremendously under the brutal regime of Saddam Hussein has moved on. It is peaceful and the government is busy building the infrastructure that they never had in the past.

Kurdistan lacks hospitals. They also do not have enough doctors, who can run the few hospitals that exist. To make matters worse they are desperately short of anesthetists, thus surgeons have to sit idle waiting for the anesthetists, so that they can operate. Thus, most people from Kurdistan prefer to travel abroad for their healthcare needs and Indian hospitals, with their low costs and high quality care attract a lot of people from this region.

While at the Erbil airport, waiting for my flight, I noticed that many of my co-passengers on the flight were patients. I started interacting with them informally and learnt how difficult it is for them to make this journey.

For many patients, who were ready to travel, this journey was a great leap of faith. I met a gentleman, who was traveling with his wife and daughter. The wife needed spine surgery and they were traveling to Fortis Hospital in Vasant Kunj. Without revealing that I work at Fortis, I inquired from them about the surgeon, who was to operate on the lady, they had no clue. Needless to add that they did not know what the surgery was, all they knew that they will be required to stay in New Delhi for 10 days and the ‘wife would be as good as new”, guffawed the old man. The surgery had been arranged by a lady, who is a Kurdish refugee living in Delhi and all these people had was her phone number, which they were to use on arrival in New Delhi. Scary, to say the least.

Another interaction with a co-passenger yielded information that they were headed for Apollo Hospitals. The young man’s mother needed a gynecological surgery and they believed that Apollo Hospitals will be able to perform the surgery. They had been recommended to Apollo, by someone they knew and who had had undergone a surgery at Apollo Hospitals many years ago.

Another co-passenger informed me that he was going to ”BKL” Hospital and that he has been told that this is the ‘best’hospital in New Delhi. I did not disabuse him of this notion and gently corrected the name of the Hospital to BLK Hospital.

As we boarded the flight I was truly appalled by the primitive facilities at the Erbil airport. There were no ramps for patients on wheel-chairs and they had to be awkwardly maneuvered to reach the boarding gates. At the boarding gates, they were unceremoniously hauled into a hydraulic lift, which took them to the aircraft. Logically, the patients should have been allowed to board first and they should have been occupying the front end of the aircraft. This was not the case. Passengers boarded the aircraft as they normally do, followed by patients on wheel-chairs, with many being wheeled to the back. The width of wheel-chair was such that it could hardly be moved in the aisle. Thus many, patients had to literally carried by their attendants to their seats.This to say the least is embarrassing and extremely undignified. And lest you wonder, which airline this was, we are talking about Etihad Airways, one of the leading and sought after airline of the world!

The lessons for healthcare companies and the airlines are self evident. With the burgeoning demand for medical travel, hospitals, who wish to attract patients from far corners of the world, must invest in establishing information centres, which provide patients with correct and timely information about the patient’s condition, treatment, prognosis and costs. They centres should be manned by local staff, trained by the hospitals, who should be able to build a relationship with patients and their attendants.

The airlines must realize that the segment of medical tourists will grow significantly in the days ahead. They must also invest in systems, which allow people with special medical needs to travel in relative comfort and adequate safety. they should have proper equipment to manage patients on wheel chairs and perhaps stretchers, trained people who can make the patient’s journey smooth and hassle-free.

Essentially, we must see a collaborative approach involving hospitals and airlines emerge. They must start talking to each other to help patients make these life saving journeys with ease and comfort.