Medical Trafficking and Medical Value Travel are very Different

I was recently in Kenya and learnt about a new term called “medical trafficking”.

This came up in discussions with a member of the Kenyan parliament, who is also an eminent clinician of Indian origin. The MP is a prominent citizen of Kenya, owns a chain of hospitals and believes that what passes for medical travel in Kenya is mostly medical trafficking.

Well, I wouldn’t agree entirely but there is more than a grain of truth in what the lawmaker is talking about. Essentially, he defines medical trafficking as dubious agents persuading gullible and sometimes desperate Kenyan citizens looking for the medical treatment to countries like India. He believes that many of the problems for which the Kenyans are travelling can be treated in his own and other hospitals in Kenya. However, ordinary Kenyan citizens, when faced with a medical crisis are lured away by unscrupulous medical travel agents with promises of magical cures at jaw-dropping prices in faraway places. This is largely achieved through an unholy nexus between local clinicians, hospitals, medical travel agents and hospitals in India and other countries.

The Hon’ble MP believes that Kenyan government should take steps to prevent exploitation of Kenyan patients in this manner. He is sponsoring a private member’s bill in the Kenyan parliament, which will regulate medical travel from Kenya and allow only patients, who have serious medical conditions and for which treatment is currently not available in Kenya to travel abroad.

I believe this is good.

However, there are a few caveats.

More than restricting patient travel for better medical care, Kenya needs to invest a lot more in building capacity and appropriate skills enhancement in the medical centre. The hospitals in Kenya, while making progress are still far behind those in India and elsewhere. The government hospitals are overcrowded, filthy and struggling. The hospitals in the private sector, barring a few are at best secondary care centres equipped to handle only routine surgeries. There is an all-pervasive shortage of clinicians, nurses and para-medical staff. The problem is a lot more acute outside of Nairobi. Unless, Kenya bridges this gulf, patients will always seek to travel abroad in search of better care.

This cannot be done overnight. Building new hospitals and finding highly trained and experienced clinicians will take years. In the short run, some gains can be made through collaborations with foreign hospitals, who might be willing to share their expertise with local Kenyan hospitals. It might also be possible to import a team of highly trained clinicians and allied technicians to be able to work in Kenyan hospitals for short periods. This will help Kenyan patients get access to high-quality care closer home and the local clinicians will be able to learn while working together with foreign experts.

Sure enough, some clinical work, particularly for higher-end tertiary care specialities, may still not get done with-in Kenya. Patients for these conditions will still need to travel abroad. These patients must be guided through proper well-established medical travel operators governed by suitable rules and regulations. These need to be framed urgently.

The medical travel industry continues to be largely unorganized not only in Kenya but in almost all parts of the world. Small-time operators with very little understanding and knowledge of the patient’s needs or the capabilities of the hospitals that they are being referred to continue to thrive. This is the soft underbelly of medical travel that the Kenyan lawmaker referred to as ”medical trafficking”.  This, of course, needs to be rooted out. It will be possible only when well-established medical travel operators employing doctors and other experts come into play. The government of Kenya should establish guidelines on who can be a medical travel operator, give them incentives to set up their offices in Kenya and let them effectively collaborate with Kenyan Hospitals, the NHIF and other large public sector undertakings for patient referrals. Only authorized medical travel operators should be allowed to facilitate patients for treatment abroad.

Finally, I must make a point about patient choice. The fact that a particular treatment is available in Kenya should not mean that the patient must be treated in Kenya. This will be clearly wrong. Availability of treatment does not guarantee quality. If a patient prefers to go abroad for her own treatment, she must be allowed to do so. After all, it is a matter of her own health and if she has the necessary wherewithal to pay for the treatment at a place of her choice, she must be allowed to do so.

Medical Trafficking is a result of unorganized, mercenaries masquerading as medical travel operators being allowed to work unchecked in Kenya. It must be curbed through effective legislation. However, patients genuinely needing high-end medical care or those who wish to travel abroad for treatment must be allowed to do so. They should be guided to bonafide and licensed medical travel operators who may help them seek the best possible care anywhere in the world.