Possible Early Examples of Medical Tourism.

Health tourism has hundreds of years of history, most notably in visitors traveling to thermal baths. Medical tourism, a type of health tourism, has rapidly expanded in the last quarter century by patients travelling abroad to health centers for medical treatment. Because of lack of records in ancient times, the history of tourism for actual medical treatment is unknown. In Ottoman archives, medical treatment consent forms of patients were officially documented. We analyzed these existing records to identify foreign citizens who came to the Ottoman Empire for medical treatment. In our screening of Konya Ser'iye registration records, we found medical consent forms for three non-Ottoman foreign citizens. All three patients had the same medical illness and came to Konya for medical treatment. Therefore we emphasized that those patients searched for the name of doctor who was an authority on that illness. This study indicates that medical tourism may have occurred well before the 20th century.

Liver Transplant in Colombia.

Liver transplantation began in Colombia in 1979. It is one of the most active countries in this field in Latin America but has faced problems with the regulation and appropriate management of solid organ transplantations, including transplant tourism, which is a worldwide problem. There is a well-structured donation and transplant network regulated by the government in all the stages of the process. In 2017, the country was ranked fourth for the number of liver transplantations (LTs) performed in Latin America, after Brazil, Argentina, and Uruguay, with a rate of 5.6 LTs per million population. Current regulatory bodies were created to coordinate and provide transparency and equality to transplant recipients. This article describes the evolution, government commissions, assignation criteria, and current status of LT in Colombia.

[From educational and health tourism for children to social tourism: vacation camps in the Province of Buenos Aires, Argentina]. / Del turismo escolar y sanitario infantil al turismo social: colonias de vacaciones en la Provincia de Buenos Aires, Argentina.

The early twentieth century saw the rise of vacation camps for frail children as educational and health-giving experiences provided by medical and philanthropic organizations. This article analyzes some of these early experiences, seen here as the predecessors of social tourism, in the Province of Buenos Aires. A combination of written sources are examined, mainly institutional reports, periodicals such as the Monitor de la Educación Común - published by the Consejo Nacional de Educación (National Board of Education) - or laws, with photographs and plans for different examples. I argue that these buildings were both physical and cultural "brands" in the places where they were located, and that their architectural structure encapsulated ideas about leisure space and cures in unique natural environments.

Moral maps and medical imaginaries: clinical tourism at Malawi's College of Medicine.

At an understaffed and underresourced urban African training hospital, Malawian medical students learn to be doctors while foreign medical students, visiting Malawi as clinical tourists on short-term electives, learn about "global health." Scientific ideas circulate fast there; clinical tourists circulate readily from outside to Malawi but not the reverse; medical technologies circulate slowly, erratically, and sometimes not at all. Medicine's uneven globalization is on full display. I extend scholarship on moral imaginations and medical imaginaries to propose that students map these wards variously as places in which­or from which­they seek a better medicine. Clinical tourists, enacting their own moral maps, also become representatives of medicine "out there": points on the maps of others. Ethnographic data show that for Malawians, clinical tourists are colleagues, foils against whom they construct ideas about a superior and distinctly Malawian medicine and visions of possible alternative futures for themselves.

Inventing Caribbean climates: how science, medicine, and tourism changed tropical weather from deadly to healthy.

This article examines how four major historical factors--geographical features, social conditions, medicine, and tourism--affected European and North American views of the tropical Caribbean climate from approximately 1750 to 1950. It focuses on the British West Indies, a region barely examined in the historiography of climate, and examines the views of physicians, residents, government officials, travelers, and missionaries. International perceptions of the tropical Caribbean climate shifted markedly over time, from the deadly, disease-ridden environment of colonial depictions in the eighteenth century to one of the world's most iconic climatic paradises, where tourists sought sun-drenched beaches and healing breezes, in the twentieth. This analysis of how environmental conditions, knowledge systems, social relations, politics, and economics shaped scientific and popular understandings of climate contributes to recent studies on the cultural construction of climate. The approach also offers important lessons for present-day discussions of climate change, which often depict climate too narrowly as simply temperature.

Health tourism in a Czech health spa.

This paper is about the changing shape of health tourism in a Czech spa town. The research focuses on balneotherapy as a traditional Czech healing technique, which involves complex drinking and bathing therapies, as it is increasingly being incorporated into the development of a Czech health tourism industry. Today, the health tourism industry in Mariánske Lázne is attempting to 'harmoniously' combine three elements--balneology, travel and business activities. One detects subtle shifts and consequent incongruities as doctors struggle for control over the medical portion of spa hotels. At the same time, marketing groups are creating new packages for a general clientele, and the implementation of these new packages de-medicalizes balneotherapy. Related to the issue of the doctor's authority in the spa, the changes occurring with the privatization of tourism entails the entrance of 'tourists' to Mariánske Lázne who are not necessarily seeking spa treatment but who are still staying at spa hotels. There is a general consensus among spa doctors and employees that balneotherapy has become commodified. Thus, while balneotherapy remains a traditional form of therapy, the commercial context in which it exists has created a new form of health tourism.

Fertility tourism: circumventive routes that enable access to reproductive technologies and substances.

"Fertility tourism" is a journalistic eye­catcher focusing on the phenomenon of patients who search for a reproductive treatment in another country in order to circumvent laws, access restrictions, or waiting lists in their home country. In Europe, the reasons why people seek reproductive treatments outside their national boundaries are quite diverse, in part because regulations differ so much among countries. Beginning with four examples of people who crossed borders for an in vitro fertilization (IVF) treatment with gamete donation, this article provides some insight into these transnational circumvention practices based on material from ethnographic fieldwork and interviews in Spain, Denmark, and the Czech Republic. In all three countries, gamete donation is made strictly anonymous. Clinical practices such as egg donor recruitment and phenotypical matching between donors and recipients serve to naturalize the substitution of gametes and to install social legitimacy through resemblance markers with the prospective child. In comparison to other areas of medical tourism, which are subjects of debate as a consequence of neoliberal health politics and international medical competition, mobility in the area of reproductive technologies is deeply intertwined with new forms of doing kinship. For prospective parents, it holds a promise of generating offspring who could pass as biogenetically conceived children. Therefore, IVF with gamete donation is mostly modeled after conceptions of nature. Through anonymity and concealment it creates forms of nonrelatedness that leave space for future imaginings and traces of transnational genetic creators.

Interrogating medical tourism: Ireland, abortion, and mobility rights.

Medical tourism in Ireland, like in many Western states, is built around assumptions about individual agency, choice, possibility, and mobility. One specific form of medical tourism­the flow of women from Ireland traveling in order to secure an abortion­disrupts and contradicts these assumptions. One legacy of the bitter, contentious political and legal battles surrounding abortion in Ireland in the 1980s and 1990s has been securing the right of mobility for all pregnant Irish citizens to cross international borders to secure an abortion. However, these mobility rights are contingent upon nationality, social class, and race, and they have enabled successive Irish governments to avoid any responsibility for providing safe, legal, and affordable abortion services in Ireland. Nearly twenty years after the X case discussed here, the pregnant female body moving over international borders­entering and leaving the state­is still interpreted as problematic and threatening to the Irish state.

Medical tourism in the Caribbean.

Although travel for medical reasons has a long history, it has more recently evolved from a cottage industry to a worldwide enterprise. A number of countries are positioning themselves to attract visitors who are willing to travel to obtain health services that are more accessible, less expensive, or more available than in their countries of origin. This has in turn given rise to medical packages that combine tourism with health. Several Caribbean nations - including Cuba, Barbados, Jamaica, and Puerto Rico - hope to expand their revenues in this new market. Each country has selected specific service niches and promotes its services accordingly. While Cuba has been promoting its services to other countries for several decades, medical tourism is just beginning in the other islands. Ultimately, these nations' economic success will hinge on their comparative advantage vis-à-vis other options, while their success in terms of improving their own health care depends on the extent to which the services for tourists are also available to the islands' populations.

"Almost invisible scars": medical tourism to Brazil.

Along with a handful of other nations in the developing world, Brazil has emerged as a top destination for medical tourism. Drawing on the author's ethnographic fieldwork in plastic surgery wards, this article examines diverse factors - some explicitly promoted in medical marketing and news sources, others less visible - contributing to Brazil's international reputation for excellence in cosmetic plastic surgery. Brazil's plastic surgery residency programs, some of which are housed within its public health system, attract overseas surgeons, provide ample opportunities for valuable training in cosmetic techniques, and create a clinical environment that favors experimentation with innovative techniques. Many graduates of these programs open private clinics that, in turn, attract overseas patients. High demand for Brazilian plastic surgery also reflects an expansive notion of female health that includes sexual realization, mental health, and cosmetic techniques that manage reproduction. Medical tourism is sometimes represented as being market-driven: patients in wealthier nations travel to obtain quality services at lower prices. This article ends by reflecting on how more complex local and transnational dynamics also contribute to demand for elective medical procedures such as cosmetic surgery.

Surgeon and Safari: producing valuable bodies in Johannesburg.

This essay explores how concepts of value and cheapness circulate around the bodies of clients of the Johannesburg-based cosmetic surgery tourism company Surgeon and Safari. I show how the production of a luxurious experience and the mitigation of risk take place within a transnational network enabled by the presence of medical tourism in multiple locales. By placing Surgeon and Safari's activities within the context of the neoliberalization of health care in South Africa, I explore how the division between private versus public health spaces functions as both a technique of valuing clients' bodies and as a process of racialization.

Medical tourism: reverse subsidy for the elite.

The medical tourism sector in India has attracted global attention, given its phenomenal growth in the past decade. India is second only to Thailand in the number of medical tourists that it attracts every year. Estimates indicate that the medical tourism market in India could grow from $310 million in 2005 to $2 billion by 2012. These figures are significant when contrasted with India's overall health care expenditure - $10 billion in the public sector and $50 billion in the private sector. Factors that have contributed to this growth include the relative proficiency in English among health care providers and the cost effectiveness of medical procedures in India. Generally, most procedures in Indian hospitals cost a quarter (or less) of what they would cost in developed countries. The expansion of medical tourism has also been fueled by the growth of the private medical sector in India, a consequence of the neglect of public health by the government. India has one of the poorest records in the world regarding public financing and provisioning of health care. A growing driver of medical tourism is the attraction of facilities in India that offer access to assisted reproductive care technologies. Ironically, this is in sharp contrast with the acute neglect of the health care needs of Indian women. The Indian government is vigorously promoting medical tourism by providing tax concessions and by creating an environment enabling it to thrive. However, there is a distinct disjunction between the neglect of the health care needs of ordinary Indians and public policy that today subsidizes the health care of wealthy foreigners.

Medical tourism in the backcountry: alternative health and healing in the Arkansas Ozarks.

Tourists travel to Arkansas' mountain regions to experience, appreciate, and consume multiple aspects of otherness, including sacred sites and pristine and authentic peoples and environments. A largely unexplored aspect of this consumption of authenticity is alternative medicine, provided to tourists and day travelers in search of physical and emotional restoration. Traditional forms of medicine are deeply rooted in women's social roles as community healers in the region and are perpetuated in part because of the lack of readily accessible forms of so-called modern medicine. Contemporary medical tourism in Arkansas has promoted access to folk health systems, preserving them by incorporating them into tourists' health care services, and also has attracted new and dynamic alternative medical practices while encouraging the transformation of existing forms of traditional medicine. Ultimately, the blend of alternative, folk, and conventional medicine in the Arkansas highlands is evidence of globalizing forces at work in a regional culture. It also serves to highlight a renewed appreciation for the historic continuity and the efficacy of traditional knowledge in the upper South.

Complicating common ideas about medical tourism: gender, class, and globality in Yemenis' international medical travel.

Three cases of international medical travelers from Yemen, a capital­poor country in the southwest corner of the Arabian Peninsula, help to counter misconceptions within discussions of medical tourism. These misconceptions include the suggestion of leisure in medical tourism, the role of gender and class, and the ease with which we dismiss the health concerns of wealthy individuals. Instead, this article proposes, we should uncover commonalities and differences within international medical travel while avoiding slipping into generalities and stereotypical portrayals.

[Sanatoria for tourists, drugs at home, healers on demand: healing cultures in the Duchy of Gotha (1850-1950)]. / Sanatorien füir Touristen--Medikamente für zu Hause--Heilkundige nach Bedarf: Heilkulturen im Herzogtum Gotha (ca. 1850-ca. 1950).

Up to 1920 Thuringia was separated into many territories some of which were known for their unorthodox pharmaceutical industries. Gotha was the only famous duchy because one of its princes had married the Queen of England in 1840. The country was backward and the state administration was incapable of solving health issues. It was due to the interest of some physicians that the fragile balance between homeopathy, naturopathy, physicians and pharmacists broke down after 1900. But the state bureaucracy was unable to convince the people of its new healthcare approaches that were just based on scientific medicine.

Shifting subjects of health-care: placing "medical tourism" in the context of Malaysian domestic health-care reform.

"Medical tourism" has frequently been held to unsettle naturalised relationships between the state and its citizenry. Yet in casting "medical tourism" as either an outside "innovation" or "invasion," scholars have often ignored the role that the neoliberal retrenchment of social welfare structures has played in shaping the domestic health-care systems of the "developing" countries recognised as international medical travel destinations. While there is little doubt that "medical tourism" impacts destinations' health-care systems, it remains essential to contextualise them. This paper offers a reading of the emergence of "medical tourism" from within the context of ongoing health-care privatisation reform in one of today's most prominent destinations: Malaysia. It argues that "medical tourism" to Malaysia has been mobilised politically both to advance domestic health-care reform and to cast off the country's "underdeveloped" image not only among foreign patient-consumers but also among its own nationals, who are themselves increasingly envisioned by the Malaysian state as prospective health-care consumers.