The Middle Eastern Patient

The Middle East has unique dual position in the Medical Tourism
Industry. On one hand, the region’s well-developed hospitals are
preparing to capture the international market for elective procedures
while on the other, international healthcare organizations are tapping
into GCC’s affluent society in search of highly sophisticated and
advanced healthcare services unavailable within the GCC.

The Middle East is a region that spans southwestern Asia and
northern Africa. It has no clear boundaries, sometimes it is also
referred as Middle-Eastern. Arabian Peninsula or Gulf Corporate Council
is most affluent area in Middle East. GCC countries include Saudi
Arabia, Qatar, Kuwait, Oman, Bahrain and UAE.

The rise of medical tourism provides an opportunity for the Middle
East, which so far has made few inroads in the sector. From many years,
a top priority for medical providers around the world have attracted
medical tourists from the Middle East, now the trend is gradually
reversing as the Middle East is seeking to attract medical tourists
where the cost of health care and delays in getting treatment have
risen sharply.

Healthcare Demand

Healthcare demand in the Arab world is under significant pressure as
GCC spent just 2-3% of GDP on healthcare. The healthcare demand in GCC
is growing rapidly. McKinsey estimated that GCC healthcare spending
would increase five fold in next year from currently $12 billion to $60
billion. This demand will continue growing until new strategies on the
part of government and private health-care players come into play.

Although GCC health-care systems are far better than they were 20
years ago, many residents remain unsatisfied with the availability and
quality of care at government-run hospitals and clinics. Government
agencies mostly lack the managerial skills needed to run health-care
facilities, and cash incentives alone have not been enough to attract
specialists to treat the rising numbers of people with ailments such as
heart disease and cancer, stated in report by McKinsey.

Key drivers for the growth in healthcare demand are population
growth, limited investment and increase in affluent health disorders. A
recent report suggested that Arabians suffer from more than 900 chronic
health disorders. In United Arab Emirates, diabetes prevalence rate is
above 20 percent, which means one out of five is diabetic.

Today GCC population is 35 million. By 2015, the size of the
population will increase at a compound annual growth rate (CAGR) of
around 3.0 percent, one of the highest in the world. As a result, total
GCC population in 2025 will be almost twice the size it is today.

In 2008, a report done by ExHealth revealed above 50% people in UAE
are overweight mainly because of sedentary lifestyle. Healthcare
disorders will increase by 20% in next few years because of poor
preventative measures and lack of understanding.

There is lack of super specialty services in GCC especially above
tertiary level care. Emergency healthcare services are still challenge
for GCC as not many private hospitals are prepared to handle cases.

Middle Eastern Patients If the current trends continue and if
GCC countries do not take immediate measure, patients from GCC will
continue traveling for medical services, providing opportunity to
medical tourism stakeholder of west and Asia.

Arabs from GCC spend billions of dollars on healthcare outsourcing.
Saudi Arab alone sent more than 200,000 patients in 2008 abroad for
medical treatment. UAE spent over billion dollars on healthcare
outsourcing. Together, all Arab patients from Arabian Peninsula have
willingness to travel outside of UAE.

A recent survey done by the national newspaper reveal that 70% UAE
population would prefer to travel outside if they get serious illness.
The GCC market is willing to travel. In fact, they travel abroad just
for common health checkups. The market has affordability, and most
importantly, the government sponsors the medical cost in most of the

Considering all evaluations, it is believed that GCC is within
under supply today; tomorrow they may have enough supply, but still
affordability will be a big question because of inflation and several
other factors. There is great need of coordinated efforts from
government and private sector to reverse the trend till then
international healthcare providers can land a hand to provide
healthcare services to struggling GCC Healthcare.

At a recent roundtable held at the World Medical Tourism &
Global Healthcare Congress in Los Angeles, health leaders from the UAE
noted that inbound healthcare is a large an opportunity in the Middle
East as outbound. Undersecretary of Health He Nasser Khalifa Al-Budoor
of the United Arab Emirates stated, “A very important topic under
scrutiny was the economic and qualitative benefits of medical tourism
to a country’s population and the positive impact medical tourism
exerts on healthcare quality within a specific country and region”.

“We are looking at a lot of collaboration. Our recent health reform
was intended to strengthen the health systems in Dubai which will
assist us going forward. We are here to strengthen medical tourism,”
added Laila Al Jassmin, CEO of the Clinical Support Services Sector for
Dubai Health Authority.

Understanding the Outbound Target Market

When healthcare providers intend to serve GCC market, their prime
target could be Arab patients. Providers can build a successful brand
if they just provide personalized care to Islamic Patients. Many
healthcare providers consider Arab patients demanding, but my last ten
years of experience in Middle East helped me to realize that if we
understand Islamic patient requirement, we can make Arab patients happy
very easily.

Regrettably, companies spend most of their money on advertisements
and promotion; they do not spend on cultural consultancy services.
Understanding culture is one of the key component in serving medical
tourism industry.

If a healthcare provider would like to extend personalized service
to a Muslim or Islamic patient, the below suggestions could be very
helpful. Implementation of below guidelines would make the stay of a
Muslim patient in hospital more acceptable and contented. It would also
make sure that the care being provided was of the highest quality
possible for Muslim patients. The recommendations cover aspects of
clinical care, food services, religious observance and visiting
arrangements amongst others.

Food Services. All catering staff should be aware that only
halal meat (ie. meat slaughtered according to religious requirements)
must be given to Muslim patients. They should also be made aware that
Muslims do not eat pork or any other pig meat and its products eg. Hand
washing before and after meals is particularly important to Muslims.
Bathroom facilities are readily available to ambulant patients, however
washing facilities should be made available to bedridden patients at
meal times.

Clinical or Nursing Care. It is preferable for a female
Muslim to be cared for by females and a male Muslim by males. This is
most important during confinement when strict privacy is very
essential. Only female health workers should be present. Exposure
should be kept to a minimum. The position of delivery should be
discussed and the woman given the choice.

Present medical examination techniques should be modified where
possible so that as little of the patient is exposed as possible,
whilst not inhibiting the medical procedures. Facilities should be
provided for male circumcision if required.

Alcohol. Alcohol and any other intoxicating substance are
prohibited in Islam. Where a choice exists, medicines containing
alcohol should not he used. In emergencies, this rule does not apply if
an alternate drug is not available, but this should be explained to the
patient. If the medication is necessary, then Islam permits its use.

Forms In most circumstances informed consent must not be only
in English. It must be verbal as well as written in their own language
so that the issue is fully understood. In circumstances where the
patient has difficulty communicating in English, a professional
interpreter should be arranged.

Maternity Services After delivery, the placenta (which is
part of the baby) should be offered to the parents for disposal by
burial in accordance with Islamic tradition.

In Case, After Death The face and indeed the whole body of the
deceased must be covered by a sheet. The body must be handled as little
as possible. Muslims believe that the body ‘feels’ pressure and pain
numerous times more than that applied. Muslims also believe that the
soul remains close to the body until burial. The body must be handled
with utmost respect only by a person of the same sex. Relatives may
wish to pray close to the body or in a room close by. Islam prohibits
post-mortems. However, the statutory laws of the country must be
followed with respect to post-mortems.

Fasting In the month of Ramadan, fasting is compulsory for
all healthy, adult Muslims on reaching puberty. Every individual is
responsible for his or her own fast. Fasting begins an hour before
sunrise and ends at sunset. It is a total fast with abstinence from any
food or drink. Smoking is not allowed. Gargling is acceptable as long
as no fluid goes down the throat. Besides fasting in Ramadan, some
Muslims also keep optional fasts. Fasting is a purification inwardly
and outwardly. Exempted from fasting are pregnant, lactating or
menstruating women, the ill and travelers.

Visiting The Sick Strong emphasis is placed on the virtues of
visiting the sick. The sick Muslim is usually happy to receive many
visitors. It is a requirement of the family members of the sick Muslim
to notify as many people as possible of the illness. This is usually
done by the close relatives.

Above are just few basic tips provided by authorities, as this helps in understanding Islamic patient needs.


As marketing guru Kotler writes “What should our aim be with
customers? First, follow the Golden Rule of Marketing: Market to your
customers as you would want them to market to you. Second, recognize
that your success depends on your ability to make your customers
successful. Aim to make your customers better off. Know their needs and
exceed their expectations. Organizations must view the customer as a
financial asset that needs to be managed and maximized like any other
asset. Tom Peters sees customers as an “appreciating asset.” They are
the company’s most important asset, and yet their value is not even
found in the organization’s books.

Dr. Prem Jagyasi is a Chartered Management, Healthcare Marketing and
Medical Tourism Consultant. Providing high-profile consultancy services
to Government Authorities and Private Healthcare organizations, he is
noticeably leading medical tourism consultant. He also serves Medical
Tourism Association, as an Honorary Chief Strategy Officer. He can be
reached at |