Worst Medical Tourism Disasters
Does the idea of saving thousands of dollars on an operation and spending seven days of healing time in a serene eco-resort surrounded by pristine rainforest sound appealing?
What about flying 10 hours home with a weeping wound and being rushed to the emergency room for revision surgery the minute you land?
These are the potential upsides—and downsides—of modern medical tourism, a $20 billion industry that’s become especially popular with Americans, and even Canadians, Brits, Western Europeans, and Australians, patients often faced with pricey hospital treatments in their home countries.
To take advantage of this demand, foreign clinics are increasingly vying for recognition from the Joint Commission International, the leading U.S.-based hospital accreditation body. Applicants must meet a stringent set of criteria, including having a competently trained medical staff who understand foreign languages and cultures, an honest admission and price policy, and performance requirements in 20 other specific areas. “The risks for patients in traveling far distances for care can be significant,” says JCI’s president and CEO, Karen H. Timmons. “Patients need assurance that their physician and health-care provider have the right qualifications and credentials. Patients must also understand the legal redress available to them.”
Advocates of medical tourism have criticized Western naysayers for being xenophobic. They also claim that while botch jobs top the headlines, there are as many competent doctors and medical professionals in, say, Brazil or Singapore—two countries that have leaped ahead in the race for med-tourism dollars—as there are in the U.S. Meanwhile some insurance companies, such as Blue Cross Blue Shield of South Carolina, are facilitating arrangements for patients who choose lower-cost offshore hospitals. And a growing number of private businesses have encouraged their insured employees to travel abroad for more affordable health care.
The objectives of medical tourism are also changing, as the procedures have moved far beyond the “getting some work done” type. Various countries themselves are emerging as medical specialists—Costa Rica for dentistry, Malaysia for cardiac bypass surgery, and Taiwan for bone marrow transplants. Other countries, including Singapore, are developing high-tech generalized hospitals, often staffed with American-schooled doctors, to service patients seeking deeply discounted treatments.
“People think medical tourism is cheap surgery and therefore lower quality,” says Renée-Marie Stephano, president of the international nonprofit Medical Tourism Association. “But our role is to provide transparency about the quality and pricing of health care and to let people know that overseas, they can get as good if not better health care than at home, and afford it.”
Hotels and resorts want in on the action and have created attractive medical vacation packages, which offer clinic shuttle service, holistic personal cooks, and luxurious accommodations designed for recovery.
But there are virtually no resources or organizations monitoring which hospitals or countries have the most malpractice cases or highest patient satisfaction rates. And high-profile botch jobs continue to make the news from time to time. It was widely reported that Usher’s soon-to-be-ex wife, Tameka Foster, had severe surgery complications in Brazil. Irish newspapers reported that Irishman Pierre Christian Lawlor traveled to Bogota for lipo and didn’t live to return. And according to the New York Daily News, Big Apple native Stacey Cavaliere flew to Costa Rica for some nip and tuck work but upon her return was rushed to the emergency room; it took eight additional surgeries to correct her condition.
Dr. Sam Rizk, a New York–based, board-certified facial plastic surgeon, director of Manhattan Facial Plastic Surgery, and one of a handful of revision surgeons in the U.S. who correct botched operations, sees the dark side of medical tourism. “A lot of patients who go to South America to get cheap surgery end up coming back with problems,” he says. “I’ve seen everything, from a patient who caught hepatitis in the Dominican Republic to one who had a piece of silicone implant sticking through his nose.”
The big question remains: Is it safe or do you get what you pay for? “We are trying to collect more valid primary data and are monitoring all the trends and issues in medical tourism,” says Dr. David G. Vequist IV, founder and director of the Center for Medical Tourism Research. “I personally see medical tourism as a similar trend to outsourcing—or more specifically, offshoring.”
Dr. Andrew Smith, a New York–based neurologist, has a more poetic outlook: “Healing happens as a result of a relationship which is then informed by technical skill, never by commodity trading.”
In short, caveat emptor.
Cosmetic Surgery in Brazil
The Botch Job: Usher’s soon-to-be-ex wife, Tameka Foster, had a much-publicized mishap at a non-JCI-accredited hospital in Brazil before undergoing a simple liposuction procedure. Foster, 38, went into cardiac arrest while being anesthetized, but was revived immediately by heart massage.
The Real Deal: Brazil’s devaluation of the real makes surgeries across the country dirt cheap and appealing. Brazil has 16 JCI-accredited hospitals and clinics but is plagued by a plethora of garage clinics, which should rarely be trusted, especially for surgery that requires anesthesia. (In the U.S., many malpractice cases are anesthesia related.)
Liposuction in Colombia
The Botch Job: Irishman Pierre Christian Lawlor, 33, traveled from Ireland to Bogota in 2007 to have a few nips, tucks, and some lipo done, reported Irish newspapers. The day before the surgery, Lawlor found an Irish pub and drank alcohol and used cocaine, his wife reportedly told authorities later. The next day, Lawlor died of cardiac arrest shortly after the lengthy surgery. The doctor performing the autopsy said she was of the opinion “that his death should be classified as a operative death,” according to Ireland’s Herald.
The Real Deal: Though conditions are improving countrywide and Colombia is the highest ranking country in the Americas on the World Health Organization’s world health systems list, many garage clinics have popped up and none of Colombia’s hospitals have JCI accreditation yet, though three have applied and are under review.
Facelift in Singapore
The Botch Job: A woman from Melbourne traveled to Singapore for a discreet and affordable $4,000 facelift, which can cost up to $6,500 in Australia. She returned to her home with various problems, reported the Herald Sun, including a damaged facial nerve that caused the right side of her face to collapse; the left side developed an untreated hematoma due to hair left under the skin. After months of hiding, she spent nearly $10,000 to have her lumpy face repaired by a Melbourne revision plastic surgeon.
The Real Deal: Singapore is one of the biggest medical-tourism markets around and has developed a reputation for heart surgery. Its health-care system is ranked the best in Asia by the World Health Organization (and the sixth best in the world), and the country has about a dozen JCI-accredited facilities. But it has one of the lowest doctor-to-patient ratios among developed countries (about 1:635 as opposed to 1:374 in the U.S.); the country has begun to recruit medical professionals from America and Europe and is opening new med-tourism facilities, like Connexion at Farrer Park, a 20-story “mediplex” slated to open in 2011, which will feature a hospital, private hospital suites, and a full-service hotel for patients and caregivers.
Skin Tucks in CostaRica
The Botch Job: Thirtysomething New Yorker Stacey Cavaliere had lost 100 pounds and sought out a budget physician in Costa Rica to tuck and tone the excess skin. According to the New York Daily News, during the surgery she endured massive blood loss, and an emergency secondary operation was needed to stop internal bleeding. The doctor, who diagnosed her with anemia but operated anyway, told her she should return in a few months for reconstructive surgery. After returning home, Cavaliere was rushed to the emergency room; her abdomen had a raging infection and needed to be cleaned out. A skin graft from her thigh to her stomach was needed in order to close a deep wound. Her condition took eight additional surgeries to fix.
The Real Deal: Beware of the providers who are most visible on the Internet. They are not necessarily the most reputable and often lack credentials. Many dentists are schooled in America, and most are concentrated in San José. Consult the website of the U.S. Embassy in Costa Rica for recommended dentists.
Fertility Treatments in Romania
The Botch Job: A 45-year-old woman from Israel traveled to a Bucharest clinic for fertility treatments. According to Israeli newspaper Haaretz, Romanian authorities broke into a clinic in the middle of her procedure to arrest three of the clinic’s doctors who were allegedly running an illegal egg-trafficking business that involved overstimulating patients’ ovaries with drugs for extraction and sale on the black market. The woman was dragged out of the clinic by authorities immediately after her treatment ended.
The Real Deal: Egg trafficking is a big business in Eastern Europe and Israel, where fertility laws are looser than they are in Western Europe and the U.S., and where egg-trafficking schemes have scandalized a handful of fertility clinics.
Counterfeit Prescription Drugs Around the World
The Botch Jobs: In 2000, at least 30 people died as a result of counterfeit malaria medicines sold in Cambodia as mefloquine and artesunate, according to the CDC and WHO. In 2006, an unlicensed Chinese company sold counterfeit cough syrup containing diethylene glycol, a chemical similar to antifreeze, to Panama, resulting in 100 deaths, reported the New York Times. And countless numbers of tourists have experienced bizarre side effects from drugs purchased at the drugstore closest to their resort.
The Real Deal: Thinking of popping into the farmacia in Cancún to score some discount Ambien or Viagra? First consider that more than 700,000 people die every year from counterfeit drugs and alcohol. Much of the phony drugs are manufactured in China’s “Chemical Country” and in India, and exported via a ruthlessly toxic black market to resort areas in developing countries, according to the BBC. Pharmacies in Europe and North America have also seen sharp rises in counterfeiting.
Leg-Lengthening in Iran
The Botch Job: An American man in his late 20s hated being 5-foot-6. After doing some Internet research, he decided to travel to Iran for a risky leg-lengthening operation. After he returned home from Tehran, he claimed in an online forum, he noticed screws protruding from his right leg, and X-rays showed broken nails in both legs. He said he needed two more surgeries to correct the botch job.
The Real Deal: Illegal in most countries and recently banned in China, cosmetic leg-lengthening surgery is still legal in the U.S. and in a handful of other countries, among them France, Germany, Greece, Italy, Egypt, Jordan, India, and Russia—where the Ilizarov technique was developed. The procedure is excruciatingly painful and requires at least 12 months of healing. Risks involved include infection, damage of nerves and blood vessels and fat embolism, which can result in death. But beyond this, the Middle East is an emerging medical tourism destination for Europeans seeking cheaper health care. Jordan, Iran, and the United Arab Emirates are becoming medical-tourism hot spots.
Cosmetic Surgery in Thailand
The Botch Job: A woman in her 50s decided to take a “scalpel tour” from Sydney to a Bangkok hospital for a breast lift and tummy tuck, reported Reuters in 2007. She was discharged and within five days developed an infection in her abdomen and left breast. The doctors offered to readmit her, but at her own cost. Her budget depleted, she boarded the nine-hour flight home, gravely ill and with weeping wounds and a potentially fatal infection. She has had several rounds of revision surgery.
The Real Deal: Thailand’s medical tourism is booming, and the country offers some of the cheapest medical treatments in the world. Many problems can be traced back to private clinics, so seek out accredited institutions and don’t buy into Internet hype or word-of-mouth recommendations.