Awareness of bariatric procedures and obesity management has risen in Mumbai and doctors have observed that over the last six months, more patients have been approaching doctors to tackle obesity at earlier stages. Amongst various factors including rising consciousness about health, the higher awareness was attributed to Egyptian national Eman Ahmed, labelled world’s heaviest woman, who had visited India last year for a bariatric surgery but passed away in an Abu Dhabi Hospital in September 2017.
Medical tourism agents, however, claimed that following massive coverage of Eman’s case, who remained in Saifee hospital for three months before seeking transfer to Abu Dhabi following a dispute with doctors, cases of foreign nationals opting for bariatric surgery in India has declined. According to Huzefa Ajmeri, who coordinates with foreign nationals for treatment in seven major corporate hospitals in Hyderabad, Delhi and Mumbai, obesity treatment cases dipped from 30-35 in 2016 to three in 2017 under him. “Patients from Middle East have reduced. We do not know what may be the leading factors behind it, but cases have reduced since several months now,” he claims.
Surgeons, however, differ. According to Dr Aparna Bhasker, who was treating Eman and now works with Global Hospital, the change is due to several factors. “Middle eastern patients prefer Jordan, where bariatric surgery may cost Rs 1.-1.5 lakh. There hasn’t been a significant rise in foreign nationals in Mumbai for obesity because several prefer Delhi over Mumbai,” Bhasker said. According to Dr Raman Goel, attached with center for metabolic surgery, Wockhardt Hospital, patients from mostly East Africa, Middle East, Europe and USA visit India for bariatric procedures. Lower cost, he claims, has remained a major attraction for medical tourism in India.
In a registry started by Obesity Surgery Society of India last year, with 340 bariatric surgeons as members, data showed that 15,000 procedures had been carried out in India in 2016, Goel added. “The number of medical tourists remained constant for the last two-three years,” he claimed. In 2017, he treated about 50 foreign patients for obesity – 20 per cent of total patient pool. “The figure was similar in 2016,” he says. Eman was admitted to Saifee hospital in February 2017, and shifted to Abu Dhabi in May after her sister had disagreements with treating doctors over her hospitalisation. In May, she was shifted to Abu Dhabi’s Burjeel Hospital where she passed away due to renal failure in September.
Her case, doctors claim, has raised awareness amongst Indian patients about seeking earlier medical attention for obesity. “Earlier, patients came to us when they had gone beyond BMI of 40 or 45. Now I am seeing patients much earlier, maybe within a range of a 30 BMI,” said bariatric surgeon Dr Shashank Shah, who operates upon 80 patients a year.
Two months ago, a 41-year-old African national visited Shah for obesity management. Weighing 84 kgs, she decided to undergo treatment following death of her mother who was severely obese. “She asked for a balloon surgery for weight loss as she knew she was headed in direction of super obesity. In two months she lost 8 kgs,” Shah said, adding, “We suspected cases of foreign nationals may drop after the episode of Eman, but it has remained constant. People became more conscious about weight gain. We also learnt lessons, like to prepare patients better and longer for obesity surgery,” Shah added.
According to Huzaifa Shehabi, chief operating officer at Saifee hospital where Eman underwent sleeve gastrectomy surgery before being moved to Burjeel hospital, said, “The government wants to promote medical tourism but the situation on the ground reveals that the industry is unregulated and there’s an absence of a clear framework. Price parity, especially in the non-medical segment of medical tourism, is another area which needs to be analyzed carefully,” Shehabi said and added that a new pool of patients is emerging from Cambodia, Vietnam, and Laos and a sys-tem is required to provide treatment options for them in India.