I will never forget the first Canadian medical tourist I interviewed. I was gripped when this person told me about travelling abroad for invasive surgery, accompanied by their spouse. While in India, this spouse required emergency surgery to address a chronic condition that had worsened.
This situation sounded so distressing and the researcher in me wondered: Could the mental and physical stress of caregiving in an unfamiliar, international context have negatively impacted the spouse’s health to the point that surgery was required?
There are many reasons why patients opt to seek health care abroad. In some cases, it is because they cannot access timely surgery locally. In others, they are seeking an experimental procedure that is not available at home, such as an unapproved stem cell therapy.
For most of the last decade I have been involved in extensively studying medical tourism. I have spoken with patients, policy-makers, doctors, nurses, tourism officials, travel operators and many others in well over a dozen countries. Much of this research has examined ethical and equity questions related to medical tourism. For example, trying to understand if and how local patients, health-care providers and health systems can benefit from medical tourism in the Caribbean.
One thing I have learned is that many medical tourists do not travel on their own. Many travels with a friend or family member.
Friends and family provide support and companionship. They serve as a source of familiarity and comfort. They can assist with very practical matters, such as confirming travel plans and keeping people at home informed about the medical tourists’ health status. My own research has found that these roles and responsibilities can be quite extensive.
I would like to take a step back and offer a more critical perspective on this practice of informal caregiving by friends and family members in the context of medical tourism.
‘Shadow workers’ in a multi-billion dollar industry
It is often reported that medical tourism is a multi-billion dollar global industry. (Though, let’s be careful not to rely too much on the numbers that are reported because most of the quantitative figures that exist are wrong.)
Clinics, hospitals and entire countries are actively trying to attract medical tourists through costly advertisement campaigns and other promotional efforts. But what about the friends and family who accompany them?
I rarely see a mention of friends and family in the brochures, websites, e-mails and trade shows that advertise medical tourism services.
There is no formal guidance on what they can expect while they are abroad. No formal resources to prepare them to do things like change wound dressings in hotel rooms or navigate airports with someone recovering from surgery.
These friends and family are, in many ways, “shadow workers” in a multi-billion dollar global industry.
The unpaid care work they provide to medical tourists is invaluable. And I have no doubt that many patients would not even consider medical tourism without someone to accompany them on what can be a painful and challenging journey.
Yet, in my opinion, the industry does little to protect them.
Nine factors to consider
I think there are many things that can be done to transition these friends and family members from unpaid “shadow workers” to prepared members of medical tourists’ support networks.
My collaborative research shows that one tangible action is to develop resources to help these individuals make informed decisions, become prepared travellers and caregivers and stay safe and healthy.
I was recently involved, with a research team, in interviewing Canadians who had accompanied a family member or friend abroad for medical tourism. Their stories contained very important pieces of advice for people considering taking on this role. We gathered this advice together and published it in an academic article.
We also put together a simple, one-page information sheet that offers nine specific factors that I strongly urge friends and family to carefully consider before accompanying a medical tourist abroad.
Read, share, discuss
The information sheet we developed can be shared widely. The text can be copied and pasted freely onto the websites or promotional materials of clinics and hospitals seeking to treat medical tourists.
I invite people to read it, share it and talk about the content.
This sheet also serves as a companion to another information sheet we developed —for Canadians thinking about participating in medical tourism.
The global medical tourism industry relies on the unpaid labour provided by patients’ friends and family members. Their unpaid labour needs to be acknowledged. Their needs must be assessed. Their health and safety need to be protected.
The Conversation I push for these things to happen when I meet with medical tourism sector representatives, and I call on others to push for the same.