First it was Medical Tourism and now it is Fertility Tourism

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On the one hand India produces some of the best, most talented, skilled and knowledgeable doctors in the world; they are settled all over the world and are considered to be some of the best medical brains in the world. So much so that the Indian expat as a doctor has become something of a cliché in Hollywood films and American sitcoms.

Also on the one hand we have people arriving in India in their droves for cheap but highly competently performed medical procedures and after surgery care; a phenomenon that has come to be called medical tourism.

On the other hand however, there is this dismal disparity, with significant percentages of our population being malnourished and having practically no access to health care. Poverty and living in remote areas offers practically no opportunity for people to access even basic medical aid. Some of the glaring disproportions are:

  • ·         Our infant and maternal mortality is worse than Thailand and Sri Lanka. Between 245 and 450 women die per one lakh live births. 2.1 million children die every year in India before reaching their fifth birthday
  • ·         46% of Indian children are malnourished
  • ·           Children die routinely from diseases like diarrhoea which are preventable by putting in place basic hygiene.
  • ·         Eighty percent of medical work force serve just 20 percent of Indians living in cities; so glaring is this disparity.

Sadly while parts of India battle endemic malnourishment in prosperous urban centres it is lifestyle related problems such as obesity that are on the rise. Urban Indian lifestyles are falling prey to the same problems as developed countries: sedentary lifestyles and unhealthy convenience foods mean rising rates of diabetes, hypertension, heart disease and cancer. Worryingly even urban children are far from the picture of health they should be, with obesity levels rising in this demographic as well. Consider this:

  • ·         India is the world’s diabetes capital with over 30 million diabetics
  • ·         India has now overtaken the west in terms of numbers of people suffering from chronic lifestyle related diseases.

As for ‘Medical tourism’ whereas this phenomenon was restricted to people flying in from countries with less developed health care systems like Bangladesh and Pakistan, now they come from further afield, from the USA, Canada and Europe (as many as 35 countries round the world), enduring 24 hour flights for the sheer cost effectiveness of having a procedure performed here.

And it isn’t just the savvy Gujaratis who come down from Leicester and New Jersey for their surgeries; foreigners come here for procedures ranging from heart and spinal surgery to dental to cosmetic procedures. For instance people come down from the United States because a surgery here would cost 10 to 15% of what it would cost at home; translating to substantial savings even when factoring in airfare and extended stay here. Consider this

  • ·         Foreign patients get treatment on demand; no waiting
  • ·         World class specialists at a fraction of the cost
  • ·         Care and hospitality comparable with the best in the world.

For this reason it is the glaring disparity that exists in India: nonexistent health care in the poor villages and swank health care facilities that rival the fanciest of five star hotels in the urban centers. As in all things; India remains the land of Extreme Contrasts.

And What is Fertility Tourism?

It would seem that there is little that wealthy westerners will not outsource to needy people in countries such as India. They outsource a variety of jobs with a result that there is the still flourishing BPO industry (in spite of President Barack Obama’s many threats against exporting American jobs) in India. The medical tourism business is booming, with people from developed countries flooding into India to have all sorts of medical procedures performed at a fraction of the cost they would incur back home, while medical skills and hospital services remain comparable.

And now, the latest phenomenon is that of Fertility tourism, as Web MD puts it – where surrogate mothers in India rent out their wombs to childless couples from the west, who have run out of options in their own country.

Surrogacy is service provided by poor women across India, at a cost that is a fraction of what would have to be paid in the west. The rent-a-womb procedure could cost about $12,000 in India, whereas it would cost about $70,000 in the United States.

Take the example of Akanksha Clinic in Anand in Gujarat, where Dr Nayana Patel, offers the service to westerners, having some 45 surrogate mothers available ‘on her books’.  27 are currently pregnant, and will receive about four to 5 thousand dollars for carrying a baby to term and handing it over to the childless couple.

There are two types of surrogacy – Traditional and Gestational. In traditional surrogacy, for whatever reason the female of the childless couple is unable to produce eggs requisite for creating a pregnancy. Here the male of the childless couple will use his sperm and the eggs of the surrogate will be used to create an embryo. So in a traditional surrogacy, the child is genetically that of the surrogate as well. In a gestational surrogacy, the female of the childless couple has healthy eggs but for some reason is unable to carry a pregnancy to term (or in some cases are scared on unwilling to undergo the rigors of childbirth) and so the embryo is created using the eggs and sperm from the couple and is simply implanted into the surrogate, for her to carry the fetus to term for a fee.

In a Bizarre Way the Mutually beneficial phenomenon of fertility tourism makes sense

This mutually beneficial relationship between rich couples from the west and poor women in India and this symbiotic feeding of one entity from the other seems somehow to smack of exploitation. Yes the childless couple will benefit; after years of trying unsuccessfully at becoming parents, they now have hope of fulfilling a long cherished dream. And it is of benefit for that poor woman who lends out her womb as well, who can now think of a slightly better life for herself and her family.

So really should be we offering criticism and sitting in judgement or offering applause for a solution that seems to work for all concerned? Even if ‘Fertility Tourism’ does sound unseemly and does seem like Globalisation gone mad.

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