East Africa boosts its hospitals, staff, services to attract medical tourists

The region is positioning itself to become a medical hub in a bid to reduce the number of patients seeking treatment abroad. The bloc will also offer medical services to patients from Zambia, Democratic Republic of Congo, Malawi, South Sudan, Somalia and Ethiopia.

Free movement of services and workers will not only ease cross-border referrals but also allow medical specialists to work across EAC countries. The region now boasts advanced technology and more specialised doctors. It is also setting up centres of excellence in regional hospitals.

This year, Kenya is expected to start work on revamping the Kidney Institute of Kenya to upgrade it into a regional nephrology and urology centre, while Uganda will refurbish the Uganda Cancer Institute for diagnosis and treatment, making it a centre of cancer treatment in East Africa. Both countries have already received funding of $69.8 million from the African Development Bank to improve their health facilities.

Tanzania is expected to upgrade its Heart Institute; Burundi will have the Regional Nutritional Sciences Institute, while Rwanda will host the EAC Health, Vaccines and Immunisation Logistics Institute.

But, this comes as private healthcare providers from around the world open shop across the region mainly through partnerships with local private healthcare providers. Some have also launched greenfield operations.

For instance, India-based Mediheal Group of Hospitals, which currently operates in Kenya — specifically in Eldoret, Nakuru, and Nairobi Counties — recently entered the Rwanda market and will soon officially launch its operations. The hospital specialises in fertility treatment-assisted reproductive techniques and invitro fertilisation among other medical services. It also plans to set up operations in Ethiopia, Zambia and Uganda.

“Medical tourism is our focus; we can see East Africa playing a big role, which is why we are setting up infrastructure, human resource and technical capacities,” Anup Dinesh Das, the group CEO and managing director of Mediheal Hospitals told The EastAfrican, adding, “We are targeting the whole of East and Central Africa. We do not want any patient to go to India, South Africa or the US for treatment. We want to provide basic and specialised treatment right here in East Africa.”

READ: Medical tourism growing as more travel to Kenya

India-based Dr Agarwal’s Eye Hospital, which handles complicated eye cases, has also opened a hospital in Kigali at a cost of more than $6 million. The hospital handles retina surgery, hi-tech cataract surgery, glaucoma, paediatric ophthalmology and corneal transplantation.

John Nkurikiye, the local partner for Agarwal, said that even though the hospital is targeting patients from across the region, its priority is to remove the need for referrals for eye treatment outside Rwanda.

“The highest number of patients are from Rwanda,” said Dr Nkurikiye, the only Rwandan ophthalmology specialist.

Competition

While medical tourism has long been the preserve of a few countries in Africa, in particular South Africa, new research shows that Kenya and Rwanda are catching up.

The two countries are competing to become the regional hub for medical tourism, according to a new analysis from Frost & Sullivan.

The health research firm said that a diverse set of forces, including favourable economic factors, a supportive regulatory environment, and a high disease burden will make Kenya and Rwanda among the most attractive countries in East Africa for medical tourism.

“The consolidation of the rising middle class and heightened healthcare awareness will drive up per capita healthcare expenditure and provide lucrative opportunities within these markets,” said the report.

Healthcare systems development in the two countries is regarded as the driving force behind the influx of foreign patients into the two countries.

Medical tourism is regarded as the fourth-most attractive investment sector in Africa.

As the East African economies continue to grow and the population earns more disposable income and can afford better healthcare, the demand for specialised services is expected to increase.

Kenya has been positioning itself in recent years as a medical hub by marketing its specialised medical services in East African countries. The country expects to treat more than 2,000 patients a month this year from the other East African countries, up from 1,300 patients received per month last year.

The majority of these patients come from Burundi, Rwanda, Tanzania, Uganda and some from as far away as Zambia, Malawi and DR Congo. They go to seek medical services such as in vitro fertilisation (IVF), open heart surgery, cancer treatment, kidney transplants, and neurological disorders and diagnostics services.

According to Stephen Masinde, director of A&K Global Health, a medical tourism company in Kenya, firms are now taking their services to patients in their home countries.

Rwanda has been revamping its healthcare by investing the social infrastructure and human resources, which has made it a global reference point for quality health care. The country is currently in the process of privatising King Faisal Hospital — its biggest referral hospital — as it seeks to make it a regional referral hospital for patients from Burundi, DR Congo and other countries in Central Africa.

It is also investing over Rwf1.8 billion ($2.6 million) in upgrading the operations of the Rwanda Military Hospital to include a luxurious VIP wing.

In March last year, the Rwanda Military Hospital signed an MoU with Memorial Health Care Group, an international hospital chain based in Turkey, in a bid to improve the quality of its specialised services. Under the deal, the Turkish hospital chain will provide specialist consultation services, train medical personnel, assist in research and conduct clinical lectures. It will also conduct medical speciality clinics in transplant surgery, cardiology, oncology, orthopaedics, nephrology, neurosurgery and paediatric cardiology.

“We are seeing an increase in non-communicable diseases, which require specialised care and treatment,” said Nathan Mugume, the head of division, Health Communication Centre at Rwanda Biomedical Centre.

Rwanda is also working on providing uniform, quality and affordable healthcare.

“Thirteen tertiary hospitals will be evenly distributed across the country. There will also be one teaching hospital in each province acting as a centre of excellence,” said Mr Mugume.

The country has also ventured into research, becoming the first African country to host trials of PrePex, a non-surgical method of circumcision that has now been approved by World Health Organisation. PrePex has since been rolled out in Uganda, Kenya, Zimbabwe, Botswana, Mozambique, South Africa, Malawi, Swaziland and Zambia.

Amit Thakker, the chief executive director of the Kenya Healthcare Federation, said Rwanda has developed a strategy for positioning itself as the next medical tourism destination by embarking on renovation and expansion of its already existing hospitals as part of efforts to make their services world class.

The country has also been recognised by international health organisations like WHO for its sharp becoming a model of quality healthcare delivery and its sharp reduction in maternal and infant mortality rates. “This makes it a trusted destination in the region for foreign patients,” said Dr Thakker.

However the Frost and Sullivan analysis shows that the lack of skilled resources — as reflected by the low health worker density of 0.84 per 1,000 people in Rwanda and 1.3 per 1,000 people in Kenya — as well as inadequate infrastructure; the need for capital investment, and high construction costs hamper the availability of specialised care and high-end technologies in both countries.

Shortage of skilled workers

To address the shortage of health professionals, Rwanda has rolled out Human Resource for Health, a seven-year annual exchange programme, under which medical professionals share knowledge and skills.

Introduced in 2012, the HRH programme will train over 550 medical specialists, upgrade the skills of over 5,000 nurses and introduce formalised training in health management and dentistry.

“A greater level of investment in infrastructure and the latest technologies, along with the ability to attract skilled healthcare personnel, will be vital for market success,” said Frost & Sullivan healthcare research analyst Saravanan Thangaraj, adding, “Kenya and Rwanda are therefore focusing on the development of these areas. Both countries, however, are relying on external funding to boost the development of the healthcare sector.”

The report also says that as the two countries compete to become East Africa’s medical tourism hub, they will see enhanced interest from private-sector participants interested in constructing hospitals.

“To expedite the development of the healthcare industry, providers must digitise their services and adopt technologies such as e-health, m-health and telemedicine by leveraging on the improved ICT infrastructure and mobile penetration rates, which stood at 74 per cent in Kenya and 73 per cent in Rwanda in 2013,” says the report.

Medical tourism in Kenya is a relatively new but growing industry. The sector is now valued at $100 billion globally. Medical tourism occurs when patients choose to travel abroad with the intention of receiving some form of medical treatment.

India is still the preferred medical destination for most Africans due to affordability and quality of their service. According to statistics, India received 1.1 million medical tourists between 2009 and 2012, earning the country $2.4 billion. Up to 100,000 people go to India for medical treatment from East Africa every year and the number is increasing by four per cent annually.

READ: East Africa loses $150 million annually in treatment abroad

“India is cheaper in terms of cost because it has many specialists. Because of its large population, the doctors gain experience by conducting many procedures and are capable of handling more complicated cases,” said Dr Thakker.

“A hospital in India, for example, can conduct up to 32 open heart surgeries in a day, while in Kenya maybe one heart surgery is done in the private hospitals in a day and one a week in public hospitals,” he added.

Dr Thakker said that in order to grow medical tourism faster, bilateral agreements between governments are needed so that bureaucracy does not stall efforts to make the bloc a regional medical hub.

“India’s case is an example of partnerships that have helped to build a robust health sector, making it one of the most globally competitive medical travel destinations,” he said.

Analysts say that medical tourism is one of the fastest growing industries in the EAC region, expanding by almost 15 per cent, or $60 billion annually.