Edited by Ronald Labonté, Vivien Runnels, Corinne Packer and Raywat Deonandan (University of Ottawa). Imagine leaving your own country to buy a surgery or an organ or even a pregnancy. The personal enormity of such actions seems at odds with the frivolous term used to describe them: medical tourism. Whatever one calls them, though, these things are occurring, often to the accompaniment of whispered rumours or blaring journalism.
Travelling Well: Essays in Medical Tourism, a new electronic publication from the Institute of Population Health at the University of Ottawa, attempts to demythologize these stories, to attach muscular facts to a skeleton of gossip and sensationalism. A collection of pieces by scholars from a variety of disciplines, Travelling Well tackles the “who,” “where” and “why” of medical tourism.
Travelling Well’s real purpose is to describe the “how much,” in both quantitative and qualitative senses. Although several authors acknowledge that this description, hampered by the quality of existing data, is incomplete, the picture that emerges is impressively vast. Medical tourism is a multibillion dollar industry that continues to grow. It involves not only the tourists themselves, but the health care professionals who provide services, the companies that employ them, the brokers who make arrangements and the governments that permit (or encourage) it all. And don’t forget those citizens of the destination countries who might provide an organ or a uterus for a price. Travelling Well ambitiously, but successfully, reports the scale of it all, in economic and human terms.
Primarily a descriptive work, Travelling Well gives little attention to what might be medical tourism’s most important question: So what? What are the ultimate effects of medical tourism? Who stands to benefit and who can be harmed? These are complex questions that can be interpreted variously as inquiries about health care, economics, social justice or ethics.
Some of these issues, such as the “internal brain drain” that might result when a developing country devotes scarce resources to visiting medical tourists, are mentioned on occasion, but rarely addressed in depth. A chapter by Raywat Deonandan from the University of Ottawa gets its hands dirty with the ethical bramble of reproductive tourism, and tantalizes the reader with its engaging discussion. However, such discussions might be considered to belong to a different publication.
A discussion of the history of medical tourism would have been appropriate to include. It would seem unwise to think about the future trajectory of this phenomenon without understanding its past. This discussion is largely absent, beyond mention of Middle Eastern oil sheiks who travelled to the United Kingdom for state-of-the-art care that they had not yet financed in their own countries, and the origins of medical tourism remain mythologically obscure.
This important omission aside, Travelling Well is an interesting read that challenges its audience: this is what medical tourism is, now what do we think about it?