Medical Tourism Market Report 2009

The high-growth medical tourism industry is estimated at US$100 billion by the year 2012. This is propelled by globalization and the increasing healthcare costs in developed countries, including USA. By then 500,000 Americans are expected to travel abroad for healthcare. These millions of medical tourists will travel to more than 30 countries in Asia, Eastern Europe, Central America and Africa.

In Asia the most popular destinations are Singapore, India, Thailand, Malaysia and the Philippines. Thailand is reputable for cosmetic surgery especially medical tourists from Western Europe. Singapore attracts mainly medical tourists seeking for more complex procedures and world-class healthcare facilities and quality. India is another option and has a lower cost advantage.

The numbers of medical travelers to Singapore has declined because of the economic downturn. The sharpest decline is from Indonesia but this is compensated by more patients arriving from the Middle-East, Vietnam and Russia. The private hospitals are affected most and may continue to see declining medical tourists. Other countries offering medical services are also getting fewer patients.

The medical tourism industry in Thailand is still robust and is a very popular destination for tourists in general. Its medical costs are lower than Singapore and about one-fifth the cost of USA.

Malaysia is fast catching up with its neighbours and the government is promoting medical tourism aggressively. Among other measures, it has extended the visa period for medical tourists to 6 months from just one month. It is now attracting more medical tourists from Vietnam and Cambodia.

India is one of the first few countries in Asia to promote medical tourism and remain a sought-after destination for low cost and high quality healthcare services. Its cardiovascular and orthopaedic procedures are about one-tenth the cost of similar surgeries in the US.

Taiwan offers high quality and competitively priced healthcare services but is not as aggressive in promoting it. Its main target market is China, which makes sense as its culture and language are similar.

Korea has set a target of 100,000 international patients by 2012 and is actively promoting it as a medical tourism destination.

Which Asian country will lead in this fast growing medical tourism industry will depend not just on cost, quality and reputation. Other factors include ease of travel, communication, infrastructure, and the people that will make it a complete package.

Every year about 200,000 patients in the United States need a new heart valve because they have severe aortic stenosis. This is a condition in which the aortic valve starts to narrow and affect the efficient flow of blood from the heart to the other parts of the body. This can lead to congestive heart failure and sudden death.

Open-heart surgery is a very common procedure for such heart patients. However for some who are too old, too sick or may have had chest surgery before, this is not the option.

A less invasive procedure is now available for these patients. The doctor has to mount a valve on a catheter and then insert it into the patient’s groin or chest and thread it towards the heart.


This technique does not require stopping the heart and placing the patient on a heart-lung bypass machine, so weaker or sicker patients can endure the procedure. Without valve replacement, the life expectancy of patients with severe aortic stenosis is typically less than five years.

This two-hour procedure to replace the damaged aortic valve with a ‘stent-supported valve’ was pioneered in France in 2002.  In February 2009, Singapore became the first country in Asia to perform it.

Since then, five elderly patients have undergone this procedure at the Singapore General Hospital’s National Heart Centre. This treatment is recommended only to patients who have no other options or who are suffering from narrowed-valve symptoms like chest pain and breathlessness.

This procedure is still relatively new and how long the valve will last and the long term effects are still unknown. Comparatively the synthetic valves used in conventional open-heart surgery lasts 10 to 20 years.  For this reason, the hospital is not promoting the procedure to younger patients and those who are eligible for standard surgery.

There are also risk factors and a patient undergoing such procedure can die from a punctured blood vessel.

The success rates for this transcatheter technique in USA and Europe have been reported to be 90%.

The conventional valve costs about US$3000 while the new valve is almost 10 times more, though this is expected to be reduced in time.

With an ageing population in Singapore, the heart centre expects to treat an increasing number of patients with valve problems.

Singapore Health Partners Mediplex

Singapore Health Partners Mediplex

One of the things I worry about when a foreign patient comes to town is accommodation.

Singapore offers a wide variety of accommodation types to suit different budgets, needs and preferences. These range from budget and boutique hotels, to 6 stars hotels and fully furnished serviced apartments in good locations.

Despite these choices, it is sometimes a challenge to find the right combination that pleases a fussy patient.

However this problem may be alleviated when a new integrated hospital complex is scheduled for completion towards the end of 2010.

This 19 storey Mediplex comprises a medical centre with specialist suites, hospital, and a hotel. This concept is believed to be the first in Asia and the objective is to capture a big slice of the estimated S$100 billion medical tourism market.

The medical centre has 189 consultation suites to house a wide spectrum of medical specialists. The hospital next door has 11 operating theatres, three day surgery units with 60 attached beds, an intensive care unit with 23 beds, radiotherapy unit, clinical laboratories and a full-service pharmacy.

Connected to the hospital is the hotel and guests have a choice of standard hotel rooms, serviced apartments and villas. All accommodations feature large bathrooms with rain showers, bay windows presenting floor to ceiling view.

The hotel is designed to offer a lush tropical garden ambience, with large spas, gymnasiums, six pools, ballroom, banquet hall, seminar and conference rooms, and a floor dedicated to retail food and beverage outlets.

A patient can check into the hotel in the morning and walks over to the medical centre to consult the doctor. Then he goes for lunch in one of the many restaurants and proceed to do some investigative tests in the afternoon. He returns to the hotel a few steps away, do some window shopping in the evening follow by a good massage in the spa. The next day he goes to the hospital next door for surgery and returns to the hotel to recuperate. All these activities are done in the same medical complex without leaving the building.

Family members and companions can stay in the same hotel, and enjoy the comfort and convenience of world-class facilities and at the same time provide emotional and physical support to the patient. This is healthcare and wellness at its best.

I am eagerly looking forward to the pleasure of showing this new integrated medical complex to my next patient.

Going Bananas


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I like to watch tennis matches on TV especially the grand slam series. Running under the hot sun for hours at high speed require a lot of energy and stamina. So during the breaks players would replenish their bodies with fluids and sometimes bananas.

Why bananas and not other fruits? There are many reasons. Banana is easy to peel and eat and provide a quick boost of energy. Depending on the type and size of the banana, it typically contain 110 calories, 3 natural sugars (glucose, fructose and sucrose), about 6 vitamins, and 11 minerals. It is a good source of potassium and fiber and has no fat and cholesterol.

Bananas have many health benefits

Bananas have many health benefits

I love to eat banana and there are so many ways to prepare and consume it. Banana can be made into cake, bread, pie, sauce, ketchup, pudding, chips, yogurt, and beer, among many others. You can freeze it, deep-fry it, steam it, squeeze it into juice, split it and serve with ice-cream, slice and put it in a sandwich, or cut it up and mix it in a salad bowl. For me, eating it on its own at 90% ripeness is a super treat.

Banana has a long list of health benefits, some of which are:

1.   Ease Constipation: its high fiber content helps digestive tract and bowel movement

2.   Diarrhea: the potassium replaces the lost electrolytes

3.   Anemia: the iron helps to replenish the red blood cells

4.   Healthy bones: bananas contain a complex sugar compound that nourishes good bacteria in the colon. This good bacteria produce enzymes which help digestion and in the process increase the absorption of calcium

5.   Prevent High blood pressure: its high potassium and low sodium ratio helps prevent high blood pressure and stroke

6.   Help reduce Ulcers: bananas stimulate the cells on the internal stomach lining to produce a thick mucus protecting it against acid; it contain enzyme inhibitors that get rid of bacteria in the stomach that cause ulcers.

7.   Reduce Depression: bananas contain an amino acid that can be converted to serotonin and help reduce depression.

8. Relief Stress: when a person is highly stressed, his potassium level will deplete quickly. Eating bananas, which is high in potassium, will restore the level and provide a good balance in the body.

9. Reduce Heartburn: bananas help to prevent the build-up of acids in the stomach and provide relief for people suffering from heartburn.

10. Reduce Morning Sickness: bananas help keep the blood-sugar level up and reduce morning sickness.

11. Help to quit Smoking: bananas contain vitamins B6, B12, potassium and magnesium that can help a person trying to quit smoking to recover from nicotine withdrawal.

12. Anti-Cancer quality: a fully ripe banana produces a substance known as TNF that can fight abnormal cells. Dark spots will appear on the skin of the banana as it ripens. The more dark spots it has the better its fighting ability and anti-cancer quality.

In researches conducted in Japan using animals, the health benefits of various fruits were compared. The fruits include banana, apple, pear, pineapple, persimmon, grape, and water melon. Banana came out top. Eating bananas produced the anti-cancer substance TNF, increased the white blood cells count, and improved the immunity of the body.

So eat a banana a day and keep the doctors away. Care to join me?

Who is more overweight: men or women ?

Who is more overweight: men or women?

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No one can say for sure whether men are fatter or more overweight than women.

Men and women gain weight differently when exposed to different conditions.

There is a link between gender and weight gain. Men burn off more calories than women, and therefore gain weight slower. Biologically women have a higher average body fat content compared with men. During pregnancy, women tend to gain weight to provide sufficient nourishment for the growing baby.

Men and women grow fat in different parts of their bodies. For women it is normally at the hips and thighs and for men, more often than not, their pot bellies.

So men look more like “apples” and women like “pears”.

Most doctors agree this is due to a number of factors, including genetics, hormonal differences, body-fat distribution as well as the environment.

Men and women gain weight very differently when they are exposed to stressful situations. Researchers found that women gain weight when they have problems with finances, rigid job routines, and strained family relationships.

On the other hand, men gain weight mainly in response to work related problems and stress.

According to scientific research, men and women also have different eating habits and preferences. In general, men prefer eating meat and poultry while women are more likely to eat fruits and vegetables. Men view food as a matter of enjoyment whereas women tend to be more concerned about their health and seek nutritional advice.

A new study by the Centre for Medical Education at McGill University in Montreal found that women eat more when they eat with a large group of female friends.

However, when they eat with a smaller group of female friends, or dine with men, they eat

less. This may be due to social conditioning. Women who eat less and who are thin are viewed as more feminine and attractive.

Whether you are a man or woman, you should learn to manage your weight. Here are some tips:

  • Be aware of the stressors in your life and manage them.
  • Exercise regularly
  • Adopt a routine of deep breathing, meditation, or yoga.
  • Eat a balanced, healthy diet and include fruits and vegetables.
  • Get enough sleep; I would recommend at least 7 hours.
  • Replace salty food with herbs and spices to enhance the taste.
  • Reduce intake of fat, oil, salt and sugar
  • For those with bad appetite, try eating small but frequent meals
  • Take high-quality multivitamin, especially vitamin B, C and D each day.
  • Avoid or minimize alcohol

If you are obese and know how to overcome it  or have tips on healthy living, please share them with us.

HERBS can help heal and prevent ULCERS.

HERBS can help heal and prevent ULCERS.


In America, about 500,000 people are diagnosed with ulcers problems every year

There are many types of ulcers that can be found in our body, and the most common is peptic ulcers.

Peptic ulcers are found in the lining of our stomach or upper small intestine (duodenum).

Ulcers develop when the intestine or stomach’s protective layer is broken down. When this happens, digestive juices can damage the stomach or intestine tissue and even the esophagus, the tube that connects our throat to our stomach.

However we don’t have to live with this problem as most ulcers can be treated, and symptoms go away quickly.

Common symptoms include:

  • A burning and aching, persistent pain between the breastbone and the navel. Some people also experience back pain. The pain can last from a few minutes to a few hours and may come and go for weeks or months.
  • Feeling of bloating after meals.
  • Nausea and Vomiting.
  • Loss of weight and appetite.

Different people have different symptoms, and some have no symptoms at all.

Treatment of ulcers include antibiotics, drugs and in serious cases, surgery.

For people who prefer a more natural alternative, herbs could be the answer.

Herbs can help in healing and prevention of ulcers.

There is a wealth of fauna and flora on our planet earth and many plant species possess exceptional medicinal properties!

Herbs that Help Heal Ulcers

  • Aloe vera: Soothing and anti-inflammatory
  • Astragalus: root of the Astragalus membranaceus plant used traditionally to treat ulcers
  • Oregon grape and barberry: Contain berberines, which have been shown to inhibit bacterial growth.
  • Cranberry: help prevent colonization and infection
  • Turmeric : Used by Chinese and Ayurvedic physicians to treat gastrointestinal disorders; may decrease acid production in the stomach. However, high doses can actually damage the stomach lining
  • Green arugula, or Eruca sativa: may also contain a number of antioxidants, which may help protect stomach cells from damage
  • Licorice root: soothes and coats the stomach lining; also increases gastric circulation and mucus production. Deglycyrrhizinated licorice (DGL) is recommended, as the native root causes fluid retention and hypertension
  • Cat’s claw (a woody vine): Decreases inflammation at ulcer sites
  • Slippery elm: the inner bark of a plant, high in mucilage content; thought to coat the stomach lining
  • Marshmallow : Another demulcent that help relieve pain and inflammation
  • Cabbage juice: High in glutamine, which has been shown to help heal ulcers;
  • Rhubarb: Rich in flavonoids, which may inhibit the growth of H. pylori, a type of bacteria
  • Dong quai (Angelica sinensis): Used for thousands of years in traditional Chinese, Korean and Japanese medicine
  • Chamomile, calendula, cinnamon, agrimony, Indian basil, ginger, and capsaicin (found in hot peppers) have all been used in various ulcer formulations


No one single simple herbal treatment may heal ulcers, because the underlying causes of gastrointestinal problems are complex.

Herbs may interact with prescription drugs and can cause side effects for some people.  Only use herbs under the care of an herbalist, and inform your doctor of herbs that you are taking before a new prescription of medicine is given.

Pregnant women should avoid certain herbs commonly used to treat an ulcer. Check with a herbalist about safety and suitability.

Lifestyle modifications that help heal Ulcers

  • Stop drinking alcohol which can inflame the stomach lining
  • Consume a diet rich in fiber, especially fruits and vegetables that are high in flavonoids
  • Consume 500 to 1000 mg of vitamin C everyday. Vitamin C appears to inhibit H. pylori’s growth in some people
  • Add probiotics (e.g., Lactobacillus, Bifidobacterium) to your diet. These are live organisms commonly found in yogurt, cheese, wine and fermented food
  • Reduce intake of coffee and carbonated drinks. Even when decaffeinated, these beverages can increase stomach acid production
  • If you regularly take NSAIDs (aspirin, ibuprofen, naproxen, etc.) discuss other options with your doctor
  • Stop smoking. Nicotine is extremely irritating to the stomach lining, and its use increases ulcer risk, slows ulcer healing, and increases recurrence rates
  • Manage and try to reduce your stress level.

Peptic ulcer disease is a common medical condition. Besides causing discomfort and inconvenience, its complications can seriously impair one’s quality of life. However herbs can be a good alternative to standard treatment regimens. If you wish to add herbal supplements to their medical treatment it is advisable to first consult your herbalist and doctor.

If you have any interesting stories or experiences in herbal treatment, you are welcome to share them with our readers. I would be pleased to hear your comments.

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Stem Cells solution for bigger breast

Stem Cells solution for bigger breast

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Breast augmentation procedures are on the rise. In USA alone, more than 350,000 women have their breast enlarged each year. In Britain about 30,000 women underwent cosmetic breast enlargement last year.

A new type of breast augmentation is now being tested at the London Breast Institute in the United Kingdom. It uses stem cells from the extra fat in a woman’s stomach or thighs and implanting them into the bust.

Half of the extracted fat is treated to separate out the stem cells. These stem cells are then added back into the rest of the fat and injected over time into the breast tissue to increase their volume

Unlike regular cells, stem cells are able to self-renew and regenerate tissue. Breast augmentation using stem cells provide a more natural feel and look than conventional implants because they are made of the body’s own cells and tissues rather than foreign implants such as silicone and saline.

The trial is currently used to repair the breasts of women who have had cancerous lumps removed. Soon healthy women seeking breast enlargement will start to use this new technique.

This stem cell therapy could boost breast size by at least a cup and at the same time reduce fat in the stomach and thighs. This is “killing two birds with one stone”. The cost for this procedure is estimated to be about US$13,000.

This treatment offers considerable improvement over conventional cosmetic surgery using implants, which may leak, cause scarring and require replacement.

Although this technique enlarges the breast, the increase in size is modest and it will not provide firmness and uplift. Research is currently being done to see if bigger augmentation is possible.

This technique is in fact not new. In the year 2004, Dr. Kotaro Yoshimura, a surgeon at Tokyo University Medical School founded this same technique and had treated 39 patients with no major problems.  It was used initially to treat women with breast deformities caused by cancer treatments and more recently, for cosmetic breast augmentation in healthy women. It is not available in USA and is currently under medical review. It is legal in the EU and trials on about 30 women are expected to take place around the middle of 2009 at the London Breast Institute.

The use of this technique for cosmetic surgery on healthy women is controversial. Medical bodies have argued that this technique should not be offered to healthy women until large-scale trials in cancer patients are proven safe and effective.

So women all over the world, stay tuned.

If you have any comments or stories to share, you are welcome to do so.

The Secrets of Ageing

The Secrets of Ageing

Many years ago I watched a very captivating movie entitled “Lost Horizon”.

I remember vividly the beautiful scenes of a paradise called Shangri-La, where the inhabitants live in peace and tranquility, enjoy fresh air, clean water, and bountiful farms.

The most intriguing thing was, the people there hardly grew old !

How nice it would be if one can find the formula to immortality. The world’s top pharmaceutical companies will pay you millions of dollars to buy the formula.

Healthcare agencies all over the world would want you to work for them, at all costs.

In reality this is only a dream. In fact ageing-related problems are creating nightmares for many people, while medical professionals are researching for solutions and breakthroughs.

Scientists in Singapore have recently made an age-defying discovery ! They have discovered that the ageing process in certain organs in mice, such as the pancreas, liver and spleen, can be delayed by deactivating a molecule.

They found that the ageing process in the pancreas of the mice with the molecule deactivated  slowed down, compared with that of the wild mice.

The team of nine researchers have studied this for five years and found that the pancreas in a two-year-old mouse in which the molecule had been deactivated functioned like that of a three-month-old mouse. In human terms this roughly equates to a 60-year-old man having the pancreas of a 20-year-old man.

This means that diseases such as Type 2 diabetes can be controlled by inhibiting the molecule through medicine to prevent ageing in certain organs. It would take at least two years to find a treatment as more research is needed on humans.

A second team from the same agency in Singapore, Agency for Science, Technology and Research (A’Star), is also working to unlock the secrets of normal ageing.

Dr Alan Colman, a stem-cell specialist from the agency has been studying Progeria, a very rare genetic condition, wherein symptoms resembling aspects of ageing are manifested at an early age. This premature ageing lead to heart problems, hardened arteries, and hair loss.

By manipulating Progeria patients’ skin cells to revert to stem cells, Dr Colman and his team hope to find out how the genetic condition affects the production of a mutant protein called progerin in these cells. Progerin is also found in healthy individuals as they age.

Dr Colman said at a recent symposium that it was a worthwhile study to see whether similarities existed between the rare disease and the normal ageing process.

In another separate study, scientists from Swedish medical university Karolinska Institutet claimed to have identified the cause of premature ageing. They have linked the normal ageing process to problems with cell respiration. This is the process in which cells extract energy from the nutrients. The study showed that certain proteins become unstable and disintegrate, which in turn can impair cell respiration and cause premature ageing.

These cell respiration problems  affect the normal ageing process and may lead to many medical conditions, including diabetes, cancer, Parkinson’s and genetic diseases.

What causes ageing ? This is a mystery and no one knows for sure. However people are living longer because of better healthcare, improved living environment, availability of quality and cleaner food.

Scientists may soon unravel the secrets to ageing and the solutions to prevent it.

Will we find our Shangri-La ? Is this a good thing ? Will this lead to social, ethical and other problems ?

Your comments are welcome.

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