Uplifting words have prophetic and catalytic empowerment; sayer beware

We need about 10,000 or more of us to indeed find time to read and write about Africa. We need that critical narrative by Africans about Africa and the World. Sometimes I wonder if the term "poor" has not corrupted some of us into complacency. Uplifting words have prophetic and catalytic empowerment. 

While in Uganda, I mostly worked in the regional health districts, urban areas, on the big islands, rural areas and in emergency situations like the two Ebola episodes we had. I saw more pyrexia of unknown origin, idiopathic, neurological, trauma, mental health, physiotherapy and psychological cases that went unaddressed. It is no wonder that many patients see our hospitals or clinics as "death destinations that need not be embarked upon." 

Medicalizing medicine and the practicing of medicine in Uganda (perhaps in Africa too) have created power structures. I have closely followed African country-based health outputs as far as the Millennium Development Goals/Sustainable Development Goals go. I have written comparison reports and shared with people from other continents. 

I am a member of the International AIDS Society and Africa AIDS Society. In those capacities, it is my opinion that integration is the way to go. A change of mindset was due by 1970. This means we have to redefine our sense of health by imagining a spectrum. At one extreme, we should have any parameter defining a condition e.g., maternal mortality. At another end we can have wellness measures such as how many people are able to afford full antimalarials; have shuttered (with good ventilation, windows and doors) homes; can afford to control or avoid mosquito bites and other aspects. 

Health is so immediate a context and we need to define the good and problematic parameters equally if we are to talk of progress. It comes as no surprise when it stirs different emotions and criticisms. Who wouldn't want want first class care?  We need to combine the medical and social aspects, evidence-based medicine and contextualize the belief models experienced by Africans. Hospitals or clinics should not be shaming spaces for patients who want to take the after-birth back with them and place it at a sacred place in their home gardens. We should look into the patterns of African empathy and how these add to the numbers of people who visit loved one in the hospitals. We should use statistical reports to predict trends in demand and supply. We can motivate health workers through provision of better work conditions, task shifting and proper housing. We may have solutions to overcrowding, drug stock-outs and absenteeism. 

Lastly, I still think in place of words like "poor" or "backward," we can actually borrow from social science research or theories and contextualize African situations in a more proactive way with a goal of upliftment. I posit the following adjectival epithet: "low resource context countries" instead of "poor." Thanks for adding a narration to what matters in Africa and other low resource context countries.

Text-book America, Hollywood America meets Street Level America; An African Immigrant’s Testimony

Five years gone by, it seems like yesterday. It was a hot July with the sun’s dancing beams reflecting fiercely off plane fuselages, that I landed at Washington DC’s Dulles Airport. I reminisce about that day. I also reminisce about the firsts, the onlys, the forevers and the lasts. It was my first time in Washington DC; it was the first time I was scared to leave my own apartment on Michigan Avenue right in the middle of Washington DC for fear of getting lost; it was the only time when I made up my mind to experience what it means to actually get lost; it was a gamble I never regret. Truly, I got lost! I missed my stop and ended up in Baltimore. 

It is at Baltimore Union Square that I met an officer who gave me the right directions. This person, also told me he had served as a Marine, part of a Corps that served in Uganda! imagine my reaction to this revelation. My take back home is that there is always “The Quiet American.” You guessed right, I am fixated to Graham Greene novels. This fixation will be the subject of another blog. But, suffice it to say that an Irish-Ugandan educator (whom we grew up calling our 'white' daddy, because he was initiated by my father into our clan) taught me how to read these kinds of books. 

Where was I? 

Ah! Yes, I managed to get my way back to my apartment and as if a veil had lifted I immediately started figuring out streets, addresses and where to pick up a cab, bus or train. I have since traveled to different American cities (Chicago, Minneapolis, Boston, Los Angeles, Berkeley, Oakland…) and I am comfortable in all of them. Last week I got a friend, who was visiting from Los Angeles, on a train. We traveled to three cities in the Bay Area in Northern California i.e., Dublin, Richmond and Pleasanton. 

As we were travelling we shared on what it meant to be New Americans from Africa. We touched on many things Africa has given to the world yet they are unsung. We decried the seeming tendency for African leaders to miss in the action. But, we also cautioned ourselves from taking the long view when we were actually comfortable in the arms of America and did not really know what was on the ground in Africa. 


It was this latter remark that made me reflect about my own life as events raced like a film running in fast-forward review. I also noticed the three long haired young girls speaking animatedly with three other boys. All were in their late teens or late tweens. I caught parts of their conversations and heard  “………Kamusta……….Salamat…………nognog.” This last one must have peeked my ears. When I next heard it,  I immediately looked at the three boys for reaction.

None showed any outward sign of reprehension or bitterness. In fact they also spoke fluently in Tagalog (a major language in the Philippines). I later knew that they were children of US Army officers stationed in the Philippines and were in the U.S. on vacation.  Behind our seat were four pairs of mixed white, Asian and black couples who it was clear were long time friends. They had tagged luggage and perhaps were so tired after a long flight. They were  coming from the San Francisco Airport and I imagined they were looking forward to one, two, three days of sleep. May be. 

I caught parts of what they were saying: “…………I’m going to say this right off the bat………………….I will bite the bullet and be your first……………………..home stretch….…”  This reminded me of the subtleties that textbooks on America don’t say about American people. Hollywood only paints a picture of villains vanquished by the good. 

In Hollywood films about America, the homes are big, food is aplenty, workers come back home after a hard day’s work and watch TV. The streets are well swept, the grass islands are well manicured, shopping malls fill up with shoppers and the address signs are all in place. 

But…….the tossed salad version is different. The street level America calls for reaching out and negotiate how to share space with others. It means noticing nuances.  One has to have appropriate intercultural competences or learn them very fast. The expectations of one’s task role or relational role behaviors must be spot on. Text books nor Hollywood can teach these unless one gets to interface with Americans blunders, sorry's and thank you's to boot.

Religion and Personal Culture influence the way I relate and communicate with other people

As a practicing Roman Catholic, I have had the chance to follow Pope Francis from the day he ascended to Papacy and I embraced his philosophy of: making opportunities available even to those were previously shunned.The Pope says that we should walk together and that we should not exclude anyone (Maike Hickson. 2016). I respected the Pope when he realized that he was not going to make impacting change within the Roman Catholic Church if he himself could not sacrifice or do away with some of the cultures of the Church that are a show off of splendid regalia bedecked with gold but impotent in feeding the hungry or housing the homeless. The Roman Catholic religion played a key role in education, invention, art, architecture and socialism. However, as an institution it is also looked upon, copied as well as vilified by many. The Pope and the way he has dealt with criticism is what fascinates me. His mature approach and readiness to face issues as they present themselves is what I am going to write about. Examples that come to mind include: the hosting of the Syrian refugees who saw themselves as moslems first and humans second. Yet, the Pope saw human beings with needs like any other and provided them opportunities for a shelter at Sant’Egidio (Paula Cocozza. 2016). Having lunch at the Casa Santa Marta, the hotel on Vatican grounds where Francis resides with 21 Syrian refugees (Crux Staff. 2016) is another example. The present crises of displacement, environmental catastrophes, famine, wars and poverty are some of the issues the Pope is tackling. His pronouncements on issues like Climate change have galvanized many  to do something. Pope Francis’s  in his encyclical on ecology, Laudato Si, says that climate change is real and mainly “a result of human activity” (Pope Francis Encyclical and Climate Change). As far as world views go, the traditional Catholic teaching on marriage and the family has reared its head again with many questions are being raised around it. Can remarried divorcees be married in two valid marriages at the same time? The Amoris Laetitia, is a letter the Pope wrote in which he explained why the Church should let divorced but remarried Roman Catholics play major roles in the Church. It is claimed that the letter leaves open the answer to this crucial question that it itself has provoked. The letter points out Non-sacramental, natural marriage can also be, in the eyes of the Church, a valid marriage, for example in the case of a mixed marriage. This has brought about a rift even far deeper than that caused when the Pope mentioned homosexuality in the same breath with forgiving. Many feel a betrayal and that the pope may be personally virtuous, but he is naive and a wicked antipope carrying on in positions of authority and influence (akaCatholic). Others, have taken a go slow approach that allows the Pope to make decisions as the Spiritual Head of the Roman Catholic Church (Maike Hickson.2016). Pope Francis affirms mercy and love. He said that unity is created on the move because unity is a grace we need to ask for. The Gospel shifts the axis of Christianity away from a certain kind of legalism which can be ideological, towards the Person of God, who became mercy through the incarnation of the Son (Pope Francis). The burning issues that are sure to have impact on a world view are: position of the Pope on his apostolic exhortation on the family, “Amoris Laetitia”; church’s ban on communion for divorced Catholics in new (and adulterous) marriages; and church’s traditional opposition to situation ethics (Ross Douthat. 2016). Religion has influenced the way I position myself and my spirituality. Religion improved on my culture positions and it affirmed my work ethics and relationships with other people. Because I believe relationships are a means of communication, I dare say  the synergy of my personal culture and religion influence the way I relate and communicate with other people.

References:

akaCatholic. BREAKING: Francis responds to the dubia. Retrieved from: https://akacatholic.com/breaking-francis-responds-to-the-dubia/. Retrieved on November 29th 2016.

Paula Cocozza. 2016. What happened to the 12 Syrian refugees rescued by the pope? Retrieved from: https://www.theguardian.com/world/2016/may/25/what-happened-pope-francis-syrian-refugees-rescued-lesbos-vatican-rome. Retrieved on November 29th 2016.

Crux Staff. 2016. Pope has lunch with Syrian refugees he brought to Rome. Retrieved from: https://cruxnow.com/vatican/2016/08/11/pope-lunch-syrian-refugees-brought-rome/. Retrieved on November 29th 2016.

Maike Hickson. 2016. Confusion, Conflict, and Chaos Increase in the Wake of the Dubia. Retrieved from: http://www.onepeterfive.com/confusion-conflict-and-chaos-increase-in-the-wake-of-the-dubia/. Retrieved on November 29th 2016.

Maike Hickson. 2016. Cardinal Hummes: On the Dubia, “The Whole College of Cardinals is With” the Pope. Retrieved from: http://www.onepeterfive.com/cardinal-hummes-on-the-dubia-the-whole-college-of-cardinals-is-with-the-pope/. Retrieved on November 29th 2016.

Pope Francis. La Stampa. Francis:“The Church is not a football team in search of fans”. Retrieved from: http://www.lastampa.it/2016/11/18/vaticaninsider/eng/inquiries-and-interviews/francisthe-church-is-not-a-football-team-in-search-of-fans-lyrmN8s0Uu3zpMsmG730VO/pagina.html. Retrieved on November 29th 2016. 

Pope Francis Encyclical and Climate Change.Retrieved from: http://www.catholicclimatecovenant.org/encyclical. Retrieved on November 29th 2016.  

Ross Douthat. 2016. His Holiness Declines to Answer. Retrieved from: http://www.nytimes.com/2016/11/26/opinion/sunday/his-holiness-declines-to-answer.html?_r=0. Retrieved on November 29th 2016. 

My personal culture informs my communication choices

My story is one of an immigrant and I kindly ask you to look at it from that lens. For me communication is not only verbal but also how one meshes or embeds in another culture. It is a deliberate negotiation in relation to one’s ethnic identity. It is a move toward engaging in cultural allegiances. It is an ongoing education that allows one to break into newer patterns of life (Tywoniak, F. E., & García, M. T. 2000).   I have lived in USA for quite some time now. As someone who chose to emigrate to this country, my priority needs were to assimilate, survive and seek subsistence here. I learnt at an earlier time reading notices, brochures and information from the State Department and United States Citizenship and Immigration Services (actually, I still look for any information on immigration and settlement in USA even today). This desire to  use existing literature to make informed decisions which A. L Kennedy calls “a tradition of fierce education and enlightenment” helped me figure out my requirements beyond proper documentation, e.g., Lawful Permanent Residency Visa (Green Card); proper immunizations; Social Security; Work Permits; and Identity Card. Without these it is hard to set foot out one’s house, or get proper employment and interact with other people. The needs for someone who has only lived here for say under a year, are different from those of one who has lived here beyond a year. They are also different from those of a person who is still undocumented and is always looking at their back for U.S. Immigration and Customs Enforcement (ICE) officers!  In my earlier years I had to find time to attend seminars and courses for refugees and immigrants. I wanted to immerse myself fully and hoped to achieve that through guidance of a do’s/dont’s list. I had my challenges too. These included: dressing down to casuals; figuring out the bus route and later on the train route; speaking even more slowly (because I was told I spoke a different kind of English); learning to go out; understanding the U.S. nuanced coffee culture as opposed to my own culture; and almost over indulging myself with Kentucky Fried Chicken, tasty burgers and sugary-drinks (something I later unlearnt). I would say, ensuring I lead a productive life in USA; where I am able to live peacefully at my place, pay rent/other dues; seek out and make friends; join community events; and participate in activities with others have become my belief, value and norm milieu. Indeed, I agree that intercultural communication can be seen as a negotiation of competing values, beliefs and norms (Week 1 Discussion). Sovereign countries have laws and codes that must be followed. But, those very countries also have cultures that are older than the sovereigns themselves. A.L Kennedy, in her essay, shows clearly the existence of Scots, Welsh, Irish and English cultures in Great Britain. In making the statement “I am Scot” now and not so many years ago shows how much the Scots wanted to  be part of and participate in a Great Britain owned by all who made it. I come from a country that was a former colony of Great Britain and I feel A.L. Kennedy is talking about an experience I knew so well from hearing fire side stories narrated by cultural elders. Now that I came across books and documents illuminating a reader on Britain’s divide and rule; subjugation of peoples (referred to as ‘uncultured’ in most correspondences. Meanwhile they were loading ships with gold, diamond, iron, copper, cotton and coffee and sending them back to UK in the name of Queen and Country); and raw material extraction policies in Colonial Africa, I can corroborate what she writes. I come from Buganda Kingdom which is part of Uganda. My tribe is part of 56 tribes that make up Uganda as a nation. We are both a matrilineal and patrilineal culture. As a first born boy, there things expected of me in form of responsibilities, duties and roles. But, now that I am in USA, all that changed. Right now, all that matters is to be a better participant in USA affairs. There in lies all the tasks that face me.

References:

A. L. Kennedy. 2012. “People will laugh at you if you sound like that.” Retrieved from: http://www.newstatesman.com/culture/2012/04/%E2%80%9Cpeople-will-laugh-you-if-you-sound-that%E2%80%9D. Retrieved on November 29th 2016. 

Tywoniak, F. E., & García, M. T. (2000). Migrant daughter: Coming of age as a Mexican American woman. Berkeley, CA.: University of California Press. Retrieved from the Walden Library databases. Retrieved on November 29th 2016.

Week 1 Discussion. Discussion 1: A Fish Out of Water: Cultural Transmission and Worldview. Retrieved from: https://class.waldenu.edu/webapps/blackboard/content/listContent.jsp?course_id=_16247427_1&content_id=_38983705_1. Retrieved on November 29th 2016.

A Health Educator /Promoter with Talking Drums: Community Event November 2nd 2016

My name is Tom R. Muyunga-Mukasa. I am inspired by other African-born immigrants who help raise what I call ‘health-consciousness.’ Yesterday we had a community event under what we call the “talking walls/drums” drum circle. The idea is we get a venue, in this case a park, through our drumming we mobilize people, entertain them while educating them. Now, I came across the story of Dr. Chimezie Raymond a Nigerian-born immigrant and it continues to inspire me. I realized our work is relevant. For that story see: https://www.waldenu.edu/connect/newsroom/spotlight/2016/channeling-his-passion-for-public-health.   This is wonderful. This is one of the reasons why some friends of mine and I came up with the Black, African, Atlantic and Indian Ocean Islands-born Immigrant Support Organization (BLAIR) dba Bay Area Healthy Living Support and Communication Platform (Bayheal). Between 2012-2015 alone, I had met 20 diabetic cases; 3 expectant mothers who had never attended antenatal check-ups; 14 people who confessed they had never done any medical check up ever since they came to USA in 2008-2009; 2 who needed dental surgery but had kept putting it off; and 9 who self-medicate. Please follow our work at: https://www.bayheal.org. I enjoy doing community work such as: community clean ups and it is not a problem to me to pick up plastics and discarded materials and safely put them in a waste bin. I enjoy conducting health education and promotion sessions with the San Francisco General Hospital’s Family Clinic; BayHeal (www.bayheal.org);  I also volunteer with San Francisco's Department of Public Health's Zero HIV/Zero Stigma Committee; UCSF ACTG; and SF AIDS Syringe exchange program. Someone said (a naysayer) in 2011 that one has to first acquire a degree to do community service work. Being an yeasayer, I went ahead and started an immigrant self help organization. In 2012, with common sense, a drive and planned focus,  I started by meeting and talking health issues to immigrants at social events (Washington DC, Boston MA, Minneapolis MN, Chicago IL), worship centres (Los Angeles CA, Oakland CA, Berkeley CA), restaurants and bars ( San Francisco CA, Antioch CA, Ashby CA, Lafayette CA, San Leandro CA, Richmond CA). Now, with the "talking walls/drums" project I meet large groups and talk about health. In the pictures you see, we are at the Nicholl Park of Richmond CA.

Once upon a time, perhaps even now, there was a drum

And three talented drummers

Through the talking drums, they shared the good news about healthy living

On and on the drum beat reverberated

drum.....drum....drum....

drum.....drum......

single drum......

double drum......

And finally the message was taken home, the audience dispersed and everybody went home happy.

Obamacare! America's Goose that lays the golden eggs

Obamacare! America's Goose that lays the golden eggs, I dare say President Donald Trump will be happier if the goose was taken care of.

Employers and Employees should be equally invested in the tenets of Obamacare because it's spirit positions squarely responsibilities of everyone when it comes to quality long life. It is through reconciling ourselves with that fact that such issues like obesity as an emerging event of the 21st Century America will be tackled comprehensively.

Cackling Geese: Google Images

According to the Affordable Care Act (Obamacare), it is perfectly legal for employers to assess their employees as much as 30% of the cost of provided health benefit (insurance) coverage, if the employee doesn’t meet certain wellness goals (established by the Department of Health and Human Services) which include weight and/or body mass index (BMI). When, the employee engages in obesity management therapy this effort should be rewarded by coverage. This should not be seen as paying into social programs but as an act of addressing risk for protracted sickness and hence wage loss (Shi & Singh, 2015). This approach increases self care and engagement in early and timely diagnosis for any likely adverse effects (Marieb, 2015). This is a motivation and it establishes an incentive for people to work toward long-term health goals. There are some assumptions I am making here: obesity affects performance at work and self esteem so employees and employers are invested in addressing it; universal coverage is part of American value for life, liberty and pursuance of happiness; employers pay for employees’ coverage has social-wide dividends; concepts like individual or limited benefits, shared responsibility and minimum essential coverage are apparent; and penalties of not having insurance coverage exist to encourage participation in healthy lifestyles. Also in this essay, I write a bit more emphatically on obesity and its significance as a social, clinical and medical factor. As well as the fact that indirectly, Obamacare is shining a brighter light on significance of prevention and community participation in addressing chronic illnesses. 

The Affordable Care Act (ObamaCare) is a law mandating medical coverage benefits for individual and families. One such benefit is that an employer is able to pay at a very low cost for an employee’s insurance coverage. The other benefit is that this establishes grounds for a basic and minimum essential coverage. This minimum essential coverage includes all government, job based insurance and most Private Insurance. A minimum essential coverage means any major medical insurance on or off the marketplace, whether it is a public program, or through work you typically have minimum essential coverage.

ObamaCare’s individual mandate requires that most Americans obtain and maintain health insurance, or an exemption, each month or pay a tax penalty. A penalty deters one from not fulfilling the duty to be covered. The individual mandate went into effect at the beginning of January 2014 and continues each year. The penalty for not having coverage is paid for using one’s Federal Income Tax Returns for each full month one or a family member doesn’t have health insurance or an exemption and is based on one’s Modified Adjusted Gross Income (MAGI).The annual fee for not having insurance in 2016 is $695 per adult and $347.50 per child (up to $2,085 for a family), or it’s 2.5% of your household income above the tax return filing threshold for your filing status – whichever is greater. It is important to note that one pays 1/12 of the total fee for each full month in which a family member went without coverage or an exemption. 

An individual should be aware of the concept of limited benefits and the areas where this individual has to pay using their own cash. Minimum essential coverage does not include coverage providing only limited benefits, such as coverage only for vision care or dental care, and Medicaid covering only certain benefits such as family planning, workers’ compensation, or disability policies. The following types of health insurance are not minimum essential coverage:

Short Term Health Plans
Fixed Benefit Health Plans
Supplemental Medicare like Part D and Medigap
Some Medicaid covering only certain benefits
Vision only, Dental only, and limited benefit plans
Grandfathered Plans (one will avoid the fee, but won’t get the new rights and protections)

Obesity is a medical condition in which excess body fat has accumulated to the point that it has an adverse effect on health and may shorten one’s life expectancy. This has social, clinical and medical implications (Battle, 2009). Employees will have to be provided time off work for medical reasons. Livelihoods may in turn be affected with reduced or loss of incomes. Obesity is an epidemic in U.S., it is associated to significant morbidity, mortality for and risk fact for hypertension, type 2 diabetes, coronary disease and stroke (Gordis, 2014). Where obesity lurks, so does diabetes. (1) in three (3) people may develop diabetes in the next 40 years; diabetes is a debilitating disease, a cause for blindness, kidney failure, limb amputation and a leading cause of death in U.S. 35.7% of adults 20-years-old and above are obese. They are 20% over their ideal body weight. One third of children and adolescents are either overweight or obese. In 2012 alone, it cost $245 billion for the U.S. to provide medical care and attendant care for people diagnosed with obesity related conditions (Judson & Harrison, 2016). Prevention measures and management of obesity to stop worse events are increasingly calling for the wider participation by many stakeholders. Participation by more stakeholders, establishes interventions that reduce overall incidence and prevalence by affecting frequency distributions in entire populations (Turnock, 2015); the range of settings include multilevel response to social, behavioral and environmental influences (Edberg, 2015); it creates social capital, resources, norms, values and institutional policies affecting energy balance and weight status (Coreil, 2010). 

References

Battle U.C. (2009. Essentials of Public Health Biology; A Guide to the Study of Pathophysiology. Jones & Bartlett Learning. Burlington, MA. 

Coreil, J. (2010). Social and Behavioral Foundations of Public Health. Sage Publications, Inc. Thousand Oaks, CA

David H. (2014). 14 Ways Obamacare Is Still A Disaster (That You Won’t Learn From Vox). Retrieved from: http://thefederalist.com/2014/11/12/14-ways-obamacare-is-still-a-disaster-that-you-wont-learn-from-vox/, Retrieved on October 24th 2016.
Edberg, M. (2015). Essentials of Health Behavior; Social and Behavioral Theory in Public Health. Jones & Bartlett Learning. Burlington, MA. 

Gordis, L. (2014). Epidemiology. Elsevier Saunders. Philadelphia, PA.
Judson, K., & Harrison, C. (2016). Law and ethics for the health professions. (7th ed.). New York: McGraw-Hill. 
Marieb, E.N. (2015). Essentials of Human Anatomy and Physiology. Pearson. Boston, MA.
Minimum Essential Coverage. Retrieved from: http://obamacarefacts.com/minimum-essential-coverage/. Retrieved on October 24th 2016. 
ObamaCare Individual Mandate. Retrieved from: http://obamacarefacts.com/obamacare-individual-mandate/. Retrieved on October 24th 2016.

10 Things You Get Now That Obamacare Survived. Retrieved from: http://www.motherjones.com/mojo/2012/06/obamacare-supreme-court-regular-americans. Retrieved on October 24th 2016. 

Shi & Singh. (2015). Delivering HealthCare in America; A Systems Approach. Jones & Bartlett Learning. Burlington MA. 
Turnock, J.B. (2015). Essentials of Public Health. Jones & Bartlett Learning. Burlington MA. 

Africa and medical Tourism: Lessons from countries outside Africa

According to the Journal of Tourism & Hospitality, tourism is "traveling to and staying in places outside their usual environment for not more than one consecutive year for leisure, business and other purposes". Tourism is commonly associated with international travel as well as refers to travel to another place within the same country (Journal of Tourism & Hospitality). Medical tourism is one purpose why people travel, it is a reality and a worldwide market for international patient care at approximately $40 billion (Kelly Gooch. 2016). Traveling abroad to access medical treatment is increasing with countries like U.K. providing large numbers of exported patients (Hanefeld J, Horsfall D, Lunt N, Smith R 2013). Medical tourism comes in different forms ranging from skilled providers sharing skills and services during medical treatment safaris/camps, concierge services, affordable healthcare options in the global market to beneficiaries traveling from their home countries to other countries where they can get services. There are other reasons why medical tourism is booming and these are: avoiding long waiting lists; shifting priorities for healthcare; tightened eligibility criteria; financially empowered individuals making decisions to seek services; competitive quality and prices of health care in some countries being pocket friendly; low air fares and hotel stay fees; increased number of immigrants who are skilled in health care provision providing services in home countries; alternative medicine other than western medicine; partnerships between teaching hospitals and establishing green field ventures; and cutting edge care (Reenita Das). 

Dallol Salt Lakes, Ethiopia, Africa

Africa, you can learn from this scenario: medical tourism is a net importer/ exporter of patients in really big numbers. In U.S. alone in 2007, an estimated 750,000 Americans traveled abroad for medical care; the number is expected to increase to 6 million by the end of this year. It is increasingly becoming apparent that there are affordable healthcare options in the global market outside of U.S. with pocket-friendly costs. Most surgeries cost 50% to 90% less than the average cost of the same surgery at a U.S. hospital, e.g., stent placement for iliac artery stenosis, estimated bill: at approximately $35,000 in USA can cost $18,000 in Bumrungrad Hospital in Bangkok, Thailand. There are reasons why cost are much less at overseas hospitals, as compared with U.S. and these include: lower wages for providers; less expensive medical devices and pharmaceutical products; less involvement by third-party payers; and lower malpractice premium. The annual liability insurance premium for a surgeon in India is $4,000; the average cost of a New York City surgeon’s liability insurance premium is $100,000 (Rajiv N. Thakkar. 2010).

Africa tap into social media and showcase the good side of the hot springs, the herbal medicines and the fact that a tropical/equatorial climate is medicinal. Showcase places like Dallol Salt Lakes in Ethiopia or Buranga Hot Springs (Geysers of Africa). You are missing out! Social media is playing an important role as an advertisement platform and this makes it possible for beneficiaries to make comparisons in nature, quality, access and prices of health care services (Zheng Xianga & Ulrike Gretzel. 2010). Advisories from the U.S. embassies, missions , media coverage as well as presence of U. S. military inform destination risk perception (Grzegorz Kapuścińskia & Barry Richards. 2016). It is increasingly easier for Americans to travel around the world for life-changing procedures due to a powerful dollar at the exchange rate, the fact that it has become safer, more cost-effective and appealing for Americans than ever (Kevin Gray. 2013). 

Well, at the same time Africa, get your act together as far as organization goes. If you will want to be number one in the medical tourism market (yes you can), copy from say, the U.S. Talking about medical tourism without talking about how health care evolved into a quality service in say, the U.S. would be saying half the story. It is now a lifestyle and experiential activity(Constantine Constantinides. 2016). Aspects to talk about include the motivations put in place by employees for employers to stay longer at given jobs while at the same time they enjoy a quality life has in turn impacted on advances in the health care field. This as ensured medical and health services access by large employers through being self-insured; ensuring health benefit mandates are met; provision of benefits; provision of incentives in form of perks; and providing other forms of wage. A motivated employee is able to pay for health services. This kind of money invested in say, health care from services to infrastructure has made developed countries establish quality health care services. The technological advancement; economic growth; new market innovations; demand for services; and continued trainings and skills development in these countries have in turn improved technology; provided an understanding of demographics; and enabled the promotion of lifestyles that in turn protect people from risky health outcomes. Market conditions or regulations have made it possible for continued quality assurance. This is possible because of the specialized medical care provision; licensure laws; Intellectual property law; expansion/reduction of health government subsidized health care/insurance; and product safety, law or rules. 

So, medical tourism is a sustainable phenomenon and not simply a passing fad. Medical Tourism affects healthcare in developed countries (e.g., United States, England, and Canada), developing or underdeveloped countries in form of: established health care markets providing low cost quality concierge and medical services; mutual partnerships between air travel companies, hotels and hospitals; the higher exchange rate of the Dollar, Euro and Pound against currencies where people go for medical services; safe destinations; and the increasing success rate of medical procedures outside say, U.S.

References:

Constantine Constantinides. 2016. Making Health Tourism “Truly” Sustainable and Resilient-Fro All. Retrieved from: https://www.imtj.com/articles/making-health-tourism-%E2%80%9Ctruly%E2%80%9D-sustainable-and-resilient-%E2%80%93-all/. Retrieved on October 18th 2016. 

Geysers of Africa. Retrieved from: http://www.wondermondo.com/Best/Af/AfGeysers.htm. Retrieved on October 18th 2016.

Grzegorz Kapuścińskia & Barry Richards. 2016. News framing effects on destination risk perception. Retrieved from: http://www.sciencedirect.com/science/article/pii/S0261517716301030. Retrieved on October 18th 2016. 

Greenfield Venture. Retrieved from: http://www.mbaskool.com/business-concepts/marketing-and-strategy-terms/8506-greenfield-venture.html. Retrieved on October 17th 2016.

Journal of Tourism & Hospitality. Retrieved from: http://www.omicsgroup.org/journals/tourism-hospitality.php. Retrieved on October 18th 2016. 

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