- Cultural Geography Chair Group
Wageningen University & Research
P.O. Box 47
6700 AA Wageningen
The Netherlands
Meghann Ormond
Wageningen University, Cultural Geography Chair Group, Faculty Member
- Cultural Geography, Transnationalism, Global Health, Philosophy of Social Science, Tourism Geography, Political Geography, and 84 moreIdentity Politics (Political Science), Global Citizenship, Citizenship and Identity, Consumerism, Health Literacy, Identity construction and cultural production, Medical Tourism, Health Care Service Access and Utilization, Sustainable Tourism Development, Consumers Rights, Geography, Tourism Studies, Material Culture Studies, Migration Studies, Science, Technology and Society, Southeast Asian Studies, Genealogy, Indonesia, Citizenship And Governance, Regional Integration, Malaysia, Hospitality Studies, Health Care Ethics, Cross-border cooperation, Care Ethics, Tourism mobilities, Genetic Genealogy, Soft Power and International Relations, Border Crossing, Geography of Mobility and Migrations, Human-Nonhuman Assemblages, Health and Place, Diaspora Tourism, Research Ethics, Global Health Diplomacy, Lifestyle Migration, Retirement, Lifestyle & Consumption, Social Movements, Ethical Consumption, Seyla Benhabib, Citizenship, Immigration Status & Nationality, Nationalism, National Identity, Development Studies, Biopolitics, Social Geography, Family, Family studies, Health Inequalities, 23andMe, Participatory Research, Medical Anthropology, Kinship, Activism and Knowledge Production, Networks, Migration, Health Social Movements, Diaspora, Racial & Ethnic Disparities in Healthcare Access, Diaspora Studies, International Retirement Migration, Singapore, Residential Mobility, Gerontology, Aging, Crossborder Cooperation, Public Policy, Portugal, Personalized Medicine, Anthropology of Food, Sociology of Food and Eating, Foodways (Anthropology), Food and Gastronomy Tourism, Expatriates, Tim Ingold, Museum Studies, Migration Museums, Communication Of Memory In Archives, Libraries And Museums, Learning and Visitor Studies in Museums and Galleries, Accessible Tourism, Cultural Mapping, Creative Placemaking, and Transformative pedagogyedit
- Meghann Ormond is Associate Professor in Cultural Geography at Wageningen University (NL). A human geographer, her re... moreMeghann Ormond is Associate Professor in Cultural Geography at Wageningen University (NL). A human geographer, her research focuses mainly on transnational mobility, health and care. She's especially interested in intersections between migration and tourism.edit
• The future of the private healthcare in Johor and in the Iskandar Malaysia (IM) special economic zone in particular is intimately tied to larger property developments and trends in the region, both because private healthcare developers... more
• The future of the private healthcare in Johor and in the Iskandar Malaysia (IM) special economic zone in particular is intimately tied to larger property developments and trends in the region, both because private healthcare developers are increasingly the same as property developers and because IM’s future population growth relies heavily on corporate settlement in IM and the jobs that such settlement generates. Volatility in corporate investment and settlement in IM may have significant consequences for the sector’s development.
• The Federal and Johor State Governments intend to turn IM into a world-class private healthcare destination for local residents and foreign visitors alike. A range of strategies and policies have been launched to develop IM’s medical care, aged care, and lifestyle and wellbeing sectors.
• It is essential to track the impact of federal and regional fiscal incentives for private healthcare development and monitor actual demand for private-sector capacity in order to assess the value and utility of such incentives, especially given the potential for such incentives policies to promote the generation of excessive private-sector hospital and clinical capacity if left unchecked.
• Private healthcare providers in the region depend mostly on local residents as their consumer base because Johor and IM are not (yet) significant medical tourism destinations. Given the current rate of expansion of existing hospitals and construction of new ones in Johor and specifically in IM, local demand must be secured via measures that increase the Johor household income base, foster interstate migration, attract higher-income talent in larger numbers to live in the region, and improve quality of life in the region.
• To strengthen medical tourism, private players – both large and small – require greater coordination and cooperation at the regional level in promoting medical tourism and in setting up centres of excellence and medical tourist-friendly services that cater to the actual needs of international patients.
• The Federal and Johor State Governments intend to turn IM into a world-class private healthcare destination for local residents and foreign visitors alike. A range of strategies and policies have been launched to develop IM’s medical care, aged care, and lifestyle and wellbeing sectors.
• It is essential to track the impact of federal and regional fiscal incentives for private healthcare development and monitor actual demand for private-sector capacity in order to assess the value and utility of such incentives, especially given the potential for such incentives policies to promote the generation of excessive private-sector hospital and clinical capacity if left unchecked.
• Private healthcare providers in the region depend mostly on local residents as their consumer base because Johor and IM are not (yet) significant medical tourism destinations. Given the current rate of expansion of existing hospitals and construction of new ones in Johor and specifically in IM, local demand must be secured via measures that increase the Johor household income base, foster interstate migration, attract higher-income talent in larger numbers to live in the region, and improve quality of life in the region.
• To strengthen medical tourism, private players – both large and small – require greater coordination and cooperation at the regional level in promoting medical tourism and in setting up centres of excellence and medical tourist-friendly services that cater to the actual needs of international patients.
Research Interests:
"What this insightful, challenging and beautifully written book demonstrates, then, is that the destinations, routes and points of departure of MT [medical tourism] are formed by specific geographies, historical relationships and power... more
"What this insightful, challenging and beautifully written book demonstrates, then, is that the destinations, routes and points of departure of MT [medical tourism] are formed by specific geographies, historical relationships and power struggles […] This book is not only about Malaysia. In many ways it provides a model for analysing and evaluating MT in any destination. It makes a significant contribution to debates on MT and will no doubt prove its influence as this important field develops." – Ruth Holliday, University of Leeds, in Australian Geographer, 45(1), 2014, pp. 93-94.
"This book provides great detail on the actors and activities involved in the industry, along with discussion of the impacts of neoliberal strategies on public health and the ongoing policy considerations created by this industry. [...] Her book provides great insight into the difficulties facing health care systems that are increasingly reliant on other nations, philanthropic organizations, and corporations to provide appropriate health care. [...] Ormond’s book provides an excellent description of neoliberal practices and the impacts of international travel for health care on public health."
- Krystyna Adams, The Canadian Geographer, 2015, DOI:10.1111/cag.12144
The book is available in paperback in early 2015.
"This book provides great detail on the actors and activities involved in the industry, along with discussion of the impacts of neoliberal strategies on public health and the ongoing policy considerations created by this industry. [...] Her book provides great insight into the difficulties facing health care systems that are increasingly reliant on other nations, philanthropic organizations, and corporations to provide appropriate health care. [...] Ormond’s book provides an excellent description of neoliberal practices and the impacts of international travel for health care on public health."
- Krystyna Adams, The Canadian Geographer, 2015, DOI:10.1111/cag.12144
The book is available in paperback in early 2015.
Research Interests: Cultural Geography, Tourism Studies, Development Studies, Southeast Asian Studies, Mobility/Mobilities, and 22 moreBorder Studies, Health Geography, Global Health, Governance, Identity (Culture), Consumerism, Malaysia, Indonesia, Singapore, Medical Tourism, Migration Studies, Health Care Ethics, Biopolitics, Care Ethics, Outsourcing, Hospitality, Health and Wellness Tourism, Healthcare, Trade Liberalization, Global Health Diplomacy, Deterritorialization, and Medical Diplomacy
The preliminary report for the project, 'Reunificação familiar e imigração em Portugal' ('Family reunification and immigration in Portugal'), is divided into two parts, organised in four chapters. The first part provides a framework of... more
The preliminary report for the project, 'Reunificação familiar e imigração em Portugal' ('Family reunification and immigration in Portugal'), is divided into two parts, organised in four chapters. The first part provides a framework of the phenomenon of family reunification and the integration of immigrants in host societies, by examining the experiences of countries with a deeper tradition of immigration than Portugal, such as North-western European countries and the United States. The second part comprises a general characterization of Portugal’s experience with immigration, based on information available from official statistical sources. It includes an appendix with a comparative table that summarises selected European Union member-states’ national legislation on family reunification as well as an analysis comparing the Portuguese legislation with the EU Directive relative to family reunification (Directive 2003/86/CE).
Taking into account the general lack of data and the limitations of the data that does exist, a survey will be performed in the second phase of this project on a sample of non-EU citizens living in Portugal representative of the largest immigration populations or of populations that, despite currently being small, have displayed significant growth potential.
Finally, in order to evaluate the potential to receive immigrant families at the regional level, case studies will be made throughout a variety of districts across the country, based upon interviews and focus groups with immigrants, socio-cultural institutions, NGOs and other relevant local actors from both public and private sectors.
Taking into account the general lack of data and the limitations of the data that does exist, a survey will be performed in the second phase of this project on a sample of non-EU citizens living in Portugal representative of the largest immigration populations or of populations that, despite currently being small, have displayed significant growth potential.
Finally, in order to evaluate the potential to receive immigrant families at the regional level, case studies will be made throughout a variety of districts across the country, based upon interviews and focus groups with immigrants, socio-cultural institutions, NGOs and other relevant local actors from both public and private sectors.
Research Interests:
For people conscious and critical of their settler-colonial immigration heritage, the desire to forge and claim a deep connection with a plot of land can generate deep ambivalence. Engaging with Wall Kimmerer's reflections on indigeneity... more
For people conscious and critical of their settler-colonial immigration heritage, the desire to forge and claim a deep connection with a plot of land can generate deep ambivalence. Engaging with Wall Kimmerer's reflections on indigeneity and migration, this essay explores the ways in which embodied and material practices of gardening and caring for the soil enable visceral recognition of both the urgency for – and the challenges associated with – decolonizing relationships with morethan-human beings that have been subjugated in diverse ways through colonial capitalism over time and space.
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This article explores tensions between urgency and climate justice in a climate activist movement context through the case study of Regenerative Cultures in Extinction Rebellion Netherlands. We argue that urgency obstructs climate justice... more
This article explores tensions between urgency and climate justice in a climate activist movement context through the case study of Regenerative Cultures in Extinction Rebellion Netherlands. We argue that urgency obstructs climate justice through encouraging ‘whatever-it-takes’ mentalities that sideline justice concerns in the pursuit of action, and through propelling activist burnout, which causes climate justice movements to falter over time. We situate Regenerative Cultures as a tool used by Extinction Rebellion Netherlands to negotiate these obstructions to climate justice posed by urgency. Regenerative Cultures comprises an attempt by Extinction Rebellion Netherlands to ‘hold space’, away from the urgency which pervades the movement, in order to afford activists the time to experiment with modes of inner transformation. The techniques used by activists to ‘hold space’ for these transformations constitute a form of utopia building. In these utopian spaces, activists learn to acknowledge and manage feelings of urgency, thereby constituting a form of emotional and affective inner transformation. However, the utopian spaces of Regenerative Cultures are isolated from the rest of the movement. As a disconnected utopian enclave, the political potential of ‘Regenerative Cultures’ as a prefigurative vehicle for social change is blunted. This case study is testament to the difficulties involved in carving out spaces to practice prefigurative forms of politics in a context of planetary emergency, while simultaneously outlining the necessity of such spaces for cultivating the inner changes required to enable and sustain projects of climate justice.
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Het nieuwe en ernstige karakter van het virus en het gemak waarmee Covid-19 wordt overgedragen, hebben geleid tot verreikende en ongekende internationale reisbeperkingen. Dit essay richt zich op de manieren waarop nationale regeringen... more
Het nieuwe en ernstige karakter van het virus en het gemak waarmee Covid-19 wordt overgedragen, hebben geleid tot verreikende en ongekende internationale reisbeperkingen. Dit essay richt zich op de manieren waarop nationale regeringen tijdens het begin van de Covid-19 crisis de internationale mobiliteit, waarvan ze de afgelopen decennia steeds afhankelijker zijn geworden, in goede banen probeerde te leiden. Het artikel gebruikt het concept van ‘biologisch burgerschap’ als een lens om te onderzoeken hoe de Covid-19-pandemie een nieuw perspectief biedt op eeuwenoude politieke dilemma's van het in toom houden van de verspreiding van besmetting. Door die lens kan de opkomst van nieuwe ruimtelijke vertrouwensrelaties in de vorm van ‘bubbles’, luchtbruggen en verbindingscorridors worden gezien. Hier pleit ik voor de waarde van het steeds zichtbaarder maken van de manieren waarop onze biologische identiteit zich verhouden tot onze politieke identiteit in een steeds meer geglobaliseerde wereld.
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In bringing people together that otherwise might have little more than passing contact with one another, tourism is appreciated for its potential to transform mindsets by fostering multi-perspectivity, a cornerstone of global citizenship... more
In bringing people together that otherwise might have little more than passing contact with one another, tourism is appreciated for its potential to transform mindsets by fostering multi-perspectivity, a cornerstone of global citizenship education, among both ‘tourists’ and ‘locals’. Hence, while tourism plays a significant role in marginalising and exploiting immigrants’ bodies, labour and heritages, it also holds significant potential as a critical pedagogical tool for transcending the limits of multicultural tolerance discourse and combatting exploitation and xenophobia. In this article, we reflect on two Europe-based global citizenship-inspired initiatives bringing together migration and tourism in novel ways: Migrantour guided walking tours and the Roots Guide guidebook. They endeavour to rework guided tours and guidebooks, two of tourism’s most conventional pedagogical tools, into ‘good company’ that supports the Arendtian practice of ‘visiting’ as a key mode of civic learning. In so doing, we explore the representational and structural opportunities and challenges that these two initiatives encounter as they seek to co-create multi-dimensional narratives and routes in ways that recognise guides’ diverse experiences and perceptions of the places they call home, avoid stereotypical representations of ‘communities’ and hold space for the real-life frictions that accompany diversity.
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In recent years, scholars have focused on the concept of healthcare deservingness, observing that healthcare professionals, state authorities and the broader public make moral judgements about which migrants are deserving of health care... more
In recent years, scholars have focused on the concept of healthcare deservingness, observing that healthcare professionals, state authorities and the broader public make moral judgements about which migrants are deserving of health care and which are not. Such literature tends to focus on migrants with irregular status. This article examines how state calculations of healthcare deservingness have also been applied to authorised migrants. Focusing on Malaysia, we examine the ways in which state authorities construct migrants as ‘desirable’, ‘acceptable’ and ‘disposable’, differentiated through calculations of their biological and economic risks and potential contribution to ‘the nation’. To do this, we analyse recent government and commercial policies, plans and practices to reflect on how such biopolitical orderings create the conditions for risk entrepreneurship – where public and private actors capitalise on profit-making opportunities that emerge from the construction of risky subjects and risky scenarios – while reinforcing hierarchies of healthcare deservingness that exacerbate health inequalities by privileging migrants with greater economic capital and legitimising the exclusion of poor migrants.
Research Interests:
Transnational medical travel -- the temporary movement by patients across national borders in order to address medical concerns abroad that are unable to be sufficiently met within their countries of residence -- is an important... more
Transnational medical travel -- the temporary movement by patients across national borders in order to address medical concerns abroad that are unable to be sufficiently met within their countries of residence -- is an important therapeutic coping strategy used by growing proportions of peoples with a diverse range of mobility profiles and intensities of global moorings. Studying this phenomenon provides useful insight into the rapidly globalising era of health governance, where an ever-wider array of state and non-state actors are transcending the increasingly restrictive national containerisations of health care and engaging in cross-border action to effectively address contemporary health challenges at both individual and collective levels. In our introduction to this special issue on transnational medical travel, we draw on both ‘medical tourism’ and migrant health scholarship to acknowledge the diversity of motivations among migrant and non-migrant patients alike and the complex nature of mobile patients’ attachments to the multiple places in which they seek care. We then bring attention to how dynamic structural issues in mobile patients’ countries of residence and destination shape their attachments to places and health systems over time, examining the linkages between vitality of the political and social systems in these places to which they are differently attached and their dis/satisfaction and dis/enfranchisement with them.
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This paper draws on an affirmative biopolitical framework to analyze the governing of young lives in education and social spaces in Cusco, Peru. We engage with Berlant’s theorization of affect and spatialization of biopolitics in order to... more
This paper draws on an affirmative biopolitical framework to analyze the governing of young lives in education and social spaces in Cusco, Peru. We engage with Berlant’s theorization of affect and spatialization of biopolitics in order to discuss youth’s embodied experiences of alternatives forms of biopolitical governance. With a case study of a grassroots, non-profit center for residential care and social and educational programs for Quechua-speaking girls, we investigate how the girls sense and respond to the center’s mediation of rural-to-urban projects of ‘getting ahead,’ domestic work, and the tourism and hospitality sector. We reveal the center’s biopoliticization of their lives in an affective manner within the processes of postcolonial educational marginalization, precarity in urban economies, professionalization, and tourism in and beyond Cusco. Our study intends to contribute to an expanded understanding of production of education, aid, social care, and protection spaces, and to highlight the utility of affective inquiry in examining the contested terrains of (alternative) childhoods/youth.
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In October 2016, the Global Healthcare Policy and Management Forum was held at Yonsei University, Seoul, South Korea. The goal of the forum was to discuss the role of the state in regulating and supporting the development of medical... more
In October 2016, the Global Healthcare Policy and Management Forum was held at Yonsei University, Seoul, South Korea. The goal of the forum was to discuss the role of the state in regulating and supporting the development of
medical tourism. Forum attendees came from 10 countries. In this short report article, we identify key lessons from the forum that can inform the direction of future scholarly engagement with medical tourism. In so doing, we reference on-going scholarly debates about this global health services practice that have appeared in multiple
venues, including this very journal. Key questions for future research emerging from the forum include: who should be meaningfully involved in identifying and defining categories of those travelling across borders for health services and what risks exist if certain voices are underrepresented in such a process; who does and does not ‘count’ as a medical tourist and what are the implications of such quantitative assessments; why have researchers not been able to address pressing knowledge gaps regarding the health equity impacts of
medical tourism; and how do national-level polices and initiatives shape the ways in which medical tourism is unfolding in specific local centres and clinics? This short report as an important time capsule that summarises the current state of medical tourism research knowledge as articulated by the thought leaders in attendance at the forum while also pushing for research growth.
medical tourism. Forum attendees came from 10 countries. In this short report article, we identify key lessons from the forum that can inform the direction of future scholarly engagement with medical tourism. In so doing, we reference on-going scholarly debates about this global health services practice that have appeared in multiple
venues, including this very journal. Key questions for future research emerging from the forum include: who should be meaningfully involved in identifying and defining categories of those travelling across borders for health services and what risks exist if certain voices are underrepresented in such a process; who does and does not ‘count’ as a medical tourist and what are the implications of such quantitative assessments; why have researchers not been able to address pressing knowledge gaps regarding the health equity impacts of
medical tourism; and how do national-level polices and initiatives shape the ways in which medical tourism is unfolding in specific local centres and clinics? This short report as an important time capsule that summarises the current state of medical tourism research knowledge as articulated by the thought leaders in attendance at the forum while also pushing for research growth.
Research Interests:
Through an examination of two festivals – Qing Ming and Cap Go Meh – in the town of Singkawang in Indonesian Borneo (Kalimantan), we show how Singkawang-bound Chinese Indonesian tourists and their Singkawang-based relatives produce a... more
Through an examination of two festivals – Qing Ming and Cap Go Meh – in the town of Singkawang in Indonesian Borneo (Kalimantan), we show how Singkawang-bound Chinese Indonesian tourists and their Singkawang-based relatives produce a diasporic heritage network through ‘moorings’ generated by both transnational and internal migration. Instead of returning to a singular ‘homeland’ in distant China, these tourists return to Chinese-majority Singkawang as a result of their personal genealogical roots and of their broader cultural allegiance with a kind of Chinese-ness that Singkawang has come to represent within a post-Suharto Indonesia. Through these two festivals, we demonstrate how personal heritage practices like ‘roots tourism’ and visiting friends and relatives (VFR) are intimately bound up with identity and developmental politics at local, national and international scales. In so doing, we identify a range of ways in which migratory and tourism flows by Chinese Indonesian internal migrants shape relations to their ancestral hometowns and cultural ‘homelands’ in Indonesia within the context of membership to and participation in a broader transnational diaspora.
Research Interests:
Background: Medical tourism is now targeted by many hospitals and governments worldwide for further growth and investment. Southeast Asia provides what is perhaps the best documented example of medical tourism development and promotion on... more
Background: Medical tourism is now targeted by many hospitals and governments worldwide for further growth and investment. Southeast Asia provides what is perhaps the best documented example of medical tourism development and promotion on a regional scale, but interest in the practice is growing in locations where it is not yet established. Numerous governments and private hospitals in the Caribbean have recently identified medical tourism as a priority for economic development. We explore here the projects, activities, and outlooks surrounding medical tourism and their anticipated economic and health sector policy implications in the Caribbean country of Jamaica. Specifically, we apply Pocock and Phua’s previously-published conceptual framework of policy implications raised by medical tourism to explore its relevance in this new context and to identify additional considerations raised by the Jamaican context.
Methods: Employing case study methodology, we conducted six weeks of qualitative fieldwork in Jamaica between October 2012 and July 2013. Semi-structured interviews with health, tourism, and trade sector stakeholders, on-site visits to health and tourism infrastructure, and reflexive journaling were all used to collect a comprehensive dataset of how medical tourism in
Jamaica is being developed. Our analytic strategy involved organizing our data within Pocock and Phua’s framework to identify overlapping and divergent issues.
Results: Many of the issues identified in Pocock and Phua’s policy implications framework are echoed in the planning and development of medical tourism in Jamaica. However, a number of additional implications, such as the involvement of international development agencies in facilitating interest in the sector, cyclical mobility of international health human resources, and the significance of health insurance portability in driving the growth of international hospital accreditation, arise from this new context and further enrich the original framework.
Conclusions: The framework developed by Pocock and Phua is a flexible common reference point with which to document issues raised by medical tourism in established and emerging destinations. However, the framework’s design does not lend itself to explaining how the underlying health system factors it identifies work to facilitate medical tourism’s development or how the specific impacts of the practice are likely to unfold.
Methods: Employing case study methodology, we conducted six weeks of qualitative fieldwork in Jamaica between October 2012 and July 2013. Semi-structured interviews with health, tourism, and trade sector stakeholders, on-site visits to health and tourism infrastructure, and reflexive journaling were all used to collect a comprehensive dataset of how medical tourism in
Jamaica is being developed. Our analytic strategy involved organizing our data within Pocock and Phua’s framework to identify overlapping and divergent issues.
Results: Many of the issues identified in Pocock and Phua’s policy implications framework are echoed in the planning and development of medical tourism in Jamaica. However, a number of additional implications, such as the involvement of international development agencies in facilitating interest in the sector, cyclical mobility of international health human resources, and the significance of health insurance portability in driving the growth of international hospital accreditation, arise from this new context and further enrich the original framework.
Conclusions: The framework developed by Pocock and Phua is a flexible common reference point with which to document issues raised by medical tourism in established and emerging destinations. However, the framework’s design does not lend itself to explaining how the underlying health system factors it identifies work to facilitate medical tourism’s development or how the specific impacts of the practice are likely to unfold.
Research Interests:
Both at the individual and health system levels, the burden of complex illnesses associated with and which rise in mid- to later life, such as cancer, is expected to increase further. The advent of personalized medicine, or the use of a... more
Both at the individual and health system levels, the burden of complex illnesses associated with and which rise in mid- to later life, such as cancer, is expected to increase further. The advent of personalized medicine, or the use of a patient’s genetic profile to guide medical decisions, is touted to substantially improve drug tolerance and efficacy and, in so doing, also improve the effectiveness and efficiency of oncological care. Amidst the hype and hope surrounding personalized cancer care, there is increasing concern about its unnecessary, unintended effects especially with regards to the financial burden of targeted therapies using specialty drugs. In this paper, we take a patient-centered perspective on the therapeutic benefits of personalized medicine as well as the limitations of current practice and its psychological and financial toxicities by focusing on advanced-stage lung cancer. We argue that the modest clinical benefits of targeted therapy, premium prices for many specialty drugs and the narrow focus on the genetic constitution of individual patients run the risk of undercutting personalized lung cancer care’s contribution towards realizing health and non-health outcomes. We discuss the contribution of grading the financial burden of treatment and seamless integration of palliative care as key action areas regarding patients’ access to and appropriateness of care given patients’ needs and preferences.
Research Interests:
Growing numbers of people are going abroad in pursuit of healthcare, and the social, political and economic significance of these flows at a range of levels cannot be ignored. This special issue brings together papers from a key... more
Growing numbers of people are going abroad in pursuit of healthcare, and the social, political and economic significance of these flows at a range of levels cannot be ignored. This special issue brings together papers from a key international conference held in June 2013, Transnational Healthcare: a Cross-border Symposium – an event that was itself transnational, with hosting shared by institutions in two countries: first in Wageningen, The Netherlands, with delegates then travelling to Leeds, UK, for further presentations and discussion. The aim of this symposium was consider the impacts of ‘medical tourism’ in a range of different contexts, and it brought together scholars involved in cutting-edge empirical and conceptual studies of the transnational pursuit and provision of medical care. It included findings from small-scale as well as large, multi-site research projects. In this introduction, we outline the articles’ main themes and highlight priorities and agendas for the vital shared project of empirically and conceptually investigating the multi-scalar relational geographies -- from the macro/national to the local/embodied – that are currently transforming policies, economies, professions and patient experiences of what some scholars suggest might more appropriately be called ‘international medical travel’ (Kangas 2007) or ‘transnational healthcare practices’ (Stan, this issue) instead of ‘medical tourism’. In recognition of the array of initiatives around the world that challenge and move beyond attempts at self-sufficiency in healthcare at the national level, this special issue draws attention to the breadth of regional capacity-building, forms of governance, relations and identities forged through both high-profile, long-distance pursuits of ‘medical tourists’ and more ‘everyday’ cross-border and intra-regional health-motivated flows (Ormond 2013b). The diversity of case studies presented in the special issue is intended to reflect the many forms of movement that together constitute transnational healthcare practices (though there remains much work to fully map these practices). In the remainder of this introduction, we draw out some of the themes and issues raised in the papers that prompt us to rethink ‘medical tourism’.
Research Interests: Medical Tourism, Regional development, Migration Studies, Global Health Governance, Medical Travel, and 4 moreHealth, Wellness & Medicall tourism, spas, Cosmetic and Reconstructive Plastic Surgery, Medical Tourism, Cosmetic Surgery Studies, Transnational migration and caregiving, and Transnational Health
Globally, more patients are intentionally travelling abroad as consumers for medical care. However, while scholars have begun to examine international medical travel's (IMT) impacts on the people and places that receive medical... more
Globally, more patients are intentionally travelling abroad as consumers for medical care. However, while scholars have begun to examine international medical travel's (IMT) impacts on the people and places that receive medical travellers, study of its impacts on medical travellers' home contexts has been negligible and largely speculative. While proponents praise IMT's potential to make home health systems more responsive to the needs of market-savvy healthcare consumers, critics identify it as a way to further de-politicise the satisfaction of healthcare needs. This article draws from work on political consumerism and health advocacy and social movements to argue for a reframing of IMT not as a 'one-off' statement about or an event external to struggles over access, rights and recognition within medical travellers' home health systems but rather as one of a range of critical forms of on-going engagement embedded within these struggles. To do this, the limited extant empirical work addressing domestic impacts of IMT is reviewed and a case study of Indonesian medical travel to Malaysia is presented. The case study material draws from 85 interviews undertaken in 2007-08 and 2012 with Indonesian and Malaysian respondents involved in IMT as care recipients, formal and informal care-providers, intermediaries, promoters and policy-makers. Evidence from the review and case study suggests that IMT may effect political and social change within medical travellers' home contexts at micro and macro levels by altering the perspectives, habits, expectations and accountability of, and complicity among, medical travellers, their families, communities, formal and informal intermediaries, and medical providers both within and beyond the container of the nation-state. Impacts are conditioned by the ideological foundations underpinning home political and social systems; the status of a medical traveller's ailment or therapy; and the existence of organised support for recognition and management of these in the home context.
Research Interests:
While scholars increasingly acknowledge that most contemporary international medical travel is comprised of South-South flows, these have gone curiously unexamined. Rather, policy, scholarly and media attention focuses predominantly on... more
While scholars increasingly acknowledge that most contemporary international medical travel is comprised of South-South flows, these have gone curiously unexamined. Rather, policy, scholarly and media attention focuses predominantly on North-South flows of ‘medical tourists’. However, this focus diverts attention from the actual and potential impacts of South-South intra-regional medical travel flows in both their source and receiving contexts. As such, we present findings from a study examining South-South intra-regional medical travellers’ motivations, preparations and practices to better understand the social, economic and political situations that condition them and their effects on the destinations that receive them. Our study of Indonesian medical travellers pursuing health care in Malaysia draws on 35 semi-structured interviews with Indonesian patients, their companions, medical staff and agents in both countries. From this, we suggest that South-South medical travellers’ diverse socio-economic conditions shape decision-making and spending behaviour relative to treatment, accommodation and transport choices as well as length of stay. We identify ways in which informal economies and social care networks sustain the formal medical travel industry. Finally, we observe how medical travel increasingly serves as a means through which chronic and everyday health needs are met as a result of temporary, visa-free intra-regional movement.
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Following on the identification of medical tourism as a growth sector by the Malaysian government in 1998, over the last 15 years significant governmental and private-sector investment has been channelled into its development. This is... more
Following on the identification of medical tourism as a growth sector by the Malaysian government in 1998, over the last 15 years significant governmental and private-sector investment has been channelled into its development. This is unfolding within the broader context of social services being devolved to for-profit enterprises and ‘market-capable’ segments of society becoming sites of intensive entrepreneurial investment by both the private sector and the state. Yet the opacity and paucity of available medical tourism statistics severely limits the extent to which medical tourism’s impacts can reliably assessed, forcing us both to consider the real effects that resulting speculation has itself produced and to re-evaluate how the real and potential impacts of medical tourism are -- and should be -- conceptualised, calculated, distributed and compensated for. Contemporary debate over the current and potential benefits and adverse effects of medical tourism for destination societies is hamstrung by the scant empirical data currently publicly available. Steps are proposed for overcoming these challenges in order to allow for improved identification, planning and development of resources appropriate to the needs, demands and interests of not only medical tourists and big business but also local populaces.
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This exploratory study analyses user-generated web content in Singapore and Malaysia to examine how the management of Singapore’s rapidly aging population within the emerging cross-border metropolitan space of Singapore and the Southern... more
This exploratory study analyses user-generated web content in Singapore and Malaysia to examine how the management of Singapore’s rapidly aging population within the emerging cross-border metropolitan space of Singapore and the Southern Malaysian state of Johor is perceived and framed by different social actors. It reveals a range of perspectives on the growing numbers of Singapore seniors and their families beginning to consider Johor as a post-retirement alternative to an over-priced and overcrowded Singapore to satisfy their needs and desires for more affordable medical and residential care, larger homes and greater independence.
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International medical travel is increasingly big business. Using Indonesian patient-consumers’ transport experiences in the pursuit of private medical care in Malaysia, this paper explores how transport operators and infrastructure are... more
International medical travel is increasingly big business. Using Indonesian patient-consumers’ transport experiences in the pursuit of private medical care in Malaysia, this paper explores how transport operators and infrastructure are responding and adjusting to the embodied specificities of the growing market’s access and travel needs. In offering faster and more frequent linkages, they have both expanded the physical and geo-political scope and increased the immediacy of care provision. These practices underscore the value of examining how the mobile spaces of transport common to international medical travel actively intersect with, blur and re-articulate diverse understandings of ill-health and impairment, care and subjectivity.
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Drawing on literature on self-help and travel guide writing, this paper interrogates five international medical travel guidebooks aimed at American and British audiences interested in travelling abroad to purchase medical care. These... more
Drawing on literature on self-help and travel guide writing, this paper interrogates five international medical travel guidebooks aimed at American and British audiences interested in travelling abroad to purchase medical care. These guidebooks articulate a three-step self-help “program” to produce a “savvy” international medical traveler. First, readers are encouraged to view their home healthcare system as dysfunctional. Second, they are encouraged to re-read destinations’ healthcare landscapes as excellent and accessible. Finally, these texts explicitly enjoin readers to see themselves as active, cosmopolitan consumers whose pursuits are central to rectifying the dysfunction of their home healthcare systems.
Research Interests: Cultural Geography, Tourism Studies, Travel Writing, Transnationalism, Health Geography, and 10 moreDestination Management, Global Health, Health Education, Medical Tourism, Consumer Culture, Citizenship and Identity, Quality of Healthcare Services, Travel Literature, Self-help, and Tourist Guidebooks
‘Medical tourism’ frequently has been held to unsettle naturalised relationships between the state and its citizenry. Yet, in casting ‘medical tourism’ as either an outside ‘innovation’ or ‘invasion’, scholars have too often ignored the... more
‘Medical tourism’ frequently has been held to unsettle naturalised relationships between the state and its citizenry. Yet, in casting ‘medical tourism’ as either an outside ‘innovation’ or ‘invasion’, scholars have too often ignored the role that the neoliberal retrenchment of social welfare structures has played in shaping the domestic healthcare systems of the ‘developing’ countries increasingly recognised as international medical travel destinations. While there is little doubt that ‘medical tourism’ impacts destinations’ healthcare systems, it remains essential to contextualise them. This paper offers a reading of the emergence of ‘medical tourism’ from within the context of on-going healthcare privatisation reform in one of today’s most prominent destinations: Malaysia. It argues that ‘medical tourism’ to Malaysia has been mobilised politically both to advance domestic healthcare reform and to cast off the country’s ‘under-developed’ image not only among foreign patient-consumers but also among its very own nationals, who are themselves increasingly envisioned by the Malaysian state as prospective healthcare consumers.
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This paper examines the kinds of politics that are enabled by the Internet with respect to immigrants to the United States; its primary concern is whether the political spaces created through the Internet can foster incorporation of... more
This paper examines the kinds of politics that are enabled by the Internet with respect to immigrants to the United States; its primary concern is whether the political spaces created through the Internet can foster incorporation of immigrants in the political community or whether the political activity on the Internet seems likely to lead to a more fractionalized political community in which the position of immigrants remains marginal. This exploration is based first on a random sample of web-sites about immigration and second on a more targeted sample of sites aimed specifically at two immigrant groups. The analysis of web-sites indicates that there is a great deal of information about immigrants on the Internet, and that most of it seems to be directed to service providers, policy makers, and researchers. There is relatively little discussion by or about immigrants, and beyond a few notable sites, there is almost no sign of mobilization. To the extent that the Internet is used to create new political spaces, it may not be spaces for deliberation and discussion. Rather, the political spaces seem to be informational spaces in which the politics are not easily or directly read.
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The novelty and severity of the virus and the ease with which COVID-19 is transmitted have led to far-reaching and unprecedented international travel restrictions. This chapter focuses on the ways in which national governments scrambled... more
The novelty and severity of the virus and the ease with which COVID-19 is transmitted have led to far-reaching and unprecedented international travel restrictions. This chapter focuses on the ways in which national governments scrambled at a moment of unprecedented crisis to manage different forms of international mobility on which they have grown increasingly dependent over the last decades. It uses the concept of 'biological citizenship' as a lens through which to explore how the COVID-19 pandemic offers new perspective on age-old political dilemmas of controlling the spread of contagion and its management. Through that lens, the emergence of novel spatio-relational configurations of 'biological trust' in the form of bubbles, bridges, and corridors; biological risk loopholes legitimizing the resumed movement of 'high value'-'low volume' flows; and biologically inclusive regularizations policies can be seen. The chapter argues for the need to make increasingly visible the ways in which our biological identities articulate with our political identities in a highly globalized world.
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Each year, millions of people around the world, disenfranchised by the restrictive national laws and unresponsive health systems in their countries of residence, circumvent these barriers by travelling to countries where their desired... more
Each year, millions of people around the world, disenfranchised by the restrictive national laws and unresponsive health systems in their countries of residence, circumvent these barriers by travelling to countries where their desired medical treatment is more accessible to them. These patients’ international medical travels (IMT), sometimes referred to as “medical tourism,” have drawn popular, political, commercial and scholarly attention, first, to the diverse global patchwork of healthcare ideologies and practices; second, to the national containerization of health care; and, third, to the consequences of IMT in traveling patients’ source, transit and receiving countries.
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Demographic and epidemiological transitions in Global South countries, on the one hand, and the neoliberalisation both of national health systems and international development aid, on the other, have produced widening health gaps between... more
Demographic and epidemiological transitions in Global South countries, on the one hand, and the neoliberalisation both of national health systems and international development aid, on the other, have produced widening health gaps between those who can afford care and those who cannot. The vast majority of so-called medical tourists receiving treatment in Global South destinations today are themselves from other parts of the Global South, their transnational movements reflecting and fostering asymmetrical social, economic and political relations that enable those in some countries to be in a position to address the care deficiencies of those in others. This chapter argues that medical tourism reconfigures relations between and within source and destination countries’ populations, by establishing novel forms of post-national market-mediated solidarities and forms of aid. Furthermore, medical tourism reconfigures relations between national governments and their citizens by advancing subjects’ neoliberal self-responsibilisation or re-claiming bonds of social solidarity between states and their subjects. These alliances between medical tourism destinations’ private hospitals, on one end, and national and state governments, insurers, intermediaries, and individuals and their families, on the other, largely bypass government-to-government diplomatic and aid relations. This upends conventional thinking about the geography of care and solidarity.
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Closed adoptions – where birth and adoption records are legally sealed to obscure adoptees’ biological parentage – were once the norm in many western Anglophone countries. Grassroots resistance to closed adoption relied upon the belief... more
Closed adoptions – where birth and adoption records are legally sealed to obscure adoptees’ biological parentage – were once the norm in many western Anglophone countries. Grassroots resistance to closed adoption relied upon the belief that deprivation of knowledge of their true biological origins could lead to psychological trauma among adoptees. In this chapter, I reflect on my own mother’s sense of deprivation as a resullt of closed adoption, her desire for a coherent origin story and her consequent process of cobbling together disparate fragments of legally-, religiously-, scientifically-, commercially- and familiarly-authorised and -authorising heritages from among diverse analogue, digital and biotechnical resources rendered intelligible, relevant and truthful by societal and (bio)technological transformations over time. In so doing, I call attention to complicated power relations in everyday personal heritage practices that challenge the simplistic pitting of ‘heritage from below’ (Robertson 2012) against ‘Authorised Heritage Discourse’ (AHD) (Smith 2006).
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With more people living longer than ever before, populations' medical and long-term care needs are increasingly placing strain on individual and collective resources and capacities. Neoliberal policies have (restructured d care relations... more
With more people living longer than ever before, populations' medical and long-term care needs are increasingly placing strain on individual and collective resources and capacities. Neoliberal policies have (restructured d care relations by (redistributing g health and social care in ways that (re-)domesticate, individualize and commoditize responsibility. Yet, while much earlier research has focused on this (redistribution n of care responsibility within countries, a growing literature traces how formal and informal health and social care provision extends well beyond the national. The transnational dimension of health and long-term care has been significantly heightened not only by neoliberal trade policies facilitating transnational flows of people, goods and services but also by advancements in communication technologies and biotechnological innovation. In this chapter, we draw health geographers' attention to the increasingly diverse transnational flows of care-givers and-seekers as well as the complex networks that they and their movements constitute and in which they get enfolded. To do this, we highlight contributions by scholars working at the crossroads of migration studies, transnational studies, health and social geography and anthropology, and social gerontology. This set of literatures critically engages with how transnational care practices challenge conventional conceptualizations and territorializations of care responsibility and entitlement between (non-)citizens and states; individuals, families and communities; and consumers, workers and markets.
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Transnational medical travel/tourism, by and large, involves travel to cities and metropolitan areas. Only urban areas possess the sufficient volume and variety of world-class medical expertise, cutting-edge technology, transportation... more
Transnational medical travel/tourism, by and large, involves travel to cities and metropolitan areas. Only urban areas possess the sufficient volume and variety of world-class medical expertise, cutting-edge technology, transportation infrastructure, communication and mediation facilities and hospitality services and infrastructure to be able to emerge as transnational medical travel destinations. Yet how cities and transnational flows of patients, standards and capital interact to generate new urban assemblages and new assemblages of health care is a story that has yet to really be told. While research on transnational medical travel/tourism is becoming more nuanced, involving a broader variety of perspectives, actors and medical mobilities, any attention given thus far to urban areas has been largely implicit and, thus, conceptually under-explored and -utilised. In this chapter, we argue for a relational approach on the urban as well as on transnational health care. Our focus was on how elements become mobile, circulate and assemble to form medical travel/tourism and how this assembling entangles with the elements and relations that constitute the urban. The presented cases show that networks are fluid and constantly being made, as elements entangle and disentangle and, through relational processes of dissociation and re-association, themselves transform. Through the assembling of medical travel/tourism, hospitals’ incomes can rise and their interiors can be ‘internationalised’; neighbours and hotels can learn to accommodate the presence of ‘sick’ bodies; patients can become health consumers and, perhaps, evangelise the benefits of travelling abroad for medical purposes; penniless refugees and wealthy doctors alike can become care brokers; and, last but not least, hopeless, ignored ‘medical cases’ at home can become hopeful, desired customers abroad.
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Research Interests: Refugee Studies, Health inequality, HIV/AIDS, Social Determinants of Health, Health Disparities, and 6 moreMigration Studies, Migration And Health, Access to health services, Mental Health Services Research, Asylum and refugees studies, migration and integration, and Immigrant and Refugee Access to Care
In this chapter, we look at how economic, political, social, cultural and biological influences work together within the space of the Association of Southeast Asian Nations’ (ASEAN) political, economic and social ‘community’ experiment,... more
In this chapter, we look at how economic, political, social, cultural and biological influences work together within the space of the Association of Southeast Asian Nations’ (ASEAN) political, economic and social ‘community’ experiment, which today encompasses over 600 million people. We focus specifically on how economic liberalization and the corollary increases in movements of people, goods and services within, between and beyond ASEAN member-states is transforming and challenging entrenched ideas about who is entitled to and responsible for health and social care within and across national borders.
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Tapping into migrants’ diverse tacit healthcare knowledge can bring a range of stakeholders in countries of origin great insight, at both macro and micro levels, not only into how to improve on local healthcare delivery but also how to... more
Tapping into migrants’ diverse tacit healthcare knowledge can bring a range of stakeholders in countries of origin great insight, at both macro and micro levels, not only into how to improve on local healthcare delivery but also how to effectively respond to the needs and interests of ‘medical tourists’, travellers and other migrants. This chapter reviews recent literature on migration and ‘medical tourism’ in order to look in greater detail at the role, first, of migrant patients and, second, of migrant health workers in the development of Global South destinations’ ‘medical tourism’ industries. It offers a series of lessons drawn from the many examples of migrant knowledge transfer and barriers presented.
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Many of the world’s demographically oldest countries are increasingly ‘outsourcing’ care from abroad for their elderly. Indeed, seniors wishing to age in place in countries like Germany and Singapore are making – and in some cases, as in... more
Many of the world’s demographically oldest countries are increasingly ‘outsourcing’ care from abroad for their elderly. Indeed, seniors wishing to age in place in countries like Germany and Singapore are making – and in some cases, as in Japan, beginning to explore how to make – use of at-home help, frequently provided by female migrant care workers. However, as with the 2011 film The Best Exotic Marigold Hotel, premised on budget-conscious British pensioners opting to spend the rest of their lives in India, more seniors are also relocating abroad for more affordable long-term domestic or institutional living and care arrangements. Compared with traditional accounts of ‘International Retirement Migration’ (IRM) that take as their prime subjects a pool of relatively autonomous, mobile, affluent and healthy ‘young old’, this relatively novel type of relocation draws attention to the significance of economic precariousness and its attendant embodied socio-spatial dependencies, vulnerabilities and ‘stuckness’ underlying this form of transnational mobility for many older people living abroad.
Research Interests: Southeast Asia, Migration Studies, Social Care For Older People, Transnational migration, Japan, and 9 moreCare Ethics, Central and Eastern Europe, Germany, International Retirement Migration, Care Economy, Post-retirement life satisfaction, Transnational Mobility and Cosmopolitanism, Oma Export, and Greisen Export
Why exactly can an American save up to 80% on a medical procedure by simply travelling to Malaysia? Flush with excitement over the panacea medical tourism seems to promise so many, have stakeholders paused long enough in the construction... more
Why exactly can an American save up to 80% on a medical procedure by simply travelling to Malaysia? Flush with excitement over the panacea medical tourism seems to promise so many, have stakeholders paused long enough in the construction of the medical tourism industry to reflect on what this fact says about the striking economic, social, political and technological imbalances in both home and destination countries underlying the relatively novel phenomenon of medical tourism? What has actually been democratized and levelled, and for whom? In this chapter, I seek to geographically situate medical tourism supply and demand as well as responsibility for it by exploring what’s where, why it’s there, and the challenges we face in caring about this uneven distribution.
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This chapter provides an overview of current government and governance strategies relative to medical tourism development and management around the world. Most studies on medical tourism have privileged national governments as key actors... more
This chapter provides an overview of current government and governance strategies relative to medical tourism development and management around the world. Most studies on medical tourism have privileged national governments as key actors in medical tourism regulation and, in some cases, even facilitation and provision. However, with the multiplication of supra- and sub-national regions, each with their own distinct responsibilities and levels of autonomy, it is important to consider the various nested and overlapping governance types and practices at play in medical tourism. This chapter, therefore, identifies how governments at various levels (e.g., national, sub-national, supra-national) in both source and host contexts play different, yet often overlapping, roles relative to medical tourism as facilitator, regulator and provider.
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Contemporary medical tourism builds upon long-standing links between travel and the pursuit of physical, mental, and spiritual well-being. It is produced today through the combination of, on the one hand, shifts in concentrations of... more
Contemporary medical tourism builds upon long-standing links between travel and the pursuit of physical, mental, and spiritual well-being. It is produced today through the combination of, on the one hand, shifts in concentrations of accessible medical expertise and technologies around the world and, on the other, increased medicalization, care commodification, and perception of bodies as improve-able, malleable property. This chapter considers the impacts of this transnational phenomenon on contexts both generating and receiving medical tourists as well as the lesser-explored virtual and transit spaces between them and the methodological challenges that researchers face in studying medical tourism.
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Migrant diasporas are increasingly pegged as the ‘natural’ markets for and ‘ambassadors’ to the world-class private health care increasingly available in their countries of origin. This chapter explores the pursuit and provision of health... more
Migrant diasporas are increasingly pegged as the ‘natural’ markets for and ‘ambassadors’ to the world-class private health care increasingly available in their countries of origin. This chapter explores the pursuit and provision of health care by migrant populations ‘back home’, and examines the potential of healthcare to deepen their diasporic linkages with the countries of origin.
Research Interests: Tourism Marketing, Development Studies, Transnationalism, Immigration, Central America and Mexico, and 18 moreHealth Inequalities, Global Health, Global Citizenship, Consumerism, Health Literacy, Health Care Service Access and Utilization, Diaspora, Philippines, Medical Tourism, Migration Studies, Biopolitics, Citizenship, India, Healthcare Marketing, Brain Drain, Balikbayan, Non-resident Indians, and Immigration Status & Nationality
‘Culturally-competent’ patient-centred care plays an increasingly expedient role in medical tourism destinations’ ability to capture international patient-consumer markets. While Malaysia’s ethnic, linguistic and religious pluralism had... more
‘Culturally-competent’ patient-centred care plays an increasingly expedient role in medical tourism destinations’ ability to capture international patient-consumer markets. While Malaysia’s ethnic, linguistic and religious pluralism had been framed as threatening to nation-building efforts in the early period following independence, recent decades have witnessed growing state awareness of the value of its culturally diverse population for plugging Malaysia into lucrative transnational networks. Engagement with global capital has helped to revalue and identify cultural diversity as central to Malaysian identity. This chapter argues that Malaysia’s burgeoning medical tourism industry is profoundly entrenched in this task and explores how claims to ‘cultural’ expertise get enacted, mobilised and reified in the promotion of the country as a destination.
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Considering the growing relevance of healthcare-motivated travel across borders, this chapter draws attention to tensions derived from destinations’ focus on satisfying the needs of the desired western ‘medical tourist’ while the more... more
Considering the growing relevance of healthcare-motivated travel across borders, this chapter draws attention to tensions derived from destinations’ focus on satisfying the needs of the desired western ‘medical tourist’ while the more everyday intraregional flows of medical travellers, though constituting the bulk of international medical travel today, pass largely under the radar. The chapter situates the development of Malaysia’s principal medical travel destinations as a response to the growth of patient-consumers from Indonesia for the treatment of ailments ranging from the mundane to the acute. It then identifies the disjuncture with Malaysia’s burgeoning national ‘medical tourism’ agenda, disproportionately orientated towards catering to an ideal tourism still largely devoid of tourists by directing investment towards adapting to the ‘everyday’ standards deemed requisite to attract the high-spending, long-haul ‘medical tourist’ archetype, eclipsing the response to the needs of a significant proportion of medical travellers. In offering a grounded reading of the management of Indonesian medical travel to Malaysia, this chapter points to the active role of destinations at a range of scales in recognising and catering to different categories of medical travellers, laying out the complex ethical, economic and political contours shaping the recognition of medical travellers’ corporeal vulnerabilities and the correlate extension of hospitality.
Research Interests: Geography, Tourism Studies, Southeast Asian Studies, Hospitality Studies, Transnationalism, and 10 moreGlobal Health, Consumerism, Health Care Service Access and Utilization, Health Care Ethics, Citizenship And Governance, Political Geography, Geography of Mobility and Migrations, Regional Integration, Citizenship, and Immigration Status & Nationality
This essay takes a brief look at services being developed throughout the world to cater to a specific population that has chosen to cross borders in order to receive quality health care: people from wealthier countries who, for a variety... more
This essay takes a brief look at services being developed throughout the world to cater to a specific population that has chosen to cross borders in order to receive quality health care: people from wealthier countries who, for a variety of reasons, are unable to receive adequate urgent or elective medical treatment in their places of origin yet who have sufficient personal financial resources that enable them to receive lower cost medical treatments in other generally less-developed countries. How is this type of mobility – oftentimes referred to as ‘health tourism’ or ‘medical tourism’ – accepted and handled by the places that send and receive these ‘tourists’? How does it impact these places and their residents at different scales, bearing in mind their variable levels of development?
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"Book abstract: The family lives of immigrants and ethnic minority populations have become central to arguments about the right and wrong ways of living in multicultural societies. While the characteristic cultural practices of such... more
"Book abstract:
The family lives of immigrants and ethnic minority populations have become central to arguments about the right and wrong ways of living in multicultural societies. While the characteristic cultural practices of such families have long been scrutinized by the media and policy makers, these groups themselves are beginning to reflect on how to manage their family relationships. Exploring case studies from Austria, the Netherlands, Norway, Portugal, Spain, Switzerland, the United Kingdom, and Australia, The Family in Question explores how those in public policy often dangerously reflect the popular imagination, rather than recognizing the complex changes taking place within the global immigrant community.
Book review: http://www.etmu.fi/fjem/pdf/FJEM_3_2010.pdf#page=105"
The family lives of immigrants and ethnic minority populations have become central to arguments about the right and wrong ways of living in multicultural societies. While the characteristic cultural practices of such families have long been scrutinized by the media and policy makers, these groups themselves are beginning to reflect on how to manage their family relationships. Exploring case studies from Austria, the Netherlands, Norway, Portugal, Spain, Switzerland, the United Kingdom, and Australia, The Family in Question explores how those in public policy often dangerously reflect the popular imagination, rather than recognizing the complex changes taking place within the global immigrant community.
Book review: http://www.etmu.fi/fjem/pdf/FJEM_3_2010.pdf#page=105"
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This thesis examines the shifting relationship between the state and its subjects with regard to responsibility for and entitlement to care. Using Malaysia as a case study the research engages with international medical travel (IMT) as an... more
This thesis examines the shifting relationship between the state and its subjects with regard to responsibility for and entitlement to care. Using Malaysia as a case study the research engages with international medical travel (IMT) as an outcome of the neoliberal retrenchment of the welfare state. I offer a critical reading of postcolonial development strategies that negotiate the benefits and challenges of extending care to non-national subjects.
Research Interests: Human Geography, Tourism Studies, Development Studies, Brand Management, Welfare State, and 22 moreSovereignty, Health Geography, Corporate Governance, Governance, Merchandising, Consumer Behavior, Medical Tourism, Regional development, Biopolitics, Health Citizenship, Urban And Regional Planning, Consumer Research, Healthcare, Citizenship, Retail Management, Soft Power and International Relations, Global Health Diplomacy, Healthcare policy, Medical Diplomacy, Citizenship identities, Immigration Status & Nationality, and Buying and Sourcing
With dual-income households and rapidly ageing populations, care labour – whether formal or informal nursing, childcare, care for dependent seniors or domestic work – is in ever-greater demand. Yet such jobs are among the least desirable... more
With dual-income households and rapidly ageing populations, care labour – whether formal or informal nursing, childcare, care for dependent seniors or domestic work – is in ever-greater demand. Yet such jobs are among the least desirable to take up, given that they are often physically and emotionally demanding, poorly remunerated and prone to exploitation. As a result, an increasing proportion of care labour is performed by migrants, most often migrant women. In her book, An Archipelago of Care, Deirdre McKay engages with what scholars have called a 'migrant ethic of care' (25), the notion that migrant care-givers are somehow equipped with a better disposition for caring for strangers than their non-migrant counterparts. She argues that this 'migrant ethic of care' exists among the Kankanaey-speaking Filipino migrants working care jobs in London who are at the heart of her study. In her view, a specific ethic of care is generated and sustained through these migrant care labourers' personal transnational care networks, networks through which affirmative affect flows and replenishes their own care needs in order to be able to provide good-quality care for their employers. This relational perspective – one she defines as 'archipelagic', a creative nod to the (physical and, ultimately, political) geography of the Philippines – builds on and complicates dominant conceptualisations of transnational care flow configurations as chains and diamonds by acknowledging the dynamic spatial and temporal constellations of nodes through which affect nourishes migrant care labourers and enables them to plough ahead. Especially unique about McKay's contribution amidst existing studies of transnational care labour is her acknowledgement of migrant care labourers' own individual emotional (inter)dependencies and the ways in which their coping strategies are transnationally articulated through an ever-changing range of nodes that complicate conventional thinking about proximity, distance and directionality in caring/being cared about and caring/being cared for.
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In Jorgen Leth and Lars von Trier’s 2003 documentary film The Five Obstructions, von Trier uses the method of ‘obstructive limitation’ to disrupt conventional filmmaking habits that inhibit Leth from seeing, experiencing and relating the... more
In Jorgen Leth and Lars von Trier’s 2003 documentary film The Five Obstructions, von Trier uses the method of ‘obstructive limitation’ to disrupt conventional filmmaking habits that inhibit Leth from seeing, experiencing and relating the story in alternative ways. In this intellectual exercise, Leth must creatively respond to a set of rules and obstacles devised by von Trier that force him to perceive and approach both the story and the art of filmmaking differently. With their playful volume, Disruptive Tourism and its Untidy Guests, Veijola et al. take up a similar daunting phenomenological challenge: to disrupt ‘the standard templates’ of tourism and hospitality scholarship in order to permit space for alternative, even radical, approaches to reconceptualising and practicing the relationship at the core of tourism, hospitality and even research itself: host(ess)ing and guesting (Veijola and Jokinen 2008).
The Netherlands is today home to an estimated 2.5 million people with disabilities, and this number is on the rise with the country's rapidly ageing population. Given that the Dutch government ratified the UN Convention on the Rights of... more
The Netherlands is today home to an estimated 2.5 million people with disabilities, and this number is on the rise with the country's rapidly ageing population. Given that the Dutch government ratified the UN Convention on the Rights of Persons with Disabilities (CRPD) only in 2016, there remains a lot to be done within the country to implement the Convention's articles. Recently, the country's tourism and travel industry has begun to respond, trying to identify how it can comply with (international) regulations regarding the rights of travellers with disabilities as well as how to tap into this growing sector. In light of recent developments, the Dutch Association of Travel Operators (ANVR), Reiswerk, the Dutch Association of Specialised Travel Operators (NBAV) and CELTH together commissioned a report on current and future challenges and opportunities for accessible tourism in the Netherlands. The team of researchers working on that report came from three Dutch institutions: Wageningen University's Cultural Geography Group, Breda University of Applied Sciences (BUAS), and NHL Stenden University of Applied Sciences' European Tourism Futures Institute (ETFI). The report is organised around the customer journey of people with disabilities, describing the barriers that people with different kinds of disabilities experience before, during and after their journeys and how the travel industry can respond to these challenges.
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Roots Guide is a novel tool developed to help us not only see the world differently but also be in the world differently. Taking the form of an interactive, reflective travel guidebook, Roots Guide invites us to undertake both outer and... more
Roots Guide is a novel tool developed to help us not only see the world differently but also be in the world differently. Taking the form of an interactive, reflective travel guidebook, Roots Guide invites us to undertake both outer and inner journeys by revisiting what we think we know about life in the Netherlands, starting on our very own doorsteps.
Through visual and personal stories, it welcomes us into the lives of our Roots Guide hosts, more than 60 people from diverse backgrounds. Learn about what brought our hosts to the places in which they live and their experiences of these places. And, along the way, get fantastic travel tips and recommendations that shed new light on the wonder, weirdness, struggles, and joy that portray contemporary life in the country we call home.
Roots Guide is for everyone who lives in the Netherlands and is curious to explore themselves and their place in this country in a new way. Experience and connect with people and places just next door or all the way across the country, ones you thought you already knew like the back of your hand, ones you’ve never heard of, and perhaps even ones you may have feared.
Through in-depth stories, trip suggestions and guided multisensory reflective activities specially designed for its readers, Roots Guide opens us up to different ways of seeing and being in our Netherlands, not the Netherlands as some mythical fixed place and culture to which we either do or don’t belong.
Through visual and personal stories, it welcomes us into the lives of our Roots Guide hosts, more than 60 people from diverse backgrounds. Learn about what brought our hosts to the places in which they live and their experiences of these places. And, along the way, get fantastic travel tips and recommendations that shed new light on the wonder, weirdness, struggles, and joy that portray contemporary life in the country we call home.
Roots Guide is for everyone who lives in the Netherlands and is curious to explore themselves and their place in this country in a new way. Experience and connect with people and places just next door or all the way across the country, ones you thought you already knew like the back of your hand, ones you’ve never heard of, and perhaps even ones you may have feared.
Through in-depth stories, trip suggestions and guided multisensory reflective activities specially designed for its readers, Roots Guide opens us up to different ways of seeing and being in our Netherlands, not the Netherlands as some mythical fixed place and culture to which we either do or don’t belong.
Research Interests:
Numerous national and sub-national governments around the world are actively engaged in the development and promotion of ‘international medical travel’ (IMT), many with several ministries actively and simultaneously collaborating with... more
Numerous national and sub-national governments around the world are actively engaged in the development and promotion of ‘international medical travel’ (IMT), many with several ministries actively and simultaneously collaborating with private-sector stakeholders. This presentation examines how expectations, strategies and policies for IMT develop, travel across borders and circulate, and, finally, how they get adopted and adapted elsewhere. To do this, I focus on the production and reproduction of strategies and policies anchored around tools increasingly used by IMT destinations to facilitate foreign patient consumers’ awareness of and access to medical treatment, like the altering of national medical advertising regulations, the development and production of medical travel visas and easing of other types of entry requirements, and the development and professionalization of national IMT booster organizations. My analysis focuses on developments within and between significant IMT destinations like Dubai, India, Jordan, Korea, Malaysia and Thailand. How do different stakeholders adopt and adapt - or not - IMT development strategies and policies in global circulation? What enables certain strategies and policies to take hold in one place and not in others? And if they are adopted, how are they renegotiated, by whom and under what conditions?
The term ‘governance’ is frequently used to describe the many ways in which public and private actors from the state, market and/or civil society are relationally configured at multiple scales in order to govern, organise and manage... more
The term ‘governance’ is frequently used to describe the many ways in which public and private actors from the state, market and/or civil society are relationally configured at multiple scales in order to govern, organise and manage ‘common pool resources’ like health or environmental resources. It acknowledges that the management of and responsibility for such resources lies not only with national governments but also with an array of others, like municipalities, businesses, international organisations, civil society and consumers. As such, understanding the dynamic ways in which these different actors articulate themselves and their objectives in relation to the resource itself and to one another becomes paramount. The cross-border movement of people in pursuit of healthcare and the global industry developing around it have attracted significant attention from a range of actors because it challenges conventional modern understandings of entitlement to and responsibility for health resources. Governance of international medical travel (IMT) involves numerous actors, each with their own conceptualisations of, capacities relative to and vested interests in IMT. Yet IMT governance is largely understood and practiced as a novel arrangement between national governments, businesses and consumers. While IMT’s use and redistribution of health resources has encountered resistance to certain more morally polemic areas, leading to changes in national regulation (e.g., commercial surrogacy, transplantation, etc.), its growth overall has gone largely and curiously unproblematised in IMT destinations around the world. This paper looks at how resistance to IMT is (not) manifested and (not) handled in existing governance arrangements.
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For the full programme, visit: http://medicalmobilities.blogspot.nl/2016/02/upcoming-conference-imtj-academic.html This two-day conference will bring together scholars from academic and research institutions from around the globe in... more
For the full programme, visit: http://medicalmobilities.blogspot.nl/2016/02/upcoming-conference-imtj-academic.html
This two-day conference will bring together scholars from academic and research institutions from around the globe in order to critically examine and discuss existing and emerging national, sub-national, transnational and cross-sectoral strategies for the following:
- Promoting and dissuading ‘medical tourism’ and ‘transnational patient mobility’ in and between source and destination sites, in order to draw attention to the diversity of stakeholders, interests and scales involved;
- Evaluating and managing the range of real and expected impacts of (diverse stakeholders’ investments in) ‘medical tourism’ and ‘transnational patient mobility’ in and between source and destination sites, in order to move beyond an unproductive circulation of often poorly-grounded claims and counter-claims; and
- Identifying and assessing the real-life needs, desires, expectations and practices of a broader range of foreign healthcare-users and -consumers, in order to recognise not only the great diversity of mobile patients (e.g., geographical origins, socio-economic and political status, etc.) but also other resident ‘foreigners’ (e.g., expatriates, lifestyle migrants, foreign students, etc.) who make use of ‘medical tourism’ resources.
This two-day conference will bring together scholars from academic and research institutions from around the globe in order to critically examine and discuss existing and emerging national, sub-national, transnational and cross-sectoral strategies for the following:
- Promoting and dissuading ‘medical tourism’ and ‘transnational patient mobility’ in and between source and destination sites, in order to draw attention to the diversity of stakeholders, interests and scales involved;
- Evaluating and managing the range of real and expected impacts of (diverse stakeholders’ investments in) ‘medical tourism’ and ‘transnational patient mobility’ in and between source and destination sites, in order to move beyond an unproductive circulation of often poorly-grounded claims and counter-claims; and
- Identifying and assessing the real-life needs, desires, expectations and practices of a broader range of foreign healthcare-users and -consumers, in order to recognise not only the great diversity of mobile patients (e.g., geographical origins, socio-economic and political status, etc.) but also other resident ‘foreigners’ (e.g., expatriates, lifestyle migrants, foreign students, etc.) who make use of ‘medical tourism’ resources.
Research Interests:
Since official reporting began in 1998, Malaysia’s published ‘medical tourism’ figures have indiscriminately included all registered patients with a foreign passport. These figures are used promotionally to frame Malaysia as a global and... more
Since official reporting began in 1998, Malaysia’s published ‘medical tourism’ figures have indiscriminately included all registered patients with a foreign passport. These figures are used promotionally to frame Malaysia as a global and regional medical care hub for ‘medical tourists’ – what most literature understands to be non-resident, short-stay travellers who purchase preventive screenings, diagnoses, invasive and non-invasive treatments and medicines over a limited period of time that then – importantly – return to their homes abroad. However, this reporting practice actually lumps together non-resident non-citizens (e.g., tourists and day travellers) with the growing number of categories of resident non-citizens (e.g., foreign students, labour migrants, retired expatriates, etc.) required to use private healthcare in the country within the scope of a range of special government-promoted programmes (e.g., Malaysia My Second Home, Education Malaysia, etc). In so doing, existing ‘medical tourism’ figures effectively obscure important differences in these diverse populations’ heterogeneous political and socio-economic statuses and associated variations in entitlement and access to healthcare in Malaysia. This paper draws on King’s (2002) conceptualisation of a privatised ‘migration industry’ in order to examine the privatised healthcare industry developing around the growing number of resident and non-resident non-citizens in Malaysia.
Research Interests:
This two-day conference therefore aims to bring together scholars from academic and research institutions from around the globe in order to critically examine and discuss existing and emerging national, sub-national, transnational and... more
This two-day conference therefore aims to bring together scholars from academic and research institutions from around the globe in order to critically examine and discuss existing and emerging national, sub-national, transnational and cross-sectoral strategies for the following:
• Promoting and dissuading ‘medical tourism’ and ‘transnational patient mobility’ in and between source and destination sites, in order to draw attention to the diversity of stakeholders, interests and scales involved;
• Evaluating and managing the range of real and expected impacts of (diverse stakeholders’ investments in) ‘medical tourism’ and ‘transnational patient mobility’ in and between source and destination sites, in order to move beyond an unproductive circulation of often poorly-grounded claims and counter-claims; and
• Identifying and assessing the real-life needs, desires, expectations and practices of a broader range of foreign healthcare-users and -consumers, in order to recognise not only the great diversity of mobile patients (e.g., geographical origins, socio-economic and political status, etc.) but also other resident ‘foreigners’ (e.g., expatriates, lifestyle migrants, foreign students, etc.) who make use of ‘medical tourism’ resources.
We invite scholars to submit papers that critically engage with the abovementioned issues. Papers focused on multi-scalar and cross-sectoral governance of ‘medical tourism’ and ‘transnational patient mobility’ initiatives, partnerships and networks as well as those examining how ‘medical tourism’ and ‘transnational patient mobility’ fit within broader development objectives (e.g., transition towards the creative economy, biotech development, regional and city place-branding, etc.) are especially welcome.
The Academic Conference (25-26 May 2016) will overlap with the International Medical Travel Journal’s (IMTJ) Medical Travel Summit (24-25 May 2016), which brings together governmental and industry representatives from around the world who are involved in the development of medical tourism. This will provide a unique opportunity for conference participants to attend parts of the IMTJ Summit and actively foster and engage in much-needed cross-sectoral knowledge exchange and dialogue.
To submit a paper proposal, please send an email with a 250-word abstract and a 100-word bio via http://summit.imtj.com/academic-application/ before 11 December 2015. Scholars and researchers in any stage of their career (e.g., PhD students, etc.) are encouraged to share their studies. Successful applicants will be contacted by 8 January 2016 and will be expected to register for the conference by 12 February 2016 to secure their place in the May 2016 conference programme. For further information about the call for papers, please contact a member of the Academic Advisory Board:
• John Connell (Univ. of Sydney, Australia) [email protected]
• Neil Lunt (Univ. of York, UK) [email protected]
• Meghann Ormond (Wageningen Univ., The Netherlands) [email protected]
• Promoting and dissuading ‘medical tourism’ and ‘transnational patient mobility’ in and between source and destination sites, in order to draw attention to the diversity of stakeholders, interests and scales involved;
• Evaluating and managing the range of real and expected impacts of (diverse stakeholders’ investments in) ‘medical tourism’ and ‘transnational patient mobility’ in and between source and destination sites, in order to move beyond an unproductive circulation of often poorly-grounded claims and counter-claims; and
• Identifying and assessing the real-life needs, desires, expectations and practices of a broader range of foreign healthcare-users and -consumers, in order to recognise not only the great diversity of mobile patients (e.g., geographical origins, socio-economic and political status, etc.) but also other resident ‘foreigners’ (e.g., expatriates, lifestyle migrants, foreign students, etc.) who make use of ‘medical tourism’ resources.
We invite scholars to submit papers that critically engage with the abovementioned issues. Papers focused on multi-scalar and cross-sectoral governance of ‘medical tourism’ and ‘transnational patient mobility’ initiatives, partnerships and networks as well as those examining how ‘medical tourism’ and ‘transnational patient mobility’ fit within broader development objectives (e.g., transition towards the creative economy, biotech development, regional and city place-branding, etc.) are especially welcome.
The Academic Conference (25-26 May 2016) will overlap with the International Medical Travel Journal’s (IMTJ) Medical Travel Summit (24-25 May 2016), which brings together governmental and industry representatives from around the world who are involved in the development of medical tourism. This will provide a unique opportunity for conference participants to attend parts of the IMTJ Summit and actively foster and engage in much-needed cross-sectoral knowledge exchange and dialogue.
To submit a paper proposal, please send an email with a 250-word abstract and a 100-word bio via http://summit.imtj.com/academic-application/ before 11 December 2015. Scholars and researchers in any stage of their career (e.g., PhD students, etc.) are encouraged to share their studies. Successful applicants will be contacted by 8 January 2016 and will be expected to register for the conference by 12 February 2016 to secure their place in the May 2016 conference programme. For further information about the call for papers, please contact a member of the Academic Advisory Board:
• John Connell (Univ. of Sydney, Australia) [email protected]
• Neil Lunt (Univ. of York, UK) [email protected]
• Meghann Ormond (Wageningen Univ., The Netherlands) [email protected]
Research Interests: Medical Sociology, Development Economics, Medical Anthropology, Tourism Studies, Development Studies, and 23 moreHealth Economics, Mobility/Mobilities, Tourism mobilities, Migration mobilities, Patient Safety, Health Geography, Cross-border cooperation, Global Health, Medical Tourism, Public Health, Healthcare, Medical Geography, Health Systems, Expatriates, Privatization, Healthcare Management, Health and Social Care, Patient Satisfaction, Lifestyle Mobilities, International Retirement Migration, Medical Travel, Lifestyle Migration, and Healthcare Economics
On the face of it, medical tourism and film-induced tourism appear to have little to do with one another apart from holding a word in common. Indeed, growing numbers of scholars, travellers and industry practitioners have even come to... more
On the face of it, medical tourism and film-induced tourism appear to have little to do with one another apart from holding a word in common. Indeed, growing numbers of scholars, travellers and industry practitioners have even come to find denoting people’s healthcare pursuits abroad as ‘medical tourism’ to be pejorative, seemingly downplaying the seriousness and urgency of their needs and aspirations with the frivolity with which ‘tourism’ is oftentimes associated. Those promoting ‘medical tourism’ destinations, therefore, must consider the complicated ways in which people considering travelling abroad for health care have come to construct and understand themselves, first, as patients and self-responsible consumers of medical services and, second, as capable of pursuing such services abroad as medical tourists/travellers. For this paper, I draw on Ostherr’s (2013) Medical Visions to consider the role of film, television and imaging technologies in shaping people’s inward-looking medicalised gazes and journeys – how, in other words, certain kinds of images are interpellating ‘medical tourists’ and both inducing and emerging from ‘medical tourism’ practices. As I come from a ‘medical tourism’-focused perspective, with this paper, I seek to provoke film tourism experts involved in this conference to consider the ways in which ‘film tourists’ are themselves imagined, desired and produced not only by the destinations seeking to receive them but also by and through other social actors and industries vying for their pocketbooks, hearts and minds.
Research Interests:
While much literature has looked at migrants’ access to healthcare, retirement migration and medical tourism separately, an explicit examination of the broad spectrum of health care for foreign residents and foreign visitors is curiously... more
While much literature has looked at migrants’ access to healthcare, retirement migration and medical tourism separately, an explicit examination of the broad spectrum of health care for foreign residents and foreign visitors is curiously absent. This is the case in spite of the conspicuous ways in which they are connected ‘horizontally’ as foreigners without ‘natural’ entitlement to health care and ‘hierarchically’ as foreigners who provide care for and receive care from one another as employees and employers. This paper compares and contrasts healthcare provision and access in Malaysia for i) undocumented and documented economic migrants, ii) retirement migrants residing in Malaysia in the scope of the MM2H programme and iii) international medical tourists. This paper examines legal, policy, civil society and media documents on resident and non-resident foreigners’ use of healthcare in Malaysia over time. It also draws from qualitative fieldwork throughout Malaysia to gain insight into contemporary perspectives on healthcare from undocumented and documented economic migrants, retirement migrants and international medical tourists as well as a range of stakeholders concerned with the management of these populations and their wellbeing. The paper demonstrates how Malaysian healthcare services are being restructured to deal with foreigners/non-citizens via the privatisation of risk within the context of a neoliberal focus on self-responsibility and self-care. The growth of healthcare privatisation in Malaysia appears to be making citizens and non-citizens arguably more similar as they both become consumers.
Malaysian authorities’ desire for foreign patient-consumers from higher-income countries and the spectacular medical tourism infrastructure being developed to cater to them exists in contrast to the actual everyday flows of intra-regional... more
Malaysian authorities’ desire for foreign patient-consumers from higher-income countries and the spectacular medical tourism infrastructure being developed to cater to them exists in contrast to the actual everyday flows of intra-regional lower-income patient-consumers who, comprising the bulk of medical travellers to Malaysia, have been fundamental in both constituting and sustaining the country’s medical travel destinations. This paper draws on interviews with medical travel companies in Malaysia and Indonesia that promote Malaysian private health care to prospective patient-consumers from both higher-income and lower-income countries. It compares and contrasts the functions of these companies, their relationships with patient-consumers and the ways in which they represent and negotiate the differences between health care in patients’ countries of origin and in Malaysia.
Research Interests:
Contemporary medical tourism builds upon longstanding links between travel and the pursuit of physical, mental, and spiritual well-being. It is produced today through the combination of, on the one hand, shifts in concentrations of... more
Contemporary medical tourism builds upon longstanding links between travel and the pursuit of physical, mental, and spiritual well-being. It is produced today through the combination of, on the one hand, shifts in concentrations of accessible medical expertise and technologies around the world and, on the other, increased medicalization, care commodification, and perception of bodies as improve-able, malleable property. This presentation first provides a general overview that considers the impacts of this transnational phenomenon on contexts both generating and receiving medical tourists as well as the lesser-explored virtual and transit spaces between them and the methodological challenges that researchers face in studying medical tourism. It then zooms in to describe and situate the emerging range of research that has been undertaken on medical tourism within the scope of Southeast Asia in particular.
At the end of this presentation is a reference list of publications focusing on medical tourism specifically in Southeast Asia that could be of use to scholars focusing on the region.
At the end of this presentation is a reference list of publications focusing on medical tourism specifically in Southeast Asia that could be of use to scholars focusing on the region.
Research Interests:
Note: A revised version of this paper has been published as Ormond, M. (2014) 'Resorting to Plan J: Popular perceptions of Singaporean retirement migration to Johor, Malaysia', Asian and Pacific Migration Journal, 23(1), 1-26. Available... more
Note: A revised version of this paper has been published as Ormond, M. (2014) 'Resorting to Plan J: Popular perceptions of Singaporean retirement migration to Johor, Malaysia', Asian and Pacific Migration Journal, 23(1), 1-26. Available HTTP: http://www.smc.org.ph/apmj/index.php?comp=com_issue_details&id=77
This exploratory study analyzes user-generated web content in Singapore and Malaysia to examine how the management of Singapore’s rapidly aging population within the emerging cross-border metropolitan space of Singapore and the Southern Malaysian state of Johor is perceived and framed by different social actors. It reveals a range of perspectives on the growing numbers of Singapore seniors and their families beginning to consider Johor as a post-retirement alternative to an over-priced and overcrowded Singapore to satisfy their needs and desires for more affordable medical and residential care, larger homes and greater independence.
This exploratory study analyzes user-generated web content in Singapore and Malaysia to examine how the management of Singapore’s rapidly aging population within the emerging cross-border metropolitan space of Singapore and the Southern Malaysian state of Johor is perceived and framed by different social actors. It reveals a range of perspectives on the growing numbers of Singapore seniors and their families beginning to consider Johor as a post-retirement alternative to an over-priced and overcrowded Singapore to satisfy their needs and desires for more affordable medical and residential care, larger homes and greater independence.
Research Interests:
There is a disjuncture between Malaysia’s growing desire for foreign patient-consumers from high-income countries and the corresponding governmental and private sector investments in spectacular medical tourism infrastructure, on the one... more
There is a disjuncture between Malaysia’s growing desire for foreign patient-consumers from high-income countries and the corresponding governmental and private sector investments in spectacular medical tourism infrastructure, on the one hand, and the essential yet relatively invisible role that everyday intra-regional medical travellers from nearby lower-income countries – who comprise the bulk of medical travellers to Malaysia – actually play in constituting and sustaining the country’s principal medical travel destinations, on the other. Seeking to bring attention to the relevance and realities of these more everyday medically-motivated mobilities, this paper explores the influence of ASEAN developmental regionalism on transborder economies developing around the pursuit of health care in the Malaysian city of Kuching by patient-consumers from the neighbouring Indonesian province of West Kalimantan. The paper argues for greater consideration of the political, economic and social ties fostered by these everyday medical mobilities and their potential for fostering a consumer-based regional belonging and solidarity.
Research Interests:
Given the dearth of quality health care throughout much of Indonesia, a growing middle class, the advent of more affordable cross-border transport and greater political ease in crossing borders, an estimated one million Indonesians travel... more
Given the dearth of quality health care throughout much of Indonesia, a growing middle class, the advent of more affordable cross-border transport and greater political ease in crossing borders, an estimated one million Indonesians travel abroad for health care annually. Encountering obstacles to adequate health care in Indonesia, many of these international medical travellers have opted to purchase essential care in neighbouring Malaysia instead of going to the streets to protest the poor condition of healthcare financing, infrastructure and human and material resources. In the place of conventional collective civic action is individual consumer-centred action. What are the political consequences and potential of this consumer practice in both medical travellers’ home and receiving contexts? This paper examines the international pursuit of privatised medical care through the lens of political consumerism, a body of theory that challenges and complicates conventional moral distinctions between ‘citizen’ and ‘consumer’. Throughout history, decisions and acts of purchasing have been frequently linked to the care of the self or one’s family – i.e., ensuring the access, safety, quality, value-for-money, honest advertising, etc. of what ‘we’ consume. Though frequently held in less esteem than other types of social movements where people primarily self-identify as political subjects instead of as consumers, much progress has come about through such consumer-centred advocacy for social justice in market-dominated practices (e.g., access to generic pharmaceuticals, food safety, etc.). In examining international medical travel between Indonesia and Malaysia, this paper posits consumer-centred international health mobilities and the liberalised political and commercial responses to them as a loose ethico-political movement that reimagines and remaps productive relations and terrains of care, justice, solidarity and responsibility in ways that at once transcend and yet remain thoroughly shaped by idealised state/citizen relationships.
The pursuit of medical treatment abroad has often been limited by dissuasive distances and barriers that require travellers with health conditions to tolerate long hours in transit uncomfortably. A growing number of low-cost airlines,... more
The pursuit of medical treatment abroad has often been limited by dissuasive distances and barriers that require travellers with health conditions to tolerate long hours in transit uncomfortably. A growing number of low-cost airlines, long-distance coach and ferry operators in Indonesia and Malaysia, however, – keen to benefit from disparities in the two countries’ health systems and improve Malaysia’s standing as a regional medical hub – are increasingly working to make medical travel more attractive and accessible. In offering faster and more frequent linkages to Malaysian hospitals to handle routine check-ups, chronic needs and evermore acute conditions, they have both expanded the physical and geo-political scope and increased the immediacy of care provision. Airlines have begun to contemplate retro-fitting their aircraft with spaces for stretchers and ambulances meet planes on airport tarmacs, foregoing traditional immigration and customs border procedures, so as to facilitate smoother cross-border transitions for an increasingly desirable mobile population of differently-abled bodies and the suitcases of cash which pay for their treatments and construct them as legitimate medical travellers in Malaysia. This paper draws on experiences of transporting Indonesian medical travellers pursuing care in Malaysia in order to examine the material prosthetics that help constitute and mobilise these ‘passenger bodies’ (Bissell 2010) of international medical travel.
There is a disjuncture between Malaysia’s growing desire for foreign patient-consumers from high-income countries and the corresponding governmental and private sector investments in spectacular medical tourism infrastructure, on the one... more
There is a disjuncture between Malaysia’s growing desire for foreign patient-consumers from high-income countries and the corresponding governmental and private sector investments in spectacular medical tourism infrastructure, on the one hand, and the essential yet relatively invisible role that everyday intra-regional medical travellers from nearby lower-income countries – who comprise the bulk of medical travellers to Malaysia – actually play in constituting and sustaining the country’s principal medical travel destinations, on the other. Seeking to bring attention to the relevance and realities of these more everyday medically-motivated mobilities, this paper draws on recent fieldwork that explores transborder micro-economies developing around the pursuit of health care in the Malaysian city of Kuching, where private hospitals actively court and receive high numbers of patient-consumers from neighbouring Indonesian Kalimantan. The paper argues for greater consideration of the political, economic and social ties fostered by these everyday medical mobilities and their potential for fostering regional development at the micro-level.
There is a disjuncture between Malaysia’s growing desire for foreign patient-consumers from high-income countries and the corresponding governmental and private sector investments in spectacular medical tourism infrastructure, on the one... more
There is a disjuncture between Malaysia’s growing desire for foreign patient-consumers from high-income countries and the corresponding governmental and private sector investments in spectacular medical tourism infrastructure, on the one hand, and the foundational yet relatively invisible role that everyday intra-regional medical travellers from nearby lower-income countries – who comprise the bulk of medical travellers to Malaysia – actually play in constituting and sustaining the country’s principal medical travel destinations, on the other. Seeking to bring attention to the relevance and realities of these more everyday medically-motivated mobilities, this paper draws on current fieldwork exploring the pursuit of health care by Indonesian patient-consumers in Kuching, capital of Sarawak, where private hospitals actively court and receive high numbers of Indonesians coming by land and air from neighbouring Kalimantan districts. The paper argues for greater consideration of the political, economic and social ties fostered by these everyday medical mobilities and their potential for enhancing regional development.
The movement of people from one place to another in search of care is neither new nor unidirectional. The range of terms that attach to the bodies that cross national borders points to the complex political geographies that enmesh states... more
The movement of people from one place to another in search of care is neither new nor unidirectional. The range of terms that attach to the bodies that cross national borders points to the
complex political geographies that enmesh states and their subjects - medical travel, tourism, and refugees invoke contested landscapes of uneven of development, rights and responsibilities that structure the provision and consumption of healthcare. Nonetheless, there is growing prominence of private-sector healthcare that seeks to attract a commoditized patient-cum- consumer, often understood to flow from the rich to the poor world. Central to this is the figure of the comparatively
rich western medical traveler who seeks treatment – often in developing countries – in response to the perceived failures of the healthcare system of their home country. This figure of the rich medical traveler can be both of a romantic sojourner or a fully entrepreneurial consumer. In this paper, we draw on empirical examples from medical travel guidebooks to argue that this focus on the individual agency of the medical traveler not only obscures the explicit interpellation of medical travelers as a particular kind of agent who can negotiate the cultural, institutional and medical
landscapes of care destinations, but also obscures the specific ways in which care destinations themselves are produced as sites for the production and consumption of care. Medical travel guidebooks constitute one example of a range of intermediaries who facilitate, legitimate and increasingly regulate the movement of bodies in search of care.
complex political geographies that enmesh states and their subjects - medical travel, tourism, and refugees invoke contested landscapes of uneven of development, rights and responsibilities that structure the provision and consumption of healthcare. Nonetheless, there is growing prominence of private-sector healthcare that seeks to attract a commoditized patient-cum- consumer, often understood to flow from the rich to the poor world. Central to this is the figure of the comparatively
rich western medical traveler who seeks treatment – often in developing countries – in response to the perceived failures of the healthcare system of their home country. This figure of the rich medical traveler can be both of a romantic sojourner or a fully entrepreneurial consumer. In this paper, we draw on empirical examples from medical travel guidebooks to argue that this focus on the individual agency of the medical traveler not only obscures the explicit interpellation of medical travelers as a particular kind of agent who can negotiate the cultural, institutional and medical
landscapes of care destinations, but also obscures the specific ways in which care destinations themselves are produced as sites for the production and consumption of care. Medical travel guidebooks constitute one example of a range of intermediaries who facilitate, legitimate and increasingly regulate the movement of bodies in search of care.
The bulk of the literature on medical travel to date has been framed in terms of metropole/periphery, largely limited to describing Western healthcare consumers crossing borders to pursue care in “developing” countries as a result of the... more
The bulk of the literature on medical travel to date has been framed in terms of metropole/periphery, largely limited to describing Western healthcare consumers crossing borders to pursue care in “developing” countries as a result of the effects of neoliberalism on what had previously been understood as domains of the state and entitlements of its citizenry. Influences on patients’ selection of medical destinations abroad have been largely attributed to push factors (e.g., prohibitive costs and waiting times) that make medical care in patients' countries of origin unattractive. This paper offers further insight into who moves where and why by considering the lesser explored role of cultural competence in appealing to prospective international healthcare consumers, as stakeholders representing medical travel destinations tout quick and easy access to discount care right alongside their cosmopolitan ability to satisfy patients’ diverse cultural (e.g., linguistic, religious and dietary) requirements. I examine the politics behind some of these claims to cultural expertise in one of the most established medical travel destinations today: Malaysia. The Malaysian medical travel industry leverages its domestic diversity and diasporic connections to draw international patients by tapping into a range of shared supra-, trans- and postnational belongings that reflect and reinforce cultural, social, economic and political attributes that strategically link the country into diverse global flows and networks, positioning it as an expert in the provision of culturally diverse, high-skilled and high-tech care.
Recent work has called for recognition of the multiplicity of influences and motivations that drive people to cross national borders for health. This paper seeks to complicate and blur distinctions between cosmopolitan market-savvy ‘medical tourists’ and what Thompson (2008) terms ‘medical migrants’, whose access to quality healthcare is conditioned in various ways by their foreign or migrant status. The bulk of the literature on international medical travel (IMT) to date has been framed in terms of metropole/periphery, largely focused on Western ‘medical tourists’ crossing borders to pursue care in ‘developing’ countries where they can escape the prohibitive costs and waiting times that render receiving care ‘at home’ difficult. In response to these and other obstacles, many migrants opt to pursue care ‘back home’. Recent research on the role of affect and expectations of cultural competency in shaping better resourced emigrants’ decisions to return to their countries of origin for care has played down the significance of cost differentials in favour of emphasising the neoliberal ‘privilege’ of transnational ‘shopping around’ for care that satisfies migrants’ diverse linguistic, religious and dietary requirements. With the emergence of world-class private medical care facilities in their countries of origin, migrant diasporas – given their cultural, social and economic ties with the ‘homeland’ via remittances, media and routine visits – are increasingly pegged as these facilities’ ‘natural’ markets. Yet little work has explored this pursuit of healthcare and its potential contributions to constituting and deepening linkages between migrant diasporas and their countries of origin. By drawing from examples in IMT destinations in India, the Philippines and Malaysia, I demonstrate how emigrants are being strategically re-imagined as belonging to ‘national diasporas’ and enjoined to contribute to the development of their countries of origin as healthcare consumers.
Recent work has called for recognition of the multiplicity of influences and motivations that drive people to cross national borders for health. This paper seeks to complicate and blur distinctions between cosmopolitan market-savvy ‘medical tourists’ and what Thompson (2008) terms ‘medical migrants’, whose access to quality healthcare is conditioned in various ways by their foreign or migrant status. The bulk of the literature on international medical travel (IMT) to date has been framed in terms of metropole/periphery, largely focused on Western ‘medical tourists’ crossing borders to pursue care in ‘developing’ countries where they can escape the prohibitive costs and waiting times that render receiving care ‘at home’ difficult. In response to these and other obstacles, many migrants opt to pursue care ‘back home’. Recent research on the role of affect and expectations of cultural competency in shaping better resourced emigrants’ decisions to return to their countries of origin for care has played down the significance of cost differentials in favour of emphasising the neoliberal ‘privilege’ of transnational ‘shopping around’ for care that satisfies migrants’ diverse linguistic, religious and dietary requirements. With the emergence of world-class private medical care facilities in their countries of origin, migrant diasporas – given their cultural, social and economic ties with the ‘homeland’ via remittances, media and routine visits – are increasingly pegged as these facilities’ ‘natural’ markets. Yet little work has explored this pursuit of healthcare and its potential contributions to constituting and deepening linkages between migrant diasporas and their countries of origin. By drawing from examples in IMT destinations in India, the Philippines and Malaysia, I demonstrate how emigrants are being strategically re-imagined as belonging to ‘national diasporas’ and enjoined to contribute to the development of their countries of origin as healthcare consumers.
This paper seeks to engage with debates regarding the geopolitics of transnational healthcare, contributing to work on who moves where and why. It problematises the value of foreign ‘health tourists’ in the fostering and portrayal of... more
This paper seeks to engage with debates regarding the geopolitics of transnational healthcare, contributing to work on who moves where and why. It problematises the value of foreign ‘health tourists’ in the fostering and portrayal of Malaysia as a ‘health tourism’ destination. Drawing from analysis of promotional materials and events, media coverage and in-depth interviews with stakeholders representing a broad range of ‘health tourism’ interests and scales of engagement, this paper examines the dominant geopolitical discourses shaping which groups of foreigners are privileged, targeted and cultivated as prospective consumers of Malaysian private healthcare and the ways in which this is accomplished. The pursuit of private healthcare by these ‘ideal’ foreign health-seeking subjects confers prestige upon as well as reflects and reinforces a variety of cultural, social, economic and political attributes that link Malaysia into diverse global flows and networks and position it as an expert in the provision of ethnically diverse, high-skilled and high-tech care.
∎ Portugal only became a migration destination in the 1970s, with the fall of the dictatorship & the independence of its former African colonies (Angola, Mozambique, Guinea-Bissau, Cape Verde & São Tomé e Príncipe) that also brought back... more
∎ Portugal only became a migration destination in the 1970s, with the fall of the dictatorship & the independence of its former African colonies (Angola, Mozambique, Guinea-Bissau, Cape Verde & São Tomé e Príncipe) that also brought back hundreds of thousands of Portuguese who were living in the colonies (retornados)
Research Interests:
"Today, more and more people are travelling abroad for medical treatment, yet surprisingly little is known about this unique group of tourists. This week, world experts on medical tourism are gathering at a landmark event to set the... more
"Today, more and more people are travelling abroad for medical treatment, yet surprisingly little is known about this unique group of tourists.
This week, world experts on medical tourism are gathering at a landmark event to set the agenda for research on this growing global industry. Travelling from around the world for the Transnational Health Care conference, these experts will discuss findings from important international studies that present the key players in medical tourism, what drives tourists abroad, the itineraries tourists take, the places they go, the medical treatments they seek out, the management and promotion of the emerging industry, and the impacts of medical tourism on both sending and receiving countries.
Co-sponsored by the Cultural Geography Chair Group at Wageningen University (The Netherlands), the Academy for Tourism at NHTV Breda University of Applied Social Sciences (The Netherlands), the University of Leeds (UK) and the Economic and Social Research Council (UK), the conference will explore the links between medical tourism and the increasing privatization and commercialization of health in tourists’ home countries and their destinations, the transfer of responsibility for health from the state to individuals, and the limits to the ‘healthy investments’ people can make to their bodies. What does it mean when home health systems get circumvented? Does medical tourism only impose challenges for health systems – such as additional costs and aggravated healthcare inequities – or can it also create opportunities for (sustainable) development within and between countries?
For further information, in the UK, please contact Ruth Holliday ([email protected]) and, in the Netherlands, contact Meghann Ormond ([email protected]) or Tomas Mainil ([email protected])
Transnational Health Care: A Cross-Border Symposium – 20-21 June 2013 in Wageningen, The Netherlands, and 24-26 June 2013 in Leeds, United Kingdom. Website: http://transnationalhealthcare.leeds.ac.uk/
"
This week, world experts on medical tourism are gathering at a landmark event to set the agenda for research on this growing global industry. Travelling from around the world for the Transnational Health Care conference, these experts will discuss findings from important international studies that present the key players in medical tourism, what drives tourists abroad, the itineraries tourists take, the places they go, the medical treatments they seek out, the management and promotion of the emerging industry, and the impacts of medical tourism on both sending and receiving countries.
Co-sponsored by the Cultural Geography Chair Group at Wageningen University (The Netherlands), the Academy for Tourism at NHTV Breda University of Applied Social Sciences (The Netherlands), the University of Leeds (UK) and the Economic and Social Research Council (UK), the conference will explore the links between medical tourism and the increasing privatization and commercialization of health in tourists’ home countries and their destinations, the transfer of responsibility for health from the state to individuals, and the limits to the ‘healthy investments’ people can make to their bodies. What does it mean when home health systems get circumvented? Does medical tourism only impose challenges for health systems – such as additional costs and aggravated healthcare inequities – or can it also create opportunities for (sustainable) development within and between countries?
For further information, in the UK, please contact Ruth Holliday ([email protected]) and, in the Netherlands, contact Meghann Ormond ([email protected]) or Tomas Mainil ([email protected])
Transnational Health Care: A Cross-Border Symposium – 20-21 June 2013 in Wageningen, The Netherlands, and 24-26 June 2013 in Leeds, United Kingdom. Website: http://transnationalhealthcare.leeds.ac.uk/
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The Iskandar Malaysia (IM) special economic zone (SEZ) was established in Malaysia’s southernmost state, Johor, in 2006. Despite its relative insignificance in the SEZ’s broader investment portfolio, healthcare – a driver for other... more
The Iskandar Malaysia (IM) special economic zone (SEZ) was established in Malaysia’s southernmost state, Johor, in 2006. Despite its relative insignificance in the SEZ’s broader investment portfolio, healthcare – a driver for other health-related industries (e.g., biotechnology, medical devices and equipment, pharmaceuticals and education) – has been thought to be a more solid and steadier growth catalyst over the last decade than other projects that IRDA initially saw as significant growth catalysts. This is due in part to healthcare, like schools and transport infrastructure, functioning as a key infrastructural anchor and ‘enabler’ to make retail/mixed-development and residential property development more attractive to investors and consumers. In this report, we provide a contemporary snapshot of the key policies and players shaping the development of private healthcare in Johor in order to inform policymakers, current commercial stakeholders and potential investors, and resident...
ABSTRACT Many of the world’s demographically oldest countries are increasingly ‘outsourcing’ care from abroad for their elderly. Indeed, seniors wishing to age in place in countries like Germany and Singapore are making – and in some... more
ABSTRACT Many of the world’s demographically oldest countries are increasingly ‘outsourcing’ care from abroad for their elderly. Indeed, seniors wishing to age in place in countries like Germany and Singapore are making – and in some cases, as in Japan, beginning to explore how to make – use of at-home help, frequently provided by female migrant care workers. However, more seniors are also relocating abroad for more affordable long-term domestic or institutional living and care arrangements. Compared with traditional accounts of international retirement migration (IRM) that take as their prime subjects a pool of relatively affluent and healthy ‘young old’, this relatively novel type of relocation more heavily underscores the significance of economic precariousness in such migration. In this chapter, we look at how IRM discourses and practices are shifting and growing more complex by focusing on ‘young old’ and ‘old old’ Japanese and German pensioners who have resettled abroad as a result of such precariousness.
Transnational medical travel/tourism, by and large, involves travel to cities and metropolitan areas. Only urban areas possess the sufficient volume and variety of world-class medical expertise, cutting-edge technology, transportation... more
Transnational medical travel/tourism, by and large, involves travel to cities and metropolitan areas. Only urban areas possess the sufficient volume and variety of world-class medical expertise, cutting-edge technology, transportation infrastructure, communication and mediation facilities and hospitality services and infrastructure to be able to emerge as transnational medical travel destinations. Yet how cities and transnational flows of patients, standards and capital interact to generate new urban assemblages and new assemblages of health care is a story that has yet to really be told. While research on transnational medical travel/tourism is becoming more nuanced, involving a broader variety of perspectives, actors and medical mobilities, any attention given thus far to urban areas has been largely implicit and, thus, conceptually under-explored and -utilised. In this chapter, we argue for a relational approach on the urban as well as on transnational health care. Our focus was on how elements become mobile, circulate and assemble to form medical travel/tourism and how this assembling entangles with the elements and relations that constitute the urban. The presented cases show that networks are fluid and constantly being made, as elements entangle and disentangle and, through relational processes of dissociation and re-association, themselves transform. Through the assembling of medical travel/tourism, hospitals’ incomes can rise and their interiors can be ‘internationalised’; neighbours and hotels can learn to accommodate the presence of ‘sick’ bodies; patients can become health consumers and, perhaps, evangelise the benefits of travelling abroad for medical purposes; penniless refugees and wealthy doctors alike can become care brokers; and, last but not least, hopeless, ignored ‘medical cases’ at home can become hopeful, desired customers abroad.
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Closed adoptions – where birth and adoption records are legally sealed to obscure adoptees’ biological parentage – were once the norm in many Western Anglophone countries. Grassroots resistance to closed adoption relied upon the belief... more
Closed adoptions – where birth and adoption records are legally sealed to obscure adoptees’ biological parentage – were once the norm in many Western Anglophone countries. Grassroots resistance to closed adoption relied upon the belief that deprivation of knowledge of their true biological origins could lead to psychological trauma among adoptees. In this chapter, the author reflects on her own mother’s sense of deprivation, her desire for a coherent origin story and her consequent process of cobbling together disparate analogue, digital and biotechnical fragments of legally, religiously, scientifically, commercially and familiarly authorised and authorising heritages from among diverse resources rendered intelligible, relevant and truthful by societal and (bio)technological transformations over time. In so doing, the author calls attention to complicated power relations in everyday personal heritage practices that challenge the simplistic pitting of ‘heritage from below’ (Iain Robertson, Heritage from Below, 2012) against ‘Authorised Heritage Discourse’ (AHD) (Laurajane Smith, Uses of Heritage, 2006).
The family is widely accepted as a basic unit of cultural, social and economic production and reproduction which plays a fundamental role in the successful integration of its members, and functions as a support network for them. Many... more
The family is widely accepted as a basic unit of cultural, social and economic production and reproduction which plays a fundamental role in the successful integration of its members, and functions as a support network for them. Many immigrants arriving in Portugal are at first deprived of this support structure, having left their families behind in their country of origin. While some will return to their families and countries of origin after temporarily living abroad, others will reunite with their families in Portugal and still others will start new ones. As a ...
In October 2016, the Global Healthcare Policy and Management Forum was held at Yonsei University, Seoul, South Korea. The goal of the forum was to discuss the role of the state in regulating and supporting the development of medical... more
In October 2016, the Global Healthcare Policy and Management Forum was held at Yonsei University, Seoul, South Korea. The goal of the forum was to discuss the role of the state in regulating and supporting the development of medical tourism. Forum attendees came from 10 countries. In this short report article, we identify key lessons from the forum that can inform the direction of future scholarly engagement with medical tourism. In so doing, we reference on-going scholarly debates about this global health services practice that have appeared in multiple venues, including this very journal. Key questions for future research emerging from the forum include: who should be meaningfully involved in identifying and defining categories of those travelling across borders for health services and what risks exist if certain voices are underrepresented in such a process; who does and does not 'count' as a medical tourist and what are the implications of such quantitative assessments; ...
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ABSTRACT Tapping into migrants’ diverse tacit healthcare knowledge can bring a range of stakeholders in countries of origin great insight, at both macro and micro levels, not only into how to improve on local healthcare delivery but also... more
ABSTRACT Tapping into migrants’ diverse tacit healthcare knowledge can bring a range of stakeholders in countries of origin great insight, at both macro and micro levels, not only into how to improve on local healthcare delivery but also how to effectively respond to the needs and interests of ‘medical tourists’, travellers and other migrants. This chapter reviews recent literature on migration and ‘medical tourism’ in order to look in greater detail at the role, first, of migrant patients and, second, of migrant health workers in the development of Global South destinations’ ‘medical tourism’ industries. It offers a series of lessons drawn from the many examples of migrant knowledge transfer and barriers presented.
In this study we calculated the economic impacts of medical tourism in Malaysia, for the country as a whole and for individual states. In Malaysia, a country which ranks among the world’s most recognized international medical tourism... more
In this study we calculated the economic impacts of medical tourism in Malaysia, for the country as a whole and for individual states. In Malaysia, a country which ranks among the world’s most recognized international medical tourism destinations, medical tourism is identified as an economic growth engine with the potential to spur growth in both medical and non-medical sectors. A state-level analysis of economic impacts is important given differences between states regarding their economic profiles and numbers, origins and the spending patterns of the medical tourists they receive. The method we used is input-output (I-O) analysis, applied to state-specific I-O data and disaggregated foreign patient data. In 2007, 341,288 foreign patients generated MYR 1,313.4 million (USD 372.3 million) output, MYR 468.6 million (USD 132.8 million) in value added and 19,586.7 jobs. Impacts related to non-medical expenditure are more substantial than impacts related to medical expenditure and indirect impacts make up a substantial part of total impacts. Differences between economic impacts per state are explained by looking at numbers of foreign patients, their expenditure and multipliers. Recommendations are formulated to improve data-collection regarding medical and non-medical expenditure of medical tourists in order to enable more detailed future analysis.
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ABSTRACT This book’s examination of international medical travel (IMT) – where people cross national borders in the pursuit of healthcare – builds on an intersection of feminist and postcolonial scholarship that seeks to challenge... more
ABSTRACT This book’s examination of international medical travel (IMT) – where people cross national borders in the pursuit of healthcare – builds on an intersection of feminist and postcolonial scholarship that seeks to challenge embedded assumptions about the sources, directions and political value of care. In so doing, it contributes to contemporary social science debates on the role of mobility in questions of care, responsibility and interdependence. With many of the countries currently being promoted as IMT destinations holding ‘developing’ status, IMT poses a significant challenge to popular assumptions about who provides and receives care since it inverses and diversifies presumed directionalities of care. Taking as a point of departure the notion that the boundaries to the terrains and subjects engaged in the provision and receipt of care are constantly in flux, the book examines the discursive and material positioning of Malaysia as one of the world’s most prominent IMT destinations at a moment when the status of the nation-state is undergoing profound transformation. In light of rapidly growing academic interest in IMT, its focus on the political framings of transnational mobilities and claims to cultural competence will make a timely and important empirically-grounded theoretical contribution at a moment in which both critical theoretical engagement and in-depth empirical material are widely acknowledged to be sorely missing in literature on IMT. The book aims to contribute to a growing body of work that pushes beyond the pronounced Ameri-centrism that currently dominates studies of IMT by decentring the focus from Western industry interests and medical travellers through acknowledging the significance and nuanced diversity of the majority of IMT flows and destinations which are, today, largely concentrated in the Asia-Pacific region. Reflecting important global shifts in healthcare provision and its regulation, the book frames Asian IMT destinations not as passive receptacles for Western ‘outsourced’ care interests but, rather, as active providers negotiating complex changes in health governance and the benefits and challenges of extending care beyond national borders. Across four empirical chapters, it demonstrates how ‘Malaysia’ gets positioned as a hospitable destination within a range of imagined geographies of care. The extension of care – through the harnessing of IMT – can serve as a place-making technology to re-imagine the state as a provider and protector within a globalising marketplace in which care, increasingly commoditised, is tied to the production of new political, social, cultural and economic geographies. This signals a fundamental reterritorialisation of care aligned with the pursuit of greater ‘global’ economic, political, social and cultural integration and legitimacy that reconfigures the relevance of the nation-state. Neoliberal rationalities of governance have manifested themselves in the retreat of the welfare state along with projects of economic liberalisation that have profoundly affected the pursuit and provision of healthcare in recent decades. With healthcare increasingly framed as a tradable commodity via international trade agreements and the involvement of transnational agencies and companies, states are reimagining healthcare less as a public good and more as an industry. Reflecting this shifting conceptualisation are increasingly hybrid, transnationalised spatialisations of healthcare. With the movement of people, goods and services rapidly redrawing the geographical boundaries to healthcare, IMT represents a significant shift from what were previously imagined as nationally-bound, locally-based care settings to what are now commonly held to be ‘chaotic global networks, controlled by large mega healthcare corporations, consumer demand, employers, governmental offices of economic development and increasingly insurers… in an era of ever deteriorating national, technological, mental and physical boundaries in the delivery of healthcare services’. Given healthcare’s significant role in defining both the legitimacy of the modern nation-state and the value of its citizenry, much of the disquiet surrounding IMT derives from profound uncertainties regarding the future of care – both responsibility for it and entitlement to it – in light of this shifting relationship between the state and its subjects. While much scholarly work has attended to the configuration of places of health and healing at the micro-scale, little has explicitly conceptualised them at the national level. This book ventures to do just that by deconstructing claims, made by a broad range of social actors keen to turn Malaysia into an international hub of medical excellence, about the country’s credentials for providing care to specific markets of foreign patient-consumers through the provision of a unique ‘package’ of regulation, human resources, political and economic stability and cultural…
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Wageningen UR publication. Title: Medical tourism, medical exile: responding to the cross-border pursuit of healthcare in Malaysia, ...
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Many of the world’s demographically oldest countries are increasingly ‘outsourcing’ care from abroad for their elderly. Indeed, seniors wishing to age in place in countries like Germany and Singapore are making – and in some cases, as in... more
Many of the world’s demographically oldest countries are increasingly ‘outsourcing’ care from abroad for their elderly. Indeed, seniors wishing to age in place in countries like Germany and Singapore are making – and in some cases, as in Japan, beginning to explore how to make – use of at-home help, frequently provided by female migrant care workers. However, more seniors are also relocating abroad for more affordable long-term domestic or institutional living and care arrangements. Compared with traditional accounts of international retirement migration (IRM) that take as their prime subjects a pool of relatively affluent and healthy ‘young old’, this relatively novel type of relocation more heavily underscores the significance of economic precariousness in such migration. In this chapter, we look at how IRM discourses and practices are shifting and growing more complex by focusing on ‘young old’ and ‘old old’ Japanese and German pensioners who have resettled abroad as a result of ...
Malaysian authorities’ desire for foreign patient-consumers from higher-income countries and the spectacular medical tourism infrastructure being developed to cater to them exists in contrast to the actual everyday flows of intra-regional... more
Malaysian authorities’ desire for foreign patient-consumers from higher-income countries and the spectacular medical tourism infrastructure being developed to cater to them exists in contrast to the actual everyday flows of intra-regional lower-income patient-consumers who, comprising the bulk of medical travellers to Malaysia, have been fundamental in both constituting and sustaining the country’s medical travel destinations. This paper draws on interviews with medical travel companies in Malaysia and Indonesia that promote Malaysian private health care to prospective patient-consumers from both higher-income and lower-income countries. It compares and contrasts the functions of these companies, their relationships with patient-consumers and the ways in which they represent and negotiate the differences between health care in patients’ countries of origin and in Malaysia.
Medical tourism is now targeted by many hospitals and governments worldwide for further growth and investment. Southeast Asia provides what is perhaps the best documented example of medical tourism development and promotion on a regional... more
Medical tourism is now targeted by many hospitals and governments worldwide for further growth and investment. Southeast Asia provides what is perhaps the best documented example of medical tourism development and promotion on a regional scale, but interest in the practice is growing in locations where it is not yet established. Numerous governments and private hospitals in the Caribbean have recently identified medical tourism as a priority for economic development. We explore here the projects, activities, and outlooks surrounding medical tourism and their anticipated economic and health sector policy implications in the Caribbean country of Jamaica. Specifically, we apply Pocock and Phua's previously-published conceptual framework of policy implications raised by medical tourism to explore its relevance in this new context and to identify additional considerations raised by the Jamaican context. Employing case study methodology, we conducted six weeks of qualitative fieldwork...
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ABSTRACT Why exactly can an American save up to 80% on a medical procedure by simply travelling to Malaysia? Flush with excitement over the panacea medical tourism seems to promise so many, have stakeholders paused long enough in the... more
ABSTRACT Why exactly can an American save up to 80% on a medical procedure by simply travelling to Malaysia? Flush with excitement over the panacea medical tourism seems to promise so many, have stakeholders paused long enough in the construction of the medical tourism industry to reflect on what this fact says about the striking economic, social, political and technological imbalances in both home and destination countries underlying the relatively novel phenomenon of medical tourism? What has actually been democratized and levelled, and for whom? In this chapter, I seek to geographically situate medical tourism supply and demand as well as responsibility for it by exploring what’s where, why it’s there, and the challenges we face in caring about this uneven distribution.
Both at the individual and health system levels, the burden of complex illnesses associated with and which rise in mid- to later life, such as cancer, is expected to increase further. The advent of personalized medicine, or the use of a... more
Both at the individual and health system levels, the burden of complex illnesses associated with and which rise in mid- to later life, such as cancer, is expected to increase further. The advent of personalized medicine, or the use of a patient's genetic profile to guide medical decisions, is touted to substantially improve drug tolerance and efficacy and, in so doing, also improve the effectiveness and efficiency of oncological care. Amidst the hype and hope surrounding personalized cancer care, there is increasing concern about its unnecessary, unintended effects especially with regards to the financial burden of targeted therapies using specialty drugs. In this paper, we take a patient-centered perspective on the therapeutic benefits of personalized medicine as well as the limitations of current practice and its psychological and financial toxicities by focusing on advanced-stage lung cancer. We argue that the modest clinical benefits of targeted therapy, premium prices for many specialty drugs and the narrow focus on the genetic constitution of individual patients run the risk of undercutting personalized lung cancer care's contribution to realizing health and non-health outcomes. We discuss the contribution of grading the financial burden of treatment and seamless integration of palliative care as key action areas regarding patients' access to and appropriateness of care given patients' needs and preferences.
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ABSTRACT While scholars increasingly acknowledge that most contemporary international medical travel is comprised of South-South flows, these have gone curiously unexamined. Rather, policy, scholarly and media attention focuses... more
ABSTRACT While scholars increasingly acknowledge that most contemporary international medical travel is comprised of South-South flows, these have gone curiously unexamined. Rather, policy, scholarly and media attention focuses predominantly on North-South flows of ‘medical tourists’. However, this focus diverts attention from the actual and potential impacts of South-South intra-regional medical travel flows in both their source and receiving contexts. As such, we present findings from a study examining South-South intra-regional medical travellers’ motivations, preparations and practices to better understand the social, economic and political situations that condition them and their effects on the destinations that receive them. Our study of Indonesian medical travellers pursuing health care in Malaysia draws on 35 semi-structured interviews with Indonesian patients, their companions, medical staff and agents in both countries. From this, we suggest that South-South medical travellers’ diverse socio-economic conditions shape decision-making and spending behaviour relative to treatment, accommodation and transport choices as well as length of stay. We identify ways in which informal economies and social care networks sustain the formal medical travel industry. Finally, we observe how medical travel increasingly serves as a means through which chronic and everyday health needs are met as a result of temporary, visa-free intra-regional movement.
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Globally, more patients are intentionally travelling abroad as consumers for medical care. However, while scholars have begun to examine international medical... more
Globally, more patients are intentionally travelling abroad as consumers for medical care. However, while scholars have begun to examine international medical travel's (IMT) impacts on the people and places that receive medical travellers, study of its impacts on medical travellers' home contexts has been negligible and largely speculative. While proponents praise IMT's potential to make home health systems more responsive to the needs of market-savvy healthcare consumers, critics identify it as a way to further de-politicise the satisfaction of healthcare needs. This article draws from work on political consumerism, health advocacy and social movements to argue for a reframing of IMT not as a 'one-off' statement about or an event external to struggles over access, rights and recognition within medical travellers' home health systems but rather as one of a range of critical forms of on-going engagement embedded within these struggles. To do this, the limited extant empirical work addressing domestic impacts of IMT is reviewed and a case study of Indonesian medical travel to Malaysia is presented. The case study material draws from 85 interviews undertaken in 2007-08 and 2012 with Indonesian and Malaysian respondents involved in IMT as care recipients, formal and informal care-providers, intermediaries, promoters and policy-makers. Evidence from the review and case study suggests that IMT may effect political and social change within medical travellers' home contexts at micro and macro levels by altering the perspectives, habits, expectations and accountability of, and complicity among, medical travellers, their families, communities, formal and informal intermediaries, and medical providers both within and beyond the container of the nation-state. Impacts are conditioned by the ideological foundations underpinning home political and social systems, the status of a medical traveller's ailment or therapy, and the existence of organised support for recognition and management of these in the home context.
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In Jorgen Leth and Lars von Trier’s 2003 documentary film The Five Obstructions, von Trier uses the method of ‘obstructive limitation’ to disrupt conventional filmmaking habits that inhibit Leth from seeing, experiencing and relating the... more
In Jorgen Leth and Lars von Trier’s 2003 documentary film The Five Obstructions, von Trier uses the method of ‘obstructive limitation’ to disrupt conventional filmmaking habits that inhibit Leth from seeing, experiencing and relating the story in alternative ways. In this intellectual exercise, Leth must creatively respond to a set of rules and obstacles devised by von Trier that force him to perceive and approach both the story and the art of filmmaking differently. With their playful volume, Disruptive Tourism and its Untidy Guests, Veijola et al. take up a similar daunting phenomenological challenge: to disrupt ‘the standard templates’ of tourism and hospitality scholarship in order to permit space for alternative, even radical, approaches to reconceptualising and practicing the relationship at the core of tourism, hospitality and even research itself: host(ess)ing and guesting (Veijola and Jokinen 2008).
ABSTRACT This chapter provides an overview of current government strategies relative to medical tourism development and management around the world. Most studies on medical tourism have privileged national governments as key actors in... more
ABSTRACT This chapter provides an overview of current government strategies relative to medical tourism development and management around the world. Most studies on medical tourism have privileged national governments as key actors in medical tourism facilitation and regulation and, in some cases, even provision. However, with the multiplication of supra- and sub-national regions, each with their own distinct responsibilities and levels of autonomy, and the growing role of private-sector players, it is important to consider the various nested and overlapping governance types and practices at play. This chapter, therefore, identifies governance strategies at various levels in and across both source and host contexts relative to medical tourism.
'Medical tourism'article, published in the journal Tourism Management, offered valuable insight into the emergence of contemporary medical tourism. Five years later, Connell has produced a volume that maps out the maturing and... more
'Medical tourism'article, published in the journal Tourism Management, offered valuable insight into the emergence of contemporary medical tourism. Five years later, Connell has produced a volume that maps out the maturing and increasingly complex field and the new geographies of globalised health care within which medical tourism is embedded. The book offers a refreshingly critical engagement with the social, political and ethical complexities involved, taking clear stances on the socio-economic inequalities out of which medical ...
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∎ Portugal only became a migration destination in the 1970s, with the fall of the dictatorship & the independence of its former African colonies (Angola, Mozambique, Guinea-Bissau, Cape Verde & São Tomé e Príncipe) that also brought back... more
∎ Portugal only became a migration destination in the 1970s, with the fall of the dictatorship & the independence of its former African colonies (Angola, Mozambique, Guinea-Bissau, Cape Verde & São Tomé e Príncipe) that also brought back hundreds of thousands of Portuguese who were living in the colonies (retornados)
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Medical tourism industry has experienced a rapid growth in recent years, witnessing an increase in tourists’ mobility to seek healthcare services. Even though India positions itself as a prominent key player in medical tourism industry in... more
Medical tourism industry has experienced a rapid growth in recent years, witnessing an increase in tourists’ mobility to seek healthcare services. Even though India positions itself as a prominent key player in medical tourism industry in the world, strategic knowledge from the perspective of suppliers remains limited. This study explores the profile of medical tourists in India from the perspective of the hospital marketing managers in Chennai (South India) and Delhi (North India). It also examines various strategies undertaken by the hospitals to cater for the needs of medical tourists. We purposely identified and in-depth interviewed ten marketing managers, and analyzed the data using NVivo qualitative software. The findings provide insights on the South-South flow of medical tourists in terms of nationality and types of treatment they seek. We discovered that the managers from the two regions perceive degree of competition differently. Among the strategies deployed by the hospitals are customer oriented services, personalized services, collaboration with various parties, quality control and marketing and promotion efforts. The knowledge of medical tourism mobility and the current hospital strategies is crucial in facilitating the formulation of appropriate product development and marketing communication.
Research Interests: Business, Management, Marketing, Tourism Studies, Tourism Marketing, and 18 moreTourism Management, Medical tourism (Sociology), Travel & Tourism, Medical Tourism, Strategy (Business), Marketing Strategy, India, Tourism, Strategy, Travel and Tourism Industry, Travel, Marketing Strategies, New Delhi India, Delhi, Medical Travel, Chennai, New Delhi, and International Medical Travel
“…feeling entitled to say you are from a place that you didn’t grow up, but you chose to be a part of it, I think that is extraordinarily powerful.” – Meghann Ormond // A year ago, Hiraeth was invited to participate in a session on... more
“…feeling entitled to say you are from a place that you didn’t grow up, but you chose to be a part of it, I think that is extraordinarily powerful.” – Meghann Ormond // A year ago, Hiraeth was invited to participate in a session on “Whose Heritages Matter” during a conference at Wageningen University in the Netherlands. Meghann Ormond, Associate Professor in Cultural Geography at Wageningen, speaks about her own heritage, from her two passport countries, the U.S. and Portugal, as well as the Netherlands, where she has made her home for the past eight years, and other countries that have touched her life. Meghann’s own identity has been shaped by both her own travels around the world and her multifaceted family history, including her mother’s search for her birth parents on two continents. Through this experience, she realised: “We are all inheritors of extraordinarily transnational stories.”
Heritage from Below is an acknowledgement that the everyday stories and lives of ordinary people should be included as a part of history. Meghann started the Heritage from Below Educational and Research Collective (HERC) to bring together cultural heritage and history scholars, practitioners and educators to help children of all backgrounds feel that their history and culture are important and recognised as part of a larger whole.
Heritage from Below is an acknowledgement that the everyday stories and lives of ordinary people should be included as a part of history. Meghann started the Heritage from Below Educational and Research Collective (HERC) to bring together cultural heritage and history scholars, practitioners and educators to help children of all backgrounds feel that their history and culture are important and recognised as part of a larger whole.