WHO First Global Patient Safety Challenge.

On behalf of the First Global Patient Safety Challenge: Clean Care is Safer Care, I extend a very warm welcome to everyone who accesses this new and exciting addition to the Challenge. SAVE LIVES: Clean Your Hands is a significant step forward in taking country pledges to the patient, to further promote hand hygiene at the point of care.

Since the First Challenge began in 2005, 120 member states have pledged their support. Our energies and those of health-care workers in these countries must now be directed towards sustaining improvement with hand hygiene and thereby reducing health care-associated infections.

Every year people die or are considerably affected by diseases such as MRSA, Clostridium difficile and other infections. By cleaning their hands, health-care workers can prevent such diseases and contribute to reducing the global burden. The WHO multi-modal strategy for hand hygiene which is explained on this website, demonstrates how and why diseases spread and what can be done to promote change.

Encouraging hospitals and health-care facilities to adopt the WHO 5 Moments for Hand Hygiene will contribute to a greater awareness and understanding of the importance of hand hygiene. Our vision for the next decade is to encourage this awareness and to promote the need for improved compliance and sustainability in hand hygiene practice.

On 5 May 2009, the Challenge is launching the WHO Guidelines on Hand Hygiene in Health Care (after a 3-year pilot period) and the toolkit for hand hygiene implementation in a revised format for easy access either by downloading from this website, or in hard copy where health-care workers do not have ready internet access.

Together, our aim is to spread the message far and wide – clean hands save lives. I warmly commend and congratulate everyone who participates in this project. It is your energy at the point of care that will make the difference.

Professor Didier Pittet
Lead, WHO First Global Patient Safety Challenge.

 

UK patients attracted to Norway for diagnostic procedures

Norway has excellent diagnostic imaging facilities, costs much less than private UK healthcare and can be reached by budget airlines.

The cost of an MRI scan in the UK at a private hospital starts from £750, but in Norway a simple MRI plus the cost of the trip is around £300.

Health service providers in Norway have identified the UK as an overseas market for their cost effective imaging and diagnostic treatments and are offering access to CT and MRI scans, ultrasound, x-rays, mammography and bone density measurement.

Companies such as Scanhealth Scandinavia, a partnership of 3 healthcare companies, offer a full range of diagnostic procedures.

The Norwegian Board of Health supervises the running of Norway’s health and social services system, and the Directorate of Health manages private hospitals and clinics in Norway. Norway is only a 90-minute flight from London – Stansted airport.

Scanhealth arranges flights to Norway by Ryanair’s direct route from London Stansted Airport to Haugesund. This is a short flight of approximate 90 minutes. They collect patients at the airport and take them to the hospital for treatment. They provide accommodation for patients and companion at a local hotel, and personally escort patients to the airport in time for their flight home, with your patient case report in the luggage.

 

 

Statement for World Health Day 2009

Dr Margaret Chan Director-General of the World Health Organization

When an emergency or disaster occurs, most lives are lost or saved in the immediate aftermath of the event. People count on hospitals and health facilities to respond, swiftly and efficiently, as the lifeline for survival and the backbone of support.

The tragedy of a major emergency or disaster is compounded when health facilities fail. When a hospital collapses or its functions are disrupted, lives that depend on emergency care can be lost. Interruptions in routine services can also be deadly.

In large emergencies, such as those caused by earthquakes or floods, some countries have lost as much as 50% of their hospital capacity, right at the time when life-saving services were most acutely needed.

Apart from causing increased suffering and loss of life, the failure of health facilities during an emergency can provoke a public outcry, especially when shoddy construction or violations of building codes are thought to be at fault.

Such public concern is fully justified. As this web site shows, it costs surprisingly little to construct a new hospital that can withstand the shocks of earthquakes, floods, or high winds. It costs even less to retrofit existing facilities to keep their services running at critical times. It costs almost nothing to integrate risk management and emergency preparedness into a hospital’s operational plans.

To commemorate World Health Day this year, WHO is advocating a series of best practices that can be implemented, in any resource setting, to make hospitals safe during emergencies. Apart from safe siting and resilient construction, good planning and carrying out emergency exercises in advance can help maintain critical functions. Proven measures range from early warning systems to a simple hospital safety assessment, from protecting equipment and supplies to preparing staff to manage mass casualties and infection control measures.

Different types of emergencies bring typical patterns of injuries, such as crush injuries in earthquakes and hypothermia in floods, with corresponding needs for training and supplies. These needs can be anticipated in advance, and surge capacity can be tailored to manage them.

It is smart to think and plan ahead. Worldwide, the number of emergencies and disasters is rising. This trend is certain to continue as urbanization crowds people together on unsafe sites and climate change brings more frequent and more severe extreme weather events. We need to anticipate a growing number of areas that will become disaster-prone.

Abundant experience demonstrates the tremendous pay-off, also at the political level, when hospitals remain standing and functioning as beacons of security and solidity in the midst of disaster and despair. We must never forget: hospitals and health facilities represent a significant investment. Keeping them safe in emergencies protects that investment, while also protecting the health and safety of people – our foremost concern.

 

Medical tourism agency IndianHealthGuru offer discounted dental treatment in India

You can get relief from your dental problems with discounted price dental treatment in India in Chennai, Kerala, Bangalore, Delhi and Mumbai.

Medical tourism agency IndianHealthGuru is now sending medical tourists to JCI accredited hospitals all over India. Patients select dental surgery in India, as dental surgeons are highly experienced experts.

IndianHealthGuru says that getting dental treatment in India has become a very good option for uninsured and underinsured American patients who seek affordable healthcare overseas. The cost of care is typically a fraction of that found in the US, with equal or superior outcomes. Even with travel expenses taken into account, the comprehensive treatment packages offered by IndianHealthGuru provide considerable savings.

The agency is partnered with a select number of leading cosmetic dental surgeons and private hospitals in India to offer the highest possible standards of healthcare to patients. They have a large panel of oral surgeons, implantologists, endodontists, periodontists and general dentists. Dentists in India operate on patients from the USA and UK, and from across the globe.

Indian Health Guru will help patients make informed decisions about dental treatment in India. They have negotiated special prices and assist by planning and co-coordinating all services. They offer special packages for implant and restorative dental surgery; highly discounted packages for comprehensive implant procedures and laser teeth whitening. The travel and concierge service offers patients tailor made services to deliver a comprehensive, fully integrated and individualized package.

 

Condoms for HIV prevention

Condoms, when used correctly and consistently, are highly effective in preventing HIV and other sexually transmitted infections (STIs). A large body of scientific evidence shows that male latex condoms have an 80% or greater protective effect against the sexual transmission of HIV and other STIs.

Condoms are a key component of comprehensive HIV prevention. WHO supports a combination of approaches to prevent the sexual transmission of HIV, including correct and consistent condom use, reduction in the number of sexual partners, HIV testing and counselling, delaying sexual debut, treatment for STIs and male circumcision. In 2007, 2.7 million people were newly infected with HIV.

WHO works with its key partners in HIV prevention, in particular UNFPA and UNAIDS, to define global policy standards and support countries in condom procurement, quality assurance, promotion and distribution.

 

Plan for a Healthy America

Barack Obama and Joe Biden's Plan

On health care reform, the American people are too often offered two extremes - government-run health care with higher taxes or letting the insurance companies operate without rules. Barack Obama and Joe Biden believe both of these extremes are wrong, and that’s why they’ve proposed a plan that strengthens employer coverage, makes insurance companies accountable and ensures patient choice of doctor and care without government interference.

The Obama-Biden plan provides affordable, accessible health care for all Americans, builds on the existing health care system, and uses existing providers, doctors and plans to implement the plan. Under the Obama-Biden plan, patients will be able to make health care decisions with their doctors, instead of being blocked by insurance company bureaucrats.

Under the plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year.

If you don’t have health insurance, you will have a choice of new, affordable health insurance options.

Make Health Insurance Work for People and Businesses - Not Just Insurance and Drug Companies.

Require insurance companies to cover pre-existing conditions so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums.

Create a new Small Business Health Tax Credit to help small businesses provide affordable health insurance to their employees.

Lower costs for businesses by covering a portion of the catastrophic health costs they pay in return for lower premiums for employees.

Prevent insurers from overcharging doctors for their malpractice insurance and invest in proven strategies to reduce preventable medical errors.

Make employer contributions more fair by requiring large employers that do not offer coverage or make a meaningful contribution to the cost of quality health coverage for their employees to contribute a percentage of payroll toward the costs of their employees health care.

Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.

Ensure everyone who needs it will receive a tax credit for their premiums.

Reduce Costs and Save a Typical American Family up to $2,500 as reforms phase in:

Lower drug costs by allowing the importation of safe medicines from other developed countries, increasing the use of generic drugs in public programs and taking on drug companies that block cheaper generic medicines from the market

Require hospitals to collect and report health care cost and quality data

Reduce the costs of catastrophic illnesses for employers and their employees.

Reform the insurance market to increase competition by taking on anticompetitive activity that drives up prices without improving quality of care.

The Obama-Biden plan will promote public health. It will require coverage of preventive services, including cancer screenings, and increase state and local preparedness for terrorist attacks and natural disasters.

A Commitment to Fiscal Responsibility: Barack Obama will pay for his $50 - $65 billion health care reform effort by rolling back the Bush tax cuts for Americans earning more than $250,000 per year and retaining the estate tax at its 2009 level.

 

 

China confirms woman died of bird flu in Beijing

BEIJING/HONGKONG - A 19-year-old woman has died of the H5N1 bird flu virus in Beijing after coming into contact with poultry, health authorities in Beijing and Hong Kong said on Tuesday.

This human H5N1 case would be China's first in almost a year. Experts said while the case was not unexpected as the virus is more active during the cooler months between October and March, it points to holes in surveillance of the virus in poultry.

With the world's biggest poultry population and hundreds of millions of farmers raising birds in their backyards, China is seen as crucial in the global fight against bird flu.

"The woman fell ill on December 24, was hospitalized on December 27 and died on Monday at 7.20 am," the Beijing Municipal Bureau said in a faxed statement.

 

Preventable injuries kill 2000 children every day

More than 2000 children die every day as a result of unintentional or accidental injuries. Every year tens of millions more worldwide are taken to hospitals with injuries that often leave them with lifelong disabilities, according to a new report by WHO and UNICEF.

The World report on child injury prevention provides the first comprehensive global assessment of unintentional childhood injuries and prescribes measures to prevent them. It concludes that if proven prevention measures were adopted everywhere at least 1000 children’s lives could be saved every day.

“Child injuries are an important public health and development issue. In addition to the 830 000 deaths every year, millions of children suffer non-fatal injuries that often require long-term hospitalization and rehabilitation," said WHO Director-General Dr Margaret Chan. "The costs of such treatment can throw an entire family into poverty. Children in poorer families and communities are at increased risk of injury because they are less likely to benefit from prevention programmes and high quality health services."

“This report is the result of a collaboration of more than 180 experts from all regions of the world,” said UNICEF Executive Director Ann M. Veneman. “It shows that unintentional injuries are the leading cause of childhood death after the age of nine years and that 95% of these child injuries occur in developing countries. More must be done to prevent such harm to children.”

Africa has the highest rate overall for unintentional injury deaths. The report finds the rate is 10 times higher in Africa than in high-income countries in Europe and the Western Pacific such as Australia, the Netherlands, New Zealand, Sweden and the United Kingdom, which have the lowest rates of child injury.

However, the report finds that although many high-income countries have been able to reduce their child injury deaths by up to 50% over the past 30 years, the issue remains a problem for them, with unintentional injuries accounting for 40% of all child deaths in such countries.

The report finds that the top five causes of injury deaths are:

Road crashes: They kill 260 000 children a year and injure about 10 million. They are the leading cause of death among 10-19 year olds and a leading cause of child disability.

Drowning: It kills more than 175 000 children a year. Every year, up to 3 million children survive a drowning incident. Due to brain damage in some survivors, non-fatal drowning has the highest average lifetime health and economic impact of any injury type.

Burns: Fire-related burns kill nearly 96 000 children a year and the death rate is 11 times higher in low- and middle-income countries than in high-income countries.

Falls: Nearly 47 000 children fall to their deaths every year, but hundreds of thousands more sustain less serious injuries from a fall.

Poisoning: More than 45 000 children die each year from unintended poisoning.

“Improvements can be made in all countries,” said Dr Etienne Krug, Director of WHO’s Department of Violence and Injury Prevention and Disability. “When a child is left disfigured by a burn, paralysed by a fall, brain damaged by a near drowning or emotionally traumatized by any such serious incident, the effects can reverberate through the child's life. Each such tragedy is unnecessary. We have enough evidence about what works. A known set of prevention programmes should be implemented in all countries.”

The report outlines the impact that proven prevention measures can have. These measures include:

laws on child-appropriate seatbelts and helmets;

hot tap water temperature regulations;

child-resistant closures on medicine bottles, lighters and household product containers; separate traffic lanes for motorcycles or bicycles;

draining unnecessary water from baths and buckets;

redesigning nursery furniture, toys and playground equipment;

strengthening emergency medical care and rehabilitation services.

It also identifies approaches that either should be avoided or are not backed by sufficient evidence to recommend them. For example, it concludes

that blister packaging for tablets may not be child resistant;

that airbags in the front seat of a car could be harmful to children under 13 years;

that butter, sugar, oil and other traditional remedies should not be used on burns;

that public education campaigns on their own don't reduce rates of drowning.

URL.http://www.who.int/mediacentre/news/releases/2008/pr46/en/print.html

For more information please contact:

Laura Sminkey
WHO, Geneva
Telephone: +41 22 791 4547
Mobile: +41 79 249 3520
E-mail: sminkeyl@who.int

Najwa Mekki
UNICEF, New York
Telephone: +1 212 326 7162
E-mail: nmekki@unicef.org

 

International Health Tourism

Health tourism is providing health care without frontiers in a truly global market.

Countries as diverse as Turkey, India, South Africa, Argentina and Lebanon are embracing the International opportunity to attract patients with a combination of medical quality, speedy treatment, comparatively low cost health care, and tourism.

Patients have been seeking health benefits abroad since the 19th century, with resorts on the European mainland and beyond gaining plaudits from the fashionable upper-classes, for their miraculous healing benefits. In the 21st century, an era of relative wealth, Internet communication and cheap and easy air travel, health tourism is a rapidly burgeoning commercial market with an infrastructure that is becoming increasingly sophisticated. In 2006, the type of health care available abroad goes some way beyond miraculous waters and leeches, and health tourism is truly migratory. All this and the recent EU law changes ruling that national health bodies will have to provide International health care options to their patients, today’s health care has no frontiers and few limits in a truly global market.

In Europe, probably the seminal territory of healthcare tourism, Munich International Airport is a centre for health care tourism. Featuring two surgery rooms and 13 beds, individually designed packages can include diagnosis, inpatient or outpatient surgery, hotel accommodation, transfer to a partner clinic for long-term treatments, and sightseeing programs for patients and their families. The clinic will even collect patients at the aircraft and take them through immigration. Specialties include orthopedics, hand surgery, plastic surgery, endocrinology, minimally invasive surgery for various conditions, ophthalmics, ear-nose-throat medicine, urology, gynecology, gastroenterology, and treatment of cardiovascular conditions. The clinic even has a magnetic resonance (MR) scanner.

Eastern Europe countries, bidding for EU membership, are keen to prove their medical standards are comparable with EU member countries. Lithuania had no difficulties complying with the EU requirements, is active in the health tourism market, providing health care at comparatively low cost and has been welcoming patients from the UK, mainland Europe and the U.S.

Elsewhere, there are few corners of the world that are not actively involved in the health tourism phenomena. In South America, Argentina has emerged with a reputation for what might be called cutting edge for plastic surgery and has become a booming tourist draw amid the country’s ongoing economic crisis, as the devaluation of the peso makes aesthetic enhancement more affordable to foreigners. In the Middle-east a sophisticated and well established understanding of intercountry healthcare is well established. In Jordan 30 percent of private sector patients come from the surrounding countries of Saudi Arabia, Egypt, Lebanon, Iraq, Syria and other Middle East countries. The combination of highly qualified Jordanian medical personnel, up-to-date facilities, relatively low costs for sophisticated as well as general medical treatments and surgeries makes Jordan highly competitive in the provision of healthcare services for both its domestic and regional patients.

In neighboring Dubai, a well publicized programme of development is seeing a spectacular and somewhat unearthly new world of steel and glass emerging from the desert dust. At the forefront of Dubai’s rapid development is tourism, and a key part of this is health tourism. Dubai sees itself as well positioned and capable of attracting visitors for this sector, from Middle Eastern countries and, in particular, the neighbouring Gulf states, Asia, particularly the subcontinent, and from parts of Africa. In the longer term there is also a large supply potential from some European and North American countries. For Dubai to succeed in attracting this market, developers admit that appropriate planning, legislation, infrastructure building is required, and crucially, a supply of internationally renowned specialists and a strong promotional campaign must take place. The plan to build a Health care City in Dubai is a key strategy. There are, however, many challenges which will have to be overcome for Dubai to reach its goal. For example, the perception of the healthcare service in Dubai. Plus Dubai salaries are comparatively high in the middle-east, and so neighboring states and East European countries will provide stiff competition to patients without insurance or state funding. For Dubai, as with all its development in commerce and real-estate, the potential for health tourism in Dubai is vast. The proximity of Dubai as a healthcare centre to its potential supply countries.

In the Lebanon, health and wellness tourism, an innovative niche market in Lebanon’s tourist industry, is about to move out of the specialty market and become an important asset to the Lebanese economy with the establishment of the Lebanese Council for National Health Tourism. While the international travel and tourism industry continues to be hit by war, terrorism and economic weakness, a growing awareness of tourism’s capacity to promote health tourism has fueled investment in this area. With this ambition, the Lebanese Council for National Health Tourism has invested over $500,000 (euros 415,000) in the brand new industry with the aim of getting travel-related commerce back on course and turning Lebanon into the biggest hospitalization sector in the region, which will have a direct and positive impact on the country’s economy. According to Mr. Khalil Malaeb, General Manager of K & M International, who is entrusted to promote this new sector, health care and hospitalization services are well developed in the country and are an integral part of Lebanese culture. Lebanon has over 130 years of excellent medical experience. So far, the council has managed, through teamwork with various health ministries and related sectors, to create concrete relationships with seven Arab Countries, including Saudi Arabia, Dubai and Kuwait.

Although health tourism has been a large and even lucrative industry in other countries in the region, Malaeb believes that Lebanon has as much, if not more, medical experience to offer and can be competitive. Health tourism has endless opportunities and benefits, and it ties extremely well into Lebanon’s reputation as a rejuvenating place and a healthy state. Lebanon is returning to its roots, as is demonstrated by the promotion campaign of a 19th century photograph that shows Lebanon’s medical experience dates back to the early 1800s. “With only one month since its launch, we have already attracted some 50 clients from the Arab World,” Malaeb said. With the anticipation of eventually covering all 22 Arab countries, the council is aiming to train all parties involved, enabling them to become acquainted with the existence of this sector and the market, and provide detailed, accurate information to clients

“The key in creating this industry and succeeding in it depends completely on Lebanon’s excellent doctors and their experience as well as Lebanese universities, which have the highest standard of medical education,” Malaeb added. Medical assistance includes pediatrics, psychiatry, surgery, orthopedics, the ophthalmology program, the ENT program, obstetrics, gynecology and other areas. The council also offers an executive check-up program designed to meet the individual needs of each patient and address health issues, make recommendations for any further testing or follow up and counseling about personal health habits. A schedule of tests and consultations is prepared based on information patients provide before the visit. The executive check-up program takes one to two days. “The patient has to come a few days in advance for his check-up and stay for a certain time even after medical assistance.”

According to the statistics of the council, Lebanon has 10,500 doctors who have completed their specializations in European, North American and Lebanese universities, 48 medical societies, 161 hospitals, 48 hospitals with international accreditation, 144 medium and short stay hospitals, 17 hospitals for long term stays and seven university hospitals. The importance of this council lies in the fact that it provides the patients who come to Lebanon with all facilities and services from the moment they leave their country to the moment of their return. Pre-planned, tailor made packages are prepared to make patients and that families accompanying them, feel at home and to let them get the most out of their “healthy visit”.

Phuket, in Southern Thailand, world famous as a tourist destination, and more latterly for being in the eye of the tsunami tragedy, is a center of international commerce, a hub for the development of the entire Andaman region, as well as a center of higher education and fast becoming a medical holiday destination. The Bangkok Phuket Hospital has been meeting the medical needs of international clients for more than eight years, with English-speaking, UK and American trained health professionals on staff. A member of the first and largest integrated hospital group in South East Asia, the Bangkok Hospital Group level of medical care and patient comfort are attracting patients from all around the world. Like many institutions, it offers a complete package service from scheduling to travel arrangements, accommodation car hire and even tours, and the competition in Malaysia is very competitive. Recently, in a bid to legislate the market, the Association of Private Hospitals Malaysia (APHM) finalised the recommended fees for the common health tourism packages, Health Minister Datuk Chua Jui Meng said: “ A sub-committee on fee packaging, chaired by the APHM recently, had finalised the recommended fees to ensure that tourists coming to Malaysia for medical reasons get value for their money.”

The fees were highly affordable and competitive internationally. “Basically, there are three health screening packages – the Basic Health Screening package, the Well Woman package and the Well Man package with fees ranging from RM450 (Euros) to RM1,150 (Euros) depending on the number and complexity of tests performed,’’ he said when opening the Penang Adventist Hospital’s Clinical Pathology Laboratory services and launch of the Architect ci 8200 Analyser. He added that the packages would also include minimum and maximum recommended fees for 18 procedures commonly performed in cardiology, ophthalmology, orthopaedics, plastic surgery and diagnostics such as endoscopy, MRI and CT-scan. Chua said the Government was making efforts to expand the health tourism industry in a big way and had identified health tourism as one of the potential growth areas in the country’s tourism industry.“A survey commissioned by the Government last year estimated that our foreign patient market was worth close to RM90mil and admission of foreign patients into our healthcare facilities have grown at an annual rate of about 30% over the past three years,’’ he said. Chua added that 35 private hospitals were identified and currently being promoted as providers of health tourism services. “Although none of our Health Ministry hospitals has yet to be promoted as a provider of health tourism services, the setting up of many new, sophisticated and ultra-modern hospitals under the ministry have been identified as prime movers of health tourism in the future. “Our public hospitals have the potential of raking in at least RM2bil a year in health tourism earnings by the year 2010,’’ he said. Southeast Asia has proved irresistible to ailing tourists. Singapore entered the clinical fray about a decade ago, followed by Thailand a few years later; now Malaysia is on the health-tourism bandwagon.

Efforts to promote Malaysia as a health tourism destination are starting to pay off with more foreign tourists coming to the country for treatment and recuperation, Health Ministry parliamentary secretatry S. Sothinathan said. He said they were attracted by the affordable costs and quality healthcare facilities offer by private hospitals. “The Health Ministry will cooperate with these hospitals, tour agencies and other relevant bodies to come out with packages to attract more of such tourists,” Sothinathan said after opening the Atmos Medizintecknik (Asia) office in Kuala Lumpur on Thursday. Sothinathan said about 100,000 foreign toursits sought treatment in hospitals in 2001 which generated revenue of RM 150 million compared to about 39,000 tourists and RM 90 million in revenue in 1998. “We have set a target of RM 400 million (Euros) in revenue within a few years and RM 2.2 billion by 2010,” he said. He said there were over 200 private medical centres with over 10,000 beds in the country, accounting for about 25% of the total number of hospital beds in the country compared to 50 private hospitals with 2,000 beds in 1980. Malaysia was chosen as the hub because the healthcare standards in the country were on par with the western countries and better than some developing countries. Capitalizing on its Western-trained medics and a favorable exchange rate (neighboring Singapore’s treatments cost twice as much), Malaysia’s wards now benefit everything from laparoscopic surgery to liposuction. And patients are flocking: the Association of Private Hospitals of Malaysia (APHM) claims that in 2002 nearly 85,000 medical tourists checked themselves in to Malaysian clinics, mostly from Indonesia and other Asian countries but also many from Europe. “We’re multicultural and multilingual,” says the association’s Datuk Dr. Ridzwan Bakar. “And we’re the most competitively priced country in the Asia- Pacific region, bar India.”

Malaysia’s other major selling point is its ability to perform difficult treatments. Among the most popularly requested operations are cardiac bypass surgery, the National Heart Institute is a leading center in the region, and fertility treatments, with the country’s premier Damansara Fertility Centre claiming in vitro success rates that match top U.S.clinics’.

There are few corners of the Earth where healthcare tourism is not positioned as a key component of development and change. Territories actively working to alter the world’s perceptions, after decades of unrest, economic depravation and war. Then there are parts of the world, renowned for their beauty where conventional tourism is being packaged with low cost health care. It is a curious paradox that countries such as the UK, mainland Europe and U.S. are the main source of the world’s health tourism market. Without question, the rapid development of this phenomenon raises many opportunities as well as challenges, both for the health care sector and governments, and in forthcoming issues, Healthcare International will report on the sector, and invites contribution from the health care community.*more