Medical Tourism in Developing Countries

104 ● Medical Tourism in Developing CountriesUniversity, some 60 percent of graduate students in the sciences are foreign,most from Asia. In the course of a single year, all graduate students inmathematics were from China. 22 In addition, Indian immigrants to theUnited States represent 3 – 4 percent of all immigrants, but they account for20 percent of those with professional or technical skills. 23Public sector expenditure on education is an indicator of governmentpriorities. Thailand has the highest percent of expenditure on overall education(28.3 percent) while Malaysia leads with respect to government expenditureon tertiary level education, spending 33.3 percent of its totaleducation budget.As noted above, the knowledge explosion is characterized by rapid obsolescenceof techniques and equipment. This is clearly reflected in medicine,with its multilayered specializations and superspecializations, all of whichchange daily with respect to diagnostics, procedures, and pharmaceuticals.For this reason, it is important to have seminars, symposia, conferences, andworkshops to keep updating one’s knowledge and sharing information withothers. Cross-fertilization of ideas is crucial. The countries that have beenable to tie that into their training have benefited. To the extent that theyhave contacts with Western medical institutions, acquisition of new knowledgeis enhanced. To the extent that they have diversified into medicaleducation, keeping up with ideas is also enhanced.But the most important expenditure must be on training medicalstaff and in this way, all countries under study sponsor medical education.In India, the authorities encourage medical tourism by helping trainover 20,000 new doctors per year. 24 Altogether, India produces some20,000–30,000 doctors and nurses every year. 25 Cuba also trains doctorsand nurses at home, and even offers training to those from Guatemala,Venezuela, and Honduras. 26 South Africa, despite having lost skilled medicalworkers when it switched to majority rule (and many whites emigrated),has stepped up its training facilities to make up for the void.The Language of Medicine and ResearchFluency in world languages, especially those in which medicine and biomedicalresearch is being conducted, is a clear advantage for countries intheir pursuit of medical tourism. English has become the lingua franca ingeneral, and especially with respect to technical research. As a result, Indiaand the Philippines have an advantage over other countries as English isone of their official languages and the only one that is used outside itsborders. For the same reason, China has a disadvantage. Although theEnglish language is the most popular foreign language studied in China,