An Opinion by
Stella Tsartsara*, Valentina Poberskaya and Vladimir Yezhov
What was common between the Romanov’s, Anton Chekhov, Stalin and Lenin? Not much except one common fact: they all were going to Crimea, and lived part of their lives there to receive medical treatment.
This was when Crimea was branded for the first time as a Medical Tourism destination. People from the Russian empire, after URSS, now Russia and CIS, where travelling to Crimea for medical rehabilitation its main product until today.
Crimea has a territory as big as Sicily where were built 600 Sanatoria some still active until today, to host 300 URSS million citizens, the size of USA today. Crimea was fed by a welfare system that still nourishes this system today. What if this stops? Now is the time to change the Medical Tourism Model and modernize medical marketing and sales.
This created since centuries an inherent system medical knowledge on its abundant medical natural resources and human capacity on its traditional Product: Medical Rehabilitation in orthopaedics, injuries, neurology, cardio-respiratory and reproductive system disorders. This is not balneology, it is certainly not SPA.
This is Medical Tourism and as the Crimean Doctors say “in Crimea we do not just improve the health of people, we cure them”.
* Author for correspondence; email: [email protected]
The article expresses the opinions of the authors and do not necessarily represent the opinions of Jlag Ltd.
The answer may seem to be “no” due to factors Medical Tourism professionals already know (lack of political will, uncoordinated policy in the industry development, soviet-type of marketing the Product, obsolete banking, investment and PPP laws, etc.) it can also be affirmative, if we connect the dots.
Ian Youngman in his last article “The potential of potential powerhouse economies in medical tourism” said: “Russia and the CIS countries offer the biggest long-term market for medical tourism, but while they want a reasonable price, they also demand top quality care and service”.
While I was Team Leader in Ukraine, in the Crimean Tourism Diversification and Support Project funded by the EU, together with MD, Professor Poberska and Professor Yezhov we went on a famtour of 53 Sanatoria and one University Clinic in Crimea – Ukraine in 2012, to investigate what is the Medical Tourism Product value.
Crimea is the only tiny spot of a transcontinental vast Russian and CIS territory from Japan to Germany, where people had access traditionally from the URSS times, to warm sea and moderate climate. The microclimate of Yalta is like no other in the Black Sea – there are studies proving this. The curative mud and brine from the Lakes of Crimea is responsible of 30% effectiveness of medical rehab treatments.
Crimea was discovered by the Romanovs’ dynasty. It was the Russian Emperors that built the first train line to a no man’s land to receive cure and holidaying and actually built the Brand of Crimea as a healing destination. Then it was discovered by the Russian intelligentsia that was also receiving treatments while vacationing and in those 2 centuries Crimea was metamorphosed with Royal palaces – that today are still hosting Sanatoria – in the country side with marvellous architectural buildings. Anton Chekhov built in Yalta a Sanatorium where he treated patients – as he was Doctor first and then the writer of the Cherry Orchard.
The Anton Chekhov Sanatorium in Yalta
Then Vladimir Ilitch Lenin declared Evpatoria as the Soviet Union City for Child Rehabilitation and Treatment, and here is where all begun to take the shape of a Crimea as we know it today.
Because of these assets, in a territory as big as Sicily, were built 600 Sanatoria, to serve the needs of the entire Soviet Union.
It is like the entire USA population, would wish to go for treatment in Sicily. This was paid by a social security system of an admission card that almost all workers could have in the Soviet Union and do treatment and holidays with family. Today still this system partly finances the Sanatoria in Crimea.
However, it is clear that one day this will be over.
But what is today a Sanatorium in Crimea – not in legal terms but what is its real product market value for the Medical Tourism markets, state and private?
The definition of a MT Product in a Sanatorium in Crimea should be read under the light of 2 conditions. What is the Brand of the Crimean Medical Tourism (what primary diseases are treated there) and most importantly what is the profile of the main segment that occupies by 98% the Crimean Sanatoria.
There is a certain profile of diseases that Crimean Sanatoria treat very successfully today: orthopaedics, spinal cord injuries, musculoskeletal disorders, Palsy, cardio- vascular and respiratory disorders and chronic diseases including post cancerous treatment and pain relief.
The segment that the Crimean Product will address for the next 10-15 years at least is first of all, 98% Russian speaking and second it is not the Samsung Galaxy S one. It is the LMIC segment of growing Europe in crisis and of hundreds of millions of Russian and CIS people who cannot afford other destination than Crimea due to its Mediterranean climate too, for medical purposes.
We are not going to examine the public sanatoria where certain pre-conditions are necessary from the Ukrainian government for Crimean’s destination attractiveness; until those are part of the official legislation, the discussion is postponed for a later period.
Let’s take the example of few successful private Sanatoria in Crimea. What do they offer?
The Crimean Sanatoria are huge areas of 4 to 18 hectares each, with natural parks inside with endemic flora, with 5 to 10 six- floor buildings of hotels and medical facilities with shops, restaurants and cafes, movie theatres and libraries, forming what we can call today Integrated Medical Resorts selling all-included medical and leisure services.
The Product of Crimea today is Medical Rehabilitation of diseases, chronic syndromes, injury and post-surgery recovery, in all-included package of 4 to 8 medical procedures per day with 3 meals and accommodation for 60USD per person and per day. For us this is where it started to get interesting.
The Product of Crimea is not balneology for general SPA and health recovery. I endorse the definition of Susie Ellis separating SPA and Medical Tourism and clearly the main Product Offer in Crimea is Medical Rehabilitation – as they say “here we cure people we do not just improve health”.
It is like if Acropolis was never exposed to the public
This map shows also that Ukraine is the only country of all countries in green surrounding it that the term Medical Tourism does not even exist in any legal framework, policy or strategy on that matter.
This asset is unexploited. It is the same as if Greeks decided not to expose Acropolis to the public.
Only few private and even lesser public Sanatoria have realized where the goldmine is.
We saw Sanatoria with diagnosis – non – invasive surgery and rehabilitation of orthopaedic cases in the city of Kerch, Evpatoria and Yalta. We saw Sanatoria specialized in diagnosis – non – invasive surgery and rehabilitation of Palsy that in the summer was flooded with families treating their children for Palsy, a disease that only rehabilitation can have long lasting effects.
And I asked myself the question: if I got to get the triad of diagnosis, non – invasive surgery and rehab including 3 three courses meal per day and accommodation costs 75 euro per day – all included, in a park with alpine vegetation and Mediterranean climate, with movies, shops, cafes, and excursions at a low cost, would this for a low-middle income employee be an interesting perspective rather than not having it at all? The answer is definitely yes and maybe is with the Third Party Payers in this buisiness.
In an OECD scoping review on Medical Tourism: Treatments, Markets and Health System implications, the authors conclude in an interesting statement: “Clearly, however, source-country payers may benefit from outflows of patients – including employers and employees contributing to health plans, and the public insurance system itself. There may be some opportunities for financial benefit if medical tourism is an option”, through bilateral medical tourism trade deals.
I would agree that Crimea is a non-sophisticated destination and this includes Medical Tourism but it has assets that each country in the map for some reason does not have: either climate, or they do not have the resources, or hotels are far away from the Clinics and not equipped as they should for impatient treatment, and even if they would, nowhere the price for all included services and quality of treatment are so competitive as in Crimea.
Moreover, it is in geographic proximity from the main markets that are of interest to Crimea, there is cultural proximity except from Russian, with European but also with Muslim segments as its second biggest population are Muslim Tatars, the destination image is appealing to lower and middle income consumers that would prefer off the beaten track destinations, the environment is unspoiled and beautiful and if the price is 75 euro for treatment, travel and stay then maybe some infrastructure hiccups here and there can be forgiven.
There was not one Sanatorium that claimed that they would pass into the modern Medical Tourism era alone. They all thought that partnership with the medical tourism professionals, in any form that would be mutually interesting is what they need to modernize their models. Some of them are really eager to do that and meet for the first time the medical tourism industry in this year’s medical tourism fairs.
Put the Acropolis in the North Pole and it is no more the Acropolis. It is the same with Crimean Sanatoria: the Crimean Medical Rehabilitation Product is a Brand in itself; a tradition for Crimea that defines not only the Medical Tourism destination identity, but it’s in the root of the Crimean civilization.
| “Medical Tourism: Treatments, Markets and Health System implications. A scoping review”, by Neil Lunt, Richard Smith, Mark Exworthy, Stephen T. Green, Daniel Horsfall and Russell Mannion – OECD Publications.|