Many Nigerians claim that they were exploited by Indian healthcare companies when they come to India for treatment. In this interview with EZRA IJIOMA, the Country Manager (Nigeria) of Fortis Healthcare (India), Sudhir Singh Rathore, explains what actually happens and how India became a global force in cheap but high-quality medical treatment.
WHAT ACTUALLY DOES YOUR COMPANY DO?
We have our head office in New Delhi [capital of India] and our global office in Singapore and Dubai. We have around 68 hospitals in India and other hospitals in Singapore, New Zealand, Australia, Mauritius, Sri Lanka and we are looking to buy some hospitals in Canada, United States and some other European countries. Right now, we are the largest healthcare chain in Asia.
TELL US ABOUT THE STATE OF HEALTHCARE IN INDIA.
Since the last 20 years, India has made progress in its healthcare. If you look at the scenario some years back, the healthcare [in India] was something like what you have now in Nigeria. People used to go to other developed countries like US and the United Kingdom for treatment but since the last 20 years, India has opened its borders for foreign investments. They have liberalised the economy and we have seen a reverse trend that doctors who were working in developed countries like the US and UK have come back and that actually started the revolution in India’s healthcare. So whatever you see happening in India’s health system is primarily driven by the private sector. They have improved Indian health facilities. The load on the government healthcare institutions have reduced. The quality of healthcare has improved. There are advancements in the healthcare and researches are going on. There are certain things we do in India which have not been done in the world. We can do cardiac surgery through endoscopy – a tube will go through your mouth and we perform a cardiac surgery. Now that is a specialised surgery which happens in a few places in the world. We are doing bone marrow transplant, liver transplant and these are not happening everywhere in the world. We are doing stem cell research but it is still a sensitive issue because of the ethical questions. Our company began robotic surgery last year. This surgery is more precise and efficient, thereby reducing the recovery rate. A person can recovery and leave the hospital in three days after bypass surgery but this is possible in open heart surgery which takes about 15 days for the patient to recover.
ALTHOUGH YOU HAVE TOUCHED IT A LITTLE, TELL US MORE WHAT ACTUALLY SPURRED INDIA’S HUGE ADVANCEMENT IN HEALTHCARE DELIVERY?
Of course, there was the brain drain reversal. Also, India has a huge population, over one billion people. So the market was there. Every kind of medical specialty had a huge market. The patients are ready, the donors are ready and the people are ready for whatever medical service there is. Another thing is the availability of related structures to support the medical advancements. The medicines are made in India, so their cost is low. The machines are made in India, so the cost is still low. Surgeons are not charging too much because most of the people pay from their pockets. So in India you don’t charge too much for medical services. The whole thing is that the market is charging low for high quality services in medicine. For example, a knee replacement can cost about $8,000 but about $40, 000 to $50, 000 in the US and UK because most of the money is paid by insurance agencies and the whole thing is very expensive there. The lifestyle is different [in the US and UK] and the cost of living is different. So people from developed and developing world come to India for that low price but high quality medical services.
WHAT HAS BEEN THE ROLE OF GOVERNMENT IN THESE MEDICAL ADVANCES?
Recently, government has given a lot of support to the private sector. It has reduced taxes. It has provided some subsidy. It has liberalised licensing and all that kind of things. It has helped the people to go abroad to become surgeons and opened the borders for people to come to India for treatments.
MANY NIGERIANS COMPLAIN THAT THEY ARE EXPLOITED BY HEALTHCARE PROVIDERS LIKE YOUR COMPANY WHEN THEY COME TO INDIA FOR TREATMENT. HOW DO YOU RESPOND?
What I have to say is that it [accusation of exploitation] is only a perception and not a reality. What happens is that medical treatment is not what you can accurate assess most of the time across the border. Let’s say you come across a patient suffering from cancer. So he sends his report to India and the hospital tells him that this the tentative cost of treatment. And the patient goes there and it is discovered that the medical problem is far more than was described, so the cost goes high. The cost can only be fixed in particular cases like a knee transplant. It is a procedure and you can give a fixed cost. But you have a patient saying that he wants to go for surgery but he is not revealing to you that he has other ailments like diabetes and hypertension. So he goes to India and is admitted for surgery but the doctor finds that he has diabetes and hypertension. So the length of days of staying in hospital increases because the sugar level must be brought down before any surgery and this adds to the total cost. So the patient will think that he has been charged a higher price than agreed. So it is a kind of complex issue. In India, every hospital is governed by law and you can easily report any malpractice and action will be taken immediately. India is a consumer driven society and the consumer is king.
WHAT HAS BEEN YOUR COMPANY’S CONTRIBUTION TO IMPROVED HEALTH DELIVERY IN NIGERIA?
We have been in Nigeria for about five now. We are doing a lot of activities in Nigeria. We recently did three cardiac surgeries in LASUTH [Lagos State University Teaching Hospital] at free of cost. The whole team of doctors came from India to Nigeria and this gave Nigerian doctors the opportunity to learn how this can be done. This was the first time this kind of thing was happening in Nigeria. We have helped a private hospital in Lagos set up a dialysis unit. We have also done about 20 free medical check-up camps for poor and needy people in Nigeria in the last two years. We bring our doctors from India and they go to the small villages and towns to do some consultancy for the people. The people can come to them and get free medical consultation and counselling. Also in the paediatric cases, like hole-in-the-heart surgeries, we offer reduced costs, charging only for the drugs and consumables used in the surgery. We also train the doctors, nurses, paramedical personnel, radiologists and many others. We have trained more than 50 medical workers in the last one year. We also are helping Ahmadu Bello University Zaria to set up its neurosurgery department, which will be the best in Nigeria.
HOW DO YOU ASSESS NIGERIA’S HEALTHCARE SYSTEM?
What I see in Nigeria is that the doctors are well qualified because many of them go abroad and come back to practice here. The problem here is lack of equipment to practise. It is like a soldier without a gun in a war. So the problem is not with doctors but with the availability of resources. Government has to make resources available but investors have to look into healthcare as a prospective business and invest in it. If both government and private sector provide the resources, I think the problem in Nigeria’s healthcare system will be solved in the next five to six years and not more than that.