How India Is Turning Into A Popular Medical Tourism Hub

India issued 463,725 visas for medical travel in 2024, a number that depends on its relations with other countries, the economic conditions in those countries and the global economy, among other things.

“We haven’t issued many visas to Afghan patients since 2021, because India does not officially recognise the current Afghan regime,” said Anas Abdul Wajid, chief sales and marketing officer at Max Healthcare, New Delhi. The political upheaval in Bangladesh and the souring of ties between India and its neighbour means that fewer Bangladeshi patients will visit India, he explained.

Medical tourism is of value not just to hospitals but also to other businesses that benefit from the inflow of patients and their families from abroad.

“Khamsa ashra [15 in Arabic],” said a baker in response to an inquiry about the price of his flatbread from a Sudanese man. The baker can count up to 20 in Arabic, Pashto and Russian, he claimed. Behind his stall in Sector 50 in Gurugram is a restaurant that sells Arabic-style roasted meats, and on either side are hotels and accommodations for patients.

Unable to speak the language and unaccustomed to the climate and crowded public spaces, patients said they are driven to India because it is the most affordable option and meets the standards of quality that they are not assured of in their home countries.

Indian tertiary care more affordable, better quality than most countries

When one-year-old Zulqarnain Ali was diagnosed with biliary atresia, a condition that would require a liver transplant, his parents had two options: get the surgery done in their home country of the Philippines or to travel to Japan, the USA or India.

The Philippines is also an emerging medical tourism destination, ranking 24th of 46 countries on the 2020 Medical Tourism Index. India ranks 10th on the index. “We ruled out the Philippines because his chances of survival would be lower there,” Ali’s mother, Cassandra, said. “Japan and the USA would be expensive, which left us with India.”

Fluent in English, they travel to their hotel from Max Super Specialty hospital in Saket (and at times around the city) using Uber. Other than having to cook food in a kitchenette in a hotel room, their stay has been comfortable, the couple told IndiaSpend.

Cassandra donated part of her liver to her son for the surgery in the first week of March, and the surgery was a success. They will stay in India for another month, when the doctors will clear their son to travel back home.

Amer Ali and Cassandra from the Philippines with their one-year-old son Zulqarnain Ali. The couple traveled to India in March for the child’s treatment.

In 2023 alone, there were 18,378 organ transplant surgeries performed in India, close to a tenth of which (1,851) were performed on foreigners, according to a report from National Organ and Tissue Transplant Organisation (NOTTO). The National Capital Region (NCR) accounted for a bulk of these: 1,445 transplants among foreigners were performed in Delhi NCR.

Of the total transplants performed on foreigners, only nine involved a deceased donor. The rest were from live donors who donated their bone marrow, a kidney or a part of their liver. Organ donations in India are governed by the Transplantation of Human Organs and Tissues Act 1994. Foreign nationals can get on the registry of patients in need of organs, but they will be considered for allocation only if there is no Indian available to take the organ anywhere in India.

“The patient brings a donor with them, and usually it is a blood relative. We do DNA tests to ensure that there are no commercial interests involved. This is at the hospital level,” explained Abdul Wajid. NOTTO requires the donor and recipient to provide proof of relationship.

Limited food options for the sick; safety concerns

Spicy food and crowded public places are what struck Serdar Niyazov as the most different from his home country Turkmenistan. With a population of 7 million, the Central Asian country has fewer people than Delhi (16.8 million) or Mumbai (12.8 million).

“My wife and I don’t mind the spicy food as much as my daughter. Every restaurant I go to, I ask them not to add any spice to my food but they don’t listen. My daughter tastes the food, and after one bite, puts it down saying that it’s too spicy for her,” said the former engineer from Turkmenistan, whose name has been changed here to protect his privacy. Niyazov added that his daughter is slowly getting used to the food.

This is his family’s second trip to India. His seven-year-old daughter, who was operated on for epilepsy last month, first came here when she was one. “The doctor says that she has made considerable recovery and they can take her off her medication gradually and stop it eventually.”

While there are several small hotels and restaurants that cater to international patients in and around Max Super Specialty Hospital in New Delhi, where the Alis and the Niyazovs are staying, Gurugram has transformed to meet the needs of foreign patients, and has more facilities for them, we found.

A restaurant and hotel in Gurugram for patients who travel to India for treatment (left). An advisory from Gurugram police for these patients in English, Arabic and Russian (right).

Abu Ismail (name changed) sat in his hotel lobby, his back turned to the dust and heat outside as he recited verses from the Quran. A resident of Iraq, the 55-year-old spoke no English.

“My brother is being treated for cancer at Fortis Hospital,” he explained with the help of a translation app on his phone. The phone and a visiting card from the hotel’s manager, which has the address and phone number of the hotel, are crucial for his stay in Gurugram.

The hotel where he will live for the remainder of his six-month stay is a four-storeyed building with four flats on each floor. None of the staff speak Arabic or English but inquire about their guests’ special needs through their phones or at times, a translator, according to manager Teg Bahadur.

Bahadur and his colleagues provide laundry and housekeeping services to their guests with special regard for hygiene (since many of them are immunocompromised). At times, they have to intervene in arguments with autorickshaw and cab drivers on behalf of their guests. “Some of them stay for months in a country that is foreign to them. We have to make sure that they are comfortable.”

Bahadur’s establishment is one of several that cater to overseas patients undergoing treatment in Gurugram’s Medanta and Fortis Hospitals. Pharmacies and dentists’ clinics in the lanes nearby have signboards that advertise their services in Arabic and Russian. Auto rickshaw drivers read their destinations off hotel visiting cards, such as the one Abu Ismail has in his front pocket, to ferry the families back.

Most medical visa holders from Bangladesh, Arabic-speaking countries

India, as we said, was the tenth most attractive destination for medical tourism, as per the Medical Tourism Index 2020-21.

Bangladeshi patients were given 323,498 visas in 2024, the highest number of visas for treatment in India (around 70% of all visas). This number will likely fall since the strain in the relations between India and Bangladesh, according to Abdul Wajid.

This is what happened with Afghanistan in 2021. The number of Afghan nationals who visit India for treatment has fallen to one person in 2024 from 22,463 in 2021--the year in which the Taliban overthrew the US-backed regime in the landlocked South Asian country. India responded by moving its embassy from Kabul to New Delhi in August 2021.

Nepal nationals who may have availed of treatment in India are not listed here, because Nepali nationals can enter India without a visa.

India is one of the most affordable destinations for medical value travel, and is preferred by the uninsured even in developed countries like the UK and USA. In 2024, 1,911 people travelled to India from the USA on medical visas, as did 785 people from the UK, data from the external affairs ministry show.

E-visas welcome, standardisation and regulation of the market needed: experts

Treatment at a private hospital for breast cancer, the most frequently occurring cancer among women in India, starts at $3,800 (Rs 3.25 lakh). That is ten times the median expenditure by an Indian household on inpatient activities in a year (Rs 35,000). But this is often a cheap option, especially for patients who do not have the same facilities in their own countries.

“Most West Asian governments, [such as Oman and the UAE], bear the cost of treatment of their sick, and India is one of the most popular destinations for them because of the low cost of treatment compared to western countries,” explained Abdul Wajid.

Other ways in which the overseas patients pay is through insurance or through nonprofits in their home country or in India. Sometimes, they pay out of pocket.

In the mid–2020s, India’s medical tourism sector was estimated to be worth $5–6 billion, with the segment expected to grow to $13 billion by 2022, according to a NITI Aayog report. 

Niyazov, who paid out of pocket for his daughter, was all praise for the e-visa process. “That is because India reciprocates the ease with which its citizens are given visas to the foreign country,” explained Abdul Wajid. Indians can enter Turkmenistan, Niyazov’s home country, by paying a fee ranging between $35-$1015 (Rs 2,983- Rs 86,525).

While this works for countries that are popular tourist destinations, it has a discouraging effect on citizens of poorer countries with whom India has no incentive to negotiate better terms, explained Abdul Wajid. “Nobody wants to go to Nigeria or Ethiopia from India for medical reasons, so even if they do charge us a high medical visa fee, we are not missing out on much.

“However, the Indian government also charges high fees from medical tourists from those countries, which discourages patients at times.”

To make it easier for foreigners to visit India for treatment, the Indian government allows e-visas for patients and attendants. It included Medical Value Travel (MVT) as one of the ‘Champion Service Sectors’, sectors for which the government had set up a Rs 5,000 crore dedicated fund in 2018.

At the same time, the government should bring in more regulations for the sector, according to Abdul Wajid.

“A person sitting in another part of the world has no way of knowing if the healthcare facilitator they have contacted in their home country will take them to a world-class hospital or a nursing home with questionable credentials,” explained Abdul Wajid. He has come across patients who were left stranded in India without getting the required treatment and had to be transferred to a better facility, he recounted. “They have no means of getting a redressal.”

IndiaSpend has reached out to the Ministry of External Affairs, Ministry of Health and Family Welfare and the Delhi government to ask about the means of redressal available to a foreigner treated in India, the number of people who were duped into coming to India in an inadequate medical establishment, the effect of regime change in Bangladesh and Afghanistan on the number of visas given to people from these countries and the government’s plan for promoting India as an MVT destination abroad. This story will be updated when they respond.

For those who get connected to the right doctors and facilities, medical treatment in India is a boon. “Both doctors who treated my daughter were very helpful, and we are optimistic that our daughter will lead a healthy life,” said Niyazov.

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