Medical tourism has been decimated by the Covid-19 pandemic border closures, but patients in critical condition are still willing to travel to their preferred destination to address their urgent health needs.
Malaysia remains a popular, accessible and affordable country, especially for patients from Indonesia.
Every life is precious and the longer the wait for treatment, the poorer the outcomes.
In 2019, retired businessman Alex Sannata Tauvic, 65, experienced frequent abdominal pain and discomfort – a sign that something was not right.
Alex was admitted to a hospital in Surabaya, where he lives, and a series of tests revealed he had pancreatic cancer.
Unconvinced, he sought a second opinion in Singapore and was told nothing much could be done.
Not wanting to sit idle watching her husband suffer, his wife Endang Susilawati, 56, consulted their family physician and was advised to speak to a hepato-pancreato-biliary and liver transplant surgeon in Malaysia.
After communicating with the specialist, the couple flew to Malaysia at the end of 2019 to see him.
“Prior to this, we had come to Kuala Lumpur in 2018 to do our medical check-up and visit some tourist sites.
“We were given a clean bill of health, so it was a shock when Alex was told he had cancer a year later.
“We were there for 11 days to do all kinds of tests and returned again in 2020 for an operation to remove part of his pancreas.
“Then Alex had to undergo three weeks of chemotherapy followed by a week’s break; during the break we decided to go home,” recalls Endang, whose husband was asleep at the time of this interview last week.
Alas, when it was time for them to return to Kuala Lumpur for the next cycle of chemotherapy, most countries, including Malaysia, had gone into lockdown and shut their borders.
Since no flights were flying in or out of the country, Alex was asked to continue his 15 cycles of chemotherapy in Surabaya, which took a few months to complete.
To monitor his progress, he was required to do a computerised tomography (CT) scan and more blood tests.
Endang says: “The results showed the cancer had metastasised and spread to his liver.
“We gave the information to the oncologist in Kuala Lumpur and was told to fly there immediately.
“But we were in a fix as to how to go about doing this (as there were no commercial flights), so we had to charter a flight.
“It was extremely expensive, but we had no choice.”
At the height of the pandemic, chartered flights were only allowed into Malaysia for medical emergencies.
And in Indonesia, chartered flights would only fly if there were three patients, along with one companion each (six persons maximum).
So Alex and Endang had to wait a month for the places to fill up.
As the chartered flight was taking off from Medan and there were no flights from Surabaya to Medan, they had to fly to Jakarta first, then take another flight to Medan before jumping on the chartered flight.
It was one big logistical mess, but they persevered.
Then they had to do Covid-19 tests before departure and after arrival – vaccines were not yet available at that time.
Finally, after all the paperwork was sorted, they arrived in Kuala Lumpur in October 2020 and were whisked away in an ambulance to the hospital.
“The hospital had a special ward to quarantine patients, and Alex was placed there while I was in a rented apartment.
“We stayed for eight months while Alex was undergoing more aggressive chemotherapy,” says Endang.
While Alex went in and out of hospital, she would spend her time cooking, making friends with other foreign patients and their companions, and exploring food courts or shopping malls nearby.
“Nothing much was open, so I couldn’t really go anywhere or walk on the streets.
“There were other Indonesians in the same apartment block, so we supported each other.
“I’d also cook and share food with them,” she shares.
When Alex completed his treatment (he also did his cataract surgery here) and the doctor was satisfied with his results, the couple flew back to Surabaya last June (2021).
By then, global lockdown restrictions had eased and some commercial flights had resumed operations.
Thankfully, Alex has medical insurance and only paid 20% of the total treatment cost, along with the cost of living in Malaysia.
“The cost is comparable to Indonesia, but Malaysia has much better facilities and equipment.
“Despite Surabaya being the second biggest city in Indonesia after Jakarta, there is no PET (positron emission tomography) scan available in any of the hospitals.
“We have to fly to Jakarta to do it and this is costly.
“In Malaysia, everything is available in one place.
“Some medicines are also not available in Indonesia, so we have to order them from specific pharmacies or ask our friends to get them if they come to Malaysia,” Endang explains.
The couple returned again to Malaysia last November for a follow-up and were given the good news that there were no traces of cancer.
To celebrate, their close-knit family of three children and four grandchildren, whom they had not seen for over 18 months, took a much needed vacation to Bali over the Christmas holidays.
Endang had such a good experience in Malaysia that she has become the unofficial medical tourism marketing agent in Surabaya!
“I just want to share my experience with others!” she says, laughing.
“Alex’s next check-up is in May (2022), and this time, we hope to go jalan-jalan (travelling) to Genting Highlands!”
Sorting out fibroids
She had been suffering from multiple uterine fibroids and painful periods for years, often requiring blood transfusions.
Tannias, 31, was offered open surgery and laparoscopic treatment, but worried it would affect her fertility.
One of her relatives then recommended she speak to a consultant obstetrician and gynaecologist in Melaka, who was carrying out non-invasive treatments to treat fibroids.
After teleconsulting him, she opted to go for the High-Intensity Focused Ultrasound (HIFU) treatment, which is non-invasive, has a shorter recovery period and preserves fertility.
Unlike other therapeutic procedures, patients undergoing HIFU do not need to wait for their uterus to heal entirely before trying to conceive.
Tannias says; “After we agreed on the treatment and the date, the hospital arranged all other things related to my travel.
“I was only required to submit my details and documents.
“The process at the airport was also swift and efficient despite the pandemic regulations.
“My mother accompanied me, and both of us were fully vaccinated.”
She stayed in Malaysia last Oct 3 to 21 (2021), which includes 14 days of quarantine and two days of treatment and post-treatment, followed by two days of rest and a day to fly home.
“I feel better after the treatment and my condition has definitely improved,” says the delighted Tannias, whose overall expenses here totalled RM40,000, inclusive of flights and accommodation.
Oral treatment, please
Melina Kusuma, 64, was diagnosed with lung cancer last year (2021) and her family was obviously devastated.
The Jakarta resident consulted oncologists in her native country, but as her cancer was already in stage IVa, they said she needed chemotherapy.
“Due to my mother’s old age, we didn’t want her to go through chemotherapy and suffer the side effects, so we looked around for oral treatment, which wasn’t available in Jakarta.
“We chose to do it in Malaysia because it is the closest country to us, and cheaper than Singapore,” shares Susanti Kusuma, Melina’s daughter.
They sent all Melina’s medical reports to a Malaysian private hospital, did video consultations with the doctors and got the assurance that the cancer was treatable orally.
As most of the travel documents required were taken care of by the hospital, the duo only had to wait for the paperwork to be approved before flying here two months ago (January 2022).
Susanti says: “Initially, we were a bit worried about having to land with a patient, along with multiple luggages, but the process turned out to be smooth.
“The hospital staff were very kind and helpful towards us as foreign patients.”
Melina was admitted for a month and has slowly started showing signs of improvement.
“Before, after walking for about 100m, she would require oxygen assistance.
“Now she can walk further without the help of oxygen, and can even do some daily activities like taking a shower or walking around the house on her own.
“She is also able to breathe easily and can take longer, deeper breaths,” relates Susanti.
She has nothing but praise for the Malaysian healthcare team.
“The doctor was so caring and extremely detailed in his explanations.
“The cost of treatment itself is not too far off when you compare Malaysia and Indonesia.
“However, one should also consider other factors when budgeting for treatment, such as the cost of living, as the treatment might require a few months of stay,” adds Susanti, whose mother is still being treated on an outpatient basis.
The duo will be here for a while until Melina is given the green light to go home.
Bouncing back
According to the Malaysia Healthcare Travel Council (MHTC), the top medical treatments sought by international healthcare travellers include cardiology, oncology and fertility.
In addition, Malaysia aims to become the hepatitis C treatment hub of Asia via synergistic public-private partnerships.
While the majority of medical tourists sought care in Kuala Lumpur and Selangor, states such as Penang and Melaka also saw increasing numbers until the Covid-19 pandemic struck.
Prior to the pandemic, Malaysia’s healthcare travel industry had contributed significantly to the national economy, with a 90% increase in healthcare travellers from 2011 to 2019.
In 2019, Malaysia’s healthcare travel industry recorded RM1.7 billion in revenue.
Last year (2021), Malaysia garnered RM551 million in revenue based on hospital receipts alone – 6% above the targeted revenue goal, but a far cry from pre-pandemic times.
The full data for 2020-2021 has yet to be finalised.
“Based on our initial projections, we estimate that as the industry recovers, our healthcare has the potential to contribute up to RM7bil to the economy by 2025.
“With our borders reopening on April 1 (2022), it is certainly a positive indicator towards the recovery of Malaysia’s healthcare travel industry,” says MHTC chief executive officer Mohd Daud Mohd Arif, adding that the council is looking forward to welcoming international travellers back to Malaysia, even as we embrace Covid-19 endemicity.
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