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Health tourism booms in Tunisia
The beaches of Hammamet and the antiquities of Carthage are no longer Tunisia's main attractions for international travellers. Tourists are now coming for liposuction, breast augmentations and other cosmetic surgery procedures. In just the last few years, Tunisia has seen a 7500% increase in the "health tourism" phenomenon.
The waiting room at cosmetic surgeon Tunis clinic is a busy place these days. It is filled with Tunisians, Moroccans and Europeans of all shapes and sizes. But despite a wide assortment of languages and nationalities, the prospective patients have one thing in common; they have all come to change their faces, reshape their bodies or fix a defect that has spoiled their self image. Many of the visitors are nervous, but three decorative paintings of Venus, the goddess of beauty, give them strength and hope.
Beginning with the patient's very first appointment, Dr. BB assistants work hard to create a comfortable atmosphere. "We have to put the client at ease, psychologically," says anesthesiologist N. "The stress he or she feels is perfectly normal and natural and our role is to answer all questions, even if they are boring," he adds.
The majority of Tunisia's cosmetic surgery clients are European women whose visits are co-ordinated by Tunisian travel agencies focused specifically on what has quickly become known as "health tourism". Three years ago, the number of health tourists visiting Tunisia was no more than 2,000. In line with Tunisia's overall growth in the tourism sector, travel agencies saw the surgery market's potential and opened specialised offices throughout the capitol and in cities such as Nabeul and Djerba. By 2007, 150,000 of Tunisia's 6.4 million visitors were health tourists, according to a January report from the National Syndicate Chamber of Private Clinics.
The concept of health tourism is nothing new; the British have long headed to Pakistan or the Philippines for cosmetic surgery. With Tunisia's debut on the market, however, many foreigners are now choosing clinics like Dr. B for their proximity and affordable prices.
Indeed, only a short flight from Europe, Tunisia appeals to those short on time and who want to save money. For instance, the cost of a face lift in Tunisia is 3,200 euros. The same operation in France would cost 5,000 euros or more. Breast enlargement surgery costs 6,000 euros in France, but if done in Tunisia, the procedure price is 2,600 euros.
Word that Tunisia provided moderately-priced cosmetic surgery soon spread to other European countries and beyond. Now, clients looking for an affordable makeover and vacation wrapped into one jaunt come from as far away as Sweden, Russia and the United States. Rym B, a marketing employee at Estetica Tour, a leading travel agency in the field of cosmetic surgery tourism, tells TAYSIR that the majority of prospective patients come from France, Belgium and Switzerland.
Approved and regulated by Tunisia's ministries of tourism and health, cosmetic tourism specialists can organise every aspect of a visitor's stay, from booking air tickets and scheduling appointments to arranging comfortable accommodations, usually at beach hotels, to allow patients to comfortably convalesce.
A few years ago, Dr. D says he could count the number of patients per week on one hand. Most of them were either from the Maghreb, he adds, or else they were "low-income Europeans" unable to afford cosmetic procedures in their own countries. It is a different story today.
Now, he says, "[W]e perform cosmetic surgeries on a daily basis after we have proven our worth in the field and after winning the trust of our clients, who [then] advertise our work through the word of mouth. Many of the people who contact my clinic are people who have seen changes in the lives of a neighbour, friend or a colleague at work." He acknowledges that "the western media, and especially the French media, plays an important role in marketing cosmetic surgeries in Tunisia, which put an end to the logic of 'North medicine' as compared to the 'South medicine.'"
Dr. D recognises the challenge of facing doubts over his performance because he is "a surgeon in a developing country". He adds, "As a cosmetic surgeon from a South country, I had to succeed. I have to do this throughout my practice of this profession, in which the science of surgery is mixed with the art of drawing and psychology."
Growing recognition of both the competence of Tunisian surgeons and the country's good health sector infrastructure has contributed to the recent boom in health tourism, according to Abou Bakr Zeghama, president of National Syndicate Chamber of Private Clinics.
Helen K., who came to Tunisia from Switzerland for abdominal liposuction, spoke with TAYSIR while recuperating at one of the hotels in Tunis' northern suburbs. "I feel as if I have removed tons of fat from my body. My life has changed, and I'm happy with the result," she said. She became interested in seeking her cosmetic surgery In Tunisia after seeing the big difference in one of her friends. "She had a lifting that turned her into a young woman again," she noted.
Another European patient, Catherine M., travelled from France for a breast enlargement operation. She saw a French TV program called "Right to Knowledge" last year which featured cosmetic surgeries in Tunisia, she told TAYSIR, and decided to get her procedure after hearing "reassuring and encouraging testimonies from many women" on the episode. After the program aired in France, she added, TF1 received more than 10,000 telephone calls from people looking for the addresses of cosmetic surgery clinics in Tunisia.
However, a Tunisian surgeon who worked and studied in the United States expects that cosmetic procedure costs in Tunisia will soon approach those found in Europe. "We no longer need to prove our worth," Dr. A Ch said. "Personal work is the thing that distinguishes a good surgeon from a bad one," he explained, adding, "The competition in the future will not be among those who offer the lowest prices, but among those who are the best."
"We are now ready to raise the challenge," he said.
Cosmetic surgery is booming. Specialists in the field are delighted with the progress already made after just a few years of business, thanks to Tunisiens' infatuation with beauty. Practices in Europe and the United States are taking root in TUNISIA.
According to plastic surgeon DR R , Tunisia is seeing a growing number of clients. The majority of practices have seen the number of patients double or even triple over the last few years. "Many patients come to us for simple size reductions," DR R says. He says 60% to 70% of cosmetic surgery patients are younger than 40. "We are a long way from the average age of the past, which was sixty years. There's no typical profile."
The consumer "ends up being influenced by new images and techniques shown constantly on television. Cosmetic surgery has become a solution for many people. In the past, it was restricted to the elite. Today it has become accessible to people from all layers of society," Sociologist Mr Ali says.
Prices in TUNISIA are within reach for many in the country. In fact, prices do not follow any set rule -- with no fixed prices, patients can haggle. The same operation will cost one patient twice what it costs another.
Liposuction can cost from 1000 to 4000 dinars a breast implant from 2000 to 3000 dt. Lift surgery prices start at 2500dt. A face and neck lift will cost between 2500 and 3500 dt. Cosmetic surgery to eyelids is from 800 to 1200 dt. A new nose costs between 500 and 1500dt. Hair transplants go for between 600 to 1000 dtper session.
According to Dr. A , a pioneer in hair transplants in TUNISIA, these prices are not inflated. "Certainly, people on the minimum wage cannot dream of cosmetic surgery. But some people can have cosmetic procedures thanks to credit."
Tunisia has also become a destination for medical tourism. Westerners use have their procedures done in the country because of low prices and the discretion of being abroad. Tour companies are increasingly offering packages that include cosmetic surgery.
Tunisia is starting to train specialists who are heading out to the smaller towns or country areas to practise cosmetic surgery and surgical dermatology. Funding, however, is a problem. Insurance companies consider cosmetic operations a luxury, and do no pay for these procedures.
Professor B says that patients are not always warned of the risks, and it is not always possible to improve certain imperfections. "Ethics require the doctor to be frank with his patient, who must be informed that cosmetic surgery is carried out principally to improve their condition, but other imperfections may appear."