CHAPTER – 1

INTRODUCTION

1
 INTRODUCTION TO MEDICAL TOURISM IN KERALA:

PIC1.1
KERALA
Kerala is not only a beautiful destination in Southern India known for its scenic beaches and
serene backwaters. Of late Kerala has gained international attention for Medical Tourism and
is becoming a popular international medical tourism destination.

Kerala is famous for its alternative medical therapies such as Ayurveda, which help to
rejuvenate and revitalize the body. What many tourists have now discovered is that Kerala
has a pool of trained doctors and nurses and an excellent network of hospitals that offer
international standard treatments at very affordable prices. Previously Indians working
abroad, such as residents of Kerala working in the Persian Gulf countries, would return to
India for medical treatment. Now International patients too have realized the advantages of
traveling to Kerala and the medical tourism industry has begun to take off in a big way.

Faced with exorbitant fees for procedures such as cardiac surgery, dentistry and cosmetic
surgery in their home countries, patients from the West and the Middle East have begun
looking at India and Kerala in particular.

2
Indian doctors have established themselves as highly skilled and conscientious caregivers
worldwide. Many doctors who have trained or worked abroad have returned to India to work
here. Their reputation has led to the growth of the Medical Tourism industry in Kerala.
Kerala Travel Tourism offers tour packages that combine medical treatment with a restful
holiday in Kerala India. The world-class hospital facilities, pre and post-operative care and
pleasant climate make your medical treatment and recovery in Kerala a positive experience.

3
 OBJECTIVES

• To discus about the growth of foreign tourists in Kerala.

• To discuss the growing popularity of Ayurveda in the world.
• To find out why foreigners are taking keen interest in Ayurveda.
• To find out what health & recreational facilities are provided for guests in hotels in
Kerala.
• To find out the costs of medical facilities provided in Kerala.
• To discuss the healing effects of ayurveda.
• To find out what products i.e oils ,pastes ,herbs are used in the medicinal spas &
activities in Kerala.
• To find whether there is awareness in India about medicinal tourism in Kerala
compared to that in the world.

4
 CHAPTER – 2

REVIEW OF LITERATURE

5
 2. REVIEW OF LITERATURE

Review of literature was undertaken to collect the relevant literature on the subject with
reference to the methodology and finding of the related studies in consideration to make the
discussion more systematic and meaningful.

This chapter will include the following heads:

2.1 Theoretical Consideration

2.2 Related Studies

2.1 Theoretical Consideration

2.1.1 Introduction of Kerala.

2.1.2 History

2.1.3 Major Attractions

• Beaches

• Backwaters

• Hill Stations

• Wildlife

2.1.4 Culture

2.1.5 Ayurveda

2.1.6 Why Kerala as a medical tourism destination?

2.1.7 Ayurveda uses

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 2.1.8 Treatments by Ayurveda

2.1.9 Yoga & Meditation

2.1.10 Health resorts offering Ayurvedic treatment.

2.1.11 Alternative medicine in Kerala.

2.1.12 Treatments other than Ayurveda in Kerala.

• Cardiac care

• Dental care

• Transplant

• Opthalmology

• Speciality Hositals

• General Surgery

• Fertility Treatment

• Neurosurgey

• Ortheopedic

2.1.13 Medical & Legal Aspects

2.2 Related studies

2.2.1 Awards for Kerala tourism

2.2.2 Advertising Campaigns

2.2.3 Move to boost tourism in Kerala.

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 Introduction

2.1.1 INTRODUCTION:

Kerala, a state situated on the tropical Malabar coast of southwestern India, is one of the most
popular tourist destinations in the country. Named as one of the ten paradises in the world by
the National Geographic Traveler, Kerala is famous especially for its ecotourism initiatives.
Its unique culture and traditions, coupled with its varied demography, has made Kerala one of
the most popular tourist destinations in the world. Growing at a rate of 13.31%, the tourism
industry is a major contributor to the state's economy.

Kerala is famous for its alternative medical therapies such as Ayurveda, which help to
rejuvenate and revitalize the body. What many tourists have now discovered is that Kerala
has a pool of trained doctors and nurses and an excellent network of hospitals that offer
international standard treatments at very affordable prices. Previously Indians working
abroad, such as residents of Kerala working in the Persian Gulf countries, would return to
India for medical treatment. Now International patients too have realized the advantages of
traveling to Kerala and the medical tourism industry has begun to take off in a big way.

Faced with exorbitant fees for procedures such as cardiac surgery, dentistry and cosmetic
surgery in their home countries, patients from the West and the Middle East have begun
looking at India and Kerala in particular.

Indian doctors have established themselves as highly skilled and conscientious caregivers
worldwide. Many doctors who have trained or worked abroad have returned to India to work
here. Their reputation has led to the growth of the Medical Tourism industry in Kerala.

8
2.1.2 HISTORY

Until the early 1980s, Kerala was a hitherto unknown destination, with most tourism circuits
concentrated around the north of the country. Aggressive marketing campaigns launched by
the Kerala Tourism Development Corporation—the government agency that oversees tourism
prospects of the state—laid the foundation for the growth of the tourism industry. In the
decades that followed, Kerala Tourism was able to transform itself into one of the niche
holiday destinations in India.

The tag line Kerala-God’s own country was adopted in its tourism promotions and became
synonymous with the state. Today, Kerala Tourism is a global superbrand and regarded as
one of the destinations with the highest brand recall.In 2006, Kerala attracted 8.5 million
tourists–an increase of 23.68% in foreign tourist arrivals compared to the previous year, thus
making it one of the fastest growing tourism destination in the world.

2.1.3 MAJOR ATTRACTIONS:

• Beaches

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PIC 2.1 Varkala beach

Flanked on the western coast by the Arabian Sea, Kerala has a long coastline of 580 km
(360.39 miles); all of which is virtually dotted with sandy beaches.

Kovalam beach near Thiruvananthapuram was among the first beaches in Kerala to attract
tourists. Rediscovered by back-packers and tan-seekers in the sixties and followed by hordes
of hippies in the seventies, Kovalam is today the most visited tourist destination in the state.

Other popularly visited beaches in the state include those at Alappuzha Beach,Nattika
beach[Thrissur], Vadanappilly beach[Thrissur], Cherai Beach, Kappad, Kovalam, Marari
beach, Fort Kochi and Varkala. The Muzhappilangad Beach beach at Kannur is the only
drive-in beach in India.

• Backwaters

PIC 2.2 KERALA BACKWATERS

The backwaters in Kerala are a chain of brackish lagoons and lakes lying parallel to the
Arabian Sea coast (known as the Malabar Coast). Kettuvallam (Kerala houseboats) in the
backwaters are one of the prominent tourist attractions in Kerala. Alleppey, known as the
"Venice of the East" has a large network of canals that meander through the town. The
Vallam Kali (the Snake Boat Race) held every year in August is a major sporting attraction.

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The backwater network includes five large lakes (including Ashtamudi Kayal and Vembanad
Kayal) linked by 1500 km of canals, both manmade and natural, fed by 38 rivers, and
extending virtually the entire length of Kerala state. The backwaters were formed by the
action of waves and shore currents creating low barrier islands across the mouths of the many
rivers flowing down from the Western Ghats range.

Hill stations

PIC 2.3 HILL STATIONS

Eastern Kerala consists of land encroached upon by the Western Ghats; the region thus
includes high mountains, gorges, and deep-cut valleys. The wildest lands are covered
with dense forests, while other regions lie under tea and coffee plantations (established
mainly in the 19th and 20th centuries) or other forms of cultivation. The Western Ghats
rises on average to 1500 m elevation above sea level. Certain peaks may reach to 2500
m. Popular hill stations in the region include Devikulam, Munnar, Nelliyampathi,
Peermade, Ponmudi, Vagamon,Wayanad and Kottanchery Hills...

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• Wildlife

PIC 2.4 WILDLIFE

The forests play host to such major fauna as Asian Elephant (Elephas maximus), Bengal
Tiger (Panthera tigris tigris), Leopard (Panthera pardus), and Nilgiri Tahr (Nilgiritragus
hylocrius), and Grizzled Giant Squirrel (Ratufa macroura). More remote preserves,
including Silent Valley National Park in the Kundali Hills, harbor endangered species
such as Lion-tailed Macaque (Macaca silenus), Indian Sloth Bear (Melursus Ursus)
ursinus ursinus), and Gaur (the so-called "Indian Bison" — Bos gaurus). More common
species include Indian Porcupine (Hystrix indica), Chital (Axis axis), Sambar (Cervus
unicolor), Gray Langur, Flying Squirrel, Swamp Lynx (Felis chaus kutas), Boar (Sus
scrofa), a variety of catarrhine Old World monkey species, Gray Wolf (Canis lupus).

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2.1.4 CULTURE

PIC 2.5 CULTURE

Kerala's culture is mainly Dravidian in origin, deriving from a greater Tamil-heritage region
known as Tamilakam. Later, Kerala's culture was elaborated on through centuries of contact
with overseas cultures.Native performing arts include koodiyatto, kathakali – from katha
("story") and kali ("play") – and its offshoot Kerala natanam, koothu (akin to stand-up
comedy), mohiniaattam ("dance of the enchantress"), thullal, padayani, and theyyam. Other
arts are more religion- and tribal-themed. These include chavittu nadakom, oppana (originally
from Malabar), which combines dance, rhythmic hand clapping, and ishal vocalisations.
However, many of these artforms largely play to tourists or at youth festivals, and are not as
popular among most ordinary Keralites. These people look to more contemporary art and
performance styles, including those employing mimicry and parody. Additionally, a
substantial Malayalam film industry effectively competes against both Bollywood and
Hollywood.

Several ancient ritualised arts are Keralite in origin; these include kalaripayattu (kalari
("place", "threshing floor", or "battlefield") and payattu ("exercise" or "practice")). Among

13
the world's oldest martial arts, oral tradition attributes kalaripayattu's emergence to
Parasurama. Other ritual arts include theyyam and poorakkali.

In respect of Fine Arts, the State has an abounding tradition of both ancient and contemporary
art and artists.The traditional Kerala murals are found in ancient temples, churches and
palaces across the State. These paintings, mostly dating back between the 9th to 12th
centuries AD, display a distinct style, and a colour code which is predominantly ochre and
green.

Like the rest of India, religious diversity is very prominent in Kerala. The principal religions
are Hinduism, Christianity, and Islam; Jainism, Judaism, Sikhism, and Buddhism have
smaller followings. The states historic ties with the rest of the world has resulted in the state
having many famous temples, churches, and mosques. The Paradesi Synagogue in Kochi is
the oldest in the Commonwealth of Nations.

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2.1.3 WHY KERALA AS A MEDICAL TOURISM DESTINATION?

Kerala is usually marketed as a health destination for its Ayurveda packages. Medical tourism
is marketed along with ayurveda and other health packages.
Medical tourism is like any leisure product where apart from travel package, one gets medical
treatment at the best hospitals. The medical treatment for various ailments are packaged with
leisure packages at luxurious tourist resorts.

• Well connected by Air from major medical tourism markets in the Middle East
European markets and South Asia.
• Moderate weather throughout the year.
• Advanced and sophisticated hospitals of International standards located in Kerala.
• Renowned doctors specialized in almost all major disciplines.
• Easier communication with majority English speaking public
• World class Resorts & Hotels.
• Incredibly competitive cost for packages of medical treatment and surgery compared
to other countries.

2.1.4 AYURVEDA

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 PIC 2.6 AYURVEDA
The most fascinating aspect of ayurveda is, it was using almost all methods of healing like
lifestyle regimen, yoga, aroma, meditation, gems, amulets, herbs, diet, jyotishi (astrology),
color and surgery etc. in treating patients. Though ayurveda came into being as an
independent upaveda of Atharva Veda, it has close links with other Vedas also. The Yajur
Veda, which recommends rituals to pacify the panchamahabhuts in a view to heal both the
Cosmic Being and the individual soul, is related to ayurveda in its principles and regulations
of lifestyle. The upaveda called Dhanur Veda or the martial arts and ayurveda both refer to
each other in the treatment of marmas or sensitive points in the body. Ayurveda recommends
specific ayurvedic massages, exercises and bodywork for this purpose.

Around 15,00 BC ayurveda was delineated into to two distinct schools: Atreya—The School
of Physicians, and Dhanvantari—The School of Surgeons. This made ayurveda a more
systematically classified medical science, hereafter. Dhanvantari, who is considered to be a
reincarnation of Lord Vishnu, was the guiding sage of ayurveda. He made this science of
health and longevity popular and widely acceptable. In fact, these two schools of thought led
to the writing of two major books on ayurveda—Charaka Samhita and Susruta Samhita.

These two Samhitas were written in the early part of 1000 BC. The great sage- physician
Charaka authored Charaka Samhita revising and supplementing the text written by Atreya,
which has remained the most referred ayurvedic text on internal medicine till date. Susruta,
following the Dhanvantari School of Thought, wrote Susruta Samhita, comprising the
knowledge about prosthetic surgery to replace limbs, cosmetic surgery, caesarian operations
and even brain surgery. He is famed for his innovation of cosmetic surgery on nose or
rhinoplasty. Around 500 AD, Vagbhatt compiled the third major treatise on ayurveda,
Astanga Hridaya. It contained knowledge comprising the two schools of ayurveda.

From 500 AD to 1900 AD, sixteen major Nighantus or supplementary texts on ayurveda like
Dhanvantari Bhavaprakasha, Raja and Shaligram among others were written incorporating
new drugs, expansion in applications, discarding of old drugs and identification of
substitutes. These texts mention about 1814 varieties of plants in vogue.

16
Evidences show that ayurveda had nurtured almost all the medical systems of the world. The
Egyptians learnt about ayurveda long before the invasion of Alexander in the 4th century BC
through their sea-trade with India. Greeks and Romans come to know about it after the
famous invasion. The Unani form of medical tradition came out of this interaction. In the
early part of the first millennium ayurveda spread to the East through Buddhism and greatly
influenced the Tibetan and Chinese system of medicine and herbology. Around 323 BC,
Nagarjuna, the great monastic of Mahayana Buddhism and an authority on ayurveda had
written a review on Susruta Samhita. In 800 AD ayurveda was translated into Arabic. The
two Islamic physicians Avicenna and Razi Serapion, who helped form the European tradition
of medicine, strictly followed ayurveda. Even, Paracelsus, considered to be the father of the
modern western medicine toed the line of ayurveda, as well.
In the postmodern age, the popularity of this vibrant tradition of ayurveda lies in its, subtle
yet scientific, approach to heal a person in its totality. It aims, not only at healing the body,
but also the mind and spirit, at one go. Its unique understanding of the similarities of natural
law and the working of human body, as well as its holistic treatment methods, help it to strike
a balance between the two. This gives ayurveda an edge over other healing systems. Perhaps
that's the reason behind ayurveda being the longest unbroken medical tradition in the world,
today.

2.1.5 AYURVEDA USES

PIC 2.7 BEAUTY CARE

Beauty Care

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Herbal face pack, herbal oil massage, intake of herbal tea etc. improves complexion and
beautifies the body.

Body Slimming
Medicated herbal powder and medicated herbal oil massages, an Ayurvedic diet of herbal
juices etc. are part of the program.

Hair Care

'Thaali' is a traditional shampoo. It can be any herb, usually the soapy paste of crushed
'Hibiscus Rosa' leaves or 'Cheevakkai' (Shikakai) powder, made into a paste and rubbed into
the hair during the bath.

Plain boiled rice soup rubbed into the scalp for ten minutes prior to the bath is an excellent
cure for dandruff. 'Moong' (green gram) is a good hair and body scrub. 'Mylanchi' (henna or
Egyptian privet) is widely used as a hair dye.

Adding 'Amla' (dried and powdered Gooseberry, 'Phylanthus embilica') and beating in an Egg
Yolk makes the dye fast. Unlike chemical dyes, this is quite harmless. A mixture of Coconut
Milk and Lemon Juice can prevent hair loss.

Yoghurt, eggs and Lemon Juice rubbed into the scalp is said to accelerate hair growth, while
Cucumber has excellent astringent properties.

18
Skin Care

Pastes of Cucumber, Sandalwood, Papaya and Pineapple Fruit are used for making face
masks. Honey acts as a powerful moisturizer. Turmeric paste is another popular skin care
herb, applied both as a face pack as well as all over the body, to improve the skin tone and
prevent skin disorders.

A mixture of Lemon Juice and Honey is used in skin care. A paste of 'Raktha Chandanam'
(red sandalwood) in Honey, applied once or twice a day for about a fortnight, has a magical
effect in erasing scars.

Panchakarma Treatment

A five-fold treatment for mental and physical well being - tunes the body, organs, mind,
breath, nerves and purifies the blood.

2.1.6 AYURVEDA TREATMENTS

Pizhichil :-

It is one among the rare and special treatments of Kerala. In this treatment, lukewarm herbal
oils are applied all over the body by two to four trained therapists in a special rhythmic way
continuously for about 60 to 90 minutes per day for a period of 7 to 21 days. This treatment is
done in a special table made from a single piece ofStrychnos Nuxvomica wood. This

19
treatment is very useful for Rheumatic diseases like arthritis, paralysis, hemiplegia, paralysis
– agitanus, sexual weakness, nervous weakness and nervous disorders etc.

Njavarakizhi :–

It is a type of sudation process in which the whole body or any specific part there of is made
to perspire by the application of certain medicinal puddings externally in the form of boluses
tied up in muslin bag. Two to four masseurs apply this for about 60 to 90 minutes per day for
a period of 14 days. This treatment is for all types of rheumatism, pain in the joints,
emaciation of limbs, high blood pressure, high cholesterol and certain kind of skin diseases.

PIC 2.8 SIRODHARA

Sirodhara :–

Sira – means Head and Dhara means the continuous flow of a liquid. In this process some
herbal oils, medicated milk, medicated butter milk etc, are poured on the forehead in a special
method of about 40 minutes in a day for a period of 7 to 21 days. This treatment is mainly for
insomnia, loss of memory, headaches, mentalltention and certain skin diseases.

20
Vasthi :–

Otherwise known as Medicated Enema. Vasthi is a Therapeutic procedure in which certain

herbal oils, herbal extracts, etc are applied through the rectum daily for a period of 5 to 25
days. This treatment is effective for arthritis, paralysis, hemiplegia, numbness, gastric
complaints, rheumatism and chronic constipation.

Sirovasthi :–

Certain lukewarm herbal oils are poured into a cap fitted on the head and held for 15 to 60
minutes per day according to the patient’s conditions for a period of 07 days. This treatment
is highly effective for facial paralysis, dryness of nostrils, mouth and throat, severe headaches
and other diseases of the head.

Udvarthanam:–

This treatment is otherwise known as Powder Massage. This is found very effective in the
obesity, hemiplegia, paralysis, skin diseases, impaired circulation etc and similar diseases. In
this procedure 2 therapists apply certain special Herbal Powders in a peculiar way on the
body for about 30 to 40 minutes daily for a period of 14 to 28 days.

21
 PIC 2.9 ABHYANGAM

Abhyangam :–
This is a special type of oil massage in which strokes arte given according to the circulatory
channels for 45 minutes per day for 14 days. This treatment is very useful for obesity, loss of
skin luster, sleeplessness and fatigue.

Nasyam :–

Being one among the Panchakarma procedures, Nasyam is a treatment in which herbal juices,
medicated oils etc, are applied through nose for 7 to 14 days. This treatment is highly
effective for certain kinds of headaches, paralysis mental disorders, some types of skin
diseases etc.

22
 PIC2.10 KIZHI

Kizhi :–

Herbal leaves or powders are made in boluses and are applied on the whole body or a part
specified after dipping it in warm medicated oils. This is done for 45 minutes daily for a
period of 07 to 14 days. This is very effective for osteo arthritis, spondylosis, sports injuries
etc

Sandhi Vatha Chikilsa :–

Unlike the modern medicine Ayurveda has very effective cures for Arthritic conditions like
rheumatoid arthritis, gout, osteo arthritis, ankylosing spondylosis, cervical spondylosis, osteo
porosis etc. This programme includes massage, lepanam, and oil application on affected
parts, kizhi, steam bath, snehavasthy, kakshaya vasthy, pizhichil, njavarakizhi, snehapanam
and internal medicines

Snehapanam :-

This word literally means oral intake of medicated oils or ghee preparations. This is done as a
therapeutic procedure and also as a preparatory process during the body purification therapy.
In this treatement medicated ghee or oils are given internally in proportionally increasing
quantity for a period of 08 - 12 days. This treatment is very effective for osteo arthritis,
psoriasis chronic constipation, haemorrhoids etc,.

23
 PIC 2.11 DAHANYAMLA DHARA

Dahanyamla Dhara :-

Warm herbal liquid is poured all over the body in rhythmic way using a special vessel. This is
done for 45 minutes to 01 hour daily. this treatment is very effective for hemiplegia, paralysis

Kativasthi :-

In this process specially prepared warm medicated oil is kept over the lower back with herbal
paste boundary. This treatment lasts for 45 minutes to 01 hour and it is good for any type of
back pain and spinal disorders.

Urovasthi :-

24
Like Kativasthi warm medicated oil is kept over the chest for 45 minutes. This is an effective
treatment for Asthma, other respiratory problem, heart diseases and muscular chest pain.

Ksheeradhoomam :-

This is a special procedure in which a mixture for medicinal decoction and cows milk is
heated and the steam thus liberated is passed to a tube and applied over the affected area or
whole body. This is found very effective for facial palsies, speech disorders, ptosis and
various nervous disorders

Thalam :-

Special powder mixed with medicated oil is applied on the top of the head for 20 to 45
minutes. This treatment is helpful for curing ENT problems, insomnia, migraine etc.

Lepanam :-

This is a process in which medicated herbal paste is applied on the affected part, this is useful
for various types of inflammatory conditions, skin diseases, arthritis, gout, etc.

Thalapothichil :-

Various medicinal herbs selected according to dosha predominance is made into a paste and
applied to the scalp for 30 to 45 minutes. This treatment is good for insomnia, premature,
greying and other problems to the hair and scalp.

25
Swasa Kasa Chikilsa :-

Respiratory diseases like bronchill asthma, prolonged cough, allergic rhinitis, sinusitis etc,
can be very effectively treated in Ayurveda. This program includes body massage, urovasti,
pizhichil, podikizhi, snehavashti, kashaya vasthy, nasyam and internal Ayurvedic medicines.

Sukhanidra :-

Ayurveda , the knowledge of the life is not only related with the body, but with the mind and
soul also, this particular treatment program is very much helpful for conditions like insomnia
(lack of sleep), anxiety and it improves immunity and self confidence. This treatment
program includes body massages, shirovasthy, ksheeradhara, thailadhara, thalam,
thalapothichil and internal Ayurvedic medicines , yoga and meditation.

Psoriasis Treatment Program ( Sidhma Chikilsa) :-

Ayurveda forms very effective treatment for all type of psoriasis and various other skin
diseases. This special Ayurvedic treatment program last for 21 to 28 days. This program
includes special lepanam, abhyangan, snehapanam, pizhichil, medicated steam bath,
shirovasty, exclusievely prepared internal herbal medicines along with yoga meditation
because, Ayurveda emphasis that most diseases are psychosomatic.

2.1.9 YOGA AND MEDITATION

26
 PIC 2.12 YOGA AND MEDITATION

Yoga, the science based on ancient Indian wisdom and culture, is an art of living a healthy,
balanced, peaceful and contented life. Yoga, being a total integrated system, studies man in
his wholeness - body, mind and spirit and is integrated to certain principles, ideas, values,
attitudes and a way of life for personal and social benefits.

The form of Yoga that has gained popularity worldwide and which is taught in schools
across Kerala is Hatha Yoga, which emphasizes the training of the body and mind to attain a
higher state of fitness and consciousness. Yoga has gained popularity worldwide as a form of
exercise and relaxation. While the asanas taught at yoga schools in Kerala, promote
flexibility and the physical conditioning of the body, the breathing exercises improve
concentration and the wholeprocess helps relieve mental and physical stress. Well-known
international systems of yoga include Iyengar Yoga and Bikram Yoga.

Yoga had recognised and accepted the importance of the mind and the subconscious over the
total human personality much earlier than modern psychology did in its present form. Yoga is
a stepwise, stage wise eight fold path to final liberation from pain and suffering.These steps
progressively take us to the highest state of creativity, of discriminative knowledge and
towards attaining the desired perfection.

27
2.1.10 HEALTH RESORTS OFFERING AYURVEDA TREATMENTS

Kairali Health Resort

Specialty In : Ayurveda
Location : Pallakkad, Kerala
Address : Kairali Ayurvedic Health Resort, P.O. - Olassery, Kodumbu, Palakkad Dist.
Kerala, India, Pin- 678551.

Awards and Recognition

• 2005 SPA ASIA CRYSTAL AWARD – Kairali Health Resort won the famous Spa
Crystal Award in 2005 for “Best Ayurvedic Center in Kerala” in Asia Pacific.
• Kairali Health Resort has been selected in the list of “Best Wellness Meccas” by the
National Geographic Channel.

About the Health Resort

Kairali Health Resort is one of the premiere health resorts of Kerala in India. If you wish to
avail the benefits of harmony between nature and science can bestow on you, visit the Kairali
Health Resort. The resort provides conventional oil massages that boosts up the general
health and rejuvenates the body. It gives the Ayurvedic treatments minus any adverse side
effects and toxicity. It also has a meditation and a Yoga center.

Pamper your body by Ayurvedic herbal massages for a toned disposition, weight loss,
pregnancy health care, migraine, sinusitis, vitality and vigor. The trained and qualified
professionals treat you with much care. Located amidst the natural environs, the resort is
serene and peaceful, helping you to regain and recover soon. It provides the visitors with
healthy food and products are thereby grown in the garden resort. The “Dairy Fresh” products
are also available for the visitors to the resort.

Kottakal Arya Vaidya Shala

28
Specialty In : Ayurveda, Alternative medicine
Location : Kottakkal, Kerala
Address : Kottakkal Arya Vaidya Shala, P382, 4th Cross , Vivek Nagar, District Malapurram
Kottakal, Kerala, India, PIN 676503

About the Hospital

Kottakal Arya Vaidya Shala, as it is popularly called, is almost a century old ayurvedic center
of Kerala. This is one of the oldest living Ayurveda rejuvenation center founded by Late
Vaidyaratnam P.S. Varier.

Since being the oldest, the treatment provided by Arya Vaidya Shala is authentic. The
hospital and research center at Kottakkal comprises of 160 rooms with all necessary
amenities.

Though its main office is at Kottakal, the branches could be located in almost every part of
the country. New Delhi, Kolkata, Mumbai, Secunderabad, Chennai, Coimbatore, Madurai,
Trivandrum, Kottayam, Ernakulam(Kochi), Aluva, Calicut, Kannur, Palakkad and Tirur are
cities where you could find Arya Vaidya Shala.

The Ayuevedic center has well experienced staff that provide excellent services to patients
seeking ayurvedic treatment. It also run clinical and educational centers along with hospital.

Somatheeram Beach Resort

Specialty In : Ayurveda, Yoga, Meditation

Location : Kovalam, Kerala

29
Address : Somatheeram Ayurvedic Beach Resort, Chowara P. O, South of Kovalam,
Trivandrum, Kerala, India, PIN- 695 501

About the Resort

Oozing with resplendent natural ambiance and tradition of India, Somatheeram Beach Resort
in Kovalam is one of its kind. The resort gives you opportunity of discovering the secret of
relaxing and enjoyable vacations. Explore the new 'You' at the resort by the programs offered
for a complete transformation. It has gained much popularity among travelers because of the
world class services provided to the tourists in Kerala.

Come to the Ayurvedic Rejuvenation Centre in Somatheeram and avail the benefits of
exquisite program of Ayurveda based on the Vedic Science. The program is more towards
strengthening and advancing your immune system to fight against diseases. You are
thoroughly examined by the ayurvedic physicians and thereby given treatments according to
your needs. You also get the chance to set on a sight seeing tour to the nearby places.

The yoga programs at the resort are to help you to have a balanced, harmonized and peaceful
life with equally charming disposition. It helps you to shed the negativities away and have the
right attitude and tranquility within and around you.

With many facilities like - Doctor on call, airport pick-up facility, Money exchange services,
Laundry service, Beach umbrella service, Room service, Ayurvedic treatment center, Cultural
show, Travel assistance, Sightseeing & package, Tours arranged on request and Car parking
facilities – the resort has became a hotspot for medical tourists in India

2.1.11 ALTERNATIVE MEDICINE IN KERALA

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Kerala is known the world over for its alternative medicinal therapies. Ayurveda is the best
known of these alternative wellness therapies practiced in Kerala. Other Alternative therapies
such as Naturopathy, Siddha and Panchakarma are commonly practiced in Kerala and have
gained recognition worldwide for their therapeutic nature.

Naturopathy in Kerala:

Naturopathy involves treating the body with natural substances, treating the body with a
controlled diet and the application of medicines derived from plants. According to
Naturopathy the human body has five primary elements. These elements are Earth, Fire, Air,
Water and Ether. The elements are collectively known as the Panchamahabhootas. An
imbalance of these elements results in ill health. Naturopathy attempts to restore the balance
by treating the body in a holistic manner. By addressing the root causes of an illness and by
avoiding artificial chemicals Naturopathy provides effective long lasting relief for many
chronic conditions. Patients who have benefited from Naturopathy continue to live a healthier
lifestyle and apply the principles of naturopathy to their daily diet. Naturopathy is thus not
merely a system of treatment but also a way of life.

Siddha in Kerala:

The Siddha form of medical treatment is a Dravidian system of Medicine that is passed down
through families of traditional healers. Believed to have been founded by the Sage Agastya,
‘the word ‘Siddha’ means achievement and the Siddha method of treatment was developed
by 18 Siddhars or saintly teachers. Siddha treatment consists of Siddha massage and Siddha
medication. According to the Siddha school of medicine there are 72,000 nadis or pulse
points in the body. These points can be stimulated to help the body heal itself. The healing

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therapy includes various forms of massage using medicinal oil and leaves. Many musculo-
skeletal conditions and chronic nerve disorders have been cured by Siddha treatment

Panchakarma in Kerala:

Panchakarma is a form of Ayurveda, which involves evacuative processes to purge the body
of ill health. According to Panchakarma, the body consists of humors, which when balanced
result in good health. An imbalance however requires active intervention and this is what
Panchakarma provides. Various methods of purging are used in Panchakarma to detoxify the
body of ‘doshas’ or negative humors. Panchakarma is considered the intervention aspect of
Ayurveda, just as surgery is the intervention form of modern medicine.

Some of the centers where you can experience the benefits of alternative medicine in Kerala
India are the Kairali Ayurvedic Health Resorts and the Kottkal Arya Vaidyashala in Kerala.
The Siddha Medical College near Thiruvananthapuram is known for its Siddha treatments.

2.1.12 TREATMENTS OTHER THAN AYURVEDA

• Cardiac Care in Kerala

Cardiac Care in Kerala is a branch of medicine that attracts many patients from around the
world. Patients from the Gulf countries, Sri Lanka and from many other countries are coming
to India to experience the excellence of Cardiac care in Kerala.

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With specialty hospitals, extremely well-trained doctors and nursing staff, and the quick
scheduling of surgery, cardiac care in Kerala has proved to be an attractive medical tourism
option for many patients.

Some of the hospitals that offer world-class cardiac care in Kerala, are the Trichur Heart
Hospital, and the Sree Sudihindra Medical Mission Hospital in Cochin. The Sri Chitra
Thirunal Institute in Thiruvananthapuram is another renowned research and treatment
facility.

With hospitals equipped with the latest equipment including Color Doppler
Echocardiography and Nuclear Scanning hospitals in Kerala offer advanced cardiac care
procedures such as minimally invasive surgery, angioplasty, bypass surgery and
interventional cardiac catherisation. With well-trained teams of Cardiologists, cardio-thoracic
surgeons and anesthesiologists, specialty hospitals in Kerala are the preferred choice of
cardiac patients, worldwide.

Cardiac surgery is also very reasonable in Kerala compared to international rates. The
complete cost of airfare to India, hospitalization, pre and post operative care, doctors fees and
recuperation put together is between 1/3 to ½ the cost of similar surgery in most western
nations, where a long waiting list of cases also has a negative impact on the health of the
patient.

• Transplant Surgery in Kerala

Transplant surgery in Kerala is offered at several specialty hospitals in the state. Common
forms of transplant surgery are:

• Renal transplant surgery where a donor kidney is transplanted into a recipient.

• Liver Transplant surgery, where part of a liver from a donor organ is transplanted into
a recipient
• Bone Marrow transplant, an essential therapy in cases of leukemia
• Corneal transplant, practiced routinely in eye donation.

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Transplant surgery is a specialized branch of surgery offered at select hospitals in Kerala.
Each transplant operation requires a team of surgeons and doctors with different skills,
including immunology, anesthesiology and surgery to come together and work in unison to
provide the patient with the complete surgical procedure.

Transplant surgery is the last resort when an essential organ of the body, such as a kidney or
the liver fails to function. The well-equipped hospitals, highly-skilled doctors and trained
teams of support staff at hospitals in Kerala have led to a positive success rate in transplant
surgery in Kerala.

Some of the hospitals in Kerala where transplant surgery is offered are:

• Amrita Institute of Medical Sciences & Research Centre, Ernakulam

• Calicut Medical College
• Medical Trust Cochin

• Dental care in Kerala

Now you have another reason to smile when you travel to Kerala India. Kerala is increasingly
becoming known for the quality of its Dental Care services. Dental Care in Kerala is a cost-
effective alternative for residents of western countries and nations in the Middle East. The
extremely high cost of dental care in these nations has prompted many Indians and residents
of these countries to travel to Kerala in search of a better solution. Dental Care in Kerala
draws upon the large manpower of trained dentists and nurses who provide international
quality services at very reasonable prices.

Tourists can avail of world-class treatments including specialized periodontal treatment,

orthodontic and prosthodontic treatments at dental care centers, dental clinics and hospitals in
Kerala. From routine dental procedures such as root canal treatment and surgical extraction of
impacted wisdom teeth to cosmetic dentistry procedures, such as tooth realignment and smile

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designing, dental care in India offers a complete range of medical solutions to medical
tourists from around the world.

With well-equipped clinics and hospitals, Dental Care in Kerala has proved to be one of the
most popular forms of medical tourism to Kerala. With modern equipment, a completely
sterile environment, the use of disposable syringes and gloves, and international standards of
treatment, dental care in Kerala now draws large numbers of medical tourists every year.
Eager to receive personalized treatment of an international standard at an affordable price
medical tourists have been increasingly exploring the options offered by dental care in Kerala
India.

• Opthalmology in Kerala

Ophthalmology in Kerala is one of the foremost branches of medical tourism. Many patients
from neighboring countries and the Middle East, travel to Kerala for ophthalmology
treatment. Specialized Eye Hospitals and Ophthalmology departments in hospitals in Kerala,
offer a wide range of ophthalmology treatments, at very reasonable prices. The combination
of world-class eye treatment at an affordable price, makes ophthalmology in Kerala a sought
after medical tourism option.

Ophthalmology involves treatment of various ocular conditions and diseases, from diagnosis
of the medical condition to its treatment and follow-up care. Hospitals and clinics that offer
ophthalmology in Kerala are well equipped to provide the latest medical treatment. From
Lasik – Laser assisted eye surgery for myopia to cataract surgery to corneal transplant
surgery and treatment of conditions such as retinopathy, hospitals in Kerala offer the latest
ophthalmic treatment.

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Some of the hospitals known for ophthalmology in Kerala are:

• Sree Chitra Tirunal Institute of Medical Science, Trivandrum

• Atingal Multispeciality Hospital, Trivandrum
• Amritha Institute of Medical Science & Research Centre, Ernakulam
• Chaithanya Eye Hospital & Research Institute Trivandrum
• Specialist’s Hospital, Ernakulam

• Specialty Hospitals in Kerala

Kerala has become one of the leading medical tourism destinations of India. There are a
number of specialty hospitals in Kerala that offer specialized care for complex medical
conditions. The quality of health care offered by the doctors, nurses and support staff, make
medical tourism in Kerala the preferred choice of patients seeking healthcare solutions in
India.

Specialty hospitals in Kerala are at the forefront of medical tourism. Many of the hospitals
offer a complete package that includes consultancy with a medical specialist, diagnosis,
appropriate medical treatment, pre and post-operative care, and even arrangements for a
family member or attendant to stay with the medical tourist. Specialty hospitals in Kerala
have opened their doors to patients from around the world and have gained a reputation for
their quality treatment and medical care.

Specialty Hospitals in Kerala offer treatment in various medical specialties. From specialized
eye care centers to brain and spinal surgery centers, specialty hospitals offer world-class care

36
in select medical disciplines. Many of the specialty hospitals in Kerala have faculty who have
studied and worked abroad and have returned to India to teach and to build a world-class
medical infrastructure in India. These specialty hospitals are now attracting patients from
around the world.

Some of the specialty hospitals in Kerala are:

• Amritha Institute of Medical Science & Research Centre, Ernakulam

• Sree Chitra Tirunal Institute of Medical Science, Trivandrum
• Chaithanya Eye Hospital & Research Institute, Trivandrum
• Atingal Multispeciality Hospital, Trivandrum
• Indo-American Brain & Spine Hospital, Vaikom

2.1.13 MEDICAL AND LEGAL ASPECTS

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 PIC 2.13 MEDICAL AND LEGAL ASPECTS

Medical Tourism in India is a growing trend, with increasing numbers of patients from
Europe, the Middle East and India's neighboring countries coming to India for specialized
treatment at very reasonable prices.

Certain medical and legal aspects of medical tourism need to be kept in mind, since Medical
Tourism to India is still a very new field.

Medical Visa:

The Government of India has recently authorized a new category of visas for prospective
medical tourists. This Medical Visa will enable patients who wish to travel to India for
medical reasons, to enter India on this specialized visa, and stay for the duration of their
treatment.

Medical Insurance:

This is another area about which patients should remain informed. Currently medical
insurance firms in the West may not recognize treatment at a hospital in India as part of their
medical insurance policy. Thus a patient may have to fund his or her own treatment, which
could be a significant amount, though still far less than the same treatment in a privately run
hospital in the west.

Legal Issues:

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The legal aspects of medical tourism are undefined at present. All medical procedures carry
an element of risk. Even routine surgery may sometimes lead to medical complications. A
patient may be unsatisfied with the results of their surgery or medical treatment, and wish to
seek legal recourse. Currently there is no international legal regulation of medical tourism. As
medical tourism increases worldwide, it is likely that an international regulatory authority
will come into being. If an international legal framework were to come into place then issues
of jurisdiction between a patient's home country and the country where the medical treatment
was availed can be resolved.

2.2 RELATED STUDIES

2.2.1 AWARDS FOR KERALA TOURISM

The state has won numerous awards for its tourism initiatives. These include:

• 2005 - Nominated as one among the three finalists at the World Travel and Tourism
Council's ‘Tourism for Tomorrow’ awards in the destination category.
• Das Golden Stadttor Award for Best Commercial, 2006

Pacific Asia Travel Association

• Grand award for Environment, 2006

• Gold award for Ecotourism, 2006
• Gold award for Publication, 2006
• Gold Award for E-Newsletter, 2005
• Honourable Mention for Culture, 2005
• Gold Award for Culture, 2004
• Gold Award for Ecotourism, 2004
• Gold Award for CD-ROM, 2004 and 2003
• Gold Award for Marketing, 2003
• Grand Award for Heritage, 2002

Pacific Asia Travel Writers Association

• International Award for Leisure Tourism, 2000-2001

39
Government of India

• Best Performing Tourism State, 2005

• Best Maintained Tourist-friendly Monument, 2005
• Best Publishing, 2005
• Best Marketed and Promoted State, 2004.
• Best Maintained Tourist-friendly Monument, 2004
• Best Innovative Tourism Project, 2004
• Best Promotion Literature, 2004
• Best Publishing, 2004
• Best Performing State for 2003, 2001, 2000 and 1999 - Award for Excellence in
Tourism.
• Best Practices by a State Government, 2003
• Best Eco-tourism Product, 2003
• Best Wildlife Sanctuary, 2003
• Most Innovative Use of Information Technology, 2003 and 2001
• Most Tourist-friendly International Airport, 2002
• Most Eco-friendly Destination, 2002
• Best Tourism Film, 2001

Outlook Traveller - TAAI

• Best State that promoted Travel & Tourism, 2000-2001

Federation of Indian Chambers of Commerce and Industry

• Award for Best Marketing, 2003

• Award for Best Use of IT in Tourism, 2003

Galileo - Express Travel & Tourism

• Award for the Best Tourism Board, 2006

• Award for the Best State Tourism Board, 2003

2.2.2 ADVERTISING CAMPAIGN

Kerala Tourism is noted for its innovative and market-focused ad campaigns. These
campaigns have won the tourism department numerous awards, including the Das Golden

40
Stadttor Award for Best Commercial, 2006,Pacific Asia Travel Association- Gold Award for
Marketing, 2003 and the Government of India's Best Promotion Literature, 2004, Best
Publishing, 2004 and Best Tourism Film, 2001.

Catchy slogans and innovative designs are considered a trademark of brand Kerala Tourism.
Celebrity promotions are also used to attract more tourists to the state.The Kerala tourism
website is widely visited, and has been the recipient of many awards. Recently, the tourism
department has also engaged in advertising via mobiles, by setting up a WAP portal, and
distributing wallpapers and ringtones related to Kerala through it.

2.2.3 MOVE TO BOOST TOURISM IN KERALA

Sankar Radhakrishnan

Thiruvananthapuram , Dec. 11

KERALA Tourism is working on an initiative to give a boost to medical tourism in the State.

According to Mr B. Suman, Director of the State's Department of Tourism,the availability of

high-quality healthcare infrastructure at reasonable prices makes Kerala an ideal destination
for medical tourism.

Even things like ordinary medical check-ups cost less in Kerala than they do in Europe, he
added. Therefore, medical tourism has tremendous potential in Kerala, he pointed out.

Kerala Tourism is working on a marketing campaign to promote the State as a medical

tourism destination. On the anvil are promotional events in Sri Lanka, Maldives, Europe and
in countries in West Asia, he said.

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The tourism department is also working on creating partnerships between hospitals in Kerala
and insurance companies in Europe, especially in the UK, he added.

Meanwhile, the Indian Healthcare Federation is working with the Confederation of Indian
Industry to develop a classification and accreditation system for hospitals, Mr Suman
explained. Hospitals in Kerala that desire to operate in the medical tourism segment will have
to be classified under this system before they can be marketed abroad, he added.

In keeping with its strategy of turning Kerala into a year-round destination, Kerala Tourism is
giving a big push to `monsoon tourism', Mr Suman said.

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 3.METHODOLOGY

3. Methodology

This chapter deals with aspects to make the research study more systematic and
effective. It is divided into the following sections :
3.1 Pilot Study

3.2 Selection of Samples

3.3 Development of Tools

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 3.4 Collection of Data

3.5 Analysis of Data

1. Pilot Study :-
It is explanatory in nature ; it is used to identify the problems clearly. Study the
different variables and design appropriate methodology, based on the information collected
from the pilot study, certain modifications can be made in the methodology as well as sample
collection. Keeping in mind, a pilot study was carried out by designing a questionnaire and
testing it on samples of selective people.

2. Selection of Samples :-
Samples are selected from employees from the travel agencies and people who visited
the place. Most of them were interviewed at their respective area. To some of them,
questionnaires were e-mailed which was collected later giving some time. The total sample
size was 1.

3. Development of Tools :-
To get accurate responses, a questionnaire was designed, consisting of 8 questions.
These questions consisted of general information and topics related to subject.

4. Collection of Data :-
As mentioned earlier the total samples were 25 and the questionnaires were
distributed to all the samples in such a way that data was collected with maximum interest
and co-operation by the samples.

5. Analysis of Data :-
The data which was collected during the study with the help of questionnaires were
analyzed with the help of the standard statistical method such as tables.

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45
 4. RESULTS AND DISCUSSIONS

4. Results and discussions

The study on “Medical Tourism in Kerala” was undertaken for the purpose of research, it
involves the growing importance of medical tourism and its popularity. Also, it involves the
interview

• To find out the costs of medical facilities provided in Kerala.

• To discuss the healing effects of ayurveda.

………….. Based on which the results are discussed below.

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This interview is a research project done in partial fulfillment of Bachelor’s Degree of Hotel
and Tourism Management Studies. Your assistance in the same would be greatly appreciated.
No personal information is required. However if you wish to provide us with the same, please
do so in columns provided.

Name: Mrs. Swati Singh

Name of organization: Travel Tours Pvt. Ltd.

Designation: Regionl Manager

Years of experience: 2 years

This survey is a research project done in partial fulfillment of bachelor’s degree of hotel and tourism
management studies. Your assistance in the same would be greatly appreciated. No personal
information is required. However if you to provide us with the same, please do so in the columns
provided.

Interview questionnaire

Role and importance of medical tourism in Kerala

1. What is the importance of Kerala in Indian tourism ?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

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 2. Are people aware of the concept of medical tourism in Kerala?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

3. What percentage of people know about it?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

4. Who are more interested in visiting Kerala for medical purpose, foreigners or Indians?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

5. Are there any legal rules & regulations for foreigners undergoing any medical
treatments in the state?

Yes ( ) No ( )

6. Are the medical treatments in Kerala affordable to the middle class income group?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

7. Do you think medical tourism in Kerala should be promoyed on a larger scale?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

8. Are people aware that other than Ayurveda treatments, Kerala also has modern world-class

48
 hospitals?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

9.Do hotels and hospitals providing medical treatments give value for money?

10. .Do you believe that medical tourism in Kerala is the next big thing for Indian tourism?

Yes ( ) No( )

Conclusion:

As per the interview conducted coffee shops and lounges play an important role towards the
revenue generation and as well as satisfying experience to the guest. It is a soothing
experience to the guest that imparts a sort of rejuvenation to their minds. Harmony of music
and food entails an integral part in promoting your restaurant.

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50
 5. SUMMARY AND CONCLUSION

5. SUMMARY AND CONCLUSION

The topic Medical Tourism in Kerala was undertaken for research by me to study the

growing popularity of the concept in the country as well as other parts of the world.In this

research I have tried to bring out the fact that medical torism is one of the most happening

things in Indian tourism.

My research shows that people were only aware of Ayurveda treatments in Kerala

51
whereas the state also offers world-class hospitals and recreational centers which cure all

major diseases using latest of technologies.

Medical tourism in Kerala is the next big thing for Indian tourism as people nowadays

like to relax and rejuvenate in their holidays and rather than going to crowded cities people

prefer silent places.

Indulging in ayurvedic treatments like massages and spas are a bit costlier because of

the exotic herbs and oils used in thhe treatment.

Hospitals in Kerala offer treatments of all diseases and problems like

cardiac,ortheopedic,transplant etc. and at comparatively lesser cost than in west countries that

is why foreigners prefer coming down to the state for treatment.

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 6. LIMITATIONS AND RECOMMENDATIONS

6. LIMITATIONS AND RECOMMENDATIONS

While the study was been conducted the following limitations had come across which gave
some trouble in carrying out the process of study:

LIMITATIONS:

• Very limited number of books on the related topic.

• Unable to meet marketing heads of some travel agencies.

• Very less number of people have knowledge on the topic.

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RECOMMENDATIONS:

• People should be made aware of what exactly medical tourism is all about.

• The medical tour packages should be reasonable so that people from all income
groups can afford.

• Informing the people that medical tourism in Kerala is not only about Ayurveda but
also has world class hospitals equipped with latest technologies.

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:

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