Tom Spender

I left the UAE a year ago and went to Thailand. By coincidence, it turned out that Bangkok was full of Emiratis and other Arabs, many of whom were there to get medical treatment. So I did a story that in the end did not get published. A year on, I think it’s pretty safe to assume it never will be published – but it’s interesting, I think, because it contains some pretty strong comments by Emiratis about their own health service. Of course, it may be that in the intervening year, UAE health services have changed dramatically and that as a result no one wants to go abroad for operations any more. If that’s the case then this material is obsolete.

STORY

Sitting with his medical record on his lap in the plush lobby of Bangkok’s spankingly modern Bumrungrad International Hospital, Fahed bin Jassas waves to a couple of other young Emiratis descending a nearby escalator.

“Those guys are from Dubai,” says the 22-year-old, a crime scene photographer with Abu Dhabi Police who is sipping an iced Starbucks coffee. “It’s just like being in Abu Dhabi Mall here.”

Fahed, suffering from a slipped disc in his back, is one of a growing number of Emiratis and other residents who have so little confidence in the UAE health system that they are voting with their feet.

They prefer to pay for treatment abroad rather than put themselves at the mercy of doctors whom they do not trust to make correct diagnoses or carry out successful operations. They also complain about long waiting times for appointments in government hospitals and the high price of treatment in private hospitals.

Their concerns come after a YouGov survey of UAE residents commissioned by The National showed that more than 70 per cent would seek medical treatment overseas if they fell seriously ill, a figure that includes 57 per cent of Emiratis. Thailand was the top destination for Emiratis (64 per cent). For western expatriates, the UK was the top choice for 61 per cent, while Thailand and the US attracted 17 per cent each.

[Health Authority Abu Dhabi responded by saying the YouGov results contradict its own research, which found in-patient satisfaction rated an overall 89 per cent, out-patient satisfaction rated a respectable 86 per cent and overall patient satisfaction increased to a significant 79 per cent from 2005 to 2008 for all public and private hospitals in Abu Dhabi.]

A visit to the enormous Bumrungrad hospital reveals just how popular this and some of the other modern hospitals that have sprung up in Bangkok have become among Emiratis and other Gulf Arabs.

Entire families, some in national dress, wander in and out of the hospital’s various entrances. A woman wearing the traditional gold-coloured Emirati face mask, the burga, is gently helped out of a wheelchair and into a waiting taxi by Thai hospital staff. Fahed and his three friends lounge at a table among the pharmacies, boutiques and restaurants in the cavernous lobby.

Meanwhile, on the streets outside the hospital, numerous pharmacies and private clinics advertise their services in Arabic, while shisha cafes offer Middle Eastern food and a diet of news from Al Jazeera.

“UAE hospitals are very expensive but the doctors are not good,” said Fahed, who is from Shahama in Abu Dhabi and heard about Bumrungrad from an acquaintance. He is paying for his treatment there himself.

“In our country we have a lot of amazing machines but nobody knows how to use them. Hospitals are also really crowded. It can take two or three months to get an appointment while here I was seen the same day. The doctors here tell us directly and in Arabic what the problem is and what can be done about it. In the UAE you might go to five different hospitals and hear something different from each doctor.”

Fahed’s friend Nabhan Alhosani described his UAE health insurance, known as Thiqa, as “useless”.

“Everybody when he has a bad problem will go private because with Thiqa by the time they see you you will already be dead,” he said.

He estimated that there were “hundreds” of Emirati families visiting Bangkok for health tourism.

“At our hotel it is all Abu Dhabi, Dubai, Al Ain,” he said. “Some are here for fun but a lot are here for treatment.”

Many of the Emiratis seeking treatment in Bangkok said a bad experience suffered by a friend or relative in a UAE hospital had convinced them that their lives were at risk at the hands of largely unaccountable doctors.

“We don’t trust the management of the health service in our country and so we think it is not worth risking our lives there,” said Mohammed Ahmed, a 29-year-old geologist with Adnoc who arrived in Bangkok this week with his mother and sister to support his 68-year-old father Ahmed, who has swellings on neck and back.

“If a doctor makes a mistake there is no accountability. The doctor will simply say sorry or not even give any excuse. We need strong management. Instances of doctors being found to have faked their qualifications make you think a thousand times before entrusting your health to them.

“We should be much harder with the rules. If a doctor makes a mistake then he or she must be stopped from working. One of my uncles spent a month in intensive care because a doctor didn’t make the correct diagnosis. My father saw this and decided not to risk his own life.”

The Ahmed family, also from Shahama, said they had been impressed by their experience of Bumrungrad.

“This hospital has a good reputation and they are very keen to keep it,” said Mr Ahmed. “Why don’t we have this at home? Why should there be a difference between Thailand and the UAE?”

Mohammed, a 37-year-old businessman from Abu Dhabi who refused to give his family name, said he had had to fight to get his sick mother treated in Bangkok after doctors in the UAE first failed to diagnose the peripheral vascular disease she was suffering from in both legs and then bungled an operation to cure her when the condition reoccurred years after a successful operation in the US.

“The doctor at Zayed Hospital wanted to operate again after messing up the first one,” said Mohammed. “He seemed to be using my mother for his personal training.”

Mohammed used “wasta”, or personal connections, to get the government to agree to send his mother to Bumrungrad for treatment.

“It was very difficult because the government will not send you abroad if you have a doctor saying he can do the treatment in the country,” he said. “Here, the doctors knew what the problem was instantly. They treated her. Two days later she was walking. Now she’s walking all over the place. This is the reason we came here.

“In the UAE we have all the equipment but no hand to use it. In the US or Thailand the doctors tell you straight if they can help or not. In my country the doctors all claim that they can cure you and there is no accountability.”

Thailand first became popular as a health destination for Arab patients following the 9/11 terror attacks because US visas became more difficult for Arabs to get, according to Kenneth Mays, marketing director for Bumrungrad.

The hospital now receives about 100,000 day visits by Arab patients each year, he said, compared to less than 10,000 visits per year before 9/11.

“We have a reputation of being a US-quality hospital and our Arab patients come for a combination of medical quality and service,” said Mr Mays. “Health services in countries such as the Gulf are playing catch-up in getting good and well-trained doctors over there.”

Many Arab patients arrive after coordination between Bumrungrad and hospitals in the UAE because they have conditions that hospitals in Abu Dhabi and Dubai are not yet able to treat.

“These are often advanced cases,” he said. “We coordinate with hospitals in the UAE so we are often aware of some of the cases they will send us.”

He said Bumrungrad’s facilities, such as a large prayer room, halal food and a team of 50 Arabic-speaking interpreters, ensured Arab patients were happy to return to the hospital themselves and would recommend it to friends and family.

And Hamed al Jabri, a 30-year-old Omani who is considering going into partnership with a Thai doctor to open an alternative therapy clinic in Oman, said it would take a big cultural shift to persuade Gulf Arabs to seek treatment at home.

“There is the belief that if we are really sick we are better off abroad and high profile medical mistakes make it difficult to improve confidence,” he said. “At the same time, the health service is free but we have the mentality that in order to get quality service you need to pay money. I wonder how many Gulf health ministers get medical treatment in their own countries.”

Mr al Jabri suggested that Gulf governments should invest the huge sums of money they spend on sending their nationals abroad for treatment on improving their own health services. The money includes allowances of hundreds of dollars per day for family members to accompany relatives, he said.

“My mother was sent abroad to India for treatment three times – each trip cost thousands of Omani Riyals,” he said. “Because Thailand is so cheap you can bring your entire family with you on the allowances governments give out. If they invested the same amount in their own hospitals that they pay to send people abroad it would pay off.”

ENDS