Hospitals abroad no longer have the reputation of being grungy, dirty, primitive and ineffective. As U.S. health care costs soar and many operate on tight budgets, many Americans are opting to go abroad for medical services.

Labor is cheaper in most other countries, thus lowering medical costs. In Thailand, Bangkok's Bumrungrad Hospital offers everything from regular check-ups to open-heart surgery for one-eighth the price of similar treatment in the United States, according to a 60 Minutes report on April 21, 2005. Bumrungrad offers packages including roundtrip airport transport, a welcome massage, a cell phone, a half-day Bangkok orientation tour, two round trips to the hospital with outpatient registration and process orientation plus 24/7 assistance for a patient’s entire stay in Thailand, according to Inq7 (news.inq7.net), a member of the largest television network in the Philippines. After surgery, many patients go sightseeing or recuperate in the hospitals, which are often furnished like first-class hotels.

In the Philippines, the government is making an estimated $2 billion after it encouraged expansion of the medical tourism industries. Faith healers, geriatric care and plastic surgery procedures are all offered at low prices. St. Luke’s Hospital, currently based in Houston, Texas, hopes to profit off of medical tourism too, and may open a hospital in the Philippines, according to Collins National, a Filipino news source (collins.org).

illustration by Susan Lau

Though "sun, surf and surgery" paired with cost efficiency is a definite lure for patients, some American medical professionals remain skeptical of medical technology in other countries.

"As far as I can see, cost is the only reason why people are going overseas for surgery and transplants," said Rosana Tsui, a registered nurse with experience in post-surgery nursing at California Pacific, one of the transplant centers in the Bay Area. "After all, technology here is already developed whereas in other countries, infections and blood clots are more prevalent."

As the University of Miami’s Medical school wrote on their Web site (med.miami.edu), cheap cosmetic surgeons abroad advertising their affordable services often botch their surgeries, having their patients return with “scarred bodies and infected wounds, rushing from the airport to the emergency room.”

Indeed, organ transplants are highly risky. Hepatitis, AIDS and even West Nile disease have all been known to transmit from donor to recipient via organ transplants, according to the Center for Disease Control’s Web site (cdc.gov).

According to the Mercury News, (mercurynews.com), several Japanese transplant patients received transplants which lead to their death. But this is not only a problem overseas. Two kidney recipients, one lung recipient and one liver recipient all received organs in the New York and New Jersey area; three of these patients contracted West Nile Virus, and one became catatonic from August to September 2005.

According to All Headline News, an online news source (allheadlinenews.com), two Americans sued Biomedical Tissue Services in New Jersey for tissue transplants infected with hepatitis in April. In other cases, organ recipients have caught life-threatening diseases, such as AIDS, from some of these transplants. Currently, the infected people and their families are suing Biomedical Services. The source of the infected organs is unknown.

The lengthy waiting time for organs has also spurred many to seek organs abroad. The average wait for an organ in the United States is 528 days, according to California Donor Network, partly because the numbers of donors lag far behind the number of patients needing transplants.

“If more people said yes to donations, then people wouldn’t be desperate enough to go to other countries,” said Jennifer McGehee, public coordinator of the California Donor Network, part of a federal organization that links patients to donors.

Currently, more than 92,230 people are on the national organ transplantation waiting list, which included 2,308 children under 18 as of October 2004. As of April 21, 2006, 2,299 of the needed 92,000 organ transfers have been made — only a fraction of total organ demand. There simply aren’t enough donors out there; according to the United Network for Organ Sharing (UNOS), only 1,205 new donors were registered since January 2006.

This dire need for organs may be prompting abuses in other, poorer nations. In 2002, National Geographic followed an international kidney-trafficking ring and spotlighted a poor Indian village where many residents had sold one of their kidneys for $800.

Hospitals in China brag that organs and tissues are available often within a few weeks. “Viscera providers can be found immediately!” reads China’s International Organ Transplant Web site (en.zoukiishoku.com), which advertises towards patients in Japan, Korea, Russia and the United States.

"If more people said yes to donations, then people wouldn't be desperate enough to to go other countries." Jennifer McGehee public relations coordinator

Controversy surrounds China’s seemingly endless organ supply. The Epoch Times, an independent newspaper based in New York, reported that some of the “donors” are still alive when organs are harvested and have not consented to have their organs removed. China’s International Organ Transplant Web site in fact confirmed that some of their donors are living, stating that living donors’ organs are safer and more reliable there than in other countries.

“Human organ harvesting from jail detainees, including political dissidents, has a long history in Communist China,” stated a report from the World Organization Investigating the Persecution of Falun Gong. “In recent years, more and more foreign patients have gone to China for organ transplants, driving the demand of human organ harvesting.”

Based on information available on the Chinese government’s news Web site (china.org.cn), China's organ donation system lacks any regulation that could protect against abuses. As of July 1, however, the “Interim Regulation for Human Organ Transplant Practice,” issued shortly after the exposure of China’s questionable organ donation practices, will take effect, requiring medical institutions to obtain written agreements from donors before transplants are conducted.

Here in the United States, doctors follow a set of rules in which patients go through a detailed process of registering for an organ, contributing to the long wait. Doctors in America refer patients to transplant centers that then determine whether organ transplant is the only option. If it is, then patients are put on a waiting list based on the urgency of their situation, according to David Heneghan, California Donor Network's public affairs manager. Blood type, tissue type, size of the organ, medical urgency of the patient's illness, time already spent on the waiting list and distance between donor and recipient are considered, according to the National Women’s Health Information Center Web site (womenshealth.gov).

Organs in America are in high demand and in short supply, which is why doctors can get away with charging high prices for procedures done elsewhere for less. Here, kidney transplants could cost about $90,000, according to Washington University in St. Louis’ Web site (news-info.wustl.edu). China Transplant Network’s Web site prices kidneys at about $56,000.

If more people donated organs willingly, costs might go down, and perhaps Americans would not feel compelled to seek help elsewhere.