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CHAPTER 1

INTRODUCTION


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INTRODUCTION TO MEDICAL TOURISM IN 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.

PIC1.1
http://en.wikipedia.org/wiki/File:Gods_own_country.jpg


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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.


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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 inKerala.

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.


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CHAPTER 2

REVIEW OF LITERATURE


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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

2.2.1Awards 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.


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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 Corporationthe government agency that oversees tourism

prospects of the statelaid 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-Gods 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

touristsan 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
http://en.wikipedia.org/wiki/File:Kerala_varkala_north-beach.jpg


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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.
http://en.wikipedia.org/wiki/File:Kerala_houseboat.jpg


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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...
http://en.wikipedia.org/wiki/File:Munnar_rakak2.jpg


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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
http://en.wikipedia.org/wiki/Kathakalihttp://en.wikipedia.org/wiki/Kerala_Natanamhttp://en.wikipedia.org/wiki/Koothuhttp://en.wikipedia.org/wiki/Koothuhttp://en.wikipedia.org/wiki/Mohiniaattamhttp://en.wikipedia.org/wiki/Thullalhttp://en.wikipedia.org/wiki/Thullalhttp://en.wikipedia.org/wiki/Padayanihttp://en.wikipedia.org/wiki/Theyyamhttp://en.wikipedia.org/wiki/Chavittu_nadakomhttp://en.wikipedia.org/wiki/Oppanahttp://en.wikipedia.org/wiki/Malayalam_Cinemahttp://en.wikipedia.org/wiki/Bollywoodhttp://en.wikipedia.org/wiki/Hollywoodhttp://en.wikipedia.org/wiki/Kalaripayattuhttp://en.wikipedia.org/wiki/Kalarihttp://en.wikipedia.org/wiki/File:Kadakali_painting.jpghttp://en.wikipedia.org/wiki/Kathakalihttp://en.wikipedia.org/wiki/Kerala_Natanamhttp://en.wikipedia.org/wiki/Koothuhttp://en.wikipedia.org/wiki/Mohiniaattamhttp://en.wikipedia.org/wiki/Thullalhttp://en.wikipedia.org/wiki/Padayanihttp://en.wikipedia.org/wiki/Theyyamhttp://en.wikipedia.org/wiki/Chavittu_nadakomhttp://en.wikipedia.org/wiki/Oppanahttp://en.wikipedia.org/wiki/Malayalam_Cinemahttp://en.wikipedia.org/wiki/Bollywoodhttp://en.wikipedia.org/wiki/Hollywoodhttp://en.wikipedia.org/wiki/Kalaripayattuhttp://en.wikipedia.org/wiki/Kalari


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the world's oldest martial arts, oral tradition attributes kalaripayattu's emergence to

Parasurama. Other ritual arts include theyyam andpoorakkali.

In respect ofFine 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.
http://en.wikipedia.org/wiki/Theyyamhttp://en.wikipedia.org/wiki/Poorakkalihttp://en.wikipedia.org/wiki/Fine_Artshttp://en.wikipedia.org/wiki/Murals_of_Keralahttp://en.wikipedia.org/wiki/Hinduismhttp://en.wikipedia.org/wiki/Christianityhttp://en.wikipedia.org/wiki/Islamhttp://en.wikipedia.org/wiki/Jainismhttp://en.wikipedia.org/wiki/Judaismhttp://en.wikipedia.org/wiki/Sikhismhttp://en.wikipedia.org/wiki/Buddhismhttp://en.wikipedia.org/wiki/History_of_Keralahttp://en.wikipedia.org/wiki/Paradesi_Synagoguehttp://en.wikipedia.org/wiki/Theyyamhttp://en.wikipedia.org/wiki/Poorakkalihttp://en.wikipedia.org/wiki/Fine_Artshttp://en.wikipedia.org/wiki/Murals_of_Keralahttp://en.wikipedia.org/wiki/Hinduismhttp://en.wikipedia.org/wiki/Christianityhttp://en.wikipedia.org/wiki/Islamhttp://en.wikipedia.org/wiki/Jainismhttp://en.wikipedia.org/wiki/Judaismhttp://en.wikipedia.org/wiki/Sikhismhttp://en.wikipedia.org/wiki/Buddhismhttp://en.wikipedia.org/wiki/History_of_Keralahttp://en.wikipedia.org/wiki/Paradesi_Synagogue


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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: AtreyaThe School

of Physicians, and DhanvantariThe 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 ayurvedaCharaka 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.


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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.


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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


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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.


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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 patients 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.


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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.


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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,.


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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 herbalpaste boundary. This treatment lasts for 45 minutes to 01 hour and it is good for any type of

back pain and spinal disorders.

Urovasthi :-


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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.


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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


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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.


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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
http://www.meditripkerala.com/cities/palakkad.htmlhttp://www.meditripkerala.com/cities/palakkad.htmlhttp://www.meditripkerala.com/cities/palakkad.html


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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
http://www.meditripkerala.com/cities/kollam.htmlhttp://www.meditripkerala.com/cities/kollam.htmlhttp://www.meditripkerala.com/cities/kollam.html


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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 acontrolled 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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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 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 latestophthalmic 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

Specialists 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 specializedeye care centers to brain and spinal surgery centers, specialty hospitals offer world-class care


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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


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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


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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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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 Bachelors 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 bachelors 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


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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 therevenue 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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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


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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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