Balneo Research Journal DOI: http://dx.doi.org/10.12680/balneo.2015.1094 Vol.6, No.2, Mai 2015

COMPARATIVE ANALYSIS OF CĂLIMĂNEŞTI - CĂCIULATA AND TECHIRGHIOL IN TERMS OF TOURISM DEVELOPMENT OF MEDICAL REHABILITATION

Manuela Liliana Mureşan

Abstract: Spa tourism has a long tradition in Europe and is no stranger to Romania, being practiced here since 2000 years ago, two of the most important resorts are Călimăne ti – Căciulata and Techirghiol. This paper aims to highlight the comparative analysis between the two resorts tourism potential of rehabilitation and encourage the creation of international branding strategies Romanian spa tourism. The future of Romanian spa tourism in the international market consists in the cooperation of all stakeholders in creating a system of medical rehabilitation, wellness and anti-aging treatments where we have a real potential. Key words: spa tourism, medical rehabilitation, balneology, Călimăneşti - Căciulata, sustainable development, Techirghiol.

1. Introduction legislative framework, generated the In Romania spa tourism sector is degradation of material, both in terms of complex, involving numerous actors, obsolete equipment and outdated treatment which through collaboration and the of the bases and the protection and development of partnerships can restore investigation of natural healing factors, this area to its once international success. which have been degraded considerably. Why? Because our country has approximately 8,500 mineral and thermal 2. Brief history of balneology in Europe springs, the extraordinary potential value compared to our country of natural therapeutic factors. Spa Tourism Employers state that Romania is the Balneotherapy propose mineral richest country in Europe in terms of water and mud treatments that are applied resources resorts, accounting for about a to diseases using most or even running third of Europe's mineral and thermal water, not just spring water whose quality springs, but only 10% of the springs are is limited to mechanical effects. It can be exploited because of the gap approach to practiced anywhere. Mineral waters and scientific research. The awareness of the therapeutic muds are known from ancient potential for development of spa tourism times. The first practical applications, in conjunction with using strategic therapeutic, more random quickly advantages provided by the scientific expanded so that the ancient Greeks and research of the natural factors is Romans, especially mineral waters and unfortunately very low today compared to springs, were well known as places of the years before the revolution. occurrence and medical qualities. Unfortunately, after 1990, scientific In ancient times, spa treatments research has declined significantly, which, occupied an important place in the together with the lack of investment and therapeutic arsenal in alternative and poor policies have generated the today’s traditional medicine. situation of spa tourism. The extended Thus, as the time passed, and the transition period, the fall of the economy, technological progress in medical science declining purchasing power, have failed to diminish the significance of mismanagement, lack of investment, the balneotherapy. This kind of treatment has

98 Balneo Research Journal DOI: http://dx.doi.org/10.12680/balneo.2015.1094 Vol.6, No.2, Mai 2015

been improved, it’s nuanced with precise state's role is very important in the indications and contraindications, enriched development of spa resorts so of the 100 with new procedures and earned a existing stations, 60 depend from private scientific foundation. organizations, 5 are directly or indirectly Through history, in Europe, spa towns placed under the guardianship of the state knew how to use water as a tourist and over 30 are funded and administered attraction, for example: Amnéville in by local municipalities. France, Baden-Baden in Germany, (http://www.scritub.com/geografie/turism/ Karlovy Vary, Czech Republic, Badgastein Particularitatile-turismului- in Austria or Abano Terme in Italy b1052111820.php, becoming so-called "hot springscities". (J. The particularities of the spa tourism, Benabdallah, J. Tomatis, 2009, p. 7). last accessed on 13th of May 2015). Analyzing several countries which have The development of balneary activities similar resources in Romania neighboring in our country takes place since the and in Europe, we note the following: nineteenth century. During this time, most Hungary has a territory rich in mineral sources of mineral water are being water, it has more than 1,300 springs of captured, the scientific basis of water which 800 are active. (Bender T, Bálint G, exploitation is being established (spa Prohászka Z, Géher P, Tefner I, 2012, p. research, chemical analysis, hydrological 44). They also make large investments to research). Following resorts are being renovate treatment centers, modernization planned and constructed: Cozia, of infrastructure, creation of wellness Călimăneşti - Căciulata, Govora, Băile complexes or aqua park centers (in urban Herculane, Băile Govora, Oglinzi, Borsec, areas and in proximity to the Romanian Buziaş, Moneasa, Mălnaş, Sângiorz Băi, border), a traditional example is the Lipova, Tuşnad, Tinca, etc. Also, during Hajduszoboszlo, the third largest city in this period, the exploitation of therapeutic Hajdu-Bihar County and most famous spa mud and salt lakes and the seaside are in the Great Hungarian Plain. established (Lacul Sărat, Balta Albă, Techirghiol). Analyzing spa tourism in Germany, we The mud will be introduced as a spa can observe a policy of encouraging the treatment in Bazna and Slănic. During combination of thermal cures and leisure 1926-1928 there were about 80 resorts, in resorts, here we encounter a famous many of them were between 80 thousand historic resort Baden-Baden. Another and 180 thousand baths, annually. The country with a tradition in spa tourism is water bottling activity took place in the Italy, which is visited annually by tourists interwar years in 26 units of different from all over Europe, thanks to a series of capacities. (Berlescu E.,1998). strategy research of SPA process, so their In present, Romania has 160 resorts policy is supported by nearly 380 spa and balneary centers with natural centers in the country, which allocates a treatment, out of which 60 resorts of percentage of their income directly to the general and local importance and 18 of Foundation for Scientific SPA Research them were promoted during the launching appeals on issues of medical spa international tourism circuit. After the therapy. (Vitale M, Vaccarezza M, 2012, p. revolution, in many of them, the 46). accommodation centers were being France is another Latin country with a modernized, treatment hotels and modern tradition of spa tourism, on its territory we sanatorium complexes were built, out of can find approximately 1,200 sources of which, the services of accommodation, mineral and thermal waters and a number diagnosis and treatment are offered during of over 100 resorts. It is noted here that the the same buildings, as it is practiced in the

99 Balneo Research Journal DOI: http://dx.doi.org/10.12680/balneo.2015.1094 Vol.6, No.2, Mai 2015

balneo climateric resorts of global concern tourist resorts). Based on these criteria, such as: Băile Herculane, Băile Felix, following areas were granted as balneary Sovata, Băile Tuşnad, Covasna, resort or spreading areas: Băile Felix, Călimăneşti - Căciulata, Mangalia, Călimăneşti - Căciulata and to the cities Techirghiol, Slănic Moldova, Vatra Techirghiol, Covasna, Amara, Sovata, Dornei, Eforie, Govora, Olăneşti, Buziaş. Ocna Sibiului, Băile Govora and Băile Along with the natural processes or Olăneşti (HG nr. 1016/2011 regarding physiotherapy, a wide range of therapeutic granting the status of spa or balneary resort procedures with physical factors are being for some localities and areas that have used. Basic such treatment have natural healing factors, Official Monitor of specialized departments assembled with Romania). modern equipment and facilities, but not at Călimăne ti-Căciulata is located in other resorts, competitive in Europe, why? Vâlcea, Valea Oltului, in the Carpathian Because of the lack of an integrated plan Depression Jiblea-Călimăneşti (260m). for urban development and restoration of The resort is situated at a distance of 17 historical and architectural heritage, in km of the city Râmnicu Vâlcea, a order to qualify for a pro-active investment subalpine zone and it operates all year aid in the the balneary domain, from the round. Romanian state and also from the The balneoclimaterical resort structural funds allocated by the European Călimăne ti-Căciulata is considered to be Union for development. (J. Benabdallah, J. the “pearl” of the stations from the Oltului Tomatis, 2009, p. 27). Valley, it has been documentary attested in 1386 and it is being internationally famous 3. Presentation of the resorts from in the mid nineteenth century on the Călimăne ti - Căciulata and recommendation of Dr. Carol Davila, Techirghiol from the perspective of the Emperor Napoleon III himself was being past/present development treated with bottled mineral water from the springs here, being sent to Paris; Austro- The prior objective of this paper work Hungarian Emperor Franz Joseph was also is to identify the tourist potential of the spa the recipient of miracles mineral waters of resorts Căciulata-Călimăne ti, respective the resort. Techirghiol and also comparing them as a (http://ro.wikipedia.org/wiki/C%C4%83li development/tourist image for the national m%C4%83ne%C8%99ti, accessed last and/or international clients. time on the 13th of May 2015). The Romanian legislation has We have to mention that here established the criteria for certifying the works also the clinical department of the tourist resort of local or national interest, Institute for physical, balneology and covering, among other things, the location medical rehabilitation of Bucharest, the in a natural setting without pollutants; the clinical base of the specialist department certification and value of the natural of the Medicine and Pharmacy "Carol healing factors; facilities and equipment Davila" University. Călimăneşti-Căciulata for sport practice; organization of tourism, is the only resort from the country which culture, sport events etc. and for the has five profile treatments: balnearic resorts: medical spa, technical • kidney and urinary diseases; equipment for operation, protection and • digestive tract and glands diseases; use of therapeutic mineral resources, • muscular-skeletal and peripheral facilities and equipment for basic services nervous system diseases; and revive therapeutic exploitation of • professional diseases (intoxication natural resources(HG nr. 852/2008 for the with heavy metals, lead, mercury); approval of norms and criteria attesting • silicosis.

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The internationally known curative time: Mihail Kogălniceanu, Mircea Eliade, factors of the resort are mainly recognized Mihai Eminescu, Constantin Tănase, due to the thermal waters of the almost 32 Tudor Arghezi, etc. We can see that, from springs (of which only five are known), 1930, the resort equipping was represented Căciulata water being diuretic with by a 6000 sqm landscaped beach, 80 exciting action on the gastric and billiaric cabins, 23 hotels and 318 villas with 4,000 secretion, the temperate climate and the rooms. Techirghiol, due to its benefits, is bio-climate protector completing the ideal declared monument in 1972, a distinction conditions for a vacation. The treatment is that offers, also today, protection regarding divided into several sections: the movement of boats on the lake and the electrotherapy, hydrotherapy, paraffin, wharf demolition. (http://www.i- mud, massage, acupuncture, aerosols, tour.ro/techirghiol-lacul-statiunea-si- carbon dioxide baths, herbal baths, istoria-ei/, ultimate accesed on the 14th of galvanic baths, physiotherapy, chromo May 2015.) therapy and aromatherapy. The number of In order to study the natural healing medical treatments is of 1,500 patients at factors, from the balneotehnic and six medical doctors. There are 80 medical physico-chemical point of view, under the personnel treating the patients. We have an scientific guidance of medical activity in estimated of 11,800 patients annually who the state, in 1949 it was established come for rehabilitation, 11,000 through the Balneology and Physiotherapy Institute. reference tickets from the House of Health The Institute has three sections: Insurances and 8000 from the travel • The study of natural resources: agencies; 3% of this total are from abroad, climate, mineral waters, mining, fountain mainly from Germany. captures, special spa; The infrastructure development and the • Experimental balneofiziology; equipment provision adapted to current • Clinical balneofiziotherapy. requirements began in 2007, increasing Due to the therapeutic properties of the gradually from 2011 to 2012, only in the mud recovery, treatment is structured into Interbelic or Central Hotel, as it is known, three main purposes: recovery, curative has been invested 200,000 euro in German and prophylactic and it addresses to the and polish medical rehabilitation following disorders: degenerative equipments. rheumatic diseases, inflammatory Techirghiol is a seaside resort on the rheumatic diseases, post trauma, diseases Black Sea coast, located 16 kilometers of the central and peripheral nervous south of Constanta. The city and the region system, gynecological and skin diseases, were inhabited since the Neolithic period, peripheral vascular diseases, and the settlement Techirghiol is included in associated diseases. phase two of Hamangia-Cernavodă Analyzing the treatment center, we see Culture. a number of approximately 13,200 patients In 1894, the Ministry of Agriculture annually, the profile of patients receiving and Domain sells 100 ha by the lake to the annual rehabilitation is often female, and Charity society of Civilian Hospitals in the age generally is 50-59 years (31%), 60- Bucharest. This is the first step in building 69 years (29%) compared to groups 40-49 health resort near the lake. The years of age (15%) or more than 70 years foundations of what will later become (17%). Most patients are from urban areas Techirghiol-Eforie and then Techirghiol - 84%. town today begin to be built. It is By comparing the two balneary and important to note that, throughout history, climatic resorts over time, we observe here have lived or received curative similarities with regards to the abundance treatment one major personalities of the of natural medical resources, yet they

101 Balneo Research Journal DOI: http://dx.doi.org/10.12680/balneo.2015.1094 Vol.6, No.2, Mai 2015

differ by geographical locations and some balneary and climatic tourism, based on a of the medical recovery procedures. It is single kind of tourism – tourism for worth looking into the weightage of the treatment, a specific form of R&R tourism, aggregated factors, which determine the which has enjoyed speedy development, relative touristic success of the area. Both particularly in the last few decades, owing Căciulata – Călimăne ti and Techirghiol to an increase in exhaustion and work- enjoy prominence among the top medical related diseases caused by the stress of resorts across the country, and previously modern living in large metropolitan areas also well-known abroad. The former (Snack, Baron, Neacşu, 2001, p. 38). This developed on its own by means of private perception is fully justified, as the Eastern initiative and capital, chiefly after 2000, European balneary and climateric resorts, while the latter remained state-owned and including the ones in Romania, have run. This accounts for the weakness of traditionally been medical centres and Techirghiol: higher percentage of obsolete spas, which cater for the tourists, often equipment; lack of private-sector partners called „patients”, in search of relief of and companies; shortage of medical staff; physical conditions. These centres are low remuneration leads to ageing staff; characterized by: the relatively linear and strategic short-sightedness in attracting constant tourist flow around the year, local and foreign middle-aged tourists with reduced seasonality, longer-term holidays medical recovery packages, rather than the (between 12 and 30 days), loyal clientele, retirees, who seek healing therapies; lack health-improving recurrent balnearic of PR and marketing at both international treatments, above average per tourist and and national level at trade fairs and with day expenditure as owing to complex and tour agents. qualified services (compare Snack, Baron, These shortcoming are less felt in the Neacşu, 2001, p. 39). privately-run Călimăne ti – Căciulata, Nevertheless, the Romanian market although the international marketing displays a latent demand, which means campaigns aimed at the foreign tourists are that the consumers’ needs are not deficient. Merely 3% of the clientele are appropriately satisfied by the current foreign tourists, albeit little is known balneary offer. Furthermore, the whether they are repeat customers, as their consumers are unaware or are not feedback is not centralized, nor are there interested in the product, or do not realize any loyalty programmers designed for the their need for a treatment and they fail to medical recovery tourist. understand the importance of maintaining their health. 4. The importance of development of medical recovery tourism A SWOT analysis of the Romanian The balneary tourism has enjoyed a balneary tourism reveals: considerable development under the umbrella of the medical recovery tourism, 1. Strong points: a niche product which blends medical • the presence of natural mineral springs services, as well as tourist products (Yu, in the majority of the resorts and their Ko, 2012, pp. 80-81). Within the potential of being used in the treatment of framework of the international different diseases, as well as for the international travel, patients from tourism development; developing countries travel to avail • the quality of higher medical medical services in high-standard medical education and very capable Romanian facilities in developed countries doctors; (Horowitz, Rosensweig, 2007, p. 26). Previous research points at a monolithic

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• the maintenance of a traditional • the lack of international accreditation profile in the majority of balneary resorts for the locations in the balneoclimaterical of international interest; resorts; • the possibility of 2 stars balneary • insufficient or inexistent development hotel accommodation, in accordance with of entertaiment and recreation activities in tourists' income, which for now represent most of the balneary resorts; the majority in the structure of solicitations for balneary tourism in total; 3. Opportunities: • the possibility of combining balneary • the involvment of pleased customers tourism with many other types of tourism in raising the visibility of the locations; (cultural, religious, or rural tourism) in • high potential but not enough most of the resorts; highlighted of the resources of the area where the balneoclimaterical resort is 2. Weak points: located; • not enough or sometimes absolutely • the customers' change in attitude and no involvment on behalf of the local mentality towards health, in general, and communities in the development of spa tourism in particular, worldwide; balneary resorts; • the innovation of natural, no harmful • the lack of co-operation/partnership traditional treatments in accordance with between different sustainers of tourism's integrative, holistic medicine; interests in general, and of spa tourism in • the opportunity of accessing different particular, in order to develop this founds in order to make investments with segment; direct impact on bringing tourists in the • no relevant information or studies balneary resorts; regarding some quality indicators/ • the need of increasing different kinds qualitative elements like recurrence of partnership between public and private degree/ loyalty programs; sectors in this area; • the psychological profile of the tourist • special conditions for obtaining loans that might be turned into additional data with preferential interest for the private usefull for different market researches; operators, in order to invest in the • total dependence on state subventions modernization of the accommodation ( by issuing treatment vouchers only for facilities and treatment platforms in the certain types of illnesses, not to mention a resorts. wrong perception of the tourism agents/agencies regarding a lack of interest 4. Threats: and action in satisfying internal consumers of such services); • more and more doctors choosing to • not enough accession of European practice medicine abroad; founds for the infrastructure development, • increasing development of medical for the acquisition of high performance and wellness tourism in more and more equipment, or for the creation of a strategy countries; for the promotion and branding of • random constructions that were made balneoclimaterical resorts; in some of the balneoclimaterical resorts • low comfort accommodation facilities, led to the loss of potential of the mineral most of them of one or two stars, or even springs; unclassified, not in accordance with • the appearance of an increased acceptable standards of the 21'st century; number of competitors offering a wide range of balneary holistic products for all the market segments;

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After listing all the above we emphasize of the region (monasteries, parks or nature that the role of the personnel working in reserves). These resorts must offer any kind of touristic/balneary facility is multiple ways of entertainment, but even more important as such coordinates diversity needs to be implemented as the professionalism and competencies gradually through a national strategy of the health care professionals are not just (healthy customers shouldn't mix with elements that positively complete the those with health problems, and the same touristic product but, moreover, they build goes for socially assisted customers and it, as without them the purpose of recovery the rest of the groups). and maintaining health during the tourist's Another advantage Romania has regarding trip is strongly affected. For this reason, in medical rehabilitation tourism comes from any strategy of development of the the aging process which has become a balneary tourism, for any destination or problem for all the states in the European market, the structure of personnel should Union. The average life expectancy be in perfect accordance with its' surpasses 70 years. Our country can be an resources/specific. example for "slow and beautiful aging" and for defeating aging through the 5. Conclusions creation of an international medical brand that mixes the benefits of thermal waters Romania has an advantaged position with the famous history of the cosmetic comparing with other European states for products and treatments Dr. Aslan. having these two balneoclimaterical resorts analysed above, Caciulata - Bibliography Calimanesti and Techirgiol, and not only. Although the potential of the Romanian • Benabdallah, J & Tomatis, J, balneary tourism is exceptional, the results (Noiembrie 2009), Master Plan for of its' exploitment don't raise up to the Balneary Tourism Development Phase 2; level of the natural resources, and for this • Berlescu E., (1998), The reason our country is unfairly situated at a encyclopedia of climatology of the significant distance below the major Romanian spa tourism, Bucure ti, Editura international competitors with tradition in All; balneary tourism. The causes can be • Benabdallah, J & Tomatis, J classified on all levels (macro, micro and (Septembrie 2009), Master Plan for medium) and they come from both sides Balneary Tourism Development, Executive (from consumers, whose perception need Summary; to be changed, but also from a several • Bender T, Bálint G, Prohászka Z, owners of these resources). But before Géher P, Tefner I,(2012), The Research of analyzing the causes, we need to Balneology in Hungary, Francisco understand, acknowledge and bring to Maraver & Mufit Zeki Karagulle, common denominator the concepts and Balnea/Medical Hidrology and dimensions of the spa/medical Balneology: Environmental Aspects, No 6, rehabilitation tourism. Editura Publicaciones Universidad The future of balneary tourism depends Complutense de Madrid; on the development of a proper global • Snack, O., Baron, P., Neacşu, N., infrastructure, by involving all parts, both (2001),Tourism Economy, Editura Expert, public and private sectors, by creating new Bucure ti; facilities (entertainment, bike trails, golf • Smith, M., Puczko, L,. (2009), fields) depending on the advantages of the Health and Wellness Tourism, Elsevier; resort, as well as by highlighting the • Vitale M, Vaccarezza M, (2012), natural, historical and cultural patrimony Research in Italy: research products and

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