Health and its Potentials and Impacts on Tourism Industry of

Abstract routes. The natural beauty of Sri Nimal Shantha Lokupathirage Lanka's tropical forests, beaches ihis paper discusses the and landscapes, as well as its rich cultural heritage, make it a world nature of the health tourism, famous tourist destination. Sri of medical treatment abroad. a distinctive phenomenon in the T Lanka is famous for its tropical Indu stry should make every making on the horizon of international ecosystem, The New York Times has endeavour to attract tourists for tourism industry and examines its ranked Sri Lanka as number one health purposes as Sri Lanka is potentialities in the context of the tourist destination in the world, while endowed with necessary potential international scenario and its impact National Geographic magazine has for development. A burgeoning fact cited Sri Lanka among the best 25 on the tourism industry in Sri Lanka is the potential to develop health tourist destinations in the world. in the sphere of development tourism to attract many tourists Thus, Sri Lanka is endowed with strategies. Medical tourism, if properly into Sri Lanka, as Sri Lanka could almost all possible tourist utilised, could well be a great spur well be proud of its traditional attractions except winter sports, healthcare system brought down for in the arena of local tourism industry, and the industry should be able to if one properly discerns the probable exploit to its potential. So it is the centuries. If cogently planned and competitive advantages over the bounden obligation of the relevant masterfully guided, health tourism, regional counterparts. Sri Lanka is authorities to exploit the hitherto with additional potentiality of endowed with the necessary unexploited segments of tourism. exporting ayurvedic drugs, could definitely make a significant infrastructure, inclusive of the Appended are some of the areas to be exploited in a synergized contribution to the tourist traditional healthcare system nurtured programme. industry. If health tourism is for centuries, for the development of properly propagated, Sri Lanka could the health tourism industry. The i. Ayurvedha treatment be more a unique tourist results of evaluation of the magnitude ii. Buddhist doctrine and meditation destination. of Ayurvedha and its relevant (retreat to find solace) disciplines in the context of tourism iii. Meditation as a healing process According to the industry experts, study and the potentialities of of ailments the global medical travel industry promoting as a salient feature in vi. Ayurvedic Beauty Therapy has been projected to earn US$ 40 tourism industry in Sri Lanka are billion by 2010. (Horowitz, Michael Ayurvedha system professed, discussed. Also discussed is the D, Medical Insight International of practised and nurtured is unique US, "Why in the world Do Patients inevitable aspect of regulatory to Sri Lanka as the legend goes, it Travel for Medical Care?, Asia measures which are necessarily is practised, cherished and embedded in a master development elegantly guarded for many Pacific Biotech, Vol.12, No.07 May strategy in health tourism. I millennia from the days of great 2008, p24). sage Rishi Pulasti, (2668-2616 The term medical travel denotes Introduction B.C.), the grandfarther of Ravana, who was invited to chair the several major patterns and could be international medical conference enumerated as follows: Global travel is not a new held in Himalaya. phenomenon. Historically, i. People receive medical travellers embarked on adventures Defining the Features of Health treatments outside their own risking seas from the early to the Tourism countries. This mostly involves middle 20th century. Then travelling with the Allopathic, the mainstream became the privilege of the affluent Tourism inherently based on medical practice in the western few who could afford to the luxury curiosity and interests of people. world as rapid strides made by the of travelling abroad for the purpose Tourist attractions are varied and system with the techniques and the of leisure. At present, it is open to multifaceted, which are also technological innovations. a wide range of people. basically dependent on the apprehension and the attitude of ii. The people of the developed Sri Lanka is strategically located the people. One such aspiring countries who need immediate anxiety of tourists is the seeking connecting many sea routes and air medical treatment would resort to 19 Economic Review: Feb./March 2011 alternative measures, move to travelled in search of better care. augment the growth by tapping the Asian and other countries to mostly Today, constraints and long waiting potential of the international undergo complex operationsldue to lists at home countries, as well as patient market. various reasons such as exorbitant the ease of global travel, make financial implications ' and health tourism even more Prologue to Traditional Medical exacerbate waiting list in their own appealing. Health tourism usually Treatments countries and expertise found in refers to the idea of middle-class other countries. or wealthy individuals going abroad Medical practice in the world is in search of effective, low-cost broadly categorised into five iii.The affluent patients in less treatment. Professor Tarun Khanna segments, namely, Ayurvedha, developed countries continued to of the Harvard Business School Siddha, Yunani, Allopathy and have poor access to expert medical predicts that "the medical services Complementary and Alternative services journeyed to have medical industry is evolving quickly and Medicine. Health tourism- care in other countries prospective dynamics in generates medical treatment under similar to those in and in two major segments of medical iv. Patients preference to secure other parts of South-east Asia are discipline, i.e., Western and traditional medical treatments in on the horizon." A forecast by Ayurvedha medical systems. Asian countries where confident Deloitte Consulting, a consultancy Tourists, usually, are attracted for treatments are available for certain firm in the USA, published in western treatment, particularly in prolonged illnesses such as August 2008, projected, that seeking of complicated medical diabetes, hypertension, coronary medical tourism originating in the surgeries in Asian countries due to problems, Parkinson disease, etc. USA could increase by tenfold over high cost of treatment of their own the next decade. The San Francisco countries. Nevertheless, Ayurvedic v.Traditional medicines in Asian Chronicle estimated 750,000 treatments are mostly sought as a countries also offer treatments for Americans went abroad for reliable treatment for prolonged obesity, excess level of cholesterol, healthcare in 2007, and the report common sicknesses, such as beauty culture, 'stay healthy predicted that a million and a half hypertension, heart diseases, systems', would seek healthcare outside the diabetes, paralysis, excess USA in 2011. The statistics indicate cholesterol level, orthopedic, etc. vi. People travel to Asian countries that there is a huge potential There are specific Ayurvedic schools in search of mental solace in the market for health tourism. (Family Traditions) specialised in form of Yoga exercise and particular diseases, which have meditation techniques. Health tourism is a rap idly-growing nurtured and preserved the system i practice of travelling across with a closely-guarded regime. In As described by Michael D Horowitz international borders to obtain Sri Lanka, there are number of of Medical Insight International of healthcare. Over 50 countries have traditional 'Paramparika' (traditions the USA, medical travel is driven identified medical tourism as a passed down for centuries) and shaped by the complex Ayurvedha centres and some attend interactions of myriad of medical, national industry. Present global to incurable diseases with positive economic, social and political trend in health tourism is in a results. forces. Nevertheless, the reason somewhat jeopardised manner as for people to travel thousands of potential tourist Find it difficult to In Ayurvedha, in a broader miles, frequently crossing national locate accredited treatment and spectrum, diseases are divided into borders can be classified as follows: other measures of quality, and there are also risks and ethical two categories, namely, the communal diseases and non- i. Affordability of care, issues that make this method of communal diseases and are based accessing medical care highly ii. Timeliness of care, on the following four crucial stages controversial. Also, some during the course of treatment. iii. Availability of care, destinations may become hazardous or even dangerous for i. Adherence to a particular course iv. Patient preference to specific medical tourists. Sri Lank tourist of food providers, industry could well exploit such ii. Adherence to a particular living potential situation with an v. Patient preference for special style improved pragmatic awareness geographical locations. campaign, executed effectively. iii. Course of medicine Medical tourism is a new term, but Medical tourism presents a great not a new idea. Patients have long opportunity for Sri Lanka to iv. Daily regime

20 Economic Review: Feb./March 2011 Hospital services, spa (massage interwoven with the religious kings of ancient Sri Lanka. Of clinic) and particularly treatment traditions. "In spite of the profound these, the earliest is in the reign th for prolonged illnesses, such as, Indian influence, Sinhalese of Pandukabhaya in the 4 century hypertension, heart diseases, medical knowledge has developed BC. KingBuddhadasa, the renowned diabetes, paralysis, excess on its own course with the passage physician, (340-368 A.C.), was adept cholesterol level, orthopedic, etc. of time, and we note a number of in general medicine, midwifery, for which Ayurvedha system distinctive features, which mark it veterinary medicine and even provides a highly confident course out from other medical systems" carried out complex surgeries. of treatment with prospective total (www.virtual.library). Ayurvedha in recovery (subject to nature and Sri Lanka is unique and endemic Polannaruwa Council Chamber other inherent symptoms and in its very sense and had been in inscription refers to a rent paid,to ). There was an instance in practice for millennia. a hospital. (EZ 4.1.44) The same Sri Lanka that Parkinson disease inscription refers to a grant to the was completely cured through Ayurveda was practised over the chief physician (Maha-Vedana) who Ayurvedha medical treatment, in last three or four thousand years, was one of the principal this case, the symptoms have been while the western system has a functionaries of the State. The detected early, a contributory factor history of only three or four literature also refers to physicians, in treatment. centuries. Numerous references medicines and their methods of have been made to medical treatments. The physicians jealously guarded their reputation Ayurvedic traditional treatment has practices in Sri Lanka since the and also guarded their science as become an inseparable service in very early days of the Aryan well. Whenever the medicines were some of the hotels in Sri Lanka as civilisation. The ancient Sinhalese prepared, they discreetly did the Ayurvedha has, now occupied an are perhaps responsible for recipes themselves concealing the important place in beauty care, introducing the concept of hospitals formulae from others. Ayurvedha Herbal Remedy and to the world. Prof. Arjuna Aluvihare Ayurvedic Beauty Care. contends that there is no evidence, literary or otherwise, to show that During the ancient period, Ayurveda is part of education of Historical Evolution of hospitals were known elsewhere in every Sinhala noble including the world before and during the Ayurvedha System in Sri Lanka monks. Medicine and surgery seem time of King Pandukabhaya (437 BC to have been rather widely studied, Ayurvedha, the "science of life", is to 367 BC). In ancient Sri Lanka, and the Ayurvedic system of historical evidence is intensely a system of traditional medicine medicine, as it is known today, recorded in chronicles on medicines native to the Indian subcontinent. seems to have been in quite an and medicated gruels of physicians In Sanskrit, the word ayurveda advanced state. Medicine consists of the words syus, and hospitals for the sick and administered under the, native meaning "longevity", and ueda, convalescent homes for those practice took several forms, meaning "related to knowledge** or recovering from illness and consists chiefly of oil and "science". Hinduism and kumbalgeya or maternity wards in decoctions, pills and gruels have been an influence on the villages and towns . The people who internally taken, and poultices and ,h development of-many of ayurveda's lived in Sri Lanka before Vijaya (5 pastes externally applied. Plants, central ideas/ particularly its century BC) had their own systems roots, nuts and tubers are used in fascination with balance, known in of medicine. 'The system of their manufacture which is carried out in accordance with a set of Buddhism as moderation. medicine practised by the Ayurvedic advanced formulas serving as Ayurvedha stresses on moderation physicians of Sri Lanka dates back prescriptions. in food intake, sleep, sexual to many thousands of years, and intercourse, and the intake of these texts were said to have been The ingredients for making medicine. Balance in life is compiled by Rishis. They are medicines were collected from the emphasised. Sri Lanka has been a complete works of science, surroundings, and every person had including even the practice of centre of the Buddhist religion and a general knowledge of medicinal surgery and anatomy, and they culture from ancient times and is plants. Their medicinal one of the few remaining abodes of contain descriptions of surgical preparations were chiefly Buddhism in South Asia with a instruments used at that time. compounds of herbs, for which an highly acclaimed cultural heritage. immense number were employed. Medical treatment forms part of The Mahavamsa, the ancient chronicle, Plants were not the only this cultural heritage as the contains a number of references of ingredients applied to make native medicine. In some instances, cultural fabric was closely hospitals and dispensaries by the 21 Economic Review: Feb./March 2011 minerals were used. Strong indigenous medicine of Asian South-Asian countries to exploit minerals seem to have been used countries, as well, for acute since indigenous Ayurvedic for exceptional cases by well illnesses, such as diabetes. The Medicinal system has established quality of treatment was however experienced physicians. itself an unwavering conviction in found to be a key determinant. Over its indelible position in the western Joao Ribeiro, the famous 100,000 foreign medical tourists visit Malaysia annually, while world as a trustworthy method of Portuguese soldier-historian who Singapore and India also experience treatment in respect of certain served in Sri Lanka from 1641-1658, positive growth in patient visits as ailments and sicknesses. has written in his reputed work a result of their aggressive "Fatalidade Historia de Ceilao". marketing initiatives. However, i. Indigenous external treatments "They are great herbalists, and in (Oil Baths, Panchakarma, etc.) Thailand leads the Asia-Pacific case, of wounds, tumors, broken region with about 400,000 foreign ii. Medication for serious diseases arms and legs, they effect a cure in patients each year. (Supplementary such as Hypertension, coronary- a few days with great ease. As for Growth with Medical Tourism, Ivy ailments, diabetes etc. cancer, which is a loathsome and Teh and Calvin Chu of incurable disease among us, jthey iii. Orthopedic treatment Synovate Business Consulting- can cure it in eight days, removing www, synovated.com). iv. Herbal beauty therapy all viscosity from the scab without v. Massage and spa so much as leaving a mark Many Asian Pacific countries are anywhere to show that the disease medical tourism destinations. The had been there. I have seen a large most popular treatments sought in The development of health tourism number of soldiers and captains India by medical tourists are in a material and non-material cured during my residence in the alternative medicine, bone-marrow dimension is a challenge country, and the ease with which transplant, cardiac bypass, eye confronted by the stakeholders of this was done was marvelous. In surgery and hip replacement. India the tourist industry in Sri Lanka. truth, the land is full of medicinal is known, in particular, for heart This invites different dimensional herbs and many antidotes to surgery, hip resurfacing and other analysis of the situation to be poison, which I have myself tried areas of advanced medicine. Except considered in a broader perspective. to learn as a remedy against snake­ alternative medicines, other Material dimensions are inclusive bites." Dr C.G. Uragoda asserts treatments are usually based on of providing suitable environment that a good deal of traditional western medical surgery. Medical for such industry and non- material Sinhalese medical concepts, tourism is a growing sector in dimensions are inclusive of practices and drugs have a sound India. India's medical tourism expertise of the art of treatment scientific basis. ^ sector is expected to experience an annual growth rate of 30%, Nearly with suitably adapted treatment Challenges of Health Tourism 450,000 foreigners sought medical systems for foreigners. treatment in India in 2007. Even in Sri Lanka reached a historical land the case of indigenous medical Marketing Potential mark with 600,000 tourist arrival in treatment, India poses a greater A major driving factor of seeking 2010, acording to Sri Lanka Tourism challenge over other countries, offshore medical treatment is the Development Authority. (http://www.indianhealthcare.in.). availability of care for respective Infrastructure facilities, a sine qua ailments, and it is the onus of the non, have occupied the centre stage Prof. Rezvi Sheriff, Director of the strategists to make this factor, in the sphere of development efforts Postgraduate Institute of Medicine known intern ationaHy^; which would spur tourism as well. of the University of , in an Optimistic sentiments . are interview conducted by the Thailand, India, Philippines, and reassuring that the country can National Television of Sri Lanka on

22 Economic Review: Feb./March 2011 encompasses a wide range of an grab a bigger share of Asia's available. Most Americans prefer integrated and interconnected booming health tourism industry. India for affordable cardiac surgery development aspects, such as, The medical tourist visas, to be which is less than one tenth of the economic factors, physical, introduced later this year by the price quoted in the USA for the industrial, social factors, Bureau of Immigration of same procedure and India has Philippines, will allow foreigners to reliable cardiac surgeons, a factor infrastructure developments and stay in the country for six months emphasis on offshore medical other conventional segments of without having to apply for tourism. There seems so many management planning. Tourism extensions, and India has now Indian service providers planning is a highly sophisticated exempted foreign tourists from the established in the USA where they process as the planning procedure mandatory two-month gap to re­ connect patient to affordable top- take shape of different dimensions, enter the country for regular quality healthcare in India. Non­ such as, international competition onward medical treatment. surgical treatments are also in in the international scenario and growing demand which is welcome the threats posed by many In the international tourism arena, sign for Sri Lanka tourism. In 2007, developing countries inclusive of there is a huge potential market for Americans alone spent an our own region, who are lucidly medical treatments. According to a enormous US$4.7 billion for non­ involved in sophisticated tourism report, in North America alone, surgical treatments. {Asia Pacific planning. The tourism millions of people are awaiting Biotech, Vol. 12 No. 07 {2008)p.40). development should encompass the medical treatments. There are four characteristics of a master plan basic groups in North Americans Earnings from tourism can be with a series of overall guidelines, who are mostly interested in related to factors such as duration future projections, integration of all medical tourism and the cost saving of stay of a tourist and the amount stakeholders, {tour operators, hotel it provides. They are: of money a tourist spend on food, owners, transport sector, airlines, drinks, accommodation, travel, etc.), identification of development i. 47 million uninsured Americans recreation and shopping. These are opportunities, introduction of novel ii. 252 million insured Americans the traditional norms of tourist attractions, such as, with restricted coverage due to pre­ expenditure of a tourist, and if the Ayurvedic treatments, Ayurvedic existing conditions, resulting in tourist be aware of the medical beauty therapy, meditation, out-of-pocket expenses services available, this list could be constant study and survey of iii. 34 million Canadians receiving expanded into health segment as development plans of other socialized medicine and enduring well. Medical treatments could be countries so that necessary long waiting lists for many adjustment could be made popular surgeries a direct stimulating factor to travel, and they also have an influence on accordingly, and so many other iv. Potentially 330 million North the choice of particular factors which deemed essential. Americans seeking elective destinations. In the present cosmetic and/or dental surgery. context, Sri Lanka should formulate After termination of the protracted conflict in Sri Lanka, prospects are With the foregoing statement, it can novel approaches in persuading provided with a favourable more tourists into the country by be easily presumed of the demand environment and an opportunity to improving the health tourism from other western and Europeans accelerate the development segment and making Sri Lank an countries for medical tourism as strategies in no uncertain terms. inescapable destination in the well. The major factors to be Optimum utilisation of this unique sphere of health tourism. Health considered in a broader marketing opportunity must be apprehended, tourism could contribute a drive are referral agencies, synergising possible resource at considerable percentage of overall advertisement, internet marketing, hand with distinctive tourism in Sri Lanka word-of-mouth, medical professionalism culminating with breakthrough, premium mark-ups, integration of inputs needed to fixed-price surgery, tax treatments, Strategic Health Tourism meet pre-defined objectives and a visa customs clearance, etc. Development Plan cohesive effort sans meandering approaches. Tourism has been Referral agencies play a higher Tourism planning essentially is a identified as a prominent segment profile in dissemination of component of national development of the development strategies, and information regarding the details of planning. Health tourism should a considerable investment has treatments packages available, occupy a greater aspect in the been allocated in the development since it is. the practice of the tourism planning of the country. of this sector with a master plan. potential medical tourist in the 'Tourism Planning can be defined It is of paramount importance to Western countries to get their all as the physical planning of draw up a unique strategy to inclusive services. India has many resources on which tourism is confront the inevitable regional websites which gives based." In a broader spectrum, competition and the complexities comprehensive details on health tourism planning is not generated by global tourism to tourism and the treatments only physical planning, but entice an extended tourist inflow 23 Economic Review: Feb./March 2011 to an unprecedented level. Sri disseminate the dominance factors in terms of health tourism. Lanka is endowed with all potential on indigenous treatments Patients' concern of the treatment attractions that appeals to the available. system of indigenous medicine in tourism industry, inclusive of treating countries, is a very salient traditional healthcare system Patient preference for specific feature to be considered in the discreetly and conscientiously providers is another factor which context of healthcare tourism. In guarded for centuries, In a instigates foreigners to seek 2008, Ayurvedic Drug Mnaufactiring promotional campaign, instigating medical advice by a specific Association of India has entered factors should be exclusive and physician or at a certain medical explicit as against the other facility with the established fame into an agreemetnt of cooperation destinations so that prospective of explicit acumen of the physician. with the American Herbal Products tourist would be attracted to such Indigenous medical system stands Association. Under the agreement, factors over other destinations. a high potential, if properly each association would keep the exploited. Also, Sri Lanka stands a other associations informed of the Potential market for health tourism better prospect in terms of relevant information that may effect is naturally the developed geographic destination, as some the functioning of the herbal countries in Europe, America, patients chose to have medical care ayurvedic industry. So, this would Middle East and Japan, mainly abroad because of the opportunity definetely be a huge thrust in the because of their large populations, to travel to exotic locations and to sphere of Indian prospects are affordability of expenses and lack recover and vacation in exotic concerned of health tourism which of healthcare options 'locally. A surroundings. would be beneficial in terms of recent case study of Harvard patient confidence as both Business School describes that Regulatory Status of Herbal countries would regualte the herbal medical tourism is on the rise for Medicines products reciprocaly. It is the duty everything from cardiac care to of the Sri Lanka authorities to plastic surgery to hip and knee International recognition is an assuage doubts in minds of the replacements. imperative factor in practising the Western community and inculcate Traditional Medicine and to win the the exquisite, eminent, Patients are now learning more and confidence of those who seek accomplished and remarkable more about their own illnesses, and traditional medication, and it is nature of the treatement of are most familiar with available vital and significant to generate a tradtiohal medical systems in Sri treatment options. Patient resolute confidence in traditional Lanka. marketing, such as, informative medicine systems. With a view to websites, transparent pricing realise the necessary recognition In Sri Lanka, the national policy on schemes, or advertising for Ayurvedic system, the World Traditional Medicine (TM) and placements, such as, within in­ Health Organisation (WHO),in Complimentary and Alternative flight magazines, have thus 2005, conducted a global survey and become- basic information and compiled a Traditional Medicine Medicine (CAM) is currently in the advertising platforms Strategy, for which a Sri Lanka a development stages. Laws and participator, to promote the regulations on TM/CAM were issued in 1961, and the national In respect of health tourism, there integration of Traditional Medicine programme in 1982. The should be highly compounded and Complementary and Alternative Destination Programme Medicine into the national Department of Ayurvedha in the Ministry of Health was established Management strategy to help healthcare systems. Development patients navigate through the of national policies and regulations in 1961. There is a national expert procedures and other requirements are essential indicators of the level committee, and a national research like pre-arranged hotel check-in, of integration of such medicine institute on traditional medicine, doctor consultation, transport, within a national healthcare complementary medicine and interpretation assistance, system. The use of medicinal plants herbal medicines, established in provision of emotional support, is the most common form of 1962. Yet, no national laws or arranging excursions, assuring the traditional medication worldwide. regulations on herbal medicines customer comforlability, etc. Sri Regulation of herbal medicines is have been formularised. Herbal Lanka tourism industry should a key means of ensuring safety, medicines do not have any adapt to the international system efficacy and quality of herbal regulatory status which are sold of luring the potential tourists with medicinal products. Sri Lanka does with medical, health, nutrient the accepted norms of procedures currently have a national policy on content and structure/function by following the typical process. It Traditional Medicine. The imminent claims. is expedient to explore the factor is that regulations of herbal 1 medicine must be recognised by the possibility of developing a network The national pharmacopoeia, the of medical tourism providers and international community who Ayurvedha pharmacopoeia, was the travel agencies who could ultimately patronise those services published in 1979. The Compendium

24 Economic Review: Feb./March 2011 of medicinal plants containing 100 constituent, extract or combination analyse available opportunities in national monographs was published of these ingredients. the sector, spearhead sectoral in 2002. The information contained development, and formulate v. Health food: health foods could therein is considered to be legally strategies to invest in medical binding. Regulatory measures for be products that are presented with tourism and improve their manufacturing include adherence to specific health claims and therefore competitiveness. requirements in the pharmacopoeia regulated differently from other and monographs that apply to foods. Conclusion conventional pharmaceuticals. Yet no control mechanism exists for vi. Functional foods: like health The health tourism sector, as a these requirements. There are no foods, functional foods may be whole is a booming quarter in the safety requirements. products which are offered with international tourism sector and specific health claims and therefore There is no national registration the potential for development, both regulated differently from other system, nor are herbal medicines locally and internationally, is included on a national essential foods. enormous. Even though it is drug list. A post-marketing leniently manifested in the entire' surveillance system is being vii. Other: products classified planned. In Sri Lanka, herbal differently from the above arena of tourism industry with a medicines are sold in pharmacies mentioned categories. less significant status, the as prescription and over-the- development prospects of heath counter medicines. Although Sri It is a mandatory and obligatory tourism in Sri Lanka is vast and Lanka does currently have a factor for the authorities to could take a dynamic turn in the national policy on Traditional recognizes that Ayurvedha as an industry, if properly handled, with Medicine, various other measures important segment of national a pragmatic approach by developing are imminent for due recognition in development and to secure a the existing system with the the sphere of medicinal practice. If pragmatic approach. formation of regulations and the Ayurvedic system is under regulatory measures, the following (i) Ayurvedha should be developed converting it into a system of practice of issuance of medicine as a sustainable industry workable proportions. Identifying which is a mandatory in the potential subdivisions in the internationally recognoised (ii) A Regulatory Body must be in health induttry, which are ideally system, could be in place. place for monitoring the industry in existence and/or in an operational status, could be easily i. Prescription medicines: (iii)Maintain a comprehensive integrated into a development medicines/drugs that can only be database indicating local treatment master plan with imperatively purchased with a prescription (i.e., centres a physician's order}. In some possible implementation plans on countries, the legal framework a priority basis. A steering (iv)Develop a national allows traditional practitioners to committee with field expertise pharmacopeia for herbal medicine prescribe medicines. inclusive of local ayurvedic wisdom (v) Establish regulatory status for would be ideal in the formation of ii. Over-the-counter medicines: a plan. medicines/drugs that can be herbal medicine purchased without a prescription from a physician. (vi)Secure recognition for local Acknowledgements medicine from other world fii? Self medication only: regulatory bodies My profuse appreciation goes to medicines/drugs permitted for self Rev. Dr. Wijithapura Wimalaratana, med^^ion purposes only. (vii | Increase government a senior lecturer of University of investment on Bio-medical research Colombo and Dr. G. Jayewardene, iv. Dietary supplements: a a prominent traditional medical dietary supplement is a substance This pragmatic approach would practitioner, of Mansuva Lanka (pvt) which contains, for instance, a definitely augur the confidence of Ltd., Castle Street, Borella for their vitamin, a mineral, a herb or other foreigners who intend to seek local valuable contribution and for botanical or an amino acid. A medical treatments. If government reviewing the text. dietary supplement may be intended to increase the total daily is keen to elevate medical tourism, intake of a concentrate, metabolite, the private sector would definitely Contd. on page 43 25 — Economic Review: Feb./March 20 11 Contd. from page 25 decade," The San Francisco (11) Dr C.G. Uragoda ,"A scientific Chronicle, (August 3, 2008) basis for some traditional beliefs and Bibliography practices in Sri Lanka". Journal of (6) Supplementary Growth with Royal Asiatic Society, Sri Lanka. 1989/ (1) Horowitz, Michael D, Medical Medical Tourism, Ivy Teh and Calvin 1990. Insight International of US, " Why in Chu of Synovate Business Consulting the world Do Patients Travel for (www.synovated.com) (1 2)http: //www.indianhealthcare.in. Medical Care?, Asia Pacific Biotech, Vol. 12, No. 07 May 2008 (7) Prof. Arjuna Aluvihare ("Rohal (13) Martha Lagace, The Rise of Kramaya Lovata Dhayadha Kale Sri Medical Tourism (2007) Faculty (2) Marsek, Patric, Managing Director, Lankikayo" Vidhusara Science Research, Harvard Business School, Medical Retreat LLC, "Is Medical Magazine, (Nov. 1993) Harvard Business Review Tourism for You? Asia Pacific Biotech, Vol. 12, No. 07 May 2008 (8) Prof. M B Ariyapala, Society in (14) Prof. Herath Madena Bandara, (3) Professor Tarun Khanna, The Jorge Medieval Ceylon, (1958) University of Sabaragamuva, Sri Paulo Lemann Professor at , Harvard Lanka, Tourism Planning in Sri l^inka Business School, Harvard Business (9) Dr. Rev. Wijithapura Wimalaratana, (2003) Krview Senior Lecturer in Economics, University of Colombo, PhD. (15) World Health Organization (2005) (4) Wikipedia Encyclopedia National Policy on Traditional Dissertation submitted to University Medicine and Regulation of Herbal (5) Linda A. Johnson, "Americans look of Nijmegen, Netherland Medicines - Report of a WHO Global abroad to save on health care: Medical Survey. tourism could jump tenfold in next (10) www.virtuallibrary.com

Contd. from page 38 UNWTO (2011). Economic Williams, A. M. and Shaw, G. (1991). Empowerment, Home Page, Tourism and economic development: Tosun, C. (2005). Stages in the www.unwto.org. Western European experiences. 2nd emergence of a participatory tourism ed. London: Belhaven Press. development approach in the Walford, N. (2001). Patterns of WTO (1994). National and Regional Developing World. Getoforum, 36:333- development in tourist accommodation Tourism Planning, Methodologies and 352. enterprises on farms in England and Case Studies, London: Routledge. Wales. Applied Geography, 21:331- Unwin, T. (1996). Tourist 345. Ying, T. and Zhou, Y. (2007). development in Estonia Images, Community, governments and Wang, X. and Zhao, 2. (2001). The external capitals in China's rural sustainability, and integrated rural transformation for tourism in Cultural tourism: A comparative study Development. Tourism Management, traditional vernacular settlements. of two adjacent villages. Tourism 17(4) 265-276. Architecture Journal, 9:8-12. Management, 28:96-107. •

contd. from Diary of Events

The UN Chief Ban-Ki Moon was tried to attack in Cairo by A major earthquake hit Myanmar. At least 75 people were killed Gadaffi supporters. and hundreds were left homes. Bangkok, Vietnam, and Chinese borders were also threatened. 23* The External Affairs Minister of Sri Lanka Prof. G.L.Pieris 25,b The Secretary General of NATO (North Atlantic Treaty said in Parliament that Sri Lanka as a member State of the Organisation) Andres Fogh Rasmussen said the alliance had agreed UN does not approve or encourage the air strikes on Libya to enforce a no-fly-Zone over Libya "to protect civilians" but not to The Libyan Leader Muammar Gaddafi claimed that his country carry out ground strikes. is 'ready for battle' while Western leaders planned their next The Russian President Dmitry Medvedev urged US counterpart • steps. Barack Obama to avoid civilian casualties in Libya.

The World Bank Chief Economist said, China could overtake A massive sand-storm hit Kuwait. the as the world's largest economy if it maintains j annual growth of 8% over the next 20 years. 27** Pope Benedict XVI called the international community to immediately begin a dialogue on Libya to bring about a ceasefire. Iran's supreme leader Ayatbllah Ali Khamenei accused the United States of assuming contradictory stands on people's 30** Al-Qaeda in the Arabian Peninsula welcomed the wave of | revolts in Arab countries and criticised its inability to revolutions engulfing the Middle East as a "tsunami of change", j understand Middle East events. The Libya's foreign minister flew into Britain, telling officials that he no longer wanted to represent the Tripoli regime. The Russian Duma (lower chamber of Parliament) approved a statement demanding the end of military actions against Libya, The Bolivian President Evo Morals rejected the decision of the United echoing similar opinions of Prime Minister Vladimir Putin. Nations and its Security Council to endorse military action in Libya.

31" China has urged immediate cessation of US-led military air J 24u The Pakistan President Assif al Zardari condemned the strikes against Libya. attacks made by US drones in the northwest of his country and urged President Barack Obama to stop incursions. Ministers and Bankers of the G20 nations met in China to discuss challenges facing the global monetary system due to Japan's quake and Bolivia decided to work to strip Barack Obama of disaster and Euro zone woes, such as budget deficits, public debt Nobel Peace Price. and private savings. |

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