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Medical tourism can do harm

BMJ 2000; 320 doi: (Published 08 April 2000) Cite this as: BMJ 2000;320:1017
  1. Rachel A Bishop, codirectors,
  2. James A Litch, physicians
  1. Kunde Hospital, Solukhumbu District, Nepal

    We are expatriate doctors living at 3900 metres in the Mount Everest region of Nepal and running a health care system serving a population of 10 000. The area is remote, mountainous, and roadless, with the villages scattered along high valleys. Over the past 32 years a health system of one hospital and eight health clinics has been established so that most residents are within an hour's walk of a health clinic or hospital.

    The area is popular with tourists. Last year 19 000 visitors came into the Sagarmartha National Park where Mount Everest, the hospital, and five of the eight health clinics are located. Inevitably, there are many doctors and other healthcare professionals amongthem.

    Can you realistically treat chronic disease after a single consultation?

    Although the presence of the hospital is well publicised, many doctors touring the area hold ad hoc clinics along the trail. They often conduct these clinics just …

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