The Introduction To Medical Tourism Tourism Essay

The Introduction To Medical Tourism Tourism Essay A patient going to a different country for either urgent or elective medical procedures is called medical tourism. Medical tourism is a term that has risen from the rapid growth of an industry, where people from all around the world are traveling to other countries to obtain medical, dental, and surgical care, while at the same time touring, vacationing, and fully experiencing the attractions of the countries that they are visiting. Medical tourism is next booming sector in India as information technology. Patients going to a different country for either urgent or elective medical procedures are fast becoming a worldwide, multibillion-dollar industry. The reasons patients travel for treatment vary. Many medical tourists from the United States are seeking treatment at a quarter or sometimes even a 10th of the cost at home. From Canada, it is often people who are frustrated by long waiting times. From Great Britain, the patient cant wait for treatment by the National Health Service but also cant afford to see a physician in private practice. For others, becoming a medical tourist is a chance to combine a tropical vacation with elective or plastic surgery. And more patients are coming from poorer countries such as Bangladesh where treatment may not be available. Medical tourism is actually thousands of years old. In ancient Greece, pilgrims and patients came from all over the Mediterranean to the sanctuary of the healing god, Asklepios, at Epidaurus. In Roman Britain, patients took the waters at a shrine at Bath, a practice that continued for 2,000 years. From the 18th century wealthy Europeans travelled to spas from Germany to the Nile. In the 21st century, relatively low-cost jet travel has taken the industry beyond the wealthy and desperate. Countries that actively promote medical tourism include Cuba, Costa Rica, Hungary, India, Israel, Jordan, Lithuania, Malaysia and Thailand. Belgium, Poland and Singapore are now entering the field. South Africa specializes in medical safaris-visit the country for a safari, with a stopover for plastic surgery, a nose job and a chance to see lions and elephants. Health tourism is another name or synonym for medical tourism. However it is sometimes used in the context of wellness, where people are looking to make healthy lifestyle choices such as eating better, practicing yoga or undergoing spa treatments. Medical Travel is another name or synonym for medical tourism. Medical Wellness and Spas Medical Spas and Wellness is sometimes called Health Tourism. Medical Wellness and Medical Spas have become an accepted industry within healthcare. Peoples wellness in general has been seen as a way to heal the body naturally. Many hospitals around the world have started to integrate medical wellness. Sometimes these medical wellness and spa treatments are called complementary or alternative treatments. The mayo clinic recommends for certain people the following forms of medical wellness for cancer patients, Acupuncture, Aromatherapy, Biofeedback, Exercise, Hypnosis, Massage Therapy, Music Therapy, Relaxation, Tai Chi, and Yoga. Medical Packages The health care sector in India has witnessed an enormous growth in infrastructure in the private and voluntary sector. The private sector which was very modest in the early stages has now become a flourishing industry equipped with the most modern state-of-the-art technology at its disposal. It is estimated that 75-80% of health care services and investments in India are now provided by the private sector. An added plus had been that India has one of the largest pharmaceutical industries in the world. It is self sufficient in drug production and exports drugs to more than 180 countries. Bone Marrow Transplant Brain Surgery Cancer Procedures (Oncology) Cardiac Care Cosmetic Surgery Dialysis and Kidney Transplant Drug Rehabilitation Gynecology Obstetrics Health Checkups Internal/Digestive Procedures Joint Replacement Surgery Nuclear Medicine Neurosurgery Trauma Surgery Preventive Health Care Refractive Surgery Osteoporosis Spine Related Urology Vascular surgery 1.2 Medical Tourism in Karnataka Situated in the southern part of India, the state of Karnataka spreads over the Deccan Plateau. At 300 BC., it had formed the southern tip of the Mauryan Empire. Its boundaries enlarged or receded swaying to the drum beats of history today it accounts for a sixteenth area of India has a population of about 45 million. Its language is Kannada its people are known as kannadigas. The three distinct regions are a narrow coastal area along Arabian Sea; high hills, the Western Ghats; sprawling plains towards the east. Karnataka popularly known for Carnatic Music through out the World has given much more to the World than Carnatic Music, a unique form of Classical Music patronized by many across the continents. Karnataka with all its richness in culture and traditional grandeur is also one of the fastest growing states in terms of industries and facilities. Karnataka is also known as the Capital of Agarbathi (Incense Sticks), Arecanut, Silk, Coffee and Sandal Wood. All this is apart fro m the fact that it has been the culture center for hundreds of years and its testimony stands spread across the state pulling millions of tourists from all parts of the world to Karnataka. Karnataka was known as Karunadu (elevated land) in ancient times. It is also believed that the name Karnataka has come from Kari-nadu meaning the land of black soil say the scholars some others hold that Karunadu also means beautiful country; either way the land is celebrated as beautiful throughout its ancient literature. The western strip across the Arabian sea is humid warm in summer, water-soaked in monsoon, profuse with coconut grooves paddy fields criss-crossed by strips of silvery streams sparkling stretches of sand. The hilly uplands of Malanad, One of the wettest regions of the world, where the bamboo flourishes wild areca, teak, rosewood matti are grown. It is also the home of the stately gaur langur. In its southern reaches frequent kheddas are held to capture roaming groups of e lephants. Also the swift deer the deadly tiger, roam animatedly in the forests. The east of the ghats is strikingly bare. This elevated stretch is supposed to be the oldest land on the earth where ancient rocks of earth are seen jutting in out odd shapes. Rivers like Cauvrey, Sharavathi Ghataprabha pass through upgraded valleys resulting in water-falls occasional rapids. 1.2.1 The Capital par excellence The capital par excellence Bangalore today has become an Industrial Metropolis. It is also called Indias science city. Sophisticated industries in the public sector employ thousands and thousands of workers. It is also called the Electronics city because most of the countrys basic electronic industries are based here. It is the fastest growing city in Asia. Aircraft building, telecommunication, aeronautics, machine manufacture, etc., have taken giant strides here. Bangalore was known for its salubrious climate, which however is now being debated because of the accelerated progress of modern industry. It is also called an air-conditioned city and a pensioners paradise. Karnataka is beautiful not only in the eyes of her sons and daughters. She captivates any one who sets eyes on her. It was the great Mauryan Emperor Chandragupta who traversed all the way from Magadha to distant Sravanabelagola to lay his remains in this land before entering the Kingdom of God. The course of Karnatakas history and culture takes us back to pre-historic times. The earliest find of the Stone Age period in India was a hand axe at Lingasugur in Raichur district. The Ashokas rock edicts found in the state indicates that major parts of Northern Karnataka were under the Mauryas. Chandragupta Maurya, the great Indian emperor abdicated the throne and embraced Jainism at Sravanabelagola. Adding new dimensions to the cultural and spiritual ethos of the land, many great dynasties left their imprint upon the aesthetic development of Karnatakas art forms. Prominent among them were the Chalukyas, the Hoysalas and the mighty Vijayanagara Empire. The Chalukyans built some of the very early Hindu temples in India. Aihole turned up as an experimental base for the dynamic creations of architects. The Hoysalas who ruled from the 11th to the 13th century chiseled their way into the pages of glory by building more than 150 temples each one is a masterpiece in its own way. The amazing dexterity and fluidi ty of expressions at Somnathpur, Halebid and Belur open themselves to the wide-eyed wonder in ones eyes. Vijayanagara, the greatest of all medieval Hindu empires and one of the greatest the world over, fostered the development of intellectual pursuits and fine arts. The eye of the pupil has never seen a place like it and the ear of intelligence has never been informed that there existed anything to equal it in the world is what Abdur Razaaq the Persian ambassador had to say about Krishnadevarayas time. The Vijayanagara Empire with its capital at Hampi fell a victim to the marauding army of the Deccan Sultan in 1565 A.D. As a consequence of this, Bijapur became the most important city of the region. This city is a land of monuments and perhaps no other city except Delhi has as many monuments as Bijapur. The Bahmani Shahis and the Adilshahis of Bijapur have played a notable part in the history of Karnataka by their contribution to the field of art and architecture and also by their propagation of Islam in the state. Hyder Ali and his valiant son Tipu Sultan are notable figures in the history of the land. They expanded the Mysore kingdom on an unprecedented scale and by their resistance against the British, became personages of world fame. Tipu was a great scholar and lover of literature. His artistic pursuits were also many and he made rich gifts to the Hindu temples. Tipu Sultan Tiger of Karnataka was killed in 1799 A.D., and the Mysore throne was handed over to the Wodeyars. The wh ole of Karnataka came under the control of the British in the beginning of the 19th century. The new state was named as new Mysore and the Maharaja of Mysore was appointed Governor by Independent India. This unified state was renamed as Karnataka on November 1, 1973. 1.2.2 Karnataka on global medical map Karnataka and especially Bangalore is now an acknowledged global medical destination. This is because of referral quality health services supported by qualified and experienced medical professionals, reputed medical research institutions, well connected for travel, conducive climate and cost of treatment being just one tenth that of global hospitals. Between 2005 end and 2006 August, the state has also witnessed a funding of 445 crore from leading corporate hospitals as a part of the brownfield and green field projects. These include a Rs. 200 crore from the Manipal Health Systems, Rs. 140 crore from Wockhardt Group of Hospitals, Rs. 100 crore from One World Hospital and Healing Centre promoted by Maureen Berlin and Rs. 5 crore by HealthCare Global Enterprises Limited (HCG), a leader in oncology care in the private sector in India. Bangalore has been acknowledged as the city with the highest number of multi speciality medical centres which have successfully treated a large number of international patients. These hospitals have proved the clinical competence and clinical delivery systems, In the last 18 months, there has been a major growth in the healthcare sector in the state. From new hospitals to expansions and partnerships, the healthcare sector is on an upward swing both at the government and private levels, stated the health minister. Under the state governments medical tourism project, six ISO 9000 certified district hospitals strategically located at tourist spots in Mandya, Hubli, Chitradurga, Kolar, Belgaum and the Vani Vilas Hospital in Bangalore are now ready to administer treatment during tourist emergencies. One of the main reasons why patients from the west come here is the long waiting period for a surgery in their country. Hence healthcare in Karnataka is on an expansion mode, stated Vishal Bali, vice president, Wockhardt and president, Confederation of Indian Industry (Healthcare). The state attracts foreign tourists in large numbers right through the year and many of the medical facilities can provide treatment on par with international standards. The team of qualified doctors, paramedics and extremely low treatment costs open up a huge business potential arising out of the difference in the cost of treatment. The ISO processes has helped in putting in place standardized protocols for functioning in a ll the departments of the hospitals in terms of processes and work instructions which are drawn from handling patients from reception to discharge. This has allowed the state to offer medical tourism services, stated Bali. Foreign tourists can cash in on the treatment cost factor which is one tenth lesser than in other countries stated Premachand Sagar, vice chairman and CEO, Sagar Hospital. Bangalore is also known for its leading medical facilities in all disease segments which include cardiac, nephrology, oncology, mental health, neuro care, orthopedics, ophthalmology, general medicine. Hospitals here get patients from Bangladesh, Pakistan, Sri Lanka, the Middle East and several African countries. Patients come here even from the UK and the US, informed Dr. Nagendra Swamy, Manipal Hospital. The hospitals identified for the medical tourism project are A.J Hospital and Research Centre, Bhagwan Mahaveer Jain Hospital, Hosmat Hospital , Mallige Medical Centre, Mallya Hospital, Manipal, Sagar Apollo, St.. Johns Medical College Hospital, Bangalore Institute of Oncology, Bangalore Kidney Foundation, National Institute of Mental Health and Neuro Sciences, Rajan Speech and Healing Centre and Shekar Nethrayalaya. Besides, the International Holistic Health Centre (IIHC), headed by Dr. Issac Mathai. IIHC where its health and medical centre referred to as Soukya a recognised exclus ive world class therapeutic facility which adopts the concept of holistic healing combining all systems of medicine and therapies is also a recognised centre by the Union government. Soukya-India is a full-fledged health and medical facility at Whitefield near Bangalore which is thronged by patients from 42 countries. More hospitals, better services and corporate management have all created more jobs in the healthcare sector in Karnataka not just for doctors, nurses and technicians, but managers, administrators and IT-enabled services as well, stated government sources. For 2006-07, MHS will invest around Rs. 200 crore for setting up new hospitals and acquisitions. In Bangalore, a 300-bed facility will come up in 2009 neat the new international airport at Devanahalli in Yelahanka. This will be a one-of-a-kind Quardinary Care Centre focussing on multiple organ transplant among other specialities. We need to deploy a combination of concepts in healthcare management like mergers, acqui sitions and new investments which is an approach to survive in a high-risk business besides chalk strategies to keep ahead. In terms of bed strength, MHS is the highest in the country with a capacity of 5,000, informed R Basil CEO, Manipal Hospital. Wockhardt Hospitals Group has commissioned its state-of-the-art second hospital in Bangalore which is on the Bannerghatta Road. The multi specialty 400-bed facility with cardiac care, brain spine, bone joint and womens health is expected to touch Rs. 140 crore investment once it is completed. The facility will have the highest intensive care unit of 75 beds. For paediatric cardiology it will become the National Referral Centre with a neonatal ICU of 15-bed. Between the two hospitals in Bangalore, the Group will have 520-bed offering. It will have the latest equipment from medical technology majors like Medtronic, GE Healthcare, Philips and Siemens and with the best medical professionals. A 200 bed One World Hospital and Healing Centre promoted by Maureen Berlin at an investment of over Rs. 100 crore on a 10 acre area within the premises of the leading 1,200 bed missionary medical centre, St. Johns National Academy of Sciences campus. Is expected to be commissioned in late 2007. Thi s is a multi super specialty hospital with eight operation theatres, 44 intensive care unit beds. The treatment and therapy is based on the blended medicine concept proven and tried by Dr. Earl Bakken co-founded Medtronic, Inc. and inventor of the first transistorized cardiac pacemaker and founder, the North Hawaiian Hospital in the Big Islands, Hawaii. Hence the hospital will integrate modern medical practices along with yoga, Pranic healing and Reiki besides aqua-therapy proved by the western healthcare specialists HealthCare Global Enterprises Limited (HCG), a leader in oncology care in the private sector in India, has raised Rs. 5 crore in equity from IDFC Private Equity Fund II, a fund managed by IDFC Private Equity. The funds are to develop a nationwide network dedicated to oncology. Under the first phase of the project which entails an investment of Rs. 1.5 crore , 13 new cancer treatment centres at various locations and expansions to Bangalore Institute of Oncology will be m ade. Besides, PET-CT centre and GMP radiopharmaceutical unit and Central reference laboratory and clinical trials management centre will be set-up, stated Dr. Ajai Kumar, Chairman and Promoter of HCG Enterprises. 1.2.3 Dual Purpose Tourism According to an official from the Karnataka Tourism Department, healthcare in Bangalore came into the limelight when Noor Fatima from Pakistan came to Narayana Hrudayalaya in July 2003, and was operated on by Dr Devi Shetty. After that, there was no looking back for the city. Her surgery was a landmark because not only did it help in thawing the hostility between the two neighbouring countries, but also drastically reversed the table in the medical scenario of the city for the better. Hospitals and corporate establishments in the city have realised the potential of this niche market and have accordingly channelised their needs and facilities. Travel agents and hotels are structuring their packages and holiday schemes in accordance with the inflow of foreign patients coming into the city. Corporate bigwigs like Apollo have collaborated with travel agents to come up with SitaCare in a bid to attract more tourists to the city. Its not just the Indians and the NRIs from the neighbouring countries who are streaming into India for medical treatment. Apart from NRIs, foreign patients mainly come in from the Gulf, Europe (mainly UK) surprisingly from South East Asia and the US. They come to Bangalore with a dual strategy in mind to get their medical treatment at one-third the cost and to explore Bangalore. A spokesperson from Thomas Cook India informs, International patients mainly go to Coorg, Mysore, Hampi, Ketur, Belgaum and Bagalkot. In the long run, they add to the foreign exchange of the country. The idea is to kill two birds with one stone. 1.2.4 Bangalore as a destination From being a global outsourcing centre, Bangalore has now become a health giver to the world. Medical tourism as a phenomenon is only eight to ten years old in the city. Compared to metros like Mumbai and Chennai, Bangalore was a late starter in the race. However, considering the entrepreneurial spirit of the city, it has caught up. Today, the city aims to become the numero uno in attracting foreign patients from all across the world. So the question is, why Bangalore? How has it managed to emerge as the hot seat for healthcare both for domestic and for offshore patients? Experts point out myriad reasons. Dr Kishore Murthy, CEO, Hosmat Hospital explains, Bangalore is a well-known brand in the world. It is a knowledge city, has the top hospitals and also offers pleasant weather for patients coming here for treatment. Vishal Bali, CEO, Wockhardt Hospitals echoes, Bangalore has a tremendous impact in the world. Today, people abroad associate India with Bangalore. There is a lot of new h ealth infrastructure. Courtesy the IT industry it is known as the knowledge hub and the hospitals here are internationally acclaimed. According to a spokesperson from Manipal Hospital, The weather of Bangalore is perhaps the biggest factor for foreign patients coming into the city. It suits almost all patients. Patients say that unlike other cities, they are extremely comfortable with the weather here. Vittal Murthy, Secretary, Kannada Culture Information and Tourism throws light on another aspect. Bangalore has always been the hub for healthcare since the British era. Now, it has become the centre of attraction primarily because of the large number of top hospitals in the city and the innumerable medical institutes and colleges. Hence, the number of medical experts and professionals are also increasing by the day. Another source from Karnataka Government Tourism points out, Most of the hospitals in Bangalore have capitalised on the growth of the floating population and the growth o f the income bracket. Additionally, holistic health centres in the city also offer alternate systems of therapy like yoga, Art of Living courses and Ayurvedic therapies. Moreover, most experts from the industry acknowledge the fact that the cost of surgeries like cardiac surgeries, cancer treatment or an orthopaedic surgery is one-third the cost charged in developed countries like the US or the UK. There is also a close nexus between technology and the healthcare sector in Bangalore. There have been cases in our hospital where a patient had not been diagnosed of a particular disease abroad but when they came here their disease was detected, adds the same spokesperson from Manipal. Online appointments with doctors and specialists have made treatment easier and the waiting period for patients has considerably reduced. This in turn has led to an inflow of foreign patients into the city, informs HOSMATs Dr Murthy. The concept of telemedicine is being used on a large scale by hospitals s uch as Manipal and Narayana Hrudayalaya. Resumes of doctors are displayed online so that international patients can choose their doctors. 1.2.5 International Collaboration Internationally-acclaimed doctors and specialists choose to venture out in this city-this is yet another feather in the cap for the city, which till date was only associated with IT. This is not all. Hospitals are having tie ups with internationally acclaimed medical brands. Bali adds, Perhaps the plus point for Wockhardt is its association with Harvard Medical International (HMI), which has a reputation across the world for the quality services rendered to its patients. This in turn has led to more foreign patients coming into our hospital. International patients are very discerning. Before venturing out for treatment to another country, they see to it that they are well informed and not kept in the dark. At the end of the day, patients are always on the look out for quality services, and that is exactly what hospitals in Bangalore are aiming to achieve-to strike the perfect equilibrium between quality and quantity. 1.2.6 Different Strokes for Different Folks Different hospitals adopt different strategies to attract overseas patients. Sagar Apollo Hospital, for instance, has systematically planned its strategies. We have standardized almost all protocols in terms of smoother licensing with international system of integrated health-oriented value additions, holistic health solutions as well as conceptual health-oriented options. For instance, we have started with a system of cashless payment with providers and working on a new concept healthcare focusing not only on the highest international standard healthcare but also on integrated health and hospitality snergy where the services are not just promoted as a package. It is rather positioned as an effort to highlight Bangalore as just not a medical hub but as a place which in technology travellers in taking their healthcare beyond boundaries at their personal standards. Hospitals in Bangalore are now providing the services usually provided by a five-star hotel. Accommodation in hotels, whic h is usually a herculean task for foreign patients, is provided both for the relatives as well as the patients. HOSMAT Hospital even has a building within its campus to accommodate relatives of patients. Airport drops and pick-ups for patients and relatives are all rendered by the hospitality division of the hospital. Most of the hospitals have come up with a travel desk to cater to foreign patients and their relatives. Manipal Hospital, for instance, has an International Patient Care Centre. Additionally, a lot of emphasis is laid on the infrastructure of their hospital. Manipal, for example, has specially designed delux rooms, with posh dà ©cor and offers myriad facilities like pantry service and a wireless Internet connection. HOSMAT Hospital is coming up with two floors in its premises dedicated to international patients. These two floors alone have around 80-100 beds. This is indicative of the growing realisation about promoting medical tourism in the city. 1.2.7 Government Does Its Bit Apparently the Karnataka Government is taking a slew of initiatives in promoting medical tourism in the state. An expert says, Not just the Karnataka Government, but State Governments all across the country are realising the potential and the benefits that can come about through medical tourism. Most experts from the industry have acknowledged the fact that the State Government is supportive and enthusiastic in promoting medical tourism in the city in particular and the State as a whole Commissioner, Department of Tourism, Karnataka, states, We have regular annual meets wherein we talk with the medical industry on a one-to-one basis. We do have plans to form a council of the medical community, but it is in a nascent stage as of now. The Karnataka government right now is working in a meticulous manner. They first conduct research to study key players in the field, which include not just the top hospitals but travel agents and consulates in the city. Their performance over the year is reviewed and simultaneously suggestions are taken. Consulates and travel agents have their networks abroad. So, it is easier for us to have international conferences and contacts, adds Tourism commissioner. Vittal Murthy also gives an interesting bit of information. After the advent of the IT industry in Bangalore, the IT park was opened up. On similar lines, with the advent of the healthcare industry here, we are contemplating opening up a health park. However, the endeavour is still in its ideation stage and will take some time before it takes shape. The Government also holds health tourism expos. A recent one was held at Bahrain. Such meets are a platform for the Government to meet international experts from the medical fraternity and brief them about the competence of Indian healthcare industry. Its not just the State Government which is putting in a lot of interest. The Central Government, realising the potential of this sector, has come up with a national agenda and is holding tourism trade fairs at regular intervals around the year. This has given new impetus to medical tourism. Naik diplomatically adds, We are open to anything that will promote medical tourism. Ultimately, it is the doctors and experts from the medical fraternity who are responsible for the boom of medical tourism in the city. This remark is indeed a testimony to the positive nexus of private healthcare with the government. 1.2.8 Travel Reaps the Fruits It is not just the hospitals which are grabbing the limelight. Travel agents and hotels are cashing in on the situation and are coming up with schemes and packages to attract foreign patients to the city. They are gradually realising that immense benefits can be reaped. The Leela Palaces and Resorts, Bangalore, which purely caters to the corporate class, have now decided to spread its wings according to the change in times and trends. The five-star hotel group has decided to tie up with Manipal Hospital. Nitienaa Arif, Head- PR and Communications, Leela Palaces, Bangalore mentions, We are a business hotel, but understanding the need for medical tourism in the city, we have tied up with Manipal. Everything is in the processing stage. This is not all. The five-star hotel has also joined hands with Globe Health Tours. Air Travel Enterprises (ATE) also offers a whole lot of packages to foreign patients. EM Najeeb, Chairman and Managing Director, ATE, points out, We offer packages for car diac surgery, plastic surgery, dental surgery, Ayurveda and orthopaedic surgeries. In addition to this, ATE has a meticulous plan chalked out. We first identify patients who want medical treatment in this part of the country. We then recommend them to hospitals. Their arrival, departure and accommodation are all handled by us. An important point to remember is that the role of travel agents and hotels is only in its elementary stage. Purnima Castelino-Dabreo, Public Relations Executive, Taj Hotels Resorts and Palaces, Bangalore, states, Medical tourism is in a nascent stage, but we are looking at cultivating it as a potential segment. The opening of the international airport in the city has attracted the attention of not just the tourists but even players in the hotel industry. Altogether, there are 39 projects coming up in the city. This, in the long run can eradicate problems of accommodation in the city. It will take some time before these agents become one of the major forces in promoting healthcare in Bangalore. Vigilance and patience are the keywords-perhaps the means to achieve that end. 1.2.9 Hurdles to Overcome The grass always looks greener on the other side of the fence. But the fact remains that for any upcoming trend, the journey is not smooth sailing. There are always two sides to any story. As of now, the major obstacle that might hamper the growth of this promising trend is the unsystematic infrastructure of the city. Due to increase in the floating population, the roads are congested and traffic snarls have become the order of the day. Hene, commuting in the city has become a major problem. Paucity of hotel accommodation within the city for patients and relatives also poses an obstacle for international patients coming to the city. Despite an increase in service flats and a boom in the real estate business, there is no change in the problem. International flights have commenced in Bangalore, but there is connectivity only to a few countries. Bali points out, The first impression is lasting in the mind of a person visiting Bangalore for the first time. International patients in parti cular get dismayed at the appalling conditions of Bangalores infrastructure in contrast to the plush dà ©cor of the hospitals. Daniel gives another interesting aspect, In case of medical evacuationswhere patients have to be airlifted, at least eight seats have to be reserved. Most of the time, this is not possible. Moreover, a lot of money is required to transport the doctor, the attendants the patients and their relatives. 1.2.10 Possible Solutions Government officials have chalked out a solution to this problem. In another one to one and a half years, the international airport in Bangalore will have connectivity with almost all the major countries across the globe, predicts Murthy. He further adds, We are also coming up with a Metro Rail Project and five townships in the city to ease congestion. There are plans to launch air ambulances and helipads to facilitate easy transport of patients from other countries. And as far as the problem of accommodation is concerned, most hospitals are coming up with accommodation within their premises for patients as well as t

Cultural Purity and the Refute of the Inevitable Momentum :: essays papers

Cultural Purity and the Refute of the Inevitable Momentum In the introduction to â€Å"The Pure Products Go Crazy,† James Clifford offers a poem by William Carlos Williams about a housekeeper of his named Elsie. This girl is of mixed blood, with a divided common ancestry, and no real collective roots to trace. Williams begins to make the observation that this is the direction that the world is moving in, as Clifford puts it—â€Å"an inevitable momentum.† Clifford believes in that, â€Å"in an interconnected world, one is always to varying degrees, ‘inauthentic.’† In making this statement, Clifford is perhaps only partially accurate. In the western hemisphere, where Williams was located, perhaps it can be said directly that the influence of modern society has attributed to the lack of general ancestry, as one culture after another has blended with the next. Perhaps it can be said as well that, as Clifford puts it, â€Å"there seem no distant places left on the planet where the presence of Ã¢â‚¬Ë œmodern’ products, media, and power cannot be felt† (Clifford, 14). The intention of this paper is to contend first that there is essentially such a thing as â€Å"pure† culture, and contrary to Clifford’s belief, that there are â€Å"pure† unblended cultures that remain (while not altogether untouched by foreign influence), natural within themselves. It will be argued as well that the influence of modern society does not necessarily lead to a loss of cultural soundness itself, but rather that a presence of certain cultural practices within the respective cultures has attributed to the lasting â€Å"purity† of certain cultures. In this case, we will be discussing the cultures that exist in Haiti and Bali. To address the first part of my argument, we fist must take in hand what exactly is this â€Å"pure† culture that has been mentioned thus far. Clifford believes that cultures, for the sake of the argument being made can be said to be impure cultures, â€Å"have had to reckon with the forces of ‘progress’ and ‘national’ unification,† and that essentially this has led to â€Å"many traditions, languages, cosmologies, and values [being] lost, some literally murdered† (Clifford, 16). He argues that inevitably, all cultures either will, or have experienced this, and in the end have transformed into an alternate version of themselves. I propose that a â€Å"pure† culture is one that has either not had to deal with such circumstances, or has dealt with outside influences, without altering what is wholly exclusive about itself.

Corporation, Partnership, or Sole Proprietorship?ÂÂ

Corporation, partnership, or sole  proprietorship? Now that you have decided to start your own business, you will have to determine what business structure or form of organization suits your needs. The structure of your business will depend on whether you want to run your business yourself or with a partner or associates. There are four types of business structures: sole proprietorships, partnerships, corporations and cooperatives. On this page: 1. 1. Sole proprietorship 2. 2. Partnerships 3. 3. Corporations 4. 4. Cooperatives 1. Sole proprietorship^TopWith this type of business organization, you would be fully responsible for all debts and obligations related to your business and all profits would be yours alone to keep. As a sole owner of the business, a creditor can make a claim against your personal or business assets to pay off any debt. Advantages: * Easy and inexpensive to form a sole proprietorship (you will only need to register your business name provincially, except in N ewfoundland and Labrador) * Relatively low cost to start your business * Lowest amount of regulatory burden * Direct control of decision making Minimal working capital required to start-up * Tax advantages if your business is not doing well, for example, deducting your losses from your personal income, lower tax bracket when profits are low, and so on * All profits will go to you directly Disadvantages: * Unlimited liability (if you have business debts, personal assets would be used to pay off the debt) * Income would be taxable at your personal rate and, if your business is profitable, this may put you in a higher tax bracket * Lack of continuity for your business, if you need to be absent * Difficulty raising capital on your own 2.Partnerships^Top A partnership would be a good business structure if you want to carry on a business with a partner and you do not wish to incorporate your business. With a partnership, you would combine your financial resources with your partner into th e business. You can establish the terms of your business with your partner and protect yourself in case of a disagreement or dissolution by drawing up a specific business agreement. As a partner, you would share in the profits of your business according to the terms of your agreement. You may also be interested in a limited liability partnership in the business.This means that you would not take part in the control or management of the business, but would be liable for debts to a specified extent only. When establishing a partnership, you should have a partnership agreement drawn up with the assistance of a lawyer, to ensure that: * You are protecting your interests * That you have clearly established the terms of the partnership with regards to issues like profit sharing, dissolving the partnership, and more * That you meet the legal requirements for a limited partnership (if applicable) Advantages: Easy to start-up a partnership * Start-up costs would be shared equally with you an d your partner * Equal share in the management, profits and assets * Tax advantage, if income from the partnership is low or loses money (you and your partner include your share of the partnership in your individual tax return) Disadvantages: * Similar to sole proprietorship, as there is no legal difference between you and your business * Unlimited liability (if you have business debts, personal assets would be used to pay off the debt) * Hard to find a suitable partner Possible development of conflict between you and your partner * You are held financially responsible for business decisions made by your partner (for example, contracts that are broken) 3. Corporations^Top Another business structure is to incorporate your business. This can be done at the federal or provincial level. When you incorporate your business, it is considered to be a legal entity that is separate from the owners and shareholders. As a shareholder of a corporation, you will not be personally liable for the d ebts, obligations or acts of the corporation.When making such decisions, it is always wise to seek legal advice before incorporating. Advantages: * Limited liability * Ownership is transferable * Continuous existence * Separate legal entity * Easier to raise capital * Possible tax advantage as taxes may be lower for an incorporated business Disadvantages: * A corporation is closely regulated * More expensive to incorporate than a partnership or sole proprietorship * Extensive corporate records required, including shareholder and director meetings, and documentation filed annually with the government * Possible conflict between shareholders and directors Possible problem with residency of directors More information: To learn more about incorporation, please consult the following information: * Guide to Federal Incorporation Step by step guidelines to help you incorporate your business and set up an appropriate structure. Provincial or territorial  incorporation Alberta * Corporate Registry To conduct business in Alberta, register your cooperative, corporation, extra-provincial company, non-profit company, society, trade name and/or partnership. Manitoba * Companies Office – Business name registration and provincial ncorporation (Manitoba) How do you register your business, and what do you need to know about provincial incorporation? New Brunswick * Incorporation / Registration of a business Find out about the rules, procedures and fees for registering a provincial corporation in New Brunswick. * Incorporation of non-profit companies (New Brunswick) Find out about the rules, procedures and fees for incorporating a not-for-profit company in New Brunswick. Newfoundland and Labrador * Registry of Companies (Newfoundland and Labrador)In Newfoundland and Labrador, you must register with the Registry of Companies if you decide to incorporate provincially. Northwest Territories * Corporate Registry — Co-operative Associations Are you looking to establis h and incorporate a co-operative within the Northwest Territories? Find out the rules pertaining to starting your venture and what is needed to remain compliant with the law. * Corporate Registry — Business Corporations Are you looking to incorporate your business? Find out how you can register to do business in the Northwest Territories. Corporate Registry — Societies Are you interested in starting a society or non-profit organization? Find out the benefits of incorporation and what you are required to do at the territorial and federal levels. Nova Scotia * Business incorporation and registration (Nova Scotia) Incorporate your business provincially through the Nova Scotia Registry of Joint Stock Companies. Nunavut * Business corporations — Territorial corporations – (Nunavut) Find out how to incorporate as a territorial business in Nunavut. Ontario * Ontario Business IncorporationIncorporate your Ontario business online, in person, or by mail. * Professi onal corporations Find out how you can incorporate your practice in Ontario for specific regulated professions. * Correcting errors on your Ontario corporation documents You can ask to have errors corrected in documents you have filed for your Ontario corporation. * Making changes to your corporate information Find out how to make changes to the information about your Ontario corporation, including its name, address and number of directors. * How to merge Ontario corporationsDo you have two or more active Ontario business corporations that you would like to merge? * Involuntary dissolution of Ontario business corporations Your corporation can be dissolved or cancelled if it has failed to comply with specific rules and regulations. * Reviving your corporation You may be able to revive your Ontario corporation if it was involuntarily dissolved within the past 20 years. * Incorporation (Not-for-Profit Corporations) You can incorporate your not-for-profit organization provincially with the Government of Ontario. Making Changes to Your Ontario Not-for-Profit Corporation Find out how to make changes to the information about your Ontario not-for-profit corporation. * Reviving your Ontario not-for-profit corporation You can restart your previously cancelled Ontario not-for-profit corporation by filing an Application for Revival. Quebec * Incorporate a business (Quebec) Learn the steps to incorporate your business in Quebec, especially the forms to be filled out and the application process. Saskatchewan * Incorporating Your Business in SaskatchewanFind out how to incorporate your business in Saskatchewan, including the fees, the forms required and the turn-around time. * Forming a Non-Profit Corporation in Saskatchewan Find out how to register your non-profit corporation in Saskatchewan, including the fees, the forms required and the turn-around time. 4. Cooperatives^Top The last business structure you could create is a cooperative. With a cooperative, you would have a business that would be owned by an association of members. This is the least common form of business, but can be ppropriate in situations where a group of persons or businesses decide to pool their resources to provide access to common needs, such as the delivery of products or services, the sale of products or services, employment, and more. Advantages: * Owned and controlled by members * Democratic control (one member, one vote) * Limited liability * Profit distribution Disadvantages: * Possible conflict between members * Longer decision-making process * Participation of members needed for success * Extensive record keeping * Less incentive to invest additional capital

Similarities Between Genesis And Numbers - 1119 Words

â€Å"You intended to harm me, but God intended it for good to accomplish what is now being done, the saving of many lives.† (Genesis 50:20). This is a Bible verse found in the first five books of the Bible, otherwise known as the Pentateuch. Each of these five books (Genesis, Exodus, Leviticus, Numbers, and Deuteronomy) all have similarities and differences between each other. More specifically, we can see this between the first and fourth book. Genesis and Numbers have both similarities and differences in not only the obvious discussions but also in their themes and purposes. One of the first similarities found between the two books is the act of blessing and curses. In Genesis 12:3 we read this: â€Å"I will bless those who bless you, and†¦show more content†¦The last similarity that was found between the two was the mention and faithfulness of God with His covenant between Him and Abraham. In Genesis 15, the covenant between Abraham and God is presented and made. This is seen throughout the rest of the Pentateuch. Specifically, in Numbers we see multiple times the people fail to obey God and face the consequences, but God always remained faithful. With these three similarities in mind, however, there is a fair share of differences by their side. One of the first and more prominent or obvious differences between Genesis and Numbers is the overall stories that are told. In Genesis, we get the story of creation, the fall, and going forth stories of the people God worked with; such as Noah or Abraham. In Numbers, however, we get the census and the rebellion and wilderness. These aren’t only representations of the differences between the overall stories, but also the undergoing themes. Each book has the underlining themes, all different and unique, even if categorized under a certain ‘section’ of the Bible. The themes of Genesis are beginnings, disobedience, sin, promises, obedience, prosperity, and Israel. In Genesis 1, we see the first theme. Then with the fall of man, the next two are shown. Promises are then made, for example God promises to Noah that he will never flood the whole earth again. We also see promises in the covenants made, which leads onto the obedience and prosperity thatShow MoreRelatedThe Book of Genesis vs. the Epic of Gilgamesh1029 Words   |  5 PagesTwo Different Books with Similar Stories The Book of Genesis and The Epic of Gilgamesh have many clear similarities. One major, noticeable similarity is that in both stories, there are flood legends. There is the legend of Noah and the Ark in The Book of Genesis and the story of Utnapishtim in The Epic of Gilgamesh. In both stories, a higher power wants to wipe out the human race and decides to save one person who is then assigned to build an ark to hold himself, his family, and one of each animalRead MoreGENESIS AND ANCIENT MYTHS OF THE NEAR EAST930 Words   |  4 PagesWhen one approaches the biblical text, it is important to explore the cultural context in which the text occurs. With regard to the Book of Genesis, it is important to examine the writing with other contemporary works of similar geography and topics. The people of ancient Mesopotamia, where the oldest civilizations originated, produced a number of stories of creation and natural occurrences. It is important to note that many of the stories of the Sumerian s, Akkadians and Hebrews began as oral traditionsRead MoreEnuma Elish Vs Genesis1352 Words   |  6 PagesLyons 21 September 2017 There are multiple debates and arguments concerning the creation story of both mankind and the universe from the Bible and the Babylonian creation poem the Enuma Elish. There is a debate on whether the two accounts have similarities or one of them borrowed its content from the other. Enuma Elish is a great Assyrian poem which narrates the story of the creation of the world and man. The poem contains what the old empires believed concerning the creation of the universe. ThisRead MoreGenesis vs. the Popol Vuh806 Words   |  4 Pagesï » ¿Genesis vs. the Popol Vuh Throughout history, a number of different cultures have developed their own versions to how the world began. 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The first creation story is found in Genesis 1-2:4 and it explainsRead MoreThe World Was Made By Native American Origins And The Sky Tree1557 Words   |  7 Pagesthe United States or the Iroquois Constitution. They did share similarities such as in each spiritual story Earth started as water but differences such as religion based constitutions versus non religion based constitutions also existed. Many stories have been created explaining who actually created the Earth. Popular creation stories are â€Å"How the World was Made† and â€Å"The Sky Tree† with Native American origins and the story of â€Å"Genesis† from European origins. These creation stories do have comparisonsRead MoreCreation Myths: Genesis vs. The Koran1354 Words   |  5 Pagesï » ¿Creation myths: Genesis versus the Koran Creation myths can be profoundly revelatory of the values of the cultures that produce them. They reflect how the culture views its place in the universe, the relations between the sexes, and above all the relationship of human beings to God. The creation myths of the Judeo-Christian tradition and Islam share many similarities. Both put human beings squarely in the center of Gods creation in terms of His importance, and give Man dominance over plants andRead MoreGilgamesh Flood Comparison Essay823 Words   |  4 PagesBoth the story of â€Å"Noah and the Flood† in the book of Genesis in The Hebrew Bible and the flood story in The Epic of Gilgamesh detail a grand flood in which a man saved life from extinction by building an ark, earning fame and immortality in some form. The theme of completing this grand task for a moral purpose holds true to both stories, but the depiction and actions of the divine and mortal characters in the stories contain different similarities and diff erences. The theme of virtue and its importanceRead More Flood in Epic of Gilgamish and Book of Genesis of the Holy Bible873 Words   |  4 PagesThe story of the great flood is probably the most popular story that has survived for thousands of years and is still being retold today.   It is most commonly related within the context of Judeo-Christian tradition.   In the Holy Bible, the book of Genesis uses the flood as a symbol of Gods wrath as well as His hope that the human race can maintain peace and achieve everlasting salvation.   The tale of Noahs Ark begins with Gods expression of dismay as to the degenerate state of the human race atRead MoreComparative Essay1281 Words   |  6 Pagesnebular hypothesis† (Numbers. 1977). This viewpoint suggests â€Å"About 4.6 billion years ago our solar system formed from a cloud of gas and dust which slowly contracted under the mutual gravity of all of its particles† (The Solar Nebula. N.d.). It is believed that this cloud of g as and dust was spinning at an accelerated rate and at the center of this flattened spinning ring particles formed to create the sun. â€Å"The planets were created from the atmosphere of the sun† (Numbers. 1977). With the sun