KABUL, 29 June 2009 (IRIN) - The lack of quality health services at home is prompting thousands of Afghan patients to travel to India for medical treatment despite the high costs.

The Indian embassy in Kabul said it had issued 5,224 medical visas in 2008 - up from 4,658 in 2007 and 3,844 in 2006.

The real number of Afghans going to India for treatment is higher than these figures suggest, as visas are also issued by four Indian consulates dotted around the country, and some who travel to India as tourists seek medical treatment on arrival.

In total 21,420 visas (tourist, business and diplomatic) were issued to Afghan citizens by the embassy in 2008.

"In respect of individuals going for medical treatment on a private, self-financed basis, the embassy has no specific role. All arrangements are made directly by them," Akhilesh Mishra, deputy chief of the Indian mission in Kabul, told IRIN.

Medical tourism is one of India's most successful industries, attracts tens of thousands of people annually from around the world and generates revenues of up to US$2 billion.

Unlike the stringent visa procedures for many other countries, applications for Indian visas are relatively straightforward for Afghans (no requirement for financial statements or medical insurance), and in most cases the whole process takes 5-8 working days.

However, some travellers complain about the strict security procedures for Afghan citizens in India: "We spent one full day in long queues to register our entry and another day for our departure," said a man who travelled to Delhi in May.

Muddling through

Travel to and treatment in India requires at least several hundred dollars and it is therefore believed that only well-off Afghans can afford such trips.

However, some are forced to borrow from relatives or muddle through as best they can.

"I took my mother to India for heart surgery and it cost me over US$4,000, including the airfare, accommodation and medical fee," said Hasmatullah, a private guard who earns $150 a month.

Another man said he borrowed money to pay for his son's treatment at a hospital in New Delhi.

Health care in Afghanistan remains poor: "The diagnosis and treatment of some diseases require advanced medical technology and professional medical staff which are currently not available here," Saeed Kabir Amiri from the Ministry of Public Health, told IRIN in Kabul.

"For instance we don't do CT scans [using computerised tomography scanners], MRI [Magnetic Resonance Imaging] scans and there are no dialysis facilities at hospitals in the country," said Amiri, adding that there was little capacity to treat things like heart disease, cancer or impotence.

Whilst for many Westerners Indian hospitals might offer a cheaper alternative, for many Afghans India is their only option for reliable medical treatment.

"I have seen numerous doctors here and taken all kinds of medicines but have not felt any improvement. Now I am going to India and I am sure I'll be healed there," Najiba, who has an orthopaedic disorder, told IRIN outside the Indian embassy in Kabul.

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