Home to Sandton, Africa’s richest square mile, Gauteng is gearing up for more action as a world-class hub for business tourism. And Nonnie Kubeka is driving it.

Gauteng, one of South Africa’s nine provinces, is a sought-after address for global brands and some of the continent’s biggest businesses. As Head: Gauteng Conventions &amp; Events Bureau, Nonnie Kubeka, who has 21 years of experience in marketing across several sectors, has the tough task of developing business tourism in the province through lifestyle events and the MICE (Meetings, Incentives, Conferences, Exhibitions) sector, which makes a sizeable contribution to Gauteng’s economy.
Describe the landscape of Gauteng and its offerings? 
We don’t have the sea or the mountains or iconic leisure [sites] where people come for holiday. We are a business destination, therefore business-related events are 70% of Gauteng’s push. Social beneficiation, social cohesion and job creation are a bigger part of the events. 
We have more than 400 venues that can accommodate the MICE space in Gauteng. In that, we have top heritage sites people are interested in. We have the Constitution Hill and Apartheid Museum, but when we bring business tourism to the destination, we don’t just bring business tourism according to market segments, but in terms of sectors. We are big on research that attracts people to come do business here.
How does Gauteng differ from the rest of Africa? 
We are the economic powerhouse and that is why when we do business tourism, it is for the benefit of the economy. For us to maintain our status in business tourism, we don’t grow the market, we draw the sectors so that everybody from all over the world can come and contribute to our economy.
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As the richest square mile in Africa, what does Sandton attract? 
We have got the Sandton Convention Centre that in the whole of Gauteng can accommodate more than 30,000 people at a time and we utilize that particular center to attract more business into Sandton and the nice thing about it is that it’s a precinct. People want to walk from the center itself to the hotels and the bed nights we get out of Sandton are more than 15,000 at a time, so it becomes much easier to host a big conference. The combination of shopping, convention centers, hotels and dining is a unique offering.
Are there any trends you have picked up in the last year? 
We have had disruptors in the digital space where people join conferences through web-streaming. They have not succeeded on a bigger scale. Conferences are about networking. Face-to-face gatherings are important. We are gathering people in business – that is where they share deals and ideas. Instead of going to golf courses for networking, they would rather go to a conference where they will gather knowledge and meet the relevant people they can leverage on. Business tourism will not be affected by the digital space.
What are the objectives of the Gauteng Conventions &amp; Events Bureau? 
Township revitalization, meaning giving business to the township. The inclusive economy includes small businesses and women-owned businesses. Business tourism is about inclusive economy and transformation of disadvantaged people. Women take leadership in organizing professional international conferences. Business tourism is not as big as leisure tourism in our country; it has just started so we are using it to revitalize what women can do within that particular space.
How does South Africa benefit from medical tourism? 
We are like India and the UK, and especially in South Africa, you get a lot of specialists. We package it in a way that friends and family can also come and visit through the process. Most people who come for medical tourism stay on in the country or the province for three months or more. Sometimes, they take the whole bed-and-breakfast [options] with their families especially when [they are] next to the hospital. We have an example in Tembisa where a guesthouse [hosts] patients and their families. We have packages for them to go to the botanical gardens to de-stress for instance. This tourism also includes the doctor conferences.

LION4873

All Roads To The Economic Powerhouse

If you have got hard currency, you can afford to come to Africa to look good or feel better for less. Fourteen million people, spending between $3,800 and $6,000 per visit, are travelling the world looking for medical treatment with a beach holiday.
It&#8217;s a market estimated to be worth between $45 billion and $72 billion, and South Africa is sitting at the top table, according to Patients Beyond Borders (PBB), a US-based firm that has given medical tourism advice for a decade. The country has the advantage of good hospitals, English speaking doctors and breathtaking landscapes.
They call it medical tourism and it&#8217;s growing among the wealthy and not-so-wealthy. Even those who don&#8217;t have so much money are heading to hospitals in countries like South Africa where their hard currency makes it cheaper and also helps them escape hospital waiting lists in their own land.
Even in these hard times, PBB expects this multi-billion-dollar industry to increase by up to 25% per year over the next 10 years.
One entrepreneur who is banking on this is Cape Town-based Faith Cartwright, who founded Medical Tourism SA three-and-a-half years ago. Cartwright, a hospitality and guesthouse owner, noticed many of her guests were in South Africa for medical procedures.
&#8220;Who wouldn&#8217;t pay if they knew that they had to go through two years of pain waiting for a knee operation? Imagine you have decided you want children and you are told you can&#8217;t go through fertility treatment because you are 39 and cannot get an appointment,&#8221; says Cartwright.
&#8220;I thought ‘what if medical tourists like these could be given access to private medical care, have their accommodation and travel needs taken care of, and plan safaris and other tourist excursions, all through the same service provider?’&#8221;
Sitting by the harbor at the V&amp;A Waterfront, a popular tourist destination in Cape Town, it is easy to see why many decide to find a hospital bed here. Above us are the stunning peaks of Table Mountain and just down the road you can book a tour to see a great white shark, helicopter rides or pirate cruises. All this to the sound of seals, seagulls and many languages, as wealthy tourists from around the world stroll by with their bulging shopping bags.
<div id="attachment_33732" style="width: 510px" class="wp-caption aligncenter"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-33732" class=" wp-image-33732" src="https://www.forbesafrica.com/wp-content/uploads/2017/10/FaithCartwright-Medical-Tourism-e1506930410225-300x165.jpg" alt="" width="500" height="275" />Faith Cartwright, the founder of Medical Tourism SA. (Photo by Jay Caboz)</div>
Cartwright has as many customers as there are tourists on this street on this morning.
&#8220;It&#8217;s the reason why I&#8217;m so busy. Just this morning I was facilitating 65 women from Botswana to meet a doctor in Johannesburg at a fertility clinic. Sometimes you do get a good feeling about the work. But it can also be hard work and frustrating. It is rewarding when you know you are helping someone who has been struggling for years to get pregnant,&#8221; says Cartwright.
&#8220;Fertility is a big thing here. We get a lot of it from all over the world, but in Africa, there is a particular stigma that if you can&#8217;t get pregnant, you can be kicked out of your community. I also see a lot of requests for bone marrow transplants and women looking to slim themselves with gastric bypass surgery.&#8221;
It&#8217;s the start of the high tourist season in Cape Town and Cartwright is on call 24/7. For this 48-year-old mother, her time needs to be managed down to the minute.
&#8220;Thanks to the weakness of the rand, hundreds of medical procedures are available at a comparatively low cost, with most surgeries coming in at roughly a third of the price for an equivalent procedure in the UK. Affordable breast augmentation, for example, costs around $8,000 in the UK, but only about $3,600 in South Africa. More minor treatments, such as botox injections, can be even cheaper – $310 in the UK versus $70 in South Africa,&#8221; says Cartwright.
<a href="http://www.forbesafrica.com/cover-story/2017/10/02/suffering-waiting-wrong-side-divide/" target="_blank" rel="noopener">READ MORE: Suffering And Waiting On the Wrong Side Of The Divide</a>
It is not just the rich and famous that makes these journeys either. Cartwright has seen hundreds of clients from all walks of life.
&#8220;Our clients range from the ones who can afford to be pampered to those who can barely afford it. We&#8217;ve had people staying in Cape Town eating [maize meal] for 21 days straight, because that is all they could afford over their IVF (in vitro fertilization) treatment; they were so desperate to have a child,&#8221; she says.
&#8220;I had a woman come from Australia who failed 17 rounds of IVF and South Africa was her last option. She now has a daughter and came back to South Africa to try for a second.&#8221;
Using US prices as a reference, across a variety of specialties, PBB estimates South Africa to be 25% to 40% cheaper.
“Most nations in Africa continue to struggle to build out their healthcare infrastructure and are thus not yet suitable for the contemporary international medical traveler. South Africa (particularly Cape Town and Johannesburg), are exceptions, offering an array of medical care for regional and long-haul travelers, including cosmetic surgery, cardiology, dental care, joint and spine work, and ophthalmology,” says Josef Woodman, CEO of PBB.
It is not all rainbows and butterflies. Business isn’t helped by the lack of efficiency when crossing borders.
Cartwright tells of a US couple, a husband (the sperm donor) and wife, looking to come to South Africa for IVF treatment. It meant both needed to apply for South African visas. There was an error in the husband&#8217;s application, and, because of new visa regulations that required applications in person at a South African embassy, it meant he had to fly to the South Africa embassy twice. By the time they entered their application correctly he missed their window. The wife had to come to South Africa alone, and they had to find another sperm donor.
&#8220;As she was walking off the plane I asked her where her husband was. It was only then that she told me their story. Not only was it a huge waste of money for two flights to the South African embassy, but they lost out on their flight tickets and reservations in South Africa, which need to be paid for in advance before applying for your visa,&#8221; says Cartwright.
&#8220;This is where the medical tourism industry can help, resolving issues when you hit a brick wall. I would have been able to help them both get here. The process of IVF is incredibly stressful without worrying about the technicalities of international travel,&#8221; says Cartwright.
Another challenge is putting Africa on the map. Many patients know little about the country they are visiting and often make the mistake of booking doctors in Johannesburg with their accommodation in Cape Town, 1,500 kilometers away.
&#8220;Abroad, people still think we&#8217;ve got lions and elephants in our backyards. It&#8217;s very seldom I hear a good story about South Africa. Most of the things people know are about our crime, our president and that we have no water in Cape Town.&#8221;
&#8220;We need to tell the good story. South Africa is an amazing place. It&#8217;s got first-class treatment. What really stands out is that we are English speaking. It&#8217;s a calling point and a huge thing. Imagine when you go to a country like Thailand and you can&#8217;t read the road signs. Now imagine trying to be a patient there who needs medical treatment.&#8221;
While the costs for those traveling into Africa may seem affordable, it is a different story for those living in it. In South Africa&#8217;s case, the recently tabled White Paper on National Health Insurance (NHI) wants to give medical aid to all South Africans to make healthcare accessible to the poor. Its implementation has been hotly contested.
<a href="http://www.forbesafrica.com/cover-story/2017/10/02/healthcare-got-available-everybody/" target="_blank" rel="noopener">READ MORE: &#8216;Healthcare Has Got To Be Available To Everybody&#8217; </a>
Many fear this will be the tipping point that brings the country&#8217;s health system to its knees and results in qualified doctors emigrating. The uncertainty surrounding the impact of the NHI on the private sector, and other compounding issues like an overburdened public healthcare system, could be why medical tourists choose not to come to South Africa.
&#8220;There are a huge amount of doctors in South Africa. The NHI only affects South Africans and not my clientele. In fact, I think it will encourage more doctors to work in the [medical tourism] industry.&#8221;
&#8220;The healthcare industry needs to look at more innovative ways of looking after its patients. I get calls from lots of South Africans trying to get help [with surgeries]; most don&#8217;t even know where to find a good doctor. Most South Africans can&#8217;t afford to go overseas and pay for a surgery. My uncle died of a brain tumor while he was waiting for a date to operate,&#8221; says Cartwright.
Ultimately, the success of medical tourism will depend on exchange rates, prices, quality of medical care and hospitality services on offer to tourists. Even Cartwright is keeping an eye out for opportunities elsewhere.
&#8220;I&#8217;ve been thinking seriously of emigrating to the United Kingdom and setting up base there. My plan would be to fly down to South Africa once a month and check up on the base here. Working from South Africa is too far away. Moving to the UK is quite a good move for the business. It’s central, with access to clients from Europe and America. It&#8217;s an hour&#8217;s flight to many of the medical conventions and conferences, which are great places to network. It&#8217;s also a good idea because there has been a rise in wellness travel, doing yoga retreats and all that. It’s taking off in the UK and Europe and I&#8217;d like to get in on this wave. South Africa would be an awesome destination for wellness tourism.&#8221;
Cartwright remains optimistic. She believes that medical tourism can offer a window of opportunity for doctors who still want to work in the private sector.
&#8220;I&#8217;ve found the Tanzanians to be the most sincere and humble. I&#8217;ve found that Nigerians, if you look after them, they will become part of your family for life. The people come and go. I try not to remember their names because I am so afraid of breaking their confidentially. But when they leave, we become a huge part of their lives.&#8221;
For Cartwright there is no time to stop, relax and watch the waves. She leaves the Waterfront with a phone to her ear, as usual, talking to her next medical tourist with money to spend.
<h3>Golden Oldies</h3>
A 2014 study by VISA  found the United States to be the largest hub for medical tourism. Thailand, Singapore, Germany, Korea, and Spain are quickly catching up.
Their data showed by 2025, travelers over the age of 65 will more than double their international travel to 180 million trips, accounting for one in eight international trips globally. Older travelers can afford bigger trips and are more focused on comfort and health than saving money.
The ageing traveler will transform travel and one area that is already growing in response is the medical tourism industry as more travelers opt to combine medical treatments with vacation.
&#8220;We believe that medical tourism is primed for accelerated growth as more of these older travelers seek new treatments, as well as lower-cost or higher-quality care not available in their home country,&#8221; the report concludes. &#8211; SOURCE: Mapping the Future of Global Travel and Tourism (2014) VISA

Surgery Safaris – The Facelift Africa Needs

There is an African idiom that if a man does not eat at home, he may never give his wife enough money to cook a good pot of soup. This might just be true when applied to politicians on the continent seeking medical help anywhere but home.
Africa’s public health systems are in a depressing condition. Preventable diseases <a href="http://www.un.org/africarenewal/magazine/special-edition-women-2012/investing-health-africa%E2%80%99s-mothers" target="_blank" rel="noopener">still kill a large number of women and children</a>, people <a href="https://www.aho.afro.who.int/en/ahm/issue/14/editorial/health-systems-and-primary-health-care-african-region" target="_blank" rel="noopener">travel long distances</a> to receive healthcare, and across the continent <a href="https://www.iol.co.za/news/south-africa/western-cape/where-patients-sleep-on-the-floor-1268243" target="_blank" rel="noopener">patients sleep on hospital floors</a>. On top of this, Africa’s health professionals emigrate in droves to search for <a href="http://www.un.org/africarenewal/magazine/december-2016-march-2017/diagnosing-africa%E2%80%99s-medical-brain-drain" target="_blank" rel="noopener">greener pastures</a>.
It’s therefore not surprising that people from Africa travel abroad – mainly to Europe, North America and Asia – for their medical needs. In 2016, Africans spent over <a href="http://uncova.com/african-leaders-and-medical-tourism" target="_blank" rel="noopener">$6 billion</a> on outbound treatment. Nigeria is a major contributor. Its citizens spend over <a href="https://www.imtj.com/news/nigeria-spends-1-billion-outbound-medical-tourism/" target="_blank" rel="noopener">$1 billion annually</a> on what’s become known as <a href="https://www.cdc.gov/features/medicaltourism/index.html" target="_blank" rel="noopener">medical tourism</a>.
It can be argued that private citizens opting to seek medical help in other countries don’t owe the public any explanation, because it’s their own affair. But medical tourism among Africa’s political elite is a completely different kettle of fish and a big cause for concern, because they are responsible for the development of proper health care for the citizens of their countries.
<a href="http://www.forbesafrica.com/current-affairs/2017/06/09/pain-women-children-lost-everything/" target="_blank" rel="noopener">The Pain Of The Women And Children Who Have Lost Everything</a>
<h2>The shame</h2>
It’s well documented that politicians from across the continent go abroad for <a href="http://uncova.com/african-leaders-and-medical-tourism" target="_blank" rel="noopener">medical treatment</a>. The reasons for exercising this choice are obvious: <a href="http://www.bbc.co.uk/news/world-africa-40685040" target="_blank" rel="noopener">they lack confidence</a> in the health systems they oversee, and they can <a href="https://www.voanews.com/a/nigerian-health-care/3726922.html" target="_blank" rel="noopener">afford</a> the trips given that the expenses are paid for by taxpayers.
The result is that they have little motivation <a href="http://www.bbc.co.uk/news/world-africa-40685040" target="_blank" rel="noopener">to change the status quo</a>. Medical tourism by African leaders and politicians could therefore be one of the salient but overlooked causes of Africa’s poor health systems and infrastructure.
Since the beginning of 2017, President Muhammadu Buhari of Nigeria has spent more time in the UK for <a href="https://citifmonline.com/2017/08/14/buhari-feels-ready-to-go-home-after-treatment-in-uk/" target="_blank" rel="noopener">medical treatment</a> than he has in his own country. By seeking treatment abroad, Buhari broke one of his own electoral promises – to <a href="http://www.bbc.co.uk/news/business-36468154" target="_blank" rel="noopener">end medical tourism</a>.
Buhari is just one of many heads of state to find help elsewhere. Patrice Talon, the President of the Republic of Benin, underwent <a href="http://www.africanews.com/2017/06/19/benin-president-patrice-talon-underwent-surgery-while-in-paris/" target="_blank" rel="noopener">surgery in France</a> a few months ago.
The cases of Buhari and Talon, however, aren’t as bad as other presidents who have had decades to fix their countries’ healthcare systems, but haven’t. Robert Mugabe, President of Zimbabwe for the past 37 years, frequently seeks <a href="http://www.reuters.com/article/us-zimbabwe-mugabe-idUSKBN18711B" target="_blank" rel="noopener">eye-related treatment</a> 8,240 kilometres away in Singapore. Jose Eduardo dos Santos who has just stepped down as Angola’s leader after 38 years, also <a href="https://www.reuters.com/article/us-angola-president-spain-idUSKBN19O1SK" target="_blank" rel="noopener">travels to Spain for treatment</a>
In the recent past, some African leaders died abroad while seeking treatment. Zambia’s <a href="https://www.theguardian.com/world/2008/aug/19/zambia" target="_blank" rel="noopener">Levy Mwanawasa</a> died in France while the country’s <a href="http://www.bbc.co.uk/news/world-africa-29813612" target="_blank" rel="noopener">Michael Sata</a> passed away in the UK. Then there was Guinea Bissau’s <a href="http://www.bbc.co.uk/news/world-africa-16473457" target="_blank" rel="noopener">Malam Bacai Sanha</a> who died in France, Ethiopia’s Meles Zenawi who <a href="http://www.bbc.co.uk/news/world-africa-19328356" target="_blank" rel="noopener">died in Belgium</a>, and Gabon’s Omar Bongo who <a href="https://www.theguardian.com/world/2009/jun/08/gabon-omar-bongo-death-reports" target="_blank" rel="noopener">died in Spain</a>.
A few fortunate ones made it home, but died shortly afterwards. They include Nigeria’s Musa Yar’Adua who died in Abuja after returning from <a href="http://www.telegraph.co.uk/news/worldnews/africaandindianocean/nigeria/7683904/Nigerian-president-Umaru-YarAdua-dies-after-months-of-illness.html" target="_blank" rel="noopener">treatment in Saudi Arabia</a>, and Ghana’s Atta Mills who died in Accra after returning from a <a href="http://www.bbc.co.uk/news/world-africa-18972107" target="_blank" rel="noopener">brief medical spell in the US</a>.
The picture painted above is shameful. As long as Africa’s leaders keep going abroad for medical reasons, the ambition for better health infrastructure will remain an <a href="http://www.bbc.co.uk/news/world-africa-40685040" target="_blank" rel="noopener">illusion</a>.
<a href="http://www.forbesafrica.com/life/2015/10/01/health-hospitality/" target="_blank" rel="noopener">Health Hospitality</a>
<h2>Costs and risks</h2>
Countries pay a heavy cost for this behaviour. It’s estimated that in Uganda, the funds spent to treat top government officials abroad every year could <a href="http://www.monitor.co.ug/News/National/688334-1394344-9hmafbz/index.html" target="_blank" rel="noopener">build 10 hospitals</a>.
Not only do the leaders travel with elaborate entourages, but they also travel in expensive chartered or presidential jets. For example, the <a href="http://sunnewsonline.com/nigeria-not-paying-4000-daily-for-presidential-jet-in-london-presidency/" target="_blank" rel="noopener">cost of parking</a> Buhari’s plane during his three month spell in London is estimated at £360,000. That’s equivalent to about 0.07% of Nigeria’s <a href="http://www.financialnigeria.com/nigeria-s-health-budget-grossly-inadequate-feature-121.html" target="_blank" rel="noopener">N304 billion budget allocation for health</a> this year. And there would have been many other heavier costs incurred during his stay.
The failure of leaders to improve health care and stem <a href="http://www.bbc.co.uk/news/health-11327505" target="_blank" rel="noopener">brain drain</a> also carries a heavy price. A 2011 report estimated that nine African countries – including Nigeria and Kenya &#8211; had lost <a href="http://www.bmj.com/content/343/bmj.d7031" target="_blank" rel="noopener">$2.17 billion</a> of their investment in healthcare professionals. This figure might be higher now.
On top of this, African hospitals that were previously world class have been reduced to symbolic edifices due to political negligence. For example, Lagos University Teaching Hospital was once deemed to be one of the <a href="https://guardian.ng/opinion/african-leaders-and-medical-tourism/" target="_blank" rel="noopener">best on the continent</a>. Recently, it was criticised for <a href="http://saharareporters.com/2017/04/11/jaf-condemns-lagos-university-teaching-hospital-decadence" target="_blank" rel="noopener">decadence</a>. Not far away, Ghana’s flagship national health insurance scheme is <a href="http://www.myjoyonline.com/news/2017/April-13th/ghanas-health-insurance-on-the-brink-over-12-billion-debt.php" target="_blank" rel="noopener">ailing</a>.
Essentially, when people charged with responsibility feel they have no need for public health systems because they can afford private healthcare at home or abroad, ordinary citizens bear the brunt.
<h2>The way forward</h2>
The effective health systems in western and Asian countries that are being patronised by African leaders only exist because they were developed, and are consistently maintained, through political commitment and visionary leadership, qualities that are clearly <a href="https://theconversation.com/african-citizens-have-good-reasons-to-be-fed-up-with-their-politicians-81053" target="_blank" rel="noopener">lacking in Africa</a>.
To bring change, African citizens must start condemning political medical tourism. They must also push for regulations to curb the shameful practice. Taxpayer funded medical trips should be banned and criteria set detailing what sicknesses that can be covered by the public purse. Though a <a href="http://nigeriahealthwatch.com/wp-content/uploads/bsk-pdf-manager/1189__2014_Official-Gazette-of-the-National-Health-Act-,_FGN_1272.pdf" target="_blank" rel="noopener">law</a> to this effect exists in Nigeria, it appears to be <a href="https://www.imtj.com/news/missing-healthcare-law-nigeria/" target="_blank" rel="noopener">ineffective</a>. It must, and should work.
Essentially, if the leaders do not experience the poor state of healthcare, they might never strive for any positive changes to it. &#8211; Written by <a href="https://theconversation.com/profiles/tahiru-azaaviele-liedong-338453" target="_blank" rel="author noopener">Tahiru Azaaviele Liedong</a>, Assistant Professor of Strategy, University of Bath
Originally published by <a href="https://theconversation.com/africa" target="_blank" rel="noopener">The Conversation</a>
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Tag: medical tourism

FORBES AFRICA SOCIAL MEDIA

All Roads To The Economic Powerhouse

Surgery Safaris – The Facelift Africa Needs

African politicians seeking medical help abroad is shameful