Thailand has become a honeypot for alternative cures, therapies and promises of longevity – and for those cashing in on the trend. For thousands of years people have travelled the world looking for the elixir of lasting life and health. The Ancient Greeks journeyed to the island of Epidaurus, sanctuary of the healing god Asklepios. In Roman and medieval times, people flocked to the mineral springs of spa towns such Bath in England, Aix-les-Bains in France and Baden-Baden in Germany. Even today pilgrims travel to Lourdes in search of miracle cures and a life free from pain.
For many who visit or live in Thailand today, medical tourism conjures an altogether different image: shiny new hospitals with overseas-trained physicians performing modern operations on people from all over the world. Yet the ancient practices of “taking the waters” at spas, using herbal medicines and other traditional remedies, known as alternative or holistic medicine, have also carved out a vital role in Thailand’s healthcare picture. Although challenged by global recession, that role continues to grow, blurring the line between what’s considered mainstream and alternative healthcare. By doing so, it promises a healthy diagnosis for both sides of the health equation.
“People who come to Thailand for health, wellness and clinical reasons are all feeding at the same pool,” says Ruben Toral, chief executive officer of Mednet Asia and a consultant to healthcare providers in Asia, the Americas and the Middle East. “It’s going to reflect positively on related services.”
Alternative healthcare practitioners tend to operate out of smaller clinics that offer a diverse range of services and treatments. In Thailand, for example, there’s a provider for every niche – from spas to the Japanese tradition of medical massage known as reiki; from yoga to colonic hydrotherapy. The list is seemingly endless and includes fasting and detoxification, chiropracty, integrated weight management clinics, acupuncture and traditional Chinese medicine.
You name it, there’s a nip and tuck holistic speciality lurking round almost every corner. Increasingly, one or more of these treatments are combined by a single clinic or spa so that the customer is buying into the widest choice of “cures” possible.
While figures are fleeting for alternative medicine as a whole, the spa industry has been recording consistent growth, at least in terms of the number of clinics opened. In 2008, there were 695 spas in Thailand, according to Intelligent Spas, an independent research body based in the UK. By the end of 2009, there were more than 740. The ministry of public health reported that there were 1,254 spa and massage businesses combined, of which 276 were located in Bangkok.
The surge will likely be even more dramatic this year, thanks to recent legislation exempting registered spas from paying excise taxes. Intelligent Spas values the industry in Thailand at $349m a year compared to mainstream health’s estimated $1 billion.
Since 2000, according to Andrew Jacka, president of the Thai Spa Association, there has been a “significant growth in the number of spas as they became synonymous with Thai hospitality and a mainstay of Thai tourism”. Like many other health industries its fortunes rise – and fall – with tourism, which last year had wiped 20% off its value.
The boom hasn’t become a bust just yet, but spa owners are still waiting for an upturn in their fortunes while trimming back staff and shortening opening hours along the way. Political instability has done its damage to the industry, as have the risks associated with travelling during the H1N1 menace.
“The economic crisis causes an increase in stress, which leads to more people coming to spas to find relief. We have seen more and more Thai people coming in,” says Dr Pakpilai Thavisin, president of the S Medical Spa in downtown Bangkok.
Where once foreigners and Thais represented an even split in her business, Thavisin says locals now represent between 70% and 80% of her clientele. Those clients include workers and management from Thai Airways, Kassikorn Bank, SCIB Bank and Mercedes-Benz who see stress relief as part of their corporate package – an attitude that reflects how much perceptions of naturopathy have changed since the early 1990s.
In 1993, when the Mandarin Oriental hotel opened what’s considered the country’s first urban spa, the operation didn’t enjoy the best of reputations. But others, such as the Banyan Tree and Hua Hin’s Chivasom, quickly followed suit. Looking into the future, the Oriental’s Dr Prasanna Bhatt says she expects annual growth between 20 and 30%.
“Naturopathic and complementary treatments, by themselves or in conjunction with conventional medicine, can be used to treat diseases, promote health and aid convalescence – not just physically but also mentally and spiritually. This is the need of the hour for those with chronic ailments such as high blood pressure, diabetes, irritable bowel syndrome and other stress conditions.”
Alternative healthcare practitioners tend to operate out of smaller clinics that offer a diverse range of services and treatments. The S Medical Spa, which was named “Medi-Spa of the Year” in 2007 and 2009 by AsiaSpa, bills itself as a “one-stop-service for optimising your health, appearance and wellbeing”, and goes by the philosophy of “rejuvenation through integrated healthcare”. It employs 12 doctors, including six dermatologists who specialise in anti-ageing, two gynaecologists, a psychiatrist and an internal medicine doctor.
Although the beauty programme is the most popular treatment at the spa, many other treatments are on offer including bio-energy medicine – a rarely offered procedure that uses a unique QXEI biofeedback machine imported from the US to diagnose deficiencies or imbalances in the body, which are then treated with acupuncture. Thavisin practiced as a dermatologist for 17 years and specialises in anti-ageing medicine, a field that has caught on with the big hospitals. “Why wait until you’re sick to see a doctor?” she asks. “That is sick care not health care.”
It’s a philosophy that binds together all the various holistic health disciplines. “Treat the person as a whole, don’t just treat the symptom. Actually, ‘alternative medicine’ is not a good term. I prefer to call it complementary medicine, because you can do both things together.”
Indeed, many spa owners agree that a new trend is on the rise that fuses the two disciplines and, as a result, medical doctors are increasingly staffing spas and health retreats, while naturopaths are infiltrating the ranks of mainstream hospitals.
Few places illustrate the growing synergy between mainstream and alternative health systems than Bangkok’s Vitallife Wellness Center. “Everything that’s done here is very much on a customised basis,” says Nollada Sirisamphan, its communications officer.
Indeed, as she speaks a trio of staffers are carefully tucking away pills in small plastic bags. The pills aren’t standard prescription fare, but vegan capsules containing everything from calcium and magnesium to vitamin E and zinc.
While Vitallife, with its holistic approach to health, may appear non-mainstream, the clinic is actually owned by neighbouring Bumrungrad International Hospital.
Another form of naturopathic healthcare making mainstream inroads is traditional Chinese medicine. Hospitals such as Bangkok General, Siriraj and Yanhee have added onsite clinics to their customary facilities and report a growing interest among patients, especially Thais.
The herbs used for traditional medicineTraditional Thai medicine, which is derived from Chinese medicine, Indian ayurvedic, indigenous healing and astrological traditions, has also blossomed in recent years. The fact that naturopathy, in all its myriad forms, is shrugging off its label as an “alternative” treatment may be the healthiest indicator for the industry’s future.
“The industry will steadily become more mainstream, and less focused on the element of ‘indulgence’ and more on the element of ‘health and necessity’,” observes Andrew Jacka of the Thai Spa association. “Eventually it could even be absorbed into the broader healthcare industry, and be seen as an area of specialisation, just as dentistry or plastic surgery are today.”