From Place To Place

Change can be a funny thing. There are times when our world can change quite dramatically over a very short period of time. We think of events such as Pearl Harbor or 9-11 as the dramatic changes that define an epoch. However, when we look further into the matter, such dramatic events tend to be the culmination of processes that had been occurring for some time before. Many of the changes within our world do occur gradually, over a period of time, as the result of deeper processes that take a while to work their way through.

This is very much the case with tourism. The recent death of Arthur C Clarke served to connect a number of possibilities in my mind. In Stanley Kubrick’s film of 2001, an executive catches a Pan-Am shuttle from the Earth to the Moon. The shuttle reminded me greatly of the proposed Virgin Galactic space tourism ship (see article from The Economist). This is the type of thing that I dreamt of as a boy. Within 30 years, the cost of transportation has fallen such that commercial space flights can be seen as possible.

This reduction in the cost of travel has boosted tourism right across the world and has contributed to the shrinking of the planet as a consequence of globalisation. The impact of globalisation has been to make accessible markets that would otherwise not have been so. One of the features of the modern world has been the rise of medical tourism. The cost of travel is now so cheap, and the standard of care in the ‘developing’ world so high, that patients in the richer parts of North America and Western Europe can, quite literally, shop for their treatment on a global scale. A recent briefing from the Harvard Business School looks at the development of medical tourism between the US and India (see update).

So far, the story has considered the benefits of this process. There is also a more sinister side to the story that we need to be aware of. A growing proportion of medical tourism is dedicated to transplantation surgery. There is the question of the provenance of the body parts that are transplanted. In ‘Illicit’ by Moises Naim, three possible sources are described. Mr Naim alleges that body parts taken from executed Chinese criminals end up with western patients, as do organs purchased from ‘Untouchables’ in India. There are also allegations that children in Africa are raised with the explicit purpose of having their organs harvested. This is one aspect of globalisation that has an unfortunate consequence.

As medical science continues to develop, so will the sharp ethical practices associated with the conduct of medical trials. For example, it is more cost-effective to conduct live trials in, say, Africa, than it is to hold those trials in, say, Europe. The cost of mistakes is far lower in Africa than Europe. Interestingly enough, the BBC has just concluded a drama (The Last Enemy – see link) where a key theme has been the trials of a bio-weapon - that only attacks those who have ‘Arabic DNA’ – in Afghanistan. It would seem that, in a globalised world of cheap mass travel, even our bodies are to be treated as weapons.

And yet, do we have more to fear from pandemic contagion resulting from mass tourism than that we do from terrorists branding bio-weapons?