Sociality and transnational social space in the making of medical tourism: local actors and Indonesian patients in Malaysia

ABSTRACT

We investigate international medical travel between Indonesia and Malaysia through the conceptual lens of sociality, transnational social space and therapeutic mobilities. Drawing upon narratives of local persons, medical traveller-patients, accompanying family members, hospital staff and medical travel facilitators, we illustrate how multifaceted linkages and processes generate and sustain the flow of patients across the border. In these narratives, we see multiple mobilities articulate and cross-cut in the building of transnational connections. This paper stretches the concept of transnational social space to apply to medical travel and contributes to the literature framing of international medical travel as a complex and multifaceted arena.

KEYWORDS:

• International medical travel
• transnational social space
• transnationalism
• cross-border migration
• transnational healthcare
• Malaysian private hospitals
• Indonesian healthcare

Acknowledgments

We are grateful to Diana Wong, the anonymous reviewers and the Special Issue editors for their comments.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. The names of the two study hospitals, medical facilitator company and all interviewees are pseudonyms (unless otherwise specified) due to requirements of the ethical approval. Ethical clearance was obtained from the Human Ethics Research Committee of the University of Queensland, Monash University (CF12/1546–2,012,000,517), as well as the Ministry of Health Malaysia.

2. Interview with the PHG Chairman, 17 February 2014.

3. The PHG collects these numbers, which specifically refer to ‘medical tourists’, not inclusive of resident foreigners. The PHG Chairman claims that these statistics represent the bulk of medical tourists in Penang.

4. Malaysian Healthcare Travel Council (MHTC) (2015). According to Wong (2012), who is the CEO of the MHTC, the number of Indonesian medical travellers were 335,150 in 2011, which constitutes 52.3%.

5. Interviews with hospital executives in HOS and WEL.

6. Nevertheless, trade linkages between Malaysia and Indonesia came to a complete halt from 1963 to 1966 when Indonesia opposed the formation of Malaysia (from unifying Malaya, Singapore, and Sabah and Sarawak on the island of Borneo).

7. The ethnic Chinese population makes up 1.2% of the more than 250 million total population of Indonesia (World Population Review website, accessed 3 June 2014), but there are significant concentrations of ethnic Chinese in Medan where the total population was close to 13 million in 2010.

8. Interview with the deputy principal of a private Chinese secondary school in Penang, 11 June 2013.

9. Conversation with the head of HOS’s marketing department, 25 April 2014.

10. Interviews with PHG Chairman, and conversations with ex-nurses.

11. The discourse of ‘need’ and ‘want’ pertains to the view that medical care services available in Indonesia are inadequate and do not fulfil the needs of Indonesians, and therefore they have ‘no choice’ but to go abroad to seek the care that they ‘need’.

12. She is not a licensed money changer, so this is illegal.

13. Conversation with marketing head, 28 May 2013.

14. Conversation on 24 April 2015.

15. See http://islandhospital.com/, http://www.gleneagles-penang.com/package/index.htm, and http://www.pah.com.my/services/lifestyle/wellness_screening/files/wellness_screening_packages_en.pdf (accessed 8 September 2015).

16. Conversation on 25 April 2014.

17. Bochaton (2015) reports similar findings.

Additional information

Funding

This work was supported by the Australian government through an Australian Research Council Future Fellowship (FT110100054) and an ARC Discovery Project (DP1094895), and by the Asia Research Institute, National University of Singapore through a supplementary grant.