Tag Archives: tourism

Senderismo in Santander

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In the months since I discussed Andres’ pathology reports with his mom, he’s started chemotherapy.. I met and lost a charming, attractive man named Danny. The days have marched on.. and Finally, it was the end of May – and time for the long awaited, anticipated trip to Santander to celebrate Andres’ mom’s birthday. It was a three day hiking tour with Explorando Ando, a local travel / tourism group that specializes in hiking/ walking trips.

The bus picked me up from calle 170 at midnight along with two other members of the hiking group. We were the last people to be picked up as the bus passed through Bogota. Then we headed out on the highway. At 4:30 am, we stopped in the town of Barbosa to switch to a smaller, traditional “Chiva” bus.

(It was an amazing trip – filled with friendly and fun people, breath-takingly beautiful scenery and lots of activity, but my favorite part was riding on top of the Chiva!!)

Riding on the top of the chiva in Florian, Santander

Once we got to Florian, we had a hearty breakfast before heading out on our first hike – to the first waterfall.. We had to hike through the finca of a local man, but for a small fee – he was happy to have our group pass through. He had oranges, water and free standing bathrooms for us to use.

Hiking to the waterfalls
with Maria Eugenia at the base of one of the waterfalls
Amanda
Maria Eugenia in the cave (mouth of the waterfall)
in the mouth of the waterfall

The waterfalls were really spectacular. There is no way to really describe it otherwise… They were so immense, photos just don’t capture it. It’s an incredible sensation; looking up at this enormous waterfall and realizing just how tiny and insignificant we are in the scale of things.

(Click on the photos to see the whole image)

fbt

Sometimes feeling tiny isn’t a bad thing – it was the first time in a long time that I didn’t think about all the things that having been going on this last year.. (Long time readers know that it’s been a bumpy road this last year). This trip was the first time that I didn’t cry for a couple of days.. That I didn’t wake up with that sad heavy feeling in my chest.. I needed that.. And more importantly, I think my traveling companions, especially, Flor – needed that – to be able to get away from Bogota, and away from the sadness that envelopes us..

The second day of the hike is when we went to the the biggest of the waterfalls.

fbt

The last and final day – was the day we went to two different waterfalls, where we were able to swim, and play under the falls.

fbt

One of the really nice thing was that even though we were just a group of five (Maria Eugenia, Natalia, Flor, Amanda and I), it felt like one big class trip.. Everyone there was excited, with friendly attitudes and an adeventurous spirit.. Some people were younger than me, some people were older.. People in their 20’s and in their 70’s. The hikes were long enough and difficult enough to be challenging without being too difficult for the average person. I felt sore for a couple days after the trip – but it was the good kind of sore..

Maria Eugenia, Me, Flor, Amanda and Natalia

I don’t get to see Natalia nearly enough – she lives in Madrid, which is a city outside of Bogota…But she’s always good for some fun.. She’s the one who packed Coronitas, which are little baby cans of Corona beer to celebrate our climb on the biggest hike of the trip..

Enjoying a coronita after an all day hike and an 9 km uphill climb.. Worth it!

That was kind of a crazy day – because it started out a little drizzly, which felt good.. But as we were climbing back up to return, the fog rolled in and it was complete. Just after we reached the summit, the fog pretty much obliterated any kind of landscape. (The people trailing behind us were completely invisible to us in the dense fog.)

So we were back in Florian, relaxing after the long hike in a local tavern…
when the town crazy insisted on sitting at our table and trying to “trade” me for potatoes..
All that and a bag of chips! literally.

Now if only I could do this every week…

Thanks to the folks in the group for editing and sharing this video with me..

Termales Los Volcanes

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It’s taking longer than I thought to find the video clips I have about driving in Colombia.. so we will defer that topic for now. Instead, let’s talk about something less death-defying and much more relaxing.. Hot springs!

I know I mentioned in my post about Santa Rosa de Cabal – how much I love hot springs.. Or maybe I mentioned it when I went to to Sulfur pools in Tocaima way back in 2010, but that would have been the earliest days of the blog.. I adored the hot springs in Paipa – but those too, I might not have mentioned since it was a client trip.

Anyway – I love hot springs! I love bathtubs, jacuzzis, swimming pools – all things water. It was so important that it was one of the determining factors when it came to purchasing my house in North Bogota. Was there a bathtub / was the bathroom large enough to install one? Now, the tub at my house isn’t some massive spa tub that uses hundreds of gallons of water. It’s just a regular old tub, but I sure do love it – especially when I can’t sleep, or the damp chill during the rainy season sets into my joints. Now the tub at my rental property is the supersized luxury type, but honestly, I’ve never used it – or the golden toilet.

the bathtub at the Elvis Presley Graceland penthouse

So if you’ve never been to the ‘termales’ or the hot springs but you enjoy a hot bath – just think of a swimming pool of nice, hot volcanically heated water, usually in a beautiful outdoor location. I’ve recently made it my personal goal to visit as many Colombian hot springs as possible. I read somewhere that Cundinamarca has 42 different hot springs alone, and that Colombia has 130+. I won’t get to all of them – and I don’t need to. (I can’t image enjoying hot springs in 100 degree weather, which rules out several). But with just a few days left before I head back to the United States for a month, we decided to start working on that top ten list I posted recently.

A mid-week day trip was perfect, so we decided to pick a location close to Bogota. We decided to go to Termales Los Volcanes in Macheta, Cundinamarca. Minimal traffic to navigate to get out of the city since it was a Tuesday, low weekday prices and no crowds at the springs.

We arrived early in the morning, around 730 am, while the weather was still cool and refreshing. We had a nice breakfast before jumping in the deliciously warm springs. There are two big pools, one much warmer than the other, and two smaller pools.

The hot springs are set against the lush green background, with a waterfall, cobblestone paths and lots of flowers. There is a small hotel on site, along with a restaurant, snack shop and spa. Since we were on a day trip, we didn’t need the hotel, but we checked it out anyway. Weekday rates start at 315,000 COP and include breakfast as well as hot springs entry. Weekend rates start at 415,000 COP.

Since we were just day trippers, it cost us 35,000 COP each to get in. The hot springs are open from 7 am to 11 pm most days. We enjoyed the pools for quite a few hours, along with breakfast, snacks, lunch, massages in the spa, and quick dunks in the icy waterfall before we headed back to the city. It was a lovely day – and even lovelier because Andres and I got to spent it together. (We do a lot of family activities with his parents, cousins, uncles etc., but we don’t always get to spend time together.) He’s a great co-pilot, co-conspirator and partner-in-crime for our adventures. We have a lot of very different interests but he’s definitely game for my hot springs challenge.

I got a bit of a sunburn despite lots of sunscreen – so I’d advise wearing a rashguard, like Andres did. Otherwise, it the entire day was a bit of joy..

Cali, Cali, Cali and the best AirBnB in Cali!

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Montenegro, Salento, Santa Rosa de Cabal and now, Cali, Colombia. We passed thru multiple states, ate lots of different things, took lots of pictures, hiked in the mountains, climbed lots of stairs and enjoyed the famous hot springs on our way to the grand city of Cali, Colombia.

So…. Cali is hot.. Not warm, but hot. Maybe not to everyone (I saw locals wearing sweaters and jackets) but it’s the kind of hot that makes me grouchy and miserable – and I know this! I’ve had plenty of miserable trips to sunny beach locations (and other places that heat seekers flock to – and I know what heat does to me). Add heat = instant bitch.

It was also the surprise visit for Andres and his daughter’s shared birthday weekend.

So I couldn’t let the heat get to me. I found a charming Airbnb home with a small swimming pool. The hosts were absolutely delightful, so I posted the link above, if you are planning a trip to Cali. It was in a nice neighborhood (but not a lot of stores or restaurants to walk to) right on the river. It was the perfect solution – we basically lived in the pool for much of the weekend. His daughter loved it, we had a good time, and I didn’t become a heat enraged monster.

  • House we rented in Cali, in private cul-de-sac
  • lovely elegant split level
  • Dining room and kitchen opened out to the pool/ BBQ area
  • BBQ area
  • living room
  • master bedroom
  • master bedroom
  • view from master bedroom

I don’t usually feature someone else’s rental on the blog – but this house made all the difference. It was spacious – charming.. We barbecued, we swam, we slept in the hammock by the pool. This house made all the difference for me – (and certainly for people who had to travel with me!)

But we didn’t stay in the house the entire time. We took a morning stroll down to the Parque de los Gatos and other Cali landmarks. Of course, I did manage to bow out of one afternoon adventure in the heat – to hang out by the pool and read a book. It was lovely! I also used the time to sneak out and get ice cream for the birthday folks..

  • I enjoyed the heck out of the pool.. I even stayed home to read a book by the pool while everyone else went out one afternoon
  • the Pool
  • BBQ birthday
  • Parque de los Gatos

I probably should talk about Cali and salsa dancing.. or salsa music, drink champus or the many other things that make Cali famous and noteworthy.

But I didn’t go and experience any of those things on this visit. (This is my second visit to Cali.)

Here’s an easy Recipe for Champus. It’s a tasty nonalcoholic drink made with tropical fruits. Lots of people say they drink it at room temperature, but we usually have it chilled.

At the end of our weekend, we returned to Bogota.. I drove for a good bit of the way – but I really don’t like driving in Bogota, so we switched off at Ibague, where we stopped for lunch, and to wait out traffic with some friends. (You don’t want to drive thru/ near Bogota during peak time – it can take 3 to 4 hours to cross the city if caught in peak traffic.) On one of my future posts – we are going to talk about Driving in Colombia. I know I mentioned that I received my driver’s license and motorcycle license this year but driving in Colombia particularly in the city of Bogota is worthy of a special note.

Sundays in Cartagena

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El Centro

El Centro

Sundays in Cartagena are a bit different from Bogotá or Medellin. As a major tourist destination, Cartagena never really slows down the way other cities do in Colombia.  In Bogotá, my neighborhood (Chico) was essentially deserted on Sundays.  The only signs of life were on the streets closed for  pedestrian walking.  La Candeleria and Usaquen were the destinations of choice for Bogotanos who chose to stay in the city.

Instead the activities change – instead of business, the weekends are for boat trips to the Islands of Santa Rosario, long leisurely lunches, wandering around El Centro and looking at arts and native crafts, and walking along the beach.   Tourists stroll along Bocagrande window shopping at designer storefronts, eating ice cream.  The hotels host popular events in Castillogrande, and restaurants and bars feature the sports of the day, to standing room only crowds.

So today, after sleeping in a bit, Iris and I headed to El Centro for another leisurely stroll around El Centro.  Sunday mornings are a nice time for this – the streets are still pretty quiet and not yet packed with tourists.  (That comes later in the day.)

Cartagena 013

As we wandered down the tree-lined streets, I can’t help put take photos, even if I’ve photographed these same areas many times before.  Somehow, every time I encounter the colorful buildings with the beautiful blossoms on the curving cobblestone streets, I am enchanted all over again.

Cartagena 026

 

After walking around the neighborhood and making our way up the wall, we headed to the nearest Juan Valdez..

Cartagena 027

After our leisurely coffee, we walked back home to escape the heat of the day.  Now I am heading back out – to the beach.

 

Punta Pacifica, Hospital San Tomas and Centro Medico Paitilla

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**Due to some unforeseen changes in my itinerary, I can only provide just a brief overview of some of the facilities in Panama City, which falls far short of my usual.**

Centro Medico Paitillo (CMP)

Balboa Ave. and 53rd Street

Website: http://centromedicopaitilla.com/

Founded in 1975, CMP has grown to become the largest private facility, though  Punta Pacifica appears to rapidly approaching on their heels.  They have several well-established international health insurance programs and the hallways were well populated with English-speaking visitors and patients.  The hospital has community outreach and health promotion classes as well as a 64 slice CT scanner, MRI and other diagnostic capabilities.

Website is attractive, and well-designed with English and Spanish versions.

Clinica Hospital San Fernando

Via Espana Las Sabanas

Website: http://www.hospitalsanfernando.com

There are two facilities for Hospital San Fernando; a Panama City facility and another facility in Coronado. The Panama city facility is one of two Panamanian facilities accredited by Joint Commission International.  This is a private facility designed to entice foreign visitors and upwardly mobile Panamanians.

Website with English language version that includes price quotes for International travelers. Website is well-designed and easy to navigate.

I have not visited or viewed this facility

Hospital Punta Pacifica

Boulevard Pacífica y Vía Punta Darién
Ciudad de Panamá

Website: http://www.hospitalpuntapacifica.com/

Webpage with English and Spanish versions, and has been designed for international travellers. However, the overall quality of the website is poor. Information has been poorly laid out and is often mischaracterized. For example, visitors to the site who are seeking information about individual physicians are transferred to a poorly typed resume-style pdf. Physician specialties are mislabeled; with cardiologists listed as surgeons, which may cause confusion for potential patients.

Hospital Punta Pacifica was accredited by Joint Commission International in September of 2011. Hospital Punta Pacifica’s main claim to fame, as it were, is that it is John Hopkins International branded facility.  As such, it is aggressively marketed as a medical tourism destination.

It is located in downtown Panama City, just a kilometer from the CMP (Centro Medico Paitilla).

Victoria 001

Hospital Santo Tomas

Calle 34 Este y Avenida Balboa

Website: http://hospitalsantotomas.gob.pa/

Hospital San Tomas is the oldest public hospital in Panama. Originally started as a small facility for impoverished women in September of 1702, the hospital has grown over the last 300 years to become the largest hospital in the country. The hospital now offers multiple service lines including surgical specialties such as thoracic surgery, plastic surgery and general surgery, among others.  The campus includes separate facilities (Maternity hospital, children’s hospital), a blood bank and Cancer center.

Blue Cross Blue Shield of Panama – one of the international arms of the Blue Cross Blue Shield insurance company, and just one of the many insurances accepted at most Panamanian facilities.

What’s this about free insurance for tourists to Panama?

In one of their more effective (and dramatic) public relations gestures, the Panamanian government widely advertises “Free  medical insurance for the visitors”.  This catastrophic policy covers all visitors during the first thirty days of their stay for accidents and injuries (up to $7000.00) that may occur during a stay in Panama.  Visitors just need to show their passports on arrival to one of the participating medical facilities.

The policy also covers up to $500.00 of dental expenses, and economy class air tickets for return home for family members (in case of a death of a tourist) and repatriation of the deceased.  (This may sound like a grisly benefit but from previous discussions with tourists in various locations – this can be quite costly.)

*Just so you know – it doesn’t cover chronic conditions or pregnancy, so visitors can’t come here and expect to have free care for non-emergent problems (ie, elective hip replacement and the like.)

Going home..

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After a whirlwind three months that included trips to Chile, Bolivia and different cities in Colombia, I am getting ready to come home in a few days.  As always, leaving Bogotá is bittersweet.  I miss my friends, and my family but I will also miss the city and all of the nice people I’ve met here.

I am posting a map of Colombia, so even though I’ve taken several trips – you can see that I haven’t really explored the country at all. (I’ve posted little push pins on the areas I have visited.)  I excluded Facativa and some of the closer towns since they are really just suburbs of Bogotá, and it would just clutter the map.

Map of Colombia, courtesy of Google Earth

As you can see – I haven’t explored the southern part of Colombia, or the pacific coast at all.  My Atlantic adventures have been confined to Cartagena.  So, I guess this means, I still have a lot of work cut out for me on my next visit(s).

map showing central Colombia

But I hope that readers have enjoyed reading about my travels, the people I’ve met and the things I’ve seen.  Now – I know this is a medical/ surgery blog but since much of the surgery I write about is in this part of the world, I think that including some of my experiences is relevant/ interesting for people who read the blog.  Once I get back home, I’ll post some more articles on medical quality control and standards – and more of my usual dry fare.

Afternoon at the finca, and a day at the market

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We spent Saturday exploring Lerida and cruising around.

Ready for adventure

We stopped at several roadside stops to buy some local fruit before heading off to La Gaviota, a local finca owned by a Brazilian woman.

buying papayas

We bought some delicious sugar mangos, along with some sweet papayas and mandarins.

enjoying sugar mangos

La Gaviota, a finca in Tolima

Now, there are two kinds of fincas in Colombia; working fincas and pure vacation fincas.  A working finca is usually a farm or an orchard – often owned by a city resident but managed locally.  This allows people who live and work in Bogota to have a get-away place that also brings in income.

one of the lakes at La Gaviota

Some of these fincas have been in peoples’ families for generations and produce much of the fruit and livestock products (dairy, meat etc) that are sold in Colombia.

Other fincas are pure recreational homes, and as such, are primarily owned by wealthier Colombians though this is not always the case.  Fincas vary from modest cabin style affairs to elaborate, ornate mansions with swimming pools, tennis courts and private fully stocked ponds.  Since most working people can’t stay at their finca very often, many owners rent out their fincas part-time.  Such was the case with the lovely La Gaviota.

the pool, surrounded by fruit trees

The entire property has been planted with fruits and trees native to Brazil and the staff encourages visitors to sample the many exotic varieties.

Yaca, a fruit native to Brazil

There is a swimming pool, and several lakes stocked with fish.  There is also a hotel, and a restaurant, where they will prepare your fresh catch.  Like many of the numerous fincas that dot the landscape here, they welcome travelers and offer services at reasonable rates.  So we spent the sunny afternoon at the pool.

The next day, we went to the market in Lerida.   We bought some more ‘tipica’ or traditional Tolidense food called lechona from a very nice young man who helps his grandmother.

young man selling lechona

While I vary from vegetarianism to veganism in the states, I never hesitate to try another delicious typical dish when I am traveling – and it was marvelous; warm, savory and flavorful.

There are several variations of lechona, which is stuffed pork but the Tolidense version uses a base of garbanzo beans for the stuffing and comes with a sweet-flavored bread stuffing called insulso on the side.

lechona

The grandmother, also invited us to come to her house where she had other tolidense specialities for sale, including tolidense tamales.

with grandmother

There were other vendors selling panela which is popular sugar product here in Colombia, (and other latin American countries.)  It’s a staple, a form of unrefined sugar produced at the local sugar cane factories in the region.  (I particularly like panela in my coffee and tea.)

panela

We met and purchased several tamales from another vendor in the market, a very nice woman who was very happy to pose for the camera.  I am ashamed to say that I forgot to write her name in my little notebook because my hands were full with all of our great purchases.

homemade tamales

Bogota’s castle

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Some of you may notice that I have temporarily changed my header – to show Bogotá’s castle.  I found it the other day as I wandered some of the carerras.  (Residents of Bogotá know that once you get into the single digit carerras – all logic and inference regarding standard directions goes out the window.)  Once you cross Carerra Septima (Cra. 7) the lovely city layout that makes Bogotá such an easy place to navigate changes into a labyrinth of twisting, winding streets reminiscent of San Francisco..

It’s part of what makes the city so interesting – and at times (such as yesterday, when I was making my way to an appointment) – a bit frustrating.  Just when you think you ‘know’ the city – you stumble upon something completely different from what you were expecting..

Not what I was expecting

The castle which is located at Cra 3 – 74 was the brainchild of Dr. Juan Osorio Morales and is called Castillo Mono Osorio.   While it has the appearance of antiquity, it’s actually only about 100 years old.

Bogotá’s castle

The creator, a local eccentric – was  Colombian cultural attaché to Brussels.   Upon his return to Bogotá, he spent the next twenty years creating the castle which later served as home to his own personal theater troupe.

Like the work of many unconventional artists, after his death the castle fell into disrepair until it was rescued in recent years by one of his descendents and repaired to its current state.

It currently houses several stores including a banquet space, a gift shop and a pharmacy.  Best of all – there is currently space for let.  A new, whimsical office, anyone?

Bogota revisited

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Finishing my first week in the doctoral nursing program before heading back to Bogotá in mid-September.  (I’ll be keeping in touch with my professors via Skype, Scopia and a variety of on-line media.)

I am exciting to be coming back to a city that I have come to know and love!  In fact, my only regret is that I didn’t devote enough pages of the book to the city itself.  At the time, I rationalized that people who were interested in the city would be able to find plenty of information in the existing travel guides (and I am not a traditional travel writer) – so I devoted myself wholeheartedly to medical tourism, hospitals and surgery.  But as time has passed – I regret not sharing the city more with readers, since after living there for almost six months (and traveling all over the city daily), I certainly became intimately familiar with much of it.

So, readers will be happy to hear that I haven’t made that mistake with my latest book on Mexicali, MX – but I am just happy to be going back to Bogotá, a city that truly has captured my heart..

It’s insidious, you know.  The things that I initially didn’t like (like the ‘eternal autumn’ weather) become some of the very things that make me enjoy the city so much.   Bogotá is a city that has to be ‘known’ to really be appreciated.  If you don’t scratch beneath the surface of this vibrant, amazing place, then you really won’t see (and love) the city.

For example; that cool, mild weather, that had me groaning the first few weeks also made it possible for me to spend much of my time outdoors – exploring the city, walking miles everyday.  Spend a week sweltering in Cartagena (or Mexicali, in August, for that matter) and you will see what I mean.

The food that seemed plain and unspiced at first, became something to savor.  All of the exotic and tangy fruits, and ‘real’ food taste – unmasked by heavy additives let me appreciate how wholesome and unaltered it really was.  It made me appreciate the subtlety and complexities of the meals I was enjoying.  (If you drown everything in ketchup or hot sauce – what are you really tasting?)

So, in just a few weeks – I will be back in this wonderful, charming, whirlwind place that has claimed a little corner of my heart.

UK surgeons add their voices to speak out against Medical Tourism

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As we’ve written before, local plastic surgeons are fighting the loss of income from medical tourism.  In the UK, where 1 in 20 patients (in one poll) have used medical tourism, are adding to the dissent.  This isn’t the first time British plastic surgeons have spoken out against medical tourism – in fact, British physicians were the first ones to publish commentaries against the practice of traveling overseas for surgery in professional journals.   Last year, they released a statement condeming this practice.

Now, these surgeons are speaking out in the popular press.  The irony is, while these statements are primarily aimed at people travelling to India – as readers of our sister site know, they just as easily could apply to the United States (and our large contingent of ‘phony docs.’

But how much of this is real?  and how much of this is hype to boost their own sagging practices?  It’s hard to know since much of the ‘data’ is based on polls of UK plastic surgeons.

In related news, Las Vegas has started a new task force to weed out phony/ fake doctors operating in the hispanic community after several highly publicized incidents – including several deaths.

More stories from Cartagena Surgery:

How to investigate a potential surgeon

Busting a fake clinic in Los Angeles

Unqualified Arizona doc heads to trial after several patient deaths

The ‘fix a flat’ doc

The original fix a flat doc story

Follow cartagena surgery for more stories..

Looks like Panama may bite off more than they can chew..

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In a recently published story, the government of Panama is now offering medical  insurance for all tourists to Panama for free.  This insurance is not  ‘Complication Insurance’ which is offered by private surgeons in Colombia and other countries for patients traveling specifically for medical tourism.  Complication insurance covers all possible medical complications resulting from medical procedures at the designated clinic or destination..

No – Panama is taking the European and socialized medicine approach and is offering general medical coverage for ALL short-term travelers to Panama.  (The long-term exclusion is a wise move given the numbers of Americans and other overseas residents who make Panama their retirement home.)  This insurance resembles typical travel policies in that it covers injuries, accidents and other medical situations that may occur while on vacation..  I just hope the Panamanian government hasn’t underestimated its tourists and their injury/ illness potential.

Now readers – don’t get any wild ideas.. This is not the time to stress that ‘trick knee’ while hiking to visit the Naso-Teribes..

Meanwhile, Costa Rica is making a pitch for more corporate clients such as Pepsi-Cola.  These multi-national corporations can potentially bring hundreds of millions of healthcare dollars by diverting their employees to medical tourism destination such as Costa Rica.  (Like Colombia – Costa Rica is an ideal destination for North Americans due to proximity, quality and diversity of services available.)

Now available in the Kindle Lending Library!

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Now you can read Bogotá! for free in the Kindle lending library..  (I hope this inspires some generosity among critics for impoverished medical writers – leave some positive feedback about the book!!)

 

 

The future of medical tourism: the glass ceiling

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The International Medical Travel Journal has a new article that questions the notions that ‘the sky is the limit’ in the medical tourism industry.  This article discusses the belief that many investors have that as long as there is a new shiny facility, medical tourists will flock..  In reality, the market for medical tourism is fairly narrow, particularly for American medical tourists – who are the ones most likely to open their wallets and pay cold hard cash for surgical procedures overseas.  (That’s because medical care in many other countries is less expensive for residents – so why travel and pay cash for something you can get at home for relatively little expense (even if it requires waiting.) Many of these Americans are uncomfortable or unwilling to travel to more exotic locations – as Dubai has found out first hand.

Of course, plastic surgery and other elective procedures are a little different.)  But most Europeans, Canadians etc.  aren’t going to have to fork over 100,000 for heart surgery (or be uninsured) so the pool is limited.

The other class of medical tourist – the wealthy residents of countries that may not have elite services is also a mixed bag,  Many of these patients are going to elect to go to ‘big name’ American facilities despite the cost – for a specific level of care.  They may seek out specialized procedures that are unavailable or even illegal in their home countries – but that market is smaller than most of us realize.

It’s a good article that brings a dose of reality to the concept of medical tourism as a ‘cash cow’ route to easy and limitless cash.  Medical tourism is not for everyone, as investors are finding out.

HIPEC: the latest research results

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If you remember, previous New York Times articles questioned the efficacy of hyperthermic chemotherapy given during cytoreductive surgery.  We promised to investigate, and return with more results to this question.

Recently several articles have been published on the topic, including this one – in the journal of Clinical Oncology.  This narrative by Maurie Markman talks about the quick dismissal of HIPEC by many oncologists, particularly for larger tumors – and he questions the wisdom of this approach in light of recent research results.

In fact, several large new American studies – including one at Case Western are examining the use of HIPEC, particularly in gynecological cancers like ovarian and uterine cancers which carry a dismal prognosis.

American Hospitals are finally jumping on the HIPEC bandwagon…

Detroit hospital offering HIPEC

Atlanta docs, robots and HIPEC

This last link isn’t really news – it’s a press release, but since it’s on a surgical oncologist (Dr. Wilbur Bowne) who was an early American adopter of HIPEC, I thought readers might be interested.

Previous Bogota Surgery posts on HIPEC

HIPEC: The basics

Bogota Surgeons stay ahead of the curve

The Future is Now: HIPEC

Looks like it’s about time to check in with our favorite surgical oncologist, and HIPEC expert, Dr. Fernando Arias..

Check back soon for more..

Colombian life: an outsider looking in..

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There’s a great blog here on WordPress that I wanted to recommend to anyone interested in Bogota – and all things Colombian.  The blog is called The Wanderlust Chronicles and it follows the life, and adventures of Kate – a young teacher / translator (who reminds me a bit of myself).  I do have to say – that as I ‘cruised’ around the site, reading her posts – tears almost came to my eyes, and I became wistful for all the things I loved and enjoyed about my time in Colombia.

For everyone else –

It’s a great reference for all of you who want a bit of a different vantage point (nonmedical) on the beauty of Colombia and Colombian culture.  I hope you enjoy!

Medical Tourism Forecast for 2012

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Where is Medical Tourism & Travel headed for 2012?   Predictions vary according to sources, but all sources expect the medical travel phenomenon to continue, unabated.

Maria Lenhart at the Medical Travel Report (a private travel company blog) estimates 35% growth over the next year, based on Deloitte statistics.

Where are they going?  According to Depak Datta of the Medical Tourism Corporation – for the most part, people are staying fairly close to home..  Meaning that people from the United States and Canada favor locations in the Western Hemisphere over Thailand, India and other destinations popular with Europeans, Africans and Asians..

Domestic medical tourism remains a popular option with American corporations who are sending their employees to large, well-known facilities within the United States.

In fact, large American healthcare institutions often have the most to gain from medical tourism via international affiliations with institutions in South America, India,  and Asia.  John Hopkins, Cleveland Clinic, Duke, Harvard and several other well-known top-tier American medical giants have branding agreements and other lesser affiliations with hospitals and clinics across the globe.

In the midst of this growth, concerns over patient safety and quality of care should remain at the forefront (in all facilities – domestic and international.) But until more potential customers demand (or even display any interest) in quality, and safety issues – the industry is not going to go out of its way to provide this information.

Colombian government steps up..

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In a surprising but admirable move, the Colombian government has announced that it will pay for the removal of PIP implants.    As we discussed at our sister site, Cartagena Surgery, recent disclosures that the French company knew their breast implants were defective as far back as 2005 has sent shock waves of outrage through the medical community.  Further disclosures that the implants contained substandard construction grade materials (not medical grade) and fuel additives which contributed to the exceedingly high rupture rate (7% versus an average rate of 1% for all other implants) has important health implications for women world-wide.

In the wake of this scandal, hundreds of thousands of women across the globe, particularly women in Latin America where the implants were heavily marketed, have been panicking and storming physicians’ offices for answers.

(In a related post at our sister site – we reassured readers who received implants in 2011 by some if the surgeons profiled here..

With the French government advising over 30,000 french recipients of these implants to have them removed promptly, this goodwill gesture by the Colombian government should go far to reassure and calm Colombian women.

Update: 14 Jan 2012

Medpage Today just published a nice comprehensive article on the Poly-Implant Prostheses (PIP) implant controversy.  It’s a good story for people playing catch up on this story – and wondering if they may be affected by this news.

2011 in review: State of the Blog

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Thank you to everyone for making Bogotá Surgery.org a phenomenal success!  Surprisingly – this annual report shows a few less views than our own counters – but we are thrilled all the same..  Here’s hoping for more and greater successes in 2012!

Here’s an excerpt:

The concert hall at the Syndey Opera House holds 2,700 people. This blog was viewed about 9,700 times in 2011. If it were a concert at Sydney Opera House, it would take about 4 sold-out performances for that many people to see it.

Click here to see the complete report.

Feliz Navidad and Happy Holidays, my friends!

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Click here to see a photo array (presented by Colombia Reports) showing the lights of Christmas time..

You can find more information about Christmas, Carnival and other festivals year-round in Bogotá at this webpage here.

Wishing all of my readers and friends a happy holidays and a healthy new year!

The Motley Fool & Medical tourism

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The Motley Fool takes on medical tourism.  For you aren’t familiar with this site, it’s a very popular financial blog with stories on the economy, popular stock picks, predicted trends and investment strategies for retirement planning.  I am only passing familiar with the site myself since I come from a family of economists, but you can imagine my surprise (and delight!) to see medical tourism given serious consideration and discussion on their blog.

It’s about time that people talk about medical tourism in a fair and realistic fashion.   It tends to be sensationalized in extremes either fantastic! amazing! awesome! extreme plastic surgery makeover style or devastating.  graphic. and disturbing horror stories.

But this is a more rational and balanced discussion of health care and medical tourism – by the numbers, so to speak.. and it’s about time.

Por la navidad…

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Perdoname porque mi espanol es un poco malo pero me gustaria dar vosotros una regalos por la navidad. Por todos mis amigos quien de leimos en espanol :

Ahora, en Smashwords.com – es un promocion por este libro – Bogota! una guia de quirofano. Este descuento es 25% cuando usas codigo TA47T.

Ir a Smashwords rapido! porque este promocion es corte – solomente desde ahora a 17 de enero.

I apologize to all my Spanish readers – my written Spanish is even worse than my spoken words.  (Luckily, I hired an excellent translator, Sra. Ochoa for the spanish edition of the book.)  Happy Holidays, and here’s wishing we all enjoy the best of health in 2012.

Cartagena on CNN

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It looks like our Hidden Gem of a city is finally getting some of the attention it deserves – earlier this month, the city of Cartagena was featured as a ‘secret treasure’ on CNN Travel.    The article talks about the Caribbean flavor of this bright, diverse and colorful city and its rich history.

photo by CNN

Across ‘the pond’ in the UK – the Telegraph was also singing the praises of this tropical, elegant paradise and it’s status as a ‘cultural capital’..

Bogota receives high marks from the Boston Globe

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Ivy Hughes at the Boston Globe recently discovered the charms and attractions of this fair city in a feature article published  today.  She reviews some of the most popular sites and scenes of the city, while dispelling many of the myths surrounding Colombia and enjoying the Transmileno experience..

In other city news, Colombia Reports just published a new story on the development of a new plastic surgery center – catering to the needs of medical tourists.

I also wanted to thank everyone – we recently reached over 10,000 visits – in just the few short months since we started this site..

Hopefully, in the future, I’ll be able to afford to make this, (and the sister sites) ad free for less distractions..

Bogota’s LBGT community, tolerance and gender reassignment surgery

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Here’s the link to a nice story published on Off2Colombia as part of a press release for the city of Bogotá.  It’s a nice article (and video) that shows the diversity of this beautiful city.  As someone who lived in Bogotá for several months – I have to say that everything about this story is very true – and people in Bogotá are very friendly, warm and welcoming to EVERYONE.

Just another interesting facet of this lovely, fascinating and teeming city in the Andes..

 

Heart Surgery Abroad – coming to the big screen?

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Too bad, the independent filmmaker from Tennessee elected to travel to India rather than closer to home (like Latin America.)  Still – it places a lot of what we talk about into context – the affordability (or lack of) life-saving treatments in the United States versus numerous countries abroad..

Interestingly enough – despite making the choice to travel thousands of miles for a huge operation – it doesn’t sound like he throughly researched his surgeons, facilities  etc.  That is certainly troubling as medical tourism has not yet reached the Kayak, or Expedia level for interested travellers.  While I am very happy, relieved, pleased that everything worked out well – this could have easily been a cautionary tale (and loss for medical tourism) as a well-publicized win.

But, I will continue to hope that stories like his will help promote safe medical tourism, through the establishment of standards and regulations for medical tourism promoters.

Colombia and cultural standards of beauty

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This article on Sabotage Times talks about some of the different cultural ideas of beauty – in this case, the cultural and historical appeal of the large behind or bottom in Colombia.  (This is definitely a case of Latin influence on the United States – as this beauty ideal has been rapidly adopted here at home) – leading to an increase in the number of ‘booty enhancement procedures’ for American patients.

These different cultural standards of beauty are also something we have talked about before – and how Latin America is setting the styles for USA and much of the world.  These ideals have been quickly adopted into the mainstream American beauty ideals of the 1990’s and beyond.

(If you remember the late 1070’s and 1980’s – most of us up here in North America [and our mothers] – were out there starving and aerobicizing ourselves to try an obtain the tiny, flat bottom of a 12 year old boy.)

While some of this is undoubtably related to the large population of American residents with hispanic origins and the reflection of their beauty ideals – Colombia, Brazil, and Argentina have long been trend setters for fashion and beauty (which includes plastic surgery.)  This is one of the trends that makes these destinations so popular for plastic surgery.

For more on Bogotá plastic surgeons – see here, here and here.

For more on plastic surgery and ‘booty enhancement’ gone wrong – see here at our sister site.

New article at Eternal Beginning blog

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Eternal Beginning is book review blog by avid reader (and fellow writer), Christine Cunningham.  (It is also the title of her first book.)  Christine was kind enough to feature the Bogota book on her blog.

Clinica Shaio & Dr. Hernando Santos

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Fundacion Clinica Shaio – the first cardiac hospital in Colombia has recently unveiled the updated english-language version of their website, as part of an effort to aid international travelers, and attract medical tourists.  As long time readers know, I spent quite a bit of time at Clinica Shaio, with the Doctors Santos, (and several others).    Now as part of our new podcasting project – we will be sharing one of my favorite surgery videos from the operating room of Dr. Hernando Santos.  (If you’ve spent time here at www.BogotaSurgery.org than this video will be familiar to you.)  To my new readers from iTunes – welcome & enjoy!

Brief introduction to Dr. Hernando Santos, MD.

Bogota Surgery Podcasts

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As part of our continuing efforts to bring medical tourism and travel information to people in a multitude of formats, we are planning to begin a series of podcasts featuring physicians and topics discussed here at Bogotá Surgery.

Come back soon for more information on our latest endeavor.

The road to Monserrate

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no, this isn’t some sort of quasi-poetic allegory, or sophomoric metaphor.  The road to Monserrate – really is a path, or more accurately, the stairs to Monserrate.   Monserrate is a popular tourism destination in Bogotá:  a church set high on the Mountain above the bustling city.  Despite the religious themes, Monserrate appeals to the faithful and the agnostic alike – due to the impressive and expansive views of the valley below.

the view from Monserrate

Traditionally, pilgrims climbed to the top of Monserrate on a worn-down path.  A train and a cable car also served to bring travelers, and tourists to the top of Monserrate.

The new upgrades to the footpath have just been completed – making the walkway more accessible to visitors.

The Bogotá Hilton (located in the financial district) also opened this week.

HIPEC in the news again..

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Another story about bringing HIPEC to the masses – this time in Mumbai, India..  I have to wonder about the research for the article – everytime I see the phrase, “A ray of hope”..  sounds suspiciously like the original title of a certain article (in Colombia Reports.com) all of us are familiar with over here at Bogota Surgery.org.

HIPEC and peritoneal mesothelioma – more effective in women?

Dental care overseas

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As reported in numerous stories, many Americans are travelling to Mexico and other countries for dental care. Ex-pats or Americans living abroad are also seeking dental services.

However, as highlighted in this article – determining the quality of your provider overseas is not easy.  (Of course, it’s not easy to find a good dentist for many of us at home – but that’s a separate issue.)

Evaluating dentists and dental services is different that evaluating other health care providers – due to the nature of the service.  Unlike most surgical procedures – most dental procedures do not require anesthesia, (which means that they can be evaluated on a first-person basis).  Of course – for my colleagues who assisted me in writing Bogotá! – it meant quite a bit of time in the dentist’s chair..

November for Colombia’s tourism industry

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This month (November) is a big month for the Colombian tourism industry – and the Colombian government with several big events and meetings taking place to promote the tourism sector.

This week, the Secretary – General of the United Nations World Tourism Organization (UNWTO)(who knew such things existed?) heads to Bogota to participate as a guest of the Colombia’s minister of tourism – as part of the Tourism Race 2011..

Later this month – at the JW Marriott in Bogota – is the high end tourism conference, “Chic Travel Market“which promotes luxury tourism to Colombia.  I’m not sure if surgical tourism counts as luxury tourism but it sounds interesting, nonetheless.  (I consider surgical tourism to be “life-saving tourism”..)

Colombia listed as ‘vacation bargain’

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A new article at the Minnesota Star-Tribune highlights the reasons for heading to Colombia and other parts of Latin America for vacation.  Medical Tourism isn’t mentioned – it’s strictly a vacation article but it’s nice to see Colombia get a bit of the spotlight it deserves!

I’ve been adding a few links with information about Colombia here at Bogota Surgery – just take a look around.

Meeting of the minds – thoracic surgery

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Attended the monthly thoracic surgery meeting led by Dr. Juan Carlos Garzon yesterday for case discussions.. Several interesting cases presented.  More importantly, I met and set up interviews with the last few thoracic surgeons; Dr. Beltran and Dr. Rodolfo Barrios (that I hadn’t met previously).  Should be an interesting week in the south end of the city..

On the topic of thoracic surgery – I am soliciting articles from thoracic surgeons, and other practitioners on the site – not just here in Bogota, but from around the world as part of the mission of the site.  I’ve already had some great feedback from some American surgeons.

Over at cartagena surgery we are talking about the recent announcement by the International Diabetes Federation on treatment recommendations for diabetes including the endorsement of Bariatric Surgery.

In the OR with Dr. Mauricio Largacha, Orthopedic Surgeon

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The rest of Bogota may be quiet for the Easter holidays (la semana santa) but the operating rooms were busy at Unidad Medica Cecimin.

Dr. Mauricio Largacha, Shoulder and Elbow surgeon

I spent an interesting and enjoyable morning in the operating room with Dr. Mauricio Largacha, MD for an arthroscopic Rotator Cuff Repair. Dr. Largacha is a natural teacher, and did an excellent job at explaining different aspects of the procedure, expected post operative outcomes, and specialized equipment – since I am less familiar with shoulder and elbow surgery than other surgical procedures. (Unsurprising since as I mentioned previously, he is an expert in this area, and the author of several chapters in multiple orthopedic surgery textbooks on elbow, shoulder and ankle surgery).

Dr. Mauricio Largacha (left) and author

Surgery went beautifully, and surprisingly quick.. No intraoperative complications.

Dr. Celso Bohorquez, plastic surgeon

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When we first met Dr. Celso Bohorquez, he was donating his time and surgical skills for the repair of congenital facial malformations in Chia, Colombia as part of Operacion Sonrisa.

I went back, yesterday, to Clinica Shaio, to learn more about the man, and the surgeon that so generously contributes to improving the lives of the less fortunate.

Dr. Celso Bohorquez, plastic surgeon

We spent the day in the operating room, watching Dr. Bohorquez perform several techniques including a case with facial endoscopy as part of a face-lift. The results of the cases were striking.


 

In other news, we are discussing pre-operative and intraoperative risk reduction for peri-operative/ post operative MI (along with the high incidence of missed diagnosis) over at our sister site.

Dr. Ernesto Andrade, plastic surgeon

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Dr. Ernesto Andrade is another one of Bogota’s celebrity plastic surgeons, of “Cambrio Extremo” fame.  (A latin television version of ‘Extreme Makeover’ that was popular here several years ago.)  Unfortunately, he was delayed today so I was unable to meet with him, but I did speak with a young doctor in his office, Dr. Eliana Garces.  She filled in a bit of Dr. Andrade’s biography.

I’m hoping to meet with Dr. Andrade himself  tomorrow after I get out of the operating room with Dr. Celso Bohorquez.  If you remember, I met Dr. Bohorquez out in Chia while he was volunteering his surgical skills as part of Operacion Sonrisa (Operation Smile.)