Tag Archives: tourism

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.