1 Health Tourism Lecture 1 Historical overview (health services,, and their relation to tourism) Introduction 2 What we anticipate in our destinations is not holiness or divine visions, but something even more miraculous the opportunity to feel different from the way we feel at home. It is as if the act of travelling to a certain place in the world entitles us to feel happier and more alive. (Chaline, 2002:67) The IUTO in 1973 stated that health tourism is the provision of health facilities utilizing the natural resources of the country, in particular mineral water and climate. 1
Hall (1992) provided an analysis of health tourism within the context of adventure and sport tourism. Health tourism was compared to the other two forms of tourism based on its activity levels and motivation spectrum. 3 Health Tourism Activity and Motivation Spectrum. Source : Smith and Puczkó. 4 Van Spielen also formulated five components, each identifying a more specific market segment: Sun and fun activities Engaging in healthy activities, but health is not the central motive (adventure and sports tourism activities such as hiking, cycling, or golf) Principal motive for travel is health (e.g. sea cruise or travel to a different climate) Travel for sauna, massage, and other health activities (spa resort) Medical treatment. 2
Müller and Kaufmann (2000) define wellness tourism as: 5 The sum of all the relationships and phenomena resulting from a journey and residence by people whose main motive is to preserve or promote their health. They stay in a specialised hotel which provides the appropriate professional know-how and individual care. They require a comprehensive service package comprising physical fitness/beauty care, healthy nutrition/diet, relaxation/meditation and mental activity/ education. Wolfgang Nahrstedt (2008) suggests: that the term wellness came from a combination of the World Health Organization s (WHO, 1948) notion of well-being and the later (1950s) concept of fitness. 6 3
7 The figure demonstrates the wide range of health and wellness products and facilities which have emerged in recent years. Historical Overview 8 Your town is only a perfect town when there is a bath in it. (Abu Sir in Lee, 2004) A brief international overview of health and wellness Indian Ayurvedic practices go back as far as 5000 BC, Egyptian women in 3000 BC used similar cosmetics to the ones that are sometimes used today Chinese medicine go back to 1000 BC Ancient Greek civilizations from 700 BC introduced cold water bathing for warriors Persians (600 300 BC) already used steam and mud baths The Roman Empire left an incredible legacy of baths The Baths of Caracalla near Rome were in use for three centuries before they lost their aqueduct water supply in the siege of Rome 537 AD The Ottoman Empire built Turkish baths in 800 ad and knights from Britain experienced them during crusades in 1200 AD The Renaissance in Europe (16th century) witnessed a boost to balneo-therapy (water therapy treatments) as a medical practice The chemical and mineral properties of spa water were discovered in the mid- 17th century (for drinking and douching as well as bathing) The Japanese also had their own spas known as onsens, which are based on natural thermal springs. 4
EUROPE 9 The history of health tourism in Europe has tended to be based around spas and seawater treatments, mainly because of the large numbers of thermal and mineral springs and sea coasts. The word Spa is thought maybe to have originated from Latin and phrases such as sanitas per aqua, or from the Walloon word espa for fountain. The Romans travelled to different spas for healing purposes, with Spa in Belgium, Bath in the UK, Baden- Baden in Germany, Budapest in Hungary, and Gerona in Spain. The Roman Bath Experience 10 5
Middle East and North Africa 11 Arabian medicine was originally influenced by that of Greeks and Romans Egyptians used thermals baths, whereas Arabian hamams or Turkish steam baths played a fundamental role in Ottoman culture (around 600 AD) Arabian medicine tends to use Hippocrates idea of the four humours yellow bile, black bile, phlegm, and blood) Alexander (2001) describes the holistic system of medicine known as Tibb, which was mainly practised in Persia and Turkey in the past, but increasingly in the Middle East, India, Pakistan, Bangladesh, Afghanistan and Malaysia. TIBB 12 6
Asia-Pacific Asia s wellness traditions take a holistic approach of treating the body, mind, and spirit as one, trying to identify the root cause of a problem and encouraging the body to heal itself. Japan: onsens (traditional bathing establishments) are often visited by locals looking for relaxation or meditation and increasingly by tourists. The Balneotherapy Institute was founded by Kyushu University in 1931 and by 1955, there were over 90 medical facilities in the mineral spring locations in Japan. Therapies like Shiatsu massage or Reiki have also emerged from Japan and are commonly used in western spas nowadays. India s Ayurveda ( the science of life ) is regarded by scholars as the oldest healing system in the world (India, Sri Lanka, and Nepal) Traditional or Chinese medicine (TCM) and Chinese practices focus on the individual and provide a unique combination of therapies based on the Three Treasures listed below: Energy or life force, called Qi or Chi Jing the essence which governs vitality and longevity Shen the mind or spirit, responsible for consciousness and mental ability. to balance Yin (feminine, cold, static) and Yang (masculine, warm, dynamic) Thai massage (it is given clothed!) is around 2,500 years old The indigenous peoples in the Asia-Pacific region (including Australian Aborigines and New Zealand Maori) have always used traditional herbal remedies, massages, and deep spiritual beliefs 13 Africa 14 Africa has a wide range of indigenous herbs and plants which have been used for centuries for health and healing. MacKenzie (2005) describes sulphur and hot springs discovered around the Cape and putative health resorts with hotels and sanatoria. Lung diseases were particularly thought to benefit from a stay in Africa. 7
The Americas 15 Modern spas of the past 100 years Traditions of indigenous peoples (South America has thousands of hot springs) The American Hydropathic Institute opened in New York in 1851 The concept of naturotherapy also originated in New York. Generally spas in America tended to be more social than therapeutic, and demanded little from patients Overall, in the past 40 years or so, numerous so-called super spas have emerged in America which preserve the privacy of individuals and shelter them from the outside world so that they can relax, be pampered and rejuvenate (e.g. vine spas or spa and golf, or ski and spa products) 8