Health Tourism in the Balkans A global perspective Balkan Wellbeing Workshop 29 October, 2015
Northern Europe Landscape-based tourism (e.g. fjords, lakes, forests) contributing to lifestyle and wellbeing Active outdoor recreation (e.g. Nordic walking) Healthy gastronomy based on fresh fish, berries, rye and oats Home of saunas Cold water treatments (e.g. Lake Wellness) Development of healing landscapes Abundant geothermal resources (with hydrotherapy and recreation focus) Protestant simplicity influencing lifestyle and healing practices Southern Europe Traditional and contemporary approaches in parallel (e.g. thermal baths and holistic retreats) Primary emphasis still on treatments and therapies for the physical body Thermal facilities usually offer medical treatments supervised by healthcare practitioners Revival of thalassotherapy Home of the Slow movement Mediterranean diet contributing to wellbeing Destination of intra-european holistic travel Luxury hotel and resort spas
Western Europe Preventative focus based on lifestyle Emphasis on mental as well as physical health Lifestyle-based approach to health and wellness Complementary and alternative (drugfree) treatments growing in popularity Thermal baths or spas tend to offer relaxation and beauty treatments Central and Eastern Europe Medical (curative) focus with evidencebased approaches Emphasis on treatments and therapies for the physical body Limited application of lifestyle-based wellness Mainly conventional medicines administered by doctors or through pharmacies (Public) Baths offer medical treatments supervised by practitioners Medical destinations and thermal bath towns Maturing hotel spa and spa hotel, pleasure bath market (with signs of saturation) Medical bath destinations
Country Profiles
Albania Main focus: Culture/heritage Natural assets Resources: Thermal waters Herbal remedies Resorts (with wellness facilities) Health and Tourism Limited/not national priority Generic
Bosnia-Hercegovina Main focus: Culture/heritage & Religion Natural assets Resources: Thermal waters & Banjas Rehabilitation centres (14% of domestic guest nights) Health and Tourism National priority
Bulgaria Main focus: Sea Mountains Culture Resources: Balneology resorts (38) 1,600+ thermal springs Rehabilitation centres (30) Clinics Resorts Health and Tourism National Priority
Croatia Main focus: Sea Nature-based Food Resources: Thermal springs Clinics Resorts/Hotels Health and Tourism Medical tourism national priority Wellness tourism
Greece Main focus: Sea Culture/Heritage Food Resources: Thermal springs Clinics Resorts/Hotels (by the sea) Thalassotherapy Health and Tourism Medical tourism Wellness tourism
FYR Macedonia Main focus: Nature Wine Food Resources: Thermal springs Rehabilitation centres Health and Tourism Spa/health tourism national priority Medical tourism state subsidies for developments
Montenegro Main focus: Sea Nature Resources: Thermal springs Rehabilitation centres (domestic guests) Health and Tourism Medical tourism Healthy outdoor activities national priority Wellness treatments integrating local resources
Romania Main focus: Nature Culture/traditions Resources: Thermal/mineral springs/spas Mud Medical centres (domestic guests) Health and Tourism Health tourism national priority (strategy & communication) EU funds for developments
Serbia Main focus: Culture/traditions Events Resources: Thermal/mineral springs (1,000+) Thermal/climatic resorts (53) (domestic guests) Wellness hotels Health and Tourism Medical tourism Medical Tourism Cluster
Slovenia Main focus: Nature Culture/traditions (food) Sea Spa/wellness/health Resources: (Thermal) Spa resorts (renovated) Climatic resorts Wellness/spa hotels Health and Tourism Spa resorts Medical tourism
Turkey Main focus: Nature Culture/traditions (food) Sea Resources: Thermal springs (1,300+) Wellness/spa hotels (by the sea) Hospitals Health and Tourism Strategy & Communitation national priority (THTDC) Medical (medicine) tourism Thermal tourism Elderly and disabled tourism
Statement Agree Disagree Undecided The Balkans provide mainly sun, sea and sand tourism. There is not much potential for health and wellbeing tourism development. 2 20 The Balkans mainly offer good opportunities for spa and wellness tourism for leisure tourists. 15 2 3 The Balkans mainly specialise in thermal medical spas and rehabilitation for social tourists (e.g. government-funded). 12 4 5 The Balkans has good potential for health, wellness and spa tourism but the infrastructure and services need some development and improvements. 27 2
Healthy food and wine Suggested USPs Mountains and forests Thermal baths/balneology Natural and herbal remedies Good climate and sun Landscapes/nature
Main Challenges Poor infrastructure Mistrust / unused to working together Lack of marketing and a clear brand Unstable region / conflict Lack of product development / innovation Lack of funding and investment Outdated / poor quality facilities and services Negative image Low levels of wellbeing / unhealthy lifestyles Lack of skills / professionalism Financial and economic problems Different regulations Political and other corruption Lack of enthusiasm / engagement Poor regional / domestic demand Lacking a common language Lack of data / research on wellness Changing political and legal regulations Unknown wellness attractions Unsustainable development Differences in education levels Resistant to change
Overall Observations
Strengths Long history of health tourism in the form of balneology and rehabiliation spas Strong traditions in herbal and plant medicine Favourable climate Beautiful and often pristine natural environment Tasty and healthy gastronomy and wines Accessible region from many countries Competitive and sometimes cheap prices for international tourists Opportunities Renovation of spas and balneological facilities Promoting natural healing resources and landscape-based wellbeing Including herbal and plant medicines and therapies in health and spa treatments Developing health tourism clusters or collaborations Weaknesses Relatively poor infrastructure Lack of service quality Low level of education, training and skills Negative or unknown image Mistrust and inability to work together Threats Ongoing conflicts and instability Outmigration of talented employees because of low salaries Lack of government funding for domestic health tourism in the future Political and other corruption 20
AL BA BG HR GR MK MNE RO SRB SLO TR Thermal Herbal Wellness/ spa hotels Medical Rehabilitation Thalasso Hospitals
Overall Observations Almost all of the Balkan countries have thermal and mineral waters which have been used for healing in the past and often are still used as the basis for health or wellness tourism. However, it is often the case that a very small percentage of the available waters are actually used for health tourism. Some countries also have therapeutic mud or gas as well as a healing climate in places. Most of the countries have traditionally focused on rehabilitation for residents or domestic tourists which takes place in sanatoria or thermal baths with medical facilities. The move towards wellness is relatively recent and is more developed in some countries than others (e.g. Slovenia, Greece). Although there is potential for the development of international wellness tourism, there is a need to improve the overall infrastructure of thermal bath or spa centres, including accommodation, facilities, services and treatments. The decline has mainly been the result of public or state funding ending and privatisation not yet taking place.
1,200 spas (thermal baths) and health resorts in Europe
Overall Observations (Surgical) medical tourism is a relatively recent development in the region as a whole, it is only offered in certain destinations, and currently represents the smallest segment of health tourists. There is a growing number of hotels with spa and wellness facilities, many of them in seaside locations or in cities. Although most of the Balkan countries promote health tourism, it is usually only on a sub-page of their online communication and health tourism represents a relatively small percentage of tourists overall (sometimes as little as 1%). The traditional Balkan spa offers a combination between elements of balneology, climatology and environment.
Concepts Wellbeing Health Tourism MedicalTourism/Travel MedicalWellness Tourism Holistic Tourism Wellness Tourism Spiritual Tourism MedSpas Thermal Medical Spas (Baths) Destination Spas Hotel & Day Spas Medical Hotels & Resorts Supply Longevity Centres Hospitals& Clinics Cruises Healthy hotels& H2H Conversions Wellness Hotels & Resorts Leisure Baths Retreats
Spas Medical Rehabilitation Suggested Ideas for Development Naturebased Spiritual Nutrition Forest therapy / 'hammam' Mountain resorts Eco-villages Outdoor recreation Mountain retreats Monasteries Healthy food Detox programmes Treatments 4 Elements and 5 Senses Medical mud Local fruits