orAfter giving birth to two children, fashion vlogger Zee Allure didn’t like what was done to her body. “I didn’t look the same. It wasn’t me,” she said Caribbean Beat in an interview for Zoom. She felt she knew where to turn: the plastic surgeons of the Dominican Republic (DR) had a reputation that was almost legendary.
“I feel like DR is number one,” said Zee, who is 27 and lives in Atlanta. “No one could occupy that place. They are the best.”
So in July 2021, she flew her mother and young children to Santo Domingo for what she called a “surgery-cation,” documenting the experience in a series of videos posted on YouTube. In a video update six months later, she showed off the results of a tummy tuck, liposuction and a Brazilian butt lift (BBL).
She listed the myriad USD costs of the 18-day trip: plane tickets ($1,800); lodging ($1,450); a nurse ($810); a driver ($250); chef service ($90); massages ($180); a pre-ordered package of post-op essentials like gauze and gloves ($300); and the surgery itself ($6,000).
While she was in the DR, she also got her eyebrows microbladed ($142), her lips filled ($400), and veneers on her teeth ($2,500). The list did not include the costs of shopping and going to various restaurants.
Zee Allure is an example of why destinations appeal to medical tourists. They consume more products and services and therefore spend much more money than other tourists.
Among the CARICOM countries, the DR has been the most successful in attracting medical tourists, receiving a flood of them each year – most of them for cosmetic procedures. Many of them document their experience – positive and negative – on social media.
The DR is one of only two CARICOM countries in the Medical Tourism Index (MTI), a guide compiled by the International Healthcare Research Center (IHRC) – a non-profit organization in the United States (US) – based on the perceptions of Americans for destinations. For the MTI 2020–2021, the DR is ranked 19th out of 46 countries. Jamaica is ranked 40th and has been trying to increase its medical tourism prospects for decades.
During a 2021 webinar, Diane Edwards – then president of the Jamaica Promotions Corporation (JAMPRO), the state agency responsible for assisting investment and industry in Jamaica – said they had drawn up a medical tourism policy after four years of consultation with the government and private stakeholders. An official policy has yet to be presented.
“I would say the most consistent story is hearing high hopes from governments and not seeing the sector actually develop,” said Dr Valorie Crooks, a health geographer with Simon Fraser University in Canada. Caribbean Beat. Crooks book, Medical Tourism in the Caribbean Regionexpected to be released next year.
Plastic surgeon Dr Jan Hochtritt – who runs the ProSurgiCare clinic in Kingston and was one of the participants in the JAMPRO webinar – believes Jamaica can benefit from cosmetic surgery patients.
Zee Allure is an example of why destinations appeal to medical tourists. They consume more products and services and therefore spend much more money than other tourists
“There was a case where a Jamaican went to the DR to have a procedure and came to me for a complication. When I asked her about her implant, she didn’t know she got an implant there,” Hochtritt told her. The Jamaica Observer at the beginning of this year. “Some doctors there don’t speak English well and some Jamaicans don’t speak Spanish well. This can lead to problems.”
“Medical tourism can contribute significantly to the Jamaican economy and we believe the island will do very well if we promote the sector,” says Hochtritt. During the webinar, he explained that 40% of his patients visit from other countries, and of that number about 95% were from the Jamaican diaspora – Jamaicans or their descendants living abroad.
This is in line with a 2018 PricewaterhouseCoopers report on JAMPRO aimed at developing medical tourism in Jamaica. A study of 27 private surgical clinics found that 20–30% of their revenue came from foreigners, the majority (56%) of whom were from the Jamaican diaspora. The rest were from other Caribbean countries and elsewhere.
In a podcast interview last year, Crooks — who defines medical tourism as health care intentionally sought by visitors, to distinguish it from emergency care — talked about the importance of the Internet in promoting a destination. Social media in particular plays a large role in the popularity of DR.
“There’s a lot of networking among people who are thinking about going abroad … chat rooms and discussion boards, for example, websites where patients talk about their experience,” says Crooks. “So you can build the reputation of a particular destination.”
orAnother challenge facing Caribbean medical tourism is the limited number of medical facilities accredited by major international agencies. This is a significant consideration given that the IHRC, in its Medical Tourism Patient Survey, found that more than 63% of patients said that accreditation influenced their choice of provider.
Among the most respected international accreditors are the Joint Commission International (JCI), based in the United States; only three CARICOM providers are accredited by the JCI — although others have sought accreditation from other organizations.
“The problem is that our local accreditation process may not fully match the JCI accreditation process,” explained cardiologist Dr Ernest Madu, who founded the unaccredited but reputable Caribbean Heart Institute in Kingston, in the JAMPRO webinar. “If we do not align those processes with international standards, we will not receive international accreditation; and if we don’t get international accreditation, patients won’t come to the group.”
Madu went on to explain that the range of things that providers must put in place for accreditation are the same things that improve patient outcomes and inspire confidence in potential clients. He emphasized that all available data and research support this.
Many providers share Madu’s view of the value of accreditation—with those offering fertility treatments chief among them. The Trinidad & Tobago IVF & Fertility Center, with two locations in Trinidad, is accredited by TEMOS (Trust Effective Medicine, Optimized Services), based in Germany.
Services such as IVF and egg freezing are much cheaper in the Caribbean than in the US or the European Union. Waiting times for an appointment are also much shorter, and the tropical island location of these clinics is one of the reasons people seek medical treatment in the Caribbean. This helps them feel like they are resting while they seek their respective medical treatments.
Zee believes that the social media community can reduce bad outcomes for any medical procedure or treatment. She took her mother to support and help care for her two young children. Perhaps most importantly, she prepared well in advance—six months, to be exact.
“Don’t just decide you’re going to have surgery and then leave in two months,” she said. “Get ready. You need more time to buy the things you need. You have to build your own [blood] iron. And you also have to be mentally prepared.”
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