Health Tourism Booms In Tunisia

The waiting room at cosmetic surgeon Taher Djemal's Tunis clinic is a busy place these days. It is filled with Tunisians, Moroccans and Europeans of all shapes and sizes. But despite a wide assortment of languages and nationalities, the prospective patients have one thing in common; they have all come to change their faces, reshape their bodies or fix a defect that has spoiled their self image. Many of the visitors are nervous, but three decorative paintings of Venus, the goddess of beauty, give them strength and hope.

Beginning with the patient's very first appointment, Dr. Djemal's assistants work hard to create a comfortable atmosphere. "We have to put the client at ease, psychologically," says anesthesiologist Noureddine Azri. "The stress he or she feels is perfectly normal and natural and our role is to answer all questions, even if they are boring," he adds.

The majority of Tunisia's cosmetic surgery clients are European women whose visits are co-ordinated by Tunisian travel agencies focused specifically on what has quickly become known as "health tourism". Three years ago, the number of health tourists visiting Tunisia was no more than 2,000. In line with Tunisia's overall growth in the tourism sector, travel agencies saw the surgery market's potential and opened specialised offices throughout the capitol and in cities such as Nabeul and Djerba. By 2007, 150,000 of Tunisia's 6.4 million visitors were health tourists, according to a January report from the National Syndicate Chamber of Private Clinics.

The concept of health tourism is nothing new; the British have long headed to Pakistan or the Philippines for cosmetic surgery. With Tunisia's debut on the market, however, many foreigners are now choosing clinics like Dr. Djemal's for their proximity and affordable prices.

Indeed, only a short flight from Europe, Tunisia appeals to those short on time and who want to save money. For instance, the cost of a face lift in Tunisia is 3,200 euros. The same operation in France would cost 5,000 euros or more. Breast enlargement surgery costs 6,000 euros in France, but if done in Tunisia, the procedure price is 2,600 euros.

Word that Tunisia provided moderately-priced cosmetic surgery soon spread to other European countries and beyond. Now, clients looking for an affordable makeover and vacation wrapped into one jaunt come from as far away as Sweden, Russia and the United States. Rym El Balti, a marketing employee at Estetica Tour, a leading travel agency in the field of cosmetic surgery tourism, tells Magharebia that the majority of prospective patients come from France, Belgium and Switzerland.

Approved and regulated by Tunisia's ministries of tourism and health, cosmetic tourism specialists can organise every aspect of a visitor's stay, from booking air tickets and scheduling appointments to arranging comfortable accommodations, usually at beach hotels, to allow patients to comfortably convalesce.

Former patients often advertise for Tunisian cosmetic clinics through word of mouth. "Many of the people who contact my clinic are people who have seen changes in the lives of a neighbour, friend or a colleague at work," says Dr. Taher Djemal.

A few years ago, Dr. Djemal says he could count the number of patients per week on one hand. Most of them were either from the Maghreb, he adds, or else they were "low-income Europeans" unable to afford cosmetic procedures in their own countries. It is a different story today.

Now, he says, "[W]e perform cosmetic surgeries on a daily basis after we have proven our worth in the field and after winning the trust of our clients, who [then] advertise our work through the word of mouth. Many of the people who contact my clinic are people who have seen changes in the lives of a neighbour, friend or a colleague at work." He acknowledges that "the western media, and especially the French media, plays an important role in marketing cosmetic surgeries in Tunisia, which put an end to the logic of 'North medicine' health club as compared to the 'South medicine.'"

Dr. Djemal recognises the challenge of facing doubts over his performance because he is "a surgeon in a developing country". He adds, "As a cosmetic surgeon from a South country, health club I had to succeed. I have to do this throughout my practice of this profession, in which the science of surgery is mixed with the art of drawing and psychology."

Growing recognition of both the competence of Tunisian surgeons and the country's good health sector infrastructure has contributed to the recent boom in health tourism, according to Abou Bakr Zeghama, president of National Syndicate Chamber of Private Clinics.

Helen K., who came to Tunisia from Switzerland for abdominal liposuction, spoke with Magharebia while recuperating at one of the hotels in Tunis' northern suburbs. "I feel as if I have removed tons of fat from my body. My life has changed, and I'm happy with the result," she said. She became interested in seeking her cosmetic surgery
In Tunisia after seeing the big difference in one of her friends. "She had a lifting that turned her into a young woman again," she noted.

Another European patient, Catherine M., travelled from France for a breast enlargement operation. She saw a French TV program called "Right to Knowledge" last year which featured cosmetic surgeries in Tunisia, she told Magharebia, and decided to get her procedure after hearing "reassuring and encouraging testimonies from many women" on the episode. After the program aired in France, she added, TF1 received more than 10,000 telephone calls from people looking for the addresses of cosmetic surgery clinics in Tunisia.

However, a Tunisian surgeon who worked and studied in the United States expects that cosmetic procedure costs in Tunisia will soon approach those found in Europe. "We no longer need to prove our worth," Dr. Amir Chaibi said. "Personal work is the thing that distinguishes a good surgeon from a bad one," he explained, adding, "The competition in the future will not be among those who offer the lowest prices, but among those who are the best."