After Surgery into the Rollercoaster -- MEDICA - World Forum for Medicine

After Surgery into the Rollercoaster

Photo: Woman with a veil

Patients from the Arab world
are no curiosity in Germany;
© Jutta Rotter/

It is quiet as a mouse on the floor of the Kaiser-Karl-Klinik in Bonn. Only out of one room you can hear a foreign language. In room 159 Al Hussaimi Zainab lies on her bed and watches tv. It is an Arabic channel. Her daughter is sitting on a chair beside the bed. Two dark eyes are looking through a small slot of her veil. The two women are from Saudi Arabia, the mother was operated on her knee four weeks ago and has to do physiotherapy now every day. The 61-year old woman cannot say in detail what the doctor has done. She only knows: “In my country the treatment was not possible.”

Al Hussaimi Zainab is one of many foreign patients who are treated medically in Germany. Altogether, the Federal Statistical Office counted 71.000 patients from other countries in German hospitals in 2008. But the high number arouses a false impression because emergency cases like the stroke of an Austrian holiday-maker or the broken leg of a British tourist are also included. Only about 10.000 up to 14.000 patients decide consciously for a treatment made in Germany. Although it is a small group, it is also an interesting group because these patients bring additional money to the hospitals.

The costs of treatment are deducted similar as on German patients who are in a private insurance - and are out of the limited budget of the hospitals. How many money they lead in the hospitals depends on way and degree of difficulty of the treatment: “To cut open and sew the wound costs about 5.000 Euros”, says Khaled Guizani, manager of the project “Bonn Medical Partners”, in which nine hospitals around Bonn join forces. The Kaiser-Karl Klinik, a hospital for rehabilitative medicine, is also member. In addition to the surgery costs there are costs for the residence in hospital. “All in all a new hip costs about 15.000 Euros, a chemotherapy combined with radiation therapy up to 40.000 Euros. Hospitals which are specialized on foreign patients and offer very complicated surgery, the costs of treatment sometimes can range up to 300.000 Euros.

Merchandising of health services

The medical tourism around Bonn began in the seventies. Employees of the embassies in the former German capitol were treated in the regions’ hospitals. If they were satisfied, they recommended the medical treatment to their relatives in foreign countries. Al Hussaimi Zainab’s son did it the same way. He lives in Germany and works on the embassy of Saudi Arabia. “He initiated the treatment for me”, she says. However, in the nineties, many embassies moved from Bonn to Berlin and with this change the patients from foreign countries became less. Because of that the city originated in cooperation with a tourism company the project “Bonn Medical Partners” in 2006. The aim is to merchandise health care into other countries.

Photo: Rollercoaster in a theme park
Tourist attractions like theme parks also benefit from foreign patients; © erysipel/

Now, this is the job of Khaled Guizani and his colleagues who are specialized on Arab countries and Russia. They have regular contact to foreign physicians and present themselves on international trade fairs. And they support the patients in organizing their journey. “We send invitations to the embassies and affirm the date for surgery. This makes it easier for the patient to get a visa”, says the Tunisian. His first language is Arabic, an ideal qualification for the contact to patients from the Arab world. “In addition to this we try to find an interpreter for the patients and we recommend tourist attractions like the theme park Phantasialand.”

Foreign patients mostly come in the summer

The marketing strategy is successful. Three percent of the patients at Kaiser-Karl-Klinik are from foreign countries. Although this is only a little part of all patients, the average of foreign people in all German hospitals is only about 0.4 percent. “Especially in the summer foreign patients mean an extra income for us”, says Bärbel Langwasser-Greb, managing director of the Kaiser-Karl-Klinik. Many German patients decide for surgery and rehabilitation in the winter. That is why foreign patients are welcome in the summer. Especially for Arabic patients this is also a good solution because they can escape from the hot weather in their home country. Another reason why foreign patients are welcome guests is that they often stay longer in hospital than German patients because in their home countries they often have not the possibility to get outpatient treatment with physiotherapy and rehabilitation.

In 2007, Bonn has made a turnover of seven million Euros with foreign patients, in 2008 even nine million Euros. However, studies prove that also the whole region benefits from foreign patients. Al Hussaimi Zainab and her daughter are in Germany for two months. Before surgery they lived in a hotel and they went to hospital only for medical checkups if it was necessary. “We visited the city and once we were in Belgium and France”, says the Arab woman. A German patient spends about 13 Euros a day in Bonn, a patient of the United Arab Emirates 185 Euros.

Al Hussaimi Zainab will leave the hospital in Bonn next week. “I felt very good here. The medical and human care sometimes was better than in my home country.” Maybe she only wants to be polite. However, she will recommend a medical treatment in Germany in her home country. And she will return herself if it should be necessary.

Simone Heimann