An Afghan baby sleeps.
Credit: Mauricio Lima

NEW DELHI, India — Business is booming at Dheerendra Singh's New Delhi-based medical tourism outfit, CureMax. But his biggest client base — Afghanistan — might come as something of a surprise.

“Every month, we do IVF [in vitro fertilization] for around 50 patients from Afghanistan,” Singh said. “They also come for other infertility-related procedures. And in the peak [winter] season [when the weather is more comfortable], we have 60-70 patients a month.”

Afghanistan isn't the half of it. Though infertility is commonly associated with the changing lifestyles of the West — where more and more women are putting off childbirth until their late 30s — India's IVF clinics are testimony that the trend is growing in developing countries and conservative societies as well.

Along with the much-talked-about medical tourist trade from the US and Europe, India is seeing an influx of patients from Muslim countries in Africa and the Middle East, thanks to a thriving, low-cost domestic fertility industry and cultural connections that make India a comfortable place for conservative Muslims, medical tourism professionals say.

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Statistics aren't readily available on the total number of patients coming to India for fertility treatments from predominantly Muslim countries. But anecdotal evidence from various doctors and other agents like Singh — as well as a thriving business in the Afghan refugee colony in New Delhi — suggests that the phenomenon is significant.

According to India's Outlook magazine, for instance, fertility experts like Dr. Kaberi Banerjee number their patients from places like Iran, Iraq, Uzbekistan and Tanzania in the hundreds. Meanwhile, companies like Care Medical say they see 10-15 foreign patients from Islamic countries every month, according to managing director D. Mahendran.

“Overall, we see [medical tourism] growth of about 15-20 percent annually, and I believe roughty the same kind of number holds for IVF,” said P.R. Ramesh, the chief executive of Aaarex Medical Services, another medical tourism firm. “But we're seeing a larger number of Muslim people than previously, including Muslims from Arabic countries and Muslims from countries like Nigeria and Tanzania and so on.”

Various factors help explain the baby boom. Because of India's massive population, and the cultural importance of bearing children here, private fertility clinics have mushroomed in recent years — until there's an IVF signboard on virtually every street in the upscale neighborhoods of New Delhi.

Reputable clinics offer a high standard of care for a small fraction of the cost of IVF in the West. A typical IVF procedure, for instance, runs to $3,000 in India, compared with $8,000 in the US or Europe, said CureMax's Singh. And patients receive more attention from doctors.

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To regulate fly-by-night outfits that have begun sprouting up, the Indian Council of Medical Research recently drafted regulations and began to crack down.

“Here in India, people take IVF very serious, and they give personalized care,” said Mahendran.

But there are other reasons India is attracting patients from Muslim countries.

Proximity and historical ties link India with Iran, Iraq, Afghanistan and other countries of Central Asia in ways that are impossible for other medical tourism hotspots, like Thailand, to match. Standards of dress and behavior are similar, for instance. And the long dominance of Bollywood movies in the target region means that patients there are comfortable with Indian culture, and, especially in Afghanistan, can often already speak Hindi.

Because fertility treatments can be time consuming, the low cost of living, and the ease of blending in and finding halal meat and other familiar foods, is also a factor. In New Delhi, for instance, CureMax and other medical tourism outfits connect IVF patients with landlords operating serviced apartments in neighborhoods in Lajpat Nagar and Jangpura, which are already home to Afghan refugees who migrated here to escape the fighting at home. By cooking their own meals — and buying Afghani naan from the local shop — they avoid exorbitant hotel costs.

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Similarly, certain Iranian and African communities have ties with India that make it a more familiar destination than its competitors.

“India has got a large Muslim population, and there are many communities in Africa which relate very closely to their counterparts in India,” said Aaarex's Ramesh.

“For example, there is a community called the Ithna Asheri community in Tanzania, with strong connections to the same community in India. Many of these communities are Indian in origin. To some extent there are also family links.”

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