Indian Hospitals Are Doing a Roaring Trade in Medical Tourists From Afghanistan

Jamshed walks out of the gates of the Kasturba Niketan Colony—a gated community in South Delhi’s Lajpat Nagar area, populated mostly by Afghan medical tourists like him. He passes an Afghan grocery store, and heads onto the street outside, glancing at Afghan pharmacies and advertisements for rented accommodation written in Dari, one of Afghanistan’s two official languages.

He stops at a roadside nanwayee (Afghan bakery), to buy bread from men in khet partug (Afghan trousers) and walks into Mazaar, one of the many restaurants in the area that serves authentic Afghan food, where he sits gratefully at a table. He has spent the entire day at a Delhi hospital, where his brother is being treated for a brain tumor.

“There are big hospitals in Afghanistan too,” says Jamshed. “But the medicines are mostly fake.”

Delhi’s Little Kabul, as the Lajpat Nagar district has come to be known as in recent times, is testament to Afghanistan’s spiraling medical crisis.

Last week, a report by international charity Médecins Sans Frontières (Doctors Without Borders) said one in every five of the patients interviewed had a family member or close friend who had died within the last year due to a lack of access to medical care. Aid money can’t always fix the problem. The Special Inspector General for Afghanistan Reconstruction (SIGAR) recently revealed that construction defects, and a lack of water, staff and and power, meant that the Salang Hospital in Parwan province was unable to function properly, despite the fact that over half a million dollars had been spent on it.

“Many Afghans continue to struggle to access basic and emergency medical care due to insecurity, distance, cost and the fact that many health facilities do not function adequately,” Benoit De Gryse, MSF Country Representative in Afghanistan told TIME.

(MORE: The Woeful State of Afghan Healthcare)

All this would explain why the numbers of Afghans heading to India for medical treatment is rising. The Indian embassy in Kabul issued 32,200 medical visas in 2013, up from 26,500 in 2012.

“If you have a heart attack and if you are rich you go to London,” says Ajay Bakshi, CEO of Max Hospitals, which clocked 6000 Afghan patients in 2013. “If you are middle class you go to India.”

Few Afghans can afford the sums involved. For most, coming to India means mortgaging property, taking out a loan, or getting sponsorship. Nabiulla Wajekh works in the Afghanistan army as a registration officer. His daughter was born with a hole in her heart and a charity paid for her treatment in Delhi. Even so, the family has had to burn through money for living expenses, with Wajekh spending his meager monthly salary of $300 in two weeks.

“Who wouldn’t want to be able to walk into a hospital in his own country to get well?” he asks.

Although medical treatment would be cheaper and nearer in Pakistan or Iran, political instability in the former, and harassment by the authorities in the latter, means that many Afghans prefer India, which lays out a welcome mat.

India introduced medical visas for Afghans in 2005 and Indian hospitals have been eager to tap this new revenue stream. Many have websites in Dari and Pashto, and separate payment and service desks for Afghans. They offer prayer rooms, Halal food and Afghan cuisine. Almost all hospitals provide interpreters free of charge.

“There’s no huge financial investment in this,” says Max Hospitals’ Bakshi. “But it helps in establishing an emotional connect. It makes them feel taken care of.”

India has a strategic interest in establishing those connections. It has invested heavily in the rebuilding of Afghanistan with $2 billion in aid, seeking to win economic influence, boost security and gain a link to Central Asia. The booming medical tourism industry is a valuable projection of Indian soft power that Afghans are all too aware of. Even the medical professionals.

“Afghanistan at the moment cannot cope with healthcare,” says Mohammad Naim, who came to India to treat his uncle’s stomach cancer. His job? Surgeon, at the Mazaar-e-Shariff government hospital in northern Afghanistan.