Plans for 'Healthcare City' bring medical investments to Dubai

Pharmaceutical companies, academic centers contribute to project.

The Middle Eastern city of Dubai bears influence over some 1.8 billion people as it serves as a crossroads connecting Asia and Europe, the East and the West.

So it is no small coincidence that when His Highness General Sheikh Mohammed bin Rashid Al Maktoum, Crown Prince of Dubai, announced that the city would invest $1.8 billion in a company called the Dubai Healthcare City (DHCC), multinational interests sought to be part of the project.

DHCC will feature state-of-the-art facilities for medical services, education and research. The Dubai Development and Investment Authority (DDIA) launched DHCC in November 2002, working under an aggressive 2-year timeline.

Millicent Grim, MD, an ophthalmologist in Dubai, noted that the project would raise the already high standard of health care by increasing competition.

“It will really challenge the existing establishment,” she said. “It will also act as a health care magnet for the region.”

Population challenges

The unique makeup of the city’s population has been a challenge to local health care providers. According to the DDIA, 80% of Dubai’s population comprises expatriates; local ophthalmologists relate anecdotally that many of these individuals prefer to return to their home countries to seek health care.

Dr. Grim, who introduced LASIK in Oman in 1997 before starting her practice in Dubai in 2002, noted that there are more sophisticated diagnostic screening machines in her current office than she had available in Oman. Yet a “sizable number of people” still seek health care services abroad, she said. “We hope to change that perception,” she said.

Most of the expatriate population is younger, between the ages of 25 and 45, and cannot afford elective procedures due to financial constraints or a lack of family help, according to ophthalmologist B.S. Chidamber, DOMS, MS, a vitreoretinal surgeon.

And members of the local Arabic population, who enjoy a per capita income that ranks among the highest in the world, often travel to Europe, India and the United States for health care, he noted.

Ophthalmic services

Dr. Chidamber, who started the retinal service at Dubai’s Welcare Hospital, said that the stratified population has stunted the demand for local ophthalmic services, which has not grown at the rate of obstetrics and gynecology, for example.

When Dr. Chidamber arrived at Welcare in 1999, retinal services there were only rudimentary and lacked such procedures as vitrectomy or membrane peeling, he noted. “To create that niche took time,” he said. He added that between 2% and 5% of the population now requests vitreoretinal services.

Dr. Grim noted that the number of people seeking medical services abroad has created difficulties for local physicians in providing adequate follow-up care.

“Investments by … leaders in the health care industry will set new standards for us locally and will also tell the world in general, and the regional inhabitants in particular, that excellence in health care is now locally available and does not need to be sought overseas anymore,” she said.

Global interest

Since the launch of the project, interest has been piqued around the globe. The government of Dubai has announced partnerships with industry leaders such as Johnson & Johnson and Novartis Pharma Services as well as medical centers such as the Mayo Clinic and Imperial College, London. The list of contributors in academia includes Johns Hopkins, Harvard and Brown universities, the University of Toronto and the New England Journal of Medicine.

The largest private medical center in the Middle East and Africa, El-Maghraby Hospitals and Centers, based in Jeddah, Saudi Arabia, will offer subspecialty services in ophthalmology, including cataract, glaucoma, refractive and vitreoretinal care.

Unprecedented project

Even for a seasoned institution such as Harvard Medical International (HMI), which has shared its expertise in developing medical facilities and education in more than 30 countries, the scope of the project is unparalleled.

“There’s no project that brings everyone together as Dubai has done,” said ophthalmologist Mehul C. Mehta, MBBS, MS, MA, vice president and director of HMI. “We’ve done pieces of Dubai everywhere. [But] there are also parts that are new; they’re new to everyone.”

HMI’s role, he explained, is to provide the core clinical, education and research quality oversight structures and benchmarks for DHCC. It also provides “lifelong training” in areas ranging from technology to medical ethics. “It’s the gold standard to train educators,” Dr. Mehta said of HMI.

Economic development

Two factors have spurred the modernization of health care in Dubai. The first, Dr. Chidamber said, has been steady growth of the skilled and educated expatriate population.

“They are building up a lot of facilities for expatriates,” he said. “The whole economy really depends on providing that.”

In the United Arab Emirates (UAE), the population is growing at an annual rate of 3.3%, according to the DDIA. The current population of Dubai is expected to increase by 50% by 2010.

The government under His Highness General Sheikh Mohammed has prompted new employment opportunities, with investments in financial services, real estate, tourism, information technology, media and entertainment.

“He has a fantastic foresight,” Dr. Chidamber said. “He provides the basic infrastructure [and] whatever is needed … without compromising on the quality there by attracting the best.”

Competition

Dr. Grim added that while some of her colleagues have been concerned about increased competition, she expects local practitioners to see a greater demand for their services. She pointed to the hospitality industry as an example: Even when increased funding doubled the supply of hotel rooms, demand rose to meet and exceed availability.

James A. Garrity, MD, an ophthalmologist and chair of the Mayo Clinic’s International Activities Committee, noted that the medical center’s goal is to collaborate with physicians, not to compete with them.

“It’s existing as a resources for physicians,” Dr. Garrity said. “The intent is not to take away patients from local practitioners.”

Existing relationships

Dr. Garrity noted that the UAE and Mayo Clinic enjoyed a relationship long before the Dubai government approached the medical center about the Healthcare City project. In the 1990s, he said, more patients from the UAE than from any other country came to Mayo Clinic for medical services.

The repercussions of Sept. 11, 2001, accentuated the need to develop local health care services, according to Dr. Garrity. “We ran into a lot of trouble with visas,” he said.

Dr. Mehta also noted Sept. 11 as a changing point. But he said that Dubai was already a strategic location for investors, both because of its geography as an east-west “crossroads” and the UAE’s political and economic stability.

As a testimony to this stability, the Healthcare City has been established as a free zone, which means that it will be able to create its own laws, Dr. Mehta said. The free zone status will provide a level of “transparency” to decision-making processes there, he added.

“It’s a green field from the starting point … even the laws are a green field,” he said. “The people will benefit: You have better health care, you have better processes. This became a catalyst for change.”

For Your Information:

• B.S. Chidamber, DOMS, MS, can be reached at Welcare Hospital, P.O. Box 31500, Dubai, United Arab Emirates; +971-4-282-7788; fax: +971-4-282-8226; e-mail: chidamber@welcarehospital.com.
• James A. Garrity, MD, can be reached at Mayo Clinic, 200 First St. SW, Rochester, MN 55905 U.S.A.; +1-507-284-8538; fax: +1-507-284-4612; e-mail: garrity.james@mayo.edu.
• Millicent Grim, MD, can be reached at the Gulf Eye Center, Office Suite 615, Fairmont Hotel, Sheikh Zayed Road, P.O. Box 73259, Dubai, UAE; +971-4-329-1977; fax: +971-4-329-1979; e-mail: eyedoc@emirates.net.ae.
• Mehul C. Mehta, MBBS, MS, MA can be reached at Harvard Medical International, 1135 Tremont St. #900, Boston, MA 02120 U.S.A.; +1-617-536-6423; fax: +1-617-535-6410; e-mail: mehul_mehta@hms.harvard.edu.

• Dubai Development and Investment Authority can be reached at 44th Floor, Emirates Tower, Sheikh Zayed Road, Dubai, UAE; 971-4-330-2222; fax: 971-4-330-2233; e-mail: info@ddia.ae; Web site: www.ddia.ae.

• Dubai Healthcare City can be reached at P.O. Box 66566, Dubai, United Arab Emirates; 971-4-324-5555; fax: 971-4-324-9000; e-mail: info@dhcc.ae; Web site: www.dhcc.ae.