For avid mountaineer Sangeet Kaur Khalsa, losing the ability to walk was unthinkable.

Getting treatment at home however seemed a steeper mountain to scale - one lined with a faded confidence in and the astronomical cost of healthcare.

Tundra To Tropics For Treatment

“The first doctor I saw in Alaska pointed to my grey hair and told me that the pain in my knee was because of arthritis from old age. It peeved me that he said that without even carrying out any investigative tests,” relates 50-year old Sangeet Kaur Khalsa, who calls Fairbanks, Alaska home.

When she had to head to California for a scheduled wrist surgery, Khalsa decided to see an orthopaedic surgeon there. He was thorough and suspected a meniscal tear in her knee but any further investigation came to a grinding halt after he revealed that the Magnetic Resonance Imaging (MRI) scan she required would set her back some US$2,500.

“I was just not prepared to pay so much for that. Back home in Alaska, it was even higher, around US$3,700. I sank into despair, not knowing what to do or where I could get good treatment and afford it,” shares Khalsa who is married and has an 18-year old daughter in university.

Another thing that weighed heavy on her mind at that point was whether she had to give up one of her passions in life – mountaineering.

Since her father had introduced it to her at 15, Khalsa had always been intrigued by the mountains and nature. Ever since, she would always make it a point to regularly ‘head for the mountains’. She felt one with nature and enjoyed the spiritual connection she had with it, so to be unable to do so would definitely not sit well with her.

Khalsa tried aromatherapy, herbs, supplements and yoga but the pain in her knee persisted. The ‘avalanche’ finally hit home during an evening walk with her husband when she collapsed under her knee and had to be piggybacked home.

Though not certain what to do, the one thing she knew was that finding a solution for her condition was now in her hands and time was of the essence as the swelling and pain had exacerbated.

The Search Begins

Khalsa was not unaccustomed to challenge or being in a tight spot. After all, she had overcome harsh terrain, withstood ferocious weather conditions, trekked through thick, forested woods inhabited by a host of Alaskan wildlife, and survived.

Nonetheless, for her, searching for overseas medical treatment was new territory for her.

“I had heard of people travelling out of the country for medical care but honestly, I was on a blind search. I read up about hospitals around the world on the Internet and sent out countless emails but wasn’t sure how else to proceed.”

“I had received some replies offering me things like a knee replacement and cosmetic surgery but never directly addressing my queries. They all seemed so flaky and I found it hard trusting any of them. I grew skeptical about the whole thing,” recounts Khalsa who runs an e-business selling flower essence.

Eventually, a much-disillusioned Khalsa came across the website of the Overseas Medical Services (OMS), Canada, Inc. She subsequently called the toll-free number and spoke with Aruna Th-Hollingshead, the Sri-Lankan born Canadian woman who runs it.

OMS helps those seeking medical treatment overseas to find a physician and hospital suited to one’s specific medical needs. Besides making arrangements for travel, treatment, accommodation and even after-care once the patient returns home, OMS also provides useful information about the country such as its currency, culture and best shopping and sight-seeing spots – a genuinely ‘all-in-one’ service for the medical traveller.

“I was a little skeptical at first but then Aruna called me a couple of days later and told me she had found a doctor for me in Singapore. Within the next day, she informed me that plans were underway to get me there. She was very transparent and efficient. I was impressed but there was a problem,” Khalsa points out.

Most countries would not issue a visa to travellers if their passports had less than six months left before expiry. Khalsa’s was expiring in four.

Th-Hollingshead says, “The people at the National University Hospital (NUH) sorted out her visa with the immigration department there in no time. They clearly took pains to make things easier. This is important for patients like Khalsa because they have to endure the pain on top of the disappointment with their healthcare system. They don’t need any more headaches.”

Besides making arrangements for Khalsa, Th-Hollingshead provided her with the hospital information as well as the impressive credentials of the doctor she was to consult with.

She adds, “When I first suggested Singapore to Khalsa, it was because I knew they had the expertise to handle her medical condition and it was also affordable compared to many countries in the West. Of course their excellent infrastructure too play a part too.”

“Having said that, while other countries may also boast the same, Singapore stands out because it is one country that would bend backwards to accommodate its foreign patients. It may be small but they manage big deeds. I predict more Americans to come this way for their healthcare in time to come.”

Although no figures were available for American medical travellers to Singapore, in 2006, around 150,000 Americans sought medical treatment outside of the US.

With baby-boomers hitting their senior years, many of those who are uninsured find it costly to seek medical treatment at home. Also, they don’t want their healthcare costs to devour their retirement incomes. Another factor has to do with not wanting to sacrifice their quality of life over a long-waiting list.

Seamless As It Gets

Khalsa had heard only good things from friends and acquaintances about their visits to Singapore. Though she had previously travelled to the region, she had bypassed the island-state because she felt it was an expensive city to visit.

On 28 May 2007, she landed at Changi International Airport after a 24-hour flight and immediately was embraced with the efficiency and hospitality many a traveller has been accustomed to.

“Going through immigration was a breeze and I felt I was in good hands from the moment I landed. I was picked up at the airport by NUH staff who brought me to the hospital. They even had orchids in my room,” reports Khalsa.

She adds, “All the necessary paperwork had been done and within a short period, I got to see my doctor.”

Associate Professor James Hui Hoi Po, Senior Consultant at NUH’s Department of Orthopaedic Surgery met Khalsa and outlined what he intended to do, making sure she fully understood.

The next day, Khalsa had the long-awaited MRI scan (which cost just over US$500) which confirmed a meniscal tear was the source of her pain.

The meniscus is a wedge-like rubbery cushion where the major bones of the leg connect. It serves as a stabilising tissue to help the knee joint carry weight, glide and turn in many directions. It also keeps the femur (thighbone) and tibia (shinbone) from grinding against each other.

In a meniscal tear, the meniscus may loosen and drift into the joint causing it to slip, ‘pop’ or lock the knee. The swelling and tenderness Khalsa reported feeling were typical symptoms.

To cure the problem, A/Prof Hui decided to trim Khalsa’s meniscus and smoothen the inside of her kneecap. The 45-minute procedure, which A/Prof Hui had done on countless occasions, proceeded without any complications.

A/Prof Hui enlightens, “Khalsa’s kneecap was in good condition other than the area that was damaged. But it’s a common procedure. Moreover, it was a keyhole surgery so she benefited from minimal scarring.”

Khalsa intends to return to Singapore in a few years to have the cartilage in her kneecap fully restored with the help of bone-marrow derived stem cells. For now though, she is ‘good to go’, he remarks.

A ‘Scooting’ Recovery

Khalsa could not have asked for anything more with the level of care, compassion and professionalism that was shown by everyone at NUH.

“A/Prof and the other doctors took pains to explain things to me and kept me informed of everything. The nurses spoilt me. The healthcare system as a whole is really remarkable,” admits Khalsa.

Within a couple of days, Khalsa was moving around, feeling much less pain other than the soreness from surgery. However, with her wrist still recovering from surgery she had in California, she discovered that using crutches was a problem. Then her natural creativity kicked in.

“I saw this little kid with a tiny bicycle and I thought it would be great to move around with that. So, I managed to get one delivered to me and now, it’s so much easier to get around. It even folds up so I’ll definitely bring it back to Alaska with me,” Khalsa quips.

With her newfound mobility, Khalsa was a common sight scooting around the hospital and even braving the Singapore tropical weather to hit the famous Orchard Road shopping belt and take in some sights with Th-Hollingshead.

Says Th-Hollingshead, “Singapore’s small size is its advantage in that it’s manageable and easy to get around. Of course it helps too when it’s so cosmopolitan, clean and up to world standards.”

Khalsa concedes, “I still need some time to fully recover once I get back, but at least now I can look at the mountains and tundra with renewed hope that I will be visiting them soon.”