The holistic approach of ayurveda based wellness tourism in kerala


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The holistic approach of ayurveda based wellness tourism in kerala

  1. 1. INTERNATIONAL JOURNAL OF ADVANCED RESEARCHInternational Journal of Advanced Research in Management (IJARM), ISSN 0976 – 6324 IN MANAGEMENT (IJARM)(Print), ISSN 0976 – 6332 (Online), Volume 3, Issue 2, July-December (2012)ISSN 0976 - 6324 (Print)ISSN 0976 - 6332 (Online)Volume 3, Issue 2, July-December (2012), pp. 29- 39 IJARM© IAEME: ©IAEMEJournal Impact Factor (2012): 2.8021 (Calculated by GISI) THE HOLISTIC APPROACH OF AYURVEDA BASED WELLNESS TOURISM IN KERALA RAMESH U*, KURIAN JOSEPH** * Research Scholar, Faculty of Management, NIMS University, Jaipur, Rajasthan. e-mail: ** Research Guide, NIMS University, Jaipur Rajasthan & Associate Professor, St.Dominics College, Kanjirappally, KeralaABSTRACTThe striking feature of healthcare industry in India is its potential to grow at a much faster rate inthe foreseeable future. In this prevailing situation, Health Tourism has emerged as a separateindustry with incredible potential. Health/Wellness tourism refers to trips that are taken bytourists with the principal purpose being to improve their health and/or wellbeing. Today, onceagain, promoting the healthful and health-care benefits of a destination is gaining popularitybecause tourism marketers need ways to differentiate their products. Kerala can tap this trend byhighlighting its unique health care products. The State, almost synonymous with the wordAyurveda, is now all set to reap the benefits of the same through Wellness tourism. Kerala hasthe advantage of worldwide recognition, as it has been included in the list of the ten must-seedestinations by the National Geographic Traveler. Wellness, in general, is used to mean a healthybalance of the mind, body and spirit that results in an overall feeling of well-being. The conceptof health holiday, now better known as Wellness holiday, is based on the principles of Ayurveda,meditation, yoga, physical exercises and a balanced diet. It is like rejuvenation and clean upprocess on all levels - physical, mental and emotional. Ayurveda deals elaborately with measuresfor healthful living during the entire span of life and its various phases. Besides, dealing withprinciples for maintenance of health, it has also developed a wide range of therapeutic measuresto combat illness. In order to cope with the growing demand for wellness, resorts, hospitals,medical practitioners and Government have taken ample measures to promote alternative healthcare in Kerala. Along with the projects already underway, there is a need to draw up plans forpromotions in future. The present paper investigates the reasons why Kerala is now pioneering asan alternative healthcare destination and the main objective is to analyze the reason as to whyKerala is being chosen as a preferred destination for Wellness Tourism. An attempt is made to 29
  2. 2. International Journal of Advanced Research in Management (IJARM), ISSN 0976 – 6324(Print), ISSN 0976 – 6332 (Online), Volume 3, Issue 2, July-December (2012)study the market potential and strategies adopted for Kerala to emerge as the most sought afterWellness tourism destination in the Globe.Keywords : Ayurveda, Destination, Health tourism, Wellness.OBJECTIVES AND METHODOLOGYThe present study enquires into the current infrastructure and the market potential of Ayurvedabased wellness tourism offered at Kerala in attracting International medical tourists. A set ofquestions were employed to interview the Ayurvedic medical practitioners who were working inreputed wellness resorts. A total of 60 respondents were chosen as the survey sample fromamong the 250 wellness providers (both certified and non-certified) in the State. The districtschosen were Thiruvananthapuram, Kollam, Alappuzha, Kottayam and Idukki. Of these, 17questionnaires were incomplete as the doctors were not willing to share their real and sincerecomments and hence were discarded. Thus, 43 usable questionnaires were finally entered intothe research analysis and interpretation stage. Earlier studies carried out in the field wereanalyzed and it reveals that a striking gap exists in the field of research in this highly potentialbut understudied area. Related data were collected from the Directorate of Tourism, Govt. ofKerala, Kerala Tourism Development Corporation, Govt. Ayurveda CollegeThiruvananthapuram, Directorate of Indian Systems of Medicine, reputed and classified wellnessresorts in the private sector as well as from the published research reports on health tourism.Simple random sampling has been adopted in interviewing the wellness providers from theselected locations.AYURVEDA BASED WELLNESS TOURISM IN KERALATourism is an important economic activity and continues to be the fastest growing sector andhence is typically included among the top three industries in the country. Although India hasprogressed a lot since the fifties with respect to tourism, the country is still way behind thedeveloped or even the developing countries. India earns one seventh of China, one fourth ofIndonesia and less than half of Philippines from tourism in comparison. Kerala is the foremoststate in India that realized the potential of Ayurvedic health tourism and has widely marketed itthroughout the state. About 10-12 years back, Kerala started with the task of promotingAyurveda on a larger scale. It is estimated that about 30% of the foreigners coming to Keralaavail themselves to Ayurvedic care and about 40% of the State’s tourism revenue is generatedfrom the same. Table 1 indicates the top 10 States/Union Territories in India regarding foreigntourist’s arrivals from 2006 to 2009 30
  3. 3. International Journal of Advanced Research in Management (IJARM), ISSN 0976 – 6324(Print), ISSN 0976 – 6332 (Online), Volume 3, Issue 2, July-December (2012)Table 1: Foreign Tourist Arrivals to India- Top 10 States/UT Sl No State 2006 2007 2008 2009 1 Delhi 1974836 1995123 2339287 1958272 2 Maharashtra 1712302 1762005 2056913 1969992 3 Uttar Pradesh 1328974 1396932 1610089 1532573 4 Tamil Nadu 1319501 1338521 1594680 1534787 5 Rajasthan 1220164 1250056 12677646 1073414 6 West Bengal 998029 1024220 1133671 1080418 7 Andhra Pradesh 669617 69732 789180 795173 8 Karnataka 505524 555798 571846 614316 9 Kerala 428534 468480 598929 609880 10 Goa 380414 416355 433375 444576 Source: India Tourism Statistics – 2009Kerala – The mesmerizing land located in the south of India enjoys geographical features that areunique and rich. This state is also the only place in India which practices Ayurveda in its purestform. Ayurveda is the traditional Indian system of medicine that has brought true health,happiness and wellbeing to millions of individuals throughout the ages. This ancient art ofhealing has been in practice for over 5000years, and was also the mainstream medicine in theancient times. Derived from its ancient Sanskrit roots – ‘ayus’ (life) and ‘ved’ (knowledge) – andoffering a rich, comprehensive outlook to a healthy life, it is the only medical science in thisuniverse which is useful even when one is not ill. Ayurveda is a complete science of health thatis being applicable in all stages of life starting from birth, neonates, infants, childhood, youth, oldage and even life before and after death. For many people, the image of Ayurveda is limited tothe use of herbal or home/kitchen remedies and a traditional way of treatment. But in reality,Ayurveda is a much serious medical science, which strongly emphasizes on the diagnosis,examination, analysis of the disease, diet, medicinal properties, dose, frequency of the medicineand the medium with which it should be consumed. The Medicare in Ayurveda has broadly twoparts: one is preservation of health and prevention of diseases and the second, diseases and theirtreatment. In Ayurvedic terminology, the first is “Swasthavritha” and the later is “Athuravritha”.Ayurveda follows a totally different way of treating diseases known as “Panchakarma”, whichmeans literally “Five Therapies” which are the subtly harmonizing purification procedures thatdissolve metabolic waste products and toxins generated from the environmental ill effects, in agentle and effective way from the tissues and eliminate them from the body. This treatment isadvisable to the diseased as well as the healthy. Ayurveda also has a comprehensive system ofmassages and body treatments that gives relief from a wide range of illnesses, from migraine andsinus to arthritis and paralysis; that detoxify and cleans the body through controlled emesis,purgation, making the individual sweat; and that makes the body receptive to further treatment.These therapies are more effective in Kerala due to the almost year around humid climate of thestate. Ayurveda extends excellent treatments for ailments like Osteo-Arthritis, RheumaticArthritis, Tennis Elbow and Carpel Tunnel Syndrome, Spondylosis, Intervertibular disc prolapse,Frozen Shoulder, Insomnia, Migraine, Skin Diseases and of course Weight management. Fromthe past two decades, the necessity for a holistic approach in the treatment of diseases had beenan active topic for discussion among the scholars of modern medical sciences. As a system ofmedicine that completely eliminates the disease from the body without causing any side effects, 31
  4. 4. International Journal of Advanced Research in Management (IJARM), ISSN 0976 – 6324(Print), ISSN 0976 – 6332 (Online), Volume 3, Issue 2, July-December (2012)and which ultimately promotes the basic health, Ayurveda stands atop the alternative systems oftreatments recognized by the World Health Organization. Many foreign countries have alreadystarted Kerala Ayurveda treatment centers and the export of Ayurvedic medicines tointernational market is increasing in a faster pace day by day. But, to the surprise, foreign touristsare often just as keen to visit the origin of the practice to avail treatments and body purificationprocesses. The basic principles emerging from a holistic outlook, the peculiar and uniquetechniques of treatments, and the health promoting and non reactive herbal drugs used are themain elements which differentiate Ayurveda from the other prevailing medical systems.The Kerala government realizes that it is of vital importance to offer assurance to its wellnessseeking guests and visitors to the state that safety, hygiene, service quality and quality assuranceare top priorities. This is to be achieved through the introduction of quality standards,registration, certification and regulation, and legislation. The comprehensive plan also includesguidelines and measures to ensure fair pricing. Beyond a competitive pricing strategy, achievingquality is another key to Keralas competitiveness. The ability to attain international standardsand consistently deliver high quality products and services are critical success factors in thepromotion of Kerala products on the global market. Kerala, as part of its marketing strategy,continuously organizes road shows all around the world for the promotion of Ayurveda alongwith modern medicine. It is vitally important to create confidence in the products Kerala offers.There is much greater awareness and operators have come to realize that delivering qualitytranslates into greater business efficiency, lower operating costs and increased profits.RESEARCH ANALYSISThe first part of the questionnaire dealt with the location of the Wellness centre, qualification ofthe respective medical practitioner employed and whether the centre possessed any certifications.The percentage distribution of the sample according to selected variables is shown in the table 2below. Table 2: Percentage distribution of the sample according to selected variables Count Percent Qualification BAMS 37 86.0 of Doctor MD 6 14.0 Nil 17 39.5 Certification Govt. Approved 7 16.3 possessed by Green leaf 8 18.6 the centre Olive leaf 9 20.9 ISO 2 4.7 Alappuzha 4 9.3 Idukki 12 27.9 District Kollam 7 16.3 Kottayam 4 9.3 Thriruvananathapuram 16 37.2 32
  5. 5. International Journal of Advanced Research in Management (IJARM), ISSN 0976 – 6324(Print), ISSN 0976 – 6332 (Online), Volume 3, Issue 2, July-December (2012) • Among the 46 wellness centers, 37 employed Doctors with BAMS as their qualification and 6 centers had Doctors with Post Graduation. • Among the 46 wellness centers 9 were certified with olive leaf, 8 with Green leaf, 7 centers were Government approved and 2 possessed ISO certification while 17 lacked any certifications. • The district wise distribution was:-Thiruvananthapuram – 16, Idukki – 12, Kollam – 7, Kottayam and Alappuzha with 4 each.Certification by competent authorities were considered as the bench mark deciding factor for therespective Wellness centers and various aspects were analyzed using statistical tools to checkthe reliability, significance and validity. DestinationThe destinations chosen for the study were located either in a Beach or River/Lake/Wetland,Forest/Rain forest or Mountain. The comparison of destinations in which the selected Ayurvedicresorts are situated is shown in the table 3 below. Table 3: Comparison of destination based on certification No Yes Total Destination p# Count Percent Count Percent Count PercentBeach 6 35.3 21 80.8 27 62.8 p<0.01River, lake, wetland 3 17.6 5 19.2 8 18.6 p>0.05Forest/rainforest 3 17.6 0 0.0 3 7.0 p>0.05Mountain 6 35.3 3 11.5 9 20.9 p>0.05The statistical test employed was Fishers Exact Test and the comparison is shown in the abovetable. It indicates that 62.8 % among the wellness centres were located in destinations nearbeaches, 20.9% in destinations near Mountains, 18.6% in destinations near river/lake/wetlandand 3% in destinations near forests. 80.8% of wellness centres located in beaches possessedcertifications by competent authorities. The results displayed in the table prove that certificationis a significant factor only for Ayurvedic wellness centres located near Beaches. Number of staff employedThe total numbers of staff employed in the wellness centres were classified into three groups:less than 10, between 10 and 15, and greater than 15. The comparison of the average number ofstaff members employed in the selected wellness centres in shown in the table 4 below Table 4: Comparison of number of staff based on certification Number of No Yes Total χ2 p staff Count Percent Count Percent Count Percent<10 10 58.8 2 7.7 12 27.910 – 15 6 35.3 12 46.2 18 41.9 15.43** 0.000>15 1 5.9 12 46.2 13 30.2Mean ± SD 11.1 ± 11.2 16.5 ± 5.2 14.3 ± 8.4 33
  6. 6. International Journal of Advanced Research in Management (IJARM), ISSN 0976 – 6324(Print), ISSN 0976 – 6332 (Online), Volume 3, Issue 2, July-December (2012)41.9% among the total had their respective number of staff between 10 and 15 irrespective of thepossessing of certification. Considering the certified centres, 46.2% had staff numbers between10 and 15 and equally 46.2% had staff numbers greater than 15. 58.8% of the wellness centreswithout any certification had less than 10 numbers of staff. Analyzing the significance, thenumber of staff between 10 and 15 only proves to be valid. Open to all Categories A question was asked to the respective official to know whether the services provided at thewellness centre were made available to all categories of tourists. It was noticed that the Ayurvedadispensaries and hospitals owned by the State Government provides treatment and medicare onlyto the Indian nationals. The table 5 below shows the comparison on whether the services areopen to all categories of tourists. Table 5: Comparison of open to all categories of Tourists based on certification Whether open to all No Yes Total p# categories of Tourists Count Percent Count Percent Count PercentYes 15 88.2 15 57.7 30 69.8 p<0.05No 2 11.8 11 42.3 13 30.269.8% among the total wellness centres irrespective of the possessing of certification providesmedicare services to all categories of medical tourists. When analyzed based on certification,57.7% of the certified centres were open to all categories and 88.2% of the uncertified centreswere open to all categories of tourists. Hence the option ‘Yes’ was found significant. Patient AccommodationsThe total number of patients who could be accommodated in the wellness centre to provideconsultation and treatment were classified into three groups. Less than 10, between 10 and 15,and greater than 15. Whether the particular centre possessed any certification by the competentauthority was considered as the bases for comparison. The comparison and the respective resultis shown in the table 6 shown below.Table 6: Comparison of maximum no: of patients accommodated at a time based on certificationMax. no of patients No Yes Total accommodated at a Count Percent Count Percent Count Percent χ2 p time<10 10 58.8 3 11.5 13 30.210 - 15 6 35.3 21 80.8 27 62.8 11.04** 0.004>15 1 5.9 2 7.7 3 7.0Mean ± SD 12.5 ± 23 11.7 ± 3.6 12 ± 14.5**: - Significant at 0.01 levelA total of 62.8% of the wellness centres irrespective of the possessing of certification couldaccommodate between 10 to 15 patients at a time. When analyzed based on certification, 80.8%among the centres could accommodate between 10 and 15 number of patients and 58.8 % amongthe centres without any certification could accommodate only less than 10 patients at a time. Thenumber of patients between 10 and 15 was found significant at 0.01 levels. 34
  7. 7. International Journal of Advanced Research in Management (IJARM), ISSN 0976 – 6324(Print), ISSN 0976 – 6332 (Online), Volume 3, Issue 2, July-December (2012) Method of Fixation of Price.The method of fixation of prices and costs of medicare services is an issue of great concern.Based on the realities, the same could be classified into two categories. The first one is that theprices are standard and the patient could know it before his/her arrival and availing of theservices. The second category says that the prices are fixed after the arrival and availing ofservices by the patient. The table 7 below shows the comparison and analysis of the same. Table 7: Comparison of method of fixation of prices based on certification Method of fixation of No Yes Total p# prices Count Percent Count Percent Count PercentIt is standard. Patientknow it before p<0.05arrival 8 47.1 21 80.8 29 67.4It is fixed after arrival 9 52.9 5 19.2 14 32.6# : Fishers Exact TestA total of 67.4% of the resorts fix the prices and costs as standards. The patient who is willing toavail medicare could know the same well in advance. When the data were compared based oncertifications, 80.8% among the certified wellness centres have standard pricing strategies while52.9% of the wellness centres without certification fixes the prices and charges after the arrivaland availing of services by the patients. On statistical analysis, the method of standard pricefixation proves to be significant when compared based on certifications. Implementation of Treatments and TherapiesThe design and implementation of therapies at the wellness centres could be grouped into threecategories. Mostly the doctors will diagnose the patient and based on the report he shall designthe therapies and treatment plans. Sometimes, if a patient with ample knowledge on Ayurvedacomes as a patient, he shall inform the doctor in advance regarding his requirements and thedoctors and masseurs just follow the same. The third category is that the doctor and the patientwill discuss and will mutually discuss and arrive at the treatments plan to be implemented. Thecomparison of the mode and delivery of treatments based on whether the wellness centrepossesses certification and the respective statistical analysis is shown below in table 8. Table 8: Comparison of mode and delivery of treatments based on certification Mode and delivery of No Yes Total p# treatments Count Percent Count Percent Count PercentAs per the diagnosisreport the doctor willschedule 1 5.9 12 46.2 13 30.2 p<0.01As instructed by the patients 0 0 0 0 0 0Both 16 94.1 14 53.8 30 69.8# : Fishers Exact Test 35
  8. 8. International Journal of Advanced Research in Management (IJARM), ISSN 0976 – 6324(Print), ISSN 0976 – 6332 (Online), Volume 3, Issue 2, July-December (2012)Totally, in around 69.8% of the wellness centres, the treatments are carried out based on themutual agreement between the doctors and the patients while in 30.2%, the treatments are strictlycarried out as per the instructions and plans of the doctors alone. When analyzed based onavailability of certifications, 53.8% of the centres implemented the same based on mutualconsultation and 94.1% of the wellness centres without any certification implemented treatmentsbased on mutual discussions. Fishers Exact test was carried out to measure the significance. Patient’s knowledge on AyurvedaAnalysis was conducted in order to measure the awareness of the patients availing Ayurvedatreatments in the respective wellness centres prior to their arrival to Kerala. The comparison andthe respective analysis is shown in the table 9 below.Table 9: Comparison of patients have adequate knowledge about Ayurveda before arrival based oncertification Patients have No Yes Totaladequate knowledge Count Percent Count Percent Count Percent χ2 p about Ayurveda before arrivalNA 3 17.6 0 0.0 3 7.0Yes 11 64.7 22 84.6 33 76.8 5.21 0.157No 3 17.6 4 15.4 7 16.3In total, around 76.8 % of the patients availing medicare in both certified and non certifiedwellness centres possessed adequate knowledge about Ayurveda and other alternative wellnesstherapies prevailing and practiced at Kerala. When analyzed based on certification, around84.6% of the patients residing at certified centres possessed prior and adequate knowledge onAyurveda and around 64 .7% of the patients at non certified centres too had prior awareness. Theanalysis and significance of the answers based on chi square test is displayed in the above table.FINDINGS AND SUGGESTIONSKerala, the state almost synonymous with the word Ayurveda, is now all set to reap the benefitsof Ayurveda through health tourism. The reason for this is the popularity of Ayurvedictreatments and the manner in which Kerala is marketing Ayurveda in medical tourism.International patients seeking medical services across borders or globally look at more than justcost comparisons in their search for the right physician and right facility to address their specificneeds. The top priorities include1. Credentials – recognized international accreditations & certifications.2. Experience – board certified doctors, training, years of experience.3. Patient References – patient testimonials, before & after pictures.4. Specific Treatment Methods – uniqueness of center & procedures offered.5. Comprehensive Solution – provide complete solution to a treatment.6. Reputation – locally as well as internationally e.g., publications, research papers.7. Language – effectively communicate in patient’s preferred language.8. Geographic Location – local conveniences, transportation services, attractions. 36
  9. 9. International Journal of Advanced Research in Management (IJARM), ISSN 0976 – 6324(Print), ISSN 0976 – 6332 (Online), Volume 3, Issue 2, July-December (2012)9. Cost – clear price list, services included in the package, pricing options.10. Benchmark Data – any comparative information that will convince patients.The promotion of Ayurveda in health tourism started in 1994 and the Kerala TourismDevelopment Corporation (KTDC) started Ayurvedic health centers in its premium propertieslike Hotel Samudra, Kovalam, during the same period. KTDC has tied up with the most reputedAyurveda treatment providers and hence the authority of doctors and the quality of the medicinesused are not compromised. While all the hotels and resorts in Kerala have now started includingAyurveda in their services, there are some resorts, which are exclusive for Ayurvedic treatments.With a view to facilitate the wellness tourism industry to achieve the targets and to give a greatermomentum for this growth, the Ministry of Tourism, Government of Kerala, in association withthe Department of Indian Systems of Medicine (ISM) has identified an urgent need to evaluatethe safety and service standards of the prevailing and newly establishing Ayurveda centers andclassify them accordingly. Standards have been set in terms of Personnel – Qualified physiciansand masseurs having sufficient degree and training from recognized Ayurveda institutions,Quality of medicines and Health programmes – Prior approval by the advisory committee forthe levels of treatments, clear exhibition of the treatment programmes offered and usage ofmedicines manufactured by approved firms with proper labeling, Equipments – Standards arefixed for the size and make of massage tables, facilities for medicated hot water , sterilization,electric/ gas stove and the hygiene , Facilities - in terms of number of treatment rooms withprescribed size , proper ventilation and attached bathrooms, quality and finishing of floors andwalls, consultation room with proper equipments, separate rest rooms, locality , ambience andthe cleanliness of surroundings. Ayurvedic centers fulfilling all the mentioned essentialconditions are awarded a certification named Olive Leaf. Apart from the same, Government hasalso set some optional conditions in terms of the construction and architectural features of thebuilding, adequate parking space, facilities for steam bath, separate hall for yoga and meditation,herbal garden attached to the center and the picturesque location. The Ayurveda centers alsofulfilling these optional conditions will awarded Green Leaf. The Department of Tourism doesnot take responsibility of any centre, which is not classified in either of the above categories.Table 10 shows the distribution of Government classified Ayurvedic health centers in Kerala.Table 10: Distribution of Classified Ayurvedic Health Centers in KeralaDistrict Govt. Approved Ayurvedic CentersThiruvananthapuram 24 ( Green Leaf:15, Olive Leaf: 9)Kollam 9 ( Green Leaf:5, Olive Leaf: 4)Pathanamthitta 2 ( Green Leaf:0, Olive Leaf: 2)Allapuzha 6 ( Green Leaf:6, Olive Leaf: 0)Kottayam 11 ( Green Leaf:9 Olive Leaf: 4)Idukki 6 ( Green Leaf:5, Olive Leaf: 1)Ernakulam 19 ( Green Leaf:8, Olive Leaf: 11)Thrissur 12 ( Green Leaf:5, Olive Leaf: 7)Palakkad 3 ( Green Leaf:1, Olive Leaf: 2)Kozhikod 6 ( Green Leaf:5, Olive Leaf: 1)Wayanad 2 ( Green Leaf:1, Olive Leaf: 1)Kannur 2 ( Green Leaf:0, Olive Leaf: 2)Total 104 ( Green Leaf:59, Olive Leaf: 45) Source : Kerala Tourism Statistics 37
  10. 10. International Journal of Advanced Research in Management (IJARM), ISSN 0976 – 6324(Print), ISSN 0976 – 6332 (Online), Volume 3, Issue 2, July-December (2012)With the destination firmly established as the Wellness Capital of Asia, achieving world-classstatus is next on the national agenda. Kerala is the foremost state in India that realized thepotential of Ayurvedic health tourism and has widely marketed it throughout the state. About 10-12 years back, Kerala started with the task of promoting Ayurveda on a larger scale. It isestimated that about 30% of the foreigners coming to Kerala avail themselves to Ayurvedic careand about 40% of the State’s tourism revenue is generated from the same. The Keralagovernment realizes that it is of vital importance to offer assurance to spa guests and visitors tothe state that safety, hygiene, service quality and quality assurance are top priorities. This is to beachieved through the introduction of quality standards, registration, certification and regulation,and legislation. The comprehensive plan also includes guidelines and measures to ensure fairpricing. Beyond a competitive pricing strategy, achieving quality is another key to Keralascompetitiveness. The ability to attain international standards and consistently deliver high qualityproducts and services are critical success factors in the promotion of Kerala products on theglobal market. Kerala, as part of its marketing strategy, continuously organizes road shows allaround the world for the promotion of Ayurveda along with modern medicine. It is vitallyimportant to create confidence in the products Kerala offers. There is much greater awarenessand operators have come to realize that delivering quality translates into greater businessefficiency, lower operating costs and increased profits.CONCLUSIONThe Indian tourism industry has outperformed the global tourism scenario in terms of growth,revenue and the volume of international tourist visits. A recent trend has shown that people fromdeveloped countries are seeking treatment from the health professionals from developingcountries. The destination in wellness tourism is often an alternative space in which one canengage in self analysis without the stresses and distractions of home as well as work place. In thelong run, Wellness tourism can become the niche for foreign revenue generation as there is anincreasing trend in the number of visitors to Kerala as wellness seekers. The study reveals thatthe most favourable factor for Kerala to emerge as the Global Wellness Hub is its authenticityand rich Ayurvedic heritage with multifaceted attractions. Marketing Kerala as a safe qualitywellness destination depends on effective distribution channels, hospital-defined market nichestrategies, as well as data collection on the sources of information used to select Kerala as thepreferred medical destination.REFERENCES1. Angel, Marrica, (2004), The truth about drug companies. New York review of books, LI (12):52-582. Cooper, K. (1982). The Aerobics Program for Total Well-Being. New York: Bantam.3. Corbin, Pangrazi, & Franks, (2000), Definitions: Health fitness and physical activities,Presidents council on physical fitness and sports research digest,3(9), 1-8.4. Dunn, H.L, (1965), High level wellness, Arlington 1997.5. Kulkarni, A, (2008), Become healthy happy and balanced with Ayurveda, Medical Tourism,issue 2, 38-39.6. Melanie Smith, Catherine Kelly, (2006), Tourism Recreation Research, Vol 31 (1), 1-4 38
  11. 11. International Journal of Advanced Research in Management (IJARM), ISSN 0976 – 6324(Print), ISSN 0976 – 6332 (Online), Volume 3, Issue 2, July-December (2012)7. Mohammed, Ilyas, T, (2008) Medical Tourism: India the Right Destination, SouthernEconomist, 37-39.8. Mohanlal,P.K, (2008), The Holistic Approach of Ayurveda, Ayurveda &Health Tourism,vol:3, issue:1,22-269. .U.S. Department of Health and Human Services. (2000). Healthypeople2010: Understandingand improving health, 2nd edition in two volumes. Washington, DC: Government PrintingOffice.10. Varier, P.R., Dr. (1986) “The management of the problem of ageing, according to theAyurvedic system of medicine”, Vasudeva Vilasam Ayurveda pharmacy, Centenary Souvenir,Trivandrum, Kerala11. World Health Organization. (1947). Constitution of the World Health Organization.Chronicle of the World Health Organization 1, 29-43. 39