While hardboiled watchers of the Afghanistan scene are not overly impressed by the invitation to India as an ‘observer’ for the Qatar talks held recently between the US and Taliban to hammer out a deal for the American pullout, a tiny thaw in the Islamist organisation’s attitude towards New Delhi is discernible.

A lot of this `softening’ is grounded in realpolitic. Unlike 1996-2001, when Taliban under Pakistani influence was openly hostile to India’s presence in Afghanistan, a subtle shift has taken place with improved Indo-Afghanistan relations in the last decade or so. Some Taliban leaders have in the recent past suggested, even if somewhat mutedly, that India too has stakes in Afghanistan.

India’s investment in Afghanistan has made New Delhi a player of some standing in the land-locked, war-ravaged country. “The view in Afghanistan is that it is better to have India inside the tent than outside it. For New Delhi too, it is a realisation that Taliban is the permanent entity in that country, so you have to deal with it, rather than ignore it,” says Sushant Sareen of the ORF, a noted expert.

India’s acclaimed soft power

However, in this battle of geopolitical posturing, it is India’s acclaimed soft power that seems to have influenced attitudes across the Durand Line. India’s medical tourism has played a big part in changing Afghan attitudes, even if to a limited degree. Afghan medical tourism patients and their travelling family and friends — currently estimated at 300,000 by the PHD Chamber of Commerce and Industry – contribute some $3 billion to the Indian economy. The Max Hospitals in Delhi, for instance, count for roughly anywhere around 8,000-10,000 Afghan patients every year. A number of those who come for healthcare may have Taliban connections, either directly or indirectly and get to see another side of the picture.

Hospitals in Delhi witness a tremendous rush of Afghan patients, contributing greatly to medical tourism in India and even more important, improving people-to-people contacts between the two countries.

As part of a concerted diplomatic policy, Indian medical visas are free and do not require applicants to provide financial statements or proof of medical insurance. Years of war and crisis have damaged the healthcare infrastructure in Afghanistan, leaving many to search elsewhere for well-equipped and well-staffed facilities that maintain international standards. Here India offers the best facilities at prices that are far less than what would cost in the US and elsewhere in the developed world.

India has invested nearly $3 billion in aid to rebuild Afghanistan — seeking to win economic influence, boost security and gain a link to Central Asia — building over 200 public and private schools, sponsoring about 1,000 scholarships and playing host to upwards of 16,000 Afghan students.

The deficiencies of Afghan healthcare services have not been lost on Indian hospitals, which have been eager to lay out the welcome mat and tap into this new revenue stream. Many hospitals in Delhi already have websites in Dari and Pashto, and separate payment and service desks for Afghans. Prayer rooms, halal food and Afghan cuisine are also available and almost all hospitals provide interpreters free of charge.

Most patients from Afghanistan rent apartments in small localities of south Delhi like Lajpat Nagar, Malviya Nagar and Bhogal, which are close to premier hospitals like Apollo, Max, AIIMS and Moolchand Hospital.

Diplomatic outreach

Mohammad Gulnawaz, who underwent critical surgery for brain tumour at Max Hospital, rented an apartment for a month in Malviya Nagar. “It was at walking distance from the hospital and not very expensive,” said Gulnawaz, adding, “there are also some nice Afghan food outlets in the locality.”

Others like Mujeeb ur Rehman, 55, damaged his left leg in a mine blast while coming to Kabul from Kunar. Doctors in Kabul advised him to go to India or Pakistan for surgery. “I decided to go to India though it was a little more expensive than Pakistan,” says Rehman.

As part of the diplomatic outreach, India offers many facilities to Afghan patients with hassle-free visas in addition to addressing their security concerns, unlike Pakistan and Iran. According to the Indian Embassy in Kabul, more than 100,000 medical visas have been issued in the last three years.

Many Afghan medical tourists are as fascinated by traditional and natural medicine as by modern medicine. Ayurveda, unani medicine and yoga are also popular.

Not surprisingly, even Pakistan has confirmed that it has lost Afghan medical tourism trade to India in the last few years, mainly due to its border management policy. In October 2019, the Pakistan ministry of commerce suggested that in order to get business back, they will have to organise, coordinate, facilitate and develop health tourism in their country. Until 2016, Pakistan was the top destination for Afghan medical tourists because of their common culture and language and less expensive treatments than anywhere else in the region, including India. However, patient numbers to Pakistan have considerably decreased and most have gone to India since 2016. The ministry lists several reasons for the diversion including the border management policy of Pakistan, issues in getting Pakistani visas, unnecessary security checks at border crossing points, compulsory police reports and security clearance. Other reasons have included difficulties in getting doctors’ appointments and the rising medical and hotel prices in Pakistan.

Of course, much would depend on what the Taliban does in Afghanistan under Pakistani patronage, which does not look too promising at the moment, says G Parthasarathy, former Indian high commissioner to Pakistan. One can but hope that the gains of medical tourism are not lost in the games of geopolitical brinkmanship.

Ranjit Bhushan is an independent journalist and former Nehru Fellow at Jamia Millia University. In a career spanning more than three decades, he has worked with Outlook, The Times of India, The Indian Express, the Press Trust of India, Associated Press, Financial Chronicle, and DNA.