Dhaka, Bangladesh – Khadiza Khatun's life changed dramatically in September when doctors at the Dhaka Medical College Hospital told her that her 37-year-old husband, Mohammad Nuri Alam, urgently needed a liver transplant – a procedure not available in Bangladesh.
After careful research, he decided to go to the Asian Institute of Gastroenterology in India in Hyderabad, which is trusted by many Bangladeshi patients.
But three months later, they still haven't received their travel permits. As tensions between India and Bangladesh have escalated since the August ouster of Sheikh Hasina, New Delhi's ally, in Dhaka, Indian officials have sharply reduced visa requirements for Bangladesh.
The result: Khadiza and her husband have already missed two medical appointments, on November 20 and December 20, and are not sure if they will be able to reach India in time on January 10, the day after the hospital in Hyderabad offered them.
“We have tried everything since October – approaching travel agencies, seeking help from government partners,” he told Al Jazeera. “India remains our only hope.”
Faced with unaffordable treatment options in Thailand and other countries, Khadiza is left to watch her husband's health deteriorate and rely on daily medical care in Dhaka's hospitals – hoping that the new year will bring her much-needed visas. “I feel helpless, running between hospitals without an answer,” said the mother of two.
The Khadiza crisis highlights a serious problem affecting thousands of Bangladeshi patients, who depend on India's cheap healthcare, because visa restrictions initiated by the Indian authorities. India's visa agency, on its website, says it is “only offering limited opportunities to Bangladeshi nationals in need of medical and student visas” and is “currently processing a limited number of emergency and emergency visas”.
According to an Indian visa official in Bangladesh, the number of daily visas issued at five Indian posts in Bangladesh, including Dhaka, has “dropped to 500” from 7,000 since protests began in July that led to Hasina's ouster. .
For many Bangladeshis, like Khadiza, the actual chances of obtaining visas are slim.
Slide in the screws
Relations between India and Bangladesh have been strained since Hasina fled the country for New Delhi on August 5 after weeks of student-led protests against her authoritarian rule.
India protected Hasina, straining relations – Bangladesh's government of Nobel laureate, Muhammad Yunus, last week sent New Delhi a letter demanding her extradition.
Meanwhile, the Indian government has told Bangladesh that it is involved in a increase in violence against Bangladeshi Hindus. Dhaka, for its part, insists that most of the attacks have been political – against Sheikh Hasina's supporters – rather than religious. Bangladesh has also accused Indian media of exaggerating the extent of Hindu violence.
This conflict between the two governments has also affected the issuance of visas. On August 26, the protest was started at the visa center of India in Dhaka because of the delay, after the government resumed “limited activities” in Bangladesh on August 13. Crossing the border, the Bangladeshi delegation in the northeast of the Indian city. Agartala was attacked by a group of people in early December, which led to strong protests from Dhaka.
On January 1, the usually crowded Indian visa center in Dhaka looked deserted. Only a few employers were waiting to submit their documents. Most of the applicants received calls to submit their visa forms and fees at the visa center after handing over the form to the Indian High Commission in Dhaka a few days ago.
However, Khadiza, who followed suit last month, was unsuccessful. A visa processing center manager told Al Jazeera that authorities have started accepting more emergency applications, although online submissions are still limited.
Some Bangladeshis, who delayed their journey to India for treatment while waiting for the tensions to subside, now have expired visas.
“My and my wife's visas were valid until December 10, but we could not travel because of the disputes over Bangladesh in India,” said Shariful Islam, 40, from Joypurhat in northwestern Bangladesh.
Islam suffers from lung disease. He and five other family members – each with their own health problems, including his wife and father – have for the past four years been making frequent trips to the eastern Indian city of Kolkata and the southern city of Vellore for treatment.
In rural Joypurhat, Ridowan Hossain, who runs a visa agency, is currently struggling to find a place to get visas for patients, including a cancer patient seeking treatment in India. Over 10 days, he repeatedly tried to complete the online application process but faced failures at the time of payment, he said.
When she called the helpline, she said she was only told to try again.
“I process more than 300 Indian visas a year, but I haven't been able to get even one since July,” he said.
Now, many Bangladeshi patients are seeking alternative treatment options in Thailand, Malaysia, Singapore and Turkey.
Mazadul Noyon, manager of Suea Noi Fit & Fly, a medical and tourism agency in Bangkok, told Al Jazeera that inquiries from Bangladesh have doubled compared to before August. “Although about 80 percent of patients consider Thailand after failing to obtain a visa in India, many abandon the idea after learning about the 10-15% higher cost in Thailand,” he said.
For example, the initial cost of treatment for a Khadiza husband – related to diagnosis, medication, consultation, and other related expenses – along with travel and accommodation, can range from US$1,000 to US$2,000 in India, compared to US$10,000 to US$15,000. in Thailand. .
For making a heart ring, the price in Thailand ranges from $5,000 to $20,000 – depending on the hospital, excluding travel and accommodation. In India, $2,000 offers the highest quality rings and medical care. The price of these options is very high in countries like Malaysia, Singapore and Turkey, which makes many Bangladeshis not to buy.
A lost situation
But it's not just Bangladeshi patients who are suffering – India's “medical tourism” industry, which provides high-quality care to patients from developing countries at lower prices than Western countries, has also benefited.
Industry data shows that 60 percent of India's two million annual patients come from Bangladesh. However, since the end of August, the number of patients in Bangladesh has dropped by 80 percent. India's medical tourism industry was worth $9bn in 2023.
Amitabha Chattopadhyay, a pediatrician at Narayana Superspeciality Hospital in Kolkata, told Al Jazeera that his hospital has seen a 5 percent drop in Bangladeshi patients.
“But chronic disease hospitals are facing serious challenges,” he said.
Hospitals in Kolkata, Bangladesh's closest city and a similar culture, have been the worst hit.
At Peerless Hospital, a 500-bed hospital in Kolkata, daily patient visits from Bangladeshi patients have dropped from 150 to less than 30, and almost no one is admitted, The Print, an Indian digital publication, reported, citing an official of the hospital, Sudipta Mitra.
Other hospitals affected are Narayana Health in Bengaluru, Apollo in Chennai, and Christian Medical College in Vellore, according to Alexander Thomas from the Association of Healthcare Providers of India.
Meanwhile, two hospitals in Kolkata and Tripura reportedly turned away Bangladeshi patients, citing disrespect for the Indian flag, straining relations, according to local reports in early December.
'Very difficult'
Touhid Hossain, the head of Bangladesh's Ministry of Foreign Affairs, acknowledged that the country's patients are suffering because of the ban on Indian visas.
“Not difficult. It has been very difficult,” Hossain told Al Jazeera.
M Humayun Kabir, former diplomat and president of Bangladesh Enterprise Institute who has worked in Bangladesh in Kolkata, echoes this.
“Emergency visas are supposed to be arranged, but I have received reports otherwise… There seems to be no chance of getting visas (for India),” he told Al Jazeera.
Relations between the two countries appeared to be on the wane when Indian Foreign Secretary Vikram Misri visited Dhaka on December 9, marking the first high-level meeting between India and Bangladesh since the political transition in Bangladesh.
Hossain confirmed that Bangladeshi officials had raised visa-related concerns with their Indian counterparts during the visit. “They assured us that they will increase the issuance of visas and prioritize urgent cases,” he said.
However, there is no change so far, say patients and visa agents.
India's Ministry of External Affairs and the High Commission of India in Dhaka did not respond to a request from Al Jazeera for comment on New Delhi's criticism of the visa restrictions.
But in a press conference in Dhaka on December 24, Indian High Commissioner Pranay Verma said that the issuance of Indian visas to Bangladesh exceeds “probably all other embassies put together”.
He said he was still waiting for the future of Dhaka-New Delhi relations – something Hossain, Bangladesh's foreign minister, said in an interview with Al Jazeera.
However, experts are still skeptical.
“Both parties talk about good relations, but the reality is that they are not,” said Snigdhendu Bhattacharya, an Indian freelance journalist who works in South Asia.
Kabir, a retired Bangladeshi diplomat, said he hoped the two governments would be able to restrict the issuance of visas during their major disputes.
If they don't, the neighbors may face problems, he warned.
“Such situations create negative feelings among people and can destroy long-term relationships between people,” Kabir said.
But Khadiza does not have the chance to wait long.
“The visa agency has not yet issued the application,” he said, his voice heavy with frustration. She is mentally preparing herself to receive the updates that could not be sent – even as the time is approaching for Alam, her husband.