GENERAL EVALUATION OF FOREIGN SPA RESORTS 

Curative spa therapy means the application of medicinal waters for the treatment of people. Treatment constitutes a part of physiotherapy, that is to say the use of natural means in therapy. Spas have been known for a long time as a form of treatment. Most civilizations like the Romans, Greeks, Byzantines and the Ottoman knew the values of spa treatment. Many centers with curative spas function today throughout Europe and specifically in Germany, France, Switzerland, Italy, Greece, Russia, Hungary and the Czech Republic. Spa centers are also found in some Mediterranean countries like Tunisia, Morocco and Cyprus. The average period of stay of patients who come for treatment at the spa centers is between 15-20 days. CATEGORIES OF CURATIVE SPASA) Sulphurated Hydrogen springsB) Saltwater springsC) Sodium Chloride springsD) Alkaline springsE) Radioactive springsF) Simple acid springsG) Sulphur springs THERAPEUTIC INDICATIONS OF SPA THERAPYA) Neuralgia-NeuritisB) Acute and Chronic arthropathyC) Skin ComplaintsD) Respiratory ComplaintsE) GoutF) Gynecological complaintsG) Post-traumatic and post-operative complaintsH) Chronic fatigue strain CONTRA-INDICATIONS OF SPA THERAPYA) Advanced arteriosclerosisB) Recent brain malfunctionsC) Coronary deficienciesD) Hemorrhages of various organsE) Serious forms of diabeticsF) Malignant growthsG) Active TuberculosisI) Acute active rheumatic complaintsJ) Acute phase of respiratory diseases. CHARACTERISTIC APPLICATIONS OF CURATIVE SPASCurative spa therapy should certainly be under doctor’s examination and the accurate execution of his instructions.Preferably the temperatures of the waters should be 34-36, 36-38, and 40 degrees Celsius.Frequency of bath may range from 3-6 days per weekDuration of stay in water is15-20 minutes but in some waters it can be prolonged to 30-40 minutes.Bath may be taken once or twice daily.On the average the total number of baths per regimen is 15-20 times. The duration of a curative bath regimen is at least 2 weeks and at most 6 weeks.Enough water support should be maintainedWithout much movements the patient should remain upright or in a sitting position and shouldn’t swim in the thermal pool. If exercise is to be done in the water then it should be in waters of temperatures 34-35 degrees Celsius or below. At no time should exercise be done in a hot water. After bath the patient should certainly dry him/herself very well and at least rest for an hour under comforting thermal conditions in a room. After resting the patient can then participate in exercise or sports activities. GERMANYGermany has over 250-300 officially recognized spa and health resorts located throughout the country with over 7 million visitors in a year. In Germany, visiting health spas has been there since time immemorial and can therefore be considered as part of their culture. Until recently when the government decided to cut down its expenditure on health spas, every citizen was entitled to 4 weeks of spa vacation in every 3 years. The total cost of spa treatment depends on the disease being treated and normally varies with a 21 days treatment costing 2600-3000 euros,14 days treatment 1700-2200euros and 7-day treatment 900-1200 euros. Germany with one of the best health care systems  in the world have always  considered  health and wellbeing as one of the basic needs of all humans and therefore do not feel the need to only live healthy but to also die healthy. In fact it is one of the very few countries, if not the only country where both the private and public schemes covers a range of cures offered by the more than 300 spa and health resorts with a doctors prescription. HUNGARYHungary which is considered as one of the most developed countries in this sector has over 120 centers of curative spas with full furnishing and infrastructure. The Romans, the Ottomans and most civilisations benefited from the curative spa centers of this country. 22% of foreign visitors to the country have these centers as their destination. Only Budapest has over 80 spa centers with more than half offering curative services. Every year thousands of patients with locomotive, lung, gynaecologic etc diseases come for treatment. The total cost (hotel accommodation inclusive) normally varies with a 7-day treatment costing 400-700 euros, 14-day treatment 800-2000euros, and a 21-day treatment 1400-2400 euros. With a doctor’s prescription, the social health insurance will pay for all or half of the curative services obtained at the spa centers. GREECECurative spa has been known for a very long time in this country. Some authorities even claim that it was originated from here this country. The great historian Herodotus, the father of medicine Hippocrates, and doctors like Herophilus,Agasthinios had made mention of these curative spas. Most of the centers are found on the sea shores. Visitors normally come to these centers in August and September and stay for an average period of 15-21 days. With a doctor’s prescription, the social health insurance will pay for all or half of the curative services obtained at the spa centers. ITALYItaly with over 200 curative spa centers has approximately 6 million people visiting these centers in a year and it provides a very important work and income for the country. The volcanic mountains in various part of the country are thought of as the main reason for the many spa centers in different parts of the country. These centers offer curative services for locomotive diseases, varicosis, obesity, skin diseases etc.With a doctor’s prescription, the social health insurance will pay for all or half of the curative services obtained at the spa centers. CZECH REPUBLIC AND SLOVAKIAUsing natural methods for treatments is known for a long time in these countries. Compared to Hungary and Greece, this country is new in this sector but the recent years have the establishment of very modern curative spa centers. The two countries have over 60 curative spa centers with an approximate figure of 500,000 visitors. 14-day spa treatment cost ranges from 950-1500 dollars but the prices are generally higher in summer. With a doctor’s prescription, the social health insurance will pay for all or half of the curative services obtained at the spa centers. OTHER COUNTRIESSpas are not evenly distributed in the world, although found in some parts of Asia and Africa is most common in Europe. The spa culture is well developed in eastern and southern Europe. Spas for a long time did not develop in England, northern Europe and America and in fact the trend still continues in the same way even today. Most probably the different climatic conditions have contributed to this uneven distribution. The spa centers found in England, northern Europe and America are mostly for resting than for therapeutic purposes. In this regard, England spend approximately 1 billion pounds in a year. Some parts of Russia have well developed spa centers with one in three Russians visiting these centers at least once in a year. Curative spas are common in Russia and the other Baltic states. Customers to these centers are mostly from Finland. Bulgaria has spa history that dates back to the olden days and has over 300 spa centers along the Mediterranean coast. It has hundreds of thousands of visitors in a year. The other Mediterranean countries like Tunisia, Morocco and Israel have spa centers. InSoutheastern Asia (India, Thailand, Singapore, and Indonesia) spa services are generally offered in very big and luxurious hotels. They are more of resting and self refreshment than therapeutic. Dr. Dursun AYDIN, MDPresident ofAssociation of Improving Health Tourism