Dhaka, Bangladesh – Khadija Khatun’s life took a devastating turn in September when doctors at Dhaka Medical College Hospital informed her that her husband, Mohammad Nuri Alam, 37, was in urgent need of a liver transplant – a procedure not available in Bangladesh.

After careful research, they decided to go to the Asian Institute of Gastroenterology in India in Hyderabad, which is a trusted destination for many Bangladeshi patients.

But three months later, they have still not obtained visas for the trip. Amid escalating tensions between India and Bangladesh since the August ouster of Sheikh Hasina, a New Delhi ally, from Dhaka, Indian authorities have dramatically reduced visa issuance in Bangladesh.

The result: Khadija and her husband have already missed two hospital appointments, on November 20 and December 20, and are unsure whether they will be able to reach India in time on January 10, the next date scheduled by the medical facility in Hyderabad. I gave them.

“We have tried everything since October – reaching out to travel agencies and asking friends in the government for help,” she told Al Jazeera. “India remains our only hope.”

Faced with unaffordable treatment options in Thailand and other countries, Khadija is left watching her husband’s health deteriorate while relying on daily symptomatic treatment in Dhaka hospitals – hoping the new year will bring her the visas her husband needs and she desperately needs. The mother of two children said: “I feel helpless, and I move between hospitals without a solution.”

Khadija’s struggle reflects a larger crisis affecting thousands of Bangladeshi patients, who depend on affordable healthcare in India, due to… Visa restrictions provided by the Indian authorities. On its website, the Indian Visa Center says that it “only offers limited appointments to Bangladeshi citizens who require urgent medical and student visas” and that it “is currently processing only a limited number of visas of an emergency and humanitarian nature.”

According to an official at the Indian Visa Center in Bangladesh, daily online visa openings across five Indian visa centers in Bangladesh, including Dhaka, “have dropped to about 500” from more than 7,000 since the beginning of the protests in July that led to Hasina’s removal from office. . .

For many Bangladeshis, like Khadija, the real possibility of obtaining visas seems lower.

Slide into relationships

Relations between India and Bangladesh have deteriorated since Hasina fled the country to New Delhi on August 5 after weeks of student-led protests against her increasingly authoritarian rule.

India has since harbored Hasina, straining relations – with Nobel laureate Muhammad Yunus’ interim Bangladeshi government last week sending New Delhi a diplomatic note requesting her extradition.

Meanwhile, the Indian government informed Bangladesh that it is concerned about… A wave of attacks against Bangladeshi Hindus. For its part, Dhaka insists that most of the attacks were political in nature – against those seen as supporters of Sheikh Hasina – rather than religious in nature. Bangladesh also accused Indian media channels of exaggerating the extent of violence against Hindus.

These tensions between the two governments have also affected the issuance of visas. On August 26, protests broke out at the Indian Visa Center in Dhaka over delays in processing applications, after the authority resumed “limited operations” in Bangladesh, which witnessed protests on August 13. Across the border, a Bangladeshi diplomatic mission was set up in the northeastern Indian city. It was Agartala Attacked by a crowd of people In early December, sparking a strong protest from Dhaka.

On January 1, the usually crowded Indian Visa Center building in Dhaka appeared almost deserted. There were only a few applicants waiting to submit their documents. Most of the applicants received calls to submit their visa applications and fees at the visa center after manually submitting a copy to the Indian High Commission in Dhaka days ago.

However, Khadija, who followed the same process a month ago, did not succeed. An official at the visa center told Al Jazeera that the High Commission has begun accepting more emergency applications, although online application options are still limited.

Some Bangladeshis, who had delayed travel to India for treatment while they waited for tensions to ease, are now stuck on expired visas.

“My and my wife’s visas were valid until December 10, but we did not travel at that time due to tensions over Bangladesh-related issues in India,” said 40-year-old Sharif Islam, from Joypurhat in northwestern Bangladesh.

Islam suffers from a lung disease. He and five other family members — each with their own health problems, including his wife and father — have been traveling regularly over the past four years to the eastern Indian city of Kolkata and the southern Indian city of Vellore to receive medical treatment.

In the rural district of Joypurhat, Rizwan Hossain, who runs a visa support agency, is struggling to secure visa appointments for patients, including a cancer patient urgently seeking treatment in India. He added that he tried repeatedly, over a period of 10 days, to complete the online application process, but he constantly faced failure at the payment stage.

When he called the helpline, he said he was told to try again.

“I process more than 300 Indian visas a year, but I have not been able to process a single visa since July,” he said.

Now many Bangladeshi patients are looking for alternative treatment options in Thailand, Malaysia, Singapore and Turkey.

Mazadul Noyon, director of Suea Noi Fit & Fly, a Bangkok-based medical and tour operator, told Al Jazeera that inquiries from Bangladesh had doubled compared to before August. “Although about 80% of patients consider Thailand after failing to get an Indian visa, most of them abandon the idea when they learn that costs are 10 to 15 times higher in Thailand,” he said.

For example, the initial treatment cost for Khadija’s husband – which covers diagnosis, medication, counseling and related expenses – along with travel and accommodation, ranges from US$1,000 to US$2,000 in India, compared to at least US$10,000 to US$15,000 in Thailand. .

For a heart ring implant, costs in Thailand range from $5,000 to $20,000 – depending on the hospital, excluding travel and accommodation. In India, $2,000 covers rings and high-quality medical care. The cost of these procedures is higher in countries like Malaysia, Singapore and Turkey, making them unaffordable for most Bangladeshis.

A lost situation

But it is not just Bangladeshi patients who are suffering. India’s “medical tourism” industry, which offers high-quality treatment to patients from the developing world at relatively lower prices than its counterparts in the West, has also taken a hit.

Industry data shows that 60 percent of India’s two million international patients annually are from Bangladesh. However, since late August, the number of Bangladeshi patients has decreased by 80 percent. The medical tourism industry in India is estimated to be worth $9 billion in 2023.

Amitabha Chattopadhyay, a pediatric cardiologist at Narayana Super Specialty Hospital in Kolkata, told Al Jazeera that his hospital had seen a 5 percent decline in the number of Bangladeshi patients.

“But hospitals that treat chronic conditions face greater challenges,” he said.

Hospitals in Kolkata, the closest city to Bangladesh and culturally similar, are the hardest hit.

At Perlis Hospital, a 500-bed multi-specialty hospital in Kolkata, daily outpatient visits from Bangladeshi patients have fallen from 150 to less than 30, with almost no admissions, The Print, an Indian digital publication, reported, citing the president. Hospital executive. Sudipta Mitra.

Other major hospitals affected include Narayana Health Hospital in Bengaluru, Apollo in Chennai, and Christian Medical College in Vellore, according to Alexander Thomas of the Healthcare Providers Association of India.

Meanwhile, two hospitals in Kolkata and Tripura reportedly refused to accept Bangladeshi patients, citing disrespect for the Indian flag, further straining relations, according to local news reports in early December.

“Very difficult”

Tawhid Hossain, acting head of the Bangladesh Foreign Ministry, admitted that patients in the country are suffering due to Indian visa restrictions.

“It’s not just difficult. It has become very difficult,” Hussein told Al Jazeera.

Humayun Kabir, a former diplomat and head of the Bangladesh Enterprise Institute who previously served in the Bangladesh Mission in Kolkata, echoed this sentiment.

“Emergency visas were supposed to be processed, but I’ve received reports otherwise… there seems to be little chance of getting them [Indian] He told Al Jazeera: “Visas.”

Bilateral relations appeared to be improving when Indian Foreign Minister Vikram Misri visited Dhaka on December 9, marking the first high-level meeting between India and Bangladesh since the recent political changes in Bangladesh.

Hussain confirmed that the Bangladeshi authorities raised visa-related concerns with their Indian counterparts during the visit. “They assured us that they will increase the issuance of visas and give priority to urgent cases,” he said.

However, there has been no change so far, patients and visa agents say.

The Indian Ministry of Foreign Affairs and the Indian High Commission in Dhaka did not respond to a request from Al Jazeera to comment on the criticism directed at New Delhi regarding visa restrictions.

But during a meeting with diplomatic correspondents in Dhaka on December 24, Indian High Commissioner Pranay Verma claimed that India’s visa issuance in Bangladesh still exceeds that of “probably all other embassies combined.”

He also said he remained optimistic about the future of relations between Dhaka and New Delhi – a sentiment echoed by Hossain, Bangladesh’s de facto foreign minister, when he spoke to Al Jazeera.

But analysts remain skeptical.

“Both sides talk about good relations, but the reality indicates otherwise,” said Snigdhendu Bhattacharya, an independent Indian journalist specializing in South Asian issues.

Kabir, the retired Bangladeshi diplomat, said he hoped the two governments could insulate the visa issues from broader diplomatic tensions between them.

If they don’t, neighbors could face consequences, he warned.

“Such situations create a negative mentality among the public and can harm long-term relationships between people,” Kabir said.

But Khadija does not have the luxury of waiting any longer.

“The Visa Support Agency has not submitted the application yet,” she said, her voice heavy with disappointment. She mentally prepares herself for the update that the application cannot be submitted – even with time running out for her husband, Alam.