COMPARATIVE ANALYSIS OF CĂLIMĂNEŞTI - CĂCIULATA AND TECHIRGHIOL IN TERMS OF TOURISM DEVELOPMENT OF MEDICAL REHABILITATION
Spa tourism has a long tradition in Europe and is no stranger to Romania, being practiced here since 2000 years ago, two of the most important resorts are Călimăneti – Căciulata and Techirghiol. This paper aims to highlight the comparative analysis between the two resorts tourism potential of rehabilitation and encourage the creation of international branding strategies Romanian spa tourism. The future of Romanian spa tourism in the international market consists in the cooperation of all stakeholders in creating a system of medical rehabilitation, wellness and anti-aging treatments where we have a real potential.
1. Introduction In Romania spa tourism sector is complex, involving numerous actors, which through collaboration and the development of partnerships can restore this area to its once international success. Why? Because our country has approximately 8,500 mineral and thermal springs, the extraordinary potential value of natural therapeutic factors. Spa Tourism Employers state that Romania is the richest country in Europe in terms of resources resorts, accounting for about a third of Europe's mineral and thermal springs, but only 10% of the springs are exploited because of the gap approach to scientific research. The awareness of the potential for development of spa tourism in conjunction with using strategic advantages provided by the scientific research of the natural factors is unfortunately very low today compared to the years before the revolution. Unfortunately, after 1990, scientific research has declined significantly, which, together with the lack of investment and poor policies have generated the today’s situation of spa tourism. The extended transition period, the fall of the economy, declining purchasing power, mismanagement, lack of investment, the legislative framework, generated the degradation of material, both in terms of obsolete equipment and outdated treatment of the bases and the protection and investigation of natural healing factors, which have been degraded considerably. 2. Brief history of balneology in Europe compared to our country Balneotherapy propose mineral water and mud treatments that are applied to diseases using most or even running water, not just spring water whose quality is limited to mechanical effects. It can be practiced anywhere. Mineral waters and therapeutic muds are known from ancient times. The first practical applications, therapeutic, more random quickly expanded so that the ancient Greeks and Romans, especially mineral waters and springs, were well known as places of occurrence and medical qualities. In ancient times, spa treatments occupied an important place in the therapeutic arsenal in alternative and traditional medicine. Thus, as the time passed, and the technological progress in medical science have failed to diminish the significance of balneotherapy. This kind of treatment has been improved, it’s nuanced with precise indications and contraindications, enriched with new procedures and earned a scientific foundation. Through history, in Europe, spa towns knew how to use water as a tourist attraction, for example: Amnéville in France, Baden-Baden in Germany, Karlovy Vary, Czech Republic, Badgastein in Austria or Abano Terme in Italy becoming so-called "hot springscities". (J. Benabdallah, J. Tomatis, 2009, p. 7). Analyzing several countries which have similar resources in Romania neighboring and in Europe, we note the following: Hungary has a territory rich in mineral water, it has more than 1,300 springs of which 800 are active. (Bender T, Bálint G, Prohászka Z, Géher P, Tefner I, 2012, p. 44). They also make large investments to renovate treatment centers, modernization of infrastructure, creation of wellness complexes or aqua park centers (in urban areas and in proximity to the Romanian border), a traditional example is the Hajduszoboszlo, the third largest city in Hajdu-Bihar County and most famous spa in the Great Hungarian Plain. Analyzing spa tourism in Germany, we can observe a policy of encouraging the combination of thermal cures and leisure resorts, here we encounter a famous historic resort Baden-Baden. Another country with a tradition in spa tourism is Italy, which is visited annually by tourists from all over Europe, thanks to a series of strategy research of SPA process, so their policy is supported by nearly 380 spa centers in the country, which allocates a percentage of their income directly to the Foundation for Scientific SPA Research launching appeals on issues of medical spa therapy. (Vitale M, Vaccarezza M, 2012, p. 46). France is another Latin country with a tradition of spa tourism, on its territory we can find approximately 1,200 sources of mineral and thermal waters and a number of over 100 resorts. It is noted here that the state's role is very important in the development of spa resorts so of the 100 existing stations, 60 depend from private organizations, 5 are directly or indirectly placed under the guardianship of the state and over 30 are funded and administered by local municipalities. (http://www.scritub.com/geografie/turism/ Particularitatile-turismuluib1052111820.php, The particularities of the spa tourism, last accessed on 13th of May 2015). The development of balneary activities in our country takes place since the nineteenth century. During this time, most sources of mineral water are being captured, the scientific basis of water exploitation is being established (spa research, chemical analysis, hydrological research). Following resorts are being planned and constructed: Cozia, Călimăneşti - Căciulata, Govora, Băile Herculane, Băile Govora, Oglinzi, Borsec, Buziaş, Moneasa, Mălnaş, Sângiorz Băi, Lipova, Tuşnad, Tinca, etc. Also, during this period, the exploitation of therapeutic mud and salt lakes and the seaside are established (Lacul Sărat, Balta Albă, Techirghiol). The mud will be introduced as a spa treatment in Bazna and Slănic. During 1926-1928 there were about 80 resorts, in many of them were between 80 thousand and 180 thousand baths, annually. The water bottling activity took place in the interwar years in 26 units of different capacities. (Berlescu E.,1998). In present, Romania has 160 resorts and balneary centers with natural treatment, out of which 60 resorts of general and local importance and 18 of them were promoted during the international tourism circuit. After the revolution, in many of them, the accommodation centers were being modernized, treatment hotels and modern sanatorium complexes were built, out of which, the services of accommodation, diagnosis and treatment are offered during the same buildings, as it is practiced in the balneo climateric resorts of global concern such as: Băile Herculane, Băile Felix, Sovata, Băile Tuşnad, Covasna, Călimăneşti - Căciulata, Mangalia, Techirghiol, Slănic Moldova, Vatra Dornei, Eforie, Govora, Olăneşti, Buziaş. Along with the natural processes or physiotherapy, a wide range of therapeutic procedures with physical factors are being used. Basic such treatment have specialized departments assembled with modern equipment and facilities, but not at other resorts, competitive in Europe, why? Because of the lack of an integrated plan for urban development and restoration of historical and architectural heritage, in order to qualify for a pro-active investment aid in the the balneary domain, from the Romanian state and also from the structural funds allocated by the European Union for development. (J. Benabdallah, J. Tomatis, 2009, p. 27). 3. Presentation of the resorts Călimăneti - Căciulata and Techirghiol from the perspective of the past/present development The prior objective of this paper work is to identify the tourist potential of the spa resorts Căciulata-Călimăneti, respective Techirghiol and also comparing them as a development/tourist image for the national and/or international clients. The Romanian legislation has established the criteria for certifying the tourist resort of local or national interest, covering, among other things, the location in a natural setting without pollutants; the certification and value of the natural healing factors; facilities and equipment for sport practice; organization of tourism, culture, sport events etc. and for the balnearic resorts: medical spa, technical equipment for operation, protection and use of therapeutic mineral resources, facilities and equipment for basic services and revive therapeutic exploitation of natural resources(HG nr. 852/2008 for the approval of norms and criteria attesting tourist resorts). Based on these criteria, following areas were granted as balneary resort or spreading areas: Băile Felix, Călimăneşti - Căciulata and to the cities Techirghiol, Covasna, Amara, Sovata, Ocna Sibiului, Băile Govora and Băile Olăneşti (HG nr. 1016/2011 regarding granting the status of spa or balneary resort for some localities and areas that have natural healing factors, Official Monitor of Romania). Călimăneti-Căciulata is located in Vâlcea, Valea Oltului, in the Carpathian Depression Jiblea-Călimăneşti (260m). The resort is situated at a distance of 17 km of the city Râmnicu Vâlcea, a subalpine zone and it operates all year round. The balneoclimaterical resort Călimăneti-Căciulata is considered to be the “pearl” of the stations from the Oltului Valley, it has been documentary attested in 1386 and it is being internationally famous from in the mid nineteenth century on the recommendation of Dr. Carol Davila, Emperor Napoleon III himself was being treated with bottled mineral water from the springs here, being sent to Paris; AustroHungarian Emperor Franz Joseph was also the recipient of miracles mineral waters of the resort. (http://ro.wikipedia.org/wiki/C%C4%83li m%C4%83ne%C8%99ti, accessed last time on the 13th of May 2015). We have to mention that here works also the clinical department of the Institute for physical, balneology and medical rehabilitation of Bucharest, the clinical base of the specialist department of the Medicine and Pharmacy "Carol Davila" University. Călimăneşti-Căciulata is the only resort from the country which has five profile treatments: • kidney and urinary diseases; • digestive tract and glands diseases; • muscular-skeletal and peripheral nervous system diseases; • professional diseases (intoxication with heavy metals, lead, mercury); • silicosis. The internationally known curative factors of the resort are mainly recognized due to the thermal waters of the almost 32 springs (of which only five are known), Căciulata water being diuretic with exciting action on the gastric and billiaric secretion, the temperate climate and the bio-climate protector completing the ideal conditions for a vacation. The treatment is divided into several sections: electrotherapy, hydrotherapy, paraffin, mud, massage, acupuncture, aerosols, carbon dioxide baths, herbal baths, galvanic baths, physiotherapy, chromo therapy and aromatherapy. The number of medical treatments is of 1,500 patients at six medical doctors. There are 80 medical personnel treating the patients. We have an estimated of 11,800 patients annually who come for rehabilitation, 11,000 through the reference tickets from the House of Health Insurances and 8000 from the travel agencies; 3% of this total are from abroad, mainly from Germany. The infrastructure development and the equipment provision adapted to current requirements began in 2007, increasing gradually from 2011 to 2012, only in the Interbelic or Central Hotel, as it is known, has been invested 200,000 euro in German and polish medical rehabilitation equipments. Techirghiol is a seaside resort on the Black Sea coast, located 16 kilometers south of Constanta. The city and the region were inhabited since the Neolithic period, the settlement Techirghiol is included in phase two of Hamangia-Cernavodă Culture. In 1894, the Ministry of Agriculture and Domain sells 100 ha by the lake to the Charity society of Civilian Hospitals in Bucharest. This is the first step in building health resort near the lake. The foundations of what will later become Techirghiol-Eforie and then Techirghiol town today begin to be built. It is important to note that, throughout history, here have lived or received curative treatment one major personalities of the time: Mihail Kogălniceanu, Mircea Eliade, Mihai Eminescu, Constantin Tănase, Tudor Arghezi, etc. We can see that, from 1930, the resort equipping was represented by a 6000 sqm landscaped beach, 80 cabins, 23 hotels and 318 villas with 4,000 rooms. Techirghiol, due to its benefits, is declared monument in 1972, a distinction that offers, also today, protection regarding the movement of boats on the lake and the wharf demolition. (http://www.itour.ro/techirghiol-lacul-statiunea-siistoria-ei/, ultimate accesed on the 14th of May 2015.) In order to study the natural healing factors, from the balneotehnic and physico-chemical point of view, under the scientific guidance of medical activity in the state, in 1949 it was established Balneology and Physiotherapy Institute. The Institute has three sections: • The study of natural resources: climate, mineral waters, mining, fountain captures, special spa; • Experimental balneofiziology; • Clinical balneofiziotherapy. Due to the therapeutic properties of the mud recovery, treatment is structured into three main purposes: recovery, curative and prophylactic and it addresses to the following disorders: degenerative rheumatic diseases, inflammatory rheumatic diseases, post trauma, diseases of the central and peripheral nervous system, gynecological and skin diseases, peripheral vascular diseases, and associated diseases. Analyzing the treatment center, we see a number of approximately 13,200 patients annually, the profile of patients receiving annual rehabilitation is often female, and the age generally is 50-59 years (31%), 60- 69 years (29%) compared to groups 40-49 years of age (15%) or more than 70 years (17%). Most patients are from urban areas - 84%. By comparing the two balneary and climatic resorts over time, we observe similarities with regards to the abundance of natural medical resources, yet they 101 Balneo Research Journal DOI: http://dx.doi.org/10.12680/balneo.2015.1094 Vol.6, No.2, Mai 2015 differ by geographical locations and some of the medical recovery procedures. It is worth looking into the weightage of the aggregated factors, which determine the relative touristic success of the area. Both Căciulata – Călimăneti and Techirghiol enjoy prominence among the top medical resorts across the country, and previously also well-known abroad. The former developed on its own by means of private initiative and capital, chiefly after 2000, while the latter remained state-owned and run. This accounts for the weakness of Techirghiol: higher percentage of obsolete equipment; lack of private-sector partners and companies; shortage of medical staff; low remuneration leads to ageing staff; strategic short-sightedness in attracting local and foreign middle-aged tourists with medical recovery packages, rather than the retirees, who seek healing therapies; lack of PR and marketing at both international and national level at trade fairs and with tour agents. These shortcoming are less felt in the privately-run Călimăneti – Căciulata, although the international marketing campaigns aimed at the foreign tourists are deficient. Merely 3% of the clientele are foreign tourists, albeit little is known whether they are repeat customers, as their feedback is not centralized, nor are there any loyalty programmers designed for the medical recovery tourist. 4. The importance of development of medical recovery tourism The balneary tourism has enjoyed a considerable development under the umbrella of the medical recovery tourism, a niche product which blends medical services, as well as tourist products (Yu, Ko, 2012, pp. 80-81). Within the framework of the international international travel, patients from developing countries travel to avail medical services in high-standard medical facilities in developed countries (Horowitz, Rosensweig, 2007, p. 26). Previous research points at a monolithic balneary and climatic tourism, based on a single kind of tourism – tourism for treatment, a specific form of R&R tourism, which has enjoyed speedy development, particularly in the last few decades, owing to an increase in exhaustion and workrelated diseases caused by the stress of modern living in large metropolitan areas (Snack, Baron, Neacşu, 2001, p. 38). This perception is fully justified, as the Eastern European balneary and climateric resorts, including the ones in Romania, have traditionally been medical centres and spas, which cater for the tourists, often called „patients”, in search of relief of physical conditions. These centres are characterized by: the relatively linear and constant tourist flow around the year, reduced seasonality, longer-term holidays (between 12 and 30 days), loyal clientele, health-improving recurrent balnearic treatments, above average per tourist and day expenditure as owing to complex and qualified services (compare Snack, Baron, Neacşu, 2001, p. 39). Nevertheless, the Romanian market displays a latent demand, which means that the consumers’ needs are not appropriately satisfied by the current balneary offer. Furthermore, the consumers are unaware or are not interested in the product, or do not realize their need for a treatment and they fail to understand the importance of maintaining their health. A SWOT analysis of the Romanian balneary tourism reveals: 1. Strong points: • the presence of natural mineral springs in the majority of the resorts and their potential of being used in the treatment of different diseases, as well as for the tourism development; • the quality of higher medical education and very capable Romanian doctors; • the maintenance of a traditional profile in the majority of balneary resorts of international interest; • the possibility of 2 stars balneary hotel accommodation, in accordance with tourists' income, which for now represent the majority in the structure of solicitations for balneary tourism in total; • the possibility of combining balneary tourism with many other types of tourism (cultural, religious, or rural tourism) in most of the resorts; 2. Weak points: • not enough or sometimes absolutely no involvment on behalf of the local communities in the development of balneary resorts; • the lack of co-operation/partnership between different sustainers of tourism's interests in general, and of spa tourism in particular, in order to develop this segment; • no relevant information or studies regarding some quality indicators/ qualitative elements like recurrence degree/ loyalty programs; • the psychological profile of the tourist that might be turned into additional data usefull for different market researches; • total dependence on state subventions ( by issuing treatment vouchers only for certain types of illnesses, not to mention a wrong perception of the tourism agents/agencies regarding a lack of interest and action in satisfying internal consumers of such services); • not enough accession of European founds for the infrastructure development, for the acquisition of high performance equipment, or for the creation of a strategy for the promotion and branding of balneoclimaterical resorts; • low comfort accommodation facilities, most of them of one or two stars, or even unclassified, not in accordance with acceptable standards of the 21'st century; • the lack of international accreditation for the locations in the balneoclimaterical resorts; • insufficient or inexistent development of entertaiment and recreation activities in most of the balneary resorts; 3. Opportunities: • the involvment of pleased customers in raising the visibility of the locations; • high potential but not enough highlighted of the resources of the area where the balneoclimaterical resort is located; • the customers' change in attitude and mentality towards health, in general, and spa tourism in particular, worldwide; • the innovation of natural, no harmful traditional treatments in accordance with integrative, holistic medicine; • the opportunity of accessing different founds in order to make investments with direct impact on bringing tourists in the balneary resorts; • the need of increasing different kinds of partnership between public and private sectors in this area; • special conditions for obtaining loans with preferential interest for the private operators, in order to invest in the modernization of the accommodation facilities and treatment platforms in the resorts. 4. Threats: • more and more doctors choosing to practice medicine abroad; • increasing development of medical and wellness tourism in more and more countries; • random constructions that were made in some of the balneoclimaterical resorts led to the loss of potential of the mineral springs; • the appearance of an increased number of competitors offering a wide range of balneary holistic products for all the market segments; After listing all the above we emphasize that the role of the personnel working in any kind of touristic/balneary facility is even more important as such coordinates as the professionalism and competencies of the health care professionals are not just elements that positively complete the touristic product but, moreover, they build it, as without them the purpose of recovery and maintaining health during the tourist's trip is strongly affected. For this reason, in any strategy of development of the balneary tourism, for any destination or market, the structure of personnel should be in perfect accordance with its' resources/specific. 5. Conclusions Romania has an advantaged position comparing with other European states for having these two balneoclimaterical resorts analysed above, Caciulata - Calimanesti and Techirgiol, and not only. Although the potential of the Romanian balneary tourism is exceptional, the results of its' exploitment don't raise up to the level of the natural resources, and for this reason our country is unfairly situated at a significant distance below the major international competitors with tradition in balneary tourism. The causes can be classified on all levels (macro, micro and medium) and they come from both sides (from consumers, whose perception need to be changed, but also from a several owners of these resources). But before analyzing the causes, we need to understand, acknowledge and bring to common denominator the concepts and dimensions of the spa/medical rehabilitation tourism. The future of balneary tourism depends on the development of a proper global infrastructure, by involving all parts, both public and private sectors, by creating new facilities (entertainment, bike trails, golf fields) depending on the advantages of the resort, as well as by highlighting the natural, historical and cultural patrimony of the region (monasteries, parks or nature reserves). These resorts must offer multiple ways of entertainment, but diversity needs to be implemented gradually through a national strategy (healthy customers shouldn't mix with those with health problems, and the same goes for socially assisted customers and the rest of the groups). Another advantage Romania has regarding medical rehabilitation tourism comes from the aging process which has become a problem for all the states in the European Union. The average life expectancy surpasses 70 years. Our country can be an example for "slow and beautiful aging" and for defeating aging through the creation of an international medical brand that mixes the benefits of thermal waters with the famous history of the cosmetic products and treatments Dr. Aslan. 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