India’s emergence as a healthcare destination for South Asia is often measured in numbers: foreign patients treated, hospitals accredited, surgeries performed and revenues earned. Yet the true test of a healthcare system extends beyond operating theatres and specialist wards. It also encompasses the safety, dignity and welfare of those who arrive seeking treatment. A tragic fire in a Delhi neighbourhood has served as a grim reminder that the infrastructure surrounding healthcare can be as important as healthcare itself.

For decades, patients from Bangladesh, Nepal, Bhutan, Afghanistan and other countries have travelled to Indian cities in search of medical expertise that is either unavailable or unaffordable at home. Their journeys do not end at the hospital gate. The visitors require accommodation, transport, translators, attendants and a host of support services during what is often an emotionally and financially draining period. Around major hospitals, an informal ecosystem has emerged to meet these needs. The problem is that this ecosystem has expanded much faster than regulation. Buildings designed for one purpose frequently evolve into another.

Residential premises become guesthouses, commercial spaces become lodging facilities and temporary arrangements........

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