In this review article, the authors contextualize the contemporary practice of medical tourism in terms of the concept of worldmaking, which was introduced (in this journal) with two articles a year or two ago by Hollinshead. Here, the authors first contextualize medical tourism in terms of "worldmaking" per medium of the observations of the corporeal realms identified by Alexis de Tocqueville almost 200 years ago. In 1835, de Tocqueville wrote with enthusiasm tinged with nostalgic regret about the new world of American democracy that he then saw as the world of the future. A serious rupture in history took place of which he became a most relevant critic. But there have been (according to Mainil, Platenkamp, and Meulemans) many ruptures since then: that is, there have been short periods of "in-between worlds" that became ever more anchored in the timeline of Western history. Today, they argue that tourism as a field of expertise, practice, and knowledge is intertwined with several other networks of expertise. It is responsible (itself) for many small "ruptures" in these modern times. Mass tourism can be seen as such a shift. Sustainable tourism and the attention paid to climate change would be another such shift. And the authors of this review argue that an interesting and deep-seated case in this regard is medical tourism. They argue here that medical tourism has a great deal of worldmaking capacity, especially by means of the Internet and international marketing tools. It arises in the interstices of the interacting networks of a global world. It crosses borders in line with emerging power structures in a global network, but it also meets local resistance or regional obstacles that are related to other networks. In between these worlds of human experience, various interactions of perspectives on the concept of health itself come to the surface. Within the field of medical tourism different stakeholders play a role in a worldmaking process. Our reviewers from the Low Countries thereby argue that medical tourism itself is responsible for a Tocquevillean rupture within and across our global network society. In their view, medical tourism also constitutes a new hybrid-that is, as a hybrid medical paradigm that seems to be appearing within the performative and productive world of tourism.
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Touristification of consumption spaces describes a process in which retail and hospitality businesses adapt to the tourist demand, eroding place attachment among local residents. While this is an important cause of resistance to tourism, little is known about the mechanisms that drive or mediate this process. We address this gap by interviewing entrepreneurs in Amsterdam. We found three distinct areas in close proximity where entrepreneurs responded to increasing tourism in markedly different ways; by crowd-pleasing, niche-playing and gentrifying. The resulting microgeographies of touristification of consumption spaces have not only been overlooked in literature, but also in urban policies. This causes a mismatch between the more generic, city-wide regulation and the highly differentiated effects of tourism on consumption spaces.
Within a field that has prioritized ideas of a global tourism industry impacting on a local environment, less attention has been given to regional, cultural, and geographic differences and parallels. A problematic concern in the study of tourism was perhaps the lack of contextualization and the integration of the units of analysis (e.g., tourist destinations) to the larger regional structures and societal processes. We wish to take up the challenge to further disturb the foundations of the field and, more importantly, to participate in the advancement of a more pluralist discourse. A central component in this article is a 5-day study visit in Siem Reap, Cambodia as part of an Asia-based fieldwork of bachelor students in tourism development at NHTV University of Applied Sciences in Breda, The Netherlands. This study visit serves as an illustration of the contextual education approach developed in the tourism course and facilitated by the international classroom setting. This fieldwork's philosophy and the inspirational encounters made possible by it is an attempt to address the challenges posed by the study of the dynamism and changing character of destinations. To conclude we will bring forward selected student experiences as well as dimensions of Cambodian history and society that have enriched our understanding of Siem Reap as a destination. This experience will fuel a discussion on knowledge production in tourism and on the added value of this contextual education approach. The repeated opportunity for our students to meet, think, and reflect on what they were confronted with created a possibility to uncover more than would have been possible via standard research methods using surveys and interviews.
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