If we want North Korea to join the global community, we have to embrace any steps the country takes, and accept that tourism is part of that process.
For city officials, accepting this tourism has been a difficult and delicate balancing game.
Council representatives and travel industry executives warned, however, that China must overhaul its tourism administration and accept more foreign involvement if it is to manage the expansion.
Limited health literacy among patients, coupled with inadequate access to accurate information, could heighten their inabilities to make an informed decision about medical tourism and ultimately to accept the risks of going abroad and providing informed consent.
Together, these results reflect some of the generally accepted goals of sustainable tourism and the widespread perspective that tourism should be economically viable as well as sustain the natural environment and social aspects of associated communities (Swarbrooke 1999).
Malcolm Bell, head of tourism at Visit Cornwall said: "We have to accept that no-one is to blame, but the message it sends out is that we are cut off.
In April, too, the Ministry of Land, Infrastructure, Transport and Tourism said it wanted Narita Airport near the capital to accept more flights by domestic and low-cost carriers and business jets.
This suggests that caregiver-companions in medical tourism may be equally in need of being prompted to accept support in order to minimize their stress and burden as other types of informal caregivers.
Yet there is currently no single internationally accepted standard for green tourism.
