The sustainability and Best practices

of health and wellness spa in Iloilo

city: its role in the hospitality and
tourism industry

A RESEARCH study

JULIET TOLIBAS ESMAYA MILE – TLE

I. Introduction
The emergence of tourism destinations in Iloilo City increased the target
market for wellness and spa. However, even though the spa business is
thriving, it may not be for long because the challenge of service-business
management begins with a design that effectively meets the needs and
desires of an attractive group of customers (Frei, 2020).

The business life of most spa businesses in Iloilo City is limited to 1 to 2

years only, even though most spa businesses advertised almost the same
services. This made entrepreneurs reflect on how to start right if one invests
in the wellness and spa business. For one, the wellness and spa business
requires an enormous amount of investment and resources. The resources
include facilities, human resources such as managers and staff (mainly
therapists), the products used, and machinery. The investments are in
terms of promotion, development and investment in terms of corporate
social responsibility (CSR) programs. Fontanari and Kern, (2003) state that
in Eastern Europe, enormous amounts of cash are invested in the
“infrastructure of health‐tourism.” These are considered as “long‐term
support factors” as well as “decision-making factors,” which are necessary
for the alignment of the specific services that will be offered to the needs of
designated “target groups” (pp 20-28). The concern of sustainability,
therefore, is how to provide for the long-term needs of wellness and spa as a
business entity.

Most sustainability-minded wellness and spa businesses used sustainability

principles to guide their values and actions through leading by example and
through sustainability campaigns. The Skinetics Wellness Center Spa is
known to offer a remarkable experience as beauty enhancement and
products, Nuat Thai is popular for its Thai Massage which is concentrated
on stretching and relaxing the body and mind. There are also many services
available to its customers, such as the ventosa or cupping therapy, which is
an ancient form of traditional therapy that uses cups with suction to
stimulate the qi or the flow of energy in the different body parts. The hot
stone massage involves the use of a smooth, heated stone, usually basalt
river rocks, because of its smoothness and heat retention properties. These
stones are placed on specific points of the body while giving a hand
massage. Visiting a spa is one of the earliest forms of tourism (Smith &
Jenner,2000). Those who are planning to invest in wellness and spa should
identify their target customers as part of their marketing strategy to ensure
continuous client visits to the spa, thereby ensuring the financial stability of
the business.

Spas started many years ago and were employed for healing. Spas were
considered integral to the social structure (Vierville, as cited in Tawil, 2011).
In this study, spa clientele includes men, women, children, and olds alike.
The current spa operation is a mixture of old customs and beliefs blended
with contemporary amenities and services. For the current generation, the
significance of avoidance of stress, the practice of a vigorous way of life, and
rest have been accepted by more people, and the wellness and spa service
address such need.

Harmsworth (as cited in Tawil, 2011) claims that the spa market is one of
the fastest-growing leisure sectors, where societal trends and aspirations
find instant reflection in the developments on both the demand and supply
sides. The market is very fragmented, each segment catering for different
customer needs, which continuously change in line with social and lifestyle
changes. (p. 173) Both the demand and supply in the wellness and spa point
to the growth of the industry. Today, health is considered the absence of
disease, and many are practicing a healthy lifestyle (Fisher, as cited in
Fontanari & Kern, 2003).

People change in their attitudes (Messerli & Oyama, 2004). This change in
their attitude towards health is a measure of the modernity of society (Tawil,
2011). With more health-related concerns, people in the workforce need to
relax to fight the stress that goes with their job and to minimize the anxiety
that results from the pressures of their job.

Wellness and spa businesses in the local setting have also changed
enormously with globalization. The effects of globalization, which is the
improvement of telecommunication and travel, give rise to more tourists that
look for a place to relax and be pampered. This is also ushered by the
technological advancement in transportation that promotes travel at a lower
cost. With the coming in of various tourists seeking pleasure, one choice
offered for them is the spa services available in their destination. With
globalization, many new multinational organizations placed their branches
in many developing cities and municipalities like the Iloilo City, Cebu City
and Davao City.

The emergence of the business processing industry in Iloilo City lured many
businesses to engage in wellness and spa businesses. Many multinational
manufacturing firms also locate their companies in Iloilo City, thereby
increasing the workforce that needs the spa services. There are also more
English as second language (ESL) schools that proliferated within the city of
Iloilo, hiring local English-speaking professionals. Together with their foreign
students, they frequented the wellness and spa establishments. As observed
in Iloilo City, clients visited the spa to relieve the stress they got from their
work. The traffic problem of the metropolis that add to the pressure that
every employee has to tackle every day necessitates one to find solace in a
wellness and spa during the early afternoon when the traffic is at its height
and hope to return to their homes at the late evening when traffic already
subsides. The emergence of classy travelers, both local and foreign, with
various needs, also ignites the growth in spa-related tourism where spa
clients have high expectations. After successful visits to a spa, Harmsworth
(2004) observed that 90% of spa clients have returned for another visit.
Messerli and Oyama (2004) commented that spa clients look for new and
different meaningful experiences characterized by more quality conscious,
fully informed, and independent clients that are hard to please.

Additionally, Grihault (as cited in Tawil, 2011) said that “along with greater
health awareness, uptake of alternative therapies, and more environmental
and psychological awareness, that drive demand for spa holidays, it also
addresses the need for time out, rejuvenation, and deeper experience” (p.
157). Thus, it solved the need for a time-out to rest, rejuvenation, and
renewal with deep experience. Being a spa enthusiast, the researcher is an
avid spa guest hopping from one wellness and spa to another, enjoying the
different services it offered. It can be observed that after a few months or a
year, a new spa outlet is seen, the business closes, or new management
takes over. It raised questions about its sustainability, which is always at
risk. The study aimed to explore the experiences of wellness and spa
managers and owners on the sustainability of the wellness and spa in Iloilo
and to discover their best practices for the calendar year 2019, to propose a
guide for a sustainable business in the wellness and spa.

II. CONTENT

THE SITUATION
 According to Smith and Puczko (2008), the term spa relates to the Latin
word sanitus or “aqua,” which means “health through water.” According to
Brown (2019), wellness means a state of wellbeing with optimal health and
vitality, which includes a good diet, exercise, and treatments like massage
and bodywork that keep one functioning at their best. The growth of the
wellness and spa business has undergone great change depending on what
historical period the wellness and spa operates. According to Gilbert and
Van De Weerdt (1991), the modern age is when the awareness of holistic spa
was already known. This awareness of the different views of spas depends
on the country that they operate in and the services the customer looks for.
These were categorized as customers who want “pleasures like massages,
herb baths, and exfoliating scrubs” that made them feel relax, enjoy the
pleasure with “service beyond expectation;” (Blanich & Barrows, 2007, p. 7).
These people aim to avoid a particular health problem from recurring, thus
balancing their physical and mental health (Bhanich & Barrows, 2007).

In Iloilo, in particular, most wellness and spa businesses offered ventosas or

cupping therapy (Sandberg et al., 2017), believed to remove air trapped
within the muscle. This is an old Chinese substitute treatment using
localized suctions on the skin to remove sluggish blood flow clogged in a
particular part of the body. It stimulates healing for different lung-related
problems such as cough and colds, bronchial diseases, body malaise,
swelling of organs, and gastritis. It is believed to be capable of balancing the
chi and enhancing physical wellbeing.

There are two main types of cupping therapy, according to Al-Bedah et al.
(2018). The dry cupping involves creating an open fire with the flammable
substances like tissue paper and alcohol placed directly on the skin while
quickly placing the cup upside down over it, thus creating a vacuum that
pulls and draws the skin that is believed to contain air from the muscles
that caused pain. As soon as the hot air pressure cools down, it constricts
while pulling the skin up, creating a vacuum because of a lack of oxygen.
For ease in applying the cupping tools, oil with herbal is used to massage
the skin before the therapy. The second type of cupping therapy is wet
cupping. This technique creates a mild pressure by applying a heated cup
on the skin for 3 minutes, after which the cup is removed, and the therapist
performs a minor incision using a cupping scalpel. A second suction is
performed to extract a small amount of blood; then, the incision is treated
with antibiotics to prevent infection.

Another favorite local service offered to spa customers is the Swedish

massage and hot stone massage. Both used the same technique with
different goals. Choosing the style of massage depends on the needs and
tastes of customers. Swedish massage is an oil massage that uses a range of
specific massage movements. The hot stone massage follows the same
massage movements as the Swedish massage. The only difference is the use
of lava stones dipped in boiling water, creating a warm massage. According
to French (2011), many different strokes can be applied by the massage
therapist. An elongated suave stroke using one or both hands is called
effleurage. A kneading movement is called Petrissage, which aims to
separate layers of connective tissue enhancing blood and lymph circulation,
thus tone and relaxes muscles. Percussion is described as tapping
movement to enhance local blood circulation, while friction is a rubbing
movement used on scar tissue and other pressure points. When applying
pressure, it can be described as light, medium, and heavy, depending on the
muscles and tolerance of the client.

The concept of wellness and spa varies in the different cultures around the
world, like in Southern Europe, where seaside wellness utilizing sunshine,
sea air, and seawater as a therapy to improve clients’ wellbeing is famous. In
Germany, Austria, and Switzerland, they introduce physical fitness
combined with wellness that includes eating healthy foods, a break from
work and recreation, and mixed with spiritual activity like yoga and
meditation. There is an increasing shift towards self- responsibility and a
balanced approach to life (Smith & Puczko, 2014).

In many Asian countries, spiritual activities such as yoga, meditation, and

massage are more integrated into everyday life than they are in most
Western countries. In most Asian countries, the use of energy flows is a
more accepted form of healing like the reiki and shiatsu, while in some
countries, the balance creation for living space such as feng shui and vasati
was prominently practiced. In the Philippines, physical fitness is observed to
be practiced by the middle class and upper class of society as a means of
relaxation.

Water is shown to play a significant part in the practice of Spa in Asia.

Japanese’ “Onsen” (hot spring) or South Korean’s jimjilbang (bathhouse)
culture has a long tradition both within spiritual and secular society. Water
is also used for ritual purification by Hindus in India. Some parts of China
are rich in mineral springs, many of which are currently being developed for
tourism. In Middle Eastern and North African countries, religion has a more
central focus of life, where spirituality is not seen as an ‘optional
extra’(Smith & Puczko, 2014). For example, all Muslims are expected to
undertake the Haj pilgrimage to Mecca at least once during their lifetime.

Enhanced physical wellness may come from physical healing using spas or
medical interventions like medical trips to India. Several Asian countries,
like Thailand and the Arabic Gulf cities like Dubai, have become famous for
their recent developments in medical tourism facilities. In the United States
of America, England, Canada, and Australia, the use of “day spas and
beauty Centers” is spreading like wildfire. They emphasized more on the
application of makeup to treat clients, relaxing and indulging in beauty
treatment than medical treatment. However, there are also clear growth
trends in occupational wellness like “work-life balance” and stress
management to enhance spirituality. The concept of “MediSpa,” which is
most of the time, an outpatient beauty clinic is often located in malls, has
become popular, especially in North America (Smith & Puczko, 2014).

In the Philippines, many wellness and spa establishments are now located
in malls for the convenience of their clients. Just recently, the wellness and
spa assumed different uses. They are used for medical purposes, described
the service using spa procedures (Langviniene & Sližienė, 2010). The Health
and Wellness Tourism Industry has been recognized by the Philippine
government for its potential of creating jobs and enhancing economic
growth. The Philippine Statistic Office plans to monitor the contribution of
the wellness and spa business as an emerging economic sector in the
national development. However, the Philippine Statistical System does not
have the information to provide a significant evaluation of the health and
wellness tourism industry (Virola & Polistico, 2007).

The Iloilo Health and Wellness Council expressed the need for the active
involvement of the Spa and Wellness Association of Iloilo to build a robust
coalition as a group in selling Iloilo City as a prime tourist destination for
those seeking wellness treatment and health recuperation. Iloilo accounts
for 20% of the country’s tourists, while 10% reflects the target for medical
tourism for the country (Sandberg, 2017). The Spa and Wellness Association
of Iloilo is composed of members from day spas, resort spas, fitness gyms,
wellness clinics, yoga studios, and vegetarian cafes. More than 20 hotel-
based spas and more than 200 wellness centers offer body scrub, facial
treatment, healing, and body massage services. The Iloilo Health and
Wellness Council estimated an under-investment for the past years resulting
in a deficiency in medical facilities and services. A related problem to this is
the continued migration of Philippine healthcare workers to other parts of
the world that makes travel to the Philippines for such a purpose expensive.
However, the government and other nongovernmental organizations are
addressing the issue. Unfortunately, there has been no financial support for
this as of the present (Sandberg, 2017). The issue of sustainability is a
noteworthy discussion as a prelude to the plan of the Iloilo Health and
Wellness Council to promote Iloilo as a prime destination for tourists
seeking health and wellness treatments and recuperation.

PROBLEMS MET
The findings revealed the best practices in the wellness and spa business.
The emergent themes were in the areas of service delivery, personnel
recruitment, products used, facilities, and competence of service providers.

Different spas identified their best practices among them are the customized
products and spa services available according to their client’s needs. Vryoni,
Bakirtzoglou, and Ioannou (2017) affirmed that there are five dimensions
and twenty-two items of the Servqual model that are considered predictive
variables of spa centers around the world.

These are as follows: willingness to help the customer (responsiveness),

management support in problem-solving situations (assurance), food and
beverages (tangibles), feel secure from danger (assurance), employees’
commitment to the comfort of their customers (empathy), and honest and
empathic treatment of customers (empathy). Thus, in tailoring its services, it
shall be done by inspiring and promoting responsiveness, training for
quality enhancement to improve product tangibles to be used, improving the
amenities for security, and increasing employee’s commitment to increase
customer satisfaction.

INTERVENTION/SOLUTION

The findings also revealed the themes that emerged as factors of

sustainability. These are resources, finances, social, environmental, and
political-legal issues. They helped sustain the business of wellness and spa
in Iloilo.

Resources. Resources include the physical facilities used to operate the

wellness and spa-like building and the surrounding environment from when
the guest steps into the spa. Cleanliness is the common characteristic that
spa has to maintain. The stand-alone spa did not have the lavish facilities of
the resort Spa but maintained the cleanliness, relaxing sound of water, and
quiet atmosphere that their guests were looking for. The three types of spa
may differ in the products that they used because the resort spa and the
tourist-agency-recommended spa were using coconut virgin oil in all its
treatment because of its organic and herbal properties, the stand-alone spa
used various types of oil like mineral oil and lotions combined. The human
resources composed of the therapists, front desk guest relations, and
cashier were hired and trained differently in the three types of spa. The
resort spa hired medical graduates to join their workforce because part of
their service is the professional assessment of the wellbeing of their guests
before the application of the treatment. Decision making skill is the
important factor in the application of such treatment. In the tourist-agency
recommended Spa and stand-alone Spa, the qualifications of their therapist
and staff were not as high as the resort spa. They accept high school level
for as long as they possess a positive attitude towards their assigned tasks.
They trained them according to the standard of the spa. All types of spa
encouraged and required the therapists to take the TESDA NC II for
accreditation and apply for a Department of Health license as a therapist.

Finance aspects. The three types of spa differed in the way they acquired
their customers and in their investment approaches. The resort spa is highly
financed, and they practiced management approaches to achieve their profit
objectives. Not so much with the other two types. Their services vary
according to their marketing strategies and the marketing mix used. For the
resort Spa, they used an integrated marketing communication approach
based on the resort’s marketing plan that they created. They allow their
guests to have a unified and seamless experience interacting with the
resort’s marketing office. This includes branding, advertising, sales
promotion, public relations, direct marketing, and social media through
their respective mix of tactics, methods, channels, media, and activities.
They used the newsletter, Facebook, Twitter, Instagram, Google, Youtube,
Pinterest, Foursquare, and Weibo. For the tourist-agency-recommended spa,
they use branding, direct marketing, social media, and more on relationship
marketing by establishing contacts with tourism agents and tourist guides
who bring guests to their establishments. Although the price of the services
varies according to the type of guests that came in, for group guests, they
gave commissions to tourist guides and the agency. The rates for foreign
guest are higher than that for locals. That is why they do not post the rates
outside their establishments.

Social aspect. The relationship of the spa with their community is identified
based on the activities they prepared for them. Most of the resort spas
engaged in community work by adopting communities for their corporate
social responsibility. For the participant from resort Spa, they engaged in
the community by the products (virgin coconut oil) that they used, which
were processed by selected community workers like mothers who worked for
their supplier of the products that they used. This helped in the income
generation of the community workers hired by the suppliers. Spas that
develop their own company’s passion for quality service, as stated by Blesic,
Cerovic, and Dragicevic (2011), also help strengthen community and identity
by incorporating corporate social responsibility to achieve service quality.
Participant A showed their support for their corporate social responsibility
programs by using indigenous materials locally produced to help mothers
who are the beneficiary of the program. Because they control the production
of their supplies like oil, they can assure product quality incorporated with
the service quality to come up with service beyond the customer’s
expectation.

Environmental aspect. The use of virgin coconut oil reflects good

environmental practices that resort spas started as their contribution to the
environment. All the participants have practiced the maintenance of a clean
and green environment within the spa. The spas have either actual or the
sound of trickling water. Participant A decided to go green by installing
energy-efficient lighting and low flow faucet aerators; providing skincare
products free from ingredients known to pose health risks using coconut oil;
practicing recycling in the use of office supplies; avoiding the use of soaps
and detergents that contain phosphate; and encouraging staff to walk
instead of using the cart around the spa area and the use of alternative
pesticide in the resort.

Political Legal Aspect. Just like all business entities, the wellness and spa
cannot exist without the required business permit issued by the local
government units. They followed the requirements set by the Office of the
Building Officials to be able to secure the necessary permit to operate,
sanitary permit, and others. They are required to register the business with
the Bureau of Internal Revenue office and file the required taxes regularly.
They are also required to register the business with the Department of
Industry, Department of Tourism, and Department of Health.

The factors of sustainability for wellness and spa are as follows:

1. Resource allocation

2. Finance

3. Social

4. Environmental

5. Political-legal

The areas are the best practices:

1. Service delivery

2. Personnel recruitment

3. Products used

4. Facilities

5. Competence of service provider

LESSONS LEARNED

Every spas must have at least a a college degree holder of medical courses
such as a physical therapist, nursing, med-tech, and graduates of other
medical programs, empowering them to use their professional judgment and
decision making by offering them their choice of wellness and spa treatment.
Furthermore, they should practiced one of the three pillars of the triple
bottom line of sustainability, which is concerned with environmental
enhancement. As part of their CSR, they promoted local linkages such as
having a local manufacturer as a supplier of the products to be used in the
spa; for example, the virgin coconut oil used on the spa is manufactured
and packaged by Ilonggo mothers, giving them income-generating projects.
In the delivery of massage services, they were proud that they used only
human touch. They have competent therapists, guest relations staff, and
support staff to provide the guest’s needs to personalize the service delivery.

They trained therapist applicants according to the standard procedure that

the local spa is known for in the area. Some of the known massage
procedures used were Filipino hilot, Thai massage, Swedish massage, and
ventosa massage. They also said that a clean environment of the Spa
contributed to its sustainability.

III. CONCLUSION

The sustainability issue in the wellness and spa evolved around the
management of resources, finances, social and environmental factors, and
political-legal aspects of the business. A well thought and careful
management of these resources, coupled with the financial support of their
investors and with the local government unit’s sustainable intervention and
other stakeholders’ support like the Iloilo Health & Wellness Council and
Spa and Wellness Association of Iloilo are necessary for its sustainability.

The sustainability of the wellness and spa depends on the management’s

vision of how they see themselves as a business enterprise soon, how to be
able to achieve those visions using their crafted strategies they call plan of
operation. Such plans are implemented employing their objectives to
produce the best practices they can be proud of in their business life.

IV. RECOMMENDATIONS

This study leads to the following recommendations:

1. Design a sustainability model as reflected by the emergent areas of

sustainability for wellness and spa in Iloilo.

2. Based on the model, propose the wellness and spa sustainability

guidelines to the wellness and spa association in Iloilo.

For future research, this study recommends the following:

1. Identify competencies needed for wellness and spa.

2. Develop advocacy strategies in the promotion of the wellness and spa in

Iloilo.

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