FAIRFIELD, Texas — On a rural Texas ranch, Maudine Sherber seems out of place in Indian garb. But she wears it as a symbol of what her home country could not do for her.

Last year, after shattering her leg during a hike, Sherber was told she'd need a total knee replacement and other reconstructive leg surgery. The cost was quoted at more than $50,000.

"We came out with no insurance thinking, 'Oh, what are we going to do?'" Sherber recalled.

So Maudine and husband Sam began looking for alternatives. They settled on a hospital with world-class doctors and rock bottom prices. The catch? It was half a world away, in a third world country.

"We were without insurance here," Sam Sherber said, "so what was impossible here cost-wise was possible by going to India."

The Sherbers are among a growing number of people going abroad for healthcare. According to some estimates, in 2006, half a million Americans traveled to India, Thialand, Singapore, and other far-off places for treatments they couldn't afford in the U.S.

It's part of a trend called "medical tourism."

Poonam Dhawan is a medical tourism agent. "We organize the visas, the passports, the tickets, and we actually give them ... Indian cell phones," Dhawan said.

After struggling with healthcare for her own sick mother a few years back, Dhawan opened MedTrava, an Austin-based online agency that arranges everything from the flight, to surgery, to a post-operative vacation.

"It covers everything," Dhawan said. "Your hospital, the blood, the meds, the room, room for a companion, all the food, the surgeons, the nurses, the MRIs, the diagnostics, the post-surgery — everything all in one price."

And that fixed price is roughly one-fifth the cost of the same procedure in the U.S.

For example: A partial hip replacement in this country might cost about $40,000 In India, it's just $7,000.

A triple bypass conservatively runs $130,000. The flat fee overseas is closer to $10,500.

Those are appealing numbers to Nicki Zito, who is insured. But she is also in debt trying to treat her seven-year old daughter's rare disease.

"You think that you have insurance and it'll be OK," Zito said. "And then you just get the bills and they keep coming in. It's something we never prepared for, that's for sure."

She never dreamed of surgery overseas, either. Now, however, she sees no other way.

"There's nothing wrong with going out of the country to do it, but you have to be aware of certain problems," cautioned Dallas plastic surgeon Harlan Pollock. Dr. Pollock said potential problems include veryifying doctor and hospital creditials from afar and weighing the possibility of post-surgical complications.

"Bargain surgery or inexpensive surgery — if there's a problem — may be more expensive in the long run if they have to come back here and have additional care," Dr. Pollock said.

Medical tourism is so new, no one yet has tracked how many people have complications from overseas healthcare. The U.S. Embassy in India said "even if there were complications, it would be a private matter between them (the patient) and their health providers."

For Maudine Sherber, the experience was positive. "Yes, I feel like I was treated like a queen."

Her husband, Sam, even got $10,000 worth of dental care for $2,000 while they were in India.

But while the Sherbers are smiling, their satisfaction is also tinged with regret.

"It's a shame that I live in one of the wealthiest countries in the world, yet I have to go on a 23-hour flight across the country in order to get medical help," Maudine Sherber said. "I think that's a shame."

E-mail jstjames@wfaa.com