AYURVAEDA: ITS CONTEXT AND PROSPECTS IN NEPAL

* Prof. Dr. LM Singh & Bhupendra Nirajan

Ayurveda is the age old traditional system of medicine of the Indian subcontinent including Nepal. In spite of its antiquity going back to the Vedic period much before the Christian era, it is still in extensive practice and is also an officially recognized system of medicine in Nepal, India and Sri Lanka. It is also claimed that majority of the population in these countries is served by Ayurveda or that its practitioners are the first port of call for the health problems of the population. Emotional appeal for the promotion of Ayurveda is favorite topic in all public forums of the subcontinent and claims made by its practitioners range from probable to incredible. Its medicines are said to be cheap, without any toxic side effects and capable of radical cure of the diseases not treatable by modern medicine. Further it is often equated with herbal medicines and Nepal being rich in medicinal herbs. Ayurveda is claimed to eminently suitable for this country for utilizing its herbal resources towards self sufficiency in health care. Besides, there is increasing awareness about Ayurveda in the developed countries of the west and Japan for its concepts and as a valuable resource material of knowledge about the medicinal plants used in this system. In various aspects of oriental learning as Yoga, meditation, Zen are becoming more popular in the west than in the countries of their origin.

Today because of communication explosion world has become small an no information or knowledge however obscure it may be, wherever it may be, can remain confined to a particular region or particular people. The dissemination of information is more rapid and universal today than ever before and is further going to increase. Thus if Ayurveda is valid and relevant to Nepal or India it is not going to be limited to these countries only and will be accepted and promoted in other countries of the world. There are infact indications that Ayurveda is going to be more universal in the coming days.
Where as the intellectuals of the undeveloped and developing countries are concentrating or catching up the technological developments of the west, their counterparts in the west are turning their attention to the ancient sciences of the orient hoping to find solutions for the problems of the society created by the technological development. It is realized that capacity to land in the moon surface does not necessarily improve the quality of life, or that unlimited exploitation of the nature ............ Thus while" back to nature " is becoming popular in the developed west, preservation of ecological balance, preservation of environmental pollution are the prime concerns, scant regard or attention is paid to them in the developing countries because of the population pressure, imperatives of existence at eh basic level or else or else because of the irresistible lure of quick returns whatever the means or effects may boon man and nature. This obsession to the western model of modernization and development and aping it may bring about spectacular short tem achievements but long term effects of indiscriminate harnessing natural resources is bound to be detrimental.

Emphasis on the inner quality of life, to live in optimal terms within oneself and without, is the central theme of Ayurveda, which the west having reached almost the limits of objective analysis of man and nature are finding relevant. According to Ayurveda life or life processes is not only a combination of physical and chemical processes but an integral union of physical body with consciousness represented by mind and soul. Similarly health is not only an absence of disease but a state of harmony and equilibrium within oneself and the environment and a state of joy and clarity of our sense faculties, harmony or equilibrium is recurrent theme and also the objectives to be attained in Ayurveda. Whereas harmony is health, disharmony is disease. Therapy in Ayurveda is aimed to bringing back the equilibrium rather than specifically directed towards an organ or an organism, participation of consciousness involving mind and spirit in all life processes of health and diseases is fundamental in the conceptual framework of Ayurveda which is being appreciated now in the west now.

Newtonian model of mechanistic universe was challenged by relativistic model Einstein, now. 'God does not play dice' is being questioned by the 'uncertainty principle' of Heisenberg in the physical sciences 'Objectivity' insisted upon and the sacrosanct creed of modern science may ultimately depend upon the 'observer' and the 'observed' is accepted now Evolution be it from 'Bang' to molecules or from molecules to living protoplasm or from protoplasmic particles to human form is not evolution in the structure of the molecules or composition of protoplasm, but of organization and awareness which in absence of terminology can only be approximated to 'consciousness'. If human beings are most evolved it is not because they different kind of protoplasm than amoebae or better kidneys, liver or other organs of the body but because they have better brains, the seat of consciousness and they have most advanced mental capacity. Whether mind is a product of matter or vice versa may be a subject of debate for scientists and philosophers but mind, consciousness, sprit, soul or whatever name you give it, play a vital role in our life, health and disease is certain, modern medicine has been primarily concerned with the somatic aspects of our body so far. It was hoped that physics and chemistry can explain all our body functions. Valid to an extent it is now apparent that neither life nor health can be measure in terms of sodium, potassium or other chemicals we contain nor by the exact size and shape of our body and organs. Recently modern medicine is taking cognizance of 'Psyche', the day is not very far when it will take into account soma, psyche and sprit as well which according to Ayurveda are integral components of life.

Another aspect of oriental learning including Ayurveda, which is arousing interest is its synthetic, perceptive and experiential mode of comprehending reality. The emphasis of the western thought process so called 'scientific' has been on analysis and objectivity where as our ancient seers were concerned with synthetic experience. Objective details for them were only the means or steps to knowledge and experience of the ultimate not the goal itself. They were aware that analysis could give us the knowledge of the parts, could prepare us for an experience, but can never be the experience itself nor without synthesis we can have a picture of the whole. Knowledge and concepts are necessarily intellectual and rational, but experience can be purely intuitive, never the less a definite reality. No amount of intellectual exercise can substitute for real experience. A professor may write volumes on hydrodynamics, but not know how to swim. It is this fundamental difference in the modern analytical scientific methodology and eastern so called mystical experiential approach which seem contradictory and confusing although both ways one tries to seek the ultimate truth. Reality can not b4e compartmentalized as objective or subjective is becoming evident now. 'Objectivity of modern science is in a way illusion because ultimately it depends upon the subjective perception and ability of different persons to agree upon observed phenomena and processes of thought. Science is ultimately as subjective as all other human knowledge since it resides in the mind and senses of the individuals. It is constrained by the present evolutionary state of man, by the limitations of his senses and even more significant by the power of his reason. All that can be4 claimed for science is that it focuses upon observations about which most human observers agree and proposes concepts that satisfies all requirements of a phenomena and leads to successful predictions.

Ayurvedic philosophical system which form the foundation of Ayurvedic concepts represent the comprehension and understanding of the phenomenal universe encompassing so called ' objective and subjective' sciences of today. Essentially it is a experiential and cognitive or perceptive conceptualization of the phenomenal world and participation of consciousness is primary basis. Reality thus is not objective or subjective but cognitive experiences, either a product of subject- object interaction or transcending them. Consequently objective realities as understand today as well as psychic entities are integral parts of reality. West may not have been converted to this view but there is serous inquisitiveness and inquiry is beyond doubt.

Bedsides these the critical concepts there are other practical considerations which are of interest to the west. Advances made in medicine in recent decades are truly phenomenal. We have now recognized most of microbes causing disease and potent antibiotics to eliminate them. We also have developed more potent means of diagnosis and treatment than ever before. Number of bacterial diseases have been brought under central, but there are several metabolic chronic autoimmune, stress related disease or cancers probably increasing because of environmental changes within or without have defied satisfactory treatment. Modern conventional treatment in a number of theses diseases is also hazardous and uncertain. Western scientists are actively in search of any alternative mode of therapy including Ayurveda, or in the rich herbal repertoire it has. Synthetic chemicals were in vague for some decades for new drugs but now all multinational pharmaceutical companies are again looking into the plant kingdom for new drugs relising the limitations of chemical synthetic approach. Ayurvedic classics mention more than 700 plants of medicinal value besides the use of several hundreds of other plants used by traditional parishioners. Many of these plants used by provide effective drugs is now being recognized . Gugglu is a very common drug used in Ayurveda has been proved to be a good hypocholesteraemic drug used in Ayurveda has been proved to be a good hypocholesteraemic drug. Isolation of reserpine a antihypertensive drug from Rauwolfia serpentina another commonly used Ayurvedic drug is a old story now. There are indications that Tas baccata another plant used in Ayurveda may have anticancer compound. Thus intense enquiry in the plant kingdom has become a part of their activity with leading pharmaceutical concerns. Billions are being invested for the purpose and tons of raw herbs are being consumed from wherever they are. Massive resources available at their disposal it an added advantage to them and it is possible it will make critical difference in the very existence of several species of plants.

May be, because of serious enquiry, genuine benefits or the lure of exotic, it is certain that Ayurveda is no longer limited or specific prerogative of the countries of the Indian subcontinent. There are Ayurvedic societies, institutions in most countries of the west and Japan, increasing number of publications and import of Ayurvedic drug. Ayurveda or Ayurvedic drugs may nit have official approval of the state in these countries, but they are certainly being imported as herbal teas, health foods etc. Ayurvedic scholars are in increasing demand in these countries. Ayurvedic drug companies have set their eyes on this potential market and are extending their operations abroad. Even our nascent Gorkha Ayurveda Company have exported a considerable quantity of herbal Guduchi tea to several countries in the west so much so that this tea is proving to be their main product of sustenance. World Health Organization's support to traditional medicine including Ayurveda has also been a factor in the regard whatever their objectives or methodology may be. Increasing cost of the modern health care is a matter of concern even in the developed country as USA.

With the above background although Ayurveda is gaining recognition at large, there is always a question mark on the rational of promoting Ayurveda amongst the health planners of the underdeveloped countries, because Ayurveda is not 'scientific' and not approved by the reputed medical journals of west. As a result inspite of profuse eulegy Ayurveda receives in these countries in all public forums by politicians, ministers, government officials and well meaning social workers their intentions and public pronouncements are hardly ever translated into implementation and coherent action.
It is true neither antiquity nor extensive practice should be taken as a proof of the validity of Ayurveda nor it should be promoted because it is part of our culture and heritage. Further if Ayurveda can only provide second grade medical care there is no justification for its promotion. Only justification for its promotion should be that Ayurvedic therapy is effective and can answer the problems of today, human life be it in the city or in the village, rich or poor is equally precious and it is not justified to assume that Ayurveda is suitable for villages and poor people or poor countries.

Although it is ridiculous on the part of the Ayurvedists to claim that they can cure all disease on earth or diseases not treatable by modern medicines with all its advancements, it is equally preposterous and unjustified to dismiss Ayurveda as unscientific. If it is assumed the truth is limited to what ancient has proves, it will not only be an afferent to nature itself but also very antithesis of science. Science is not a religious dogma neither it is ever dogmatic, it is basically observation, systemization. Experimentation and verification of facts however bizarre they may be. Enquiry with an open mind is the essence of scientific temper. Mother's milk is the best for the child was not first tested scientifically. Neither we have started eating bread after it was put to scientific scrutiny.

Ayurveda represents a corpus of human knowledge and experience which has been in practice long before modern 'scientific' methodology was evolved. The primary objective should be to see whether Ayurvedic concepts and practices have any factual basis. If it is proved without as shade of doubt that the patients get relief, even if not rationally explained will in due course of time will be explained. It is a medical knowledge that works no matter how scientific its origins is a treasure that can not ignored.

Prospects in Nepal:
Nepal is one of most underdeveloped countries, its per capita income among the lowest in the world. Resources are also limited. There are no known deposits of oil or minerals and its economy is based on mainly agriculture, and trade in the natural products of the hills and the forests of Tarai. Majority of the population being below the poverty line are more concerned with providing themselves with the bare daily necessities of survival and have little time or energy or awareness beyond their immediate requirements. These at the helm of the affairs of the country - who should know, should have had the vision, or wisdom in the long term interest of the country are obsessed with gaining quick popularity and returns for their own survival. Whatever the ground realities may be selling attractive dreams of modernization, development comparable to Switzarland or Singapore, taking the country to 21st century is the popular theme than reminding the population of the hard work and discipline the development process involves. In the field of Ayurveda also we are not short of verbal elequenoe and pious intentions, but how much of it is feasible, practical or every attempted to be implemented is quite another matter. Ad hoc decisions or adhocism has been a rule rather exception. Decisions are taken not on merits of any issue, policy or program but on the immediate returns or benefitser else even on the whims or prejudices of the authorities concerned.

Inspite of all the praises it receives, till late there has never been a consistent policy about Ayurveda in the country. Long term health plan promulgated in BS 2033 has only one sentence for Ayurveda in its objectives "To study the effectiveness of Ayurvedic drugs, to increases their production and to utilize the Ayurvedic manpower in preventive and family planning activities." Some plans and programme were spelled out in subsequent plan periods but with the advent of multiparty democracy government policy after some turns has developed a positive attitude. Organizational set ups, few as they are have little changed either in their status or their functioning for the last several decades. Singha Darbur Vaidya Khana, Nardadevi Ayurvedic hospital and Vidyalaya were established during discredited Rana regime and the Department of Ayurveda was formed in Panchayat period but all of them have little change in comparison to other areas of health and education. Basic reason for this sorry state besides government lack of coherent policy in the past and the poor quality of manpower and infrastructure.
Qualified, competent and trained manpower is a primary prerequisite for any institutional development, formulation, implementation and success of any program as well s the social acceptance or status of any branch of knowledge. No science can survive without the input of competent manpower. Unfortunately Ayurvedic education has received the lowest priority in this country. Although Ayurvedic education has only the technical education provided in this country. Although Ayurvedic education was the only technical education provided in this country even during Rana regime. It was closed with the introduction of New Education plan. Whereas earlier all levels of Ayurvedists were being produced in Naradevi Ayurvdeda Vidyalaya only middle level health of certificate standard were produced after the take over of Vidyalaya as Ayurveda campus by Tribhubhan University since BS 2029. Earlier students were also sent to India for Ayurvedic studies. However ever since these changes it was stopped. As a result not a single graduate in Ayurveda has been produced in this country for the last twenty years and only a about a dozen have been able to complete their graduation-most of them at their own initiative and expenses from India in the last three years. Only two post graduates have come back this year. Production of just twelve gradates in twenty years is indeed a record in the 'promotion of Ayurveda'. Furthermore all admissions in all courses running in the existing Naradevi Ayurvedic Campus have been suspended or stopped since 2049. Thus few as they are there is little hope of any increase of qualified Ayurvedic manpower.

WHO including UNDP have been active in promoting Ayurveda after the Alma Ata declaration of Health for All by 2000 AD. In Nepal they have invested several millions through their projects dealing with primary health care, however the net outcome of these projects has been several visits of short term or long term consultants their voluminous recommendations, holding of workshops and seminars, WHO fellowships for the national to travel abroad, obtaining supplies and equipments most of which have never been put to use because of our incompetency of they were not appropriate. A s0pecific project for Ayurveda has been going on for several years with an annual budget of more than $ 40000. Obviously if our priorities are limited to somehow spend the aid money without any long term policy and programme no amount of external aid will have any results. In Ayurveda lack of infrastructure and trained manpower have been main constraints.

Much is talked about Himalayan herbal wealth. Ultimately resource of Nepal is the Himalayas, its rivers and its flora. Almost all Ayurvedic drugs are based on herbs of which Himalayan herbs are put at a premium. All Ayurvedic drug companies of India claim to prepare their products from 'genuine' Himalayan herbs, have their name as Himalaya drug Company. Quite a number of these companies have a turnover in billions. There is no doubts significant if not all their requirements of raw herbs have its origin in Nepal and their demands are increasing with their expanding trade. It is estimated that the import of Ayurvedic drugs is increasing and has reached to the value of 40 cores. As a corollary export of raw herbs from Nepal must be increasing. It is admitted that herbs beings exploited indiscriminately and exported legally or illegally so much so that numerous species have either become extinct or endangered with the growing interest of multinational drug companies and cosmetic industries. The situation is further going to be deteriorate is certain. Development of Ayurvedic manpower it can not be possible. At present in the absence of any awareness in the population or beaurocracy of their values except making quick money, we are complacently content by passing some laws and establishing some processing plants.

Nepal is also known for fits for its cultural heritage. In fact the tourist industry a major mainstay of Nepalese economy is based on Himalayas and its cultural heritage. Ayurveda is an integral part of this heritage and little people know that old manuscripts of Ayurveda which has been destroyed in India during its long history of foreign rule are still available here in the National Archives or in the private homes. They may be just relics of our past glory about which we, obsessed with 'Modern', many not be interested are valuable resource material of medical knowledge and it is the western scholars who are seeking them out. Kashyapa Samhita published for Indai and Siddha Sara Sangraha recently published from Europe were based on the manuscripts of our National Achieves. There are certainly many more which are yet to see light of the day. We may not be able or interested to publish them but even we prevent them being destroyed or being sold as trinkets in markets of Basantpur or Themal to tourists, we will be doing a great favor to mankind in general.

The purpose of this tresentatun will be served if it is bought home that Ayurveda has a potential and future perse in the universal context or in the developed countries with or without out efforts. Therefore instead of spreading volumes of eulogy of promoting Ayurveda or saving it, it will be better and more rational if we can make a coherent plan and programmes if this country concentrate on creating compent manpower in Ayurveda there is some hope of preserving out natural as well as cultural resources.

*We ayurnepal.com like to express a heartily condolence on the demise of Prof. Dr. L.M. Singh.We think, it is irreparable to the Nation. We always pay tribute to what he has done to ayurveda. Remembering him we have extracted this article from JADAN 1998, March.