Ayurveda
and the issue of integration
- Prof. LM Singh & Bhupendra Nirajan
The relationship between modern and traditional
medicine can be explained in four board forms. Monopolistic-
where modern medical doctors have sole right, tolerant
situation- where traditional practitioners are permitted
unofficially, parallel model- where both are considered
separate components and integrated model- where both are
integrated at the level of education and practice.
Obviously, Traditional Medicine and modern
medicine evolved in different philosophical assumption
and different methodological approaches, conflicts are
bound to arise when the two systems are used simultaneously
in the same country. Every system has something to offer
for the benefit of the patients. A particular system cannot
be a panacea for all diseases. As a provider of medical
care, a doctor should know what is the best in his system
and also should know what is the best for the patients
in other systems and should refer appropriately for the
relief of the patients.
Health is the fundamental right of people
and the fundamental objective of the health care system
is to keep the population healthy and treat the sick.
People’s health is much more important than the
system of medicine. There are two types of people- traditional
practitioners and modern medical personnel. It is unfortunate
if somebody believes his own system to be the best and
perfect. No medical system in health is perfect in the
world.
In contrast to modern approach, traditional
and complimentary systems of medicine deliver useful and
effective service to the people in developing countries.
We cannot imagine a situation especially in the developing
countries without traditional medicine. It is an evidence
why the Alma Ata declaration of WHO – health for
all by 2000 failed to meet its objective and has now recommended
for adoption of traditional and complimentary medicine
in national health care system (see WHO traditional medicine
strategy 2000). It is hoped that as WHO recognized it,
it will accepted in both the developed and developing
countries.
In 1929, the central government of China
passed a bill "to ban traditional medicine in order
to clear the way for developing medical works". But
in 1949, attempts began to revive the traditional Chinese
medicine, and to harmonize it with modern medicine. There
are at least four reasons why traditional medicine in
china could not be eliminated even after twenty years
of formal ban. First, traditional medicine had strong
cultural background; second, traditional remedies are
simple, convenient and affordable with least side-effects;
third, traditional medicine had unique theoretical system,
which modern medicines could not replace; fourth, modern
medicine was limited to big cities. After 20 years, the
very first step made by the then Chinese government in
1950 was to unite the traditional and Western medicine.
Now, 95 percent of the general hospitals in China have
traditional Medicine Departments. The Peoples’ of
Republic China seems to be one of the countries that have
harmonized well the functioning of the two systems of
medicine. The development in health sector in China has
become an example to the world.
In India, a parallel model to traditional
medicine and orthodox systems was adopted and recognized
through the Act of 1970. People are free to choose their
way of treatment. Despite the parallel model of official
health policy of the Indian government, practices of integration
have been accepted and are being developed in some institutes
like- Banaras Hindu University. BHU is a university of
Ayurvedic education with modern medicine and surgery.
The treatment and patient care at BHU is done in an integrated
pattern. Ailments like chronic rheumatic diseases, residual
psychosis, anxiety disorders, chronic colitis, asthma,
diseases of liver and degenerative brain diseases, which
are almost incurable with costlier treatment are referred
to the department of kayachikitsa.
In the Nepalese context, the official
medical system- modern medicine refuses to see the other
side of the story that can offer something good for patients.
Ayurveda, the age-old medical system of the Himalayans,
which still serves a big pie of Nepalese population has
become helpless under the prevailing circumstances dominated
by modern medicine. The role of traditional medicine in
national health care services, model of integration, policy,
regulation etc have not been made clear by the government.
There is a great confusion about the role of Ayurveda
in national health care.
The geographical structure of the country
has made it difficult to supply modern medicine adequately
to every corner. It is easy to bring allopathic medicine
from Europe and America to Kathmandu, but very hard to
distribute to remote area due to lack of transportation
and other infrastructure. In such condition there is no
other alternative except practices of traditional medicine.
By the middle (approximately) of the
twentieth century, it has been felt that exclusive reliance
on the formal western medicine is inadequate in health
care delivery. It has been felt that official integration
of traditional medicine into national health service is
a must. The most important thing is dialogue between the
conventional and modern medical practitioners. All medical
colleges should start introductory courses in traditional
medicine. Training for modern medical practitioners in
the scientific and clinical methodology of traditional
health system should be provided. Unit for delivering
services in traditional medicine should be established
in every hospital so that patients may have an optional/alternative
medical system in every hospital. Safety standards of
all traditional medicine should be set by the government
and adopted in the service centres. Public funds should
be allocated on equitable basis. There must be a self-regulatory
body to maintain the standard practice in traditional
medicine system. Finally, the objective of the integration
of health services should be to treat people in an effective
way (whether through allopathic or traditional method)
with least adverse effects and financially affordability.
Source: Kathmandu Post
