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Ayurveda and the issue of integration

- By 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.

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