The first health service organization and medical institution established in the country were Ayurveda Hospital and Ayurveda College, respectively. Now the country has dozens of modern hospitals and teaching institutions related to medicine. However, the central level Ayurveda hospital is the only one institution of its kind that has produced hundreds of graduates since its establishment in 1933.
It is believed that several kinds of treatments - some of which are still beyond the scope of modern science - are possible in Ayurveda for a healthy life. Unfortunately, our Ayurvedic health organizations are remembered only for certain common ailments. Besides, Nepali Ayurvedic Doctors (local products) suffer from a trememndous identity crisis. They are not even eligible to do MD in India since none of the University has recognized the Ayurveda College.
There has not been much development of Ayurvedic science for long.. Although ayurvedic science has tremendous potentials, no clinical researches have been conducted in this regard. Most of the ethno-botanical researches, researches on indigenous knowledge etc are conducted by either botanist or anthropologist. For the sake of development of the Ayurvedic science and procurement of efficient manpower, Ayurveda Health Policy (AHP) has emphasized the establishment of specific institutions. It has proposed the establishment of a National Ayurveda Study Center for quality service, management of manpower, research on Ayurveda and resource management etc. However even after a decade of policy promulgation, there has been no significant progress in this regard.
The county has only one central level Ayurveda hospital in Kathmandu with 100 beds and one regional hospital with 30 beds in Dang. Besides this, 14 zonal Ayurveda Ausadhalaya, 55 District Ayurveda Health Center and 216 Ayurveda Ausadhalaya (dispensaries) are in operation.. There is no significant difference between Zonal Ayurveda Aushadhalaya and District Ayurveda Health Center. Humla, Mugu, Dolpa, Rukum and Kalikot have only one state-run Ayurveda Ausadhalaya. Similarly, eighteen districts (almost of remote region) have only two and sixteen have three Ausadhalaya.
Besides Ayurveda College, seven institutions (under Nepal Sanskrit University/former Mahendra Sankrit University) that produce certificate level (or equivalent) technicians and three institutions (under CTEVT) for 15-month-training program are running legally. Out of eleven educational institutions, seven are in Eastern Region; one doctor-level (BAMS) college is in Kathmandu, two (AHA level) in Western region, and two in Mid-Western (both are in Dang) but not in Far-Western region. Ayurveda education is wide spread in Eastern part comparatively in Western part of the nation. People of Western region have no easy access to Ayurvedic science.
If we do study on the number of Ayurveda technicians based on their birth place, thirty-one districts have no Ayurvedic Doctors, twenty-five districts have no AHA (Ayurveda Health Assistant), and thirty-three districts have no AHW (Ayurveda Health Worker). Baitadi, Achham, Dolpa, Kalikot, Jumla, Humla, Jajarkot, Manag, Rasuwa, Tehrathum, Dhankuta and Taplejung districts have no Ayurvedic technicians. Panchthar, Sindhupalchok, Sankhuwashava and Bajura districts have only one AHW and no Doctors and AHA.
Darchula, Dadeldhura, Dailekh, Bardia, Rolpa and Ramechhap districts have only some AHA (maximum 4) and no Doctors and AHW. Makawanpur has only one Doctor and no AHA and AHW. Sad to say, Mahakali and Karnali Zones have no Ayurvedic Doctors. Among the five districts of Karnali Zone, only Mugu District has one AHA and one AHW. Janakpur is the richest in Ayurvedic technicians while Karnali is the poorest zone to have Ayurveda technicians including all levels. Similarly, nearly 49% of total Ayurvedic technicians are from Central Development Region and Far-Western Region represents just about 0.012%.
Those areas which are rich in medicinal plants have neither adequate Ayurvedic research institutions nor health centers. The regions, which are famous for valuable medicinal and aromatic plants are devoid of trained Ayurvedic technicians to use locally available resources. Transferring skills to the locals and helping them use their own local resources is the only way to improve the health status and the socio-economic status of the community people.
Ayurveda dispensaries are significantly increasing in the country but effectiveness of the service is yet to be improved. Centralized system of drug distribution, insufficient budget for drugs and poor-performance of the employees are hindering the effectiveness of the health service. Higher and middle level officers seldom attend offices in remote areas and in most cases, there are no adequate drugs to distribute.
To sum up, excessive reliance on modern medicine is not an adequate way to improve the health status of people - especially in developing countries. Therefore, the state should integrate traditional medicine into national health system and work towards the development of Ayurvedic sector in the remote areas that are rich in natural resources.
- By Bhupendra Nirajan