Events
& Issues
New Delhi, 21 January 2021
‘Mixopathy’ Protests
A MIXED REACTION
By Dr S. Saraswathi
(Former Director, ICSSR, New Delhi)
Nationwide protests
called by the Indian Medical Association against what it has labeled as
“Mixopathy”, i.e. permitting Ayurveda graduates to perform specified surgeries
are receiving wide support from allopathic doctors, but only mixed response
from the general public, whose interests centre around health without
illnesses.
A notification issued
by the Central Council of Indian Medicine approving M.S. (General Surgery) for
Ayurveda graduates to perform 58 types of surgeries is the cause of protests by
several government and private doctors. They think that the idea would create
confusion among patients and the public in addition to the practical problem of
training ayurvedic practitioners.
The notification
listed the surgical procedures that a post-graduate medical student of ayurveda
must be “practically trained to acquaint with as well as to independently
perform”. The list comprises 39 general surgeries (Shalya Tantra in ayurveda),
and 19 specialised procedures involving the eye, ear, nose, and throat
(Shalakya Tantra in ayurveda). This opening is thought of as the road to reach
universal health coverage.
The IMA is also
concerned about the decision of NITI Ayog to set up four committees for
integrating various systems of medicine in medical education, practice, public
health and administration, and research. It says that the move would lead to
the death of modern system of medicine. It is reported that IMA is even
thinking of approaching the Supreme Court - the destination of all aggrieved
parties whatever the nature of the dispute.
But, the idea of
integration is not new. It was proposed by Vajpayee government which also
established Medicinal Plants Board in 2000 to coordinate all matters relating
to medicinal plants and to support growth of trade, export, conservation and
cultivation of medicinal plants. It promoted export of indigenous medicines. Surgeries
in the selected fields have already been going on in ayurveda institutes and
the notification will have the effect of conferring legality by amendments to
Regulations of 2016.
Ayurveda is one of
the oldest indigenous systems of medicine known in the world. Many countries
have developed their own unique Traditional Medicine systems which are still
being practised despite the spread of science-based modern allopathic medicine.
Traditional Medicine
(TM) is defined by the WHO as the sum total of knowledge or practices, whether
explicable or inexplicable, used in diagnosing, preventing, or eliminating a
physical, mental, or social disease which may rely exclusively on past
experience or observations handed down from generation to generation. It shares
knowledge unlike modern medicine that recognises ownership and patent.
Traditional Medicines
are still going strong in Asia, particularly in China, Korea, and Japan where
these are included in the national healthcare systems and developed in national
health policies. It is over 3,000 years old in China like Indian ayurveda and
spread to many East Asian countries. Nearly 40% of healthcare in China still
apply TM and many allopathic doctors prescribe herbal medicines, which shows that
integration of modern and traditional medicine may not face as much hurdle as
in India. TM is a big attraction for medical tourism in China.
Use of traditional
medicine differs from country to country today with some regional similarities. In some African and Asian countries, TM is
even given priority in healthcare and given protection against misuse. Peruvian
region has outlawed bio-piracy. Several countries – China, Ghana, Malaysia,
Nigeria, South Africa, Tanzania, Thailand, and some countries in the Middle
East – seem to be attempting to create data bases for indigenous medicines.
India is keen on protecting the Western Ghats rich in many natural resources
with health and healing properties.
The terms
“complementary medicine” and “alternative medicine” denote healthcare practices
that are not part of a country’s own traditional and conventional medicine and
are not fully integrated with the dominant healthcare system. They are used for
all systems other than allopathy. In some countries, the terms are used
interchangeably. Ayurveda, Yoga, Siddha, Unani and Homeopathy are covered under
these terms.
More and more
countries are acknowledging the role of traditional and complementary medicine
(TCM) in their health systems. The WHO is publishing Global Report on TCM based
on surveys conducted in many countries. The third survey in 2016-18, has noted
that the state of TCM is globally improving. By 2018, out of about 200 member-States
of WHO, 98 had developed national policies on TCM, 109 had launched national
laws or regulations, and 124 had implemented regulations on herbal medicine.
Some have separate national policies for TCM and some integrated policies.
WHO African and
South-East Asian Regions, which have strong roots in TCM, are ahead of others
in promoting TCM with 85% of member-States having national policies. In
South-East Asia, 10 out of 11 countries have national policies on TCM and many
of them have plans to integrate TCM in national health delivery. American and
European regions depend mainly on modern medicine.
WHO supports all
traditional medicine system. In the US, Traditional
Chinese Medicine (TCM) is recognised by the National Institutes of Health. In
2004, WHO released a 10-year strategy that aims to integrate traditional
medicine into modern medical care to reach universal health coverage. It called
upon member-States to develop healthcare facilities for traditional medicine to
ensure coverage for insurance and medical reimbursement and consider recognising
and supporting education and practices in the system. In 2018, WHO recognised
traditional medicine in its global medical compendium. It endorses only that therapy
which has solid scientific evidence with no toxicity. From this viewpoint, Ayurveda
is recognised.
The next 10-year
strategy (2014-23) of WHO was launched in response to a resolution of the World
Health Assembly on traditional medicine. It is designed to support member-States
to develop pro-active policies and implement
action plans to strengthen indigenous medicines, practices and practitioners in
the health systems and services.
Developments in the
medical world have created competition between two systems of medicine in many
countries. The competition in India is
so close and somewhat bitter due to the fact that both systems are in popular
practice and patronized by many people in all States. Long British rule helped
firm establishment of allopathic medicine popularly called “English medicine”
and growth of modern medical colleges. Indigenous systems had no such official
support.
However, unlike many
scientific and technological inventions which have totally replaced the old
order, TCM is surviving everywhere sharing popularity and patronage of patients
and people along with modern medicine. That is the reason that we are
considering integration of old and new systems.
Noteworthy is the
tendency of many patients to try both systems, and readiness to adopt both for
the same ailment. It is asserted that TM produces no side effects, will do no
harm even if it does not cure and has a long shelf life with some having no
expiry date. There is no anesthesia or anti-biotic in ayurveda. Traditional
medical practitioners also resort to laboratory tests for diagnosis and
assessment of effects. TM is much less expensive
than modern medicine. While sticking to scientific base for our systems and
practices, we cannot ridicule time-tested knowledge accumulated over thousands
of years as “Mixopathy”. --- INFA
(Copyright, India
News & Feature Alliance)
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