Year : 2020 | Volume
: 7 | Issue : 1 | Page : 3--4
Medical pluralism in India: Discovering the convergence
Department of Kaya Chikitsa, State Ayurvedic College and Hospital, Lucknow, Uttar Pradesh, India
Prof. Sanjeev Rastogi
Department of Kaya Chikitsa, State Ayurvedic College and Hospital, Lucknow - 226 003, Uttar Pradesh
|How to cite this article:|
Rastogi S. Medical pluralism in India: Discovering the convergence.AYUHOM 2020;7:3-4
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Rastogi S. Medical pluralism in India: Discovering the convergence. AYUHOM [serial online] 2020 [cited 2021 Sep 21 ];7:3-4
Available from: http://www.ayuhom.com/text.asp?2020/7/1/3/321039
India is among very few countries in the world blessed with fully functional and dynamic pluralistic health care. Pluralistic health care by definition encompasses a variety of health care alternatives available to be opted on the basis of individual choices and needs. As an essential precondition, such options should have been made freely available, accessible, and affordable, and there shall not be any other compelling reason to choose one health-care systems over the other besides individual choice and need.
Among all, over 180 member states of the WHO have some or other forms of regulation for the traditional health care, whereas 98 countries, more than 50% of the 194 WHO Member States, had a national policy on Traditional and Complementary Medicine (T&CM). In countries such as China, India, Nepal, and Sri Lanka where T&CM has strong rooting, such regulations are robust and are keeping traditional medicine at par with Allopathy system which by default has become the primary health-care system worldwide.
It is realised on many occasions and at many forums including the WHO that a balance between traditional health-care practices and advanced health-care science is essential to meet the regional health-care needs. The practices of health keeping which have been in vogue since millennia and which have ensured the survival of human race so far cannot be undermined and ignored for something more recent and glittering. It was recognized as early as in 1946 by Bhore Committee that integration is needed to be adopted at every level of health care including preventive, promotive, and curative and that the primary health care is needed to be strengthened if the burden of health care is aimed to be curtailed.
Making the best use of a pluralistic health-care system essentially revolves around two fundamental principles. One is to identify the potential of every individual system at their own and to help them becoming the dependable system of care in the area of their core strength. Second equally important principle is to see how two or more health-care systems can work in tandem to maximize the net therapeutic gains. This working together is not necessary to be executed in one time frame and there can be variable methods of doing it as per the actual therapeutic goals. For example, there can be an approach where Ayurveda and Allopathy interventions are given together simultaneously or there can also be the conditions where Allopathy or Ayurveda may precede the other on the basis of dividing the therapeutic tasks into multiple small goals and seeking the appropriate system to meet the particular objective. We see that the crux of maximizing gains from pluralistic health care ideology lies in practicing mutual respect alongside with identifying the strengths and limitations of every individual system.
Unfortunately, Indian medical pluralism has so far largely been nourished by the thoughts of discovering the divergence and pointing the limitations rather than discovering the convergence and pointing the advantages. The idea of system-based loyalty prevails in any movement aiming toward working together. We may all agree that before integrating physically, there is an urgent need of integrating mentally where the other systems are not being taken as the intruders in one's niche area but are rather taken as a help to understand the complex health-care needs and to serve the people for what all they actually desire.
National Health Policy 2017 has done some foundation work in this regard. By stating ”The policy further supports the integration of AYUSH systems at the level of knowledge systems, by validating processes of health care promotion and cure. The policy recognizes the need for integrated courses for Indian System of Medicine, Modern Science, and Ayurgenomics. It puts focus on sensitizing practitioners of each system to the strengths of the others.” It has paved a much desired path leading to the mutual tolerance and co-operation in health care. Initiation of Health and Wellness Centers (HWCs) on the behest of Ayushman Bharat may be considered as one definitive step toward the policy directives. Much however is still desired to be done. The policy visualizes the initiation of bridge courses as a mode of sensitisation of one health system with another. We are of the opinion that instead of launching such formal steps which are eventually embedded with the complexity of execution and outcomes, much easier steps are to initiate the dialogs and to create the occasions to begin the dialog. There can be short-term exchange programs between different health system institutions to initiate the primary impetus. Further to this, there can be cross disciplinary fellowships and visiting faculty positions to explore the opportunity of showcasing the uniqueness of one system to the practitioners of other. This is essential to understand that a trust can be built only when the benefits of one system are clearly demonstrated to the hard core believers of other system. Such interactions therefore should not be made limited to class room and seminar halls but rather should be explored through interactions with real beneficiaries in the form of in- and outpatients.
Building the institutions providing the opportunity to work together may be an excellent method to bring the mutual trust down to the ground reality. Such institutions, on the basis of their long-term coworking and cooperation environment, can play crucial to what is conceived in National Health Policy 2017 in terms of intersystem sensitization. Factually, there had been initiatives like this earlier and institutions like Banaras Hindu University (BHU) took clear lead in such directions by providing the first ever cross disciplinary postgraduate qualification in the medical science. In the absence of proper nutrition to such ahead of time thoughts, it however soon faded out. BHU is still running the legacy of holding two of the country's most important health-care systems together under one umbrella. Institute of Medical Sciences in BHU therefore keeps Ayurveda and Allopathy as its two hands enabling it to function optimally. Within the ambit of AYUSH, North-Eastern Institute of Ayurveda and Homeopathy at Shillong has created a similar example although to a smaller scale.
Such initiatives are needed to be scaled up by building new institutions having a collective wisdom and initiating new facilities in existing institutions. Bringing the health-care systems together to work in harmony only to maximize the benefits of the patients is a mega task requiring a mental revolution. While making the health-care plans and budgeting, such initiatives however should be considered the investments rather than expenditures. If done meticulously and honestly, eventually, such initiatives have the potential to change the future of medicine as it is practiced today. India by default of its preexisting medical pluralism is all set to take a head start in this direction.
|1||WHO Global Report on Traditional and Complementary Medicine 2019. Geneva: World Health Organization; 2019.|
|2||Bhore Committee; 1946. Available from: https://www.nhp.gov.in/bhore-committee-1946_pg. [Last accessed on 2021 Mar 05].|
|3||National Health Policy; 2017. Available from: https://www.nhp.gov.in/nhpfiles/national_health_policy_2017.pdf. [Last accessed on 2021 Mar 05].|
|4||North Eastern Institute of Ayurveda and Homeopathy, Shilong, Meghalaya. Available from: http://www.neiah.nic.in/. [Last accessed on 2021 Mar 05].|
|5||Rastogi S, Singh RH. 'One Nation, One Health System' In Indian Context: Do we need a serious debate before we pitch in? Ann Ayurvedic Med 2021;10:2-4.|