System error

in june 1986, doctors at the New Delhi-based All India Institute of Medical Sciences diagnosed that 14-year old Atul Kumar was suffering from bilateral wilms tumour (stage iv ), which later spread to his lungs. A prolonged allopathic treatment -- from July, 1986 to September, 1988 -- involving four major operations, 21 cycles of chemotherapy, radiotherapy and blood transfusions failed to stop the recurring symptoms.

In desperation, the boy's family turned to ayurveda. Under the watchful eyes of Vaidya Balendu Prakash, the founder of the Dehradun-based Vaidya Chandra Prakash Cancer Research Foundation ( vcp foundation), the three-year treatment of Atul showed astounding results. Atul recovered completely and leads a normal and active life now.

Not many amongst us, however, will repose the same faith (as demonstrated by Atul's family members) in Indian systems of medicine ( ism s) -- ayurveda, siddha, unani, yoga and naturopathy -- as they would in allopathic treatment. What is the reason behind this distrust? Why is it that the ism s have failed to emerge as a truly alternate system of medicine?

The reason is a combination of governmental apathy and inadequate research. "Our fascination for the Western allopathic system of medicine, and lack of governmental encouragement and recogition of our work is one of the most important reasons," says Balendu Prakash.

The malady Before independence, the ism s, practised on the basis of knowledge delineated through family traditions and the guru-shishya parampara (teacher-student tradition), flowered despite a lack of governmental support. The post-independence era witnessed the emergence of a plethora of institutional structures to facilitate the development of ism s. These include the Central Council of Indian Medicine and the Central Council for Homoeopathy set up to register practitioners in these systems and for laying down minimum standards for education, and the Central Council for Ayurveda and Siddha, the Central Council for Research in Unani Medicine, the Central Council for Research in Homoeopathy, the National Institute of Homoeopathy at Calcutta and the National Institute for Ayurveda at Jaipur, established as apex bodies for research and teaching.

However, these councils and research institutes have been more of impediments than facilitators for the development of ism s in the country, say some leading non-governmental experts. "A major portion of the budgetary allocations to them go for paying salaries to the staff and they cannot claim any significant research achievement. For instance, research institutes under the Central Council for Ayurveda and Siddha claim to have developed Ayush-64 against malaria and Ayush-54 against epilepsy. I doubt if anybody has ever seen these formulations," says Vaidya Balendu Prakash.

"The malady that major portion of the budgetary allocation of a department goes towards paying salaries to the staff is a characteristic of probably all departments," concedes Saleem I Shervani, Union minister of state for health and family welfare. "But it is our endeavour to ensure that additional funds are made available to our research institutes so that they do quality research." The 1983 national health policy had highlighted the need for planned efforts to find appropriate role and place for ism s in the national healthcare delivery system. But it was only 12 years later that the government decided to create a new department of Indian systems of medicine and homoeopathy in 1995, under the ministry of health and family welfare, with a meagre annual allocation of Rs 40.94 crores (1995-96).

Today, the number of ism practitioners in the country is about 4.12 lakh, compared to 4.5 lakh for allopathy. There are more than 17,000 ism dispensaries, 150 teaching institutions and more than 7,000 drug manufacturers. However, a leading Delhi-based vaidya , requesting anonymity, says that over 90 per cent of practitioners having a degree in any of the ism s end up practising allopathic system of medicine, thus creating a category of second-class doctors.

The nature of curriculum and the atmosphere for studies and research in the ism institutes are appalling, concedes Balendu Prakash. India, obviously, cannot ape the Western model of research in medicine (allopathic) because of the paradox where the very minimum basic cost of finding answers to ailments afflicting humans will be so whopping that eventually, the treatment will be out of reach of most of the Indian population. But things may be heading for a change. Shervani, who took charge not too long ago, is committed to setting right the aberrations of the past; he insists that "he would do everything that helps these different systems to emerge as truely alternate systems of medicine" (see interview).