Ayush and Ayurveda

Context: Recently, the Indian Medical systems of Ayurveda, Siddha, Sowa-Rigpa and Unani Medicine have identified surgical procedures that can be performed by postgraduate Ayurvedic doctors in Shalya (surgery).

What is the history of Ayurveda and Allopathic practices in India?

• After Independence: The Indian state was faced with the difficult task of accommodating both the ascendant modern medicine brought in by the British and India’s traditional systems of medicine, notably Ayurveda.
  • Options:
• One was to take the best from all systems and integrate them into one cohesive science. This was possible but not easy as the systems had certain incompatible approaches.
• For a brief period there actually existed ‘integrated’ courses, wherein both Ayurveda and Modern medicine were taught to students.
• These withered away partly due to opposition from purists in Ayurveda who were outraged by the ‘dilution’ of their science.

Discuss the issues associated with ayurvedic graduates.

• Ayurvedic graduates experienced an identity crisis: Many of them had joined the course not for the love of Ayurveda but to get a degree with the honorific ‘Dr.’ which gave them upward mobility, social status and even value in the marriage market.
• Their role: They became resident doctors, intensive care duty doctors and operation theatre assistant surgeons.
• There is an instance of a homoeopathic graduate manning and training others on the extracorporeal membrane oxygenation, or ECMO, a complex heart lung machine in the largest unit used for critically-ill COVID-19 patients.
• They work for less pay which allows hospitals to control costs and even make profits.
• The idea of Ayurvedic surgeons: In an effort to develop postgraduate programmes, Ayurveda medical colleges developed one in “Shalya’ or “surgery”.
• A procedure called ‘Kshar Sutra’ used for anal fistula was described in Ayurveda texts and has been incorporated in modern medicine.
• Procedures and complexities
• Indian Medicine Central Council (Post Graduate Ayurveda Education) Amendment Regulations, 2020: It authorises an MS (Ayurveda) Shalya Tantra, or General Surgery postgraduate degree holder on completion of his course to perform 58 surgical procedures.
• Some of the procedures in the list are rather complicated. For example, removal of the gallbladder called cholecystectomy.

What can be done?

• Proper training: Ayurveda graduates including surgeons are a large workforce in search of an identity. If they are creatively and properly trained, they can play important roles in our health-care system.
• IMA needs to be constructive: AYUSH, or Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy, is a priority area for the present government. The IMA in its opposition needs to be precise and constructive.

Way forward

• Serious discussion about utilising India’s large workforce of non MBBS doctors to improve access to decent health care for our ordinary citizens is required.