AYURVEDA MEDICAL ASSOCIATION OF INDIA
SUGGESTIONS FOR ADDITIONS IN HEALTH POLICY
Hon’ble Health Minister
Govt of Kerala
We, the professional organization of 7000 qualified Ayurveda doctors working in Kerala in different sectors related to Ayurveda congratulate the Kerala State Government and the team behind the Kerala State Health Policy for the meticulous efforts taken to formulate a Comprehensive Health Policy and under this a Health Protection Agency- the first of its kind in India. As a policy it deals with almost all sectors related to health and interdisciplinary issues as much as possible and gives a new approach to address the current health care sector challenges.
The health indicators as mentioned in the policy are at a comparatively superior level in Kerala. Many demographic studies reveal that Kerala had attained comparatively good health status even before the spread of Modern medicine. For this, the reason is the health consciousness the Kerala population traditionally possess. The evidence to the fact was inculcated by the use of Ayurveda for their health care and treatment since ancient times irrespective of the individual socio-economic status. Almost all specialties were common in practice that included General medicine, Paediatrics, Psychiatry, ENT, Gynaecology, Surgery, Toxicology, Geriatrics, Reproductive Medicine etc. There existed and still exists very efficient ante natal and post natal care, Adolescent health care ( Arthavacharya), Geriatric care etc. The dietary practices are also styled by Ayurveda which is very effective to prevent seasonal diseases and emerging Life Style Diseases. Means and measures for public health were also in practice long before the birth and spread of Allopathy in India.
We want to point out some deficits in the draft health policy. The national health policy of 1983 clearly envisages incorporating traditional systems to strengthen the health care delivery system in the country. The draft does not give a comprehensive approach in the utilization of total health infrastructure available in the state as directed by our national Health Policy and central government policy on AYUSH. The policy only deals with the modern medicine and does not give any idea about the role of other recognised medical systems including Ayurveda, which is considered as the Indigenous medical system of Kerala.
Here are a few points we are putting forward for your attention and necessary action
1) Establish Ayush department
Central government, with a vision to revive Ayush systems started Ayush department . Health care when it was a common pool allocated very limited resources and gave little scope to Ayurveda and other systems to develop and prosper, but establishment of Ayush department made a revolution in the development of traditional systems of medicines. Many states adopted this strategy and fetched good results. It is very essential to have an Ayush department in the state. The fund allocation and approval of viable projects will be more appropriate and people of Kerala will be benefited by the health care system of Ayurveda and other systems.
2) Co location of AYUSH systems with PHC’s and CHC’s
The major draw back of this policy is the lack of integrity with national level health programs. This draft does not mention anything about the co location of Ayush systems which is a major component in the national policy on Ayush systems. Mainstreaming of AYUSH through NRHM has been one of the thrust areas to improve the quality and outreach of health care and attain integration of health services. Therefore the public health facilities ( PHC’and,CHC’s and District Hospitals) have been supported for co location of AYUSH doctors. The department of AYUSH also directed to align its programs and policy with the national Health Out come Goals of reducing IMR,MMR,TFR, Malnutrition, Anaemia, Population control and Child sex ratio etc:
The national policy also directs to utilise and contribute all on going schemes of other departments such as Janani Suraksha Yojana ( JSY- AYUSH) ICDS-AYUSH, RCH, early breast feeding, ante and post natal care etc: For this purpose the Ayush stand alone hospitals and dispensaries as well as co located PHC’s/ CHC’s/District Hospitals should be mobilized. ( Report of steering committee on AYUSH for 12th Five year Plan)
The current status of co location of AYUSH facilities with existing centers;
There were 640 districts, 6431 blocks and 638588 villages incorporating 605 District Hospitals (DHs), 4535 Community Health Centres (CHCs) and 23673 Primary Health Centres (PHCs) till March 2011.Out of these, AYUSH facilities had been co-located with 416 District Hospitals, 2942 Community Health Centres and 9559 Primary Health Centres during 2011. About 68.76 percent District hospitals had been co-located with AYUSH facilities till 2011, the ministry said in the statement. All the District hospitals existing in the states and union territories of Goa, Haryana, Jharkhand, Maharashtra, Mizoram, Sikkim, Tamil Nadu, Tripura, Lakshadweep and Puducherry had been co-located with AYUSH facilities, whereas, the states having more than 50 percent of the District hospitals co-located with AYUSH facilities were Chhattisgarh, Punjab, Madhya Pradesh, and Uttarakhand.
The co location will give maximum utility of health manpower with less expense as the Health workers and Asha workers can be utilised for all systems. This will also promote healthy referral system among different systems and give effective health care to the society. So co location of AYUSH facilities with primary and secondary level should be included in the policy.
3) Strengthen public health system through Ayurveda
Basic health care system should incorporate Ayurveda. Ayurveda doctors should be included in all national health campaigns conducted by national agencies like RNTCP. The success of Kollam model tie up of AMAI and RNTCP is a proof of this and can be implemented on a national basis to achieve the goal of such projects. Government can utilise the underutilized infrastructure of other systems in the state. As all the Medical Courses (MBBS,BAMS, BHMS, etc.) are having same syllabus regarding Public Health, effective implementation and better reach out of each program can be obtained if professionals from other systems of Medicine are also engaged in the process. Ayurveda lifestyle which is very relevant in modern era should be popularized among communities prone to various health problems caused by improper lifestyle. Service of ASHA workers should be made available to all ISM and NRHM dispensaries.
4) AYUSH practitioners in Public Health Cadre and Health protection Agency.
It is already understood and established that the control and management of emergence and re-emergence of Communicable diseases & Non Communicable Diseases with a single medical system is far from reality. Previous practical experience has proved that. To cope up with this, the utility of qualified AYUSH practitioners and Ayurveda Practices will be highly beneficial. Ayurveda is well known for Public Health Management and many practices are time tested and proven by scientific validation. Kerala, being the mother land of Ayurveda, the policy should aim at developing a Kerala model of Public Health Management System. To ensure this AYUSH doctors should be included in the public health cadre and health protection agency.
5) Modernization of ISM Dept and Institutions
Present condition of most of the dispensaries and hospitals are very pathetic. Many centers are in very remote areas and the patient find very difficulty in accessing the facility. Some clinics are in rented buildings. ISM dispensaries have no facility for diagnosis, no ministerial staff and no basic infrastructure like computers or telephones. Very limited specialty facilities are available in ISM hospitals. A master plan has to be devised and implemented to modernize all ISM hospitals and dispensaries. As people are very much aware of all clinical specialties of Ayurveda, speciality clinics can be started in all hospitals. Pay wards are available in a few hospitals only, for which demand is high. Hence introduction of pay wards in the hospitals can bring in more income to the hospitals apart from providing better health care. Facility for implementing and maintaining higher standards for hygiene and cleanliness has to be provided with. Permission to use clinical laboratory facilities and other investigative infrastructure at the nearby PHC ,CHC etc will be highly beneficial for the people as all dispensaries and most of the hospitals of ISM do not have this facility and it will be a cost cutting factor for Government as all institutions are under Health and Family Welfare department.
Only three technical staff is available at the Directorate of Indian Systems of Medicines. The director and two joint directors are there to handle all the administrative and technical issues of the department. As there are 900 plus institutions, naturally their attention and time is diversified and concentrates mainly on administrative matters. For effective use of this department, more professionals are required at the Directorate and district level for preparation & implementation of projects and programs.
6) Research on Ayurveda
A comprehensive research centre can be established in the state. Present academic centers are confined to PG level research. KUHS has been conducting broad spectrum research activities. Only minimum level and product centric research activities are conducted by a few medicine manufacturing concerns which does not be termed as real research. The state government has not started any center for promotion of Ayurveda research. Proposed Ayurveda Research University can be developed as a center for coordinating research activities with the authority to start and approve off campus centers.
7) Take effective measures to address raw material (medicinal plants) shortage
The shortage and limited availability of raw material is a major crisis in Ayurveda medicine manufacturing sector. District level societies can be established (milma model) to propagate and collect medicinal plants & raw materials. Agencies like Medicinal Plant Board, Horticops mission and Care Keralam should be empowered to take concrete steps to meet the raw material necessity of the industry. Awareness programs about medicinal plants are to be encouraged at school levels. Projects can be implemented to cultivate medicinal plants by THOZHILURAPPU (RGNREGS) workers on barren and unused land owned by Govt , schools and devotional centers.
Health, forest and agricultural departments should be co ordinate to make Kerala the hub of medicinal herbs.
8) Strengthen Education system
Ayurveda Education system has to be restructured to develop specialty cadre in Ayurveda. More specialized Ayurveda doctors are necessary for the society. MD courses and PG diploma courses in all specialties should be started in all Govt. and private sector Ayurveda colleges. Availability of qualified therapists is a major issue to be addressed. More therapist training courses are to be started to resolve the problem.
9) Kerala as Ayurveda Hub
Ayurveda is a total Science for better living. It has two approaches. The first emphasis is on preventive health care and is followed treatment approach. The Government is giving good publicity on Ayurveda Health Care in foreign countries and other Indian States to generate revenue from Ayurveda tourism sector. Keralites have been depending mainly on Ayurveda for their health care. The elite and the common population alike seek Ayurveda for health care.. There are many well known Ayurve-da Speciality Centers in Kerala, So, directives may be given in the policy to make Kerala an- Ayurveda Hub as we have all the resources required for it.
10) Stop quackery and Fake advertisements.
Quackery and Fake advertisements are the two main threats and banes of Ayurveda today. Among them quackery has been consistently causing erosion of credibility to the name and fame of Ayurveda. Anti quackery laws should be enforced strictly. A unified medical practitioner’s law should be implemented in the state. Fake advertisements are another area of concern. Such malpractices shadow the goodwill of Ayurveda and degrade professional and authentic Ayurveda.
11) Ayurveda tourism
Kerala has been the global center of Ayurveda. But Srilanka has fast and efficiently emerged as a formidable competitor. We have to assure and ensure quality health care at affordable pricing if we have to overcome the challenge posed by Srilanka. Fake and unethical practices in all aspects of Ayurveda health care should be discouraged. Model centers in Govt sector should be developed on key areas. The licensing procedures of private sector investors should be made easier. No centers should be allowed to operate without qualified doctors. Participation in international campaigns is a must.
12) School health program
Good health practices should be started from the childhood. Good health regimens and food habits control and prevent many lifestyle diseases. Ayurveda swastha vritha awareness, awareness of home remedies, knowledge about medicinal plants etc. are to be included in school health programs, Ayurveda has answer to many adolescent health problems. Hence Ayurveda health programs should be conducted in all schools of Kerala. Chapters on Ayurveda should be a part of science and social science school text books at all levels.
13) Ayurveda Mission
As Dr.Sam Petroda rightly stated the Global propagation of Ayurveda will enrich Kerala economy. Global propagation can be attained by establishing creative projects like Global Ayurveda Village ,promoting Kerala Brand of Ayurveda etc.. But no nodal agency exists in the state for co ordination such activities. An Ayurveda mission in the model of IT mission should be established as a nodal agency for global propagation.
14) Equal importance for all Medical Systems
There are people who are reluctant to follow Modern medicine. Many people wish to follow Ayurveda or other systems only, may be due to the side effects they have experienced from modern medicine or their strong belief in other systems. The present global scenario is that more and more people are moving towards Herbal Medicine or Alternative Medicine, understanding the benefits of other systems and the adverse effects of modern medicine. We can see many modern private management hospitals in Kerala have started Ayurveda wing which are operating well. Multi systems can be effectively utilized for the management of Health care & treatment of many diseases including common infections , pediatric diseases, ortho diseases, NCDs etc. In our Government Medical Colleges there are wing for Yoga therapy which is a commendable step towards this approach. China is using their traditional knowledge very cleverly along with modern medicine for health care management. We also have to tow the same line so attain a complete and comprehensive health care status in the state.
We request the Kerala State Government to take a people oriented sensible approach in this regard as it is public health at stake. We earnestly hope the Kerala State Government will not allow any Medical System to dominate and control the health sector but make sure all good things from each system is included in the policy so that Kerala population enjoys a healthy health status.
Thanking you for your time and attention and looking forward for a quick and prompt action.
Ayurveda Medical Association of India
Copy to: The Pricipal Secretary, Department of Health and Family Welfare
The Director , Department of Indian Systems of Medicine
The Chairman, Committee for drafting Health Policy