Modern India, traditional remedies

IN THE BONESETTER'S WAITING ROOM
Travels through Indian Medicine
Aarathi Prasad
Profile Books
214 pages; Rs 499

The poor state of modern health care in India is well known. There just aren't enough doctors and hospitals for the country's 1.2 billion people. To some extent, this gap is filled by alternate medicinal systems such as Ayurveda, Homeopathy and Unani. A large population of Indians reposes immense faith in these medicines. Thus, what you have in the country is a peculiar situation: Cutting-edge world-class health care co-exists with traditional remedies. And both are thriving.

Aarathi Prasad's book provides a good idea of how the two worlds co-exist happily. Her travels take her to modern hospitals and bare-bone clinics as she chronicles how health care is delivered in India. The book is the first of its kind and, therefore, deserves a careful read.

Modern and traditional medicines have made space for each other in India, and are not in confrontation with each other. Thus, Ms Prasad finds out in the clinic of a bone setter in Hyderabad that people come here in large numbers to get their fractures and dislocations fixed because it is quick and inexpensive.

However, the good hakim would not treat serious fractures, such as those in the femur, and send the patients to big hospitals for treatment. The hakim would use a stethoscope to diagnose and would also prescribe allopathic medicine freely.

Modern doctors too do not hold anything against Ayurveda, and other traditional remedies, so long as it is used to treat mild lifestyle disorders. They object only when people stick to alternate medicine even when they suffer from grave ailments.

The most famous of all alternate medicines is the fish cure for asthma offered by a family in Secunderabad. It is done on one day of the year; over 50,000 people come for the free treatment. The Goud family has been administering the nostrum for over 150 years.

On the appointed day, patients are fed a small murrel fish, along with some herbal paste. Many find it hard to swallow the fish but faith in its efficacy is supreme. As the author notes, a country that recently sent a mission to Mars is unwilling to shed its unflinching belief in traditional medicine.

Much of the space in the book has been reserved for Ayurveda. Ever since Ramdev burst into the FMCG scene with his range of herbal products, Ayurveda has been given a new lease of life. It had tremendous latent brand equity, which the yoga teacher from Haridwar has monetised beautifully. The market for Ayurveda products is on fire - look at the way even the mainstream FMCG companies are trying to join the bandwagon.

This has also prompted a lot of research into Ayurveda, especially the medicinal properties of herbs such as ashwagandha, also called Indian ginseng. There are literally thousands of research papers on it, yet the herb has not made it to modern medicine. There is not one popular medicine that uses ashwagandha. Clearly, the quality of the research that has been done is suspicious.

This, more or less, is the story of traditional medicine. Research that would have fortified its scientific credentials has simple not been done. As a result, the world regards it with suspicion. Of course, conspiracy theorists will tell you that this is a grand ploy by Big Pharma, or else Ayurveda will finish it, but the argument does not hold much ground.

One of the reasons traditional medicine has had to carry the label of being unscientific is that in many cases the medicines are a closely-guarded secret. Families zealously protect the formula for their preparations. This closes them for scientific enquiry. So it might be effective but in the absence of robust scientific data, it becomes second best.

Ms Prasad also travels to the Naxalism-hit Gadchiroli district of Maharashtra to see how health services are delivered there. If facilities are inadequate in India, they are abysmal in poor tribal areas. Worse, many of the tribes still lay a lot of stock on shamans and witch doctors. They access modern health care often when they have run out of all other options.

Women suffer more. In addition to malnutrition, they are subject to violence by their husbands. The birthing infrastructure is very poor. And infant mortality is high. In some tribal communities, there exists the practice to sacrifice an infant if its mother died - simply because there would be nobody to look after it.

In a country where specialists are all concentrated in large cities, there is still little hope for poor people.