National Integrated Medical Association (NIMA) works towards strengthening the medical education of Ayurveda, Siddha and Unani doctors. It is involved in public health activities like pulse polio, tuberculosis, Beti Bachao Andolan etc and is being funded by AYUSH. Mandar Ranade, National spokesperson, NIMA, talks more in his interview with Shalini Gupta
How many ASU practitioners are there pan-India and state-wise?
There are six lakh practitioners of Ayurveda, Siddha and Unani (ASU) across India, 80,000 are in the Maharashtra itself. There are practically no Siddha practitioners, except in Tamil Nadu. The number of practitioners is increasing because earlier there were only government colleges, but now a lot of private colleges are also coming up in states like Maharashtra and Karnataka. Out of 242 ASU colleges in India, these two states boast half of the number of colleges combined together with 100 colleges in Karnataka alone and 62 in Maharashtra.
Has the number of doctors been increasing?
Since 1965, the Maharashtra government has given permission to ASU doctors to practice allopathy. Most of them are working in the PHCs in rural health, in school health as well as in NRHM. The 108 ambulance service was awarded by the Central Ministry and is practically run by the 3400 ASU doctors who are reaching upto remote areas such as Gadchiroli. Doctors who are practising pure Ayurveda is increasing and we see meritorious students actually taking up pure Ayurveda and there are a lot of opportunities for Ayurvedic practitioners abroad.
How does Maharashtra rank as far as the role of ASU doctors is concerned?
The national census control programme had submitted a report last year according to which wherever ASU practitioners are being utilised towards health, those states show good standards of health in terms of child mortality, maternal mortality, hygiene etc. In states where ASU doctors are banned from practicing allopathy, like Kerala, Orissa, UP and the North East, health standards are not at par. In Maharashtra itself, 2,75,000 lives were saved by these 3400 ASU doctors doing deliveries, treating and mediating organo phosphorus poisoning and handling critical emergencies such as cardiac arrest too. This has been a huge support to the Government of Maharashtra. The hard work of these doctors in the family planning programme has been lauded, with the Government of Maharashtra being awarded annually. In the school health mission, our doctors are going to inaccessible places where there is no transport and telecommunication. Last year the doctors reported 1000 new cases of cardiac anomalies in school going students, which would have been ignored had they not paid attention. What is commendable is that 500 of these students were operated upon in government hospitals. So, it is for sure that these doctors are making vital contributions towards public health which in turn is being lauded and appreciated by the government. Practically, all ICUs in metros and cities are manned by our doctors and I believe that if other states too have similar legal arrangements like Maharashtra, then definitely we can overcome the shortage of doctors and measure upto the WHO required ratio of doctors.
What is your take on the opposition from allopathy practitioners to the AYUSH system?
Pandit Nehru, in his speech on Sampoorna Swarajya, had promised integrated medicine i.e one medicine stream in India. So, we are pursuing that. However, our policy makers, in due course, have forgotten. China has only one MBBS course which teaches Chinese medicine as well, so if someone wants to specialise in Chinese medicine, he becomes a PG.
So, a Chinese medicine doctor is an MBBS doctor. Hence, there is no discrimination vis-à-vis MBBS doctors. We always oppose the compartmentalisation of education. This is a newer form of racial discrimination in the medical profession, with one stream claiming its superiority over another. It should not be like this. No system of medicine is complete. If the patient has a right to avail of different streams of medicine, a doctor also needs to be well-versed in all these streams. All doctors should be on one platform, I believe. A new policy is now being chalked out and there could be one course which would be beneficial for the people of India.
Is modern medicine more effective than alternative medicine?
There are certain areas where modern medicine is more effective such as critical care, cardiac emergencies, poisoning etc. However, there are certain chronic diseases like skin diseases, neurological disorders, gynaecological problems where alternative medicine works well. So, a doctor needs to be well versed in both to provide the best care to the patient who has a right to get benefitted.
What are the difficulties faced by ASU doctors?
Inferiority in getting the training is a major challenge. Any MBBS doctor, if he wants to pursue specialisation in any stream say dialysis, laparoscopy, etc, has opportunities and a good stipend. The ASU doctors working for 108 ambulance are working for Rs 13,000 per month, whereas the starting salary of MBBS doctors is Rs 40,000 to 60,000. This is the discrimination that ASU doctors have to face if they go for further training or else they have to do it free of charge, they aren’t paid. Under the 108 service, they are getting 10 days of training on practically managing emergency situations, there are courses in Ruby Hall and Deenanath Mangeshkar Hospital in Pune under PGDEMS. There should be no bar on who wants to take the training.
How can ASU be integrated into the public health system?
We have given our recommendations to the health ministry in view of the upcoming National Health Policy, including AYUSH ministry at every state level, AYUSH PHCs and AYUSH pure hospitals. With National AYUSH mission also new opportunities will open up. The policy makers need to open their prejudiced minds and make a policy where practitioners of different systems can be properly integrated. With opposition from IMA and other such bodies, some hurdles prevail. Union Health minister JP Nadda, in a conference recently, said that IMA will have to come forward and take the process of integration ahead. So , I am hopeful that there are good times ahead for ASU practioners.
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