The govt’s plan to certify India’s esoteric healers is a bad idea

Patients flock to traditional healers based on faith and word of mouth rather than on science despite the risk of harm, which typically goes unrecorded in the absence of a regulating entity.
Patients flock to traditional healers based on faith and word of mouth rather than on science despite the risk of harm, which typically goes unrecorded in the absence of a regulating entity.

Summary

  • The right approach would be to institute research to understand why what works actually does work, and to leave the plan for certification well enough alone until that is achieved

The government’s proposal to certify practitioners of traditional medicine, those who do not have a medical qualification or standardised professional training but still seem to be effective at what they do, is a bad idea. The government would do well to abandon such a move.

What it should do, instead, is try and understand the science behind esoteric practices that have no place in the standard medical practice taught in recognised medical colleges but are effective in the real world.

Research into such practices might help understand what makes them tick and thus make them safer for patients. This is important given how patients flock to traditional healers based on faith and word of mouth rather than on science despite the risk of harm, which typically goes unrecorded in the absence of a regulating entity.

There is, indeed, considerable traditional knowledge spread out across India’s vast cultural geography that rural, and often urban, Indians have been drawing on to find remedies, including for emergencies such as snake bites and illness of many kinds. There’s a famous family in Hyderabad that administers a preparation of live fish to patients of asthma, which has for decades drawn international media coverage.

Rural India has traditionally lacked access to modern healthcare and relied on traditional medical practitioners. Such practitioners do not necessarily belong to any identifiable school of curative practice, such as ayurveda, unani or siddha. There is a specialist institute in Bengaluru trying to unravel the science underlying ayurveda.

Ayurveda works on a theory of balance among three humours—air, phlegm and bile—to keep the human body in good health. It treats disease for the imbalance detected by an ayurvedic physician. This theory fits ill with the modern scientific understanding of diseases being caused by germs that manage to surmount the defence put up by the body’s immune system.

However, many ayurvedic curative regimes are backed up by centuries of empirical experimentation and practice. How the practice can be explained by science needs to be investigated using modern tools of research, more extensively and comprehensively than has been accomplished so far.

But there are lots of so-called miracle cures at work in India’s vast expanse. People set bones, cure back aches by stretching spines using alarming techniques, and offer single-herb/root remedies to dissolve kidney stones. Instead of dismissing all this as quackery, the government must institute proper research to understand these.

One of the winners of the 2015 Nobel Prize for Physiology or Medicine went to Chinese scientist Youyou Tu, who identified the chemical artemisinin, found in a plant used in traditional Chinese medicine for treating malaria. Finding the science behind the curative properties of traditional medicine in India could yield scores of Nobel-worthy discoveries.

However, till such an understanding of traditional curative practices, the government would do well to stay away from certifying practitioners of traditional medicine.

The fundamental reason is that you cannot certify what you do not understand. What standards can you set when you have no clue as to the quantity, quality or process of the things at work in a cure that cannot be explained by science?

The only thing that a certifying body would have to guide it along is the reputation of empirical success. And reputation is something people already have access to, without official interference, which is why such curers have patients.

Imagine what would happen if the government starts to offer certification without any science-supported measurable yardsticks of performance. Some quack with access to influential politicians would wheedle his way into getting certified as being qualified to offer treatment, without actually possessing the knowledge or skill to be effective. This would harm rather than help people.

The government would do well to identify and catalogue all the different effective practitioners of non-standard cures, assign research teams to each one of them to scientifically ascertain the root of their efficacy in practice, and consolidate the findings.

Traditional physicians are often reluctant to part with detailed information about the specialty cures they offer. These are often passed down from one generation to the next as the family’s main source of income. Their reluctance to make their knowledge public is wholly understandable. The government must offer intellectual property protection to esoteric knowledge and practices, and enforce their exclusivity.

Some skills are process-oriented, such as in yoga. While the gross form of a yoga pose is easily identified, unless there is proper understanding of how to train the muscles to attain the pose, often entailing gradual easing in with the help of assorted props, the only result of untrained attempts to force the body into that pose would be to contribute a harvest of patients to the orthopaedic.

In such cases, certification would have to be outsourced to ongoing schools of authentic practice, and consumers educated to stay away from the uncertified.

The right approach for the government, as far as traditional medicine is concerned, is to institute research to understand why what works actually does work, and to leave well enough alone until that is achieved.

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