Public perception of AYUSH

Abstract

Two recent incidences speak volumes about the current public perception of the Indian knowledge systems in our country. The first incidence happened in New Delhi and another one in Pune. PERCEPTIONS OF SENIORS In the first incidence, the Union Minister of State for Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy (AYUSH), Shri Shripad Yesso Naik, while speaking at the Indian Women's Press Corps said “there is no lifestyle disease Ayurveda and Yoga cannot help cure.” This statement implies that Ayurveda and Yoga can help cure all the lifestyle disease. While the spirit behind the statement is not wrong, the term “cure” is certainly not appropriate. Learned senior journalist Shekhar Gupta wittily criticized that many bureaucrats from the government suffer from “verbal diarrhea,” who can defy AYUSH Minister's claim.[1] While the journalist did not make any direct comment on Ayurveda and Yoga, many people perceived that he is trivializing the usefulness of Ayurveda and Yoga. The perceptions of both, the minister and the journalist are right in spirit but wrong on premise. The journalist while using this incidence to make his point “why India needs to set norms for bureaucrats,” has ignored that diarrhea is not necessarily a lifestyle issue but is more of an infectious disease. Today, the world is witnessing major epidemics of noncommunicable diseases (NCDs), which are mainly due to changes in lifestyle and human behavior. The lifestyle diseases include high blood pressure, heart disease, obesity, diabetes, chronic lung diseases, cancer, Alzheimer disease, and others. Many lifestyle diseases are known to appear as a cluster of diseases resulting in more complex conditions such as metabolic syndrome. According to the WHO Director General, Margaret Chan, 85% of premature deaths in developing countries are because of lifestyle diseases. Every year, 38 million people die from lifestyle diseases, of which about 28 million are from developing countries. Nearly 16 million of these die before the age of 70. Since the beginning of the new millennium, the number of deaths due to NCDs has increased worldwide. In 2013, during the World Health Assembly, 194 member countries accepted the WHO Global Action Plan for the Prevention and Control of NCDs. This plan hopes to attain at least a 25% reduction in premature mortality from NCDs by the year 2025. The challenge to control the present epidemic of lifestyle diseases is more difficult than the battle against infectious or communicable diseases as they cannot be controlled merely by discovering powerful drugs; unless healthy lifestyle and behavioral modifications are adopted by people. This involves promoting healthy eating habits, physical exercises, and avoiding mental stress. Behavioral modifications may involve refraining from the use of harmful substances such as tobacco, drugs, and alcohol, and strengthening the mind to be able to cope up with adversaries. In addition, reducing environmental pollution, and enhancing general safety is also necessary. There is emerging global consensus that Ayurveda and Yoga through Swasthavritta, Sadvritta, Asanas, Pranayama, and Meditation can contribute to nonpharmacological management of the most lifestyle diseases.[2] Agreeably, heritage pride and past glory based sweeping statement made by the minister without sufficient scientific evidence could have been avoided; however, the role of Ayurveda and Yoga in the management of lifestyle disorders cannot be ignored or trivialized. PERCEPTIONS IN YOUNG MINDS The second incidence is more worrying than the first. While an article by Shekhar Gupta was being published, Dr. Vijay Raghavan, Secretary of Department of Biotechnology (DBT), Government of India was delivering a public lecture at National Centre for Cell Sciences, on the campus of Savitribai Phule Pune University. During a question and answer session, a bright young college student asked a question “what is the view of DBT about allegedly dubious systems of medicines such as Ayurveda and Yoga?” Dr. Raghavan answered this question in a very balanced manner with extraordinary finesse. However before finding answers, it is necessary to find the origin of such questions. Some Ayurveda lovers might take this question derogatory and react strongly while some might just like to ignore. In fact, we should be grateful to this young student who dared to ask this question in public. This question conveys prevailing perception of the Indian knowledge systems in the minds of young generation. This also in a way reflects community perceptions. This episode calls for serious introspection and raises serious of questions “why such perceptions prevail in young minds, what are we doing to encourage scientific research and evidence based practice, how to meet expectations and curiosity of young minds; how to ensure quality, safety, and efficacy; how to regain respect and confidence in our own traditions, cultures, and practices.” Some seniors still feel that there is no need to get disturbed because of criticism by so called Ayurveda-illiterate people. However, ignoring the reality of public perception and pretending to work in own ways may not help in long run. It is necessary that Ayurveda community gets proactively involved with experts of other disciplines and undertake high quality research on Ayurvedic concepts, practices, and products. As long as deafening silence of leaders continues, Ayurveda will be called a “pseudo-science” by young scientists and students. EVIDENCE CAN CHANGE PERCEPTIONS In history, there are several examples where systematic research and consistent efforts have changed public perception. It has happened in the case of Yoga in the West. For instance, seminal work was done by Dean Ornish from the University of California who learned principles of holistic health and meditation from Swami Satchidananda. He applied Ayurveda and Yoga principles on heart patients who were advised bypass surgery and scientifically showed the reversal of heart disease. He has even shown how oncogenes are downregulated, and health promoting genes are upregulated in cases of prostatic cancer. He has launched a program based on basic principles of Yoga and Ayurveda known as the spectrum.[3] Recently, the government supported Medicare and private insurance companies in the US have begun reimbursing Spectrum program because of its demonstrated value in saving national resources. He was able to change the perception that heart diseases are not reversible. He also changed a perception that Ayurveda and Yoga principles are not just theory or philosophy but they can actually help us to live healthy. We need such concerted efforts in India to change perception of people about value of Ayurveda and Yoga. Admittedly, at present healthcare in India is dominated by modern medicine and surgery. A Recent survey by National Sample Survey Organization reveals that almost 90% Indians use modern medicine. The same study also suggests increasing use of AYUSH systems with increasing urbanization. Although the methods and outcomes are being criticized, news reports from media could lead to wrong perceptions. Ironically, such surveys are used to draw misleading or meaningless conclusions. For instance, the Times of India news states that “the continued dominance of allopathy and the miniscule role of traditional medicines like Ayurveda and Homeopathy in the Indian health sector reiterates that these antiquated systems will never regain a significant role in national healthcare. Such systems fail any rigorous scientific scrutiny and continue to survive because of the lower costs of quack treatment.”[4] Such statements are certainly unjust and detrimental to AYUSH system but they do influence public perception. Just condemning such comments are not enough. The AYUSH community must work hard to demonstrate sufficient scientific evidence to counter attempts to create wrong perceptions in the minds of people. It is the reality that AYUSH colleges are not able to attract best of the best students and have remained destination of the most who denied opportunity in modern medicine schools. Our primary and secondary education does not give even introductory or historical knowledge about Ayurveda. While they are taught Archimedes, Galileo, Newton hardly any respectable mention of Charaka or Sushruta is found in our school texts. The new generation hardly knows our heritage. On the other hand, Ayurveda and Yoga have remained distanced from the modern scientific developments. The majority of AYUSH graduates tend to practice modern medicine. Many States have actually legalized this practice. Even after independence AYUSH has not been the mainstream of healthcare. As a result, AYUSH fraternity continues to be compellingly protective, defensive and submerged in past glory. NEED FOR COMPLEMENTARY EFFORTS While the emphasis on new scientific evidence for traditional practices is required, there is also a need to create awareness among the younger generation about conceptual strength of Ayurveda and scientific superstitions as well. In recent times, a lot of new evidence has been accumulated but it has not been systematically documented as monographs. At this critical juncture, both veterans and youngsters must play complementary roles. An eminent Ayurveda scholar Dr. R.H. Singh has recently suggested to form ginger groups of activists who are willing to work for contemporary uplift of Ayurveda. Such an interactive group may get engaged through meaningful dialogue and debate to widen horizons and trigger the wave of change. Renowned physician scientists, Dr. Ashok Vaidya, has given a vision for a pragmatic path for renaissance in Ayurvidya in next 5 years. According to him, the Ashwatha approach (Urdhva Mulam Adhah Sakham) where senior and young Vaidya-Scientists and Scientist-Vaidyas can set the priorities, programs, and projects of multidisciplinary nature is needed. Our modern scientists, instead of merely criticizing, must proactively contribute to study the Indian knowledge systems such as Ayurveda and Yoga. Getting isolated from mainstream or silos mentality will only extend the period of slumber and stagnancy that the sector has experienced for a long time. We need to go beyond past glory-pride based position toward intellectual challenges, debates, new ideas, and infusion of science and technology to rejuvenate, revitalize great disciplines of Ayurveda and Yoga. As this editorial is being written, the AYUSH Ministry Task Force chaired by visionary leader, Dr. H.R. Nagendra is set to submit its final report. We hope this historical report can facilitate long awaited revitalization of AYUSH sector. While the external environment is becoming conducive, AYUSH internal environment needs to change to bring more science, confidence, and open minds. For many years, AYUSH sector has enjoyed support from people (Lokashraya) but was lacking government patronage (Rajashraya). Now the situation is different. The Rajashraya is increasing. There is a need to come out of comfort zones for common good and envision a smart strategy. If we continue to turn deaf ears to perceptions of the young generation, even the Lokashraya cannot be guaranteed for the future.