IASbhai Daily Editorial Hunt | 27th Nov 2020

“Winning isn’t everything, but wanting to win is.” – Vince Lombardi

Dear Aspirants
IASbhai Editorial Hunt is an initiative to dilute major Editorials of leading Newspapers in India which are most relevant to UPSC preparation –‘THE HINDU, LIVEMINT , INDIAN EXPRESS’ and help millions of readers who find difficulty in answer writing and making notes everyday. Here we choose two editorials on daily basis and analyse them with respect to UPSC MAINS 2020-21.

EDITORIAL HUNT #263 :“Who Wins ? Ayurveda vs Modern Medicines 2020 | UPSC

Who Wins ? Ayurveda vs Modern Medicines 2020 | UPSC

Dr. Sanjay Nagral
Who Wins ? Ayurveda vs Modern Medicines 2020 | UPSC

Dr. Sanjay Nagral is a surgeon and writer from Mumbai

      HEADLINES:

A clear reading of the Ayurveda surgery move

      CENTRAL THEME:

India needs its Ayurveda graduates, including surgeons, to improve the common man’s access to decent health care

SYLLABUS COVERED: GS 3 : Medicine

      MAINS QUESTION:

Ayurveda graduates including surgeons are a large workforce in search of an identity. India needs them.. Comment -(GS 3)

      LEARNING: 

  • Father of Plastic Surgery
  • Latest Notification on Ayurveda and Surgery
  • Background : Medicine since 1947
  • Handling an identity crisis : Ayurvedic Doctors
  • Way Forward

      INTRODUCTION: 

  • FATHER OF PLASTIC SURGERY : Sushruta was an ancient Indian physician known as the main author of the treatise -The Compendium of Suśruta (Sushruta samhita)

We know about Sushruta and his surgical dexterity at a time when the world had not yet woken up to the art and the science of surgery.

  • OLD STEM CELL THERAPY : Sushruta Samhita, the ancient Sanskrit text on medicine and surgery, has procedures such as rhinoplasty where the nose is reconstructed with tissue from the cheek.

Ayurveda vs Modern Medicines 2020

      BODY: 

RESPONSE TO NOTIFICATION

  • CENTRAL COUNCIL OF INDIAN MEDICINE(CCIM) —  It is a statutory body under the Indian Medicine Central Council Act which regulates –Ayurveda, Siddha, Sowa-Rigpa and Unani Medicine.
  • RECENT NOTIFICATION : Surgical procedures that can be performed by post-graduate Ayurvedic doctors in Shalya (surgery) has stirred up a hornet’s nest.

Ayurveda vs Modern Medicines 2020

SOURCES : CONSULTANCY.IN

  • STAUNCH REACTIONS : The Indian Medical Association (IMA) has written a curious self-flagellating letter to the Prime Minister. Allopathic surgeon colleagues are outraged.

Social media and WhatsApp groups are abuzz with alarmist responses.

  • NETIZENS RESPONSE : Some have portrayed doomsday scenarios, ‘where our children will be operated’ by half-baked ‘Ayurvedic doctors’ in the future.

AFTER 1947, WHAT THE STATE DID

  • POST INDEPENDENCE : Indian state was faced with the difficult task of accommodating both the ascendant modern medicine brought in by the British and India’s traditional systems of medicine, notably Ayurveda.
  • INTEGRATION OF SCIENCE : Modern Medicine was to take the best from all systems and integrate them into one cohesive science.

This was possible but not easy as the systems have certain incompatible differences of approach.
 

  • PATRONS OF MODERN MEDICINES : The State choose to patronised and encouraged formal medical education in modern medicine as well as in other traditional systems.
  • INTEGRATION DID HAPPEN : For a brief period there actually existed ‘integrated’ courses, wherein both Ayurveda and Modern medicine were taught to students.
  • DILUTION OF SCIENCE : These withered away partly due to opposition from purists in Ayurveda who were outraged by the ‘dilution’ of their science.
  • INITIAL COURSE TO DEGREE : Thus, the degree in Ayurvedic medicine became largely an Ayurveda course.

It was necessary out of a practical career compulsion to teach the basics of modern medicine to these graduates.

  • SURVIVAL OF THE FITTEST : They had to survive in the medical market, which by that time was the dominant form of health care in India.
  • STEPPING DOWN THE LADDER : Most Ayurvedic graduates entered general practice.
  • UNDER-SERVED AREAS : Several of them went on to work in rural and under-served areas. Some set up nursing homes.

In rural Maharashtra, several nursing homes were run by integrated graduates.

  • AVAILABILITY CRISIS : In health care, availability is often more important than quality, specialisation and such extravagant ideas.

Even today we find most of the Ayurvedic doctors serving frontline in emergency wards. 

HANDLING AN IDENTITY CRISIS

  • THE IDENTITY CRISIS : As modern medicine made rapid strides, Ayurvedic graduates experienced an identity crisis.
  • LOVE FOR THE TITLES : Many of them had joined the course not for the love of Ayurveda but to get a degree with the honorific ‘Dr.’

It gave them upward mobility, social status and even value in the marriage market.They could not but practise allopathy which most of them do.

  • NIGHT SHIFT DOCTORS : Thus, they became resident doctors, intensive care duty doctors and operation theatre assistant surgeons.
  • SKILLED BUT DILIGENT : They picked up skills, were diligent and unlike their counterparts in MBBS, were not constantly distracted by thoughts of post graduation and entrance exams.

In the Konkan, the only nursing homes offering emergency obstetric and surgical services were run by non-allopathic graduates.

EXAMPLE
In Mumbai; a homoeopathic graduate manning and training others on the extracorporeal membrane oxygenation-the largest unit used for critically-ill COVID-19 patients.

  • AMBULANCE SERVICES : In Maharashtra, the ‘108’ emergency response ambulance service is manned by non-MBBS doctors.
  • FRONTLINE HEALTH WORKERS : During COVID-19, a large number of the quarantine centres were manned by Ayurvedic doctors.
  • LESS WAGES : Incidentally, they work for less pay which allows hospitals to control costs and even make profits.

SURGERY AND AYURVEDA

  • DEVELOPMENT OF SURGERY : Now to the idea of Ayurvedic surgeons. In an effort to develop postgraduate programmes, Ayurveda medical colleges developed one in “Shalya’ or “surgery”.

This is awkward as unlike the vast pharmacopeia, there is really nothing called Ayurvedic surgery.

  • AYURVEDIC SURGERIES : A procedure called ‘Kshar Sutra’ used for anal fistula was described in Ayurveda texts and has been incorporated in modern medicine.
  • SURGERY COST : Ayurvedic hospital in South Konkan who served the community for many years and at very low cost.
  • COMPLEXITIES : General Surgery postgraduate degree holder on completion of his course is to perform 58 surgical procedures.

Some of the procedures in the list are rather complicated. 

  • MODERN SURGICAL PRACTICE  : A postgraduate to perform a removal of the gallbladder called independently unless they have assisted or been taken through at least 100 odd procedures.

      IASbhai Windup: 

A SILVER LINING

  • CAPACITY BUILDING MEASURES : If they are creatively and properly trained, they can play important roles in our health-care system.
  • TRAINED PARAMEDICS ARE NEEDED : Given the right training, pay and identity, Ayurvedic surgeons can be trained to strengthen this service and save hundreds of lives.

AYUSH, or Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy, is a priority area for the present government.

  • OPPORTUNISM : If the IMA is defending science, it needs to publicly oppose such opportunism also. Pseudoscience is not a preserve of Indian medicine.
  • THE REVIVAL OF INDIAN MEDICINE : If the noise is a turf war between an overambitious Ayurveda establishment on the one hand and modern medicine with a siege mentality on the other.
  • SERIOUS DEBATESUtilising India’s large workforce of non-MBBS doctors to improve access to decent health care for our ordinary citizens needs more debates.

Since the MBBS doctors are left unpaid ; The debate is a superfluous distraction midst COVID-19 cases which will hopefully die down.

       SOURCES:   THE HINDU EDITORIAL HUNT | Who Wins ? Ayurveda vs Modern Medicines 2020 | UPSC

 

 

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