In recent events, a government notification has unveiled particular surgical procedures that a postgraduate medical student of Ayurveda must gain practical proficiency in. This move has drawn criticism from the Indian Medical Association (IMA), a non-profit organization which protects the interests of doctors practicing modern science-based medicine and the general public’s well-being.
Tracing Ayurvedic Surgery
Ayurvedic surgery has roots reaching back to ancient Indian civilization, with the Rigveda mentioning Ashwini Kumaras, the chief surgeons of Vedic periods, who performed rare surgical operations. Several ancient texts such as the Charak Samhita, Sushrutaa Samhita, and Ashtanga Sangraha focus on Ayurveda and contribute to its foundational pillars. Within these, the Sushrutaa Samhita, compiled by Sushruta – often referred to as the ‘Father of Surgery’, provides in-depth knowledge on varied surgical practices, instruments, and procedures.
The Current Controversy Surrounding Ayurvedic Surgery
The central point of current debate is the endorsement of allowing postgraduate students in Ayurveda undergoing ‘Shalya’ (general surgery) and ‘Shalakya’ (dealing with eye, ear, nose, throat, etc.) to perform 58 defined surgical procedures.
Arguments Supporting the Notification
Two key branches of surgery in Ayurveda are Shalya Tantra and Shalakya Tantra. Both subjects are studied by all Ayurveda postgraduate students, with some students further specializing to become Ayurveda surgeons. The Indian Medical Central Council governs postgraduate Ayurvedic education, allowing students to specialize in Shalya Tantra, Shalakya Tantra, and Prasuti evam Stree Roga (Obstetrics and Gynecology). It has been argued that the latest government notification offers a clearer understanding of what skills Ayurveda practitioners possess, which can help inform patient decisions.
Opposition and Criticism Surrounding the Notification
The IMA challenges the new notification, arguing that it implies that Ayurvedic doctors have equivalent skills or training to those practicing modern medicine in performing surgeries. IMA also points out that possessing textbooks from modern medicine or conducting surgeries with the help of modern medicine practitioners does not necessarily validate this claim. The IMA has invited the Central Council of Indian Medicine to demonstrate how each procedure in Ayurvedic literature equates to modern surgical procedures.
Highlighting Gaps in Healthcare Infrastructure
Recent research conducted by Brookings Institute reveals gaps in India’s healthcare infrastructure, including a doctor-patient ratio that lags behind the World Health Organization’s norms. This shortage is further accentuated by the concentration of medical colleges in Southern States and the reluctance of doctors to serve in rural areas despite measures such as compulsory rural internships.
Government Initiatives to Bridge the Gap
In response to these challenges, Government initiatives like AYUSH Health and Wellness Centres (AYUSH HWCs), part of the Ayushman Bharat scheme, have been introduced to address these issues.
A Proposed Way Forward
It is imperative for the government to ensure the safety standards are met while allowing Ayurveda practitioners to perform surgery. One suggested course of action is introducing bridge courses, as mentioned in the National Medical Commission (NMC) Bill 2017. This would serve an integral part of a broader effort to better utilize the capabilities of Ayush practitioners for healthcare delivery. It is also proposed that the government explore creative and evidence-based approaches like task-sharing to fill this healthcare gap. By doing so, India can aim to establish medical pluralism, a reality in numerous countries worldwide. Ultimately, what is needed is a robust health system capable of meeting the targets of the Sustainable Development Goals and addressing public health emergencies.
