A distortion of ayurveda

A mushrooming of clinics and spas offering dubious ayurvedic therapies for everything from diabetes to swine flu has prompted the health ministry to propose new regulations. But what’s really needed is to strengthen education in ayurveda to produce high quality practitioners of this ancient system of health, experts tell DNA.

- A severely diabetic 60-year-old man sought the sure cure being offered at a so-called ayurvedic resort off Kochi. Within days of being administered a strong detoxifying panchakarma therapy, he had to be rushed to critical care. It turned out the holistic experts had ignored the fact that his kidneys were in bad shape. The patient did not live to tell his story.

- At a five star spa in Goa, the litres of herbal oil generously poured over customers and drained off the massage bench would be collected and bottled. At Rs5,000+taxes, you were  being ‘treated’ with recycled oil.

- A group of 15 Germans landed up at a ‘holistic ayurveda resort’ in Kannur for a rejuvenation programme. A woman in the group cut short her stay and returned home severely traumatised. She had almost been sexually assaulted during what is euphemistically called ‘mixed massage’ by a male masseur.
 
Given the buzz around alternative health systems and the boom in medical tourism, ayurvedic spas/ holistic healing resorts/ herbal clinics/ panchakarma centres are mushrooming all over the country. It seems to matter little if those offering these services have a five-year degree, a six-month diploma or a three-week certificate course in ayurveda as their credentials.

The situation worries the department of ayurveda, yoga & naturopathy, unani, siddha and homoeopathy (AYUSH) in the health ministry. It now wants to standardise ayurvedic practices not just across the country but in 45 countries across the world to sort out the fake from the real.

AYUSH has summoned a meeting of health officials from across the country on August 31 in Delhi. They will discuss guidelines for the operation of ayurvedic clinics.

“Currently only ayurvedic practitioners need to be licensed, not the clinics. But we want to standardise ayurveda/panchakarma clinics too in terms of infrastructure, equipment, procedures, manpower and so on, so that they function as per the requirements of the science,” says Dr SK Sharma, advisor, ayurveda, at AYUSH.

Quick fix
AYUSH is particularly concerned about the half-baked and often risky use of the panchakarma therapy. If administered correctly, this age-old therapy holds the promise of a rejuvenated body. It is prescribed for use across a range of disorders from chronic fatigue to diabetes, but has to be customised to individual need and strength. But, more often than not, what you get is nowhere close to the classical panchakarma, which requires rigorous preparation and follow-up.

“To do a full panchakarma is a major health decision that requires the diagnosis and care of a qualified ayurvedic doctor. Much of what is called panchakarma today, particularly in hotels, is more a spa treatment of oil massage and sweating therapies, not the full therapy which involves stronger detox measures. Stronger methods require some strength in the patient and may not be suitable for those who are weak,” says Dr David Frawley, a US-based scholar of ayurveda. (See interview below)

A standard panchakarma involves five steps — vamana (therapeutic vomitting), virechana (purgation), vasti (enema), nasya (nasal medication) and raktamoksha (bloodletting). Not all these steps are mandatory and can be administered only as per the capacity and need of the patient. It is also contraindicated in many situations. (See box on do’s and don’ts.)

Sadly, few practitioners advocate this 5,000-year-old system for what it is — a way of life that promotes physical health, emotional balance and spiritual wellbeing. Unlike western medicine, it is not aimed only at curing disease, relieving pain or putting off death. It looks at the individual and not the disease. The study of disease itself is not just reduced to treatment of the liver, kidney, heart or brain in isolation but seen as a composite exercise in analysing a whole lifestyle. But since it has to now compete with modern medicine, it is forced to fit into a new format, shorn of its traditional underpinnings.

Oversimplified
“When ayurveda was at its peak it was used as a way of staying healthy, not just treating disorders. Perfectly healthy and affluent people would often take time off for what was called sukhachikilsa to maintain and boost their state of well-being,” says veteran Delhi ayurvedic practitioner Dr Sudha Ashokan.

Like many believers in the worth of this system, she watches the decline in standards around her with growing alarm. To the chagrin of those who are qualified to practice traditional ayurveda, anyone who can offer a halfway decent massage and corner some capital now sets up a clinic.

“You are looking at a system that was devised thousands of years ago and codified in Sanskrit. There are no standard therapies for diseases. Each manifestation has to be studied in detail. Which humour (dosha) is aggravated? How much? And then arrive at a diagnosis and start treatment. Which herb? In what quantity? It takes five years of studying ayurveda and a good understanding of allopathic procedures to become a good practitioner. How can you grasp all this with a six-month diploma?” asks Dr Ashokan.

Indu Ravindranath, a London-based doctor, is equally concerned by the proliferation of ayurvedic clinics backed by very little expertise, knowledge or training. For anyone with a solid background in ayureda, she says, it is mortifying to be associated with these so-called ‘healers’.

Dr Danny Devasi of Kairali Spa says this is precisely why the AYUSH move is welcome. “It will accredit the genuine clinics and weed out the fakes. Otherwise we all get lumped together as charlatans. The only practitioners who will have a problem with the guidelines are those out to make a quick buck,” he says.

Chinese medicine today is an accepted and licensed health care system in the West. This is because there are regulations in place on its education and practice. Maybe it is time we took a few tips from our neighbours on how to rejuvenate an ancient medical system.

Do’s & don’ts
- Choose a doctor who is well qualified and trained in ayurveda.
- Do not fall for promises of overnight cures.
- Ideally your doctor should follow ayurvedic practices in his own life.
- Don’t confuse an ayurvedic spa for a clinic. You need to head to the latter for serious therapy.
- Many therapies for small disorders — light massages, oral medication — can be done at home.