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Pala town in Kottayam district of Kerala is about 25 km from the district headquarters. St Thomas College in Pala is currently hosting a three-day workshop on knowledge systems, and gathered together are philosophers, sociologists, medical practitioners in homeopathy and Ayurveda, one of them from Nepal, and a few guests from Europe. The discussions on the first day focused on knowledge systems, power structures, and epistemic diversity. French researcher Jacquiline Descarpentries, who represents a unique cooperative of researchers, some of whom have no formal institutional affiliation, laid the ground, addressing the audience over the Internet.
It is significant that the cooperative of researchers in France, LUCI, was formed in 2020, the year of the Covid-19 pandemic. Many speakers pointed to the “monoculture” in health represented by biomedicine, and the enormous diversity of local health knowledge represented by different traditional systems of medicine and even folk healers, who follow no codified system. Descarpentries spoke about medical systems of the global South that work with populations, not on them. She noted the need to promote the vast and diverse understanding of the world, beyond Western medicine.
Sociologist V Sujatha from Jawaharlal Nehru University put forward a few questions, flagging issues of concern: how to decolonize knowledge; how to promote structural pluralism in medical knowledge systems; what are the core characteristics of Ayurveda and Sidda; and how can one envisage the process of transformation of these systems as they interact with other systems.
She noted that under Ayurveda, the patient is himself or herself already a knower, someone whose sense of disease is the first step towards treatment. India has several systems of medicine operating simultaneously, and to consider that “modern western medicine” was necessarily the more scientific was perhaps erroneous, given the lived experience of the efficacy of other systems.
However, she questioned whether the traditional systems were still being practiced in a sustainable manner, given the mass production of pharmaceutical remedies drawn from rare natural sources, and the growing trend of pharmaceutical dependence even in traditional healing systems.
One important point of difference between the Western system of medicine and Indian traditional systems, the JNU professor pointed out, was that the Western system studied the cadaver to understand life and health, while there was no place for vivisection in the Indian systems – she pointed also to health being something of an enigma, little understood and defined as an absence of disease, while pathology seems the dominant pathway to understanding health in the Western system.
She pointed to how the experience of the patient was the basic necessity for the definition of the disease in Indian systems, but left hanging the question about asymptomatic disease – that big bogey that caused so much disruption during the Covid-19 pandemic.
She also raised the important question of who pays for failed treatment. She mentioned one person whom she interviewed as part of her research, who functioned as a traditional healer and would sometimes receive payment in drumsticks.
In modern medicine, however, the patient and his or her kin are forced to pay not just for the medicines but also for the long years of training that doctors spend to gain expertise – even when treatment is unsuccessful, payment is expected; when treatment is wrong and medical mistakes cause death, even then, the patient’s kin often cannot escape payment.
Vaidya M Prasad, of the Thrissur clinic Sunetri, explained the basic tenets of Ayurveda – he spoke of how the original texts in Ayurveda are all in Sanskrit, and how the colleges of Ayurveda in India do not focus on the original texts and end up teaching “about Ayurveda” rather than Ayurveda itself. He spoke of his own training, in a gurukula system, for 21 long years, and a spell of working with Dr K Rajagopalan, who was trained not only in Ayurveda but also in modern medicine.
In modern medicine the patient is forced to pay not just for the medicines but also for long years of training that doctors spend to gain expertise
Vaidya Prasad had served as a teacher in an Ayurveda college and also as a principal of one, and came with a range of experience. He spoke of how those trained in Ayurveda in Kerala are not allowed to practice Allopathy in Kerala – this is possible in other states. There is a shrinking population of Ayurveda students these days, as there is a perception that this system is not “scientific”.
Vaidya Prasad spoke of the Ayurvedic precept of the continuum between man and the cosmos, and of how traditional texts often describe what happens in the human body through analogies with volcanoes, tornadoes or mountains; he spoke of shrinking self-knowledge among people he meets as patients. “I have asked people whether they feel hunger, and am told that they don’t know – people eat meals at different times, but are not self-aware about whether they are hungry.”
In Ayurveda, Vaidya Prasad explained, there are three set pathways for disease progression. These could get entangled and become complicated, but when one is aware of the three pathways, one is also knowledgeable about how to intervene and manipulate the situation.
Portuguese sociologist Boaventura de Souza Santos addressed the gathering over the Internet, congratulating Indian traditional practitioners for their perseverance in holding on to their traditional knowledge at a time when “epistemicide” was rife – when knowledge systems were being rapidly eliminated by the sweep of Western science. He warned of the tendency of the state to homogenize and make uniform, fostering monoculture.
He stressed that there are many ways to do science, and cited sociologist Shiv Viswanathan’s work showing that there is an Indian science. He reminded his audience that only 0.01% of all life on the planet is human, and diversity, not a monoculture that imagines time as irreversible and so tends to think in terms of linear development as progress, might be closer to representing reality. He warned against seeing the global as necessarily superior to the local.
Homeopath Dr Praveen T Dharmaratnam had a revealing presentation on The Kerala Public Health Act, 2023, that threatens practitioners of traditional systems by allowing powers of coercion to authorities in times of public health emergency. This is a subject that requires closer scrutiny in the national media, and a more detailed account of this presentation will be available on this website in a few days. What is significant is that this Act was passed in the state assembly in 18 seconds, with no discussion at all.
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*Freelance journalist
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