Economic revival, Ayurveda and indigenous medicine

Ayurveda offers time-tested medicine which can even till this date provide answers to diseases prevailing in the modern-day society

In the recent times, due to the unprecedented pandemic of COVID-19, there was a shift in attention towards Ayurveda and any possible Ayurvedic interventions to be utilised to prevent the disease and to help with symptoms of the disease. In light of the rapidly spreading infection, people bought, collected and commenced using well known home remedies for cold and flu like illnesses; some of these such remedies include coriander, ginger and venivelgeta. 

Although there are many Ayurvedic pharmacological properties of these herbs, their popularity among the general public lies with the strengthening of the immune system. In such situations, it is intriguing to see the multitude of Ayurvedic practices that are embedded in the society and culture of the people in Sri Lanka. A British governor described in his book an observation, “All the people of this country are physicians”. This goes to show how well versant people of Ceylon at the time were in the use of Ayurvedic medicines for their common ailments and more interestingly gives us a scope of the level of past glory of Ayurveda in Sri Lanka. 

In recent times, much discussions were had regarding the use of Ayurvedic medicines both in mass media as well as social media. Ayurvedic and Western doctors together paid more attention to such use and were discussed in public forums. Ayurveda, Indigenous Medicine, Traditional Medicines and Hela Vedakama are some of the terms which drew attention recently. 

There is a tremendous value of Sri Lankan traditional system of medicine which is an integrated practice of Ayurvedic system of medicine and the indigenous system of medicine which existed before the introduction of Ayurveda. The cultural, medical and economical value is not explored nor is it utilised to its full potential. The country is sitting on a gold mine without realising the value of this ancient knowledge.

Prior to the introduction of the Western system of medicine during the colonial period, there existed only one system of medicine, Sri Lankan Ayurvedic system of medicine. This entailed that this system was used by those in royal palaces to the common folk of the country and was given the highest pollical and governmental recognition. With the introduction of the new system of medicine during the colonial period, the Ayurvedic system of medicine was given less recognition and therefore was not supported in the furtherment of Ayurveda. 

Although there was a revival of Ayurveda post-independence period, sadly there still remains strong obstacles and discrepancies in the importance given to the development and recognition given to Ayurveda as compared to the Western system of medicine. A recent media discussion reported that only 1% of the national health budget is allocated to the services of Ayurveda. How can we expect to exploit the full potential or further develop the system with such small amount of funds allocated?

One of the common comments made by those who try to obstruct the better use of Ayurveda in the national health system is that “it lacks in scientific evidence”. 

First, that is their ignorance of the scientific evidence available in the body of knowledge. The epistemology acknowledges that there are at least four types of different sources of knowledge; intuitive, authoritative, logical, and empirical knowledge. These sources of knowledge are used in any subject or science in different levels and there is no exception to the system of Ayurveda. The empirical knowledge is based on demonstrable, objective facts (which are determined through observation and/or experimentation). The knowledge of Ayurveda was originated and developed as a system of medicine based on such empirical knowledge with a strong, high standard methods of experimentations within the paradigm of the oriental systems. 

Secondly, their argument may be that Ayurveda has not been subjected to western or modern systems of experimentation. Although this subject must be dealt in detail at a different forum, the vigorous research can be read in the international journals and moving forward to develop a more evidence based medical practice despite that lack of resources for such research. For example, in the United States of America there is a separate subdivision to provide grants for research projects of Complementary, Alternative and Integrative Medicine, along with a separate grant scheme for Ayurveda within this allocation. 

We must question if we have such research grant allocation for the Ayurvedic scientists and practitioners in Sri Lanka who would like to undertake such research projects. Although the personal resources, knowledge and skills required to perform modern research studies both in applied sciences and clinical research are available among the Ayurveda community in Sri Lanka, they lack facilities and support to carry out such projects. On the other hand there are many western doctors, scientists from all fields such as chemistry, zoology, botany, agriculture, anthropologists, economists and even the general public who would like to collaborate, participate and contribute to the development and research projects of Ayurvedic system of medicine. 

There are entrepreneurs who have invested or willing to invest in Ayurvedic hospitals and health centres or in manufacturing. They too are lacking support from the government to provide a more efficient and coordinated system for their endeavours. Again we must question if there exists a coordinated system produced by the authorities to use such interested parties and stakeholders to develop multidisciplinary projects that can give tremendous benefits to the country, to its people and moreover can lead to economical gains to the country by bringing in foreign trade and currency. 

What is Ayurveda?

Ayurveda is known as ‘the science of life’ as its scope is beyond a mere medical system. Ayurveda teaches the way of life. Though the origin of Ayurveda could be millions of years in the making however it is difficult to accurately find the true origin. The evidence and written history of human use of Ayurveda dates back 5,000 years. 

Therefore, Ayurveda offers time-tested medicine which can even till this date provide answers to diseases prevailing in the modern-day society. Prior to the introduction of Ayurveda, Sri Lanka had its own Indigenous system of medicine. Due to the close proximity and relationship between India, Ayurveda was integrated and absorbed into the Indigenous system of medicine in Sri Lanka. The ancient eminent medical physicians practised, researched, and invented medicines as well as treatment methods that are effective till date. 

Those practised evolved into a special system of medicine now known as the Sri Lankan Traditional System, or Indigenous Medicine or ‘parampara vedakama’. People of the country are aware of such traditions which are known to have highly effective treatments for ailments such as fractures, animal bites, mental illnesses, paralysis and many more. The school of teaching and training of such practitioners is known as guru-kula system, where the knowledge is passed down over lengthy periods (15 to 20 years) to their sons, daughters or grand children or any other carefully selected students starting from childhood till practising as an apprentice until the diagnostics and treatments are mastered. Unfortunately, this system is slowly vanishing today due to multitude of reasons which warrants further investigation. Yet again, we must question if there exists a coordinated system to protect, preserve and develop this area of Ayurvedic medicine practised in Sri Lanka which could give the country a unique identity. 

According to the Ayurveda Act No. 31 of 1961, Ayurveda includes four areas i.e. Ayurveda, Indigenous Medicine, Siddha and Unanai. Therefore, when we speak about Ayurveda or Hela Vedakama (a word which has drawn attraction recently) all these four areas of medical practice are included. The World Health Organisation (WHO) at its convention held in Geneva during 28 November to 2 December 1977 passed a resolution to support the need for a radical promotion and development of traditional medicine as one of the surest ways to achieve total health care coverage of the world population. 

Emphasis is placed on the need for traditional medicine to be evaluated, given due recognition, and developed to improve its efficacy, safety, availability as well as wider application at low cost. A technical report (No. 622) was produced in 1978, at which time Ayurveda and Chinese Traditional systems of medicines were given more importance as they are two complete systems of medicine that are regulated and widely practiced in their countries of origin. 

A Traditional Medicine Programme was established within the World Health Organisation in 1982 and its function has been extended further. The WHO has developed many technical reports, guidelines, benchmarks and standard operating procedures for Ayurveda Education, Ayurveda Practice, Manufacturing of Ayurvedic Medicines, Cultivation – Collection and Processing of Medicinal Plants, etc. Currently, the WHO Traditional Medicine Strategy 2014-2023 is in operation and the partner countries are requested to implement the strategies. Once again, we must question if there exists a coordinated system by the authorities to implement the strategies of WHO effectively. 

Immune boosting and prevention of viral infections

There are many Ayurvedic herbs and compound medicines which have the potential to boost immunity in order to prevent and aid in recovery from viral illnesses. Simple herbs are available to be used as home remedies as well as over the counter medicines or those more complex treatments to be prescribed by an Ayurveda physician and used under their supervision. Considerable amount of time-tested clinical experiential or heuristic evidence from the practice of Ayurveda Physicians based on the authoritative teachings is the strongest evidence of such use of Ayurvedic medicines. 

This is the simple reason why many Ayurveda doctors claimed that they can help to fight the war against COVID-19. The active contribution from the Provincial Ayurveda Commissioners, Community Medical Officers of Ayurveda, the Ayurveda Doctors at Central Dispensaries of Ayurveda in the provinces and their staff were seen on social media. They contributed as such because of the strong evidence- based knowledge they have gained from their university course and their clinical practice. 

Moreover, there is a considerable amount of preclinical, in-vitro, in- silico, case studies, and some double-blind clinical studies to support the use of such medicines with scientific evidence that have been published in international peer reviewed journals. Therefore, there are many strong contenders of Ayurvedic Medicines that must be subjected to clinical studies in Sri Lanka to validate and improvement in use of such medicines to tackle viral attacks not only in present day but also in future if new diseases appear. 

China, India and many other countries have commenced such clinical trials. Unfortunately, we are yet to see that happen in Sri Lanka despite a multitude of strong requests and commitments shown from the Ayurveda community. I too produced a Concept paper that was sent to the higher officials for consideration and offered volunteer service to develop projects based on that concept plans. But sadly, I have not even received an acknowledgement of receiving the concept proposal except for the Commissioner of Ayurveda. 

It is disappointing to see that even with such strong willingness and commitment to work shown by those in the healthcare sector, Ayurvedic or otherwise, to work towards a better health care system as a whole. Suggestions for improvements and advances fall on deaf ears and those enthusiastic individuals are lost in the system without hope.

According to a recent report published by Kenneth Research, the global immune health supplements market will reach $ 28 billion by 2027. The ongoing COVID-19 crisis has brought focus back to improving daily immune health like never before. During this time, there’s been significant increase in demand for several immune-strengthening supplements, ranging from vitamins to botanicals.

Sri Lanka has a potential of digging into this market of immune health if we develop evidence-based, value-added products following good GMP. Cultivation is another area which needs to be developed. Even if we cannot produce medicines according to the international GMP and quality standards due lack of such manufacturing facilities, selling raw material could bring in millions of dollars to the country. Immune boosting herbs is just one example but there are many other medicines and raw materials that we could export given that they are grown commercially, and product development is done correctly. 

If we tap into the gold mine of knowledge that Ayurveda offers, we can expect a significant contribution for the post COVID-19 economic revival, as well as having developed the basic infrastructure that can better the Sri Lankan health system.

Ayurvedic health tourism and wellness tourism

The Global Wellness Institute defines wellness tourism as journeys ‘made by tourists who seek to improve or maintain their well-being during or as a result of their trip’.

An estimated 17 million travellers identify themselves as being ‘health and wellbeing’ focused, with 40% of them travelling regularly – Global Wellness Tourism Economy Report (GWTER)

As far as we know the first Ayurveda Health Centre was established in a tourist hotel in 1982. Since then the Ayurvedic services provided in hospitality sector has increased to a level where at least 30% of hotels have an Ayurveda Health Centre where an Ayurveda doctor is available. There are over 5000 hotel rooms providing Ayurveda health services as well as many exclusive Ayurveda hotels. The stay of such tourists are long stays with an average of fourteen days to thirty days. Having been involved in this industry as a Consultant and as an Entrepreneur of manufacturing Ayurvedic Medicines and training of doctors and the therapists, it was evident that there are more than a few opportunities to attract such tourists.

Researchers from RMIT University in Australia found that a one-week retreat that includes educational, therapeutic and leisure activities along with an organic, mostly plant-based diet resulted in substantial improvements in all aspects from weight, blood pressure and psychological health. The benefits, which they measured through a series of questionnaires and medical screenings, including urine samples and blood pressure readings from 37 participants, were still evident six weeks later.

“Retreat experiences provide a unique opportunity for people to escape from unhealthy routines and engage in healthy practices and activities that lead to immediate and sustained health benefits,” the report said.

Ayurveda offers beyond the benefits that of a normal retreat. An Ayurveda client receives total body, mind, and spiritual treatments to enhance their positive health. Many Health tourists visit both India and Sri Lanka to receive incredibly special and unique course of treatments known as Pancakarma. These treatments are known to cleanse, detoxify and rejuvenate the body, mind, and consciousness. Therefore, it is known as bio-purification which acts at micro-circulation and cellular levels. Thus, helps to remove the toxins, promote the circulation of nutrients and their metabolism, produce biochemicals, neurohumors and immune substances which therefore means an enhancement in the immunity, rejuvenation, and vitalisation of the body. 

Over the last years these facilities offered Health promotion or wellness. Now, Sri Lanka should be considering health tourism, that is to offer treatments for selected number of diseases that has promising Ayurveda treatments. Dubai Healthcare City is an example of such a place established with many hospitals operating in one city and that attracts many patients not only from the surrounding Arabic countries but also patients from European countries.

If we were to establish such Ayurvedic hospitals, treatments given to patients must be of high quality and standards equipped with modern medical equipment and facilities. This could be a potential area that Sri Lanka should investigate as a contributor to the revival of economy of the country. 

In an authentic textbook of Ayurveda (Caraka Samhita) which has its original history of 5000 years and later edited by a well-known physician Caraka who lived 3500 years ago includes a chapter on Epidemics. This chapter is named as Janapadodvamsa, which means destruction of states or the countries due to fast spreading diseases, thus, Epidemics or Pandemics. The causes, methods of spread of contagious diseases, prevention and treatment are taught in detail in the authentic Ayurvedic texts. 

Caraka Samhita reveals the guidelines for the treatment of prevention of such epidemics described in three sections: Pancakarma, rasayana and sadvrtta. Here, we see the importance of receiving pancakarma treatments once a year to boost immunity. Rasayana is another speciality medicine in Ayurveda where treatment modalities including pancakarama is used and rasayana medicines are administered to correct aging, prevent premature aging and to prevent old age-related diseases. Herbs and medicines that have anti-aging, antioxidant and immune boosting mechanism are used in treatments. One such example that can be used by any one regularly is known as Triphala Rasayana. Sadvrtta are the health and hygiene practices including diet, lifestyle, behavioural, emotional wellbeing, and spirituality. 

In conclusion there are many areas of Ayurveda to be implemented and a select few are discussed above as examples which could contribute not only to the economic revival of the country but also to improve the national healthcare system from households to specialised hospitals and promote spread of knowledge of disease and its prevention than the disease itself. In order for this to be executed successfully, such Ayurvedic projects must be well planned, managed appropriately and approached with the enthusiasm of those 5,000 years ago yet with modern technology.

(The writer is an Ayurveda Consultant Physician, Academic and Research Consultant. He can be reached via [email protected].)