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Traditional medicine to graduate

Mostafa Kamal Majumder

The Panos Institute
8 Alfred Place,
London WC1E 7EB
UNITED KINGDOM

The following article, “Traditional Medicine to Graduate” by Mostafa Kamal Majumder is reprinted from PANOSCOPE (July 1989 - No. 13).

PANOSCOPE is produced six times a year by the Panos Institute. This article may be reproduced but with attribution to Panos.

BANGLADESH July 1989

Faced with all the severe health problems of one of the world’s poorest countries and recovering from two years’ devastating floods, Bangladesh this month opens a new graduate college of medicine.

But the graduates won’t be studying Western medicine. With support from the World Health Organization (WHO), they will be learning the techniques of traditional Unani (Muslim) and Ayurvedic (Hindu) healing.

In an attempt to reach the WHO’S target of “Health for all by the year 2000”. Bangladesh has embarked on a programme to reinvigorate Unani and Ayurvedic medicines alongside the present public health delivery system, which is based on Western medicine.

According to the director of the project for the development of indigenous medicines, Colonel (retd) Ishaque Huq, the traditional healers are already playing the key role in primary health care: they live and operate in the villages, where 85% of the Bangladeshi live, but where physicians educated in Western medicine don’t want to go.

The traditional medicines are very effective, Huq says. Many common ailments such as fever, diarrhoea, dysentery, piles, indigestion, common colds, coughs, headaches, cuts and burn injuries, can be tackled at the village level by the use of herbs and without imported technology.

Now Ayurvedic and Unani medicines have been put under the national drug administration, and efforts are underway to impose quality and price control.

So far, 850 drug manufacturing licences for the traditional systems have been issued. But quality control has been difficult - because an individual item of medicine can have as many as 50 ingredients, and different manufacturers follow different formulas according to different books.

A standard national formula for the Unani and Ayurvedic systems is being prepared by an expert committee with WHO assistance and this will make quality control easier. The government has pledged to open a separate directorate under the Ministry of Health and Family Planning, to deal with the traditional systems.

Meanwhile, about 600 traditional healers who have had no formal education or training have been given two-month crash courses to help them be more effective in their work.

The new graduate college will offer a six-year course including a one-year internship in an attached 100-bed hospital; 50 students will be trained in Ayurvedic, and 50 in Unani medicine. The course curriculums have been finalised and 10 specially trained teachers appointed.

The two traditional systems have been popular for centuries throughout Bangladesh - especially in the rural areas where Western medicines were unavailable until recently.

Long neglect and official patronage for Western medicine forced the traditional systems into decline. The systems also suffered two major historical setbacks: the partition of India, and later the separation of Bangladesh from West Pakistan.

After the 1947 partition of India, most of the qualified Ayurvedic physicians left Bangladesh (then called East Pakistan). The kitchen gardens of essential medicinal plants that they had individually maintained were lost with them.

The second setback came during the 1971 war of independence which created Bangladesh. Jogesh Chandra Ghose, the soul behind the country’s biggest Ayurvedic pharmacy - the Sadhana Aushadhalaya - was killed and the owner-managers of the biggest Unani medicines manufacturers, Hamad Dawakhana, left for Pakistan. Before 1971, the Sadhana Aushadhalaya pharmacy had even exported medicine.

Under the new plans, says Ishaque Huq, one old Unani medical college - which produced only secondary-level diplomas - is to be redeveloped, and three more higher secondary level Unani and Ayurvedic colleges are to be established at Chittagong, Khulna and Rajshahi. The government is also supporting 10 other privately run colleges.

At present, there are about 700 Unani and Ayurvedic physicians who have higher secondary level diplomas and 500 others trained by way of short courses. An estimated 30,000 healers are also practising in market-places, on trains, launches, steamers, and buses.

In comparison, about 12,000 Western-style graduate doctors operate through half a dozen specialised medical institutes, eight medical college hospitals, about 60 district hospitals and about 450 health complexes at local levels under the public health care delivery system.

But where will the traditional healers get continued supplies of the precious medicinal plants they need? Some 300 such plants out of about 500 identified so far in the country are now in regular use, says Ahmed Mozharul Huq, the Chief Scientific Officer of the Bangladesh National Herbarium.

According to one estimate, he says, the 56 major Unani and Ayurvedic medicine manufacturers each year use about 408 tonnes of fruit, seeds and tree bark, 336 tonnes of shrubs, and 386 tonnes of herbs. But the large medicine manufacturers do not have plantations of their own, and collect raw materials through agents or markets.

Continued extraction of medicinal plants from jungles without any effort at planned cultivation and conservation has made about 25 species of plants so scarce that their collection from forests is no longer viable commercially, says a pharmacist at the local Ayurvedic pharmacy. Hence large-scale producers have started importing such plants.

Mostafa Kamal Majumder is a Bangladeshi journalist specialising in development issues.