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Indigenous Medical Systems and Ayurveda: Response and Resistance from Civil Society

Madhulika Banerjee

This is an academic study of Civil Society intervention and I am not a part of any civil society organisation. In this presentation, I am trying to understand the issues that are being raised about Ayurveda in particular and to some extent traditional and indigenous medicine systems in general.

I want to begin by saying two things. One, we need to start with the understanding that Policy is a reflection of power relations in society. Policy is not about what is the most appropriate. Policy is not about what is technically the best thing in a situation. It will claim to be any or all of these things. But fundamentally, at its heart it is a reflection of the current power structure and power relations in society. And that’s why policy is deeply political.

Many of us are trying to say the same thing from their own vantage points. And I think as an academic, I just felt that it is my responsibility to bring it up and then point out what is the driving force behind what we are trying to understand here.

Two, we are talking about civil society. There is a lot of debate within our discipline on what we understand by civil society. So I have picked up a very simple definition – civil society is a social community, which is capable of organising itself independently of the specific direction of state power. The State may consider that the policy they want must move in a particular direction. It is the civil society which is outside of the political society which actually has the capacity to generate different kinds of ideas and organisations which takes it away in directions different from that of State. That’s why it is so powerful. It is important to understand that it has the capacity to influence the State.

And here, in terms of trying to understand what it does with respect to Ayurveda, I am including one component which is not what a lot of people are discussing. In understanding civil society, it is very important to include the market. Specifically in the case of Ayurveda and I suspect in other areas like power which Sreekumar was talking about, where there are so many other players. They are very powerful players. They create good products, as well as a frame that decides the direction that policy can be influenced in. And that is why it is very important to understand what it is exactly that they are doing.

The two components that I will be looking at, are the market for Ayurveda, and second the groups and movements that have mobilised people to take initiatives on health care and their relationship with Ayurveda or Indigenous systems of medicine in general.

The Market
First, I talk about the market. It does two things - It creates specific kinds of products, and consumers to suit them. The market actually constructs the drugs and cosmetics market in such a way that it uses the whole idea of traditional products, but only creates it in those forms that can “sell”. So I have studied extensively the pricing, the advertising, and so on and shown in my larger work which has been published elsewhere, that this is exactly what the market is doing

Second, it targets one segment of the consumer market that would find product attractive which means that the product selects some customers. It creates a niche market, which obviously has a certain class character, which would create a certain position in the social hierarchy, and so on. In effect this automatically leaves out others. Both the product and the marketing complement each other to do this.

It is important to understand the character of the products, simply because these are positioned by the market to be the face of Ayurveda. They have appropriated Ayurveda to make these products and have used this to influence policy. They are able to influence policy not so much to promote Ayurveda, but to bend regulations and rules, as well as generate support for these four categories of products.

For one, it seeks to focus favourable policy towards these four kinds of products while it leaves out a whole range of other things. And this is most clearly demonstrated in the 2002 policy on traditional medicines. This policy focuses a great deal on these things. And it is from there that the whole focus of the current government or rather the last two governments has been on supporting medico-tourism, of hotels, and spas. This is a very powerful trend for the market, and that is what is influencing policy most of all.

Civil Society
Then we look at the second part namely civil society. The purpose of the groups that have been working on this issue is very clearly political. While politics and politicians are constantly being put down, a political scientist, I want to say is the driving force. It is one of the most creative forces, and I use the word politics and political purpose in its best creative sense.

Basically what civil society organisations have done is to organise and mobilise communities, to work towards health care. In this process, they have taken up some kinds of positions on Ayurveda, tried to understand the politics and looked at Ayurveda in terms of a public health care system which the market couldn’t be bothered with.

And what it does is bring Ayurveda back into the public health discourse. I see that there are four kinds of movements and groups now that influence Ayurveda in particular and Indian systems of medical systems, in different forms, and in recovering a great deal of local health traditions and so on. The positions of which are highly contested and debated.

And I have discussed in some detail the four kinds of groups that influence Ayurveda in particular and Indian systems of medicine in different forms, like promoting, conserving, documenting, and so on.

The third group is actually trying to do what the market is trying to do namely making and manufacturing medicines, but making them cheaply available. The Ayurvedic medicines in the mainstream market are extremely expensive and therefore are completely outside the range of a large number of people. It is a different matter that the consumer market is large enough for the market to run itself. But as a system it leaves out many people. This is where these groups come in. They have developed and recovered the skill and capacity to make those medicines. It is an attempt to recover the knowledge and production so as to re-position Ayurveda, by placing these in the hands of those who understand the use of these medical systems in a different way – namely not simply a beauty care products, but as an effective, low cost, and decentralised health care system. Thus it is very much a political act, as I understand it.

And the fourth category or group is a very powerful voice of dissent, which actually, challenges state policy. It is a very unusual argument. It challenges the market logic of the policy intervention as well as the attempt to understand Ayurveda along the lines of Science and seeks to legitimise indigenous medical knowledge in its own terms. It first offers critiques of science itself. It then offers alternatives, for adaptation and sustenance. This is a very valuable contribution that the civil society is making, towards relocating the terms of knowledge and using indigenous medicine systems “for, by and of” the people as it were. And I am aware that I am using very blanket and large terms, and would be happy to qualify it when there is time later.

And what can we conclude from looking at civil society, and what it is doing. It is important that civil society is open to critical appraisal themselves, on whether what they are doing is okay or not. While it is different from the market, it is great because it focuses on recovering power for ordinary people, and that purpose is very important and should not be lost. Besides there are many other issues, which come up, and need to be resolved as we go along.

They need to be understood, as sources of creativity. And what dominant science, dominant Indian Science can learn from them and needs to learn from them.

This is something that those who are within the civil society, those who understand and engage with the State, are able to influence policy to do these things. They need to recognise and improve things. The reason is that they recover for these people, they restore the accessibility of these systems and they are helping realise the goal of public health care which actually the government interventions on health care are unable to do.

If you evaluate the impact of this part of civil society, it is actually very limited. But the point is that it has very deep political potential. And as Rukmini said that this kind of larger mobilisation is important, and that’s why I am excited about the KICS forum, because I think that many of us are speaking reflecting each other’s positions on this. Even though we are working in different sectors there is a common political understanding that we all share. We need to explore alternatives and tie up with each other, and that is what is possibly going to make a long term impact on policy because this is politics from the ground. And if we go from what I started with, that policy is a reflection of power structures, and politics on the ground. Then if we are able to influence and alter, politics and power structures on the ground, then we will be able to impact powerfully, policy making.

The studies refered to in this presentation, is contained in the book: "Power, Knowledge, and Medicine: Ayurveda at Home and in the World" by Madhulika Banerjee Orient Longman Hyderabad

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