Drug Pusher or Healer – What are you?...

Few years, after the inspiring  Alma Ata Declaration that proposed the goal  of Health for All by 2000AD, the Indian  Council of Social  Sciences Research and  the Indian Council of Medical Research  set up a  joint study group to review  the health care  systems  in the country and recommend a strategy  to achieve  the Health for All goal. One of the most  intriguing and provocative  observation in this report, which has kept me  wondering all these years was  a call  to vigilance against  the over medicalization of the system since Health  is ‘well being’ and not just ‘disease control’. The committee consisting  of some of the senior most   medical and social science  professionals  in the country observed that “ Eternal  vigilance  is required to  ensure  that the health care  system  does not  get medicalized, that  the doctor drug producer  axis  does not  exploit  the people and the abundance of drugs  does not become a vested  interest  in ill health” As a young  faculty  member of a well known  medical college, I found this call to ‘vigilance’ against  making ill health and drug prescribing  a vested  interest  – a  rude shock considering that doctors often thought of themselves as a noble profession concerned only about the wellbeing of their patients. This  stimulated  a life-long  learning effort  at understanding  the doctor – drug – producer  axis  in reality, identified  by the report  as the major villain and the prescribing  practices  of the doctors  as the key culprit. Two more  observations  of this expert  group based  on extensive  review of current  data and trends  were equally  disconcerting. These were : “One of the most distressing aspects of the present health situation in India is the habit of doctors to over prescribe  glamorous and costly drugs with limited...

EVOLUTION

The retrospect-o-scope is one of the finest instruments of knowledge. We understand that each developing civilization evolved its own perspective on Health and Disease. The cross-currents across these human settlements being few and far between, healing expressed itself as localized approaches isolated in their repertories that addressed local problems tackled with local resources. The simplest were “remedies” drawn from the knowledge of the shepherd and the largely unrecognized “home” bank, the chief possessor, implementer and propagator of such treasure being the woman, usually the mother. The grandmother is the wiser version of this trove, with the needed checks, balances, validation and such stuff. It is even so till date.“Therapies” derived from them were prolonged and involved, requiring more experience and understanding of the human organism and responses to disease and interventions employed. The ingredients for such interventions were mainly plant and animal (also mineral, where the other two were scarce, or this resource in abundance) with different modes of processing and differing effects being taken into account. The same stuff was given raw, crushed, dried, roasted, boiled, fried, pickled and so on – good research indeed. The philosophers and religious enter the picture now and adopt (is it co-opt?) these “peoples’ practices” into their world view. The intellectual domination begins, with a framework laid down to explain the how, why, which of what’s observed and the grounds for further development – the cons and pros (so to say) of the evolutionary path taken. The rituals, taboos, dos and don’ts get incorporated and have their say in the matter. The simple, subjective understanding of “hot” and “cold” is characteristic of explanations involving home, herbal and tribal remedies. What happens when you (manage to) consume six eggs in one meal – that’s hot (specific dynamic action...