Where do you go for treatment when you are ill? The choice is immense: international or local, Western or Eastern, contemporary or traditional... There are many options and although healing your illness is the goal of each, the diagnosis, therapy, medications and dosages differ, as do the results and even the history of each system. Ultimately, however, the choice for healing in Nepal comes down to two types, by using modern or allopathic medicine or with more traditional, alternative or complementary medicine.
The term complementary medicine and alternative medicine are used interchangeably, worldwide; and ‘medicine’, itself, may mean modern or traditional. Traditional medicine is usually defined as that which is based on what is practiced within the country of origin. Among the complementary ways of practicing medicine, however, some are considered in medical circles to be equivalent to the modern or allopathic medicine that is taught at universities.
The Open International University for Contemporary Medicines was founded in 1962 following the World Health Organization’s Alma Ata Declaration. It was accorded international recognition and charged with making alternative medical systems popular. The university was founded to help bring about a better understanding of human health by increasing public awareness and the popularity of alternative medicines. It was hoped that achieving this goal would be well underway by the year 2000, giving people a new holistic approach in life.In fact, dissatisfaction with the Western medical system was already being expressed by many people and as the popularity of alternative approaches grew, patients sought out practitioners who care about the health of the whole person and not merely interested in prescribing medications to treat their obvious symptoms. By establishing international teaching facilities, medical students could learn the variety of theories, ideologies and schools of thought on alternative medicines, from all over the world, thus broadening our approach to health. Through the Open University for Contemporary Medicine, students in various locations have the opportunity to become well-rounded practitioners in a variety of alternative medicines, while adopting a humanized approach to people’s ailments.
Since 1966, more than 50 students from Nepal have completed their Masters and Doctorate degrees in contemporary medicine from the international university’s campus in Sri Lanka, the Medicinia Alternative Institute. And, as contemporary therapy has become more popular in Nepal and elsewhere around the globe, over 50 percent of chronically ill patients who have used it say it give better results and more relief compared to modern medicines, due in part to negligible side effect and better overall response.
The spread of traditional medicine
When local people become ill in Nepal they initially resort to faith healers. They also make special requests (for healing) to temple deities. Some believe that by fasting on special days or time, or avoiding certain foods, reading rice positions, calling on the gods, or donating food, cloth or money, they can be healed. Sometimes strong faith works wonders but, ultimately, the sick (or family members responsible for them) may turn to other more established systems of medicine, where they are available in rural or urban areas.
Currently, one third of the world’s population overall and half of the population of the poor countries are dependent on traditional, alternative or complementary (local) medicine. Some of those systems are well recognized. In Nepal, for example, besides modernn allopathic medicine, systems of Ayurvedic, Naturopathic, Homeopathic, Acupuncture and Unani healing are nationally recognized and authorized.
The knowledge and practice of such alternative medical systems are traditionally passed practically and orally from generation to generation, though some are backed up by well-established and ancient schools of learning. Sometimes the practitioners are highly specialized, focusing on specific diseases. They tend to function well in more rural areas, where allopathic assistance is negligible, but are also popular among urban populations. Interestingly, many alternative medicine practitioners do well in treating and caring for some diseases where other medical practitioners have to think twice about how to proceed.
Recognizing the value of alternative medicines, in 2000 the Nepal Complementing Medicine Practitioner Association was established. This organization’s aim is to give support and share knowledge among local and international practitioners and physicians in similar fields, and to interact with local and international NGOs to increase popularity and broaden practitioner networks. The alternative approaches are very popular in Nepal, due largely to tradition and to the relative lack of modern alternatives in many parts of the country. Studies have shown that the recovery rate is good to better than average in most cases, and that in some instances, in treating some specific ailments, local systems are less successful compared with results using modern alternative medicine.
In Nepal’s larger towns and cities, patients have several choices available to them when seeking treatment for illness. It has been found, for example, that in these settings though people know about complementary/alternative or local medicine, their first choice is modern allopathic medicine, followed secondly by ayurvedic medicine. At first, the average person will consult a neighborhood medical shop or pharmacy (allopathic or ayurvedic). If that fails, or if they are unsatisfied or are considered emergency cases, they will seek out a more costly modern (Western) medical clinic or private practitioner for help. Some, however, will opt instead for complementary/alternative or traditional medicines, treatments or therapies. In short, both systems are popular, side by side, but unfortunately many ill people postpone seeking help beyond local cures and neighborhood medical shops until their condition is very serious.
In sum, while modern allopathic medicine is known to be popular and effective, fast responding, and constantly being improved upon with new research findings and the like, in chronic cases, many patients find better results by using complementary/alternative local therapies, or by using both the modern and the complementary systems side by side.
Nowadays, in fact, complementary/alternative medical systems have increased in availability, scope and popularity, compared with the not so distant past. This is partly due to the spread of information about them patient to patient, and by the modern intervention of television, radio, magazines, the Internet, and other sources. It is also helped by government initiatives in support of complementary systems. Many alternative health centers in Kathmandu, for example, have a good number of skilled physicians and practitioners, and global research on new alternative technologies, medicines and tools has raised their quality of service and results. The whole world is going ‘back to nature’, it seems, by using natural products and approached as much as possible and by attempting to rely more on the laws of nature regarding health and healing.
Comparative Medicines: Systems and Practitioners
In numbers, ayurvedic physicians and practitioners rank first among the variety of so-called ‘alternative’ medical systems compared to naturopathy, homeopathy, unani, Tibetan and acupuncture. Ayurveda is supported by government and privately run hospitals, health centers and educational and research centers and for a long time has also had its own independent council.
To increase the capacity and quality of manpower and centers, the leaders in each system of alternative medicine are trying their best to improve their hospitals and educational centers, with active support by the government in recent years. Their quality will be best judged and placed when the Alternative Medical Council Act is written. This new legislation is already under development by Nepal’s lawmakers. The Act will bring different complementing/alternative medicine systems and practitioners under one umbrella.
Meanwhile, let’s examine five of the most popular alternative systems of medicine available in Nepal: naturopathy, homeopathy, ayurveda, acupuncture and unani.
Health, both physical and mental is an important aspect of our lives. When Western sciences do not show desired results, then there is an entire range of alternative therapies. One of them is acupuncture. This therapy is not in contradiction to modern day allopathic treatment, but is an alternative or complementary therapy, using a holistic approach to treatment. Acupuncture is as much a philosophical approach towards treating the body and the mind as it is a physical therapy for healing. For some, ‘mind over matter’ is the underlying thrust of this form of treatment to obtain positive results.
The term acupuncture derives from the Latin ocus, meaning needle, and pungere meaning to puncture or penetrate. It is an external treatment for internal disorders. The treatment is carried out by inserting needles at various specified points all over the body to effect specific relief from pain and for healing. It is considered to be both a science and an art, and is drugless.
The history of acupuncture in China dates back to many centuries BC, when stone needles were used instead of today’s finely manufactured stainless steel ones. The reign of the Yellow Emperor of China saw the progression and preservation, observations and documentation of this drugless therapy. Acupuncture developed steadily in China, and between 250 and 600 AD a number of books and charts were written to describe the channels and points for the treatment of an even greater number of conditions. Through the centuries, following the publication of these important works and with many of the traditions being passed from one generation to the next, acupuncture practice progressed.
The Chinese define acupuncture as the art of healing. It is practically free of side effects commonly encountered in drug therapy. The most common side effect from acupuncture is a positive feeling of deep relaxation and an increased sense of well being. Acupuncture is a simple, safe, effective and economical form of therapy. A popular explanation offered for the discovery of acupuncture is a story of a warrior wounded by an arrow. The arrow was removed, the wound healed, and a disease in an unrelated part of the body was also cured. The cause and effect between the punctured points and the diseases it cured was worked out by an observant physician and a series of points were charted.
Acupuncture is effective in various disorders falling into three main categories:
Painful. Pain is the main syndrome of this category, including headaches, migraine, trigeminal neuralgia, low backache, sciatica, arthritis, tennis elbow, cervical spondylosis, muscular spasms, intercostal neuralgia, dysmenorrhoea, frozen shoulder, etc.
Psychosomatic. This includes insomnia, fatigue, sexual disturbance, gastritis, constipation, irritable bowel syndrome, stress related discomforts like anxiety, depression, certain allergies, certain gynaecological problems, bronchial asthma, addictions, enuresis, eczema, etc.
Musculo-skeletal. This includes facial paralysis, Bell’s palsy, stroke-causing paralysis of lower upper body, peripheral neuropathies, etc.
A Conversation with Dr Harish Chandra Shah, Senior Physician and Acupuncturist, Naradevi Ayurvedic Hospital, Kathmandu
Are you the first acupuncturist in Nepal?
Perhaps I am. I studied medicine in China under a scholarship plan and did my post graduation in acupuncture. After my return, I was appointed as a Senior Medical Officer at the Naradevi Hospital where I began my practice, almost 25 years ago.
What is the status of acupuncture in Nepal?
When I started my clinic, we just had a few patients. Now we have more than 50 to 60 patients daily. I have written many articles, perhaps more than anyone else, to introduce acupuncture in Nepal.
What factor determines the response of a patient to acupuncture?
The response of a patient to acupuncture depends on the severity of the illness, the chronicity of the illness, the general health, constitution, emotional balance, diet, lifestyle along with a very open and unbiased receptive mind to the line of treatment. Mind over matter is the key to positive results.
How quickly can acupuncture treat on illness?
In this age of ‘instant gratification’, the ‘patient’ needs to learn ‘patience’. The response varies from individual to individual. Those having good general vitality, children, and those with a less chronic illness often respond faster. And as said, mind plays an important role.
Does acupuncture cure a problem permanently - or provide temporary relief?
Nothing in life is permanent except, perhaps, death. Acupuncture does provide effective relief in many situations like low backache, cervical spondylitis, frozen shoulder, etc. In some case it provides symptomatic relief and the patient might have to take treatment at regular intervals. If the working disability is reduced and emotional anxiety and distress is effectively managed, we have more than won the battle of life.
Is it effective as a single mode of treatment or in conjunction with other?
This depends on the illness or disease that the patient is suffering from. In a case of frozen shoulder, a single mode of treatment is effective. If a person is suffering from hypertension the drug therapy and acupuncture therapy will have to be closely monitored.
Does acupuncture have side effects and how long does the treatment last?
Acupuncture has relatively no side effects except the most common—a feeling of deep relaxation and an increased sense of well-being. The duration of treatment is decided by the duration of the disease. The less chronic an illness, the less number of sittings.
Homeopathy, or homeopathic medicine, is a holistic system of treatment that originated in the late 18th century, formally founded by a German physician, Samuel Hahnemann (1755–1843). Hahnemann was disturbed by the medical system of his time, believing that its’ cures were crude and that some of its’ strong drugs and treatments did more harm than good to patients. The name ‘homeopathy’ is derived from two Greek words that mean ‘like disease’. Homeopathy is based on the idea that substances that produce symptoms of sickness in healthy people will have a curative effect when given in very dilute quantities to sick people who exhibit those same symptoms. The remedies are believed to stimulate the body’s own healing processes. Homeopaths use the term ‘allopathy,’ or ‘different than disease,’ to describe the use of drugs used in conventional medicine to oppose or counteract the symptom being treated.
Homeopathic practitioners believe that illness is specific to an individual. Thus, two people with severe headaches may not receive the same remedies. The practitioner will ask the patient questions about lifestyle, dietary habits, and personality traits, as well as specific questions about the nature of the headache and when it occurs. The main purpose of Homeopathy is to restore the body its natural state of homeostasis, or healthy balance. The symptoms of a disease are regarded as the body’s own defensive attempt to correct its imbalance, rather than as enemies to be defeated.
Homoeopathy is highly scientific, logical, safe, quick and extremely effective method of healing. It offers long lasting to permanent cure treating the disease from its roots for most of the ailments. It also is the most rational science with respect to its concept of health, disease and cure. Homoeopathy does not treat superficially by just driving away the symptoms but heals the patient from within.
The Government of Nepal has been trying to make its health system simple, cheap and more systematized. The Health Service Act of 1996 recognizes homeopathic medicine under the national health service system. It was introduced to Nepal during the Rana Regime (in the 1920s, under Prime Minister Chandra Shamsher). In 1922, during an epidemic of cholera, Dr K. Mukherjee from India visited Nepal and used camphor as a homeopathic treatment for those who were afflicted.
In 1953, Ram Agori Baba, a saintly yogi, requested King Tribhuvan to establish a homeopathic hospital, and on his initiative the Pashupati Homeopathic Hospital was established with outdoor patient services and a six bed facility located at Harihar Bhawan, Lalitpur. From 1955 to 1973, Dr Achyut Bahadur Shrestha was appointed as the Royal Homeopathic Physician.
Clinics providing homeopathic services in remote parts of Nepal were also established. There are also several private organizations, such as the Bhaktapur Homeopathic Clinic in Bhaktapur, which came into existence from a project called Bhaktapur International Homeopathic Clinic of European Doctors. The Nepal Homoeopathic Medical College is the first institute in the country to formally teach homeopathy medicine. The college was established in December 2002.
There are more than 70 homeopathic doctors in the country who have been trained and graduated from India. The government has also organized various meetings to establish an alternative council that will bring homeopathy, naturopathy, Chinese medicine, acupuncture and unani under the umbrella of alternative council.
Although Unani medicine has already crossed its 75th year in Nepal, the threads that comprise Unani healing can be traced all the way back to the second century of the Christian era. The basic knowledge of Unani medicine as a healing system was developed by Hakim Ibn Sina (known as Avicenna in the West). He was primarily influenced by Greek and Islamic medicine and also by the Indian medical teachings of Sushruta and Charaka.
Unani medicine is very close to Ayurveda. Both are based on theory of the presence of the elements (in Unani: fire, water, earth and air) in the human body. According to followers of Unani medicine, these elements are present in different fluids and their balance leads to health and their imbalance leads to illness.
A Conversation about Unani medicine with Dr. Khwaja Ali Shah
How did Unani medicine start in Nepal?
In 1926, Hakim Khwaja Hasen Shah [a Nepali Muslim] completed his education in Unani medicine from Lucknow and returned to Nepal, but he did not know how to go about practicing his profession. In the meantime, two Bengali doctors were taking care of a prince who was diagnosed with tuberculosis and in whom there were no signs of recovery. King Tribhuvan summoned Hakim Shah who determined that the diagnosis was incorrect. As the story goes, Hakim Shah then asked the king for two pearls which he crushed to dust, added other ingredients and used them to treat the prince. In time, the prince recovered. The king was pleased and at the request of Hakim Shah, he gave the doctor a tablet-compressing machine. The prime minister was also impressed and with his help the first and perhaps the only Unani medical clinic was established in Nepal.
Could you elaborate more on the subject?
In the early days, under the Prime Ministership of Juddha Shamsher, Unani Medicine Nepal came under the auspices of the Department of Health. Over time, there was a movement to discredit the practice by others and it was shut down. Some years later, King Mahendra became aware of the situation and Hakim Shah was again
appointed its keeper until the day he died, after 48 years of service.
Are there other Unani Medicine practitioners in Nepal?
I’m the son of the late Hakim and I started practicing Unani medicine from an early age. My son has not followed the profession as I did. Thus, I would say, perhaps I’m the only one at the moment.
Why did Unani medicine not develop in Nepal?
People in the government do not want its development in Nepal. I still remember someone saying that if I was not a Muslim, Unani medicine would have developed. That is the mindset of the governing body. Moreover they still have not provided us with proper
accommodation. Just imagine how we operate within three rooms at the Homeopathy hospital.
How effective is Unani medicine and what is the response by the people?
Unani is actually the mother of allopathy and I would say it is effective. According to my experience, most patients who come to us are chronic patients. They have tried everything to be cured, and as their last option they come to us. You would have to see to believe that they eventually are cured.
We would like to acknowledge and thank Dr. Subundu Gupta for providing much of the information for the article, and Bidur Dongol of Vajra Books, Thamel, for providing research materials.
Sources for the article
Nepal’s Institute of Natural Medicine - www.nepalmeditation.com, Ayurveda – ‘Resurgence of Ayurveda’ by Shivendra Thapa, ECS magazine, June 2004 (archived at www.ecs.com.np/archive/june_06/article_1.htm), Homeopathy - www.Imhint.net/is nepal.html;
Contact numbers of physicians and clinics/hospitals:
Shree Krishna Aushadhalaya, Bag Bazaar – 4222079
Ayurvedic Health Home, Dhapasi – 4358761
Naradevi Ayurvedic Hospital, 4259182, 4259764
Dr. Mohammad Shabbir Khan, Department Chief, Pashupati Homeopathic Hospital, Harihar Bhawan – 5522092
Bhaktapur Homeopathy Clinic – 6637123
Dr. Harish Chandra Shah, Senior Physician and Acupuncturist, Naradevi Ayurvedic Hospital, Contact: 9851042533 / 4482482
Dr. Khwaja Ali Shah, Unani Clinic, Bag Bazar – 9841342521, 5522092
Dr Surya Bahadur Karki, Chairman, Institute of Natural Medicine – 4380725,
Dr. Subundu Gupta - 4261629