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The Andhra Pradesh Health, Medical Education and Family Welfare department has faced significant criticism in the past couple of days after state Health Minister Satya Kumar Yadav allowed Ayurvedic doctors to perform surgeries.
A press release from the Andhra health department on Tuesday, December 23, said Ayurvedic doctors who have completed PG courses in surgical studies and have proper training, could perform surgeries independently.
“The decision is a step forward in the direction of integrating Indian traditional medicine with modern treatment methods,” the press note said. Ayurvedic students can now perform 58 types of surgeries which include 39 Shalya Tantra (general surgery) procedures and 19 Shalakya Tantra (disease of eye, ear, nose, throat, head or dentistry) procedures.
The Health Department’s announcement is in line with the Indian Medicine Central Council (PG Ayurveda Education) Amendment Regulations of 2020.
Prominent procedures under Shalya Tantra include bowel resection (cutting out a damaged or diseased part of the intestine and joining the healthy ends or creating a stoma), cholecystectomy (surgical removal of the gallbladder, usually because of gallstones or infection) and pyloromyotomy (cutting a tight muscle at the exit of the stomach (usually in babies) so food can pass into the intestine normally).
Under Shalakya Tantra, glaucoma surgery (trabeculectomy, which involves creating a tiny drainage opening in the eye to lower pressure and prevent vision loss), eye trauma repair (surgical closure and repair of injuries to the eyeball to save vision and eye structure), septoplasty (straightening the nasal septum to improve breathing) and mastoidectomy (removing infected bone behind the ear to prevent spread to the brain) are permitted.
In a statement issued on Friday, December 26, the Indian Medical Association (IMA) President Dr Dilip P Bhanushali said that the IMA was opposed to this move.
“Its not that we don't respect Ayurveda or Homoeopathy. They are their own sciences. But we want Ayurveda to be promoted in its original and pure form. Why should it be mixed with modern medicine? It takes 10 years for a modern medicine doctor to become a surgeon. In five and a half years, it is not possible to train someone to do general and ENT surgeries,” he said.
Dr Dilip also referenced a Public Interest Litigation (PIL) filed by the IMA in the Supreme Court arguing against a Central Council of Indian Medicine (CCIM) order authorising post-graduate practitioners in specified streams of Ayurveda to perform surgical procedures after training.
Why this is a problem
Speaking to TNM, retired IAS officer PV Ramesh, who served as Principal Secretary of the Department of Health and Family Welfare in united Andhra Pradesh said the move was shocking and akin to 'legalising quackery.’
“MBBS doctors also do surgical studies. They are trained for suturing, training an abscess, hernia repair – which are fairly common. But we are currently witnessing a time, where resident MBBS doctors who do Masters in General Surgery do not get to perform even one or two surgeries in a month. They are learning everything from YouTube and a website called Marrow that teaches you how to do virtual surgeries. If things are bad for general and allopathy doctors, you can imagine how much worse it would be for Ayurveda and Unani doctors,” he said.
Ramesh said the decision may have adverse impact on the marginalised residents of Andhra Pradesh. “It would have been far more advisable to employ Ayurveda doctors in primary health care. Allowing Ayurveda doctors to perform surgery would lead to poor people ending up as guinea pigs. Surgery requires anaesthesia for which you still need an allopathy trained doctor. This plan is absurd,” Ramesh said.
Problem with Ayurveda
PV Ramesh said Ayurveda has not evolved beyond the 2nd century BC unlike modern medicine that is evolving by the minute. “It is more sophisticated, less invasive and has sharper recovery rates. Allopathy has evolved through rigorous enquiry, investigation, validation, examination post which there finally is an inference,” he added.
Ramesh said the decision reflects the changing trajectory of Andhra’s political economy. “It is aligned with a new nationalist ideology that rejects modernity and western medicine. Surgery is sophisticated work and cannot be done so easily. There has to be a significant understanding of post-operative care otherwise people are likely to suffer,” he said.