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National Medical Commission Bill: Here’s why 'Barefoot Doctors' idea is worth replicating

National Medical Commission Bill: Here’s why 'Barefoot Doctors' idea is worth replicating

The National Medical Commission Bill triggered huge protests among doctors who allege that the move to allow alternative medicine practitioners to prescribe allopathy medicines after the completion of a six-month bridge course will lead to mainstream quackery

The National Medical Commission Bill has triggered doctors into huge protests. The new Bill envisages many things including the scrapping of the tainted Medical Council of India. But the most contentious portion of the new Bill, from the doctors’ point of view, is the six-month bridge course for Ayush doctors (a broad term for those practicing alternative medicine like Ayurveda, homoeopathy, siddha) allowing them to prescribe allopathy medicines in certain situations, especially in rural areas.

The eventual phrasing seems to have dropped the reference to the bridge course, but the Bill does talk of enhanced interaction between different systems of medicine. Also, the bill also provides for “Community Health Providers” who will be allowed to practice at middle level.

The doctors, in general, allege that the whole move will mainstream quackery.

It is a fact that much of alternative medicine feeds on people's gullibility and a general distrust on the modern medical ecosystem. Most of the alternative medical practitioners, especially in regional village areas are plain charlatans. In that sense, there is an inherent risk in what the government is attempting to pursue.

But at another level, it is also a fact that Indian indigenous medical practice, especially that of ayurveda, is not a pseudo-science and has centuries-old tradition. Its tenets have been handed down from families to families and is not strictly codified. Hence there is some scepticism.

But now with the collective effort of some of the stakeholders and the government, Ayurveda is getting formalised, and it can certainly be tried, especially in non-emergency medical scenarios. Of course, that is what the government has in mind. It wants to put to use these Ayush medical practitioners in non-emergency situations in a bid to tide over the perennial shortage of doctors, especially in rural areas.

The allopathy doctors are worried that the six months training (even if it is a year) for Ayush doctors would be inadequate and don't want this 'interface' with Ayush medical practitioners in any manner.

It is here that one feels that the allopathy doctors are a bit intransigent. The government is, in reality, only trying to replicate the hugely successful experiment in China with barefoot doctors and make use of the indigenous medical knowledge that abounds in regional hinterlands of India.

China’s barefoot doctors were a major inspiration to the primary health care movement. Those health workers lived in the community they served, focused on prevention rather than cures while combining western and traditional medicines to educate people and provide basic treatment.

India, with a huge body of regional health care workers steeped in local traditions and methods in medicine, had from time to time tried to emulate this hugely successful Chinese model. Many an allopathic doctor, who were sent to study this system, did come up with many proposals. But vested corporate interests always scuttled the plan through deceit and deviousness. That is a travesty, really.

“Chinese experience showed that to promote primary health care, the key issues are human resources and medicine. Chairman Mao advocated there was no need for five years’ training; one year was enough to train a doctor. Short-term training focusing on specific types of work, such as antiviral treatment or prenatal care, is sufficient to meet the demands of primary health care, especially in the countryside or poverty-stricken areas,” a WHO study report said a few years back.

The last line is precisely what the government wants to usher in here. A pity that it has run into a huge wall of protest.