As Sri Lanka faces the second - test, which caught the country unawares after about four months of respite, common sense calls for a collaborative approach of all medical experts of Sri Lanka, to prevent an over burdening of Allopathic professionals and t o assist overall the stabilising both the health and economy.
The threat of the Western medical hospitals and its profession being overwhelmed by the comparatively large numbers of Covid-19 patients (when juxtaposed with the March situation) needs to be addressed wisely. Sri Lanka currently has dozens of Ayurveda hospitals across the country, hundreds of highly qualified Ayurvedic/Siddha doctors, around 20,000 Deshiya Chikitsa traditional medicine (Sinhala beheth) and Ayurveda qualified medical practitioners and a separate State Ministry for Indigenous Medicine Promotion, Rural and Ayurvedic Hospitals Development and Community Health.
As someone writing on Sri Lankan heritage and the need to go beyond the rhetoric to put our traditional knowledge into practice, this writer spoke to several Ayurveda/traditional medicine experts to find out how we could work together as a nation to control the spread of the current pandemic. The comments below are an interweaving of observations /analysis stemming from speaking to the relevant experts. Their comments are mentioned within quotations.
Quarantine Act
At the outset it is imperative to understand Sri Lanka’s Quarantine Act (introduced in 1897 to prevent the then virulent diseases such as cholera). The Act mentions that the subject related official– in the current context the Health Minister - has the power of appointing medical experts he or she wants to control the disease. Therefore’ there is no legal barrier towards appointing any medical professional of Western or Non Western medical tradition towards the common purpose of ensuring the health of the people.
Sri Lanka is fortunate at present to have a specific ministry for the promotion of indigenous medicine for the good of community health. This particular ministry was not in existence when Sri Lanka had to first deal with the Corona virus surfacing in the country.
According to the Ayurveda Act No. 31 of 1961, the main aim of the Ayurveda department is to continue Ayurveda services for the benefit of the people and for conservation and curative purposes as well as to encourage Ayurveda research and enhance the professional capacity of Ayurveda practitioners. It also encourages research into various diseases to raise the standards of public health and developing medical practices thereof.
It now seems the time to put all the aspects highlighted on paper with regard to the Ayurveda Act into practice. This can be done in collaboration with the Quarantine Act so that the conscientious task done by the Allopathic medical practitioners/the military in the first stage of Covid-19 is supported equally strongly by Ayurveda experts as well as Sri Lanka’s indigenous medical professionals who inherit their knowledge from many generations. To have all these expertise and not make use of it strategically, wisely and harmoniously would be equal to sitting on a goldmine without benefitting from it.
Ayurvedic expert and Cultural Anthropologist Dr. Danister Perera explained how the traditional medicine of China was officially applied in that country along with western medical treatment and how the virus was efficiently controlled.
China, seems to be the only country which has so far effectively controlled the virus. Dr. Perera noted that Sri Lanka has a valuable treasure in our cultural heritage – a very powerful and rich medicinal heritage - which can be used at present when the country needs it most, alongside Western medical methods.
“As officially noted by the authorities, around 80 per cent of Covid-19 patients as detected in Sri Lanka are asymptomatic (showing very mild symptoms). Hence the focus of using the contribution of the Ayurvedic health experts should ideally be towards the goal of minimising the hospital stay of patients and thereby eradicating a shortage of hospital bed capacity and other relevant factors,” he adds.
Given that much of Covid-19 is still in the mysterious territory of early research and clouded by somewhat contrary assumptions/conclusions (such as the level to which it is airborne )we still do not know for certain if their are different strains of the virus.
What we saw in Europe and the US seems to be a far more serious manifestation of it as opposed to what we are having here in Sri Lanka with only 14 deaths, But then again, the natural genetic immunity of Sri Lankans, enhanced by our ‘food as medicine’ clichéd traditional diet, may not be compared to the genetic immunity of an average Westerner and their practice of weakening natural resistance by regular winter time vaccines (flu shots) and a disease promoting fast food oriented diet.
Research
There is also much room for research to analyse the long term practical health impact of Sri Lanka’s traditional medicine heritage practices (such as the much acclaimed immunity boosting Ratha Kalkaya given to infants up to around the age of two) and as mentioned above the traditional herb infused everyday dietary practices of our authentic/indigenous food. Whatever the reason, the immunity of Sri Lankans are in good order, as the percentage of recoveries of Covid-19 patients show. As experts such as Dr. Danister Perera highlights what we have so far as a backdrop it provides for us to carry out an integrated plan to maintain the best level of controlling the current situation without the serious economic impact which follows a full lockdown.
Concerns are rising about the need to separate those with a robust immunity and not showing symptoms of the virus until a PCR testis done, from more serious Covid-19 patients who may have other contagious diseases which could jeopardise the immunity of those who have only very minor or no symptoms.
The Secretary to the Ministry of Indigenous Medicine Promotion, Rural and Ayurvedic Hospitals Development and Community Health, K. Weerasekera when contacted by this writer maintained that several discussions are underway with the authorities concerned including the Health Minister on diverse preventive, curative and logistical aspects of pandemic control.
The National Committee of Ayurveda experts on Covid-19 which was appointed in March under the Health Ministry is to follow up on the deliberations made by them centered on a collaborative effort alongside the Allopathic doctors. The focus was on not to assert any superiority of one medical stream over the other but a mutual respect and support for the benefit of the country.
Some of the early initiatives at the Health/Indigenous Medicine Ministry level had included the producing of immunity boosting substances and making them available through the Provincial Council Ayurvedic department and other channels to reach a wide mass of people as possible.
Suwa Dharani
One of the recent steps taken by the State Ministry of Indigenous Medicine Promotion, Rural and Ayurvedic Hospitals Development, is a product designed to boost the immunity system named Suwa Dharani.
“For those in rural areas who cannot afford it, we give the immunity boosters free and for others in the city we have made such products available for purchase at various supermarkets,” explained Weerasekera.
She pointed out that the logistical and strategic matters with regard to the Indigenous Medicine Ministry’s support in the control of the pandemic is under discussion at Ministry level and that there would be a relevant meeting with the participation of the Minister of Health on Monday (26) to discuss the way forward.
The Deputy Director/Technical-Medical of the State Ministry of Indigenous Medicine Promotion, Ayurveda Dr. T. Weeraratne, said that in his capacity as the Convenor of the National Committee of Ayurveda Experts appointed in March to seek the support of Ayurveda and indigenous medicine experts, to mitigate the pandemic, that an action plan was being made for a collaborative effort.
Weda Mahattayas
He also maintained that traditional medicine practitioners (Weda Mahattayas) were informed that they could produce medicines which they felt could assist in relieving the early symptoms of the virus to the Ayurveda Department for further follow up/testing to ascertain the impact.
“These practitioners attended the large scale meeting that we organised with the relevant government authorities and a detailed presentation on how we could assistthe country was made.”
With regard to supporting Allopathic doctors, he said:
“I have formally written to the Sri Lanka Medical Association (SLMA) and we wish to discuss with them and the Government Medical Officers’ Association (GMOA) about a task sharing effort where Ayurveda professionals can contribute to a short and long term plan to prevent a health crisis and prevent a situation of over tasking the capacity Allopathic doctors.’
The Head of the Samastha Lanka Deshiya Waidya Sangamaya, Physician Upul Dela Bandara, who hails from several generations of traditional medicine practitioners says that there are over 8,000 traditional medicine practitioners around the country registered with the Ayurveda department and another 10,000 or so of Weda Mahattayas who are not registered but many of whom have been serving people throughout their lives.
“We are discussing with the Ministry of Indigenous Medicine how they too could make a contribution at this time. We are a nation noted for our medical history and is unlike many nations in this regard. We have very ancient knowledge of battling various dangerous diseases but although this pandemic is new in terms of the virus strain it is now manifesting itself in, we can link its early symptoms as similar to influenza and treat in a manner to increase the balaya (power of the body) to fight the disease so that it dies fast.”
He says that in the traditional medicine system there are many stages of a disease before it becomes a full fledged illness as a result of the body totally breaking down, and that if the immunity is built up, it is a matter of the initial infection moving away from the body boosted by the natural immunity of the person.
Mass scale education
Thus, the need of the hour is to have mass scale education for people to stay free from other ailments such as heart diseases, kidney/liver impairment obesity, diabetes and malnutrition which could crush the immune system if it is further challenged by the Covid-19 virus.
Head of the Ayurveda Teaching hospital and Registrar of the Ayurveda Medical Council Ayurveda Dr. Y. A. Supipi Sangamith Yapa, when contacted said that the Ayurveda professionals stand ready to give their utmost support to the authorities to control the pandemic.
“We have earlier given our support to the military officials handling the earlier phase of the pandemic this year and provided them with the needed Ayurveda products for immunity boosting. None of the people who took these products we made got the virus,” she noted.
In conclusion, this writer as someone who consistently writes on putting the Sri Lankan heritage into practice would like to emphasise the following points:
· If we surmount this second challenge by working towards asserting our medical heritage – without undermining the contribution of the Sri Lankan Allopathic medical practitioners (who are fellow Sri Lankans), we will be doing our ancestors and our economy proud as we would save a disastrous shutdown and would simultaneously lay the long term foundation for being able to credibly promote Sri Lanka as a tourist destination for holistic wellbeing and medical expertise.
· At present, there are several manufacturers of traditional medicine/immunity boosters/Arishta/herbal teas who are already exporting well being focused products abroad. This industry could thrive as an export industry for Sri Lanka if we work with wisdom to restore to this nation the medical stature it was known for historically.
What we have to do is see that there is not much of a gap in our past, present and future.
· We were a nation known for its rich soil where many herbs grew and where herbs such as turmeric were commonly grown in every household. We, need to re-inculcate this at individual/mass scale level, probably beginning at school level, so that we are never at the mercy of importing our much needed herbs. If correctly planned out this could lead us to having many new small time herb exporters in a decade or so.