Projected as a new-age Innovation University, the Institute of Ayurveda and Integrative Medicine (I-AIM), Bangalore, has evolved from the Foundation for Revitalisation of Local Health Traditions (FRLHT) as a unique centre of excellence for integrative health sciences in India. The Institute strives to enhance the quality of healthcare in rural and urban India and globally through creative applications of traditional health sciences. Leveraging on Ayurveda’s holistic principles and classical heritage, I-AIM focuses on research, clinical practice, education and outreach, integrating knowledge systems in a multi-disciplinary framework. Its mission is to demonstrate the contemporary relevance of Indian medical heritage by designing and implementing innovative programmes and strategic initiatives for its wider use and application for greater impact on health security of rural and urban communities.
By developing an integrated, epistemologically informed interface with the knowledge streams of biomedicine, life sciences, pharmaceutics, engineering, social sciences, art and culture, the Institute aims at building new paradigms, credible standards, products, processes, technologies and communication strategies. I-AIM, exquisitely set in an enchanting rustic environs of Jarakabande Kaval, near Yelahanka in Bangalore, Karnataka, has four reputed Schools – School of Health Sciences, School of Trans disciplinary Studies, School of Educational Innovation, and School of Conservation of Natural Resources – carrying out its mission.
The Integrative Healthcare Centre, under the School of Health Sciences, is a 100-bed facility providing efficacious, safe and cost-effective healthcare solutions through creative applicationof traditional health systems integrated with biomedical sciences. While Ayurveda Shastra with its wholesome theoretical foundation and classical applications remains the centrepiece , Yoga, Siddha, Unani,
Physiotherapy and diverse elements of Biomedicine complement the interface as a modern, multi-disciplinary model. The Centres for Local Health Traditions,
Public Health and Clinical Research are the other integral divisions of the School of Health Sciences. The School of Educational Innovation offers innovative educational programmes ranging from UG, PG and Doctoral programmes to E-learning courses in Indian Medical Heritage.
The Centre for Educational Innovation and the Indian Medical Heritage Library are part of this School. Under the canopy of the School of Trans-disciplinary Studies, mandated to explore the relationship of the basic natural and social sciences with Ayurveda, come the four Centres – one for Pharmacognosy, Pharmaceutics and Pharmacology, the second one for History and Sociology of Indian Medical Heritage, the third one for Theoretical Foundation of Ayurveda and the fourth one for Ayurveda Pharmacy. The Centre for Conservation of Natural Resources of I-AIM has been spearheading the drive to conserve inter and intra specific diversity of medicinal plants in their natural habitats in the country. It was instrumental in creating the Forest Gene Banks of 200-500 hectares each across the country. The Centre for Repository for Medicinal Resources, Centre for Herbal Gardens and Landscaping Services, and the Centre for ISM Infomatics also operate under the School for Conservation of Natural Resources. I-AIM is engaged in strategic collaborations with acclaimed knowledge institutions in the field of health sciences, social sciences and technology to improve its work on knowledge generation, and with governments, grass-root organisations and industry to enhance social impact.
Redefining Swasthya
Padma Shri Darshan Shankar
Padma Shri Darshan Shankar, Vice Chairman of the Institute of Ayurveda and Integrative Medicine, and the founder Executive Director of the Foundation for Revitalisation of Local Health Traditions, Bangalore, speaks of the profound significance of the word Swasthya in Ayurveda Shastra. Swasthya is “to be in equilibrium with the self at the physiological, sensory and mental levels.”
A human being is considered to be healthy only when the three biological functions, namely tridoshas (vata, pitta, kapha), the dhatus (seven body tissues), the three mala (waste products), panchendriya (five sense organs), manas (mind) and atma (soul) are all in equilibrium. Darshan Shankar’s perspec tives on Swasthya extend to “the cosmic vision of Ayurveda Shastra from avyakt to vyakt states of nature and their interconnectedness.”
He formulates wellness programme modules that in substance deal with the role of lifestyle, food, yoga and sound. According to him, specific Swasthya modules should be developed on how to assess individual prakriti types and their practical value for one’s own healthy living; on dhatu sar pariksha to emulate the health of one’s seven body tissues and how to make corrections through one’s diet, herbs, lifestyle and improved metabolism; on assessing one’s own metabolism (agni and mala kriya) and how to correct the same; on the concept and analysis of the state of balance of one’s tridoshas and the role of panchakarmas in their correction;
on chakras, panchakoshas and yoga with demonstration of the unique role of sound therapy, customized for one’s individual needs; and on healthy food recipes.
In essence, it would reflect a uniquely Indian model of integrative approach to wellness and healing. In the backdrop of the Global Ayurveda Summit, Emerging
Kerala, and the Kerala Travel Mart, the Ayurveda & Health Tourism met Darshan Shankar in Bangalore. Excerpts from the interview:
Kerala, with its distinct healing traditions, is positioning itself as the global
hub of Ayurveda. How would you evaluate Kerala’s scope and potential in this perspective?
Darshan Shankar: Kerala is indeed the home of Ayurveda; and within India and abroad, people connect Ayurved a with Kerala. However, the total turnover from Ayurveda manufacture, clinical services and hospitals etc is estimated to be Rs 15,000 crores. It is far below the actual potential. China, for instance, is the world leader in traditional medicine in terms of its market reach and practice.
As you are privy to the high-power Sam Pitroda- Kerala Chief Minister initiative which has identified Ayurveda as a key sector for growth and development in the state, what are the thrust areas that Kerala should focus on while showcasing its preeminence in this unique indigenous system of medicine? What are the specific areas to be nurtured?
Darshan Shankar: The Sam Pitroda-Kerala CM initiative on making Kerala State a global destination for Ayurveda spells out a six-point strategic action plan for promoting Ayurveda in collaboration with expert physicians and IT professionals and institutions; establishing collaboration with reputed clinical research institutions in India and abroad; boosting national and international sales of Kerala Ayurveda products by encouraging Kerala industry to adopt internationally acceptable quality standards; demonstrating in collaboration with corporates in selected districts of the state the world’s cheapest solution, a copper vessel or suitably designed copper device, for ensuring microbially pure drinking water; implementing a well-designed mass education programme on Ayurveda, focused on rasayanas for different age groups, home based remedies, pre- and post-natal care and nutrition; and introducing insurance cover for Ayurveda.
Visualising and implementing such an ambitious, well chalked out action strategy would definitely go a long way in developing various aspects of Ayurveda in Kerala.
In the larger philosophical as well as empirical contexts, how would you distinguish Kerala Ayurveda from its other streams in India?
Darshan Shankar: Ayurveda knowledge system has got various levels of expressions. We call them tatva (principles), sashtra (science), and practices (vyavahar). In any good system, all the three must be active. Kerala has the advantage of all three; but it is not the same case in north India.
You have been an exponent of medical pluralism. On the curative side, how can Ayurveda go mainstream in a truly authentic, comprehensive, complementary, integrated healthcare approach?
Darshan Shankar: The best feature of healthcare system anywhere in the world will be based on a pluralistic scheme. The reason is that no single system has solutions for all our needs. All over the world we will find such a pluralistic approach, adopting a combination of various systems, according to their potential and strength. Internationally,Alopathy is accepted as the world leader in surgery, while Ayurveda has the world’s best remedy for chronic diseases like diabetes, neuromuscular disordersetc. Ayurveda is the preeminent medical system globally for non-communicable diseases – for prevention, wellness and healing. It teaches you how to be healthy. And it is very rich on the pharmacy side too. In Ayurveda, there are more than two lakhs herbal formulations. In Alopathy, the maximum number of formulation is 4,000. In pharmacology, we are pioneers in producing medications in nano particle size (bhasma).
Health tourism in Kerala is largel yassociated with wellness and rejuvenation therapies, marketed under the banner of traditional Ayurveda healing practices. However, commercial exploitation of this genre of alternative therapies has opened a floodgate of fly-by-night operators without any credentials. How can we redeem the situation and implement measures for standardization for such practices?
Darshan Shankar: Wellness is a serious business. It is not only massage. Wellness means Swasthya. When you go to a wellness centre you should get swasthya. Our efforts should be focussed on developing the fuller meaning of Swastya as defined by the Ayurveda Sashtra.
Systematising, standardising, patenting and branding – these are big challenges for any traditional system of medicine. How can our classical Ayurveda products fare better in the global market?
Darshan Shankar: The standard must be common. The standards of Government of India are no doubt pharmacopoeial, but they fall below international standards. Besides, they are not implemented properly. The Care Kerala initiative in this regard is commendable. Pharmacopoeia standards are essential for quality control and universal acceptance.
Recent boom in certain Ayurveda brands dealing with lifestyle diseases, sexuality and cosmetic applications has attracted legal action with reference to Magical Remedies Act etc. What measures should the government take to ensure that stakeholders in this industry and service marketing follow certain norms with regard to quality, product testing and such parametres?
Darshan Shankar: We should strengthen the regulatory mechanisms. Kerala should concentrate on classical formulations. It is the best and the most authentic. The government should invest in ensuring a regulatory mechanism. People have a great deal of respect and credibility for self-regulated manufacturers like Kottakal Arya Vaidya Sala, Oushadhi etc. The strength of Ayurveda is in classical drugs,OTC drugs for simple diseases like cold and common problems.
What is the scope for Ayurveda reaching out to other Asiancountries and the Middle East?
Darshan Shankar: For this political initiative is needed. Countries like Sri Lanka or China have certain drive. They promote traditional medicine in a very concerted, aggressive manner. Government departments like Ayush should look into ways to promote Ayurveda in the whole region and globally.
What innovative program mes do you propose for conserving natural resources in connection with our various healing traditions?
Darshan Shankar:We should have the right perspective, get our priorities right. In the Government of India budget allocation for the federal Ministry of Health, just three per cent of it goes to Ayush, while 97 per cent goes to Alopathy. The department of Ayush is not given its due. All tax payers’ money goes to government institutions, which they seldom make use of. Private entrepreneurs don’t get support from the government bodies. China allocates over 30 per cent of their of budget provisions for traditional Chinese medicine. Their export is 10 times more. Kerala government too spends comparatively very little on Ayurveda, considering its potential value for the state economy. We should have a multi-tiered programme initiative by the government for conservation of green forests, medicinal trees in degraded forests. Encourage farmers to cultivate high-demand species of national medicinal plants.
We should establish moisture free storage facilities, low gama radiation facilities and strengthen the supply chain.
In a realistic assessment, can our medical education system do justice to the rich heritage of traditional practices?
Darshan Shankar: Ayurveda education is a weak area. At the undergraduate and PG level, there is no research, no seminar or workshop for proper interaction. The time is not well spent. We still follow teaching evaluation methods of the 19th century. The authoritarian way has to be changed. We need to create more autonomous colleges. We have use more technology to improve the standards of the studies.
Synergising Energies for Positive Change
Dr. Padma Venkatasubramanian
In its most sublime level, Ayurveda is hailed as a unique way of life rather than a curative or wellness practice. In this perspective what would be the priority areas that the Institute of Ayurveda and Integrative Medicine focus on in this globalised contemporary society?
We posed the question to Dr. Padma Venkatasubramanian, Director of Institute of Ayurveda and Integrative Medicine (I-AIM), created by the public trust Foundation for Revitalisation of Local Health Traditions (FRLHT), Bangalore,
and involved in using trans-disciplinary tools to make India’s traditional health knowledge contemporary. An alumna of Queen’s College, Cambridge, UK, and a former Research Associate at the University of Cambridge, where she got her
doctoral degree for her study on the biochemical and molecular spects of Bacillus subtilis spore germination, Dr. Padma subsequently returned to India due to her interest in Indian traditional medicines, and she has used her technical training to develop new strategies in trans-disciplinary research visà- vis Ayurveda and Modern Science. This is what Dr. Padma Venkatasubramanian had to say: “The subtleties of Ayurvedic ‘living’ is not about a product or a practice alone. It is the sum total of holistic living which involves the mind, body, soul, society and the environment.
So, it is more about way of living, which basically stems from values such as care and respect for oneself, others and also the Universe. The current day globalised societies are extremely vulnerable to being shaped by mar marketing and media in front of which they spend major parts of their days. The last one or two decades have witnessed a boom in the IT and BPO sector that have brought in several societal changes, owing to more affordability at younger ages.
Some of these include nuclear families, change in food types and times, long working hours, stressful living etc. These have also rapidly increased susceptibility to certain life-style and occupation related diseases. Basically it is because of inorganic ways of living. Ayurvedic concepts in living well have great potential for these people. In the olden days families and homes used to be the teaching and learning environments, where people had quality time to introspect. Nowadays, theyoungsters learn most from the web. I-AIM plans to reach out to households, which still have the power of influencing a child in his/her formative years.
Especially, if awareness and abilities can be strengthened in the mother who in turn can bring about healthy habits in the family. The following are some of the focus areas for the next three years at IAIM:
1. Streamline Medicinal Plant Conservation Areas (MPCAs), so that the forestry sector is able to maintain it without our further intervention
2. Mainstream the use of copper pots for storing drinking water in rural households, since just by storing, the harmful pathogens that cause diarrhoea get killed. It is a safe, scientifically tested traditional practice that can be adopted by rural poor for microbially safe drinking water.
3. Focus on the Integrated Healthcare Centre (the 100-bed hospital) to make it a centre of excellence in services, research (integrative for evidence generation) and education. Also create model for rural and urban clinics.
4. Strengthen home health practices.”
In its mission for revitalising the local health traditions, what are the prime concerns that the Foundation is focusing on today?
Dr. Padma Venkatasubramanian: Financial stability and support for the mission; building manpower capacities, in house and in communities; and constantly striving to strategise and synergise energies to bring positive changes in gap areas in the sector.
What are the biggest challenges that you face in your strategies and programmes for streamlining social processes for transmission of medical heritage? Can our modern medical education system incorporate the vital aspects of traditional healing therapies?
Dr. Padma Venkatasubramanian: Finding the right kind of people (scientists or vaidyas) with the right
skills, mind-sets and attitudes to work on inter and trans disciplinary aspects is one major challenge. All else will follow. This requires establishing a congenial environment that nurtures and promotes mutual respect, objective curiosity, debate and discussions, open mindedness to options, criticality in thinking and constructive action.
Next, consider strategies for taking research findings from lab to land. The scientists who discover new things in lab are not themselves capable of taking their findings in a ‘user friendly’ form to the users. Thirdly, financial support and buffering ability that will enable innovation and new paradigms. Modern medical education can and should include vital aspects of traditional healing therapies. The National Institutes of Health, USA has launched large initiatives to scientifically explore the benefits of Ayurveda and Yoga. Traditional Chinese Medicine is an essential part of modern medical education in China. It adds value and the patient benefits.
Traditional Chinese Medicine is an essential part of modern medical education in China. It adds value and the patient benefits. Depletion of traditional medicinal plants is a perennial problem. How do we address the issue? The Amruth Vana, medicinal plant garden, is indeed a great model for preservation of rare species of medicinal plants. What incentives can we offer to private investors or public stakeholders in such herbariums?
Dr. Padma Venkatasubramanian: We have taken a two-pronged approach at conserving medicinal plants. Amruth Vana kind of initiatives can of course help in ex situ growing of rare plants and will also be useful in education. However, conservation will only happen if it is in situ, in its own milieu. So, we have hectares of forest land across the country declared as medicinal plant conservation areas (MPCAs). There are 108 such sites already established for niche plants which are endemic to the areas and are threatened. We are currently partnering with a young enterprise to develop educational programmes for school and college children for nature trails in our garden. We are also encouraging institutes and companies to get their campuses landscaped with medicinal plants instead of using ornamental plants. This can create a healthy environment as well as provide material and knowledge for self-help in primary healthcare.
Attaining Supreme Health
Dr. G.G. Gangadharan
Through Ayurveda one can seek the ultimate life goal of reaching the supreme consciousness through the physical fitness, mental alertness and spiritual clarity, which we refer to as dharma, artha, kama and moksha,” says Prof. G.G. Gangadharan, Ayurvedacharya and Medical Director, I-AIM Health Care Centre (I-AIM-FRLHT). “Ayurveda says that unless one’s body is healthy, it cannot house a healthy mind. When the body and mind pool their efforts together to reach to the atman, one attains supreme health. This concept is very subtle, and does not easily appeal to the sense oriented, phenomenal and worldly Westerners. “Ayurveda is a tool to reach up to this, wherein healthy food, healthy thinking, health promoting medicines and purification kriyas/ karmas are useful. IAIMIHC promotes this concept to deserving people who approach it.” Excerpts from an interview with Prof. Gangadharan at I-AIM, Bangalore:
Among the Indian systems of medicine, Ayurveda has emerged as a more universally accepted stream of ethnic healing tradition. What are the elements that make it more appealing even to the Westerners?
Prof. G.G. Gangadharan: Ayurveda is a time-tested nontemporal science based on universal principles whose starting and end points are unknown – anādi and ananta. Even the word Brahma Smrutwa Ayusho Vedam (the originator of the universe viz., Brahma, recollected Ayurveda) referred in Ashtangahridaya throws light on the eternity aspect of Ayurveda. Ayurveda has been prevalent since the time of evolution of life and macrocosm. Ayurveda pervades time and it is contemporary always. It evolves with the changing times and upcoming insightful practitioners. The ancient texts are to be construed as pretexts and not as ultimate. Charaka repeatedly exhorts us about the need to learn from contemporary practices and sciences. The copious regional texts and eco specific practices corroborate this truth. Ayurveda practice varies from place to place and location to location. The concept of desha (treatment and origin of plants) and kaala (time of treatment and collection of plants) are unique features of Ayurveda. The most important reason for Ayurveda’s virility and acceptance at all times by all types of people is its adaptability. Change is default but manifests only in the ‘form’ of Ayurveda. The basic principles which are its ‘foundational’ concepts will remain unchanged as long as the senses are only five, as long as the panchamahabhutas do not make way for a sixth and as long as the sheeta (cold) and ushna (hot) values of the universe remain the same. That is Ayurveda – ever changing at application (vyavahaara) level and remaining intact at the conceptual (shastra and tattva) level.
In enhancing the quality of healthcare in rural areas, do you think a holistic approach in integrative medicaladministration can be more effective?
Prof. Gangadharan: The whole world is turning towards integrative healthcare, but there are many models. In the West, modern biomedicine is in the centre and other complementary and alternative medicine (CAM) is in the periphery. CAM are looked upon as a bunch of applications rather than a medical system. In India we should have a model which is pivotally based on Ayurveda. Other pathies including Allopathy and modern biomedical tools shall be in the periphery and should be put into use selectively and appropriately. If this model is developed appropriately, we can develop a very economic, effective and appropriate model of rural healthcare in India. National Rural Health Mission (NRHM) should adopt this model. The present effort of bringing AYUSH system into NRHM is very superficial. We need to plan comprehensively. A few models to be implemented in select villages as a pilot project to be replicated elsewhere after fine tuning.
Standardisation and quality maintenance are major factors in marketing classical Ayurveda products and services. Any major breakthrough in this regard?
Prof. Gangadharan: This is a major cause of concern in the days to come. With Ayurveda gaining importance by the day, the unscrupulous trade is poised to eclipse the Ayurveda pharma industry by pushing substandard and spurious raw materials. Proper identification, proper harvesting, conservation and propagation of the Ayurvedic raw materials have to be accorded utmost priority now. Standardisation of QC in Ayurveda products should be given utmost priority, not by making it more sophisticated, but by decentralising production and helping more cottage level industry to come up with natural products with short shelf life, say six months to one year. There are many ways of achieving this: Proper drying, proper hygiene, sterilisation and improved packing at zero-bacteria environment itself can make Ayurvedic products safe and effective. The sophisticated dosage forms cause Ayurveda to resort to harmful chemicals.
Besides wellness and rejuvenation therapies that are flaunted by tourism promoters, what specialities could play a major role in medical tourism in India?
Prof. Gangadharan: Hardcore therapies for chronic metabolic disorders (CMD), obesity, DM, MS joint inflammation, rehabilitation therapy for stroke patients and geriatric care are excellent areas for Ayurveda to showcase its potential. There are no parallels to Ayurveda in treating these conditions successfully. Hundreds of practitioners should be imparted training and young Ayurveda practitioners should be encouraged to establish small scale rehabilitation centers, and after proper approval they can be promoted by the government through its portals as designated agencies. This will fetch a great respect to Ayurveda tourism and step up revenues – internal and foreign. This tourism will be well received both by the local Ayurveda fraternity and the tourists. This will also increase job opportunities in Ayurveda related services in particular and the economy in general.
A sudden and sporadic mushrooming of fanciful remedies from various Ayurveda brands may catch the imagination of the gullible public, but the pharmaceutical sector needs more credentials for sustainable growth. What measures do you suggest for enhancing the quality control mechanism of traditional medicine?
Prof.Gangadharan: Home made remedies have to be popularised so that reliance on branded medicine is that much mitigated. As said above, raw material identification, supplies,conservation and propagation have to be monitored. Establishing an effective administrative body for checking unethical practices in ayur-pharma industry and by peer groups can make a difference.
How can we brand Ayurveda as a unique regional tourism development tool?
Prof. Gangadharan: There is the need to develop Ayurveda on its basic frontiers as stated above. Nevertheless, medical tourism is remunerative and the wellness segment of Ayurveda would do well to brace itself to meet the demands.
