11 October 2016

India Must Not Turn to Medicine's "Dark Side"

By Alex Caro
October 8, 2016
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All of us have harmless superstitions that we practice, usually without even thinking about them. Maybe you try to avoid waking up on the wrong side of the bed. Maybe you throw salt over your shoulder when you spill it. Maybe you avoid black cats.

There really isn’t anything bad about these practices, however, problems can arise when otherwise harmless personal superstitions rise to the level of national credibility, and such is the case in both American and Indian society today.

Mirroring the elevation of the Office of Alternative Medicine (OAM) to a full Center in United States in 1998, the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) was elevated to the Ministry of AYUSH in 2014 under the Hindu nationalist Bharatiya Janata Party (BJP) government in India. This past summer, I traveled to southern India and Nepal and that experience has allowed me to contextualize these events. The BJP and associated groups care deeply about their society and—correctly—see Hindu culture as having long been under assault by colonial powers with proselytistic religions. In their view, compensating for these past injustices requires government to make a proactive effort to promote Hindu cultural practices.

Yet, this is where a problem arises. While it’s unquestionable that the Mughals and the British often treated Indians poorly and attacked Hindu culture in order to promote Islam and Christianity respectively, it would be a mistake to oppose everything the Mughals and British did and to instead blindly promote every aspect of traditional cultural practices. For example, few members of BJP today would attempt to defend or resurrect sati, a custom in which widows burn themselves alive on their husband’s funeral pyres. The inhumane practice was ended in part due to the influence of India’s colonizers.

While India should certainly seek to regain cultural practices that were suppressed before it gained nationhood and the right of self-governance, it should also learn to reject practices that do not conform to reason, universal human rights, or science.

The West played an outsized role in the development of the modern world and the advance of political and scientific thought. However, those developments required the West to reject much of its own traditional cultural practices. When science and local traditions come into conflict, India would be wise to do the same, rather than wasting precious taxpayer dollars on schemes that are unlikely to reap benefits for the nation’s citizens.

To do so, the country must make proper use of its limited resources. This is especially important in medicine, as doctors educated in the use of evidence-based Western medicine are in short supply. Some promote the dubious proposal that the solution to this dilemma is to promote AYUSH as a cheap alternative to evidence-based medicine, further entrenching practices that lack evidentiary backing and providing them with undeserved legitimacy. This simply follows the path of Mao Zedong who, although not a believer in traditional Chinese medicine himself, promoted it in order to achieve a cultural revival. Both Mao and Indian Prime Minister Narendra Modi seem to promote traditional practices in order to attract foreign interest in Indian culture and stoke nationalist fervor. At the UN, for instance, Modi led the way for the creation of National Yoga Day.

However, as Dr. Steven Novella notes, even when there is evidence that these sorts of practices, like yoga, are effective, they are only effective in comparison to no treatment at all. As he puts it:

Yoga … fits into a more general phenomenon of marketing a specific intervention as if it has specific benefits, when in fact it only has generic benefits. For example, there are many studies showing that transcendental meditation is effective for lowering blood pressure. However, studies generally compare TM to no intervention, not to other forms of relaxation. The parsimonious interpretation is that TM confers the generic benefits of relaxation, but there is no evidence to suggest it confers any specific benefits.

Indians have a lot of which to be genuinely proud. They can lay claim to the world’s largest democracy; one of the world’s oldest civilizations; peace in the face of adversity (e.g., the incredible strategic restraint shown toward Pakistan, Satyagraha, and the founding of the non-aligned movement); and enviable scientific achievements.

Forcing the poor to rely on untested “medicines” or making claims about inventing spacecraftthousands of years ago in the name of preserving and promoting culture cheapens the very real accomplishments to which the country can deservedly claim. Instead of falling for superstition, India should listen to internal skeptical voices, such as the Federation of Indian Rationalist Associations and the Indian Medical Association, who demand that scarce resources be spent training real medical practitioners and adhering to rigorous science.

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