Documentation as ‘evidence’: Marginalization of local health traditions in India Arima Mishra and Devaki Nambiar, India Presented at the American Anthropological Association Annual Meeting, November, 2016, Minnesota, USA

Background “The time has never been better and the reasons never greater for giving traditional medicine its proper place for addressing the many ills that face our societies” ………. This will not happen on its own. Deliberate policy decisions need to be made. These need to be made successfully” - Director General WHO at the WHO Congress on Traditional Medicine, 2008, Beijing “The positive features of Indian systems of medicine, diversity, flexibility, affordability, low level of technological input, greater economic value have great potential to make them providers of health care that the large sections of our people need” Government of India, 2002

Background …… Resurgence of policy interest in traditional medicine and healing globally and in India due to Rising chronic disease burden Calls for universal health care Revitalize primary health care Cost-effective and sustainable health development Global movement on Complementary and Alternative Medicine

Policy interventions First National Policy on Indian systems of medicine and homeopathy (2002) to strengthen training, research and practice of officially recognized systems of medicine National Rural Health Mission (2005) and reinforces in subsequent policy documents Mainstream AYUSH (Ayurveda, Yoga, Unani, Siddha and Homeopathy) Revitalize local health traditions (undocumented community based health knowledge including home remedies, herbal healing, treatment of poisonous bites, bone setting)

Logic of the state Revitalize community based health traditions through documentation, validation and propagation of sound health practices Documentation is deemed necessary to Check erosion Prevent commercial exploitation of knowledge Ensure health security to people in rural areas Realize greater public health potential of validated practices

Myriad efforts Documentation by Government AYUSH Research Institutes Non-Governmental Organizations Indian Council of Medical Research University departments (Botany, Pharmacology) Networks and alliances among different NGOs, Government and NGOs Some are ad-hoc/projected based while others are more sustained efforts

Methodologies Processes vary Identification of healers Knowledge on plants and their usage Format: Local name, botanical name, scientific name (as in Ayurvedic pharmacopeia) Validation through Ayurveda and/or clinical trials

Products

Systematic processes of exclusion Whose knowledge counts? Primary mode of healing through medicinal plants and herbs Leaves out many others including bone setters, traditional mid-wives, women healers

Slicing knowledge What sort of knowledge merits attention? Only tangible aspects (medicinal plants) Those that can be validated through Ayurveda texts “ Basic validation is done here from Ayurvedic pharmacopeia. If information is not validated, we do not pass on this information to the AYUH department” (Official involved in documentation) “Not everything can be documented. A healer selects herbs based on experience, taste and touch” (A healer)

Ignoring existing documentation “I have written my experiences. My forefathers also wrote their experiences. We used old Kannada language but most of the word are Sanskrit. “It is necessary to write these things. What I used in my 50- 55 years of practice? How I used new herb? This is also an institute (he said in English institute), this is also a part of learning. If a patient comes to me for a particular condition then, I read what my forefather wrote about their experience and I gave the drug adding my new contents to that combination “( A reputed healer) “My great great grandfather had written about our family knowledge in a specific transcript. We got it translated later during my father’s generation”

Validation Validation as discounting local health knowledge “These traditional practitioners don’t know human anatomy. Their earlier generations might have some medical knowledge but lower generations has not have any medical knowledge. They practice it out of experience. Ayurveda is not like this. True science. (AYUSH Practitioner involved in documentation) “Healers have only experiential knowledge they have obtained. They have not validated whether it is really useful or not” (Government AYUSH personnel)

Discounting knowledge holders Healers as mere providers of knowledge Documentation de-links knowledge from its practice “Documentation cannot be a mode of preservation of our knowledge unless such knowledge is allowed to be practiced. No one is bothered about us” (A fourth generation healer) “Documentation cannot be done by anyone. Those who practice the knowledge need to be involved in documentation. How can someone who does not know the context, has never practiced the knowledge can document?”

Family manuscripts Source: A healer from south India sharing this with the research team

Contd.. “ Documentation of local health knowledge cannot be anybody’s business. Anyone who is sincere, dedicated and who has a passion for this can should document, it should not go to the hands of those with selfish motive” - Materiality of documentation exercise vis a vis sacred character of knowledge and practice

Documentation as evidence or omission? Demands for documentation misplaced Assumed universality of knowledge Bounds the knowledge by fragmenting it Pluralism lens privileging one form of evidence Need for plurality lens?