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February 2008 Edition

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How FRLHT has gone from conservation to research, value added products and clinical practice

THE campus of the Foundation for the Revitalisation of Local Health Traditions (FRLHT) sits on five acres amidst a green wilderness in the suburbs of Bangalore. The area is called Jarakbande Kaval and you get there via Yelahanka, invariably braving traffic jams, pollution and screeching horns. The campus itself, however, is an island of serenity and unruffled activity. There are three buildings with tiled roofs and architecture that ensures interiors are flooded with natural light and air. A fourth building is under construction: it is a gift from a patient. He was so happy with the treatment he received at Amruth, the FRLHT Ayurveda hospital and wellness centre, he insisted on paying for another building on the campus as a donation. Set up in 2004, Amruth is in a sense the crowning glory of FRLHT’s activities. It rounds off the work which began in the early nineties with the identification of medicinal plants, and their preservation in the wild, creation of a herbarium, identifying of folk healers, development ofmedicines and value added products and the setting up of a modern laboratory as a testing facility.

In this chain, the hospital puts everything in sharp perspective because it showcases Ayurveda in practice as physician deals with patient. The hospital is headed by the forward-looking Dr GG Gangadharan, who used to be at the Arya Vaidya Pharmacy in coimbatore.In addition to him there is a clinical team of five doctors led by a postgraduate in Ayurveda with a decade and a half in clinical experience. FRLHT on the whole has 15 Ayurvedic doctors and Siddha, Unani and Yoga consultants. “We started Amruth to mainstream Ayurveda, not as a science from the past, but as a contemporary system of medicine which can play a fruitful role in tackling degenerative, lifestyle related and chronic diseases. These are the problems of this century. Modern medicine is weak here and Ayurveda is strong,” says Dr Gangadharan.

The hospital’s 12 departments include geriatrics, mental health, diabetes and neuropathy, cardiac disorders, gastro-intestinal and respiratory disorders, ophthalmology, complementary treatment for cancer, skin diseases and so on. Ayurveda has been under assault on many fronts. If on the one hand the vanishing of medicinal plants has been depriving it of its raw material, on the other there aren’t the facilities where Ayurveda as a traditional science is kept alive in a contemporary setting and with a new relevance. Amruth in its very presence seeks to correct these imbalances. It is a modern, clean and well-equipped facility. It has 20 well-kept rooms for patients to stay and treatment facilities. In time to come there will be 100 rooms. All the Panchakarma treatments under Ayurveda are available here. There is a pharmacy with Ayurvedic medicines chosen from the most reliable manufacturers across the country.

It already has the odd-landmark success to its name. A bus driver with paralysis after a bad brain haemorrhage was brought to Dr Gangadharan. He looked at the MRI and said there was nothing that he could do. When the family persisted, he agreed to treat the man. Herbal packs for the head and other medications were given to him and in three weeks he began moving. Fresh MRIs after two months showed that clots had gone. Dr Gangadharan is however cautious about presenting Ayurveda as some kind of miracle science. Ayurveda should be used for those ailments which it is known to treat. “We believe one such hospital in Bangalore is not enough. We would like to multiply it in India and other countries,” he says. So this hospital will become a module which can be integrated into health centres, women and child health centres, allopathic hospitals etc. People today seek choices in healthcare.

The future, as Dr Gangadharan points out, is in integrated health systems. Amruth is keen to be part of the trillion dollar wellness industry. TEACHING HOSPITAL: Amruth is also meant to serve as a teaching hospital with its own syllabus and degrees both at a graduate and post-graduate level. The physicians who come out of here will be new in their orientation. They willlearn how to give treatment guided by the shastras, but use modern diagnostics to interpret biomedical parameters and assess the out comes of Ayurvedic treatment. They will also be encouraged to use information technology. Their training will be to remain within Ayurveda’s systemic framework, but simultaneously connect with the reductionist theories of modern science. Making the connection is important for communicating the benefits of Ayurveda in an age when there is a huge demand for its therapies.

Finally, it is physicians who can strike this delicate balance who will keep Ayurveda alive and relevant in a classical sense. At yet another level, Amruth will be a finishing school for shortterm training to doctors and therapists who can then work in clinics and alternative medicine departments of allopathic hospitals. A huge demand is envisaged for such professionals. The teaching of Ayurveda is either mechanical or doggedly conservative. Young Ayurveda physicians get degrees, but their knowledge tends to be superficial. It doesn’t emanate from the philosophical and logical framework of Ayurveda. They can’t explain their line of treatment and tend to hide behind the shastras as dogma. The result is that they suffer from low selfesteem in comparison to allopathic physicians who have clear answers for all that they do.

In the absence of a deep understanding, the new Ayurveda doctor does not know how to enter into a dialogue with practitioners of modern medicine and build a constructive relationship. There is also a tendency to ignore presentday public health requirements and shy away from preventive and promotive healthcare in which Ayurveda can be very effective. The challenge therefore is to be classical with such rigour that it is possible to be modern without being contrived. For the Ayurveda physician caught in today’s needs and xigencies, creative scholarship is the way forward. Get the texts right and all else will follow. It is precisely to achieve this that FRLHThas on board Prof Lakshmi Thattachar, former director of the Sanskrit Academy, Malkotte, Karnataka. He is a grammarian and he is assisted by his son, Dr MA Alwar, who is a Sanskrit logician. The two pundits are deciphering ancient medical texts, including the Charak Samhita.

They have studied 500 catalogues, taking down technical details. They plan to make primers for students of Ayurveda. The exercisealso serves to salvage important medical works. It also includes the process of finding out original manuscripts. There are many versions. The Charaka alone has 40. Then they plan to bring out a critical edition of selected manuscripts. Their research associate is Dr Shankar, an MBBS physician, who has translated from Sanskrit to English a book on dietetics called Kshemakutubalam from 13th to 14th century written by Kahema Sharma, chief cook of a Rajput king and an ayurvedic physician. The book is a scientific book on how to preserve your health with details on the right diet, when how and where to eat food, the qualitites of a cook, utensils to be used, how to detect toxins and poisons. LABORATORY: FRLHT set up a laboratory in 2001 to use chemistry and pharmacology for assessing traditional medicine.

The laboratory is headed by Padma Venkat, a PhD Cantab. She worked for 10 years in Cambridge University before Darshan got her to join FRLHT and set up the lab. “The main idea is to determine the quality standards of medicinal herbs and traditional medicine not ust from the modern scientific point of view, but also from the traditional viewpoint,” says Dr Padma. The laboratory has the complex job of providing the methodology by which concepts of traditional knowledge can be correlated with modern science. But in a less intricate role it uses standard facilities in chemistry and biology to evaluate and certify raw materials and processes used in traditionalmedicine. It has developed innovative products such as a herbal soup for industry on a consultancy basis. Traditional healers say herbs should be collected only from a particular location at a certain time, stored in a certain way to be effective. The laboratory tries to find out scientifically whether such instructions make a difference to the quality of herbs.

Pharmacognocy, or the identification of crude drugs is done here. All sorts of herbs are traded under one name. This can result in adulteration. The labs use DNA markers to determine species. It has invented a diagnostic kit for small industries that can authenticate the quality of their medicine. FRLHT has applied for a patent. The lab validates certain traditional practices in the contextof modern science. For instance, tests conducted at the lab have found that copper vessels do kill bacteria which cause e-coli, typhoid and cholera. They have identified kitchen herbs which purify water. A squeeze of lime for instance gets rid of pathogens. Pipali, boiledin milk, increases its bioactivity. The labs have invented herbal soups in sachets for acidity, digestion and as a refreshing drink. “I have totally expanded my knowledge base,” says Dr Padma.

HERBARIUM: Work on a herbarium or botanical repository of Indian medicinal plants began in 1995. Till date the herbarium hascollected about 70 per cent of the medicinal plants used by Indian systems of medicine. Work under the leadership of Dr Goraya and Dr Ravikumar is already underway to digitise the herbarium. FRLHT’s herbarium is recognised by the government as the national herbarium for medicinal plants of India. It is also an internationally accredited herbarium. When it is expanded, the herbarium will include medicinal fauna and the metals and minerals used in traditional medicine. It could one day be a chemical and cell repository. The herbarium serves to identify plants and their variants and trace them to their habitats. Plant stems, leaves and seeds are then stored away. Digitising them involves scanning them and making them available as images on computer. “We have information on 7,361 medicinal plant species, with their vernacular names, distribution data, seeds propagation,” says Vijay Barve, senior systems manager. There is a library of 14,000 images and maps showing eco-distribution and forests. A team of four to five botanists make frequent trips to hunt and identify medicinal plant species. States which have been mapped include Karnataka, Kerala and Tamil Nadu. State- wise CDs of plants are available

AMRUTHA VANA: An ethno-medicinal garden, the Amrutha Vana, has been created on the FRLHT campus. It has more than 800 species of tropical Indian medicinal plants from habitats as far away as Arunachal Pradesh. There are grasses, herbs and trees. “We would like to make this a national garden with medicinal plants fromevery region of India,” says Dr K. Haridasan, one of India’s leading botanists and a specialist on the northeast. This garden has been lovingly put together by him and Ganesh Babu. The plants re organised in some 20 different themes. There are 30 species for hair and skin care, 27 species that work as antidotes for poisonous bites, 40 species for primary health care, 56 species that are on the Red List and highly endangered. There are also a great many aromatic medicinal plants and an aquatic herbal garden as well. The Amrutha Vana has been the inspiration for other home, community and institutional herbal gardens. Thousands of kitchen gardens have been created in the Bangalore area from here. “IT companies, Ayurveda resorts and spas are asking for these plants,” says Dr Haridasan. “A garden has been built by us in Hyderabad’s Genome Valley. There is scope of going commercial. We are backed by a great knowledge base.” Dr Haridasan says FRLHT has a village botanist programme which teaches villagers to identify plants and educates them on IPR issues. This knowledge can be used for local health needs, tourism or for forest department surveys. There is also a plant identification course.

IN SITU CONSERVATION: Conservation of medicinal plants is where FRLHT began in 1993. This conservation took place in forest habitats. Since then the programme has covered nine states created 84 conservation areas for medicinal plants. These areas serve as wild gene pools. India is now a world leader in the in situ conservation of medicinal plants. FRLHT has had to work with the forest department and sensitise its staff, who have gone from being completely apathetic to medicinal plants as a forest community resource to now actively participating in efforts for their conservation. GA Kinhal of the Madhya Pradesh cadre of the Indian Forest Service is on deputation with FRLHT and oversees this programme. Kinhal says there has been a lot of learning among foresters.“Most of all I have learnt to be persistent on certain aspects of forestry and to engage in community dialogue. There is a lack of interaction between society and the forest department,” he says. Kinhal emphasises the importance of sustainable harvesting of medicinal plants.

These plants should be planted within appropriate forests by the forest department to preserve the gene pool. “Cultivating species for industry does not mean conservation,” he clarifies. To conserve, the causes of depletion should be removed. Using a mix of traditional and scientific knowledge he has helped work out how and when medicinal and aromatic plants should be harvested. The role of the community is essential in this process. Plants harvested at the right time and using the correct method are easier to preserve after processing. Similarly seeds when collected at the right time yield more oil.

IT AND TRADITIONAL KNOWLEDGE: Since 1995, engineered by DK Ved, FRLHT has been putting on to computer the botany and material medica of traditional systems. Dr SN Venugopal is an Ayurveda physician who works on digitising the texts so that they become easily available. He has built a huge database of 125,000 plant names used in Ayurveda. From the Charaka Samhita he has identified 12,875 Sanskrit names of plants. “After grouping these we get 620 plants,” he says. There is detailed information on each plant: its formulations, properties, qualities, critical comments, botanical name, identity. There are pictures of each plant. Plants from Siddha have also been computerised. Dr Venugopal designed software for this documentation. A complete grouping of plant names from the Charaka Samhita is available on CD from him for Rs 250 for students and educational institutes.

GRAM MOOLIGAI COMPANY: FRLHT’s work in mobilising communities and helping them use their local knowledge remains hugely exciting. The challenge before FRLHT lies in taking communities to the market through various connections. FRLHT has been instrumental in the setting up of the Gram Mooligai Company whose shareholders are rural women and small and marginal farmers. It is registeredunder the companies act and in the past three years has done total business worth more than Rs 1 crore. The company cultivates and collects herbal plants and produces products from them such as a natural remedy for cows.

MALARIA DRUG AND A COUGH SYRUP: FRLHT seeks to bring back local health solutions in rural communities in southern India. To do this it has sponsored conventions of folk healers at the district and state levels. It has also been giving awards to outstanding folk healers. This has led to the evaluation of local remedies. An interesting trial was conducted in districts of Tamil Nadu with a local cough remedy. Its efficacy wasmeasured against allopathic prescriptions. The study was done by M Abdul Kareem of FRLHT in collaboration with the Christian Medical College in Vellore. It showed that the local remedy was more effective. A study for scabies yielded similar results. Dr MNB Nair was asked by the Kannada Milk Federation (KMF) to help out with health ailments faced by their cattle. Nair worked with folk healers to identify 190 herbs. Five inexpensive medicines which could tackle mastitis, wounds, repeated breeding were made.

KMF has got a licence to make the mastitis medicine which costs only Rs 60. Similarly, herbal formulations have been found to inhabit malaria in the liver. “Traditional healers give different medicines for different types of fever,” says Dr Prakash BN, who heads the malaria research programme. These fevers and medicines were identified. A number of observational studies were done, including in Mayurbhanj and Keonjhar districts of Orissa. The group given the preventive herbal medicine did not develop malaria. Around 10 formulations have been identified and FRLHT will be collaborating with the Indian Institute of Science, Bangalore to commercialise these. The involvement with folk healers has also involved evaluating the work of bone-setters. Says Dr Lokesh, “Our studies have shown that they can handle simple fractures and dislocation, but not the complex ones.” The benefits of folk medicine at an affordable cost has prompted FRLHT to work with other NGOs and self-help groups of women to promote over 200,000 home herbal gardens cross the southern Indian states and in Maharashtra, Orissa and Chhatisgarh as well. Pushpa HK, a life sciences graduate says for rban residents, a complete package of 21 plants costs only Rs 300. Advice on how to look after the plants is readily available from FRLHT. Twenty plants have been identified for primary healthcare.

The home herbal garden is being promoted with herbal formulations to tackle anaemia in Chittoor district of Andhra Pradesh said Dr Nagendra. Women are encouraged to grow greens in their backyard. Around 161 herbal formulations for aneamia have been short listed. Dr Nagendra has been organising folk healers. “Each village has one or two but they have no common platform,” he says. A folk ealers network of 150 associations has been formed in nine states.. They have been taken for exposure visits and three state conventions have been held. “These are the last generation of folk healers,” says Dr Nagendra.

 

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