Ayurveda and Covid-19: The Politics of Knowledge Systems, Yet Again
From the Series: Responding to an Unfolding Pandemic: Asian Medicines and Covid-19
From the Series: Responding to an Unfolding Pandemic: Asian Medicines and Covid-19
In the wake of the current Covid-19 pandemic, the politics of knowledge systems has resurfaced. It always does, whenever there is a medical emergency of any kind, and perhaps it is high time that we are able to find the most worthwhile parameters of discussion, rather than flogging the dead horse of better claims. In the twenty-first century, there is a real need to alter the terms of discourse in the politics of knowledge, if we are to get anywhere different and fruitful. In this short piece, in order to delineate the best approach both in the short- and long-term, I am going to examine the existing dominant frame of the politics of knowledge and the main parameters that play out in times of a crisis in the field of Ayurveda—in this case, as it relates to this global pandemic.
In tracing the trajectory of the relationship between Ayurveda and biomedicine, at least three worlds of Ayurvedic practitioners can be discerned. The first are those institutionalized along modern lines, whether in medical practice, production, or education. They are practitioners such as modern doctors with degrees like the Bachelors in Ayurvedic Sciences and corresponding degrees in pharmacology. The second group continues to work within the epistemology of diagnosis, prognosis, and treatment of ayurvedic text and practice as has been handed down. These would be physicians trained in the traditional manner, their practice grounded in rigorous textual study while living and working with the guru. The third are healers whose specialized treatments share a broad circle of intelligibility with Ayurveda, but are not confined by it. These might be local health practitioners, with little or basic levels of literacy, but great knowledge of local plants and their uses for a range of complaints, usually trained by a guru of that area. The first dominates the world of Ayurveda in terms of economic and political power, which the latter two do not, but the latter two command respect for the rigor of their knowledge and commitment, catering to a significant proportion of people.
I have argued (Banerjee 2009) that in the longue dureé of their relationship, while evolving, biomedicine sought to posit Ayurveda as the “Other” in every respect; the dominant parts of Ayurveda were keen to project themselves as its “double.” This meant that to begin with, the focus was on creating commodified packaged medicines, available to both physician and patient. Then, on at least four important counts, Ayurveda sought to emulate the patterns of “being medicine” in modern society, set by biomedicine and the modern pharmaceutical industry—on the protocols of trials, the production of medicines, the positioning for sale, and pricing. That is, it accepted the hegemonic frame of knowledge and market and tried to cast itself into this fray, to garner legitimacy in the context of a “modern” society. While this effort kept Ayurveda within the reckoning of biomedical knowledge, it remained on the margins, unable to cope with the kind of capital and scientific knowledge that was being constantly poured into modern pharmaceuticals for these ends. Biomedicine’s focus on defining “medicine” as “curative substances or techniques” that could ameliorate disease meant that the part of knowledge in Ayurveda, which was about maintaining health in the specific agro-ecological context in which people lived, was brushed aside. In the same way, Ayurvedic education, with its broad emphasis on health as well as disease, and its knowledge of the cultivation of medicinal substances as well as the production of medicine, was forced into the compartmentalized institutional framework of biomedical education. Ayurveda therefore, came to be seen as inferior, like it was trying too hard for acceptance, to live up to the parameters set by biomedicine. Ayurvedic drug research even adopted the testing protocols established in biomedical pharmaceutical research, acknowledging that there could be no trials according to Ayurvedic parameters. However, the work of P. Rammanohar (in Furst et al. 2011) disproved this notion and firmly established that research of Ayurvedic drugs was possible by Ayurvedic parameters.
Every medical emergency, therefore, hearkens back to an extension of this friction. Every time biomedicine diagnoses and identifies the problem, invariably all kinds of people claiming ayurvedic knowledge claim that they have the solution. The spectrum of claims is quite remarkable in the manner in which it reconfigures the three worlds of Ayurveda mentioned earlier. The reconfiguration happens in terms of a broad spectrum in which there is on the one end a claim to cure and at the other, a claim to build immunity—the two broad responses that can be expected from it. Claims to cure can come from mostly small-time industrial manufacturers along with traditional practitioners and local healers. Claims to build immunity, but also to intervene in the curative, very judiciously, without making tall claims, are at the other end. The former mostly cite from texts that can be translated (not simply interpreted), to prove that the “new” virus was in fact known thousands of years ago; and so, a cure was also always known. The cure claims are most visible and audible; they also invite scorn and rejection—and this communication dominates the public space. In the current context of crude right-wing claims on ancient Hindu knowledge, these claims quickly gain currency as the best “nationalist” position to take. Given that pandemics are occasions that beg a certain kind of nationalism, it becomes difficult to take a contrarian position on the knowledge being appropriated. Still, the voices of doctors and researchers from informal institutions, who balk at making tall claims, know that their strength is not in the curative, but in the preventive and palliative spaces. These crucial voices are muted or altogether left out of both the public imagination and the reckoning of public policy in the handling of the emergency, even as they continue to make plaintive demands to be included.
Looking for an answer to this Covid-19 crisis requires us to step out of this predictable frame of analysis. If history is a guide, the contestations that began in the late nineteenth century (as discussed in Leslie 1976) and struggled to find resolutions in the twentieth reached a dead-end, because the merits of the fundamental differences in their epistemologies were never explored and emphasized (Shankar, Unnikrishnan, and Venkatasubramanian 2007). Both biomedicine and Ayurveda have preventive and prescriptive components, but the prescriptive dominates in biomedicine, as does the preventive in Ayurveda. Then at least at the level of policy, a complementarity of their usage is what needs to be emphasized. What prevents this visualization, then? The answer to this, too, requires stepping outside the frame of analysis adopted so far.
As long as the veracity of medical knowledge is established through the parameters of the powerful industrial marketplace, it would require Ayurveda to pass this acid test. And that is why, at the time of the approaching pandemic, when its focus should be on its greatest strength—prevention—it is forced to shift the ground to claiming a cure. At the same time, during the pandemic, claims to cure should be made, but clearly within Ayurveda’s own line of treatment, as derived from textual sources. That is, it should not be deterred by either the biomedical community’s skepticism or the clamor of uninformed media. As long as the community of Ayurveda does not face this conundrum and boldly adopt an approach that would extricate itself from this politics of knowledge, the crisis will continue.
In today’s situation, Ayurveda needs to assert two things: that its preventive side is its strength; and that its epistemology allows for a different etiology of disease and treatment, which can be applied to any new malady with the same confidence as biomedical practitioners clearly do in a pandemic. No brash claims of cure or culture can counter this.
Banerjee, Madhulika. 2009. Power, Knowledge, Medicine: Ayurvedic Pharmaceuticals at Home and in the World. Hyderabad: Orient Blackswan.
Furst, Daniel E., Manorama M. Venkatraman, B. G. Krishna Swamy, Mary McGann, Cathryn Booth-Laforce, P. Ram Manohar, Reshmi Sarin, Anita Mahapatra, and P. R. Krishna Kumar. 2011. “Well Controlled, Double-Blind, Placebo-Controlled Trials of Classical Ayurvedic Treatment Are Possible in Rheumatoid Arthritis.” Annals of the Rheumatic Diseases 70, no. 2: 392–93.
Leslie, Charles. 1976. Asian Medical Systems: A Comparative Study.
New Delhi: Motilal Banarsidass.
Shankar, Darshan, P. M. Unnikrishnan, and Padma Venkatasubramanian. 2007. “Need to Develop Inter-cultural Standards for Quality, Safety and Efficacy of Traditional Indian Systems of Medicine.” Current Science 92, no. 11: 1499–1505.