Health Practices In Nepal

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Health Practices In Nepal

• Presented By
• Dr Rishi Ram Koirala, MD (Ay)
• Bhupendra Nirajan Khaniya

COPPADES, Nepal
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Background

• Land of great altitudinal and ethnic diversity
• Many ethnic groups with different customs and
  languages
• Understanding of diseases, practices of
  indigenous knowledge and use of medicinal plants,
  minerals, animal parts, technologies for
  preparation of drugs, are highly influenced by
  their own culture and religion.
• People have strong belief and faith in
  traditional medical system.

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Existing Health system

• Traditional medical system
• Ayurveda
• Amchi
• Homeopathic
• Naturopathic
• Others
• Modern allopathic medical system

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Traditional medicine in Nepal

• Ayurveda omnipresent science of our rich
  tradition, heritage, and century-old knowledge,
  authentically recorded, culturally based health
  system, provides great wealth and heritage to our
  nation.
• The history of Ayurveda can be traced to
  different periods, the earliest being the Vedic
  period when the Aryans complied the four Veda
  (1500-800 BC) with maximum reference in Rigveda
  and Atharvaveda.
• Two types of Ayurveda practitioners are exist in
  Nepal. First, Ayurveda based traditional healers
  and academic Ayurveda practitioners

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National Resources1. Medicinal Plants/Herbal
resources

• 3500 species of medicinal plants has been
  reported belonging 938 genera 218 families.
• Majority of Nepalese people rely on these
  resources for their livelihood and health issues.
  Eighty percent of the rural economy is based on
  plants.
• There are many rare and highly important plants
  available in Nepal.
• This resource is potential for
• - innovation of new drug.
• - the improvement of the
  economic status of the community.
• - the management of the primary
  health care problems
• - provide solution to the
  difficult heath issues in the world.
• - the preservation of the
  global environment.
• Some of these herbs species are rare and
  endangered. Need immediate intervention.
• Many of these herbs are being patented in other
  countries.

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Medicinal Plants
Aduva
Amala
Rajavriksha
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Medicinal plants
Katuka
Alpine collection area
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Classical Sayings

• Nadishu Shaileshu Sarahshu Chapi
• Punyeshwaranyeshu
  Tathashrameshu.
• Sarvatra Saravah Parimargitavyah
• Sarvatra Bhumirhi Vausni Dhatte.
• Sushruta Samhita Chukitsathana 30/40
• Let us be humble and search for Medicinal
  Plants with real devotion
• in river beds,
• on the mountains,
• vicinity of lakes and their waters,
• in the in jungles and holy places,
• ashrams of Rishis and Saints,
• around roadside
• and everywhere in our motherland earth.

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Patent example Turmeric its formulations or its
active ingredients

• Patent no.
• US 6352712 Dietary supplements containing
  Rosemary and Curcumin for treating
  fatigue-related syndromes.
• DE 10029770 Use of Curcumin for the treatment of
  solid tumors, especially brain tumors
• WO 2002017906 Compositions for the treatment of
  hypertringlyceridemia
• AU 2001046863 Interleukin-12 inducing composition
  comprises curcumin or its derivatives
• CN 1300602 Traditional patent medicine for
  lowering viscisity of cholesterol calculous bile
• CN 1301535 Use of curcumin to treat Hepatitis B
• FR 2806263 Nutritional supplements based on
  tomato lycopene, pumpkin seeds oil and a
  multivitamin complex and
  turmeric
• CN 133729 Tropical treatment of skin using
  hydrolyzed vegetable proteins
• DE 20109044 Tropical formulation for the
  treatment of itching skin containing plant
  extracts
• US 6248343 Therapeutic anti-microbial
  compositions
• US 2002019382 Preparation of curcumin analogous
  for treating cancer
• US 2001051184 Method for using soluble curcumin
  to inhibit phosphorylase kinase in inflammatory
  diseases
• US 2002006966 Curcumin and curcuminoid inhibition
  of angiogenesis
• JP 2001031580 Skin preparations containing
  anti-inflammatory
• WO 2001012130 Composition and methods of
  treatment for skin conditions using extracts of
  turmeric
• US 6126950 Formulation for healing and protecting
  skin containing curcuma extract, natural gum,
  fragrant oil, beeswax and
  petroleum jelly
• JP 2001238650 Drinking water with health
  promoting effects, is formed by mixing reishi
  mushroom, turmeric and
  Panax notoginseng in water

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National Resources2. Codified Knowledge/
Classical Manuscripts

• There are more than 4000 Classical manuscripts of
  Ay. in Nepal.
• In Ayurveda there are more than 14000 classical
  recipes, and several other therapeutic
  techniques.
• This resource is potential for
• - innovation of drug
  formulations
• - therapeutic techniques,
  procedures
• - IPR research benefits
  sharing, utility model sharing,
• This resource is in severe threat due to lack of
  proper preservation, research work and lack of
  knowledge.
• There is a serious threat of patenting by other
  countries,
• Example of the some patented manuscripts
  Kashyapa samhita, Todarananda Ayurveda Saukhyama,
  Siddhasara nighantu.

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Contd.

• Our Archeology Library is one of the richest and
  rare library in the world.
• Are we able to use it? We sell things in such a
  nominal price that per page costs Rs.5/.
• There are very few people remaining who can read
  this language.
• Further the tragedy of this country is that there
  is no Sanskrita teaching in school.
• Where as in USA there are several schools and
  universities are teaching sanskrit.

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Example of the classical texts
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National Resources 3. Ayurvedic and other
Traditional Practitioners/ Healers

• The estimated number of these practitioners in
  Nepal is 400,000
• A large number of the population still depends
  upon these practitioners.
• Capable to manage a diversity of health problems
  with locally available resources.
• This resource is a potential for
• -health service challenge
• -drug innovation
• -technology development
• -economic growth
• -capable to utilize local resources
• Conservation of this knowledge and practice is
  highly important and is also in great threat.

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Ethnic PeopleNepal is the country of Ethnic
People
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Contd.

• A proper legislation system is required.
• A proper documentation system is essential.
• This wealth is so important that, they are far
  enough experienced than we people.
• These people are being easily cheated and
  exploited by so called knowledgeable peoples and
  foreigners.
• How to protect this knowledge? This is the
  challenge?

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Global scenario of Traditional Medicine
Population using traditional medicine in
developed developing countries (WHO-2002)
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In this region

• Chinas large population depends on traditional
  medicine for their health, economy and
  environment. They have invested huge amount of
  money for their infrastructure development and
  research. They have capitalize this resource.
  Last year international sale of medicinal plants
  and product was 32 Arab dollars.
• Kerala state of India the highest revenue is
  generated by Ayurveda products and services.
• India has taken big steps to capitalize this
  field through patent, IPR, copy rights regime.
  They have digitalized 35000 classical recepies
  from codified manuscripts and vigorously trying
  to digitalize and document oral traditional
  knowledge.
• Sri-Lanka, Pakistan and Thailand are not
  exception.
• Eighty percent of the worlds population relies
  on plant-based medicine as their primary source
  of health care (News Week - recent issue)

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Singha Dubar Vaidhyakhana

• Establishment King Pratap Malla
• Malla Dynasty,
• In Hanuman Dhoka
  Durbar
• Sri 3 Rana Janga Bahadur shifted it first to
  Tapathali Durbar than to Singhadurbar premises
  and it was than named as Singhadurbar
  Vaidhyakhana. Medicines were only prepared for
  Royal and Rana families.
• King Tribhuvan Bira Bikram Shahadeva on 2009
  (1952) issued Royal order to provide medicines to
  the common public on its production cost. Than
  onward this company is producing and supplying
  medicines to common public and government
  dispensaries through out the country. This
  production unit is functioning under Ministry of
  Health since that time.

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Contd.

• Spiritual therapies
• A large number of the population is still
  dependent on these practitioners. Basically they
  follow some ethno-traditional, tantrik, spiritual
  and Ayurvedic knowledge. Though they are not
  included in the official system of health care
  system, they are well known by different names in
  different communities.

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Contd.

• Homeopathy
• This system has recently been recognized as a
  national health system and a homeopathy hospital
  is running by government. The Unani system of
  medicine is also incorporated in this hospital.

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Contd.

• Naturopathy
• This is not an official system of medicine, but
  it has been well-practiced by the community.
  Training in naturopathy is provided by the
  private sector. There are private hospitals,
  training centers, clinics, and dispensaries in
  the country.

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Contd.

• Amchi
• Amchi is a Tibetan medicine or healing practice
  existing in the upper Himalayan region of the
  country. Though this is not an official system of
  medicine there are two types of practitioners in
  this system. Some of them institutionally trained
  and others follow the tradition.

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Modern allopathic medicine

• Modern allopathic medicine has been tremendously
  developing
• Although it services have not reached to majority
  of the population, most of the essential
  facilities are now available especially in urban
  area
• Despite geographical, financial, technological,
  and others constrains huge investment from
  private sector in education, health service and
  manufacturing industries, has remarkably
  contributed to promote health status
• Nepal is able to produce international standard
  manpower, drugs and services.

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Development of TM

• Educational Institution
• The first educational institution in the history
  of health sector in Nepal is Ayurveda College.
• Even today, this is only one college that is
  producing graduate level manpower in Ayurveda. It
  is functioning under Tribhuvan University.
• Besides this, several institutions are running
  under Mahendra Sanskrit University and producing
  certificate level (Ayurveda Health Assistant)
  products. Some training centers are running
  affiliating CTEVT.

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Contd.

• Health service sector
• Nearly nine decades old Naradevi Ayurveda
  Hospital is the countrys oldest health service
  institution. Contribution of Ayurveda Hospital is
  remarkable and unforgettable.
• Now country has 1 Ayurvedic Hospital with 100
  beds in Kathmandu, 1 Hospital in Western region
  with 15 beds, 75 District Ayurveda Centers 216
  dispensaries throughout the country. All the
  Ayurvedic dispensaries, health posts and
  hospitals are providing services free of cost or
  at minimal charges.

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Contd.

• Manufacturing sector
• Singh Durbar Vaidya Khana established during the
  Malla dynasty, and is the only government-manufact
  uring unit for Ayurvedic medicine in Nepal.
  Recently this unit has been made autonomous. Its
  contribution to preserve Ayurveda and fulfillment
  of herbal drugs throughout the country is
  remarkable.
• Couples of dozen private companies are
  successfully producing herbal drugs in recent
  years. Although this country has still to import
  huge portion of national requirement of Ayurvedic
  drugs, private sectors contribution is also
  incredible.

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Modern Allopathic Medicine

• Educational Institution
• Nepal has become attraction of medical students
  in south-Asian region. Reason, it has been
  producing qualified medical doctors and
  paramedical. Health education institutions
  established by public, private and joint venture
  are contributing in production of skilled
  manpower

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Contd

• Health Services
• Data shows development of modern health services
  in Nepal seems satisfactory. Especially in urban
  area, where private sector has invested in health
  sector, most of the modern facilities and
  technologies are available.

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Contd.

• Manufacturing sectors
• Private sector has been tremendously progressing.
  Nepal is capable to produce world class modern
  drugs, which are recognized by WHO. However
  production level doesnt meet a small portion of
  national requirement.

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Threats

• The official medical system-modern allopathic
  medicine refuges to see the other side of the
  story that can offer something good for patients
• Modern allopathic biomedical service has access
  to minority of the population (15)
• Exclusive reliance on the formal western system
  of medicine has been recognized as an inadequate
  solution to the problems of health care delivery

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Contd

• Traditional medicine is becoming worldwide
  popular. Nepal has century-old traditional
  medicine that has been practicing since the time
  immemorial from generation to generation.
• Nepal has already entered into WTO and
  regulations of WTO are going to be binding from
  2006. If the Nepali industries dont follow the
  WTO standard, they cannot enter into the domestic
  as well as international markets, where as
  international products have unlimited access to
  Nepal. As a result Nepali Industries will face
  great crises.
• It is regrettable to say that our students are
  not internationally recognized

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Recommendation

• Documentation
• Information Dissemination
• Training
• Research and Development
• Intellectual Property Right and benefit sharing
• Strengthening of the existing Institutions /
  organization

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Finally

• Introductory courses in traditional and
  complementary medicines.
• Choices in modern allopathic and
  traditional/complementary medicines
• Units for delivering services in traditional and
  complementary medicine
• Dialogue between the conventional and modern
  allopathic medical practitioners
• Public funds should be allocated on equitable
  basis
• Industries of Nepal should be prepared themselves
  to meet WTO standard within deadline. Ayurvedic
  academicians should initiate developing Ayurveda
  educational institutions to get international
  recognition

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Conclusion

• There is no doubt that health is the fundamental
  rights of every human being. And, there is no
  perfect health system in the world. Integration
  of traditional medicine into national health
  care, maximum utilization of local resources and
  knowledge in sustainable manner definitely
  contribute is must.

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THANKKING YOU

• NAMASKAR
• Jay Nepal
• ?

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