ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Can Maternity Services Open Up to the Indigenous Traditions of Midwifery?

Mainstreaming the ayurveda, yoga, unani, siddha, homeopathy systems should imply deep changes in maternity care. Big changes there are, but in the wrong direction. Aiming to reduce maternal and neonatal mortality, the National Rural Health Mission's Janani Suraksha Yojana scheme presses expectant mothers to go for "institutional delivery" and avoid home births. The nrhm document also speaks of revitalising local health traditions. This means that the dais who have been part of the local health traditions should be incorporated into the government structure at the lowest end as has always been the case. This paper raises various questions related to maternity care governance for the benefit of local communities and looks at the possibilities of strengthening the services with serious inputs from dais. It acknowledges the dimensions of class, caste, gender, power and ideology that would be implicated in the acceptance of the "dai tradition" within the healthcare services system.

Recovering from Psychosocial Traumas: The Place of Dargahs in Maharashtra

Dargahs have come under attack in recent times, following the tragic death of 25 mentally ill people at Erwadi in Tamil Nadu. The tragedy invited a Supreme Court suo motu intervention against local healing shrines all over the country that also included reform of the mental health system in general. This set of medico-legal events has led to the exclusive targeting of local healing shrines by various statutory agencies evoking human rights, ignoring the primary intent of the court that was reform of the mental health system in general. Against this context, we are presenting case studies of dargahs in Maharashtra which serve the purpose of healing from psychosocial traumas and argue for a more deliberate response to the vexed question of mental healing and overall health.

The Patient as a Knower: Principle and Practice in Siddha Medicine

The relation between experience and knowledge has been the subject of several debates in the sociology of knowledge, especially with regard to medical knowledge. The disease is experienced by the patient and the physician, who has the knowledge of disease, conducts the diagnoses and provides treatment. This poses two questions: Does the patient, who experiences the disease, have knowledge? Does the physician, who knows the disease and its cure, have recourse to experience? How does epistemology address the relation between the ontology of the patient the layman and the doctor the specialist? After a presentation of the problematic as it reveals itself in the analysis of biomedicine, the paper proceeds, based on fieldwork with siddha practitioners in Tamil Nadu, to examine the siddha medicine approach to these issues.

'Commercialising Traditional Medicine': Ayurvedic Manufacturing in Kerala

This is an attempt to answer two questions on the manufacture of ayurvedic products in Kerala. First, has the performance of the ayurvedic sector been impressive? Preliminary analysis shows that the ayurvedic industry, which has a concentrated market structure, is growing at a much higher rate than that of overall manufacturing. Considering the fact that the ayurvedic medicinal ingredients are sourced differently, namely, from herbal, metal and mineral substances that cannot be industrially manufactured, the second question is: what are the challenges faced by the ayurvedic medicine manufacturing sector? The paper also throws light on the economic relevance of ayurvedic knowledge and how modern firms have amassed it in a competitive environment.

Medicine as Culture: Indigenous Medicine in Cosmopolitan Mumbai

Using the framework of medicine as culture and focusing on the indigenous medicine of ayurveda, this paper examines the relationship between health, culture and medicine, and its social reproduction in contemporary India. Specifically it deals with the cultural construct of "Kerala ayurveda", and the modes of its societal reproduction and recreation simultaneously as culture and as medicine in cosmopolitan Mumbai. Through an analysis of the historical and cultural roots of Kerala ayurveda and the role of community organisations in its translocation into a city, the paper shows the analytical fragility of the tradition/modern binary in the understanding of contemporary indigenous systems and questions the belief that state and market provide the foremost sites for institutional and secular practice of indigenous medicines.

Medicine, State and Society

The demand for cure and for the care of a growing range of health conditions which elude any particular system of medicine has made pluralism in therapeutic options a way of life. The spread and continuity of indigenous systems of medicines, namely, ayurveda, siddha and unani, have thrown up a lot of concerns as well: how to incorporate these systems into a centralised health infrastructure; their expansion through the pharmaceutical industry for herbal products, massage centres and spas; the relations and negotiations between the practitioners of different coexisting systems of medicine; the position of psychosocial and spiritual dimensions of cure and care in contemporary forms of indigenous systems of medicine and the debate on notions of efficacy in multiple, coherent systems of medicine. All these are worth serious study as they raise fundamental questions not just about isms, but about organising healthcare in India. A framework for the analysis of isms requires not only recognising the presence of diverse medical systems, but engaging with them as live and efficacious traditions. The collection of papers in this special issue attempts to address some of these matters.
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