Homeopathy in Comprehensive Health Policy Kerala – Draft

Draft submitted by : Dr Ravi M Nair 

Ch.1 a. Legacy
Homoeopathy has only a history of 125 years in Kerala. It was recognized first in the State in 1928. It took its place in the Travancore Medical Practitioners Act 1943 and subsequently in the T.C.M.P Act 1953 with a provision for separate council for Homoeopathy. This was extended to the Malabar area through Kerala Adaptation Laws Order 1956. The Homoeopathy Central Council Act 1973 was enforced in the State w.e.f. 1^st August 1974. It is estimated that there are about 8500 practitioners as on date including very few practitioners registered under Part B which consists only those who are not possessing recognized qualification. It was in 1957 that Homoeopathy was included in the public sector of the health care service. The Govt., as a matter of policy, declared in the  year1967 the setting up of one dispensary each in Allopathy, Ayurveda and Homoeopathy in every Panchayat. A separate department of Homoeopathy was formed in 1973.

An interim 41/2 years (DHMS) diploma course was introduced in 1958. Following this course was conducted in 3 private colleges and wound up in 1989. In the meantime a 51/ 2 years degree course (BHMS) was started in the public sector in 1975. A graded BHMS course was also conducted to upgrade the diploma holders. A PG course (MD (Hom.)) of 3 years in 3 disciplines followed suit in the public sector in 1991 with an intake of 12  students in each discipline. A Nurse cum Pharmacist course of one year was started under the Dept. of Homoeopathy in 1994 for catering to the needs of Govt. institutions.

Research is being done mainly under CCRH, which is an autonomous organization in Central Govt. There are 31 units across the nation, among which one of the Central Research  Institute in Homoeopathy is at Kurichy, Kottayam. Clinical research and drug proving have been conducted there since 1974. It was declared as Homoeopathic Research Centre exclusively for behavioral disorders and epilepsy in 1988. There is a 50 bedded hospital dealing with psychiatric patients. This is the only one of this kind in India.

A Homoeopathic Pharmacy was started under co-operative sector (HOMCO) at Alappuzha in 1975. A State level epidemic control cell (RAECH) was set up in 2005 after formulating a scientific protocol.

Ch II.b. Situation Analysis

Under the Dept. of Homoeopathy there are 581 dispensaries, 13 district hospitals and 17 taluk hospitals providing a total no. of 945 beds. There are also 13 Dispensaries and one hospital under ESI sector, one CGHS dispensary, dispensaries in 2 Municipalities (Manjeri & Tirur) and 2 City Corporations (Kollam & Kochi). Besides the above there are temporary dispensaries numbering 328 under NRHM scheme and 29 ones in the ST/SC dominant areas.

There are two GHMCs conducting both UG and PG courses while 3 aided HMCs are running UG course with an annual intake of 50 in each college. There is a collegiate hospital attached to each college providing a total number of 300 beds.

A school health program titled “Jyothirgamaya” was started in 2004. Now there are two schools in each district coming under this program. A ‘Seethalayam’ project, a gender based program aimed at providing aid for suffering women, in particular women victims of violence in the society addressing their mental, physical and social health through medical treatment and counseling has also been launched in all district hospitals since 2010 harvesting encouraging results.

HOMCO is distributing quality medicines to various State Govt. institutions at subsidized rate in addition to several other State and Central Govt. institutions. Export of medicines has also since been undertaken recently. This pharmacy which is run on a marginal profit has its own herbal garden which is being developed in a plot of 5 acres of land at Mundakkayam (Kottayam Dist.)

COMPREHENSIVE HEALTH POLICY PRESCRIPTIONS

1. Since stress have been given only to curative medicine so far, similar thrust will also be given in preventive, promotive and rehabilitative health care including trauma care by utilizing maximum public, private and people’s participation (PPPP) and integration of all systems of medicine.
2. Medical pluralism in the country provides people with options to avail treatments of their choice and help bridging the gaps in health care. This being the case integrating and main streaming of AYUSH systems of medicine in health care delivery system would be done by ensuring maximum use of vast infrastructure of hospitals, dispensaries and physicians.
3. Facilities for developing and updating AYUSH systems would be provided by using all the trendy technologies and know-how without compromising the principles and tenets of the individual system of medicine.
4. Efforts would be taken to develop educational and research institutions in AYUSH systems of medicine into centres of excellence facilitating them to achieve their conceptual targets.
5. Efforts will be made to bring in all possible means of standardization in practice, education, research, medicine manufacturing, dispensing of AYUSH systems of medicine.

Ch. III .Infrastructure issues

1. State Policy of establishing one institution (dispensary / hospital) under 3 systems of medicine viz. Allopathy, Ayurveda and Homoeopathy in every Panchayat, declared in 1967, will be materialized in full by the year 2017 which marks the completion of 50 years of the above declaration and the end of 12th Five year Plan.
2. Steps need to be taken for providing 50 and 25 bedded Homoeopathy hospitals each with all modern facilities in all Districts and Taluks respectively.
3. Following the pattern in State Secretariat, dispensaries under 3 systems of medicine would be established in all District Civil Stations, Public Offices, ESI Medical Services, Prisons etc. for providing health care service to employees and the prisoners.
4. The institutions / centres for studies and research, suggested in the University Formation Committee Reports of the 3 systems of medicine viz. Modern Medicine, Ayurveda and Homoeopathy would be established in a phased programme by striking due priority.
5. The modern diagnostic facilities such as clinical labs, X-ray, scan, ECG etc. would also be provided in Homoeopathic hospitals with the service of the required staff.
6. An All India Institute for further advanced studies, research etc would be set up in Kerala in Homoeopathy considering its acceptance and recognition in our State compared with that of other States in India.
7. A State level Training Institute in Homoeopathy would be established for giving shape to all the training programmes and to conduct them, being monitored regularly.
8. Necessary Drug Testing Lab , Institutes for Drug Standardization and Development for Homoeopathy need to be established in the State.
9. AYUSH institutions (health care, education, research, medicine manufacturing etc) at all levels would be renovated, modernized and upgraded to provide full range of their activities and functions.
10. The realm of activities now made available in the hospitals of modern medicine such as pay wards, clinical labs etc. by KHRWS would also be extended to the hospitals of the AYUSH systems of medicine.
11. Kerala State Paramedical Services Corporation may be established under PPmix for setting up clinical labs, institutes / centres for clinical investigations and arranging the services of paramedics including Home Nurses for meeting the needs of the various institutions / houses etc. for making available standardized service at reasonable cost.
12. Kerala State Medical Publication Corporation may be established under PPmix for the publication and sales of medical books, journals, magazines, research studies, IEC materials etc. in all systems of medicine.
13. A State level Homoeopathic Archive may be setup for keeping and preserving all the invaluable records, documents, books etc. that are perishable in the passage of time.

Ch. IV  Governance

1. A separate Dept. of AYUSH under an independent Secretary to Govt. need to be established in the State Health Secretariat in order to mobilize and execute effectively the Central Schemes for the development of AYUSH systems of medicine.
2. As in the cases of Modern Medicine and Ayurveda, a Directorate of Medical Education in Homoeopathy need to be established for developing, regulating and monitoring the education and training of Homoeopathic professionals viz, practitioners, paramedics, teachers, researchers etc.
3. In the analogy of the Central Council for Health and Family Welfare a State Council for Health and Family Welfare may be constituted under the chairmanship of Chief Minister or Health Minister with other Minister (s) and H.o.Ds connected with Public Health affairs, and all the H.o.Ds. & Heads of major institutions under the Dept. of health besides the Presidents of Dist. Panchayats and Mayors as members. Regular and periodical meetings will be conducted in the matter of framing policies, and other relevant issues from time to time. Similar setup would be formed at District and Grama Panchayat levels under the Presidents of the respective councils. All these are intended to make a co-ordination of activities of the Depts. related to public health.
4. A separate Drug Control wing for Homoeopathy may be established under State Department of Drug Control with qualified Homoeopathic personnel.
5. The administrative set up of the Dept. of Homoeopathy may be strengthened in tune with its development from time to time.

Legislations Regulations

1. To avoid quackery in medical practice, only registered practitioners should be allowed to practice in the particular system of medicine alone where he enjoys registration. The required comprehensive State Medical Act will be brought into force forthwith.
2. Steps would be taken to implement Clinical Establishment Act of India 2010 in Kerala with a view to maintaining the quality and standard of health care service.
3. KPHS may be formulated in the analogy of IPHS to standardize the infrastructure and health care service in all systems of medicine.
4. Management (Treatment) protocols for prevalent diseases in each system of medicine would be formulated and brought into practice.
5. Homoeopathic treatment and attendant services would also be included in the Medical Insurance scheme.

Ch. V NRHM

1. Homoeopathic dispensaries under NRHM scheme functioning temporarily will be made permanent with adequate staff & other infrastructures.

Ch. VI Suggestions for focusing areas

1. Health education would be given to all people of the society to maintain personal & environmental hygiene, nutrition, healthy food habits along with the relative scope and limitations of prevailing systems of medicine. For educating the entire mass, necessary IEC materials may be developed and distributed. Health club with health care cadets (HCC) would be formed in educational institutions and under the organizations of employees, residents women folk etc. All such organizations would be encouraged to work in unison to promote health education and to keep all hygienic measures.
2. In order to develop a healthy generation the existing school health programme will be extended to include practice of yoga and meditation, treatment for minimizing the morbidity rate along with the correction of behavioral disorders and learning disabilities.
3. Health science would be made as a prescribed subject in school curriculum as in the case of basic science like General Science. Competent teachers will be created by starting graduate and post graduate courses in Health Science. The increase in the number of graduates & post graduates in Health Science will necessary entail a drastic change in health awareness of the society.
4. A detailed Health Informatics system including and enlightening all the aspects of health care facilities need to be developed enabling the public to get easy access to it.
5. As Homoeopathy has better scope in certain areas/conditions of maternity and child health care than other systems of medicine, steps would be taken to integrate Homoeopathy also in it.
6. Special attention may be given to provide all sorts of health care wellness to the differently abled by integrating all systems of medicine.
7. All medical practitioners would be given training for the early detection of cancer and in the detection and management of life style diseases.
8. Effective training in dealing with emergency management and first aid in medicine with auxiliary measures would be given to the undergraduate students and practitioners of the AYUSH systems of medicine.
9. As Homoeopathy has better scope in epidemic control in an affordable, acceptable, accessible, safe and simple way capable of reaching the public with in a short time, the prevailing epidemic control programme in Homoeopathy may be developed and updated scientifically. Steps will also be taken to propagate and integrate Homoeopathy along with other systems of medicine wherever epidemics break out.
10. The benefits of Bio-diversity prevailing in the State would be utilized fully for health care, by developing and preserving medicinal plant gardens, animal farms etc. simultaneously making the people aware about its significance and importance in health care.
11. The strength, competence, and co-operation of the professional organizations in the field of all systems of medicine need to be embraced, recognized, encouraged and utilized for the better health care activities.

Ethics

1. The students of the under graduate course in every system of medicine will be imparted training to make them more aware of medical ethics, to become patient-friendly and to enable them to grasp the public health issues of the community.

Ch. VII Drugs & Pharmaceuticals

1. Steps may be taken to ensure the availability of standard quality of Homoeopathic medicines, sundries etc. to all the Govt. institutions and the general practitioners.

1. Steps would be taken to dispense Homoeopathic medicines scientifically and user friendly by modernizing the mode of dispensing.

Ch. VIII AYUSH Systems (special issues)

1. Create awareness about the strength, salient features, scope and limitations of AYUSH systems of medicine among the people
2. All Homoeopathic medical officers / practitioners being engaged for any specialized field of health care will be subject to prior training in the concerned subject and subsequent  updation from time to time.
3. Steps will be taken to update the practitioners, and paramedics in all systems of medicine to undergo CME programmes obligatory for renewing their registration once in every 5 years.

Ch. IX Medical Education

1. Steps would be taken for equalizing the social and professional status of the AYUSH professionals with those of the conventional medicine to attract talented men to AYUSH systems of medicine
2. In the Medical Entrance test for AYUSH systems of medicine, an aptitude test may also be included to assess the affinity of the students in the particular system of medicine.
3. Annual intake of students in BHMS course has necessarily to be enhanced to make good the deficiency of Homoeopathic practitioners in the State.
4. P.G. courses in Homoeopathy may be started in all disciplines which have been and are being instituted from time to time by the CCH. Necessary opportunities and facilities would be provided to the Homoeopathic graduates to undergo higher studies in basic and allied medical subjects with a view to creating talented teachers and researchers
5. It would be ensured by the KUHS that standard teaching and training are done with the required infrastructure including staff as prescribed in the syllabus and regulations in each course by conducting periodical and surprise inspections.
6. All medical officers, teachers and researchers in Homoeopathy will be given necessary training prior to their entry in service and subsequent periodical in-service training.

Medical Education & Training  

1. Teaching methodology with teaching aids need to be developed scientifically in each subjects of medical science in all systems of medicine by the KUHS and the teachers would be trained accordingly with timely updation.
2. Mutual understanding about the salient features, scope and limitations of each system of medicine would be developed for the smooth and effective integration of the different systems of medicine. This will be introduced from the very beginning of medical education and continued in respective  fields where the incumbents are engaged through workshops, seminars, discussions etc.
3. Steps will be taken to establish one constituent college under each system of medicine in the KUHS campus for developing a scientific teaching methodology in all the systems of medicine in an integrated way in order to create mutual understanding for co-existence.
4. Research methodology will be included in the UG curriculum of AYUSH systems of medicine.

Ch. X Paramedical Education  

1. Paramedics in Homoeopathy would be developed after enacting necessary legislation and formulating regulatory bodies besides establishing the requisite training institutions. 

Ch. XI Medical Research  

1. State Govt. will promote to conduct research in medical science by arranging maximum convenience and facilities including providing financial assistance either through Government or other agencies.
2. Facilities for conducting inter-disciplinary and collaborative researches between the systems of medicine for studying and comparing the efficacy and merits of the systems involved will also be made.
3. The Research Council of KUHS would be so expanded as to make research guidelines for clinical research in all systems of medicine including inter disciplinary ones simultaneously taking steps to give accreditation of the deserving institutions both in private and public sectors.
4. In all colleges under the AYUSH systems of medicine, adequate facilities for conducting clinical research would be provided with necessary encouragement for promoting it.
5. Encouragement may be given to set up research forums under the professional organizations in all systems of medicine.

Ch. XII Newer Frontiers 

1. As Homoeopathy possesses holistic concepts in medicine, predicting the proneness of diseases for correcting the internal dyscrasia, personalised medicine, pre-diagonstic intervention in diseases, affordable, acceptable, accessible, safe and simple medication, it would be given more thrust in Family Medicine.
2. Medicities / Health Villages require to be developed under PPmix providing facilities for health care, diagnostic services, medicine manufacturing & pharmacy, stores for medical equipment, books & publications etc. etc. of all systems of medicine with all sorts of encouragement.
3. There are a few methods of treatment or practice of medicine including indigenous and folklore medicine which are not recognised as systems of medicine even though stray claims of effectiveness are being advanced here and there. Necessary studies may be instituted to bring out the veracity and validity of such claims. The positive claims may be taken in to account for adopting such practices in health care.
4. With a view to attracting tourists in large numbers, in the wake of the emerging significance of holistic health care, steps would be taken to promote health care tourism at its best exploiting all the available resources in Kerala giving access to State Health Informatics.

Dear Homoeopaths,
Express your comments and suggestion here if any…since this is only a draft