Seventy-one-year-old Savitri has been suffering from cervical pain and right arm stiffness for the past three years. She was treated in many private hospitals in New Delhi, but there was no relief. Then in July, during a satsang session with elderly neighbours she came to know about new Ayush day care private therapy centres for central government employees and pensioners.
She searched online and found a centre just 10 minutes from her home in northwest Delhi’s Rani Bagh. The Tulsi Ayurvedic & Yoga Centre and a handful of others are becoming a pensioners’ paradise in the capital this year. It is the newest frontier for the oldest healthcare system in India. And it is creating quite the buzz among retired government employees – with each posting the news of joining the Central Government Health Scheme (CGHS) panel on WhatsApp groups, other social media sites and through their whisper networks. For pensioners’ Panchkarma (Ayurvedic treatment) is the hot new favourite.
Ayush day care facilities made a quiet entry in Delhi-NCR in 2020 as part of a pilot project under CGHS for central government employees.
The Narendra Modi government’s move to expand the scope has opened a new channel of treatment for thousands of beneficiaries in Delhi-NCR. And the pensioners are beaming with the new possibility of relief because with increasing age they find allopathy and its side effects unmanageable.
“People are tired of injections and medicines. Through therapy, the body is detoxified, which also strengthens the muscles,” said Dr Veena Arora, who has been running the Tulsi Ayurvedic and Yoga Centre in Saraswati Vihar for five years.
What hasn’t changed in the last 28 years, since she started working in the field, is the wellness wars—the evergreen allopathy versus ayurveda debate, the collision of modern with traditional, western medicine with ancient Indian practices.
For the Indian government, such conflicts are unnecessary. Modi government wants all kinds of medical treatments to exist together, said a senior official from the Ministry of Health. It’s underscored by the need to promote traditional Indian practices just like how China marketed acupuncture to the world.
In the 2023-24 budget, allocation to the Ministry of Ayush increased by 20 per cent to Rs 3,647 crore, with an emphasis on promoting evidence-based research in Ayush systems through Ayush research councils.
“Ayurveda and naturopathy are our own, so it should be promoted,” said Dr Ashok M. Iti, Joint Director (Ayush) in CGHS.
Also read: AYUSH medicine usage declining, NSS data shows. Integrate with allopathy for better reach
PM Modi’s push
Savitri arrived at the Saraswati Vihar centre in a rickshaw on a sultry afternoon in July. As the wife of a central government employee, she is a beneficiary. She was tired of the hospital visits, endless forms, pills, doctors and specialists—each one treating a different ailment in isolation whether it was her cervical pain or arthritis or a stiff right hand. She had been reduced to a sum of her body parts.
“They suggested physiotherapy, which works slightly, but is not a long-lasting solution,” she said.
There are five empanelled day-care therapy centres in New Delhi, one in Noida and one in Ghaziabad. These centres have been included in the government’s Ayush day care therapy centre list. They were shortlisted on 28 June this year after the 2020 pilot was deemed a success.
“This step has been taken by the ministry, keeping in view of the growing popularity of Ayush system of medicines amongst the public at large and all CGHS beneficiaries,” reads the Ayush ministry in a statement back in 2020.
Though Savitri has had only three sessions so far, she says she is already seeing improvement. The stiffness in her right hand has reduced greatly, she said.
“I could see the effect on my right hand within two days. Already the pain has reduced a bit,” said Savitri raising her right hand to show improvement in movement.
But Arora, who has been an ayurvedic practitioner for nearly three decades, says it will take time.
“Aunty, you have arthritis, that’s why your hands are stiff. Ayurvedic treatment will start showing effect slowly,” Arora told Savitri.
According to Arora, even allopathy doctors come to her for treatment.
The acceptance of indigenous health care systems such as ayurveda, naturopathy and yoga has been growing in the past two decades among Indians – first with Baba Ramdev’s campaign and then under the Modi government. But pensioners’ CGHS benefits only covered modern allopathic treatment.
Before 2014, Ayush used to be just a department. But it was made into a ministry after Modi came to power. The prime minister, too, has promoted Indian healing therapies on the global platform with the aim of making it a byword from the “Arctic to Antarctica”. Covid-19 gave Ayush therapies an impetus.
In 2021, the Ministry of Ayush released a national clinical management protocol based on ayurveda and yoga therapies where it suggested steam inhalation with ajwain (carom seeds), gargling with warm water and using a netipot. Modi too encouraged people to embrace the principles of ayurveda, saying it was the right time for traditional medicines to become “even more popular globally”. Last year, he inaugurated three National Ayush institutes of eminence in ayurveda, Homoeopathy and Unani in Goa, Ghaziabad and New Delhi.
“The world is now returning to our traditional medicine and yoga and ayurveda are the new hope for the world,” he said during the inauguration. Currently India has 453 ayurvedic medicine colleges and attached hospitals.
The prime minister also declared that Ayush doctors are equally recognised as allopathic doctors now. “This has transformed medical treatment,” he said.
Also read: Incorrect to call Ayurveda, homoeopathy alternative medicine for Covid — top AYUSH official
Panchkarma, Shirodhara and more
Now that her centre has been empanelled, Arora’s phone rings non-stop. On the other end are patients asking about information on the CGHS. In the first 15 days since the scheme was rolled out, more than 100 CGHS patients have come to her centre. Most are pensioners over 60 years of age.
But to get treatment at a private day care facility, they first have to approach any of the 138 CGHS dispensaries in Delhi NCR for a referral card. The scheme allows them to get free treatment for 14 days. After three months, if the problem persists, the beneficiary can undergo another round of 14-day therapy.
People want to experience the Panchkarma treatment, which is based on ayurvedic principles of the body, mind and consciousness through Vamana (emesis), Virechana (therapeutic purgation), Nasya (nasal medication) and other traditional practices.
Arora’s centre is now always full of clients. It’s not a sprawling facility one-storey building with four to five small rooms for different Panchkarma treatments. In one room, a circular jar with a hole in the centre hangs from the ceiling. This is used in Shirodhara, a healing treatment where medicated oil drips slowly and steadily on the patient’s forehead. Another room has a sauna or steam facilities.
Arora’s centre has 13 therapists, women and men who all have expertise in Panchkarma treatment. Many are busy boiling herbs for the traditional potli massage.
Kamal Sanhotra (69) enjoyed the experience. After the traditional oil massage, followed by a steam treatment, he emerged 45-minutes later holding a cup of green tea. His last two-three years have been marred by pain radiating from a problematic hip.
“Around 80 per cent of my body is feeling relaxed. I am very happy with this treatment. It gives natural relief. Ayurveda and Panchkarma have been ancient methods of treatment, but earlier we had only allopathy as an option,” said Sanhotra, a retired officer from the tourist department. He’s a firm believer in alternative treatments that allopathy cannot address.
Over the years, ayurveda has come to be associated with the wealthy class who check themselves into expensive naturopathy centres for personalised therapies. Ayurvedic doctors also agree that traditional Ayush treatments are more expensive than allopathy. The cost of a 45-50 minutes session at Arora’s centre is anywhere between Rs 300-1500, depending on the basis of the therapy. Most pensioners cannot afford it.
“After retirement, the salary is not the same as before. But now that Panchakarma treatment in private centers has been brought under the CGHS panel, hum ye karva paa rahe hai (we can get it done),” said Sanhotra, while sipping on his green tea.
Dr. Priyanka Tiwari who works at Dalco Healthcare, another empanelled centre in Paschim Vihar, would like to make ayurveda therapies as affordable as allopathy, but it cannot be done without government support.
“We have limited infrastructure now. The main challenge is to make Ayush treatment affordable for all. The poor cannot afford it now,” said Tiwari.
NABH Accreditation
About 20 lakh people in Delhi-NCR can now turn to these centres if they get a referral. This includes 6,21,033 CGHS card holders, 19,31,822 central government employees and their immediate family, and 5,49,312 pensioners. Beneficiaries include bureaucrats and employees in central government departments, Lok Sabha, Rajya Sabha secretariat, CAG, Supreme Court and Delhi High Court.
“We want the assessment to be done in Delhi first. Now we are assessing 8 centers. And we have pending applications from 35 centers. Gradually, they will also be added to it, once they get NABH accreditation,” said one of the senior CGHS officials.
Before roll out of the year-long pilot project and adding Ayush therapies to the existing day care facilities, the Ministry of Health formed a committee comprising ayurveda and naturopathy experts to weigh in on how the scheme can be expanded, therapies that could be offered, and draw-up a blueprint for it.
On 31 May, the government invited applications for empanelment under CGHS from the National Accreditation Board for Hospitals and Healthcare Providers (NABH) accredited Ayush centres. And finally, in the last week of June, the memorandum of association (MoA) was signed between CGHS and the eight shortlisted centres. Six only provide ayurvedic treatment while two centres—one in Delhi and the other one in Ghaziabad— provide ayurveda, yoga and naturopathy therapies.
Arora’s centre was used for the pilot project in 2020, though it did not have a NABH accreditation like many centres at the time. Health Ministry officials admitted that quality parameters were not taken care of, which resulted in a lot of complaints from patients regarding cleanliness.
“After that, we asked NABH to prepare the parameters and accordingly empanelment was given,” said a senior CGHS official. “If any complaint comes now, it will be the responsibility of NABH. In such a situation, we can send a show cause notice to NABH and also get the centre closed,” he said.
Arora’s centre got the accreditation from NABH in February this year after submitting a small mountain of documents including bank guarantees, fire safety, and bio medical waste certification, among others.
“It was a new experience for us too, but we tried our best to provide better treatment. Patients also gave good feedback,” said Arora, who is planning to start Yoga classes for central government employees soon.
But most of the centres are raising the point that 14 days is very little time for treatment by Ayush method as it has a gradual effect. But Ayush department officials said this was introduced to prevent people from misusing the scheme. Even with these safeguards, there have been attempts to trick the system.
“Some centres do treatment for less days but give the bill for more days. That’s why this period has been kept to avoid this,” said Iti.
Also read: Dated, sexist and problematic—Why Indian Ayurvedic syllabus must evolve with changing times
Quacks and predatory clinics
Job hunt brought Harsh to Dalco Healthcare centre on the first floor of Paschim Vihar (West) metro station in July. He had just completed his Bachelor of Ayurveda Medicine and Surgery degree from Chaudhary Brahm Prakash Ayurved Charak Sansthan in Najafgarh. He’s part of a new army of Ayush graduates and young practitioners who are part of a nascent but thriving industry, thanks to the government’s push for traditional Indian therapies.
“In the last few years, there has been an ayurveda trend. There were 90 students in my class. After Covid, it is being considered as a good method of treatment,” said Harsh.
In the last eight years, this sector has grown from Rs 20,000 crore to Rs 1.5 lakh crore, with almost 40,000 MSMEs offering different products and taking several initiatives in the field of Ayush.
In March, the Ministry of Rural Development collaborated with the Ayush department to train 25,000 women and youth to become Panchkarma technicians, ayurveda masseuse, Kshara Karma technicians and cupping therapy assistants under the central government’s flagship Deen Dayal Upadhyaya Grameen Kaushalya Yojana (DDU-GKY).
And while Tiwari welcomes these initiatives, she expressed concern over quacks and predatory clinics misusing ayurveda to make a quick buck. This erodes trust, she said.
“People have very little knowledge about it. Treatment is available for every part of the human body. The one who has not even read Charak Samhita, also claims to know ayurveda. That’s why people’s trust in it is low,” she said.
An image of Charaka, the father of ayurveda, is pasted on the glass door at Dalco Healthcare. Inside, posters of more than hundred types of Ayush treatments are on the walls.
Unlike a local general physician clinic, the waiting area is not teeming with sniffling patients and wailing toddlers. Time slots are given and strictly adhered to. The sound of the metro coming every few minutes does not matter to the patients at the centre. Rather their entire attention seems to be on the treatment.
At Arora’s clinic, after Kamal Sanhotra leaves the room, a staffer asks loudly, “Who is the next patient?”
An elderly lady slowly gets up from the sofa and walks to one of the therapy rooms.
Over the next year, the government will assess the cost incurred for the treatment, and how it benefits patients.
“We want the assessment to be done in Delhi first. If everything is on track then we will also start Unani and Siddha for day care treatment and take it across India,” said Iti.
(Edited by Ratan Priya)