Ayurveda, "battle against NCDs"

(An opportunity for Ayurveda to go mainstream)

Narayan Prasad Acharya ( AHA, BPH ) Central Ayurveda Hospital, Nardevi

Introduction
A Non-Communicable Disease (NCDs) is a disease that is non-infectious and cannot be transmitted from one person to another. The disease includes medical conditions such as, stroke, chronic kidney disease, heart disease, cancer and osteoporosis, which are chronic medical condition that are characterized with a long duration of slow, progressive and painful illness. According to the World Health Organization, the four main types of non-communicable diseases are cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma) and diabetes. NCDs affect low- and middle-income people. Nearly 80% of deaths occur due to noncommunicable diseases in developing countries like Nepal. NCDs are projected to exceed the combined deaths of communicable and nutritional diseases and maternal and perinatal deaths as the most common death. Ayurveda is the science of life. The aim of Ayurveda is to promote the health of the healthy life and cure of the sick person. Ayurveda deals about the hygiene, lifestyle, behavior, ethics, spirit, socialization, etc. Ayurveda has eight divisions, every division deals with different aspects of peoples' health. Ayurveda focuses mostly on noncommunicable disease and its holistic approach of treatment is successful over all other systems.

Who is at risk of such diseases?

All age groups and all regions are affected by NCDs. NCDs are often associated with older age groups, but evidence shows that more than 9 million of all deaths attributed to non-communicable diseases (NCDs) occur before the age of 60. Of these "premature" deaths, 90% occurred in lowand middle-income countries. Children, adults and the elderly are all vulnerable to the risk factors that contribute to noncommunicable diseases, whether from unhealthy diets, physical inactivity, exposure to tobacco smoke or the effects of the harmful use of alcohol ( WHO). These diseases are driven by forces that include ageing, rapid unplanned urbanization, and the globalization of unhealthy lifestyles. For example, globalization of unhealthy lifestyles like unhealthy diets may show up in individuals as raised blood pressure, increased blood glucose,

elevated blood lipids, overweight and obesity. These are called 'intermediate risk factors' which can lead to cardiovascular disease.

Risk Factors of NCDs

Modifiable behavioral risk factors:

Tobacco use Physical inactivity Unhealthy diet and Harmful use of alcohol increase the risk of or cause most NCDs.

Metabolic Risk Factors

Raised blood pressure Overweight/obesity Hyperglycemia (high blood glucose levels) and Hyperlipidemia (high levels of fat in the blood).

In terms of attributable deaths, the leading NCD risk factor globally is elevated blood pressure (to which 16.5% of global deaths are attributed) followed by tobacco use (9%), raised blood glucose (6%), physical inactivity (6%) and overweight and obesity (5%). Low- and middle-income countries are witnessing the fastest rise in overweight young children. (WHO)

Socioeconomic impact of NCDs

Poverty is closely linked with NCDs. The rapid rise in NCDs is predicted to impede poverty reduction initiatives in low-income countries like Nepal. Vulnerable and socially disadvantaged people get sicker and die sooner than people of higher social positions, especially because they are at greater risk of being exposed to harmful products, such as tobacco or unhealthy food, and have limited access to health services. World Health Organization states, in low-resource settings, health-care costs for cardiovascular diseases, cancers, diabetes or chronic lung diseases can quickly drain household resources, driving families into poverty. The exorbitant costs of NCDs, including often lengthy and expensive treatment and loss of breadwinners, are forcing millions of people into poverty annually, stifling development.

AYURVEDA AND NCDs

In its own terms, expertly practiced Ayurveda can definitely yield reliable, efficacious results when applied to all manner of chronic diseases. Its etiological theory must be robust. This theory is based on the concept of Tridosha, the three doshas, Vata, Pitta and Kapha, their roles in system, subsystem and organ function and the sequence of processes occurring as they are driven out of balance in a general sequence known as Shad kriya kala, the six stages of dosha imbalance. This

is the winning point of Ayurvedic theory, allowing it to tackle chronic illness - a Trojan Horse transporting the guardians of health into the camp of disease. The reason why biomedicine cannot treat chronic disease as effectively as Ayurveda lies in its apparent lack of any knowledge structures equivalent to Ayurveda's Tridosha and Shad kriya kala. Where this lack remedied, it would be able to do so, provided that it also adopted Ayurvedic diagnostics and approaches to treatment; the whole system is needed, not parts in isolation. That is why the whole structure of Ayurveda dosha theory, the theory of tridosha should then be extended to include other Ayurveda fundamental concepts; the 5 mahabhutas, 7 dhatus and 13 agnis. One uncomfortable fact about Ayurveda is that its knowledge system is very different from that of biomedicine. Ayurveda never loses sight of the whole, while biomedicine remains primarily concerned with parts of the system. Ayurveda begins with properties of the whole organism, starting from the whole system, and moving to smaller and smaller subsystems, so to speak. Biomedicine, on the other hand, being reductionist, is wedded to the idea that, if cause and effect theories are to be properly articulated, tiniest components must be considered most fundamental, then building larger structures out of smaller ones. The primary objective of the former is to describe integration of systems, of the latter, structural components, and their individual function.

Possible Ayurveda method of preventing NCDs

Ayurveda describes about food habits, body purification, purification of the mined, meditation, medication, Rasayan and Bajikaran etc. Ayurveda is mainly associated with health where modern medicine and allied sciences are based on illness . Some possible methods preventing NCDs are illustrated bellow:

Fig. Ayurveda method of preventing NCDs

Panchakarma is the best technique to prevent NCDs

Before referring to the benefits one experience through Panchakarma one needs explain the treatment in regard to the key treatment procedures in the Ayurvedic doctrine. Originally the detoxification process of Panchakarma is one of the three important stages of Ayurvedic treatment, namely, Purvakarma or preparatory processes, Panchakarma or combination of five processes that constitute the main body of the treatment and Rasayana or healing chemistry of Ayurveda in comprising the restorative processes, rejuvenating measures, dietary methods and healing herbal preparations as well as supplements along with prescriptive life style orientation. In contrast to the other stages that are broader and gross in nature, Panchakarma is the specific Ayurvedic treatment process for the purpose of detoxification of the body through 5 specific natural physical processes. The 5 natural physical treatment processes include Vaman or medicated vomiting, Virechana or medicated purgation, Basti or medicated enema, Nasya or medicated treatment through the route of nose and Raktamokshana or bloodletting. The benefits one experience through Panchakarma treatment varies in accordance with the purity and authenticity of the above mentioned processes.

The Benefits one experience through Panchakarma

The benefits one experience through Panchakarma is huge and varies in accordance to the health condition of the deserving patient and the authenticity of the treatment process. The basic function of purification of the organic process situates the organism on the natural functional process of nature and thus prevents the body from becoming subject to reaction from the toxic wastes. The benefits one experience through Panchakarma primarily relates to this detoxification process. As our body is vulnerable to the intake of various kind of pollution and polluted materials through our regular interaction to the external world either by taking inorganic or non-hygienic food or inhaling polluted air or developing other harmful life style habits and thereby accumulating toxic wastes in the body, the detoxification process is necessary for eliminating the toxic waste from the organic system and thereby assuring smooth and natural organic function. In complete contrast to the tradition of Allopathic treatment which is centered on the separate treatment of different syndromes instead of finding and eliminating the root cause of various syndromes, Ayurveda with such key treatment processes like Panchakarma actually takes the responsibility of the purification and balancing the whole organic system that can guarantee natural wellbeing as well as health. So the benefits one experience through Panchakarma not only be considered in regard to treatment of some particular diseases or disorders, but rather in regard to rendering total health benefits that would naturally combat any disorder or disease or any malfunctioned syndromes from the inner strength and potential of our organic process. With this fact, surely it is time to explore integrative practice of Ayurveda to treat chronic disease. When the world of biomedicine is locked into a vision that the best it can do for the chronic disease crisis is to let millions languish in the pain and misery of chronic care, are Ayurveda, or Yoga and other traditional systems, going to sit by in a state of apathy? Is it not rather our call and our duty to offer the best of our knowledge and skills to assuage the crisis with which our world is now faced? All the policy makers, Stake holders of Ayurveda, herbalists and other persons related to the health should be aware about the emerging problem of NCDs and solution through the holistic Approach of Ayurveda. Now whole concern of the world is how to manage the non communicable diseases and we have many battles against it. Not only the panchakarma, Ayurveda

clearly defines the best life style, discipline of life, Health promotional activities, Diseases prevention, Rasayana & Bajikarana techniques and many more methods to prevent the noncommunicable diseases in the different Acharyas' Samhitas, like Swathyabritta. Main responsibility goes under the Ayurveda stakeholders to aware people, pressurize the policy makers and explore the efficacy of Ayurveda to go in mainstream of health service and prevent from NCDs. In conclusion, Ayurveda is of course old, but the most effective system against all of noncommunicable diseases than any other systems of treatment. This fact is proved from the successful treatment of many chronic diseases like arthritis, diabetes, thyroids, hypertension, parkinsonism, muscular dystrophy, hyperlipidemia, infertility. That is why we obviously pronounce, Ayurveda, a battle against communicable disease. This is an opportunity to promote Ayurbeda in reference to the NCDs and mainstreaming it in the health care system by integrating its services.