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PROCEEDINGS OF THE WORKSHOP ON
ROLE OF AYURVEDA IN CHILD HEALTH
4 MARCH 2014
TH




BIJU PATNAIK MEDICINAL GARDEN AND RESEARCH CENTRE, ODISHA


M.S.SWAMINATHAN RESEARCH FOUNDATION, CHENNAI

1

Organizing Committee:
Dr. K U K. Nampoothiri, Director, Biju Patnaik Medicinal Plants Garden and
Research Centre, Odisha

Dr Rama Narayanan, Ford Chair for Women and Food Security, Chennai

Mr Saujanendra Swain, Principal Scientist, Biju Patnaik Medicinal Plants Garden


and Research Centre, Odisha

Mr Tusar Ranjan Naik, Senior Scientist, Biju Patnaik Medicinal Plants Garden and
Research Centre, Odisha

Mr Akshay Kumar Panda, Senior Scientist, Biju Patnaik Medicinal Plants Garden
and Research Centre, Odisha

We thank the Global Alliance for Improved Nutrition (GAIN) and the Mitsubishi Corporation for
the financial support for the workshop

M S SWAMINATHAN RESEARCH FOUNDATION


III Cross Road, Taramani Institutional Area
Chennai 600 113
Ph: 044 2254 1229 / 1698
Fax: 044 2254 1319
Web: www.mssrf.org
PROGRAMME SCHEDULE

9.30 am Registration

10.00-11.30 Inauguration Dr. K U K Nampoothiri, Director,


am Welcome BPMPGRC, MSSRF, Jeypore

10.00 10.10 Purpose of the Dr. Rama Narayanan, Ford Chair for
am workshop Women and Food Security, MSSRF,
Chennai

10.10- 10.15 Inaugural Address Dr. G S Lavekar, Former Director


am General, Central Council for Research in
Ayurvedic Sciences, New Delhi

10.15-10.45 Tea
am
10.45-11.15 Release of the book Paediatrics In Ayurveda
am by Dr. Laxmikanta Kabi, Chief District
Medical Officer, Koraput

Keynote Address Ms. Savita Satakopan, Member,


Ayurvedic Pharmacopoeia Committee
and Member ASU Drugs Technical
Adivsory Board, Ministry of Health and
Family Welfare, Government of India.
11.15 -11.30 Authors Response Dr. Durga Prasad Dash, Associate
am Professor at Post Graduate Department,
Loknethe Rajaram Bapu Patil Ayruvedic
Medical College and Research Institute,
Islampur, Maharashtra.
11.30-11.45 Tea
am
11.45 -1.00 Session 1: Addressing Community Health Through Ayurveda
pm Experience Sharing NGO
Role of AYUSH in Addressing Child Health
Representative, AYUSH
Intervention to address Health of Young Children through
locally available medicinal plants Akshaya Kumar Panda,
Senior Scientist, MSSRF
Role of National Rural Health Mission (NRHM) in
addressing Child Health Representative, NRHM

1.00-1.45 pm Lunch
1.45-3.00 pm Session 2: Group 1 - To discuss propagation of
Group work by herbal preparations at community level
participants Group 2 To recommend herbal
preparations for common childhood
ailments from local plants
3.00-3.30 pm Presentation by Groups
3.30 pm Vote of Thanks Saujanendra Swain, Principal Scientist,
MSSRF
3.40 pm Tea


Proceedings
Inaugural Session
In his welcome address Dr Nampoothiri, Director, Biju Patnaik Medicinal
Garden and Research Centre, Jeypore said that the Centre was engaged in the
conservation of landraces of rice, pulses, finger millets, oilseeds and medicinal plants
and in making these available to the community. Three hundred and seventy four
varieties of medicinal plants were conserved in the Institutional premises and the
Centre was equipped for the propagation of these plants. These are nurtured in
nine plots representing nine different tribes. Attempts to propagate these plants were
being made through the supply of genuine seeds to likeminded institutions, NGOs
and tribal villages which need them. The centres activities by way of Natural
Resource Management, Livelihood Opportunities and Capacity building exercises all
aim at serving the community and attending to their health and nutritional needs.
Owing to special focus on children and women during the first 1000 days of the life
cycle, the use of medicinal plants in addressing child health and nutrition has been
initiated by Dr. Rama Narayanan. The good counsel and recommendations received
from this workshop would help to strengthen the work further and cater to the felt
needs of the target group.

Dr Rama Narayanan, Ford Chair for Women and Food Security, said that
the workshop was the culmination of a participatory research with the tribal
communities to develop a road map for reducing under nutrition in young children.
The observation that improvement in weight gain was offset by attacks of illnesses
prompted mothers of children to demand simple remedies which can be prepared
at the household and community level using local resources. The first thousand days
of life is very important in the life of an individual. Eighty percent of the brain
development takes place during the first two years and any setback during this period
causes irreversible damage to the brain. Hence prevention and management of
morbidity during childhood is important for improving nutritional status. While
State policy includes different systems of medicine in the delivery of community
health services, several NGOs are also engaged in the promotion of herbal remedies
in the management of common ailments. The purpose of the workshop was to
understand the experiences of different stakeholders in the use of medicinal plant
preparations in addressing common health problems, identify ways of propagation of
the same to marginalized communities and recommend simple herbal formulations
for addressing child health.

In his inaugural address Dr G S Lavekar, former Director General of the


Central Council of Research in Ayurvedic Sciences, (CCRAS) said that tribal
medicine was rich in biodiversity. There are 48,000 medicinal plants in India of
which 1200 are in use by medical practitioners including tribal healers. Of these
only 100 is in common use. This knowledge is our heritage. Ayurveda has
documented the knowledge. The undocumented part is in practice as tribal
medicine. There are three Ps in conservation of traditional knowledge.

Preservation- This can be done through surveys and by having written and
audio visual documentation. Besides medicinal plants, documentation of
types of food consumed by tribal communities and their nutritive value is very
important. CCRAS has published 12 books on medicinal plants.
Propagation Courses at graduate level can be taught on tribal heritage
system and books can be published in local language
Practice - Capacity building of communities and functionaries such as
anganwadi workers, senior citizens etc.
The acceptance of traditional system of medicine is dependent on POEM (ie)
Patience, Observation and Evidence based Medicine. In classical texts of Ayurveda a
number of plants, their medicinal properties, and effect on diseases are recorded.
Since the acceptance of evidence based medicines is better, simple clinical trials can
be done. Besides the mentioned effect, several plants are found to have potential for
further action (eg) Nirgundi - is observed to have excellent action as bronco - dilator
but is mentioned in classics only as an analgesic. We can gain excellent knowledge
by analysis of tribal medicinal practices. This can be done through observation
studies and maintenance of Clinical Record Forms (CRF) which describe the
prognosis of the disease, at periodic intervals starting from 0 day of the disease.
CCRAS has a mandate of documenting tribal foods and traditional medicines.
There is a need to develop a software with database of different plants and the
diseases they can be expected to cure.

Ayurveda has an important role to play in Child Health, Geriatrics and Womens
health. Infantile diarrhea is a common cause of childhood mortality. There is no
prophylactic which can take care of nutrition, electrolyte balance and anti diarrheal
action. Hundred grams of rice kanji with half a gram of rock salt and half a gram of
ginger juice or juice of tender leaves of guava or that of pomegranate will make an
excellent prophylactic for infantile diarrhoea. This can be freeze dried and made
into a powder for use like ORS. There are similar measures for anemia very
common in Indian women. The Government of India has given standing
instructions to all departments to allocate 10% of budget for women.

Our rites and customs are scientific. In olden days copper coins were thrown into
rivers. Aromatic substances are used in the performance of rituals. Copper and
aromatic substances are anti microbial. Children are recommended to be given an
oil massage and this is reinforced in the phrase Abhyangam Nityam Acareth. The
ear is an important acupuncture point and piercing the ear and wearing of gold
ornaments on particular parts of our body is recommended. I wish the workshop all
success and hope you will come up with a good set of recommendations.

The Chief District Medical Officer (CDMO), Koraput, after releasing the book
Pediatrics in Ayurveda said that in Odisha the structure for health delivery
integrated two types of systems namely Ayurveda and Homeopathy. There were
separate directorates for Ayurveda and Allopathy. The National Rural Health
Mission (NRHM) integrated these two systems in the existing structure which
primarily uses allopathy, since it had the manpower for delivery. The number of
Ayurvedic dispensaries are very less. The AYUSH doctors are posted in the mobile
health units. The mobile health unit consists of a doctor, a pharmacist and a nurse.
All the drugs and herbal preparations are procured from the market. Allopathic
drugs need to be judiciously used, to avoid side effects (eg) use of quinine is
restricted to resistant type of malaria due to its side effects. Of late some
pharmaceutical companies are using drugs about which we have less knowledge.
Several home remedies such as honey and tulsi for common cold are household
knowledge. We also use the extracts of several products in our daily life. I hope
that the workshop comes up with useful recommendations for the propagation of
herbal preparations.

In her address, the Chief Guest Ms Savita Satakopan, Member ASU Drugs
Techncial Advisory Board, Ministry of Health and Family Welfare, Government of
India, provided a brief historical background and explained the reason for the
decline of Ayurvedic system of treatment as being a result of the advent of western
medicine in the mid nineteenth century, particularly in the urban areas. Traditional
systems of treatment persisted in the rural and tribal areas where western medicine
did not reach. The dramatic success of western drugs in the treatment of tropical
infections, pain and use of aneasthesia in surgical interventions fascinated the
western educated Indian doctors and threatened the existence of Ayurveda in spite
of the efforts of the Government, at the time of independence to bring the
traditional systems on line with modern concepts of quality control. At present, the
belief that drugs from natural sources are perhaps a better and more longstanding
solution for many common health problems and that they are also free from the
adverse effects so common with western drugs has brought the traditional systems of
treatment once again to the fore.

But it must be kept in mind that the use of traditional medicines needs to be based
on modern concepts of quality, scientific soundness and attainability of success by
the targeted group. Therefore when suggesting a range of ayurvedic medicines from
ancient classics that are time tested and still considered effective, the Vaidyas should
bear in mind the following requirements:

Since raw materials in the form of plant parts have now been scientifically
identified, the ingredients should have the necessary quality standards as
prescribed for them. There should be no confusion in the identification. If
local substitutes are prevalent in practice, they should be proven effective.
The medicine suggested should be simple in composition, not requiring too
many plant ingredients, or any that may have to be obtained from remote
parts of the country.
It should be simple to prepare, not requiring a technology beyond the capacity
of the targeted group. This is necessary because the medicines of the Indian
traditional systems are generally multi component based and prepared under
a complicated set of procedures.
Whether recommended to be fresh or dry, the plant ingredient should be not
only easily available, but also easily recognizable. While it is necessary to
augment wisdom and restore faith in the effectiveness of traditional treatment
by drugs from natural sources and pointing out their positive aspects, one
should guard oneself from excessive promises of miraculous cures also.

The raw material is very important and it should be mentioned whether it should be
dry or fresh

It should be easily available


It should have standard names only one accepted name all over should be
taken. Replacements should also be accepted.
Preparation should be simple and there should not be too many ingredients
Processing should be simple without the aid of any equipment

Ayurveda should not be elevated as the be all and end all of everything at the same
time it should not be decried either.

Dr Durga Prasad Dash, Ayurvedic pediatrician said that many of the practices
recommended in Ayurveda were scientific based on experiential learning. Honey is
a concentrated sugar source which prevents the growth of organisms. Ayurvedic
science gives formulae for day to practices. Giving a bath to the new born based on
the lines of Ayurvedic recommendations, helps prevent hypothermia. The truth
behind Ayurvedic principles can be interpreted as per the perceptions of the
individual. My perception to the slokas of Susruta is that a constant study and
observation of the science is essential to gain experiential learning. With regard to
Charaka, scientific way of describing the disease is very important. We need to
incorporate both approaches in our daily practice. For adopting this approach we
need to follow the principles of Vidya (Wisdom); Vidarka (Argument), Vigyana
(Science) and Pratakhpramana (Direct observation); Tatparata (Punctuality) and
Triya (Scientific way to observe the topic). It is important to find the basic truth and
try and understand the subject instead of commenting it as vague.

Session 1

Field experiences in the use of herbal medicines were shared by Non Government
and Government Organizations. Mr Akshay Kumar Panda of M S Swaminathan
Research Foundation highlighted the role of Kasanthaka Churna in addressing
Respiratory Tract Infection (RTI) in children between 0-3 years in three villages in
Odisha. A baseline survey on the incidence of morbidity among 0-3 year old
children was conducted in the three villages which highlighted a prevalence of 64%
of RTI. Following a discussion with the village and community leaders, selected
representatives including the local healers were trained in the preparation and
administration of kasanthaka churna. During the period March 2012 to February
2013, 144 children were affected with RTI of which 83 underwent some form of
treatment. Of these 38 were treated with kasanthaka churna. Thirty three were
completely cured while 5 underwent multiple treatment. While listing out the
benefits of kasanthaka churna, the community members highlighted the following :
the plants were locally available, the preparation was easy to make and had no side
effects. It helped overcome constipation and indigestion and the cost was one third
of what was spent for other medicines.

Mr Prabhat Paikaray of the NGO, EKTA observed that the tribal communities
collected different plant varieties to be used as medicine. The common home
remedies were

Tulasi juice with honey or ginger or black pepper (cold and cough)
Raw turmeric and milk (Skin Infections)
Pipali Churna (cold)
Cumin seeds, black salt and Ajwain powder (indigestion)
Neem leaves paste and Ajwain (Anaemia and worm infestation)
Drumstick leaves and jaggery (Anaemia)
Pudina juice and black salt (Gastritis)
For malaria, black pepper is used along with the leaf of Leucas aspera
Most of these home remedies were ignored as not having a scientific basis
and the need for consulting the vaidyas in case of any illness was felt.

Mr Shyamlendu Padhi of Sakthi, Rayagada said that the NGO conducted health
awareness camps and disbursed Ayurvedic medicines. Simple home remedies were
possible for some common ailments such as use of fenugreek to arrest diarrhea and
tamarind seed paste for burning during urination in children. However they were
not always effective. Nutrition is an important component to be addressed while
dealing with health and there were several locally available plants which could be
effectively used (eg) for soreness in the mouth lemon grass could be used.

With regard to the experiences of the Government programmes, Dr Harishankar


Sahu and Dr Somnath Mishra, Medical Officers of Kundra Community Health
Centre shared their experiences.

The National Rural Health Mission launched in 2007 brought in AYUSH


systems of medicines besides Allopathy into mainstream health care. In
Odisha, Ayurvedic and Homeopathic doctors were posted.
There were less numbers of Medical Officers for AYUSH when compared
to Allopathy. There was one doctor for one Panchayat.
At the District level the Chief District Medical Officer (CDMO) was the
Mission Director. The tertiary Hospitals were the Community Health Centre,
Primary Health Centre and the Sub centre and there were AYUSH doctors in
the first two centres.
There were 720 mobile units with 2 doctors, 1 ANM and 1 pharmacist.
The choice of medical system does not lie with the patient. When
compared to allopathy there was a lack of medical supply of Ayurvedic
medicines.
AYUSH doctors work under allopathic doctors. There was a disparity in the
salaries and administrative norms between the doctors of different streams.

In the floor discussion that followed, the following points were highlighted

While addressing common ailments at community level and following the


prognosis of a disease, Clinical Record Forms should be maintained (ie)
clinical observations on the first day of treatment, fifth day of treatment etc
had to be recorded
Effectiveness of medicine depends on dosage and duration. Further there
has to be specificity of observation over generalized observation. (eg) if worm
infestation is being addressed then the type of worm prevalent in the patients
will have to be identified before starting treatment.
Besides medicines it is equally important to pay attention to habits and
customs. Details about mothers, other family members, their hygiene and
health care practices should be noted down.
The anomalies in the Government structures and scales should be taken up
at appropriate fora. The anganwadi workers kit should include more of herbal
medicines especially for children.

LUNCH
Session 2.

In the afternoon session, the participants divided themselves into two groups.
Group 1 discussed on ways of propagation of herbal medicines on a large scale and
Group 2 discussed the list of Ayurvedic medicines to be recommended for
addressing childhood ailments in health programmes. The recommendations of the
groups are as follows :

Group 1. Ways of propagation of herbal medicines

Capacity building of different sections of the community such as local


healers, SHG leaders and ASHA can be undertaken
Herbal gardens may be developed at schools and Panchayat
IEC materials can be prepared and disseminated
Ayurvedic Health Camps can be conducted
In implementing projects on herbal medicines technical guidance should be
taken from Central Council of Research in Ayurvedic Systems (CCRAS).
NGOs required capacity building in documentation of projects.
Celebration of special days such as Dhanvantri Diwas could be taken up.
Mass media campaigns should be taken up to propagate advantages of herbal
medicines
There has to be special fund allocation for these activities.
The infrastructure of Ayurvedic colleges and Institutions should be improved
The salary structure of AYUSH doctors should be on par with those of
allopathic doctors.
There should be greater interface between Government Ayurvedic
departments and the community
Seasonal distribution of drugs by Ayurvedic doctors should be taken up at
the Community level.

Group 2. Paediatric Medical kit

The group members felt that process of recommending a complete paediatric


medical kit of herbal medicines had to be done at two levels. One is to have a
set of general guidelines for inclusion of medicines and the other is to have an
expert group to work out the actual medicines based on the guidelines.
Selection of actual medicines for inclusion in a health kit could not be
finalized because the Vaidya members present in the group did not have
classical literature sources to consult and prepare a list. The members felt that
the scope of the group was limited to the first step (ie) giving a general set of
recommendations. These were
1. Recommendations for the Paediatric Medical Kit should be comprehensive
including information such as local availability of plants, locally available drugs
and the types of formulations.
2. A range of options should be provided rather than a single drug.
3. A basic drug list could be drafted and circulated to a wider group of
Ayurvedic paediatricians from various Ayurvedic Colleges in Odisha to arrive
at a common consensus on the recommendations.
List of Participants

Sl. No. Name Designation Address Contact details


1. Ajithkumar Bisoi Project WORD ajitkpt@gmail.com
Manager 9437475819
2. Akshaya Panda Senior BijuPatnaik Medicinal akshaya74@rediffmail.c
Scientist Plants and Research om
Garden, Jeypore 9437624491
3. Balamukunda Chairman NVCT B, Cuttack nvct.bmck@gmail.com
Das
4. Bandana Padha Scientist
5. Basanta Programme NEED Jeypore liteneed@gmail.com
Mahapatro Coordinatore 9439761043
6. Bijoy Takri Co-ordinator NIRMANA Koraput nirman.org29@yahoo.c
om
8280069445
7. Chhabirani Singh Medical At/Po Kundra, drsomucns@rediffmail.
Officer Koraput com
AYUSH 9438388775
8. Dilip Bhusan Social Action for Rural sardnbr1995@yahoo.co
Benu Development .in
(SARD)Gadbaguda 9438677673
Nabarangpur
9. Durga Prasad Associate Ayurvedic College, dpd75@rediffmail.com
Dash Professor Nayagarh 9853435916

10. Geetanjali Padhy Coordinator KBKPVP, Rayagada kbkpvp@gmail.com


9853323461
11. Govind Chandra Field Assistant BijuPatnaik Medicinal govindachandranag@g
Nag Plants and Research mail.com
Garden, Jeypore 9178268693
12. Harishankar Sahu Medical Kundra, CHC dr.harisankar1982@gm
Officer ail.com
9439480546
13. Jasaswini Padhy Nutritionist Biju Patnaik Medicinal 9438326023
Plants and Research
Garden, Jeypore
14. Kartick Lenka Scientist BijuPatnaik Medicinal
Plants and Research 9437435537
Garden, Jeypore
15. Kiranabala Rout Sarvodaya Samiti (Only Postal Address)
Gandhinagar 9658916928
Koraput
16. Lavekar G S Former gslavekar@gmail.com
Director 8826711841
General
17. Laxmikanta Kabi CDMO, 9439990496
Koraput
18. Maheswar Swain Programme Sarvodaya Samiti samiti@bsnl.in
Coordinator Koraput 9437784711
19. Manasi Field HELP Semiliguda 8763697860
Khemundu Coordinator
20. Menaka Field Assistant Biju Patnaik Medicinal menakamssrf@gmail.co
Choudhury Plants and Research m
Garden, Jeypore 8018800216
21. Mishra B N Former Govt. Ayurveda Dr.bnmishra@gmail.co
Professor College, Bolangir m
09437093231
22. Nagabhushanta P Traditional Borigumma (Only Postal Address)
health B. Singhpur Road. 9438164145
professional Koraput, Odisha
23. Nalin Takri Executive NIRMANA nalinkumar.kpt@gmail.
Secretary Ashok Nagar, Koraput com
9438377603
24. Nampoothiri K U Director BijuPatnaik Medicinal unampoothiri@mssrf.re
K Plants and Research s.in
Garden, Jeypore 9777577307
25. Nath Sharma L K Medical 9437666850 (Will call
Officer up)
26. Nath Sharma P K Retired Govt Ayurvedic profpknathsharma@gm
Principal College of Odisha ail.com
At Gopalpur cuttack 9861148641
754207
27. Nehar Parida Senior Biju Patnaik Medicinal
Technical Plants and Research 9437720348
Assistant Garden, Jeypore
28. Padhy S K District NAANDI Foundation santoshkumar.p@naand
Manager Jeypore iorg
9435538864
29. Parameshwar Secretary Dakshin Odisha (Only Postal Address)
Patra Ayurved Vikas 9337272905
Parishad,
c/o. Srinivasa
Ayurveda Bhawan
Dainika bazaar,
Jeypore, koraput -
750002
30. Prabhat Paikaray Project Co- Ekta Koraput Prabhat_ekta@rediffma
ordinator il.com
9438040662
31. Prashanth Kumar Senior BijuPatnaik Medicinal
Parida Scientist Plants and Research
Garden, Jeypore
32. Rama Narayanan Ford Chair for M.S.Swaminathan nrama@mssrf.res.in
Women and Research Foundation, 9840978576
Food Security Chennai
33. Ramachandra Senior BijuPatnaik Medicinal sriramtosh@mssrf.res.in
Tosh Community Plants and Research 9937983746
Organiser Garden, Jeypore
34. Ramanna S V Co ordinator, BijuPatnaik Medicinal
GRI Plants and Research
Garden, Jeypore
35. Rashmita Behera BijuPatnaik Medicinal rasmi_behera@mssrf.re
Plants and Research s.in
Garden, Jeypore 9937106893
36. Sailabala Naik Treasurer HELP Semiliguda 7854901084
37. Sandyarani Dash Programme ND SWAH, RK nd.swag@gmail.com
Coordinator colony 8658346155
Nabarangaban
38. Sanjay Kumar Senior BijuPatnaik Medicinal sanjayaswain@mssrf.res.
Swain Community Plants and Research in
Organiser Garden, Jeypore
39. Saujanendra Principal Biju Patnaik Medicinal
Swain Scientist Plants and Research 9437141705
Garden, Jeypore
40. Savita Satakopan Emeritus 7/4 Seventh st, 9043029419
Scientist Nanganallur, Chennai
61
41. Shyamalendu Co-ordinator Shakti, Rayagada shaktimamanaguda@g
Padhi mail.com
42. Somanath Mishra Medical Kundra,Koraput drsomucrs@rediffmail.c
Officer om
AYUSH 9438464289
43. Subhangi Sahoo Scientist M.S.Swaminathan subhangi@mssrf.res.in
Research Foundation, 9380913327
Chennai
44. Subhash Vice-President Kisan, Jeypore 9439761043
Mahapatra
45. Sudarsan Behera Principal Gopabandu Ayurvedic drsudarsanbehera@
Medical Puri 752002 9437199477
46. Suresh Rath Accountant Biju Patnaik Medicinal
Plants and Research
Garden, Jeypore
47. Susanta Kumar Secretary PRASTUTEE, prashtee@rediffmail.co
Balabatora Koraput m
9437847388
48. Susanta Kumar Individual susantabali@gmail.com
Mohanty B/203 HAL 9437182475
Township
Sunabed
763002
49. Sushanta Sekar Co ordinator, BijuPatnaik Medicinal 9937663013
Choudhury NAIP Plants and Research
Garden, Jeypore
50. Thakur P Paik Sisu and Mahila thakur.paik@gmail.com
Kalyan Samiti 9438225162
Chitrakunda
51. Tusar Ranjan Co ordinator, BijuPatnaik Medicinal tusarn@mssrf.res.in
Nayak Food Security Plants and Research 9937663008
Garden, Jeypore