“Kaza is where I go,” came a firm reply. “Initially I used to visit the amchi but then even to cure a minor disorder the amchi medicine took a long time ”, said Padma Chodon. Flicking her hand to one side she seemed to dismiss the traditional amchi medicine. “Not only does the amchi medicine take more time, it is also much less effective than the dispensary medicine,” she added.
I was in the courtyard of Padma Dorjee in the village of Lidang in the far off Spiti valley of Himachal Pradesh, speaking to his septuagenarian mother about her opinion regarding the traditional Tibetan system of medicine. Barring a few exceptions, I heard similar sentiments, being echoed by several other people from other villages that I visited in the Spiti valley. Most of them preferred to visit the Primary Health Centre (PHC) at Kaza, the capital of Spiti sub-division of Lahaul and Spiti, rather than visiting the traditional physician, the amchi.
Spiti has been one of the key regions in the world where the traditional Tibetan medicine system has been thriving since centuries. The system being local in nature comprises of rich knowledge of the locally occurring medicinal plants and herbs. In its diagnostic procedures and treatment it is a synthesis of the Indian ayurveda and the ancient Chinese system of medicine. In fact, at one point of time the system was so popular that each village in the region had at least one amchi who used to take care of the health needs of the villagers.
Now, with the entry of the allopathic medicine and the dwindling number of local amchis, this knowledge is on the verge disappearance.
A few days after our visit to Lidang, we visited Khurik, a village some 12 kilometres from Kaza. Though the long walk on the craggy edges of the Himalayas did exhaust us yet, we were eager to meet an amchi who happened to be in the village. Unfortunately, the aged amchi was indisposed and could not grant us an interview. But the village folk spoke of the amchi’s medicine and the ‘new’ medicine.
As Tsering served us hot tea I asked him about what he felt about the traditional medicine. “Most of us visit the Kaza dispensary”, he replied. “But you have an amchi in your own village, don’t you visit him first”, I asked. “Sometimes we do go to him but we still prefer to visit Kaza”, he replied. The amchi not being well off, the people visiting him seemed to have a social obligation to pay him in cash or kind for their treatment. This made the PHC at Kaza more economically accessible to the people as the treatment and medicines were provided almost free of cost. “We just need to pay 25 paise for registration and sometimes even that is not charged”, said a villager of Khurik.
But in the village of Rangrik, the situation was different. Here, the people of Rangrik, unlike the people of Lidang or Khurik, considered the traditional amchi medicine as complementary to the allopathic medicine being provided free of cost by the Kaza PHC.
For any kind of a disorder the people visited the amchi at Khurik or Hansa, a village some 30 km further from Khurik, first and then visited the dispensary. “In case the amchi is unable to cure the disorder, only then do we visit Kaza”, said Dorma Tsering. I was curious to know what happened if it was the other way round. “Then surely we would visit the amchi”, Dorma replied. Unlike in other villages, in Rangrik, the people still had a high regard for the traditional medicine.
What the amchis say….
The first amchi whom we met stayed in a far off village of Kibber. Perched at a height of 4300 m above sea level it is one of the highest villages of Asia. The traditional amchi of the village, Nowang Tsering told us that he had learned the art from his father. Tsering also spoke of the difficulties he was facing to keep his practice going. “The interest in this medicine is decreasing”, he told us. Asked whether he referred to any particular texts? He replied in the negative. “I have learnt everything from my father and that is how I practice”, he said. Nowang’s knowledge seemed to be limited regarding the traditional medicine. In fact, he himself admitted to have visited the government health sub-centre himself a couple of times.
The second amchi, Norbu Gyaltsen, unlike the traditional amchi, had taken the practice of traditional medicine system as a profession. His practice was at Kaza. Gyaltsen had graduated from Dharmashala in traditional Tibetan medicine and had returned to Spiti for practice.
As the question of the decline in amchi tradition was put to him, he provided an interesting explanation that seemed to match with our own experience at Kibber. Most of the amchis, he said, did not have an adequate knowledge of the traditional medicine system that they were practicing, he said. “When the knowledge is inadequate, then of course the quality of the medicine goes down,” he added. According to Gyaltsen, Gyud Shi the Tibetan medicinal text contained some 134 chapters but most of the local amchis did not go through the entire text. Gyaltsen also felt that the traditional Tibetan medicine was not receiving the attention it deserved from the state government.
A point which stood vindicated as we found out that the in the schematic budget outlays from the year 2000-2001 onwards of the Annual Tribal Sub-plans for the Spiti region, there had been a consistent allocation for the construction of allopathic dispensaries and also ayurvedic dispensaries in the region, yet there was no mention of any allocation for the Tibetan system of medicine. Later when we spoke to a government official, he told us on the condition of anonymity that state government “providing limited assistance for the preservation of the traditional Tibetan medicine in the region”.
To what must one attribute the changing health scenario and the declining interest in the traditional medicine of the Spitian society? On one hand, the people have to contend with physical and economic accessibility, on the other hand, they seek the perceived advantages of allopathic medicine.
Lahaul-Spiti is a declared tribal district and receives considerable attention from the state government. Moreover, as mentioned by a highly placed government official, Spiti being adjacent to the Chinese border is accorded a generous consideration by the central government. “Even in the remotest of the villages the government has provided all the basic facilities”, the official mentioned.
The basic amenities obviously include health and education apart from other infrastructure facilities. In terms of health, the government opened primary health centres and sub-centres in the villages where the allopathic medicine was provided free of cost. This however seemed to have been done without considering the consequences on the already existing system of medicine in the region. And because of the perceived advantages of the allopathic medicine system, the amchi culture started declining.
Education on the other hand mainly involved, as a government official put it, “bringing the Spiti population into the ‘mainstream’”. Though Spitian dialect is taught till standard fifth, the emphasis however remains on Hindi. Moreover, the curriculum does not reflect the rich culture and traditions of the region. This has in a way taken the younger generation away from their own roots. The propagation of traditional Tibetan system of medicine being an inherent part of the Spitian culture seemed to have suffered as a consequence.
Tandup Dorjee from Lidang village candidly admitted: “Now the younger generation is moving away from their own culture. As it is, the number of experienced amchis is low and added to that the younger generation does not want to learn this system”.
Whatever the complex juxtaposition of different factors in the Spiti valley, the fact is that traditional Tibetan medicine is on the decline. The question that remains to be answered is whether this rich system of medicine should be allowed to die a silent death.