Science in society: challenges and opportunities for indigenous knowledge in the present-day context

Abstract

Generally, when we talk or think about science, we refer to that of Western or industrialized societies, assuming that science is only there in those societies and quite often implying that scientific rigour or interest is absent in other societies. The role of science is to help mankind meet the various demands for exploiting natural resources in the best possible way without adversely affecting the environment. In most societies, there exists a rich body of knowledge based on how to meet the demands of that particular society but quite often these are ignored. We need to look at indigenous science and technology particularly when an existing body of knowledge is available. Perhaps it is better to develop it instead of disregarding it in the name of scientific progress. The prevailing health and medical system, the Western system, has unfortunately failed to meet the needs of all. In most countries, frightening policy changes place less and less emphasis on the social and welfare sectors and higher emphasis on the economic and infrastructure sectors. As such, funds allocated to health are going down. The implications of such a trend in countries where health insurance is unaffordable for the majority, is unimaginable. In this changing situation, the conditions of the poor, particularly the indigenous people, have become critical. In this paper, challenges and opportunities for indigenous health practices are examined in the context of forest situations, forest policy and related environmental issues.

Keywords:

• health for all
• traditional wisdom
• indigenous health
• forestry policy
• oral tradition

The health situation in most of the countries belonging to the South Asian Association for Regional Cooperation (SAARC) is really critical. Despite all our technological breakthroughs, we still live in a world where one-fifth of the developing world's population go hungry each night, a quarter lack access to even the most basic necessities, like safe drinking water, and a third lives in a state of abject poverty – on the margin of human existence, where words simply fail to describe it. More than a billion people in developing countries still lack safe drinking water. In developing countries, the major causes of death are infections and parasitic diseases, which kill 17 million people annually, including 6.5 million from acute respiratory infections, 4.5 million from diarrhoeal diseases and 3.5 million from tuberculosis. Most of these deaths are linked to poor nutrition and an unsafe environment, more specifically, polluted water, which contributes to nearly 1 billion cases of diarrhoea every year. In both developing and industrial countries, threats to health security are usually greater for the poor – people in rural areas and indigenous people. The disparities between the rich and the poor are similar with regard to access to health services: in developed countries there is one doctor for every 400 patients whereas in developing countries, it is 1:7000. The amount of spending on health programmes is also very different and is quite low in developing countries; for example, it is only $7 per person per year in Bangladesh. The situation is not much better in many other developing countries. Considering this alarming situation, it is not surprising that out of the seven important targets put forward for human development on the Agenda of the Social Summit, four were related to health. They were as follows:

1. The provision of primary health care for all with a special emphasis on the immunization of children.

2. The elimination of severe malnutrition, with the halving of moderate malnutrition rates.

3. The provision of family planning services for all willing couples.

4. Safe drinking water and sanitation for all.

The need for an alternative health system

The prevailing health and medical system, the Western system, has unfortunately failed to meet the needs of the world's majority. The failure of the Alma Ata Declaration to fulfil its objective of achieving “health for all” by the year 2000 makes it more urgent that we find an alternative. In most countries, a very frightening policy change is being manoeuvred by agencies like the World Bank and International Monetary Fund to place less and less emphasis on the social and welfare sectors and a higher emphasis on the economic and infrastructure sectors. As such, funds allocated to health are going down in most Asian countries. The implications of such a trend in countries where health insurance is unaffordable to the majority, is unimaginable. Based on current trends in health care financing and the failure of the Alma Ata Declaration to resolve the situation, the conditions of the poor, particularly the rural poor and indigenous people, have become even more critical (Banerjee, 1986).

Generally, when we discuss or think about science, we refer to that of Western or industrialized societies. In the context of scientific development, we prefer to concentrate on the so-called modern scientific innovations assuming that science is only present in those societies and quite often implying that scientific rigour or interest is absent in other societies. The role of science is to help mankind meet various demands, exploiting natural resources in the best possible way without adversely affecting the environment. Thus, in a given socio-economic and historical context, knowledge of making fire revolutionized human societies. People have developed their own science and technologies based on the demands of their own particular societies, but quite often these are ignored. What I want to impress here is that we need to look at indigenous science and technology, particularly when an existing body of knowledge is available. Perhaps it is better to develop it instead of replacing it in the name of scientific development and modernization (Chaudhuri, 1989; Chaudhuri, Buddhadeb, Dasgupta, & Chatterjee, 1989).

Traditional systems

Every culture, irrespective of its simplicity and complexity, has its own beliefs and practices concerning diseases and evolves its own system of medicine in order to treat diseases in its own particular way, even though when compared with the Western system, this system may appear to be irrational.

In the past, this knowledge base was oral and was almost always transmitted verbally from one generation to another. Such knowledge is in fact still used today in many areas of the world in the daily lives of many people, particularly in rural areas (Lewis, 1958). In several parts of South Asia, apart from the folk traditions, there is also a parallel classical tradition of knowledge. These classical knowledge systems have very sophisticated theoretical foundations and are codified and documented in thousands of manuscripts. They represent non-Western knowledge systems of the world and are very different in their worldview, concepts and principles from any Western knowledge system. Traditional knowledge in medicine and health has been tried and tested over generations. It is a holistic concept covering a broad base encompassing disease prevention, health promotion and healing (Chaudhuri, 1986a, 1986b). It deals with health problems ranging from the common cold, air- and water-borne diseases to orthopaedics and other complicated cases.

This system is also based on a wide range of biological resources, using thousands of plant species, hundreds of animal species and animal parts, and various mineral and metal sources. Unfortunately, over the years, traditional knowledge and skills have been neglected and a prejudice has been engineered and encouraged by powerful nations and their affiliated multinationals with the purpose of subjugating non-Western cultures. In order to evolve a proper health policy in developing countries like South Asia, particularly for the indigenous people and the poor, a number of issues must be examined.

Crucial issues and myths

A number of myths have been systematically created against the non-Western systems in general and the indigenous systems in particular. It is essential to demolish them in order to evolve a proper health policy in developing countries, particularly for the indigenous people and the poor.

1. It is often said that health is the exclusive domain of medical sciences. By restricting it in this way, the socio-economic, cultural and environmental aspects are often ignored.

2. Following the above logic, more and more resources are allocated to sophisticated research. It is not my intention to discourage research but when resources are limited, one should evaluate how they can be best utilized and whether they should be spent on expensive sophisticated facilities for the few or less expensive facilities for the many. Perhaps there is a need to balance the two.

3. Quite often it is said that rural people, particularly members of tribes, are all superstitious. Thus, if the rural people worship a deity to be cured, it is automatically assumed that they are superstitious and that they would reject so-called modern health practices. However, when the same thing occurs in the cities of India, it becomes tradition and when it is done in the Churches of Europe, it is labelled convention. The question of rationality cannot be judged or examined in isolation, without examining the ecosystem, the available health facilities and the economic conditions. Again, the mere presence of a health centre does not necessarily mean that people will automatically depend on it, especially if proper and adequate facilities are not provided by it or if the people are not convinced about its efficiency. In fact, the bulk of social scientists, who have studied the health culture of the rural population in India or in South Asia, have been over-zealous in discussing superstitious health beliefs and practices, and have not paid adequate attention to the forces that have been instrumental in causing the decay and degeneration of their health culture.

4. The advocacy of traditional methods of treatment does not mean that they are necessarily in opposition to development. The point is that there may be many positive aspects in traditional systems, which should be encouraged and propagated. In fact, there is a need to provide all the alternatives and not to depend on one system only.

5. The argument often put forward in favour of the introduction of the modern system (and for the replacement of the traditional) is that tribal and similar traditional approaches do not have the answers for many diseases. This is an undeniable fact but it does not necessarily reflect the limitations of traditional systems. Apart from the fact that many herbs are not available, one should also acknowledge that many of these diseases were formerly unknown. Naturally, the question of whether traditional systems have a remedy for them should not arise. In fact, for the same reason that modern medicine also does not have remedies for many diseases.

Strategy

1. The documentation of traditional knowledge in health and medicine is urgently needed. Most of the research and publications available in this field are purely academic in nature. Society in general is schooled into thinking that adopting traditional health skills and culture is inferior to modern medicine. This attitude has contributed to a further degeneration of this knowledge. Documentation is also urgently needed because traditional knowledge is relayed verbally and hence documentation is necessary before it is forgotten. The loss of these rich and diverse ecosystem-based knowledge systems and skills will be no ordinary loss.

2. Legal and policy issues involving the protection of traditional knowledge also need to be examined. A legislative framework is required whereby this knowledge is kept with the people from whence it originated, and that recognition, either financial or otherwise, be accorded to these individuals or the community by commercial firms who use their knowledge.

3. Changing forest policies and the changing development scenarios in Asian countries have adversely affected the strength of biological resources used in traditional medicine since many resources are depleted through deforestation. The mono-plant afforestation programmes, where emphasis is given to commercial plants, has not helped the people much. There is a need to promote conservation measures for saving medicinal plants in various ecosystems and habitats (Chaudhuri, 2003; Jain, 1968).

4. A number of studies have pointed out the nature of health hazards in relation to the unplanned/uncontrolled use of insecticides and pesticides. It has been noted how they have killed small fish in paddy fields and thus the poorer families, who generally consumed this protein, were deprived of it. This situation is very common in all South Asian countries. This is also true of many tribal areas. Thus, the whole development strategy needs a critical analysis as it may adversely affect the environment and consequently the health status of people, particularly tribal people.

5. Multinational drug companies, medical lobbies and the Western media have, on the one hand, played a major role in disrupting and negating indigenous knowledge systems while, on the other, exploiting this traditional knowledge and resource base to develop new drugs. Current efforts with research on ethnic pharmacology have often proved to be counterproductive to the development or advancement of local cultures since the objective has not been to strengthen traditional knowledge and resources but to get information for multinational drug companies. It is well known that drug multinationals have been robbing traditional knowledge for their own purposes.

6. There is a need to perpetuate and revive traditional/indigenous systems, which are close to the people, non-commercial in nature and curative in approach. To achieve this the following measures ought to be taken:

   1. identification of factors responsible for the disintegration of indigenous health care systems and the formulation of action programmes to counteract it;

   2. formulation of appropriate methodologies to instate traditional health care systems in rural/tribal areas;

   3. identification of methodologies for more in-depth and integrated documentation, research and development.

Traditional knowledge and wisdom: limitations and scope

In all rural areas in South Asia, people have traditional knowledge and wisdom concerning treatments. There is a rich source of traditional knowledge among the rural people, particularly the tribal communities, in this region. It may be added here that by virtue of close association with some activist groups, who are working in this region specifically on health and treatment, a larger number of traditional herbal medicines have been identified (Chaudhuri, 1990a, 1990b).

Disease and treatment, particularly in the rural areas including tribal societies, cannot be properly understood in isolation. Health and treatment are very much connected with the environment, particularly the forest ecology. The traditional health care system and treatment are based on a deep observation and understanding of nature, often derived from observing other animals in nature. Though we have limited our references to ethno-botanical studies concerning tribal people, nevertheless all have recognized the considerable knowledge of tribal people regarding the medicinal value of different plants, which they regularly use for cures and treatments. Moreover, many tribal groups use different parts of various plants not only for treatments, but also for population control. This knowledge could be effectively utilized in a wider context. Again, many tribal groups grow certain types of shrubs to repel insects. Instead of using insecticides, these shrubs could be planted without adversely affecting the environment and may be helpful in preserving ecological balance.

Even though there are not many ethno-botanical studies concerning tribal people, ethno-zoology, which seeks to know medicinal applications for animals and aims to study the interrelationship between man and animals in this context, is still less developed. In fact, there are few studies in this field worth mentioning. Incidentally, the first ethno-zoological study conducted by the Zoological Survey of India (Joseph, 1992) was in Madhya Pradesh as it has the largest tribal population in India accounting for 23% of the total population of the state. Out of 58 scheduled tribes, the study covered 39 communities and focused on the utility of animals in food, medicine, family planning, age stabilization, mechanical and industrial uses, fuel, fertilizers, religious purposes, witchcraft and other uses (28 uses in total). The study indicated about 894 medicinal applications of various animals, of which the maximum number of applications was related to mammals (433), followed by birds (136), reptiles (107), moullese (64), insects (44), crabs (39), fishes (35) and other animals. A review of the literature clearly indicates our meagre knowledge of traditional animal medicine, even though medicinal applications using animals are common among most of the tribal communities and in many rural areas.

Knowledge and documentation of traditional medicine, including tribal medicine, is urgently needed. It is important that the modern system begins with knowledge existing in the rural tribal societies and builds on it, rather than replacing it. In order to achieve this, information about traditional medicinal practices should be documented before it is forgotten. A study of indigenous methods of treatment may help to identify new methods of treatment for various diseases with certain modifications. In fact, a number of ethno-botanical studies have helped to identify a number of medicinal plants used by tribes to treat various types of diseases. Many of these may prove useful for treating diseases and it is urgent that we document and test them using proper scientific experiments. This has been observed in the few studies that have been conducted on tribal medicine, especially in terms of efficiency, which is very encouraging. This, however, needs to be further substantiated though sustained research. It may be said that the achievement of traditional/tribal medicine is quite revealing. However, if we are to utilize research findings for further development and applications to benefit the vast majority of the rural poor, particularly the tribes who live in areas with very few or no modern medical facilities, integrated and multi-disciplinary research is required, followed by dissemination efforts.

Even though documentation should be produced, at the same time one should be aware of the potential risks involved in a commercial interest. Hence, it should be done with certain limitations. Cases are not lacking where, after the publication of research reports on the uses of traditional medicinal plants by rural people, particularly tribes, many such plants were collected in bulk by large external industries for commercial profitable use. As a result, they are no longer available to traditional medicine men for whom they are essential as treatments. Consequently, rural people, including tribes, have been deprived of their traditional system without the modern system becoming available to them.

The relationship between forests and nutrition should be mentioned. It has been noted by many that people living in remote areas have a better health status and a more balanced diet than people living in less remote areas. The various roots and tubers available in the forest and the small animals they can hunt supply balanced sources of nutrition for them. There is no doubt that deforestation is likely to affect the nutritional status of people as most of the roots and tubers will no longer be available. Moreover, in many cases, it has been noted that certain diseases that are common in some areas may be controlled in others because of certain nutritional substances composed of vegetation available locally, or certain traditional practices. Clearly, any disturbance to the ecosystem is likely to affect this balance and consequently some diseases may spread more quickly. The mode of utilization of available natural resources often determines long-term impacts on health. A number of scholars have pointed out the nature of health hazards related to the unplanned/uncontrolled use of insecticides and pesticides for agricultural development. It has also been observed how this may affect the nutritional status of people, particularly tribal people. Insecticides and pesticides have killed the small fish in paddy fields and thus poorer families, who generally consumed this protein, have been deprived of it. This is also the case in many tribal areas. Thus, the whole development strategy needs a critical analysis as it may adversely be affecting the environment, and consequently the health status of people, particularly tribal people.

Forests happen to be the main sources of medicinal plants and animals. Naturally, the different Forest Acts restricting their use and exploitation of forest resources are adversely affecting the health and treatments of tribal societies. Thus, even though, apparently, no relationship exists between the forest and the health of an individual, in reality the Forest Acts, deforestation and certain types of afforestation programmes may adversely be affecting the health of tribal people. In some of our studies on the health care system in tribal areas, we observed how the tribal medicine men were facing difficulties getting medicinal plants. Most of the traditional medicine men, who came from the three states of Bihar, Orissa and West Bengal, while discussing the problems they face when practising their profession, clearly pointed out the difficulties they encounter gathering medicinal plants mainly from forests (Chaudhuri, 1979, 1985, 1993; Marriott, 1955). The success of their approach should be analysed in this context.

The relationship between treatment, nutrition and forests among rural populations, particularly among tribal communities, is quite obvious. Traditional herbal treatments are based on people's knowledge relayed via an oral tradition. Generally speaking, this knowledge is known by the local indigenous communities, even though a few selected persons, the traditional medicine men, are the most knowledgeable. Regardless of this, people depend on nature, particularly on forests for medicinal plants. Thus, deforestation and commercial afforestation of mono-plant forests may seriously affect the availability of such plants. Even nutrition may be similarly affected. Thus, access to forest resources can affect medical treatments and nutrition. Thus, some of the major problems that tribal communities are facing in general and traditional medicine men in particular in this context are the following:

1. Deforestation resulting in the non-availability of medicinal plants and animals.

2. Commercial afforestation and a greater emphasis on commercially important species of plants resulting in the non-availability of herbs.

3. Forest Laws and Acts restricting their use and exploitation of forest resources.

4. Commercial interest in particular plant species resulting in the non-availability of medicinal plants.

There is a need to rediscover the nature of treatments prevalent in rural areas, particularly among tribal communities, which can sustain them for many centuries. Advocacy of traditional treatment methods need not be in opposition to development. The point is that there may be many positive aspects of traditional systems, which should be encouraged and propagated. In fact, there is a need to promote all the alternatives and not to be dependent on one system only. This approach has started in many developing countries, and there is no reason why it should not be adopted also in South Asian countries where the situation and problems are very similar, particularly with regard to rural and tribal populations living in areas with few or no modern medical facilities.

Acknowledgements

The observations made in this paper are based on the findings of research studies sponsored by ICSSR (Indian Council of Social Science Research), ICMR (Indian Council of Medical Research), Asian Community Health Action Network and some action programmes sponsored by CAPART (Council for Advancement of People's Action and Rural Technology), conducted with some activist groups in West Bengal, Jharkand and Orissa. A number of workshops were also organized to generate interaction between traditional/tribal medicine men, researchers, doctors and planners in different parts of Chhotanagpur region. Moreover, sharing the experiences of Bangladesh, Nepal and Sri Lanka proved to be immensely stimulating.

Disclosure statement

No potential conflict of interest was reported by the author.