April 1, 2012
Honorable Prime Minister,
A remarkable meeting co-organized by the HAA, the International Association for the Study of Traditional Asian Medicine (IASTAM) and each of the undersigned, [recently] took place in December 2011 in Kathmandu. More than 30 practitioners of Sowa Rigpa (also known as the Tibetan “science of healing”) gathered for this eight-day workshop focused on the production of efficacious medicines. This unique event brought Sowa Rigpa medical practitioners from Nepal, India and China together in new ways, enabling them to share their knowledge and experiences of pharmacology, materia medica, medical history, ecology, and botany with a view to improving the quality of the medicines they produce and safeguarding practices of medicine production that are, we argue, critically endangered, particularly without state recognition and support in Nepal.
Organizers and participants of Amchi Conference at White Monastery (Seto Gompa). Boudhanath, Kathmandu, Nepal.
Amchis from Ladakh, India
Amchis from Dolpo, Nepal
Amchis from Mustang, Nepal
Ven. Chokling Rinpoche. White Monastery (Seto Gompa). Boudhanath, Kathmandu, Nepal
Despite the lack of official recognition and support, Nepal’s amchi have made major strides in organizing, beginning in 1998 with the founding of the Himalayan Amchi Association (HAA). Since that time, Nepal’s amchi collaborate with international researchers and conservation-development organizations, and network with colleagues in India, Bhutan, China, and Mongolia, each nation-states in which Sowa Rigpa is recognized and supported by the national government.
Following up on a key issue raised during the workshop, this open letter cordially requests the Government of Nepal to begin the process of granting official recognition to Sowa Rigpa as a system of medicine in Nepal. We, the undersigned, have worked with amchi in Nepal, India, Bhutan and China for decades. We strongly believe that recognition would not only serve to protect the unique cultural heritage of the region but would also significantly raise standards of medical training and practice and thus improve the health status of many thousands of Nepalese people. Beyond serving people from Nepal’s high mountain regions, Sowa Rigpa has the potential to make a positive contribution to the health of thousands of other Nepalis. This is the case in China and India, where Sowa Rigpa serves people from many ethnic and cultural groups. By involving Nepal’s amchi in ongoing medicinal plant conservation and cultivation efforts, Sowa Rigpa will be further safeguarded for future generations.
With a textual corpus stretching back over 1000 years, Sowa Rigpa stands alongside Ayurveda, Unani and Chinese medicine as one of the great scholarly medical systems of Asia. It is a medical science with solid theoretical foundations that uses precise diagnostic techniques and natural medicines to treat a wide range of diseases, both chronic and acute. Actively supported by the Chinese government since the 1970s, Sowa Rigpa has become a vital source of healthcare services and a driver of industrial growth in China:
By the end of 2003, statistics showed that the annual output value of Tibetan medicines [Sowa Rigpa] amounted to 1,000,000,000 yuan [approx. 146 million US$], which is over 30 times more than that of 1996. These medicines are used not only in Tibetan-inhabited areas, but also in more than 600 hospitals of other places in the country. Some [.] rare patent Tibetan medicines are sold in the sale[s] net of 30 provinces of the country, even [as] far away [as in] Southeast Asia, South and North Americas. The industry of Tibetan medicines has achieved an average increase by 129% annually since 2000 (Huang 2006).[1]
Workshop for producing efficacious medicine at Shechen Monastery in Boudha. Kathmandu, Nepal
Having recognised the potential to support local economic growth as well as the health-providing benefits, the system is currently being integrated into national programmes in India, too. In 2010, after several years of intense government scrutiny, Sowa Rigpa was formally recognised by the Government of India as part of AYUSH (Ayurveda, Yoga, Unani, Siddha and Sowa Rigpa, Homeopathy) under the Central Council of Indian Medicine, Ministry of Health & Family Welfare. Sowa Rigpa also forms an important part of public health services in Mongolia, Bhutan and Eastern Russia. Official government support in these countries has enabled advances to be made in training, practice, clinical research and medicine production, guaranteeing low-cost medical services to disadvantaged populations while providing livelihoods to thousands of practitioners and supporting workers. The system has also attracted great interest in the West over recent decades, both from scholars such as ourselves and from the growing number of patients who rely on its valuable medicines. There is also GMP-approved production of Sowa Rigpa medicines in Switzerland, where they are prescribed through both governmental and private insurance schemes and are generally easily accessible in regular pharmacies.
In today’s Nepal, more than 100 amchi serve the people living in districts bordering the Tibet Autonomous Region, China, as well as in urban centres such as Kathmandu and Pokhara. The system is represented at the national level by the Himalayan Amchi Association (HAA). Several private schools (in Mustang and Baglung Districts) are teaching a Sowa Rigpa curriculum. One school has been granted limited state recognition for its 3-year course through the Council on Technical Education and Vocational Training (CTEVT). However, this minimal certification has not translated into future employment possibilities for newly trained amchi to serve their communities as government employees in local health posts and hospitals. These institutions are struggling to survive on the basis of local support and limited foreign donor income, but they have the potential to offer a great deal more to the people of Nepal, if granted the legitimacy to do so.
Among other benefits, recognition of Sowa Rigpa by the Government of Nepal would serve to:
- Attract further foreign interest and financial support
- Raise revenue through development of the pharmaceutical sector both for local use and for export
- Provide a low-cost route to improving health in mountainous districts and in cities
- Facilitate better standards of training and medicine production
- Enable registration and professional regulation of practitioners
- Facilitate the conservation and cultivation of threatened medicinal plants
- Preserve valuable cultural heritage of Nepal.
Despite all these benefits, and more than 15 years of lobbying efforts on the part of amchi, Nepali practitioners of Sowa Rigpa, the Government of Nepal – specifically the Ministry of Health and Population – has neither officially recognized nor supported this medical system and its cadre of practitioners. This lack of recognition and support endangers the health of Nepal’s high mountain social communities and puts at further disadvantage people who are manifestly, historically underserved when it comes to health care. This has been true for decades and it remains true now, even in Naya Nepal, with its commitment to making available primary health care to all of its citizens.
On behalf of the Sowa Rigpa practitioners of Nepal and the international research community, we hereby request the Prime Minister to encourage the Government of Nepal to now take the necessary steps towards recognising this valuable medical system and the amchi who practice it, as has been done in India and China. By taking such action, you would help to safeguard and secure the future of this invaluable medical system, helping it to flourish across the Himalayan region and indeed the world.
Respectfully,
Dr. Calum Blaikie (Centre of Research on Medicine, Sciences, Health, Mental Health and Society, Paris, France)
Dr. Sienna Craig (Dartmouth College, New Hampshire, USA)
Dr. Barbara Gerke (Humboldt University, Berlin, Germany)
Dr. Theresia Hofer (University of Oslo, Norway)
Closing ceremony of Amchi Conference
[1] Huang, Fukai. 2006. Traditional Inheritance and Modern Development of Tibetan Medicine. China Tibet Information Center.
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