The fate of traditional medicine hangs in the balance in Pakistan, leaving students and practitioners in limbo.
A Troubling Uncertainty
Arsalan Ali, a student with a background in pharmaceutical chemistry, is now uncertain about his future in traditional healing. He, like many others, is caught in a storm of doubt as the government's recent moves threaten the very existence of tibb colleges and the practice of hakeems.
A Shift from Modern to Traditional
Ali's journey began with a disillusionment towards modern medicine's side effects, leading him to embrace traditional Unani medicine. He enrolled in the Fazil-i-Tibb-wal-Jarahat program, a government-recognized qualification that trains practitioners in a centuries-old healing tradition rooted in South and Central Asia. This system harnesses herbal remedies to balance bodily temperaments, drawing from Greek, Persian, and Arabic influences.
A Looming Threat
However, Ali's pursuit of this ancient wisdom is now overshadowed by a proposed legislation. He fears that his college might shut down, and his degree and license to practice could become obsolete. The government's instruction to colleges not to enroll new students from the next academic session has sparked concerns that the merger of the National Council for Tibb and the National Council for Homoeopathy will lead to the closure of these institutions, leaving thousands of hakeems without legal recognition.
A Regulatory Conundrum
This decision impacts over 70,000 hakeems and could result in the closure of all 40 tibb colleges in Pakistan. College administrators emphasize that these fears are not unfounded but are based on official government instructions. Professor Imran Lodhi highlights the distinct legal and educational framework of traditional medicine, which is at risk of being subsumed by the proposed merger.
The Unique Role of Hakeems
Hakeems, according to Professor Lodhi, are one of the three main types of healthcare practitioners in Pakistan, alongside allopathic and homoeopathic practitioners. They operate under the Pakistan Unani, Ayurvedic and Homoeopathic Practitioners Act, 1965, which establishes regulatory councils like the National Council for Tibb and the National Council for Homoeopathy. But here's where it gets controversial—the government's plan to 'right-size' these councils has sparked a debate about the future of traditional medicine.
A Sector Under Threat
Hakeem Muhammad Sajjad, General Secretary of the Pakistan Tibbi Alliance, has formally voiced concerns to the health and law ministries, urging them to halt the draft legislation. He argues that the proposed 'National Traditional and Complementary Medicine (NTCAM) Act, 2025' has critical flaws that could dismantle the traditional medicine sector. These changes, he believes, are driven by fiscal reforms influenced by international commitments, particularly the International Monetary Fund (IMF).
A Cost-Cutting Measure?
The government's decision to abolish 150,000 posts as part of IMF-backed structural reforms has raised questions about the fate of traditional medicine. Hakeem Sajjad questions the logic of merging the councils, given their minimal financial burden on the government. But is this a mere cost-cutting measure, or does it signal a shift in the government's approach to healthcare?
A Complex Merger
A senior health ministry officer, speaking anonymously, admits the policy's risks but claims limited options. They compare the merger to mixing different beverages, suggesting the councils' diverse scopes and natures. The officer also points to internal disagreements between hakeems and homoeopathic doctors, making the integration even more challenging.
The Government's Stance
The health ministry maintains that the merger is consultative and aims to improve standards. However, students and practitioners alike express anxiety about the future. Sameera Kamran, a student, chose tibb colleges for their affordability, especially for lower-middle-income families. She fears that the government's move will close doors to traditional medicine and shatter dreams, particularly for those aspiring to become tabeebs.
Rural Healthcare at Stake
The decision's impact on rural healthcare is a significant concern. Students and hakeems argue that with a shortage of doctors in rural areas, hakeems play a crucial role in providing treatment. The closure of colleges could leave these regions without essential healthcare services.
A Personal Journey
For Arsalan Ali, the debate is deeply personal. His decision to study tibb was a return to nature, believing in the healing power of herbs. After years of study, he faces an uncertain future, fearing the erasure of Unani medicine from Pakistan. He points to the success of traditional medicine in neighboring countries, such as India and China, where it generates significant foreign exchange.
Individualized Treatment
Ali emphasizes the personalized approach of Unani practice. Hakeems use various books on human temperament to prescribe tailored medicines to patients with the same complaints, demonstrating the system's adaptability.
Patient Testimonials
Patients also attest to the effectiveness of traditional medicine. Awais Siddique, a resident of Lahore, sought a hakeem's help after conventional hospital treatments failed to improve his wife's health. The hakeem's prescribed medicine brought lasting relief, according to Siddique, who claims his wife has been healthy ever since.
A Fight for Survival
Amidst growing concerns, representatives of the Pakistan Medical Alliance met with government officials to discuss the survival and protection of the 1965 Act. Until the situation is clarified, students like Arsalan continue their studies, unsure if the system they are trained in will exist when they graduate.
This issue is not just about the future of tibb colleges and hakeems but also about the preservation of traditional knowledge and its role in healthcare. The debate invites questions about the balance between modern and traditional medicine, the impact on rural communities, and the government's responsibility in safeguarding public health. And this is the part most people miss—how do we ensure access to diverse healthcare options while maintaining quality and safety? The answers may lie in a nuanced understanding of traditional medicine's strengths and limitations, and a collaborative approach to healthcare policy.
