This would leave a few gaps. We know only three things – that we need to either poison the body, to kill the bacteria we are going to poison the body; or if there is a tumour growing, we cut it out; or we shoot it through x-ray beams. These are the three things we do. All of them are very effective, very invasive and very expensive. This much modern medicine knows. With that back ground, how does India position itself for its people? I think we need to look for our own solutions, a new paradigm, and one of those things we had lost was ayurveda with all its knowledge of herbal medicine, which has got sidelined because of the lack of scientific validation.
So if we know the scientific validation and we apply it to ayurveda and herbal medicines, then in the coming years we should be able to take the gems out of that form of medicine and bring them into the mainstream. The mainstream also shows there are many things that perhaps ayurveda alone can treat, many things it can contribute similar to modern medicine like you see in arthritis, liver disorder and skin disorders and kidney disorders, which modern medicine has no treatment for. But there is hope because there are remedies in the herbal system, in the ayurveda system, maybe even in traditional Chinese medicine. To be able to combine the power of the two – that’s what we are trying to do.
We have started the process for the validations now – and we have started with Parkinson’s and multiple sclerosis. These are people who have huge amounts of disability – it is a mobility disorder – and as an early success we are seeing good results in Parkinson’s already. So much so that there is a German professor who has started a counter research project in Germany. We are collaborating to bring the results as fast as possible. There are many areas where a lot of work has already been done. For instance, in understanding the pharmacology of herbal stuff, there are lots of directories now available.
We have already picked up two molecules for cancer from a government institute in Jammu and we were ready to embrace each other. Because we are looking for the ayurveda and they are looking for the clinicians. But the reasons why clinicians were hesitant was they felt threatened as they felt there were alternatives. I’m not even saying they are alternatives –they are synergistic. So we should now explore the synergies between the different forms of medicines and try and come up with a new era of medicine, which will fully emerge out of India in the coming years.
It will have three purposes: It will be as effective as or more effective than modern medicine today. It will be less invasive to the human body. And hopefully, it will come at half the price. So that is what the dream is – I don’t know whether it would happen. With that thought I created Medanta. Medanta is what you can say, for want of a better comparison, the Cleveland clinic or the Harvard of the east.
What these institutions serve is not only the highest end of care but they are also fountains of new knowledge. India didn’t have that so we are creating that paradigm where we will continue to give the highest end of modern medicine across all specialties. At the same time, the faculty that we have selected would have a mindset that allows them to explore the possibilities beyond themselves. There is something out there that we can incorporate and make this malady less. Because there is not enough money in this whole world to treat every Indian who has a heart problem, right? So that’s the spirit behind it.
HEART CARE
Heart disease can be divided into three broad categories. The first is where a person is born with a heart disease – the congenital heart disease. About 1 per cent of children will be born with it no matter where they are in the world. There may be more in countries with malnutrition and so they will need treatment. This treatment has been by and large established and there are newer technologies that will serve this small group.
The next form is the rheumatic heart disease, which comes from rheumatic fever. As the economy moves forward there will be less and less of this form of heart disease. But there is still an overhang of millions of people who need treatment because rheumatic fever licks the joints and bites the heart. So it actually affects the valves of the heart and creates obstruction in the flow of blood. That also has by and large been solved and it is not as rampant because it is on the decline.
As coronary heart diseases go, India has the highest percentage of coronary heart patients. So, whether it is genetic, lifestyle, or dietary habits, all of them put together have led us to become the capital of heart diseases in the world. In addition to that, we are also the capital of diabetes in the world. When combined, they create a huge burden of disease, especially heart disease as a consequence of diabetes.
BOTH ARE now controllable. From the beginning one may try to maintain the sugar level so that one does not become a diabetic. If either parents – or both – are diabetic there is an additional 25 per cent chance that one will have the disease. But, even the mere education of it can keep it under control. Heart disease, similarly, has its origins in genetics. If your parents have it, then there is a 50 per cent more chance that you will get it. So there is a genetic imprint. Second, if the fat content in your blood – lipid – is high then it pre-disposes you. So if you do not exercise regularly or maintain a healthy lifestyle, these facts can add up.So if you eat properly, that is, low-cholesterol food or reasonable cholesterol food, you exercise regularly and you destress yourself, it should be better. The best ways to destress are usually yoga and vipassana. If you do that, you could mitigate heart disease by a long way. Then the point is how to make people aware of the early signs. If you do not know till you get a heart attack, then the horse is out of the barn already. Diabetics are especially prone to it because they don’t get warning signs and they don’t get chest pain. So you need to make people aware about the traps of heart disease.
THE GENE POOL An important step has happened in genetics. It took 25 years to sequence the first 20 per cent of genomics but with the advent of the IT and other facilities, within 5 years the whole gene pool was worked out. Now we understand there are a few diseases with a genetic background – where if you have a particular gene, you will be prone to that disease, especially breast cancer and things like that. So how do we treat them? We may not be able to manipulate the gene but we can be more cautious. The moment women develop a lump they should get it removed rather than wait before you need full-blown mastectomy.
Genetic mapping is one thing, genetically manipulating is another. It is a realm where we have to be extremely cautious because the abuse in India has already started. Say, you are into in vitro fertilisation where you can actually look at the ovum and see whether it is male or female – you start gender selection right there. And like I said, what are the social consequences of it when we go further? Today, there are states where this ratio has fallen to 740 women to 1,000 men. This is going to be a disaster. The psychosocial effect of the shortage of women in the community is going to lead to all sorts of law and order problems.
Then we say we are fine with cloning. Now, cloning has good and bad sides. Can you imagine everybody wanting to look like Aishwarya Rai? Where will the differential be? So, it’s crazy to think about it in those terms – that you are so brainy or so good looking that you want to clone yourself. This is something dangerous in the sense that you can also clone the worst of criminals. In any case, we don’t need factories of human beings – we already have 7 billion people. It would be a disaster for the planet, which we are already worrying about. The population could touch 8.5 billion in 10 years. How do we support all of them?
So we need to rewind a bit and talk sense to each other. Science is great. We need to look at it with a magnifying glass and say, yes, this is good or bad. This should be allowed to move forward, this has collateral damage or this would be too much for society to take, and so on. We must make regulations accordingly.
Many doctors do gender identification when they are not supposed to. So what do we do to them? We don’t have the means to implement the laws. These are the kind of things that we need to try and get rid of and stop people from destroying society for personal gains. There will be far-reaching effects of all the little things that we do. So, genetics by itself is a good thing but what we do with it is the more responsible part. As a nation, we should look at it more carefully and recognise the possible ramifications of the decisions we take today.
By:NARESH TREHAN (Chair and managing director Medanta based in New Delhi)
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