Quaid-e-Azam Mohammad Ali Jinnah was instrumental
in the passage of Homoeopathic, Unani and Ayurvedic act in 1937 in India
during British Raj. It is deplorable that the similar act was passed in
1965 in Pakistan. The progress of homoeopathy has been tardy and slow in
this country. It should be noted that health cover to its teaming masses
cannot be provided by promoting only one system (28).
Homoeopathy progressed in Pakistan to a visible level since 1967, after
the establishment of Homoeopathic Board and National Council for
Homoeopathy (NCH) in 1980.
Homoeopathy developed in Pakistan as an art rather than a science, with
emphasis on increase in number of diploma holders-DHMS. This was the
consequence of increase in the privately owned college. There is NO
government controlled homoeopathic college in Pakistan. Most people join
this profession without taking any aptitude test. The minimum
qualification for admission is simple matriculation (not necessarily with
science) (13).
The NCH followed free admission policy and part time-ism, thus producing
low quality graduate. The number of full time practicing homoeopaths is
also limited. Therefore both education and practice are part time. The
younger people join profession for being called H/Drs from which H/ is
droped with time. The aged do so for getting a source of sustenance after
retirement. The result is that there are only limited number of committed
homoeopaths. Only 10% of DHMS graduates are consequently practicing. The
low cost of education also promoted uncontrolled homoeopathic education
(12).
Majority of homoeopaths, though vocally against allopaths are really
impressed by allopaths, who are definitely superior in their knowledge of
basic medical sciences, English language and technical know how. As a
result, the numerical strength generated by NCH could not uplift the IMAGE
of a common homoeopath in the society. The only impact of numerical
strength was the establishment of trade union like organizations which
pressed the demand of the profession, proliferation of homoeopharmacies
and clinics. These phenomena made homoeopathy visible and felt by public
and government and gained repute for inexpensive treatment of profound
efficacy (12, 13).
The curriculum and syllabi are fairly well written and can cater for
producing reasonably good prescribers but the colleges which execute this
program are commercial organizations. The examination system of NCH is so
archaic that hardly any one fails. The NCH apparently
never emphasized quality because the people sitting at the helm of affairs
are college owners or pharmacists or importers. Both groups had been
money-rather than quality-seekers (12).
The people at the helm of affairs, consequently refrained from developing
higher education and providing the research base to the profession. They
did not earnestly try to develop a pharmaceutical industry of national
status. On the contrary, they kept the competent and committed homoeopaths
at bay from this prestigious organization, so much so that the practicing
homoeopaths out side these two groups have very little representation in
the NCH (12).
The NCH has a total of 21 members of which 1 is a government employee and
7 are nominated by the provincial and federal governments. Only 13 are
elected from the whole country which is divided over 4 provinces. Only
moneyed and influential homoeopaths are nominated and elected by the
practitioners which eventually come from these dominant goups. The make up
of NCH has not been revised since 1967 when the number of homoeopaths,
homoeopathic colleges and the population were far less than the present
(12, 13).
The result is that, there is still no avenue open for genuinely interested
homoeopaths to grow professionally in the absence of higher education.
There is no viable research base established. The import of remedies on
the other hand is increasing, the prices rocketing high and Pakistan has
become second largest importer of homoeopathic remedies. There is no
homoeopathic drug act consequently the exporters are sending, and local
manufacturers are making combination remedies un-checked and un-licensed
(12-18).
We have to stop and think, keeping Allah in mind; are we really serving
homoeopathy and humanity or are we serving our own un-satiahle thirst for
material benefits!.
Undivided India
Homoeopathy was recognised and the Act was passed in British India with the
support of Quaid-e-Azam Mr. M.A. Jinnah and many Muslim leaders, in 1937.
Inheritance
One College, one Pharmaceutical Company in Lahore.
Pre-recognition
One College at Karachi and two in Lahore offered MBHS Program.
Recognition
Homoeopathy was recognized in 1957. The LJnani & Ayurvadic Act was
passed in 1965 at Dhaka.
Administrative Control
Homoeopathic Board (HB) was established in 1967. Registration of lay and
qualified homoeopaths started. BHMS program was suspended. A four years post
matriculation diploma-DHMS, approved by Government of Pakistan (GOP) was started. The apex body
-National Council for Homoeopathy replaced HB in 1980, and thus the NCH
became responsible
for education, registration, research and affiliation of colleges.
Present State of Education
76 Colleges distributed in all provinces of the country: Islamabad (3),
Sindh (11), Punjab (55), NWFP (6), Baluchistan (1) and Azad Kashmir (1).
No government homoeopathic medical college in the country.
All college are in private sector, owned by individuals, therefore, run on
commercial lines. Facilities like libraries, laboratories, OPD's, teaching
hospitals, AV aids are poor or altogether missing. Faculty has to be a
DHMS with any basic qualification. Faculty is overall poor due to low pay
and is generally changing.
Part time evening classes since beginning. Now, NCH has made them day
colleges, but the order is not being implemented by majority of colleges.
Admission policy: Open. No age limit. No aptitude test, basic
qualification matriculation but Intermediate, Bachelor, Masters, Ph.D (not
necessary of science background). FTJ, RN and MBBS also admitted.
Medium of instruction is Urdu. English proficiency is generally very low.
No teacher training program for DHMS teachers, therefore no subject
specialists available.
Passing rate was DHMS: MBBS=3-4:1 (in Karachi), practically everyone
passes. Standard of the examination is very poor.
Graduates are allowed to use the title of H/Dr. In 1994 only 10% 55,000
were practicing part time or full time. Right to issue medical
certificates was granted in 1997 by a Presidential Order, Practical
training is almost non-existent due to lack of teaching
hospitals/effective OPD's in the colleges. The six months practical
training is supposedly offered by senior homoeopaths. The NCH has no
program for evaluating the trainers. Majority of the certificate issued
for practical training are the result of PR, therefore are fake.
Image of Homoeopathy Doctors
The Image of homoeopathic doctors is generally poor. There is no provision for
higher education, therefore the doctors tend to obtain spurious
qualification and put them with their names. They do not like to put H/Dr.
with their names for advertisements The NCH has warned them for this
practice.
Research
The Research Cell at NCH remained unmanned by qualified researchers as
long as it was in Karachi There is no research manpower available.
The Research Cell at NCH has one B.Sc DHMS who has produced only one paper
on hemerhoids, in collaboration with an allopath.
An unfunded homoeopathic laboratory in Botany Department (Science) and
Micro-dliuuon laboratory in Pharmacy), University of Karachi have produced
about 12 papers.
Due to the imitative of D.C. (Homoeopathy) PCSIR laboratories, Karachi,
have initiated a Homoeopathic Research Unit which is inactive due to lack
of funds.
Despite the above items, every homoeopaths talks of research which is a very
healthy sign.
Conversions
About 1000 Allopaths and a number of FTJ, RN are registered and practicing
homoeopaths.
Higher Education
Non-existent. There is no possibility of professional growth of
homoeopaths without it.
The UGC, the universities and probably the NCH are dis-interested. The
H/Drs. believe that NCH should arrange for their higher education.
The D.C (Homoeopathy) has formulated a curriculum in 1994 and submitted to
appropriate authorities.
KHLC efforts for higher education in homoeopathy have not succeeded yet,
however BHMS program has been started at Al-Khair University, Azad
Kashmir. Peshawar University is expected to follow.
Foreign training of H/Drs. is difficult, because they do not fulfill pre-requisites and have extremely low English proficiency. SAARC countries
may be able to collaborate for scholars exchange.
Some organizations/individuals are offering courses in Homoeopathy and
Allied Sciences (Acupuncture, Radiesthesia, Radionics, Magrietotherapy,
Moxibustion etc.) in affiliation with foreign institutions like OIUCM and
Sri Lanka. Important institution offering homoeopathy training by
correspondence is British Institute of Homoeopathy, England. Both are not
recognized by NCH.
Important foreign institutions operating in Pakistan are: British
Institute of Homoeopathy (BIH) which runs an international network of
correspondence course, and OIUCM, Sri Lanka.
Pharmacy
Other than an introductory course in pharmacy in DHMS, there is no
specialized training thus there are no qualified homoeo-pharmacists in
Pakistan to work in homoeo-pharmaceuticals industry.
There are about 58 local pharmaceutical companies operating. All except
very low are making combination remedies only. There are 17 foreign
companies supplying single and combination remedies. The combination
remedies have appeared about 15 years ago in homoeopathy stores.
Hospitals / Clinics
The galore of private clinics and stores have made homoeopathy visible and
felt.
There are very few hospitals. Homoeopaths are not familiar with hospital
business. There are no paramedics.
Homoeopathic Magazines
There are 23 Urdu Magazines: 7(Karachi)+7(Lahore)+ l(Faisalabad)+1 (Multan)
+1 (Hyderabad) +1 (DG Khan) + 2(Rawalpindi) +1 (Kasure) +1 (Rahimyar Khan
)+l(Gujranwala).
The only journal of international standard is' PJHAS-Pakistan Journal of
Homoeopathy and Allied Sciences, issued by Karachi Homoeo Lions Club (KHLC)
and District Committee on Homoeopathy, Lions Clubs International, District 305
(S-1), Pakistan.
Publishing Houses
There are 5 publishing houses, 2 in (Karachi) and 3 in (Lahore)
Homoeopathic Organizations
There are 35 local and one (KHLC) International.
Misconceptions About Competence
According to Pakistani tradition, seniority is equated with competence.
This conception has impeded our growth in every field, homoeopathy is no
exception. The competence should be determined on technical know how,
knowledge as well as seniority. In the present state of affairs, it is
difficult to distinguish between a good homoeopath, a successful
practitioner and a quack. It all depends upon how much money and time one
can put in his work. Some practices of self advertisement use by homoeo
doctors are unethical.
Positive Signs
Thanks to the free educational policy of NCH that along with the multitude
of matriculates some highly educated people entered the fold of
homoeopathy either out of curiosity or genuine interest through experience
or with exposure to homoeopathy. Being bewildered of what was going on in
the name of serving humanity and homoeopathy, they started raising voices
about the issues that confronted this great therapeutic science. To
antidote this phenomenon a slogan of "Degree Course" was given
by the NCH. We have been hearing about the efforts of NCH in speeches and
homoeopathy magazines for the last decade. Nothing surfaced. The main
cause was that neither homoeopaths not NCH had the slightest idea what
this course should be like.
The NCH could collect curricula and syllabi of the courses which it did,
but it could not formulate a concrete plan of action due to lack of
knowledge of educational planning and vested interests. It needed people who are familiar with the basics of educational process and can
assess the present and future needs of homoeopaths in Pakistan. Such
people were many but scattered. The establishment of Karachi Homoeo Lions
Club, brought them together under the umbrella of International Lionism
with the dynamic leadership of Lion Prof. Syed Mushtaq Husain, a trained
scientist, who embraced homoeopathy after the personal experience of
supremacy of this immaculate science. -He shifted all his energies for the
establishment of Higher Studies and a Research Base of homoeopathy in
Pakistan. He firmly believed that we can not implant any foreign system.
It should have an indigenous evolution keeping in mind all the multiple
factors in mind. It took us over two years to develop the system. The plan
or model was presented by Prof. S. M. Husain at the IV International Conference on
Homoeopathy at Lahore organized by HPCA-Pakistan, British Institute of
Homoeopathy, England and PEKANA International-Germany, where the great
grandson of Dr. Samuel Hahnemann - Mr. Tankard Hahnemann was also present.
The plan was also presented to UGC, NCH and universities, but there was no
response. Through an in house move, at Karachi University by Prof. S. M. Husain
who was teaching Plant Physiology, things started moving. Homoeopathy
being a medical science should have been placed under the Faculty of
Medicine but it could not be done for obvious reasons. Prof. Husain,
therefore, had a different vision,. He viewed homoeopathy as an
interdisciplinary science to be placed in the Faculty of Science as a
Department. The Dean Faculty of Science Prof. Dr. Viqaruddin Ahmed as well
as the then Vice Chancellor Prof. Dr. Abdul Wahab supported the idea. In
the first meeting at the Dean's Office the question of placement of
homoeopathy was raised by the staff representing the Faculty of Pharmacy.
They proposed it should be a project of Faculty of Pharmacy. The project
died its own death after Prof. Husain's retirement and lack of interested
homoeopaths on the university faculty.
Phase 4: For BHMS & B. Horn.
Curricula for M. Horn. (Master of Homoeopathy) and D. Horn (Doctor of
Homoeopathy) will be designed at suitable time.
In the private sector Prof. Husain submitted the project to Hamdard
University. He and I personaly met Hakim Mohammad Saeed Sahib and presented
it to him. After a long wait we received a response that due to
entanglement of Hamdard in their on going programs the matter would be
taken up in June 1999. This was announced by Hakim Saeed Sahib in a
recently held Moalij Evening where he served as a Chief Guest. The salient
features of the curricula are given below:
1. All the three programs have been designed after need analysis of
students and requirements of the professions, aiming at quality of
graduates and not their number. It has not been borrowed from any where
and is original in its style content and approach.
2. It is not advisable to grant license for homoeopathic practice to
people of other medical professions, no matter how much is their knowledge
of basic medical sciences. There are reports that this facility granted by
NCH is being misused. The first program-PDHS aims at producing allo-homoeopaths,
graduate nurses and hakims on one hand and train faculty for DHMS colleges
and BHMS program.
3. The BHMS program aims at upgrading committed and able DHMS graduates or
practicing doctors. The curriculum aims at removing language and
professional deficiencies inherent in DHMS program and produce well
qualified teachers for DHMS colleges and BHMS program.
4. The B. Horn. Program is for F.Sc (Pre-medical) graduates who want to pursue
homoeopathy. This program is no less than the MBBS program being followed
in the medical colleges. The B. Horn. Graduates, in addition, will have
research orientation an area which MBBS program lacks. These graduates
will be research minded scientific prescribers. They will be equivalent to
MBBS and would, be equally competent to embark on any specialty, shoulder
to shoulder, with their MBBS counterparts. They will provide faculty for
DHMS, BHMS and B. Horn.programs and will be able to obtain foreign
training, as this will be equivalent to any foreign institution.
5. After the establishment B. Horn. program attempt will be made to
develop M. Horn. (M. Phil.) and D. Horn (Ph. D.) programs.
As far as I know no such a well thought out, comprehensive and
multi-disciplinary program on homoeopathy is available any where in the
world. The essence of the whole program of higher education is the achievement
of academic and professional know-how for the service of PATIENT which
holds top priority for medical men.
Recommendations
1. Expansion of the council: Since the establishment of NCH in 1980,
the population, the number of colleges and the number of homoeopaths have
increased manifold. Yet the size of the council is still of 21 members.
This number should be increased to 42.
2. Reduction of nominations: The nominated members at present is 8. It
should be reduced to minimum in order to increase the participation of
practitioners. This will minimize the involvement and force of vested
interests on one hand and enhance the entry of deserving and knowledgeable
homoeopaths. It will also reduced lotaism and horse trading in elections.
3. Transparency of election: The NCH elections have not been very fair (as
reported in homoeopathic magazines). The procedure of elections should be
made as transparent as possible. There should be sub-offices of NCH in each
province to oversee the interest of homoeopaths and at the same time serve
as polling booths. Provincial Assistant Director (Homoeopathy) may serve
as ex-officio members of NCH and serve as provincial election officers.
4. Outsides expertise: The affiliation, inspection, examination and
research committee draw their membership from the 21 council members. The
NCH should opt for appointing unbiased outside experts. This will enhance
the effectiveness of these committees. Further more the appointments to
various positions in the council, at present, are made by internal
adjustment. These positions should be advertised and filled according to
standard procedures. Right man for the right job should be the policy.
5. Journal of NCH: It is at present of limited circulation, it should be
available to all homoeopaths. This will decrease the suspicions of the
body of homoeopaths towards NCH.
6. Improvement of DHMS program: The DHMS program is well written but
poorly executed, still it should be reviewed. The quality of teaching can
be improve provided NCH develops a program of Subject Specialist Training.
Another area which needs special care is Internship Training (six months).
This is very poorly organized. The NCH should develop a list of authorised
trainers in every city. This will be more realistic approach and put stop
to fake licencing-RHMP.
7. Government Homoeopathic Colleges: For improving the standard of private
colleges this step is very important. Each province should have at least
one government homoeopathic medical college, as there are for allopathy.
8. Higher Education and Research: The UGC, Ministries of Health and
Education, NCH and the universities must collaborate to adopt a policy for
establishing higher education for this immaculate science. Creating a
place for homoeopathy in already existing medical faculties will be both
economical and practical. The NCH Research Centre should be activated and
a team of skilled researchers which are now available should be employed.
The NCH should concentrate on realistic data collection and clinical
trials through the centre.
9. Scholars Exchanges: The Ministry of Health and NCH may developed
Scholars Exchange Program in collaboration with SAARC, QIC and WHO. This
interaction will be greatly beneficial to the country. The KHLC can use
it's international contacts to help.
10. Hospitals Establishment: There is a galore of clinics but there are
very few hospitals. The Ministry of Health and NCH in collaboration with
NGO's and appropriate private sector or existing BHU's and hospitals may
encourage the concept of hospitals among homoeopaths in both rural and
urban areas. This will be helpful in developing the infrastructure of
Integrated Health Care System.
11. National Health Policy: It is unfortunate that homoeopathy has
received no importance in the recently announced National Health Policy.
It should be given its due share. It is strongly felt the government will
not be able to provide health cover to all by patronizing only one system
of treatment. In line with WHO policy, other systems must be promoted.
12. Financial Support: The implementation of the above mentioned
recommendations will only be possible if adequate finances are ear marked
in the budget for alternative medicine.
Only through the above measures the quality of homoeopaths will be
improved resulting in their better Image, and they will be able to play
their role in helping the government for attaining WHO'S target-HEALTH FOR
ALL by 2010.
References
1. Banergea, S.K. (1992) Homoeopathy Around the World. N. Delhi: B. Jain
Publishers (P) Ltd.
2. Boerieke, W..(1990) Pocket Manual of Homoeopathic Materia Medica with
Repertory and Indian Drugs. India, N. Delhi: B Jain Publishers (Pvt.) Ltd.
3. Clarke, J.H ( ) A Dictionary of Practical Materia Medica Vol 1-3.
Pakistan, Lahore: Medical Book Centre, Urdu Bazar.
4. Cogswell, J.W. (1961) The Biochemic therapy of schuessler. Pakistan,
Lahore: The Homoeopathic Stores and Hospital 30, Allama IqbalRoad.
5. Copen, B. (1976) Electronic Medicine, England: Academic Publications,
Highfield Dane Hill, Hayward Heath, Sussex.
6. ibid, (1975). The new Homoeopathy. Ibid.
7. ibid, (1989). A materia Medico of Homoeopathic Formulas. Bruce Copen
Laboratories, ibid.
8. ibid, (1989). Advanced Radie^^e»^and Radionics, ibid.
9. Devy, R. M (1987). Strategy of Research in Homoeopathy. The British
Homoeopathic Journal 76:1-2.
10. Gliddow, A.J.L. (1991) Introduction to Electrohonoeopathy. India, N.
Delhi: B. Jain Publishers (P) Ltd.
11. Hayat, K. (1993) A comparative study of Admission Policy, Teaching,
Facilities and Practical Training in Homoeopathic and Allopathic Education
Systems in Karachi. A thesis submitted to Department of Education,
University of Karachi, Karachi, in partial fulfillment of the degree of
M.Ed.
12. Homoeopathic Magazines, Books, Souvenirs Published in Pakistan.
13. Husain, S.M., Khalid, Q., Rizki, Y. & Naqvi, S.A. (1993)
Clinicraft for Homoeopaths. Pakistan: Karachi Homoeo Lions Club, Lions
Clubs International, District 305S.
14. Husain, S.M. (1995) Homoeopathic Education 1
& 2. Muslim,
Islamabad, Feb. 16, 17.
15. ibid, (1995) A Conceptual Model for Higher Homoeopathic Education in
Pakistan. Proceedings Fourth Homoeopathic International Conference,
Lahore, pp 104 to 119.
16. ibid, (1995) Research Activities in Homoeopathy in Pakistan (Urdu).
Science Digest Dec-Jan, pp 135 -145.
17. ibid, (1996) Problems in Initiation of Higher Education of Homoeopathy
in Pakistan. A lecture delivered in National Conference on Homoeopathy,
organized by HMO & Jissarat Daily, Karachi.
18. ibid, (1998) Higher Homoeopathic Education. Why? How? Where?. Moalij
14 (12) 7 - 13.
19. Jafri, S. A. A. (1981) Homoeopathy - Its past, present and expected
future: Pakistan, Karachi: Psychological Counseling Clinic, p 49.
20. ibid, (1997) Homoeopathy: A Neglected Medical Science. Homoeo News
Lahore, Feb. pp 7 - 9.
21. Jayasuriya, A. (1992) A-Z in Acupuncture. N. Delhi: B. Jain Publishers
(P) Ltd.
22. ibid, (1994) Clinical Homoeopathy, ibid.
23. Master, F.J (1994) Bach Flower Remedies for Every One. N. Delhi: B.
Jam Publishers (P) Ltd.
24. Pai, P.N. (1987) Homoeopathy in Daily Practice India, Bombay: 1/142.
Ram Bhawan.
25. Powell, E.F.W. (1985) Biochemistry Update. Pakistan, Karachi: Dr.
Shafiq Sons Publications, Karim Centre, Saddar.
26. ibid, (1987) Group Remedy Precriber. Pakistan, Karachi: J.K.
Publications, Karim Centre, Saddar.
27. Russell, E.W. (1983) Reports on Radionics - Science of Future.
England: Neville Spearman Ltd.
28. Saxena, K.G. (1992). Struggle for Homoeopathy in India. India, N.
Delhi: B. Jam Publishers (P) Ltd.
29. Spire, D. M. (1986) Research in Homoeopathy. Greece, Athens: Medical
Institute of Homoeopathy and its affiliation, p. 4.
30. M. Tansly, D.V. (1979) Radionics - Interface with the Ether Fields.
England: Health Science Press, Bradford. Holswally, N. Devon.
31. Vicen, C. A. (1990). Homoeopathic Medicine Around the World.
Proceedings Acadamia Medica Homoeopathica de Barcelona, Spain. India, N.
Delhi: B. Jain Publishers (P) Ltd.
32. Vithoulkas, G ( ) Homoeopathy in Traditional Medicine and Health Care
Coverage, Switzerland, Geneva: WHO, pp 110-115.
33. Wasschhoeft, C. (1944). Organon of the Art of Healing. The
Homoeopathic Physician, Calcutta, pp 6 - 9, 63.
34. Weiner, M. and Gross, K. (1989). The Complete Book of Homoeopathy.
India, N. Delhi: B. Jain Publishers (P) Ltd., pp 260-261.
35. Wethered, V.D. (1961) A Radiesthesia Approach to Health and Homoepathy.
England: The British Society of Dowsers, New York House, Portugal Street,
London W.C.2.c
36. ibid, ( ). An Introduction to Medical Radiesthesia and Radionics.
England: The C.W. Daniel Company Ltd., Ashington, Rochford, Essex.
37. Who is Who in Homoeopathy, (1993). Pakistan, Karachi: Homoeopathic
Heritage Publishers.
