ACCESS/HEALTH DISPARITY ISSUES

“The country has a large stock of health manpower comprising private practitioners in various systems, for example – Ayurveda, Unani, Siddha, Homeopathy, Yoga, Naturopathy, etc. This resource has not so far been adequately utilised. The practitioners of these various systems enjoy high local acceptance and respect and consequently exert considerable influence on health beliefs and practices. It is, therefore, necessary to initiate organised measures to enable each of these various systems of medicine and health care to develop in accordance with its genius” (India’s National Health Policy Document 1983, quoted in Balasubramanian 2000, 3).

One of the main reasons Siddha medicine has been utilized in India and other regions of South Asia is the cost-effectiveness of employing such systems. In contrast with the quotation above, the money allocated to traditional systems of medicine has “never been more than 5% of our total health budget,” according to the Director of the Centre for Indian Knowledge Systems in Chennai, Dr. A.V. Balasubramanian (Ibid.).

A great deal of research shows that marginalized communities generally have the least access to health care (Lamm 2003; LeBow 2004; Spector 2000). This may occur along class, ethnic, linguistic, gender, mobility, and other factors that reduce or even prohibit access to healthcare. One way to understand these disparities is to invoke the concept of “institutional discrimination – the uneven access by group membership to resources, status, and power that stems from facially neutral policies and practices of organizations and institutions” (Smedley, Stith & Nelson 2003, 95). However, “it is difficult to distinguish the extent to which many racial and ethnic disparities are the result of discrimination or other social and economic forces” (Ibid.).

Whether these disparities are a result of social forces or institutional discrimination or some combination, the fact is they exist. The concept of “choice” in regard to medical choices may not be applicable to rural settings in India where up to 2/3 of the population lives and nearly ¾ use traditional medicine. One source cites the following reasons for their prevalence of traditional medicine outside of the infrastructure of professionalized medicine:
“these medicines have been in use for thousands of years, the easy (OTC) availability of these drugs, their inexpensiveness, and also the frequent inability of modern medicine to provide satisfactory cures in resource poor settings and the ever increasing list of adverse reactions attributable to the use of western medicines” (Bhatt et al. 2004, 74).

What kind of access is really available to the poorest sections of Tamil Nadu’s population? What health outcomes result from these policies? These are more interesting criteria to examine for understanding the disparities that result from policies which relate to professionalization, but are currently beyond the scope of this work.