PROFESSIONALIZATION OF SIDDHA MEDICINE

The movement towards the professionalization of Siddha medicine has been supported by the central government of India. It is incorporated into medical colleges, hospitals and other clinical settings through policies which support its “development” alongside biomedicine and other medical systems. However, this process has not been “natural,” nor even desirable to certain Siddha medical practitioners. This is primarily because professionalization is a double-edged sword: it gives credibility and institutional support on the one hand, yet also steals authority and places Siddha medicine in a subordinate position to Western biomedicine.

The authority which is inherent in professionalization is well-understood as a gradual construction, rather than a pre-fabricated, “given” status. Paul Starr writes:
“the legitimation of professional authority involves three distinctive claims: first, that the knowledge and competence of the professional have been validated by a community of his or her peers; second, that this consensually validated knowledge and competence rest on rational, scientific grounds; and third, that the professional’s judgment and advice are oriented toward a set of substantive values, such as health” (Starr 1982, 15).

These three claims are rather problematic in the case of Siddha medicine. First, there has been little cooperation and even commonality between Siddha medical practitioners as a community. This has definitely shifted in the past few decades, but has been an issue historically and continues to create division. Next, the agreed upon knowledge and competence of the system of Siddha medicine is something which has been contested, re-formulated, and hotly debated. Further, as the process of medicalization shows, moving towards rationalizing or scientifically verifying Siddha medicine requires a great deal of strategic negotiation, at best. Finally, values such as health, immortality, integrity and others held by Siddha physicians can vary widely between practitioners.

Professionalization is primarily a movement towards homogenization; a subtle yet forceful movement that is closely allied with the project of imperialism. In practical terms, part of the difficulty in incorporating Siddha medicine into the biomedical system is the danger of mainstreaming:
“Alternative practitioners, if mainstreamed into the current hierarchy of the medical model, would be relegated to a subservient position under Western medical doctors. Rather than working side-by-side in their respective philosophies, they would be forced into a paraprofessional role, leaving Western doctors with the final approval in a power-based model” (Phalen 1998, 176).

This cautionary advice is relevant for appreciating the complexity of the issues around professionalization, and its complicit alliance with imperialism, colonialism and orientalism.
To summarize, the professionalization of Siddha medicine is a rather sensitive issue among government sponsors and practitioners alike. This tenuous alliance is fraught with tactical blunders, miscommunication and power struggles. Professional authority is neither dispensed nor requested without considerable re-structuring, co-creation and compromise. The very “tradition” of Siddha medicine is itself inextricably linked to this process of historical and political agendas, especially along the lines of professional authority vis-à-vis Western biomedicine.

Nevertheless, the policies of the Central Government of India have been designed to assist Siddha medicine in the last 50 years:
“On May 25th, 1956, a letter from the Central Government was sent to all state governments stressing the importance of giving medical students a course in the history of medicine; ‘Encouragement of the study of the history of medicine is specially important in this country, not only in the training of physicians but also in reviving, assessing and reconstructing the indigenous systems of medicine’” (Hausman 1996, 56).

More concretely, the infrastructure to support these priorities includes 14 research units, including a Central Research Institute, Regional Research Institute, Drug Standardization Units, Mobile Clinical Research Units, Clinical Research Units, Tribal Health Care Units, and Medicinal Plant/Other Research Units. The state governments in India support 106 Siddha hospitals and 225 dispensaries which provide 983 beds for patients. There are 2 Government supported Siddha medicine colleges, and a handful of other non-certified institutions which teach Siddha medicine. These generally lead to Siddha MD degrees.

In sum, the process of professionalization has proceeded largely as a result of policies determined out by the Indian government itself:
“Over the course of the past three decades, various steps have been taken by the Tamilnadu State, as well as the Central, Governments to promote Siddha medicine. Siddha colleges have been established and expanded; Siddha conferences have been conducted; Siddha medicinal and pharmacological research has been pursued; and the number of Siddha hospital wings and dispensaries has been continually increased” (Hausman 1996, 346).