Amchi System

Amchi Medical System

 Introduction to Tibetan Medicine

Tibetan medicine is an ancient Buddhist science. There are four basic textbooks revealed by the Shakyamuni Buddha. This medicinal model is based on a three-humours theory (wind, bile and phlegm). The origin of disease is explained by ignorance drawing the person into desire, hatred and obscuration, which brings imbalance into these three humours. The Tibetan medicine physician is called amchi. He makes the diagnosis by interview, pulse taking and urinalysis. The treatment’s aim is to restore the balance by using diet, behaviour, medicinal therapies and accessory therapies like moxibustion, acupuncture and surgery.

 

The Situation in Zanskar

At present, there are around 50 amchis in Zanskar, of whom 20 are active. Most of them are over 50 years old. The amchi job is open for women and there are some young female amchi. Most work on a private level. Eight amchis are recognized by the government[1] of whom four are on duty under the NRHM. The other four get a small amount of money from the government but have to work on a private level.

Most amchis work in their private houses. The amchis take time for a patient 24/24h 7/7 days except the one employed by the government, who have an official 10 am – 4 pm schedule.

The amchis see 0-10 patients per day in summer and more in winter. They have rudimentary equipment and put their diagnosis by anamnesis and pulse-medicine. The therapy consists of food advice, behavioural counselling, exercises, massages and medicines. They prepare their medicines by themselves by picking local plants and buying the rest of the ingredients (plants and organic material) from Leh and Dharamsala. There is a common stock of medicinal ingredients in the amchi centre in Padum, which is accessible to most of the amchis.

The consultation and the medicines are for free. Some patients make a donation. Traditionally the villagers worked in the fields of their village amchi but this practice gets more and more lost. The government amchi also works with the government 2-Rupees ticket.

The amchis self-perceived efficiency to cure patients is around 60%. If they see that their care failed or if they realize from the beginning on that the patient can’t be cured by amchi care they refer to the MAC, CHC Padum or the lhapa. If they can’t treat the patient because of shortage of medicines they refer to another amchi or to the MAC.

The government amchi program is run by NRHM[2].

 

Amchi Training

Traditionally the amchis transferred their knowledge by internship and study from one generation to the other. This curriculum takes four years. Now there is also the possibility to study during 5 years in Leh or Dharamsala in an amchi school and to get an official degree. In addition to amchi knowledge and Tibetan language classes, these amchis get also English and a basic allopathic training.

 

Relation With Allopathic System

There is a cross-transfer of patients between amchi and allopathic system. Allopathic staff sends patients with osteoarthritis, paralysis, psychological complaint, diffuse body pain, cough and common cold in winter to the amchi.[3] Amchi send pneumonia, COPD, high fever and accident patients to the allopathic staff. An interesting statement of a nurse was that the amchi usually make the diagnosis and that she gives the medicines.

There is a common approval that amchi and allopathic medicine should be taken at separate times. Some amchis have basic allopathic equipment[4]. The CMO in Kargil stated that he had invited the amchi to learn preventive medicine but many had run away after one day.

 

Zanskar Amchi Association (ZAA)

The ZAA’s headquarter is the amchi centre in Ruk Ruk[3]. This centre was the Amchi School before which has been closed due to lack of financial means and non-recognition by JK government. Now the most experienced amchi receives patients in this centre every day from 10 am on. They also store the ingredients for medicines there.

Once per year a meeting and teaching is organized for all the amchis in the valley.

The senior amchis meet three times per year to distribute the common medicines.

They don’t benefit from a government support but get sponsoring from a foreign NGO[4] working with the Ladakhi association Servants of Society Club posted in Leh. Still they lack money, especially to buy ingredients from Dharamsala.

One interviewed amchi stated that he is not a member of the ZAA because of their inactivity.

 

[1] Amchi medicine has officially been recognized by the Indian government in 2009 (14)

[2] NRHM: National Rural Health program: an Indian government program to assure basic health care in remote rural areas. For further information: http://jknrhm.com/index.html

[3] According to page 20 in the book Health Through Balance amchi medicine seems particularly effective for hepatitis, mental disorders, ulcers, paralysis, gallstones, kidney stones and arthritis.

[4] BP machine, stethoscope, injection material, basic dental kit

[5] Village situated 5 km from Padum

[6] Australian Himalayan Foundation: http://www.australianhimalayanfoundation.

org.au/PROJECTS/Children-of-Zanskar/Children-of-Zanskar.asp