Fifteen years ago, Amchi medicine, a practice utilising natural resources such as medicinal herbs, minerals, etc., and directly linked with the Tibetan tradition, was quickly declining in Ladakh. Allopathic medicine had been introduced and was considered by health policy makers as the only rational way of improving the health situation of "backward communities" in remote areas. The presence of indigenous knowledge about health care, comprising comprehensive medical texts in Tibetan language, was not paid attention to, since an evaluation of it would have required intensive research on both theoretical issues and the relevance of this practice in its social-cultural context.
The Amchi tradition belongs to a system of family lineage (namely rGYUTPA) has remained unbroken for about six generations. This way of transmission has become problematic because of social mobility and economical constraints. Amchis do not charge patients for their consultation and treatment. Instead, they rely on villagers who help them with farm work, some food supply, etc. This livelihood is increasingly difficult to sustain in a fast changing rural economy.
What was on the verge of extinction was not only a highly sophisticated medical system but also a community-based curative and preventive practice, emphasising water and spring cleanliness, proper diet and healthy lifestyle. Amchis are not only medical practitioners. They are important actors of village life. Besides preserving the harmony of families, social relations, mental balance of individuals, etc., they are the main consultants for community decision making.Achievements
In 1984, Amchi Tsewang Smanla initiated a programme for revitalising the existing Amchi medical system in Ladakh. This project was granted support by Save the Children Fund (UK), and afterwards continued as a programme of Leh Nutrition Project, a local NGO.
In remote areas in which there was no access to health care, Amchis were helped through providing some raw ingredients not available in Ladakh, training, books and a nominal stipend.
An annual workshop was organised, bringing together 70 to 100 Amchis who would share their knowledge, exchange herbs, communicate processing techniques and work together on the proper identification, cultivation and preservation of medicinal plants. This has contributed to an increasing interest in the medical heritage, and generated awareness among Amchis as well as other health practitioners (allopathic doctors) who were invited to attend. The effect was to reverse negative prejudice and promote co-operative efforts.
The project further made it possible for Amchis to study in different places where various medicinal plants are available, visit medical libraries (for instance the Tibetan Medical Institute in Dharamsala), important herb trading centres in India, and become exposed to present-day herbal and medical practice and research.
This was followed with herbal study and collection tours in mountains, in order to solve controversial issues on identification, and to build a herbarium of Amchi medicinal plants. The problems of plant cultivation and replanting rare species have become an important issue of this group research. Cultivation of some commonly used plants started in several villages.
The tradition was revived with the training of Amchi Health Workers. Students selected by village communities where no medical facilities (even Amchi) exist are trained in the Amchi medical centre of Nurla for the three winter months, and return to their villages for the rest of the year to do farm work while putting their study into practice. At the end of three years, they qualify as "Amchi Health Workers" and join back their community. The ones who show motivation and competence are offered further study to become fully-trained Amchis.
We wish to articulate the project along four main topics of interest.
The place of the Amchi practitioner in his/her community has already been emphasised above. We feel it is of prior importance to involve villagers actively in the process of identifying and solving their health issues, rather than relying on subsidised "high-tech" medicine. Thanks to the Amchi Health Worker Programme, the community has taken a first positive step in selecting candidates for training as Amchis. In the long term, it is expected that the same community will effectively support modern Amchi medicine back in the village, thereby encouraging its practitioners to pass on their knowledge to the younger.