Treat me well : a ethnobotanic study on the importance of medicinal plants for the wellbeing of the Irula tribe in Sembulipuram, Tamil Nadu, India

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Treat me

well

A ethnobotanic study on the importance of medicinal plants for the

wellbeing of the Irula tribe in Sembulipuram, Tamil Nadu, India

Me, archanaa Seker and the Irulas (van Rooijen, 2014)

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Author

Lisa van Rooijen

University of Amsterdam | Faculty of Social and Behavioural Sciences Human Geography | Bachelor Thesis

Date: July 14th 2014 Student number: 10221190

Address: Boslaan 14, 3417 AB, Montfoort Tel.: +31(0)614756685

E-Mail: Lisa.van.rooijen@gmail.com

Supervisor 1: Mr J. Stephen

Faculty of Social and Behavioural Sciences Email: M.S.G.Stephen@uva.nl

Supervisor 2: dhr. drs. L. de Klerk

Faculty of Social and Behavioural Sciences E-mail: l.deklerk@uva.nl

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List of acronyms

ADTWD Adi Dravidar and Tribal Welfare Department

AYUSH Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy CCRIMH Central Council for Research on Indian Medicine and Homoeopathy CHT Classical Health Tradition

CIA Central Intelligence Agency

CRIY Central Research Institute for Yoga

FBP Forest Protection Bill

ISCICC Irulas Snake Catchers Industrial Cooperative Society ISM&H Indian System of Medicine and Homoeopathy ITWWS Irula Tribe Women’s Welfare Society

MDNIY Morarji Desai National Institute of Yoga NCCS Nature Cure Clinic and Sanatorium

NGO Non-Governmental Organisation

NHP National Health Policy

NIH National Institute of Homoeopathy NIN National Institute of Naturopathy NIS National Institute of Siddha

N.I.U.M. National Institute of Unani Medicine

OECD Organisation for Economic Co-operation and Development

OHT Oral Health Tradition

PESA Panchayats Extension to the Scheduled Areas Act

SC Scheduled Caste

ST Scheduled Tribe

TEK Traditional Ecological Knowledge

UNICEF Children’s Rights & Emergency Relief Organisation

WB World Bank

WeD Wellbeing in Development Countries Research Group

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List of illustrations, maps and tables

Maps

Map 1: Map of contemporary India……….8

Map 2: Percentage of Scheduled Tribe population………..12

Map 3: The state Tamil Nadu………15

Map 4: Locality of medicinal plants in the Sembulipuram settlement………31

Figures and pictures

Figure 1: Illustration of subjective-, material- and relational wellbeing………17

Picture 1: Free listing exercise with Irula women………..25

Picture 2: Mapping with children………..26

Picture 3: Me, my translator and the Irulas………27

Picture 4: Adai……….28

Tables

Table 1: Plants and pictures………..24

Table 2: Rarity of usage and collection of plants………...28

Table 3: When allopathic medicine are used………30

Table 4: Changes medicinal plant use / mainstream healthcare………30

Table 5: Usage of a traditional healer………30

Table 6: Seasonal differences………..32

Table 7: Stored………32

Table 8: Availability of the plants in the future………32

Table 9: Importance of rain………32

Table 10: Knowledge learned through………..34

Table 11: Knowledge on different plants……….34

Table 12: Usage between people………..35

Table 13: Loss of knowledge……….36

Table 14: Usage of plants between gender………36

Table 15: Grading of dependence of medicinal plants………..39

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1. Introduction

In 2014, a substantial part of India´s society can be classified as a Scheduled Tribe (ST). These tribes mainly live in remote areas and maintain their own specific cultures and ways-of-life1. Part of this way-of-life are distinct health systems, which are derived from generations of experience and knowledge transfer2. Even though these traditional health systems are of great importance for ST’s, health indicators are much lower for ST’s compared to the rest of India’s society3. The question is why India’s tribal people lack behind in their health indicators.

India’s tribes have a long history of being driven from their ancestral land. These regions are where they gained their experiences and knowledge of medicinal plants for generations. Therefore, the locality of tribes is of great importance to their health.

The Irulas are such a tribe that has been depended on their local, natural environment for their health and wellbeing for generations, but that has also been driven away from their ancestral lands. Being forced out of ancestral lands could result in a loss of knowledge of medicinal plants, because this knowledge is very localized. The fact that access to governmental health services is difficult for tribal people could also be an explanation for as to why health indicators for tribal people are lower compared to the rest of India’s society. Researching the importance that knowledge of medicinal plants has for the wellbeing of the Irulas in this era, is therefore of great relevance.

The central research question in this thesis is:

What is the importance of Traditional Ecological Knowledge on medicinal plants for the material, relational and subjective wellbeing of the Irulas in Sembulipuram, Tamil Nadu, India? The following sub questions will also be explored:

 What kind of interaction takes place concerning medicinal plants?

 What medicinal plants do the Irulas momentarily use, for what purpose are they being used and how are they being used? (to what end and in what way?)

 How important are medicinal plants for the material, relational and subjective wellbeing of the Irulas in Sembulipuram, Tamil Nadu, India? (is dit niet je onderzoeksvraag?)

In the first section of this thesis, the setting of the research will be explained. How India’s healthcare system and tribal programs are implemented, has an existential effect on the Irulas from

Sembulipuram. It can be assumed that the state government of Tamil Nadu, which has its own state programs regarding ST’s, has an influences on wellbeing indicators for the Irulas.

In the following section, a number of theories will be explored that are relevant to this research; the wellbeing theory, Traditional Ecological Knowledge (TEK) and some medical systems. The difference between two traditional healthcare systems (the Classical Health Tradition (CHT) and the Oral Health Tradition (OHT) will also be analysed. Subsequently, the methods used in this thesis will be explained in chapter four, where in chapter five the results of the research that was conducted among/in the Irula settlement of Sembulipuram will be analysed. In the concluding chapter, the different theories and the results of the surveys will be combined to formulate answers to the research question and the sub questions. Lastly, a critical reflection on the research process will be presented, with regard to my position as a researcher in India and also with regard to the main criticisms on the wellbeing theory.

1

See chapter 2.1.2 on Tribal Communities

2

See chapter 3.4.2 on Oral Health Traditions (OHT)

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2. Settings

2.1 India

India (see map 1), a country of 3.3 million square kilometres, and therefore the seventh largest country in the world (CIA´s World Fact Book, n.d.) is situated between Pakistan, China, Nepal, Bhutan, Myanmar and Bangladesh. The country is surrounded by three oceans; on the east the Bay of Bengal, on the west the Arabian sea and on the south the Indian Ocean.

Geographically, India is very diverse, and can be divided into four sub regions. The North is

characterized mainly by the Himalaya mountains and the Karakoram mountains, which constitute the borders of India, Nepal, Buthan and Pakistan. The Indus-Ganges-Brahmaputra lowlands, which are situated south of the Northern mountains, is an area of lowlands which is created by three rivers that have carried sediments from the mountains for millions of years, creating a fertile land and soil that is very useful for farming. Peninsular India, which is south from the Indus-Ganges-Brahmaputra lowlands, is a dry area and does not have very fertile soil. Lastly, there are the Southern Islands, where the climate is cool and moist (Rowntree, et.al., 2003).

India is a federal republic and is divided into seven union territories, which are directly controlled by the federal government. Within these union territories there are 29 states with their own elected governments (Briney, 2014).

The Indian population is momentarily estimated at 1.27 billion and is therefore the second most populated country in the world (and still growing), where it represents almost 17.31 per cent of the world’s population. 72.2 percent lives in one of the 638,000 villages (IndiaOnlinePages, n.d.). Concerns about population growth began in the 1960s, when the Indian government actively implemented family planning measures. These measures, combined with economic and social development, have significantly decreased the population growth rate in India (Rowntree et.al., 2003).

Nearly 41 per cent of the Indian people speak Hindi, which makes it the most used language. Next to Hindi there are 14 other official languages. English is also spoken throughout the whole country, as it is the main language for official communication (Central Intelligence Agencies World Fact Book, n.d.).

According to the Central Intelligence Agencies (CIA) (n.d.), there are four main religions in India, namely Hindu (80.5 percent), Muslim (13.4 percent), Christian (2.3 percent) and Sikh (1.9 percent). Economically, India is a fast growing country, but this can be deemed a relatively modern

development. Following the independence from Britain, India experienced great famine due to devastating policies of the British rulers. To generate its economy, the Indian government chose a non-capitalistic economic model of central planning (Powell, 2012). The next forty years, economic growth was very slow and India was one of the poorest countries of the world (Williamson, 2003). In the 1990s, India reformed its economy and developed models for liberalization (Powell, 2012). The country opened up its markets for foreign companies and became a more capitalist economy. The Map 1: Map of contemporary India (United Nations,

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9 result was vast economic growth. The past century, India’s economy was still growing and has been an active player in the international economy (Williamson, 2003).

Considering the rapid growth of India’s economy, the benefits for the population must be examined. Not all Indian people benefit equally from India’s economic growth. The gap between rural and urban areas has widened, as did the gap between the rich and the poor. More striking is the gap between SC’s and ST’s and the rest of India’s population. SC’s and ST’s remain the poorest of the country, where the ST’s are far worse off because of their geographic isolation4 (Das et.al. 2010). Rapid economic growth is often accompanied by the exploitation of natural resources, where the environment is degraded. This usually results in the displacement of inhabitants (generally tribal people) who are expelled from their environments that they traditionally depend on for their livelihood5. This results in deprivation, as they are forced to move into an economic system that is unfamiliar. This is one of the reasons that India is a country of high inequality between different social groups.

A more specific question to be researched is how is the rapid economic growth is effecting health services of the country. Consequently, it is important to examine what is being done to lift the deprived ST’s out of poverty. The following sections will explain the evolution of India’s healthcare systems, with regard to traditional healthcare systems, and the implementation of tribal rights throughout the years.

2.1.1 India’s healthcare systems

During the period of British colonial rule, the allopathic system6 of healthcare was introduced and encouraged, resulting in the fact that traditional healthcare systems suffered from setback. After independence, the Indian government decided to re-introduce traditional healthcare in its government plans (Ministry of Health & Family Planning, 2010).

The current healthcare system has its roots in the ‘Health Survey and Development Committee”, also known as the Bhore Committee, set up in 1943. The British rulers set up a framework of governance that would hand over the power to an independent Indian government. Part of this framework was the Bhore Committee, which had the task of undertaking a “broad survey of the present position in regard to the health conditions and health organization in British India” (Bajpai and Saraya, 2011, p.216) and that was to make “Recommendations for future developments” (ibid.). The committee published a report in 1946, with a short-term plan, which had to be executed over a period of ten years, and a long-term plan for the next forty years (ibid.).

According to Srinivasana and Chandwania (2014), the Indian healthcare sector since the Bhore Committee can be divided into three periods. In the first period, which ran from 1947 to the mid-1970s, the government focussed mainly on public health services, where the Bhore committee report recommended investing 12 per cent of India’s GNP in healthcare. This investment was supposed to provide accessible services to all of India’s citizens. The second period, from the late 1970s to the late 1980s, came with a realisation that most of the funding was invested in secondary healthcare and tertiary healthcare, instead of in primary healthcare7. This resulted in a growing inequality in access to healthcare services, due to the fact that the poorest of the country could not afford secondary and tertiary healthcare, while their needs where at better quality and accessibility of primary care. Therefore, the Indian government re-emphasized its focus on addressing health problems in rural areas, where the poorest population lives. However, due to the oil crisis in the

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See chapter 2.1.2 on Tribal communities in India for a definition on Scheduled Tribes

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E.g. The Narmada River Valley Project, a hydraulic project built in the state of Madhya Pradesh, where many different tribes were forced to move from their ancestral lands (Dieu Nguyen, 1996).

6

Allopathic health systems are those systems which are not alternative or traditional (see chapter 3.3.1 on ‘Allopathic and Traditional health systems’)

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Primary healthcare is referred to as basic care performed by hospitals, while secondary healthcare is defined as more specialized care, such as dentistry and gynecology. Tertiary healthcare is defined as even more advanced medical care (see chapter 3.3.4 on primary, secondary and tertiary healthcare)

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10 1980s, investments in public health drastically decreased. Simultaneously, the middle and upper classes started to make more and more use of private healthcare services and the gap between the quality of services between the private and the public healthcare sectors widened. As stated in chapter 1.1, the Indian government started to liberalize its economy from the 1990s to present. This resulted in more investments in the private health sector, leading to the Indian government now calling for a need for public-private partnership. The question now remains, what happened with the alternative healthcare systems in India after independence?

Since independence, alternative health systems have been incorporated into the allopathic healthcare system. In 1969 the Indian government launched the Central Council for Research on Indian Medicine and Homeopathy (CCRIMH). This counsel strived to develop scientific research on different alternative medicine systems (Mukherjee and Wahile, 2005)

In 1978, India signed the Alma-Ata declaration, a collaboration between the World Health Organization (WHO) and the Children’s Rights & Emergency Relief Organization (UNICEF). This declaration called on governments to formulate national health policies. These policies should fit their own circumstances and should aim to sustain primary healthcare as an integral part of their national health system (Majra, n.d.).

The year 2000 was set as the deadline to achieve “A level of health that would enable all of the world’s people to lead a socially and economically productive life” (WHO, n.d.). One of the principles of the Alma-Ata declaration was “the effective use of traditional system of medicine” (Goel, 2007, para.: Introduction).

The Indian government formulated its first National Health Policy (NHP) in 1983 (Bhat et.al, 2007). Its goal was “the establishment of a new social order based on equality, freedom, justice and the dignity of the individual. It aims at the elimination of poverty, ignorance and ill-health and directs the State to regard the raising of the level of malnutrition and the poor standard of living of its people and the improvement of public health as among its primary duties, securing the health and strength of workers, men and women, specially ensuring that children are given opportunities and facilities to develop in a healthy manner.” (Ministry of Health and Family Welfare, 1983, p.1). In the policy plan, the awareness and importance of India’s traditional medicinal system was also described (Ministry of Health and Family Welfare, Ibid).

In 1995, the Ministry of Health and Family Welfare launched the Department of Indian System of Medicine and Homoeopathy (ISM&H) (Ministry of Health & Family Welfare, n.d.), which had new goals regarding alternative health systems, such as the improvement of quality of ISM&H and to preserve the cultivation of medicinal plants (Planning Commission, 2005).

In 2002, a new NHP was formulated. Even though India’s NHP of 1983 had contributed to some improvements across the country, the government realised that the policy did not achieve all of its major goals. Especially the goal to generate health for all Indian people by the year 2000 was not met, due to a lack of financial resources.

In the national health policy of 2002, the government also paid special attention to traditional medicine, where it recognised its growing popularity and its importance in underserved, remote and tribal areas. Also, the government wanted to expand its potential to be one of the eight global centres for diversity in medicinal and aromatic plants. The policy planned to invest in, for example, research on the effectiveness of traditional medicine and certification of products and services. The government also determined to protect traditional knowledge against foreign exploitation.

Therefore, in 2003, the Indian government renamed the Department of ISM&H as the Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) and broadened its focus to the development of Education &Research in Ayurveda, Yoga & Naturopathy, Unani, Siddha, Homoeopathy and Sowa Rigpa systems (Department of Ayush, Ministry of Health & Family Welfare, Ibid.).

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11 The major problem in the country was the inequality in access to healthcare between the urban and the rural areas, between different states and between different sections of society (rich – poor, men – women, etc.) (Ministry of Health and Family Welfare, 2002). To address these inequalities, the Indian government launched the National Rural Health Mission in 2005 (Bhat et. al., 2007). The main mission is “to improve the availability of and access to quality health care by people, especially for those residing in rural areas, the poor, women and children” (Ministry of Health and Family Welfare, 2005, p.2). Examples of the goals of the mission are universal access to public health services, promotion of healthy life styles, but also the revitalization of local health traditions” (Ministry of Health and Family Welfare, ibid.).

Every five years the Indian government creates a Five Year Plan for the development of the country. In the latest plan, the Twelfth Five Year Plan (2012 – 2017), a special chapter is devoted to the future of the Indian systems of medicine and homoeopathy. In the plan it is stated that scientific validation of traditional, alternative systems has not progressed enough. Also, a National List of Essential Medicines is distributed to all healthcare facilities where alternative medicine is included (Planning Commission, 2012).

Even though India is still struggling to improve its healthcare (e.g. not all of the objectives of the short term plan described by the Bhore Committee in 1943 are met (Bajpai and Saraya, 2011)), a lot of progress has been made. Since independence, the Indian government has realised the importance of traditional and alternative healthcare. Especially since traditional healthcare systems are still greatly used by the poor and the ST’s. Mainly the ST’s are wary of the allopathic healthcare system, due to mistrust8 and because allopathic facilities are still difficult to reach for tribes living in remote areas. Therefore, the improvement of traditional healthcare could meet the needs of India’s tribal people.

Today, India’s Tribes are seen as a great source of knowledge on medicinal plants and alternative medicinal systems, and therefore it is of importance that their rights are to be protected. The next section will explore the rights and health issues of tribal communities in India.

2.1.2 Tribal communities

Tribal people in India are called adivasi, which can be generally translated into ‘original habitants’ (ibid.). Tribes have occupied the forests for centuries, obtaining a lifestyle with high dependence on the forest and its resources, but also ensuring the protection of these forests, by applying

management systems that prevent exploitation (Dieu Nguyen, 1996). This means that Indian tribes have always lived in a balanced way of usage and protection in the forests.

According to The Indian Census of 2001, the total population of ST´s in the country is 84,3 million, which is 8.2 percent of the total Indian population. The majority of these ST’s live in rural areas, where their population hold 10.4 percent of the total rural population of the country (Census of India, 2011).

According to the Indian Ministry of Tribal Affairs (n.d.), ST’s are characterised as:  Communities that have primitive traits;

 geographically isolated;  distinct in culture;

 shyness of contact with people outside of their community;  economically backwards

Even though many times presumed differently, ST’s do not fall within the caste system (i.e. a system of social hierarchy (Rowntree et al., 2012)). Because tribes have a distinct culture, religion and social way of living from the rest of India’s society, they cannot be classified as a certain caste. Even though

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12 ST’s and SC’s are both at the margins of the Indian society, what also distinguishes them, according to Das et al. (2010), is the fact that SC’s are socially segregated from other castes, while ST’s are generally physically isolated (i.e. situated in remote regions where access to services is limited), which can result in social isolation.

2.1.3 Geography of tribes

The Indian Government identifies 533 different tribes who are scattered all over the country (Das et al., 2010). However, the geographical spread of ST’s is unequally divided over India, where more than 80 percent of the total ST population lives in only ten different states (Census of India, 2011).

On map 2 the distribution of ST’s is illustrated by the percentage of ST’s of the total population. As shown on the map, many tribes are situated in the centre of India, an area that stretches from West Bengal to South Rajasthan. In this ‘Tribal Belt’ almost 80 per cent of India’s ST’s communities live (Neelam, n.d.). ST’s are still, together with TC’s, the poorest communities of the country. The percentage of ST’s living below the poverty line9 in 1993 – 1994 was almost 52 percent, while in 2004 – 2005, this percentage decreased to almost 47 percent (Ministry of Tribal Affairs, 2010).

2.1.4 Tribal rights

During the early nineteenth century, the British colonial rulers implemented new ways to govern forests, based on the high productivity of timber. Tribal people, who were living in these forests, were directly affected by these regulations in the form of loss of land (Bose, Arts and van Dijk, 2011).

The colonial rulers enforced legislations on Indian forests to generate its high commercial value, legislation that robbed tribes from their land. One example is the ‘Rules for the Treatment and Management of Hillmen´. This is a legislation which came into force in 1894 and which declared all forests as state property, falling under the authority of the Forestry Department, resulting in the denial of all rights of tribes to their ancestral land. This meant that forests that had been occupied by tribes for ages, were now made public to private contractors, who exploited the forests for natural resources such as timber (Dieu, Nguyen, 1996). Therefore, tribes were forced to move away from their ancestral lands, that they had inhabited for generations, to new and unknown lands, becoming migrant workers on plantations and such (ibid.).

During colonial rule, ST’s and SC’s did get some recognition, where in the 1860’s marginalized castes and tribes were clustered together as ‘Depressed Classes’ (ibid.). This was the first time castes and tribes were recognized as a social group. However, ST’s and SC’s where not yet seen as two separate groups of society.

It was only in the 1950’s, after independence, that ST’s where truly recognised as a separate group of Indian society. During this year, the Constitution of India formulated the definition of ST’s and developed the Scheduled Tribes Order (ibid.), a list of 744 tribes, spread over 22 different states (Government of India, 1950). Even though ST’s were recognized as a deprived group of society, government legislation did not prevent dispositioning of land. For example, the Forest Act of 1952,

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“A poverty threshold based on the minimum cost of a nutritional diet for differently sized households” (Chimhowu, 2009)

Map 2: Percentage of Scheduled Tribe Population (Ministry of Tribal Affairs, 2010)

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13 which did give some rights to tribal people, did not prevent the loss of forest ownership to

commercial contractors (Dieu Nguyen, 1996).

In 1976, the Forest Protection Bill came into force, which made a lifestyle of hunting and gathering illegal, resulting in the forced settling down of many tribal communities (Terjesen, 2007). Again, tribes had to move from their ancestral land to land unknown to them.

In 1980, the Forest Conservation Act was established, which gave juristic powers to forest officials who collected fines from tribal people who were collecting forest products. These officials could even jail tribal people without a process (Dieu Nguyen, 1996). Due to these legislations, tribes moved further and further away from their ancestral lands and traditional lifestyle.

It took a good twenty years for the Indian government to truly acknowledge the rights of a traditional lifestyle and to start making an effort to protect ST’s and their needs.

In 1996, the Indian government implemented the Panchayats Extension to the Scheduled Areas Act (PESA). Nine states, where the population existed mainly out of tribes, were recognised as having traditional community rights over natural resources (Das et.al, 2010).

In 1999, a separate Ministry of Tribal Affairs was installed. Its objective was to provide a “more focused approach on the integrated socio-economic development of the Scheduled Tribes” (Ministry of Tribal Affairs n.d.). The Ministry is mainly concerned with the provision of financial assistance to the separate state governments. Therefore, the different states of India are now responsible for implementing programs regarding tribal communities in their territories (ibid.). The Ministry also develops governments schemes favouring tribal groups in the country, such as the scheme on strengthening education among ST girls (Ministry of Tribal Affairs, n.d.).

In 2003, the National Commission for Scheduled Tribes was established, to safeguard the interest of ST’s who were “suffering from extreme social, educational and economic backwardness arising out of age-old practice of untouchability and certain others on account of this primitive agricultural

practices, lack of infrastructure facilities and geographical isolation” (National Commission for Scheduled Tribes, n.d.). The Commission’s main duty is to collect knowledge on issues regarding ST’s and to advise planning processes for development (National Commission for Scheduled Tribes, 2004). In 2006 the Ministry of Tribal Affairs initiated the Scheduled Tribes and Other Traditional Forest Dwellers Act, also known as the Forest Rights Act (Bose, Arts and van Dijk, 2011). The Forest Rights Act is “an Act to recognise and vest the forest rights and occupation in forest land in forest dwelling Scheduled Tribes and other traditional forest dwellers who have been residing in such forests for generations but whose rights could not be recorded” (Ministry of Law and Justice, p1). The Act recognises the rights over traditionally used land, by distributing forest land to tribespeople. This includes land that was already under cultivation by 13 December, 2005, and not new granted land. People who have rights to these land must be a member of a ST or must have been occupying the forest for at least 75 years. Communities also get legal rights to gather minor forest products 10 and grazing rights for pastoral and nomadic communities. The Act is aimed at protecting community forests and permits communities to claim property rights over traditional land (Sarker, 2011). Even though there is a lot of criticism on the Forest Rights Act, the government is finally acknowledging that tribal people have rights to use of land and that they are dependent on their natural

environment. In this way, the local, traditional knowledge of tribal people is protected.

2.1.5 Tribal health

According to Das et.al (2010), the gap between ST’s and non-ST’s regarding health indicators (such as child mortality, malnutrition and maternal care) is still very large. ST’s living in rural areas are worse off than ST’s living in urban areas, being a result of the fact that in rural areas, access to services is still insufficient. Also, according to the authors, there is still a cultural mistrust among tribal people towards non-tribal health care. One example of the fact that the usage of mainstream healthcare is

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14 lower among ST’s is that only almost 18 percent of births among tribal women are delivered in hospitals, while this is 51 percent for non-tribal women. In general, these women state that the distance to a health facility is the reason why they do not attend, but the fear that there will not be a female doctor available was also mentioned (Ministry of Tribal Affairs, 2010).

The insufficient access to services, and the mistrusting of mainstream healthcare, makes tribal communities still very dependent on their local, natural environment for health. Simultaneously (as stated in chapter 2.1.4 on Tribal Rights), during colonial rule, and also after independence, many tribal communities lost their land. Therefore, many tribespeople still don’t make so much use of mainstream healthcare in return, which results in the fact that their health problems are increased compared to non-tribal people. The Irulas, a tribe situated in the South of India, is one of these tribes that still make use of their traditional healthcare system.

2.2 Irulas

The Irula are tribespeople who are scattered all over Tamil Nadu and are famous for their snake hunting activities and their knowledge on medicinal plants.

It is estimated that around three million Irulas live in India, where 150,000 live in Tamil Nadu (Terjesen, 2007). In the past, the Irulas lived in forests and earned their livelihood by trading forest products for village products. After the Forest Protection Bill (FPB) in 1976, their lifestyle was made illegal and they were forced to settle down (ibid.). Already in the 1950s, the Irulas were recognised as a ST in the Scheduled Tribes Order (government of India, 1950), and their status has remained the same until now.

Before the FPB, the Irulas lived in forests and earned their livelihood by trading forest products for village products. One of these forest products were snake skins, but this was deemed illegal by the FPB (ITWWS, n.d.). Because the agricultural land, mainly rice fields, are inhabited by poisonous snakes, the Irulas used their knowledge on snake-catching to remove the snakes from the fields for monetary payment. The main problem was, that snakes were also protected because of the FPB, and therefore, killing them was forbidden Terjesen, 2007).

Two events made it possible for the Irulas to make use of their knowledge on snake-catching. The first was the recognition that snake venom was an important ingredient for the antivenom for snakebites. The second event was the realisation of the scale of snake related deaths in India, which resulted in people starting to kill every snake they saw (Jacobsen, 2014). These two events resulted in the Madras Snake Park, established in 1981. This project was established together with the Irula Snake-Catchers Industrial Cooperative (ISCICC), to inform people about the fact that most snakes are not dangerous, and therefore not all the snakes needed to be killed. Also, snake venom was

extracted from snakes and sold to make antivenom. This way, the Irulas could once again go back to the business of snake-catching, since they were the ones who caught the snakes to extract the venom (ITWWS, n.d.). Only this time, they milked the venom from the snakes and subsequently released them back into their environment. The snake venom is so popular throughout India, that now, the ISCICC supplies institutes all over India with snake venom (DW-tv, 2010).

Next to snake-catching, the Irulas are also known for their knowledge of medicinal plants (ITWWS, n.d.). Five years after the foundation of the ISCICC, the Irula Tribe Women’s Welfare Society was installed (ITWWS), mainly to preserve knowledge on medicinal plants and to market these products (ibid.). The ITWWS now have a tree nursery, where the Irulas grow (medicinal) plants and sell them. They also prepare medicine from plants and sell the processed plants, and organize workshop for other Irulas regarding skills, awareness and networking (ibid.).

It is clear that the Irulas somehow found a way to cope with modernisation that is happening all around them by using their skills and putting them on the market. But not all the Irula communities make their livelihood from snake-catching and the selling of medicines. Many Irula communities are

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15 still deprived and generate income as contract labourers doing physical work for landowners

(Terjesen, 2007).

2.3 Tamil Nadu

2.3.1 The state Tamil Nadu

Tamil Nadu (see map 3), the most southern state of India, occupies more than 130,000 square kilometres of Indian land (IBEF, 2014). The population of Tamil Nadu is around 74 million11 and is therefore India’s seventh most populated state (India Online Pages, n.d.). Its capital is Chennai (formerly known as Madras), where its estimated population is 6.5 million. Also, 44 percent of the population lives in cities (India Online Pages, n.d.) where the rest lives in rural areas. 88 percent of the population of Tamil Nadu is Hindu, where the other two main religions are Christianity and Islam (ibid.).

Tamil Nadu is a very forest rich area, where very dense forests, moderately dense forest and open forests occupy one sixth of the total landmass of the state (Tamil Nadu Forest Department, n.d). Only 2.54 percent of Tamil Nadu’s forests are classified as protected areas. The Tamil Nadu Forest

Department is committed to increase this percentage by ten percent, an objective made by the National Wildlife Action Plan 2002-16 from the government of India (ibid.).

Map 3: The state Tamil Nadu – The state Tamil Nadu with the two big cities Puducherry and Chennai, and the research area Sembulipuram in the middle

Many tribal communities live in and around these forests. As explained in chapter 2.1.4 on Tribal Rights, states themselves are responsible for the implementation of government schemes regarding tribal communities. In the next section, state programs regarding tribal communities of Tamil Nadu are discussed.

2.3.2 The Tamil Nadu government and tribal communities

Momentarily, 36 different tribes live in the state of Tamil Nadu (Ministry of Tribal Affairs, n.d.), consisting of a total population of 650.000 tribal people. The largest tribal groups are the Kotas, the Todas, The Irulas, the Kurumbas and the Badagas (Cencus of India, 2011). In 1988, the Adi Dravidar and Tribal Welfare Department (ADTWD) was established with the objective to “formulate polices,

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16 laws, regulations and programmes for the economic, educational and social development of the […] ST’s in the State. The aim is to empower the target groups through their educational, economic and social development” (Government of Tamil Nadu, 2009, p5).

The literacy rate among tribal people in Tamil Nadu is almost 28 percent (Tamil Nadu Forest Department, n.d), and therefore, the ADTWD is implementing many schemes regarding education (e.g. schools for tribal people, Scholarships and the supply of material such as books and uniforms) (Government of Tamil Nadu, 2009). Next to the focus on education, the ADTWD also implements economic development programmes, where they, for example, financially assist tribes to acquire land for farming, entrepreneurship and self-employment (ibid.). They also focus on basic needs of tribes, providing for example free housing, the provision of drinking water and the development of roads that link the tribes to the main roads (ibid.). It is striking though, that the ADTWD does not have any schemes regarding healthcare of tribal people in its state.

Apart from the Tamil Nadu government, there is also a wide range of Non-Governmental Organisations (NGO) that try to improve the living conditions of tribal people in the state. These NGO’s are concerned with for example education, health and women’s rights (CitiTribe, n.d.). The Irulas from Sembulipuram are a tribe who made use of various government schemes and NGO’s. 2.3.4 Irulas from Sembulipuram

Three generations ago, the Irulas from Sembulipuram lived in the Indian forests as hunter and gatherers, where they caught snakes and other animals. About fifty years ago, they settled down. At first, the Irulas squatted the land illegally, where they had no ownership rights over the land they occupied. Around 2006, the government officially handed over the land to the Irulas, which gave them ownership rights over the occupied area. To facilitate the transition from hunter-gatherers to settling down, the state government built houses and a water pomp in the settlement, while later electricity was added.

Most Irula men are contract labourers, where they generally cut trees on plantations. Some women perform this occupation as well, but most of them do house work in houses or stay at home to take care of the children and house tasks. The Irulas who work, generally earn around a 100 rupees a day, but because they do not have regular jobs, their monthly income is much lower.

Close to the settlement there is a government primary school, where all the Irula children attend to. Most children only finish primary or middle school, where they drop out of high school. The main reason for this drop-out is marriage, where the Irulas marriage at a young age (interview with Panchayat leader, 2014) .

The Irulas from Sembulipuram are not members of the ISCICC and the ITWWS. The ITWWS was involved with the building of the houses and the water pomp, but this Irula community is not involved in the marketing of their products (snake venom or medicinal plants). Therefore, the Irulas from Sembulipuram do not earn their income by using their TEK (Rajendran, 2014).

3. Theoretical framework

3.1 Well being

Theories on wellbeing are concerned with what the outcomes should be of development practises. In general, development outcomes are still measured in economic terms. The World Bank (WB) states that, even though increase in financial capital is important, there are more aspects of life that make people happy. Therefore, the wellbeing theory looks at more spectrums of life besides financial resources (Network of Well-being, n.d.).

In development practises it is now recognised that feelings of happiness about one’s life go beyond basic needs such as food and shelter. For example, on a community level, the quality of the natural

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17 environment or social cohesion can be very important factors in the feeling of having a good life. At the individual level, the feeling of being appreciated by others can also be considered of importance to someone’s happiness (OECD, 2013).

Wellbeing is very difficult to conceptualise because feelings of happiness can have different meanings to different people. Therefore wellbeing as a theory, is defined differently by different research institutes. For example, the concept of ‘responsible wellbeing’ by Robert Chamber, focusses on the power dimension of wellbeing, where the author states that the wealthier people become, the more responsibility they tend to feel towards creating a better life for the ones less wealthy (White, 2009). Where Robert Chamber emphasises the importance of the feeling of responsibility for others, the ‘new economics foundation’ (nef) focusses more on how people feel and how they function. For nef, wellbeing is about having positive feelings about one’s life and how they are functioning in the world (ibid.).

In the light of this thesis, where the importance of medicinal plants for the wellbeing of Irulas in Sembulipuram is being researched, the framework of Wellbeing from the Wellbeing in Development Countries Research Group (WeD) was used. The WeD formulates three dimensions of wellbeing (see figure 1): the material, relational and the subjective dimension, which are all interdependent. The material dimension is mainly concerned with what people have, meaning the observable, material outcomes of wellbeing. The relational dimension is concerned with interactions between people and how this influences their wellbeing. Subjective wellbeing is concerned with people’s own perceptions of their life (White, 2009). Therefore, subjective wellbeing can be seen as an overarchingdimension and placed on the top of the triangle, where someone’s perception of their material and relational wellbeing influences their feelings of happiness regarding the life they are leading (Brittona and Coulthard,2012).

So how does the natural environment contribute to someone’s wellbeing? According to the Organisation for Economic Co-operation

and Development (OECD)12 (2011), “environmental quality is a key dimension of people’s wellbeing” (ibid., p212), where they state that the quality of a person’s life is highly affected by a healthy physical environment. In around 80 per cent of major diseases environmental factors play a large role, and globally around one-fourth of diseases and overall deaths are (at least partially) caused by low environmental quality (ibid.).

The natural environment is also intrinsically of great importance. People value the beauty of their local environment and can worry about its degradation. Also, especially in developing countries, a large group of people

directly benefit from their local, natural environment, through the provision of basic needs such as water, shelter, food and medicine (ibid.).

Chapter four, discussing the results of the research, and chapter five, where the conclusion is presented, will discuss how the use and dependence on the local, natural environment (in this case the use of medicinal plants), can affect someone’s wellbeing.

Dependence on the local, natural environment for wellbeing goes hand in hand with knowledge of this environment. Since tribes have occupied forests areas for generations, their knowledge is a key

12

OECD is an organisation that promotes “policies that will improve the economic and social well-being of people around the world” (OECD, n.d.)

Fig. 1: Illustration of subjective-, material- and relational wellbeing (White, 2009)

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18 issue in the usage and dependence of their land. The next section will discuss this Traditional

Ecological Knowledge (TEK).

3.2 Traditional Ecological Knowledge (TEK)

According to the Oxford Dictionary (n.d.), ´tradition´ is “a long-established custom or belief that has been passed on from one generation to another”. This assumes that traditions are static, and not open for change. Berkers (1999) states that changes (such as new techniques and ideas) can be incorporated into traditions, as long as they fit into the already existing traditional practices. For example, the Irulas, who were by tradition snake hunters, where forced to change this tradition, but found a way to incorporate this change into their traditional lifestyle by milking and selling snake venom, and setting the snakes free afterwards.

Ecological knowledge can be defined as “the knowledge, however acquired, of relationships of living beings with one another and with their environment” (ibid. p6). When putting ‘tradition’ and

‘ecological knowledge’ together, ‘traditional ecological knowledge’ is defined as: “a cumulative body of knowledge, practice, and beliefs, evolving by adaptive processes and handed down through generations by cultural transmission, about the relationship of living beings […] with one another and with their environment” (ibid. p8).

So what exactly does TEK consist of? Berkes (1999) states that TEK is integrated into local culture, and that environmental management ideas are adapted to fit the local environment. The people who make use of the resources are generally also the managers of these resources. Traditional systems have a great moral and ethical context and nature and culture are not seen as separated. Houde (2007) has broken down the different elements of TEK, which he calls the ‘faces of traditional ecological knowledge’. The first face is made up of factual observations, which is the knowledge about for example the local natural environment, the interrelationships among species, spatial distributions etc. This knowledge is gained over a long period of time and through social life. This knowledge is mainly linked to survival. The second face of TEK, is characterized by management systems, which ensure a sustainable way of using the local natural resources and recognizes that TEK is a complex system of knowledge of the local area in the interrelationships of species. The third face of TEK is concerned with the factual knowledge seen in a historical context. This face deals with how knowledge has been transferred in the past, which is mainly orally, but can also be about, for example, the location of medicinal plants or cultural sites. The fourth face is concerned with ethics and values, and refers to the respectful usage of natural resources and the prevention of over-exploitation. This face is mainly expressed in attitudes of respect towards nonhuman species. The fifth face of TEK is seen as a means for cultural identity, and is expressed through stories and art about values, survival and social relationships and forms the cultural dimension of TEK. The sixth and last face is the cosmology and is the foundation of the other five faces. This face is the worldview that explains how all elements of life are connected and the role of humans in the world.

Even though TEK has been passed and reformulated through generations, many studies have shown changes and a loss of knowledge. Gómez-Baggethun and Reyes-García (2013) give the example of losses in medicinal knowledge, when traditional communities started to become more integrated into market economies and the national society. On the other hand, when traditional societies are incorporated into market systems, knowledge is not necessarily lost, but can also be encouraged, for example by means of the sale of traditional products (Gomez-Baggethun, 2010).

3.3 Medical systems

In this section some medicinal concepts that have a central role in this thesis, will be explained. 3.3.1 Allopathic and traditional health systems

Allopathic medicine is defined as “the system of medical practice which treats disease by the use of remedies which produce effects different from those produced by the disease under treatment” (John

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19 Hopkins University, n.d.). The term was first used by the founder of German homoeopathy,

Hahnemann in 1942 and can be seen as the opposite of homoeopathy13 (ibid.). Today, the term allopathic medicine is used to refer to all medicinal systems that are not alternative or traditional. In India, an ‘allopathic doctor’ is a doctor who received his education in British medical colleges. These doctors are also often referred to as ‘Western doctors’ or ‘scientific doctors’ (Jeffery, 1977). The main feature of allopathic medicine is that the treatment is mainly focussed on symptoms, hereby

identifying diseases based on the symptoms of patients and consequently prescribing these patients with medicines (Unnikrishan, 2004). Traditional medicinal systems tend to regard and treat diseases according to a different view.

Traditional medicinal systems are seen as all medicinal systems other than allopathic systems (Unnikrishnan, 2004). This way of healing is more etiological, where one looks at the possible causes of diseases and then applying a treatment to modify those underlying causes. In etiological healing, the cause of an illness does not necessarily have to be of a physical nature, but can also be of a mental or even spiritual nature (e.g. in the form of a curse) (Unnikrishan, 2004).

Considering traditional medicine in India, two social streams can be distinguished; the Classical Health Traditions (CHT) and the Oral Health Traditions (OHT) (see chapter 3.4 on Traditional healthcare systems). The first is a highly organized system with a refined theoretical and

philosophical foundation. Examples are Ayurveda and Siddha (see chapter 3.4.1 on CHT). The latter is not organized, but is derived from experiences and is mainly practised in rural and tribal areas in India. This tradition is mainly based on knowledge of medicinal plants (See chapter 3.4.2 on OHT) (Rajasekharan, n.d.).

3.3.2 Primary, secondary and tertiary healthcare

Healthcare can be classified into three different forms; the primary, secondary and tertiary healthcare. Primary healthcare is concerned with basic care, provided by physicians and hospitals. Secondary healthcare refers to more specialized care, such as dentistry, gynaecology and surgery. Tertiary healthcare provides advanced medicinal treatment. High skilled experts and substantial investments in equipment and infrastructure is needed (Srinivasan and Chandwani, 2014).

3.3.3 Food and medicine

According to the Oxford Dictionary (n.d.), food is “any nutritious substance that people or animals eat or drink […] in order to maintain life and growth” and a medicine is “a science or practice of the diagnosis, treatment, and prevention of disease […]”. The general difference between the two is that food is consumed to improve one’s overall health, while medicine is generally consumed to address specific health issues. But, as shown in chapter 3.4 on Traditional healthcare systems, the division between food and medicines is not always so clear.

3.4 Traditional healthcare systems

3.4.1 Classical Health Traditions (CHT)

The Department of AYUSH distinguishes seven different CHT’s and focusses on the following systems: Ayurveda, Yoga, Naturopathy, Unani, Siddha, Homeopathy and Sowa-Rigpa (Ministry of Health & Family Planning, Department of AYUSH, n.d.). These systems, including governmental plans for the promotion of these systems, will be discussed in the following sections.

Ayurveda

Ayurveda literally translates as the science of life (Ayur = life, veda = science or knowledge) and is based on the teachings of Hinduism (Chopra, 2013). This form of healthcare in India dates back to

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20 5000 years b.c. and was developed through experiments and experiences of the day to day life of the Indian people. Knowledge of Ayurveda was traditionally transferred orally and later written down. The principal objectives of Ayurveda are the “maintenance and promotion of health, prevention of disease and cure of sickness” (Ministry of Health & Family Welfare, 2010).

Ayurveda looks at health from the perspective of a unity of body and spirit. Devotees of Ayurveda believe that in the universe, everything is composed of matter, and that this matter consists of five basic elements (the Panchamahabhutas); space (Aakash), earth (Prithivi), air (Vayu), water (Jala) and fire (Agni). The last four elements all exist within the first element (space). Consequently, the human body is linked to the universe and is also built from these elements (Mukherjee et. al., 2012). The different functions of the body all need different degrees of balance between these elements. The intake of food (which is also constructed of the Panchamahabhutas) nourishes the elements that make up the functions of the body (Ministry of Health & Family Welfare, 2010).

According to the teachings of Ayurveda, sickness is a result of an imbalance between the different parts and functions of the human body. This balance can be disturbed by internal influences (i.e. unhealthy living, food, bad habits etc.), but an imbalance can also be triggered by external influences, such as seasonal differences. The Ayurvedic treatment of illnesses focusses on restoring the balance of the body, by analysing a person as a whole, meaning in body and spirit, through medicine, adjustments of diet, life-routines and behaviour (Ministry of Health & Family Welfare, 2010). The Indian government seems very dedicated to the promotion of Ayurveda, in India as well as abroad. For example, the government funds The institute for Post Graduate Teaching & Research in Ayurveda, which is the oldest research centre for Ayurveda and forms the backbone for Ayurvedic education and research (Ministry of Health & Family Welfare, 2010). In 1976, the Indian government established the National Institute of Ayurveda to develop a “high standard of teaching, training and research in all aspects of Ayurvedic System of Medicine with a scientific approach” (ibid.). The Department of AYUSH also has its own organization (The Rashtriya Ayurveda Vidyapeeth (RAV)), which focusses solely on educating graduates and post graduates in the Ayurveda health system (ibid.). The Indian government is also very committed to the development of The All India Institute of Ayurveda (AIIA), a hospital and research centre that aims to establish a synergy between the

traditional use of Ayurveda and modern technology (Ministry of Health & Family Welfare, n.d.). Yoga

According to the Department of AYUSH, yoga is “A discipline to improve or develop one’s inherent power in a balanced manner”. It is seen as a way of uniting a person’s spirit with the universe (Ministry of Health & Family Welfare, 2010).

According to the teachings of yoga, human beings do not experience life from its own centre, but are focussed on the outside world. In this notion the human being experiences the world outside

oneself, but is alienated from its own mind, body and spirit. Yoga tries to reconnect the person with his or her internal world through physical and mental exercises. Yoga is a holistic approach and its teachings are based on the idea that a person needs to become conscious of the wholeness of the human being. To reach this wholeness, control over body and mind is needed (Dijkstra, 1978). In 1976 the Central Research Institute for Yoga (CRIY) was established with the aim to generate free yoga training for the general public and scientific research on yoga. In 1998, the CRIY merged together with the newly established Morarji Desai National Institute of Yoga (MDNIY), in order to increase the quality of services regarding yoga. Also, the Department of AYUSH fully funds the MDNIY (Ministry of Health & Family Planning, 2010).

Naturopathy

Naturopathy is a healthcare discipline that considers a wide range of natural treatments (Lee and Kemper, 2000). It is based on the self-healing ability of the body and when treating an illness, the whole body is addressed (Ministry of health & Family Welfare, 2010). Illness is seen as the result of

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21 poor nutrition and therefore medicine generally consists of food (Nightingale, 1970). Naturopathy also takes into account, besides the physical, the mental, social and spiritual aspects of the patient’s life (Ministry of Health & Family Welfare, 2010). Therapies are mainly used to stimulate the self-healing abilities of the body, some examples being lifestyle modification, acupuncture14, homeopathy and detoxification (Lee and Kemper, 2000). In India there are around 1900 government registered naturopaths and around 550 naturopathic hospitals and clinics (Ministry of Health & Family Welfare, 2010).

Naturopathy is represented as an autonomous body under the Department of AYUSH, known as the National Institute of Naturopathy (NIN). Formerly the NIN was known as the Nature Cure Clinic and Sanatorium (NCCS), where Mahatma Gandhi spent a lot of time researching and experimenting. The NCCS was handed over to the Indian Government in 1975 and was renamed the NIN. The NIN conducts various activities, such as the publication of its own magazine, the organisation of several workshops and lectures, and consists of a clinic that is run by consultants that advise patients free of charge and offers low priced treatment, a health shop and a naturopathic diet centre (Ministry of Health & Family Welfare, 2010)

Unani

Unanic healthcare was introduced by Arabic people in India around the eleventh century, and India is now one of the leading countries in the practice of Unanic medicine. One important aspect of Unani is the prevention of diseases. Prevention is done by keeping food, water and air free from pollution. Clean air is considered most important for good health, food needs to be fresh and water clean. Unani is also concerned with psychological factors, such as depression and happiness. Illnesses tend to be treated with food and specific Unani medicine (Ministry of Health & Family Welfare, 2010). The Government of India has a joint venture with the state government of Karnatak, known as The National Institute of Unani Medicine (N.I.U.M). The N.I.U.M is situated on a land of more than 55 acres and has a hospital, an academic block, a hostel and a library. Also, on the land there is a three acre area for the development of a medicinal garden (Ministry of Health & Family Welfare, 2010) Siddha

The Siddha health system is one of the oldest health systems of India and is mainly practised in the Tamil speaking part of India (Ministry of Health & Family Welfare, 2010). Siddha has many similarities with Ayurveda, such as the belief that everything (including the human body) is constructed of the five basic elements of the universe. It also recognises the importance of food (ibid.). What

distinguishes Siddha from Ayurveda is that Siddha originates from Chinese alchemy, which was concerned with reaching immortality through elixirs, diets, meditation, sexual techniques and gymnastics. Practitioners of Siddha (called Siddhas, which can be translated into ‘holy immortals’) were believed to have superhuman powers and were preoccupied with surmounting mortality (Subbarayappa, 1997). Another important feature of Siddha is the belief and practice of occult sciences in health treatment (Pillai, 2003). Astronomy, tantrism and incantation are important aspects of the healing of the body (Subbarayappa, 1997).

The National Institute of Siddha (NIS) is established as a joint venture by the Indian government with the government of Tamil Nadu. The institute organises courses for postgraduate Siddha students, provides medical care and conducts research. It is seen as the leading institute in Siddha medicine, but also in promoting research activities (Ministry of Health & Family Welfare, 2010).

Homeopathy

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In acupuncture it is believed that there are energy flows through the body, which can be disrupted. This can result in physical or mental illness. These disrupted energy flows can be restored by stinging needles in specific energy points in the body (NIH Consensus conference, 1998).

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22 According to the Department of AYUSH, about 10 per cent of the population of India solely depend on homoeopathy for health care. It is also considered as the second most popular health care system in India. According to the teachings of homeopathy, disease is a disharmony in the body or the mind. It is an etiological way of healthcare and tries to heal the body using strongly diluted forms of

natural substances. When a healthy person would take a homeopathic remedy in undiluted form, the symptoms of that cure would occur. So, homeopaths give remedies that will provoke the symptoms for a healthy person, but that are believed to cure the symptoms for a person who is ill. Homeopathy also looks at the person as a whole, therefore, eating habits, emotional moods, etc. are also

examined (Visser, n.d.).

The Ministry of Health & Family Welfare established the National Institute of Homeopathy (NIH) in 1975. Since 1987, the institute offers Degree and Postgraduate courses. Apart from the focus on education, the institute also has health facilities that offer treatment at a subsidised rate and in some cases completely free of charge (Ministry of Health & Family Welfare, 2010).

Sowa-Rigpa

Where Ayurveda is based on Hinduism, Sowa-Rigpa is based on teachings of Buddhism, where it is believed that the most important text, the Rgyud-bzi, has been written by Buddha himself (Ministry of Health & Family Welfare, 2009). Ayurvedic health care has been introduced in Tibet during the 3rd century and has been exported (along with other Indian art and sciences) to Tibet until the 19th century. During this period, a lot of Indian literature regarding religion, sciences, art, culture and language has been translated and preserved in Tibet, where it is enriched with Tibetan knowledge. Sowa-Rigpa is one result of this exchange (Ministry of Health & Family Welfare, 2010). Therefore, Sowa-Rigpa can be seen as a mixture between Ayurveda and Tibetan medicine. It is seen as one of the oldest surviving system of medicine in the world and is mainly practised in the Himalayan region of India (Ministry of Health and Family Welfare, 2009).

Regarding Sowa-Rigpa, there is no main government institution, but the Indian government is funding many small NGO’s and private initiatives. Regarding education, the Central University for Tibetan Studies in Uttar Pradesh, which is under the Department of Culture, has a faculty of Sowa-Rigpa (Ministry of Health & Family Welfare, 2010).

3.4.2 Oral Health Traditions (OHT)

CHT are mainly holistically focussed, where the human body and spirit are seen as one, and an illness is cured through the healing of both body and mind. OHT are less holistic and are mainly expressed in home remedies that cure illnesses occurring in the day-to-day life (such as headaches, cuts, wounds, fever etc.). The knowledge is acquired through observation and experiences and the remedies are mainly simple preparations and are generally performed without monetary compensation

(Unnikrishnan, 2004).

Even though the remedies are not holistic in the way that they generally do not address the body and spirit as one, in OHT it is believed that a disease can occur because of supernatural imbalance, such as an evil spirit or a curse (ibid.). However, in OHT patients are generally not advised to change its lifestyle in order to address both the physical and spiritual sides of the human being as one, but a cure is applied according to someone’s health problems, which can be physical or supernatural. In India there are around 7500 wild plants that are used by tribal people for medicinal purposes, but there are still many that are not yet recorded and therefore the complete list of medicinal plants is in reality likely to be even longer (Rajasekharan, n.d.).

Unnikrishan (2004) explains the cultural dimension of OHT through the theory of sociofacts, artefacts and mentifacts. The material aspects of life, such as language, art and techniques, are called the artefacts. These artefacts are observable and interpreted by people, where this process creates symbols. These symbols are called mentifacts. Once these mentifacts are shared by a whole

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23 community, they are called sociofacts (Pim, 2009). In OHT, the artifacts are the instruments and medicines used.

The interpretation of medicines results in oral traditions, which are the mentifacts. The sociofacts are then the traditional rituals and usages of the medicinal plants of the whole community (Unnikrishan, 2004). Therefore one can state that the culture of a particular tribe is represented in its traditional, medicinal system.

These traditions can vary greatly between different tribes in different areas in India. Because of the country’s environmental diversity and since the process of creating sociofacts can differ greatly between communities, traditional medicinal knowledge is very space specific.

4. Methodology

4.1 Methods used

To understand the importance of TEK for medicinal plants, considering the material, relational and subjective wellbeing of the Irulas in Sembulipuram, three sub questions are formulated and

answered through discussing an ethno-botanic study.

The first sub question; ‘What kind of interaction takes place concerning medicinal plants?’ is answered through a literary study, to find out how medicinal plant use and OHT’s fit in the broader society of India.

To answer the second sub-question; ‘What medicinal plants do the Irulas momentarily use, for what are they used and how are they used?’, research has been carried out in an Irula community in Sembulipuram. First, focus-group interviews were conducted. During these focus-group interviews, a free listing exercise was conducted where the focus-group was asked to name every medicinal plant they knew, which resulted in a list of 51 medicinal plants (see appendix 1 on page 53). From these 51 plants, the respondents were asked to pick the ten most important and valuable plants. This was done by naming the plant, where the respondents would then discuss on whether or not this plant was among the most valuable ones. This resulted in a final list of 21 plants on which the respondents agreed that they were the most valuable.

These 21 plants were identified by the focus-group by conducting structured interviews that revolved around the plants. On each plant, questions were asked about for example the usages, how the plant is processed into a medicine, where the plant grows etc. (see appendix 5 on page 59).

The answers to these questions resulted in a database of 21 plants and their usages (see appendix 7 (page 66) and appendix 8 (page 74)). Focus group interviews were generally conducted in a group of six women (see appendix 2 on page 54). Even though this was the main group, during the interviews, it did occur that some women would walk away and other women would then join the group. These women started new discussions in the group and complemented prior information.

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24 After finishing the database of the 21

plants, five plants were selected (table 1) to be the main focus of several household surveys. These surveys also focussed on the importance of medicinal plants for the material, relational and subjective

wellbeing of the Irula’s and make up a large share of the answer to the third sub

question.

The five plants were selected on the basis of either different usages, rarity or

geographical position.

The settlement of Sembulipuram exists of 15 households, and due to a lack of time, one person per household was

interviewed, with an emphasis on their personal usage and knowledge of the plants. The interviews were a mix of open and closed questions, where the

respondents were asked about (See appendix 4 on page 56):

 Their knowledge of the plant (e.g. did they knew the plants, who educated them about medicinal plants, how was this knowledge passed on etc.);

 their usage of the plants (e.g. did they ever use the plant, when do they go to a doctor and when do they use plants for treating illnesses, what was the last time they used the plants etc.);

 thoughts about future and past usage of medicinal plants;

 geographical location of the plants (i.e. where did they collect the plants from if they used them);

 storage and home growing of medicinal plants;

 satisfaction regarding the medicinal use of the plants (the respondents were asked to give a grade on a Likert-scale from 1 (not satisfied at all) to 10 (very satisfied)

Since there are many plants that are also used as food15, it was made clear to the respondents that the questions were specifically concerned with the medicinal properties of the plants.

15_{See section 3.3.3 on Food and medicine.}

Plant Picture

Kodikalli

Panamara Veru

Mosu Mosu

Gopura Elai

karpaanpoondu No picture available Table 1: plants and pictures