The Institute of Applied Dermatology (IAD) located at Kasargodu in Kerala is a prominent world-renowned lymphoedema and integrative medicine skin hospital sought after by patients from across the country and South East Asian countries. The only such hospital in the whole of the country provides relief and solutions by integrating Ayurveda, Homeopathy treatments, Yoga and many other traditional methods combined effectively with modern medicine. Founded in 1999, the institute completed 24 years in, what Dr SR Narahari, the founding Director proudly proclaims as transforming lives.
More than 24 years of Indo-European research: Thanks to more than 24 years of Indo-European research and experience apart from treating more than 10,000 patients under its roof, IAD has blossomed from a minuscule clinic to the status of the nation’s primary dermatology hospital. In fact, the medical institute offers integrative treatment for various forms of skin-related ailments like lymphatic filariasis, vitiligo, psoriasis, lichen planus, wound care, warts and hemiplegia.
Mission to provide value-based healthcare: IAD was established with a mission to provide value-based healthcare and support to people. It also pioneered the first successful Integrated Treatment Protocol to treat chronic diseases, especially the Lymphedema. Since its inception, it began to focus on Lymphedema/Filariasis treatment apart from developing a Yoga protocol for the treatment of Lymphedema. IAD believes in clinical observation (investigation) as a prelude to fundamental research and accordingly treats the patients based on such clinical observation. It is also jointly undertaking a study of skin behaviour, development and treatment in collaboration with the Kasargodu Central University.
Recognized Centre for Integrated Medicine: The Kerala Government has recognized IAD as the Centre for Integrated Medicine and Public Health. All along, it has been continuously striving for the betterment of needy patients with a variety of activities. IAD initiated self-help groups and nutrition programs for HIV/AIDS patients that eventually became a government-supported program. It launched a project for the rehabilitation of sex workers with alternative livelihood opportunities apart from setting up a school to provide education for street children in order to rehabilitate them.
Syllabus for Dermatology Nursing: IAD, over a period of time has grown in terms of experience and expertise in the subject and hence has been able to develop a syllabus for dermatology nursing in the country. It has also conducted a field trial to know the effectiveness of integrated medicine for filariasis at Alappuzha in Kerala and Kalaburagi in Karnataka.
Finalist for BMJ Awards, United Kingdom: IAD has been recognized as Excellence in Lymphedema Practice by the International Lymphoedema Framework. It has conducted a survey of atopic diseases among school children. It has also successfully completed training in the UK for evidence-based medicine and has received the Neutrogena Oration Award of the Indian Association of Dermatologists, Venereologists and Leprologists (IADVL). It continues to surge ahead in publications as well by publishing 90 research papers so far. IAD was also the finalist for the BMJ Awards, United Kingdom.
Recognition by Bill Melinda Gates Foundation: The WHO-SEARO (World Health Organization-South East Asia Region) has conducted a clinical audit of the filariasis patients followed up for 10 years. Along with the NABH (National Accreditation Board of Hospitals) accreditation for Panchakarma, the WHO has published a report based on the findings and data of the IAD. The Bill and Melinda Gates Foundation (BMGF) has recognized IAD as the Centre of Excellence for Lymphedema.
Dr SR Narahari appointed as Coordinator: In order to develop a skin care nursing speciality, a first of its kind in the country Dr SR Narahari was appointed as Coordinator of Dermatology Nursing in India. The IAD has established four centres for Lymphedema and Lymphatic Filariasis treatment in UP and Bihar with the help of BMGF funding.
Member of Task Force, WHO: The IAD has developed a syllabus for training to treat all types of Lymphedema, including Filariasis. Dr SR Narahari has also accomplished the herculean task of developing a team of multisystem doctors and nurses from Allopathy, Ayurveda and Yoga. Apart from being a Technical Committee Member who developed the strategy for the rollout of the National AYUSH Mission, he is also a Member of the Task Force of the Global Centre for Traditional Medicine, WHO.
What is Lymphatic Filariasis: Lymphatic Filariasis also commonly called Elephantiasis or ‘Elephant Foot’ disease is reported to be prevailing in around 80 countries while it was completely eliminated in Japan during the early 50’s. Later Odisha was also declared free from this ailment. There could be around 2.6 crore people affected from Lymphatic Filariasis in 20 states particularly coastal states and Bihar. But officially this figure has been drastically reduced to 70 lakhs according to medical sources.
Dubious claims keep continuing: The apex court had taken strong objections when the government had proclaimed that Leprosy had been completely eradicated from the country. However governmental agencies continue to indulge in dubious claims even in the case of Lymphatic Filariasis also. It is a disfiguring, disabling disease usually acquired in childhood but showing no symptoms or hinting any indications about the possibility of suffering from the dangerous ailment. But in spite of the absence of symptoms the lymphatic system is damaged and this stage can get prolonged for several years.
Mosquitoes, the prime culprits: Mosquitoes are the culprits for infected persons sustaining transmission of the disease as a result of which the long-term consequences are painful due to swollen limbs. The after-effects become horrible to such an extent that even daily activities become a struggle due to frequent infections. Hydrocele in males is found to be common in endemic areas. Apart from infection from mosquitoes, Lymphoedema can also be caused due to surgery, trauma or treatment for cancer. According to the World Health Organization (WHO), Lymphatic Filariasis is the second leading cause of disability in the world. But unfortunately due to inadequate research in the field treatment options are limited!
Self-care, patient-led and evidence-based therapy: However, IAD has independently developed a self-care, home-based, patient-led, ethical and evidence-based therapy. It’s a combination of Ayurveda, Homeopathy, Yoga and Allopathy on a pathophysiological basis derived from bio-medicine. This method of treatment was envisaged and developed by IAD with support from the Government of Kerala and Prof Terence Ryan, Department of Dermatology, Oxford Medical School, UK. Interestingly WHO has been recommending this drug across the globe.
Life-long contribution to research: Prof Terence Ryan has dedicated his life to research and treatment of skin diseases and his contribution to public health is immense. But his belief of clubbing modern medicine systems with that of the traditional ones took him around the world. In fact, Prof Terence Ryan has been an adviser to IAD for a long and thanks to his mentoring IAD has been able to excel in research and formulate an integrative treatment protocol tested over a period of time and found effective as well. He has also been instrumental in guiding the IAD doctors to publish over 90 international research papers on the integrative treatment of lymphedema. Apart from such generous help, he has been magnanimous enough to part with his valuable library to the IAD which by itself is a great treasure to make use of.
Pro-bono Director from 1990: Renowned Dermatologist Dr SR Narahari, an ‘intense clinician and patient-oriented researcher’ has been practising at Kasargodu since 1990. He is the pro-bono director of the not-for-profit integrative medical organization, IAD which he founded along with nine other inter-disciplinary senior medical professionals. Thanks to the untiring efforts of Dr SR Narahari and his team of dedicated band of doctors, in 2010, a WHO publication discussing integrative medicine named IAD as a lead lymphology clinic in the world. In 2014, the Government of Kerala established its ‘Centre for Integrated Medicine and Public Health’ in IAD under a public-private partnership for furthering activities of R&D and other field works related to community dermatology.
All Doctors in the family: Both Dr SR Narahari and his dermatologist wife Dr KS Prasanna also have their own popular private clinic in the town. But more than half of their time is spent attending to needy patients at the IAD. Dr SR Narahari’s whole family belongs to the medical fraternity as both his sons and daughter-in-law' are also upcoming doctors. The eldest son has done a postgraduate degree course in internal medicine while the younger one is also a medical graduate. Both Dr SR Narahari and Dr KS Prasanna don’t receive any kind of financial benefit for their services in IAD. On the other hand, they make all-out efforts to ensure that at least a quarter of the patients admitted to IAD have sponsors for their treatment for free.
Challenge of compilation of data: Recently a Bengaluru-based private organization felicitated the doctor couple for their yeoman services to mankind. Such public appreciation and bestowing of awards keep happening now and then to the doctor couple committed to services expecting nothing. But the big worry haunting them is the funds' crunch for conducting research trials.IAD has a big data of 10,000 Filariasis patients which they are planning to put on the server soon. Nowhere else across the world, you can find such huge information on traumatic ailments. This data needs to be analyzed in the larger interests of the patients but the non-availability of required financial aid has also become a major bottleneck for the sphere heading the R&D activities.
The pharmaceutical industry has the last laugh: Red tape for real research is the biggest challenge while plagiarism is another major hazard. Added to such a state of affairs, there’s no recognition for talent in this country, laments Dr SR Narahari. But there’s also a paradoxical plight prevailing in the country as whatever WHO proclaims is considered to be gospel. And on the other hand, any drug or treatment with the use of traditional and cost-effective medicine is thwarted by the Pharmaceutical industry!
-Manohar Yadavatti
Great Journey and Achievements to Mankind
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