Why acupuncture in Kerala has become a health risk

On June 12, 2023, 48-year-old Sajid Mohammed of Veliyathunadu, Aluva collapsed at home following a cardiac arrest. Despite desperate attempts by his family to revive him, Sajid was later declared dead at a hospital. He is survived by his wife, Husna, and their four children, who now grapple not only with the weight of his sudden loss but also with unanswered questions about the kind of treatment he had been receiving in the months leading up to his death.

For decades, Sajid had suffered from chronic varicose veins, a condition that caused him recurring pain and discomfort. A trained draughtsman, he had spent much of his working life in the United Arab Emirates, sending money home and supporting his family. But during the COVID-19 pandemic, like thousands of other migrants, he returned to Kerala, forced by lockdowns, job losses, and an uncertain future abroad.

After getting treated by various doctors in vain, Sajid finally sought treatment for his long-standing condition — not from a qualified physician or vascular specialist, but from someone he trusted: a former college mate from their days at the Polytechnic Institute in Tirur. The friend, who had taken up acupuncture after completing a short course, offered to help him manage the condition through alternative therapy.

For over a year, Sajid regularly visited his friend for treatment sessions. Family members recall seeing thin acupuncture needles and herbal oils during his sessions. There was no bloodwork, no diagnostics, and no follow-up with a certified doctor.

“He had undergone various treatments for nearly 17 years, and during that time, the varicose vein wasn’t externally visible. It was only in the final phase that he turned to acupuncture, influenced by a college mate and a female relative who had been practising it. After beginning this treatment, he started living at his parental home just because the acupuncturist had advised him to avoid interacting with those who didn’t believe in the treatment or were afraid of needles,” his wife Husna told The Federal.

“He was receiving single-needle acupuncture sessions. It was only after this that his legs began to worsen — they started bruising, and eventually, an infection set in,” added Husna, who is a special educator and psychologist working in a higher secondary school.

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On April 5, 2025, in a modest rented house in Chattiparamba, Kerala, Asma Sirajuddin gave birth to her fifth child—a baby boy. Just a few hours later, the 35-year-old mother passed away. No doctor, no nurse, no ambulance, and no hospital bed could save her. Asma left behind a grieving family and an unverified certificate in acupuncture, which many in her community believed gave her the authority to manage childbirth. Her husband, Sirajuddin, reportedly holds a similar certificate. For Asma, and countless others, these credentials have proven not to be a license to deliver life, but a certificate of risk—and, too often, death.

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Recently, in Ernakulam district, an ASHA worker encountered a troubling situation during a routine house visit campaign. She heard a woman screaming from inside a house, only to discover that a complicated home birth was underway. The ASHA worker alerted a local self-government (LSG) member, but the woman's husband who claims to be a trained acupuncturist resisted any intervention. The police had to be called, and the woman was eventually taken to the hospital by force, where she safely delivered a healthy baby. However, the incident has taken a complicated turn. The husband has filed a complaint against the ASHA worker and the panchayat member, and the woman now claims that her right to bodily autonomy and choice of birthing method was violated. According to state health minister Veena George, despite the doctor warning that the situation could have been fatal for both the mother and the child had they not received timely medical intervention, the couple remains opposed to the system that tried to help them. They were adamantly against hospital childbirth. The minister describes the situation as highly complicated.

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These stories stories are not isolated tragedies. Across Kerala, a growing number of individuals armed with short-term acupuncture training are engaging in dangerous, unsupervised medical practices, from facilitating home births to treating serious ailments. These so-called practitioners often claim legitimacy through certificates obtained after completing short term courses, frequently issued by unrecognised institutions. Medical professionals and legal experts, however, are sounding the alarm: these credentials are neither recognised nor suitable for handling life-threatening medical scenarios like childbirth.

Sajid Mohammed’s case was a typical example of this practice. His wife Husna maintains that he stopped taking allopathic medication on the advice of an old college mate — a civil engineering diploma holder, who is now practicing acupuncture after completing a certificate course. However, the very person, Tirur-based Shuhaib Riyaloo, a vocal advocate of this alternative treatment, vehemently denied the allegation, stating that he has every legal right to practise acupuncture under the existing legal framework.

“Sajid had been undergoing treatment for varicose veins for more than a decade before coming to me. I treated him for a few months, as he had already developed a varicose ulcer. He had several complications from using allopathic medications and sadly passed away. I have patients in far more serious condition than he was in, and they are recovering well under acupuncture treatment. I do not wish to respond to the allegations made by his wife, as these pertain to their family matters. Since he is no longer with us, I believe it would be inappropriate for me to comment further,” Shuhaib Riyaloo told The Federal.

Practitioners performing Reiki. Photo for representation

Independent acupuncture treatment is not legally recognised as a medical treatment. As per the law, only those who hold valid registrations to practise medicine are permitted to offer acupuncture as an additional form of treatment. The law also clearly states that neither state governments nor Union territories are authorised to conduct diploma or degree courses in alternative therapies such as acupuncture, nor can they grant recognition to such courses.

“What we’re seeing in Kerala are underground institutions handing out fake certificates, with no regulation and no scientific rigour. These people are performing dangerous medical procedures with nothing more than a diploma printed off a computer,” says Hamzat Mohammed, a Ponnani-based former pharmacist and social activist, who had been waging long legal battles against these unscientific practices.

“I’ve been a cancer patient for several years now, undergoing radiation and other treatments. As a paramedic, I have a good understanding of my own health condition. Even I’ve been approached by these novice practitioners offering acupuncture as a solution for colon cancer,” says Hamzath Mohammed.

The Indian Research Institute for Integrated Medicine (IRIIM) offers legitimate acupuncture programmes, including a postgraduate certificate for MBBS holders, a medical degree in acupuncture, and an assistant-level certificate. However, even these accredited qualifications do not authorise practitioners to provide independent emergency care or assist in deliveries. The proliferation of unverified courses has created a dangerous grey area, where untrained individuals exploit public trust in alternative medicine to offer life-threatening services.

This distrust is compounded by the availability of short-term acupuncture courses, which are often marketed as empowering alternatives to conventional medical training. These programmes, sometimes completed in as little as three months, promise to teach participants how to manage pain, promote healing, and even assist in childbirth. The certificates they provide carry an air of legitimacy, despite lacking recognition from medical or regulatory bodies. For vulnerable families, especially in rural areas, these credentials can seem like a viable substitute for professional healthcare.

“There are nearly 3,000 acupuncture practitioners in Kerala, working under five different associations. All these associations operate legitimately. As per the current regulations, a background in biology is not a mandatory requirement for becoming an acupuncturist,” claims Shuahib Riyaloo, the Kerala state president of Indian Acupuncture Practitioners Association. “Unfortunately, despite a High Court directive to establish a medical council for acupuncture, Kerala still does not have one. The Health Department—whether deliberately or otherwise—appears to side with the allopathy stream. However, there are several court orders that support acupuncturists, and critics of our form of treatment often resort to slander and false campaigns when they have no legitimate grounds to oppose us,” adds Riyaloo.

“As per the RTI response received by me from the Kerala Medical Council, it is clear that they do not have registration. The claim about court verdicts allowing it is just another similar falsehood. In reality, the verdict only states that since the Tamil Nadu government has not yet established an Acupuncture Council, those with proper qualifications should not be prevented from practising. The Kerala State Medical Council has categorically stated that acupuncture is not under the purview of the Council,” says Hamzath Mohammed.

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In Asma’s case, the absence of professional medical care during her delivery likely contributed to her death. Similar incidents have been reported across Kerala, where families place their trust in practitioners who lack the training to recognise complications or provide emergency care. Many of the couples involved in reported home birth cases in the last five years had completed some short-term acupuncture diplomas, mistakenly believing these qualifications equipped them to handle labour.

So why do people continue to choose home births facilitated by minimally trained acupuncturists, often in risky environments? The answer lies in a complex interplay of factors. For some, it’s a deep-seated distrust of modern medicine, fuelled by stories of medical negligence or impersonal hospital experiences. For others, the decision is driven by practical concerns: the high cost of hospital deliveries, the inconvenience of travel, or fear of invasive procedures like caesarean sections. In a few cases, the choice reflects an ideological belief that childbirth is a “natural” process that should remain untouched by what some perceive as the poisons of modern intervention—surgeries, blood work, and injections.

Also read | Why women in Kerala are risking their lives with dangerous home births

The rise of illicit acupuncture practices in Kerala highlights a broader issue: the lack of robust regulation in alternative medicine. While acupuncture is legally practised in India under specific conditions, the absence of stringent oversight allows unqualified individuals to exploit loopholes. Underground institutions offering dubious certifications operate with impunity, preying on the public’s desire for affordable and “natural” healthcare options.

“Acupuncture is not a recognised stream of medicine. As of 2024, it is classified as a paramedical care profession — not a system of treatment,” says Veena George state health minister. “These practitioners are not eligible to provide treatment. Our district medical officers are actively shutting down illegal institutions under the provisions of the Medical Practitioners Act and the new Kerala Medical Practitioners Act,” added the minister. “We are in the process of listing recognised courses. At the same time, we cannot interfere in home birthing decisions directly, as doing so might infringe on fundamental rights — so we are taking a case-by-case approach,” Veen George told The Federal.

Legal experts argue that existing laws are insufficient to address the scale of the problem. While the Clinical Establishments Act of 2010 mandates registration and regulation of medical facilities, it does not explicitly cover alternative medicine practitioners operating out of private homes. This regulatory gap allows untrained acupuncturists to perform high-risk procedures without accountability. In the wake of Asma’s death, local authorities have promised to investigate the institution that issued her certificate, but systemic change remains elusive.

These anecdotes are stark reminders of the dangers posed by illicit acupuncture practices in Kerala. The stories underscore the urgent need for stricter regulation, public awareness, and accessible healthcare to prevent further tragedies. While acupuncture, when practised ethically and within its scope, can offer benefits, its misuse by untrained individuals has turned a traditional therapy into a deadly gamble. Until systemic reforms are implemented, the risks of these practices will continue to claim lives, leaving families to bear the weight of preventable loss.

Highly placed sources in the State Health Department admit that there has often been political pressure to go somewhat soft on these alternative practices. “For instance, it’s an open secret that former Chief Minister Oommen Chandy underwent this kind of treatment for his terminal illness. Certain organisations consistently lobby for these practices, and they have the backing of religious groups — not just from one faith,” says a senior hand in the Health Department.

“It’s a sensitive and complicate area, especially when it overlaps with traditional healing methods. These systems are not included in the Act, though there is a protection clause for traditional practices. However, we are planning to take the data directly to women in a campaign mode, Acupuncture issue will also be addressed as part of this outreach," state health minister Veena George told The Federal.

In Kerala, an illegal and particularly troubling variation of acupuncture, known as “no-touch therapy”, has gained traction. This practice, which involves manipulating energy fields without physical contact, is often marketed as a holistic alternative to conventional medicine. Experts warn that it lacks scientific backing and poses significant risks when used in critical situations like childbirth.

“People come to us because they have lost faith in modern allopathic medicine. Patients with multi-drug resistance often turn to alternative treatment streams and experience significant relief. With many drugs being banned in recent days, public trust in conventional medicine has eroded further, leading more people to consider acupuncture. This should not be misinterpreted as us campaigning against allopathy,” maintains Shuhaib Riyaloo.

“Despite the well-established benefits of hospital births, groups around the world continue to advocate for so-called ‘natural’ home deliveries. Many of these groups also oppose routine childhood immunisations and even COVID vaccinations, showing no hesitation in putting women and children at risk in the name of ‘natural living’. In Kerala too, such collectives have been sprouting in various regions, often backed by naturopaths, acupuncture practitioners, and certain religious fundamentalists. There must be firm action against such groups — at the very least, a case of culpable homicide should be considered,” says Dr KP Aravindan, senior pathologist based in Kozhikode and former president of the Kerala Sastra Sahitya Parishad, the state’s people’s science movement.