Who is a quack?

I met two medical practitioners last Tuesday. One possessing an MBBS in Alternative Medicine and another a plus two (a revelation which I take as testimony to my skills in fieldwork than their audacity). Both were offering their services for a mere Rs.20. They worked among Bengali, Oriya and Assamese migrants in Kochi.
The idea of quack has interesting genealogies and is entwined with the rise of modern medicine and how it annihilated and devalorised other medical practices and traditions. But P. Sainath says that such practitioners could be killers in rural India where there is little access to health care. He particularly gives this example of a pregnant woman who died after too many saline drips administered by such a practitioner.
In Kochi, the single most disease that is cured by these practitioners is body pain felt after long hours of arduous manual labour. Usually a liberal dose of pain killer cures such symptoms. These workers work in quarries, plywood factories and chemical factories. Pain all over the body and chronic fatigue.
Why do these workers choose these practitioners instead of our not so bad government hospitals? They describe their ailments to these doctors who speak their language.
At one level, it demonstrates the need for affordable health care among migrants in Kerala. At another, it questions our perceptions of health care as malayalees where we seek the most specialized, preferably expensive doctors and hospitals.
The misfortune of falling ill and having to encounter the health system in an alien land is dreaded so much that the workers of Banma, Bihar when they went to work in the Delhi metro took the village healer, called guruji, who does massaging besides ritual forms of healing, mainly to ease body pain. Guruji is a handicapped person and has a tri-cycle. He does not work at the site. He lives off the fee he gets when he does healing. He gets food for free from the common kitchen of the workers from the village.
The practioners in Kochi are not ritual healers, they practice allopathy.
The Bengali practitioner says “I came here as a toursist and saw the suffering of Bengalis and decided to help them.”The Assamese practitioner is being promoted by a local medical shop which sends up Assamese customers who visit their shop.
After talking to some workers, I felt that they do not trust malayali doctors with their bodies, much less their ailments. “They keep using the needle too much”
The good doctor, bad doctor and the quack?