By Dr. Eduardo G. Gonzales
The only encounter I had with an indigenous healer as a kid was when I dislocated my right middle finger while playing tag. This was in Tarlac, in the 1950s. Despite the fact that my parents are nonbelievers in traditional medicine, I was brought to a manghihilot instead of a doctor because it was common knowledge then that a manghihilot is a better bonesetter than any physician.
The manghihilot applied oil on my swollen hand and gently massaged it before reducing my finger back into its socket. The whole process took less than five minutes and was completely painless. I was so thankful my parents didn’t bring me to a doctor who, I was sure, was going to give me a painful injection or make me take a bitter pill. Since then, despite my pleasant experience with the manghihilot, I had relied completely on modern scientific medicine in handling all my health issues, until a few years ago when I had severe migraine that was unresponsive to medications. Desperate, I went to see an acupuncturist who implanted needles on my right hand and shoulder. When the needless were removed after 30 minutes, I threw up and then voila! My headache was completely gone.
My positive, albeit very limited, interactions with traditional medicine practitioners have convinced me that traditional medicine isn’t quackery but a legitimate discipline that can complement modern scientific medicine in attaining and maintaining optimal health.
The Essence of Traditional Medicine
Traditional medicine has been practiced since ancient times in every culture throughout the world. It consists of the medical aspects of traditional knowledge that developed over generations within various societies before the era of modern medicine. It is, according to the World Health Organization (WHO), “the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement, or treatment of physical and mental illness.” Traditional medicine is based on the understanding that man is part of nature and diseases arise from a lack of harmony or imbalance of the various natural forces that affect humans. Consequently, natural elements extracted from plants and animals and, in some instances, incantations and prayers can help restore this balance. Traditional medicine uses a holistic approach in understanding and curing the various diseases. It considers the entire physical, mental, spiritual, and social makeup of the individual.
Specific traditional medicine practices vary among different cultures, but it is not unusual for some practices to be adopted globally. Acupuncture is the best example.
Philippine Traditional Medicine
In the Philippines, traditional medicine has been influenced by religion, mysticism, magic, superstition, and folkloric herbalism. Philippine traditional medicine practitioners include the hilot or manghihilot who act as midwife, chiropractor, bone-setter, or massage therapist; mangtatawas who uses alum, candles, smoke, paper, eggs, and other mediums, plus incantations and prayers, to diagnose diseases; albularyo, who uses a combination of healing modalities that may include prayers, incantations, mysticism, and herbalism; medico, who is similar to an albularyo but integrates western medicine in his practice; and faith healers, who claim they have been granted divine powers to heal.
Modern Scientific Medicine
When modern scientific medicine came into being, traditional medicine was largely relegated to the background and for good reasons. Whereas traditional medicine is based on knowledge that is assumed to be true because it has been handed down through generations, modern scientific medicine is based on knowledge attained through the scientific process. It utilizes scientifically proven technologies and practices in diagnosing and treating patients. The drugs that its practitioners prescribe have undergone rigorous trials for safety and efficacy, and they come in fixed doses that vary only slightly with age or weight, or disease severity. Modern medicine practitioners are professionals who go through years of formal training in schools and universities. In contrast, in traditional medicine, knowledge is often passed informally, one-to-one through families, and practitioners are often born into a family of healers.
Scientific medicine has been highly recognized and has consequently become the official medical system of practically all governments. In most countries, it is heavily funded by the state while traditional medicine has basically relied on individual practitioners for its sustenance.
Traditional Medicine has not lost its relevance and popularity
While modern scientific medicine has been responsible for the increasing life expectancy and plunging death rates worldwide, it has its shortcomings. Medical treatment, or even diagnostic examination, can cause adverse effects, often relatively minor, but occasionally severe and life threatening. Likewise, when it comes to preventing disease and treating chronic illnesses, modern medicine continues to fall short. Furthermore, it is incredibly expensive.
Hence, largely due to its affordability, accessibility, and availability and partly because of its efficacy, traditional medicine still enjoys a large following, especially in rural areas. In fact, most people—70 percent of the population in the developing world, according to the Wold Health Organization (WHO)—rely more on traditional medicine than modern medicine for their health concerns. Traditional medicine also enjoys popularity in developed nations. Estimates suggest up to 80 per cent of the First world population has tried a traditional therapy such as acupuncture or homeopathy.
Should the two systems formally integrate?
Integrating traditional medicine and modern medicine will obviously enhance general health care knowledge for the greater welfare of society. Nothing beats modern medicine in emergency conditions such as heart attacks and strokes while herbal medicines and some traditional medicine practices have proven benefits in health promotion and therapy for chronic conditions. Formally integrating the two systems, however, is a formidable task. Much of the knowledge and practices of traditional medicine will not meet modern safety and efficacy standards. Likewise, it is impossible to integrate certain aspects of traditional medicine into modern medicine. Ritual cleansing, incantation, and divination are some examples.
Perhaps the best thing to do is simply let these two disciplines co-exist, as they presently do. In time, the good aspects of both systems will integrate freely and the two fields will co-exist harmoniously. In fact, this informal integration process is happening now. Although traditional medicine and modern medicine are seemingly separated by deep chasms both philosophically and on how each is practised, evaluated, and managed, most of the world’s population including practitioners of both systems de-facto regard traditional medicine and modern scientific medicine not as two systems that are mutually exclusive but as complementary ones. Medical and paramedical schools have already included aspects of traditional medicine into their curriculum. Many physicians now refer patients to acupuncture clinics. They likewise routinely prescribe sambong tablets for kidney stones, lagundi for cough cold and fever, etc. Similarly, practitioners of sports medicine allow their athletes to incorporate cupping (“ventosa,” in Filipino) and moxibustion into their training regimens. Also, while practitioners of both sides outwardly look down on each other with distrust, the fact is albularyos consult doctors and get confined in hospitals while doctors often resort to traditional modalities for their own health problems, such as I did when I called in on an acupuncturist for my headache.
More than formal integration, our concern should really be regulation. Modern medical medicine is presently already tightly regulated, the government and the various medical societies has seen to this. Implementation of regulatory provisions, however, needs to be strengthened in some areas and eased in others to decrease the cost of medical care and ensure that medical practitioners adhere strictly to ethical and professional standards.
In contrast, there is virtually no regulation that covers traditional medicine in the Philippines. It is very easy to market traditional medicine products for so long as you label them simply as “dietary supplements” that have “no approved therapeutic claim.” Stringent controls should be instituted because as the WHO has put so succinctly, “inappropriate use of traditional medicines or practices can have negative or dangerous effects.” The public should likewise be protected from quacks and charlatans—fraudulent or ignorant pretenders to medical skills—who prey on the gullible public, especially among the chronically and terminally ill, to amass a fortune from “donations.”