Embracing the tension between traditional and modern health care

Written by Ginger Ramirez 

I only remember going to the doctor once during my childhood in Manila, the Philippines. Perhaps I was not a sickly child. Perhaps vaccines were not very accessible then. Or perhaps my memory simply doesn’t serve me right. However, I do remember receiving treatment, which I would eventually learn in medical school as ‘traditional’ or ‘alternative’ approaches to medicine.

I remember drinking water boiled in leaves when I had fever, oils being wiped over my body to alleviate aches and sores and being massaged at key pressure points to activate or disperse certain energies. I remember being told to avoid washing my hands after a tiring day or told to lick my thumb and wipe it on a baby’s tummy to counteract the entry of negative spirits. These simple practices were common among family members and relatives, even for people like me who grew up in the middle of the city.

Throughout my time at medical school, we would discuss such experiences, but mostly in the context of informing us, medical students, of patients’ common unhealthy behaviors, or what would be labelled as ‘poor health seeking behavior’. There seemed to be this tension between what we would recognize as ‘modern medicine’ and the so-called ‘traditional’ or ‘alternative’ therapies. While the traditional therapies were relevant to patients, their results were inconsistent and there was little evidence to support these claims. But I somehow felt dissatisfied with this dichotomy. I always felt that there is something more to learn from these traditional approaches and that these should not be dismissed so easily as ‘backward’, ‘inferior’ and ‘substandard’.

Today, I work for the Province of Northern Samar, a predominantly rural area south of Manila accessible by a 1-hour plane ride or an 18-hour land trip. I am very fortunate that through this work, I had the opportunity to meet a healer for the very first time.

In one of the remote islands in the province, we met a traditional healer, a man 62 years of age, who has been providing therapeutic remedies since he was 18 years old. Attached to his name is the title ‘Mano’, a term of respect and endearment given to older men in the community. He was kind enough to welcome us and allow us to ask some questions about his work as a healer. I was extremely curious and he was particularly generous.

Unlike other healers, his gift was not passed down from his ancestors but was revealed to him through a dream. He would dream about potions and prayers and these would provide the source and instruction of his healing. Upon request, he even showed us some of the oils he had made and concoctions he would give to drink or apply on skin, for people who come to his home and ask for help.

Inside this bottle are leaves soaked in water, mixed with oils. This is given to patients complaining of gastric symptoms such as abdominal pain and vomiting. 

He told us about people who would come knocking in the middle of the night to request to be healed from so-called ‘lason’ (poisoning) or chronic, non-healing wounds. He told us how he would go deep into the forest to gather exotic leaves, roots and plants with healing capacity. He would prepare them for patients with rituals and prayers. He told us how he would feel patients’ pulses and senses energies that flowed through their bodies to identify their illness. He even told us how he would also refer patients to the doctor, when he knew cases were outside his capability as a spiritual healer.

Inside this container is a mixture of oils that give off a cooling menthol sensation when applied. It is used to relieve patients of itchiness, rashes, insect bites and even acne. 

We were accompanied by a bunch of barangay health workers (BHWs), the Philippine’s equivalent of community health volunteers. When I asked if any of them had consulted the traditional healer for treatment, there was a resounding yes from the group! While I was in no position to truly understand what he does and how he does it, what I witnessed, though, was a strong acceptance and support from the people he has helped. It was clear that these BHWs, who are exposed to ‘modern medicine’ through trainings in the formal health care system, recognize the benefits of his role as healer to the community. Other conversations with locals also revealed a strong affinity to other traditional healers and how they would readily seek their healing in times of need.

So what is it about these healers? Is it the quality of care they provide? Is it because they don’t charge for their services? Is it because patients are actually relieved of their ailments? Is it their calming demeanor and presence? Is it because their healing resonates with our cultural heritage?

I can already picture physician colleagues questioning my openness to this traditional aspect of health care.  The tension exists between what is considered ‘modern’ versus what is ‘traditional’. I think this dichotomy is something we ought to embrace and not dismiss immediately. Whether we like it or not, the health care continuum includes ‘traditional healers’ and the responsibility to understand their role in the overall system is ours, health professionals. When we understand why patients choose to seek help from them (at times even preferred over health professionals), regardless of geography or cost, we may uncover wisdom that will guide us in designing a more patient-centered health care system.

SOLACE ethnographers with the Barangay Health Workers (BHWs) and the healer 

Our response to “poor health seeking behaviour” is often through patient education. We teach patients to change their ways and adhere to the modern way of doing things. I hope, though, that we, health professionals, will also take it upon ourselves to be educated about these individuals who have a critical role and impact on our local health millieu.

Perhaps it is about time we begin mending the tension and healing this dichotomy and recognising that they too are healers in their own right. Their ways may not be of the same kind or manner as ours, but in sharing the same spirit of care and service to others, may we respect the undeniable healing presence they contribute to the communities they serve.