Filipino Indigenous Medicine: From Tradition to Mainstream Practice

Jaime Z. Galvez Tan, MD, MPH

Professor, U.P. College of Medicine Head, Traditional and Integrative Medicine Clinic, UP-PGH

Outline of Presentation

Historical Developments in CAM Definitions of CAM Concepts of Health, Illness and Wellness Global Examples of CAM Filipino Traditional Medicine Similarities and Differences : CAM vs Western Rationale for Learning Filipino Traditional Medicine and Integrative Medicine Challenges to Health Institutions and Health Sciences Students

Historical Developments in Integrative Medicine 1978-2008

Historical Developments: Global

World Health Organization (WHO): 1978 Alma Ata Declaration on Primary Health Care (PHC): Integration of Traditional Medicine in PHC 1999: US Congress established the National Center for Complementary and Alternative Medicine (NCCAM) in the National Institutes of Health (NIH) Bethesda, Maryland.

Philippine Experience in Integrative Medicine 1972-2008

Mid-70s: Private physicians started training in acupuncture in China Early 1980s: DOH physicians trained acupuncture in China; herbal medicine production started 1993-95: DOH established the Traditional Medicine Unit which promoted the use of medicinal plants, acupuncture and therapeutic massage

Integrative Medicine Policy and Practice in the Philippines #1

1995 - De La Salle University inaugurated the Center for Indigenous Medicine in Dasmarinas, Cavite - the 1st Philippine university to do so. 1997 - Republic Act 8433 established the Philippine Institute for Traditional and Complementary Health Care (PITAHC) in as an attached agency of the Department of Health (DOH).

Integrative Medicine Policy and Practice in the Philippines #2

1999-2000 Filipino physicians have organized the Philippine Association of Medical Acupuncturists Inc (PAMAI) and the Philippine College for the Advancement of Medicine (PCAM) to promote the practice of Integrative Medicine. 2001 - The UP College of Medicine started an elective course on Integrative Medicine in both graduate and undergraduate courses. The UPPhilippine General Hospital inaugurated the Traditional and Integrative Medicine Clinic.

Integrative Medicine Policy and Practice in the Philippines #3

2008 - The Philippine Institute of Traditional and Alternative Medicine (PITAHC) started the accreditation of acupuncturists practicing in the Philippines, both for medical and nonmedical practitioners.

Definitions

What is Traditional and Alternative Medicine as defined by R.A. 8433 ?

The scope of alternative health care modalities as other forms of nonallopathic, occasionally non-indigenous or imported healing methods, though not necessarily practiced for centuries nor handed down from one generation to another. (PITAHC R.A. 8433 - 1977)

Filipino Traditional Medicine

World View of Health in Filipino Traditional Medicine - 1

Theory of macrocosm and microcosm (kalawakan at sangkatauhan The balance, synergy and harmony:

Between Humankind and the Universe Between Humankind and Nature Between and Amongst people Within his body, mind and spirit

Filipino Traditional Medicine Definition of Health and Wellness

Health and wellness is the state of harmony, balance and synergy between humankind and the universe, between humankind and the nature, between and among humankind and within the human body, mind and soul.
(J.Z. Galvez Tan (2005) from interviews with hundreds of Filipino traditional healers 1975-2005)

Ang Kahulugan ng Kalusugan and Kaginhawaan sa Katutubong Medisina ng Pilipino

Ang kalusugan at kaginhawaan ay:

ang mabuting kaugnayan ng sangkatauhan sa kalawakan; ang mabuting kaugnayan ng sangkatauhan sa kalikasan; ang mabuting kaugnayan ng tao sa kapwa niya; at and mabuting kaugnayan sa kanyang sarili - katawan, kaisipan, kalooban at kaluluwa.

Filipino Traditional Medicine Definition of Illness and Disease

When the harmony, balance and synergy between humankind and the universe, between humankind and nature, between and amongst people and within his body, mind and spirit are broken and not mended, then disease, death and destruction will occur.

(J. Z. Galvez Tan from interviews with hundreds of Filipino Traditional Healers 1975-2005)

Bakit Nagkakasakit ang Tao?

Kapag ang mabuting kaugnayan ng sangkatauhan sa kalawakan, sa kalikasan, sa kanyang kapwa at sa kanyang sariling katawan, kaisipan, kalooban at kaluluwa ay naputol and hindi naisa-ayos muli, ang tao ay magkakaroon ng kasakitan, kalungkutan at kamatayan.

(J.Z. Galvez Tan mula sa mga panayam sa daang-daang katutubong manggagamot sa Pilipinas 1975-2005)

World View of Health in Filipino Traditional Medicine - 2

Theory of nature elements

fire (kalikasan ng apoy) earth (kalikasan ng lupa) water (kalikasan ng tubig) air (kalikasan ng hangin) Init (hot) and lamig (cold) Wet (basa) at Dry (tuyo)

Theory of body humours

Belief in nature spirits/guardians of nature and spirit ancestors

World View of Health in Filipino Traditional Medicine - 4

Theory of hot and cold (init at lamig) and wet and dry, and nature elements applied in:

food classification inorganic elements classification disease classification treatment of illnesses

World View of Health in Filipino Traditional Medicine - 5

The Theory of balance, synergy and harmony

Defines health and wellness, illness and disease To maintain health and wellness, there must be harmony with the Universal Spirit, with nature and the environment - seen and unseen, with families, friends, co-workers, neighbours and communities, with ancestral spirits, with the body humours, human energies, body, mind and spirit.

Mainstreaming the Filipino Concepts of Health, Well-Being, Wellness and Illness with Conventional Medicine

Conventional Medicine (Bio- Medicine) Definition circa 1878-1978

Health is the absence of disease. Biomedicine is Disease-oriented; Understanding the person physically (anatomy, histology, biochemistry, physiology, pathology etc) The Medical / Conventional Model measuring health by counting cases of diseases in populations by incidence, prevalence, morbidity and mortality.

W.H.O. Definition 1978

W.H.O. Definition of Health: It is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity

Integrative or Holistic Medicine

Health and wellness is the state of complete physical, mental, social, spiritual, emotional and environmental well-being. Quality of life and quality of daily living is primordial. It is the fusion of the best of Asian and Filipino Traditional Medicine with the best of North American and European Medicine

Six Dimensions of Health, Wellness and Well-Being

Spiritual

Emotional

Physical

Social

Mental

Environmental

Six Dimensions of Health, Wellness and Well-Being

Soul

Heart

Body

Hands Feet

Mind

Six Dimensions of National and Global Health, Wellness and WellBeing

Cultural Political

Economic

Social Environmental

Security

Other Traditional Filipino Medicine Concepts

Causes of Illnesses in Filipino Traditional Medicine 1

Concept of Hangin (wind) whether present in food, environment and within the body Concept of Bara(energy block) Concept of Pilay(misalignment of energy channels) Concept of Pasma (musculoskeletal syndrome due to imbalance of hot and cold) Concept of Hilo (Poison) Effects of seasons, habitat, diet, way of life, days of the week

Causes of Illnesses in Filipino Traditional Medicine 2

Nabalis, nabuyagan, nabati (transfer of energy from one person to another) Nakulam, nabarang (transfer of negative energies from one person to another) Nagayuma (increase of sexual attraction/energy) Nasapian (spirit possession)

Causes of Illnesses in Filipino Traditional Medicine 3

Nanuno (a person who disturbed nature spirits/nature guardians) Nagalit ang mga ninuno (a person who violated the norms of ancestors/ancestral spirits) Binangungot (sudden nocturnal death syndrome) Nabinat o nabughat (a person who has just undergone severe psychoemotional physical stress and immediately goes back to normal daily activities thus provoking a return to his previous pathologic state)

Therapies in Filipino Traditional Medicine - 1

Herbal medicine Animal medicine Mineral medicine Hilot - the Filipino traditional massage bentosa or cupping Food or animal offerings Prayers and oracion

Therapies in Filipino Traditional Medicine - 2

oslob or fumigation or steam inhalation with healing herbs Bathing practices Kurot or pinching laway or use of saliva Skin abrasions through coins or wood sticks Psychic healing Psychic surgery Angel healing

Diagnostic Tools in Filipino Traditional Medicine

Pulse diagnosis (pamulso) Use of external diagnostic tools: tawas, eggs, bottles, dahon ng saging,papel Use of animal sacrifices Use of hilot (palpation with massage) Laying of the hands Reading of aura

Prevention in Filipino Traditional Medicine

Anting-anting or amulets Habak tied around the waist or wrist, panagang sa buyag Use of garlic or bawang Use of lana or coconut oil Prayers and offerings Doing good to one another

Other Concepts and Practices in Filipino Traditional Medicine

Concept of hiyang Ethical code among arbolaryos Panata or tulumanon during the Holy Week and Season of Lent

Similarities and Differences between Conventional and Traditional Medicine

Nomenclatures: West vs. East

Western Modern Scientific Biomedicine Cosmopolitan Conventional Euro-North American

Eastern/Oriental Traditional Indigenous Biopsychosocial Complimentary Alternative Asian/Filipino

Similarities

Presence of specialists Effective Healing practices work Some practices are harmful

Differences - 1
Traditional

Conventional

Treats the whole person body, mind, spirit, family, community and social relations Individualized treatment Personalized (TLC)

Treats the disease Formula orde cahon treatment Impersonal

Differences - 2
Traditional Involved, close and intense relationship between patient and healer Readily available and affordable Conventional Detached and unemotional relationship Expensive and not within reach

Differences - 3
Traditional Familiar fits with customs and traditions Fosters selfreliance Conventional Strange, contrary to customs and traditions Dependent on doctors and hospitals

Disadvantages of Traditional Medicine

Lack of precision and standardization in dosage and preparation Need for standardization of techniques Need for refinement of experimental and instrumentation methods Mixed with superstitions Wanting in sterile techniques

Nomenclature of Integration
Integrative medicine Integrated medicine Eclectic medicine North-South medicine Wholistic medicine

Why Filipino Traditional Medicine and Integrative Medicine and Complementary Medicine in Medical and Health Sciences Education?

Why Study Filipino Traditional Medicine? #1

Cultural and ethnolinguistic competency of the Filipino Physicians, Nurses, Dentists and other Health Professionals W.H.O. recommendation of integration of Traditional Medicine in Medical and Health Sciences Education and Primary Health Care since 1978 World Health Assembly resolutions since 1981 called upon member-states to integrate Traditional Medicine in their health care systems

Why Study Filipino Traditional Medicine? #2

Filipino Physicians and Filipino Health Professionals who manifest the rich heritage, self-respect and uniquely Filipino character and identity of more than thousand year old healing traditions of our country, are truly able to express the genuine Filipino soul in their health care practice

Why Study Filipino Traditional Medicine? #3

Philippine government policies and laws supportive through the Philippine Institute of Traditional and Alternative Health Care
(PITAHC, Republic Act 8433, 1997)

Patients already inquiring if not requesting their physicians and health care professionals for complementary and alternative medicine

Why Integrative and Complementary Medicine in the Medical and Health Sciences Curricula?

Evidence Based Medicine already being applied in Complimentary and Alternative Medicine

NIH Bethesda actively promoting through the National Center for Complementary and Alternative Medicine North American, European and Asian Medical and Health Sciences Schools already incorporating Integrative Medicine and Complementary and Alternative Medicine

Challenges

Research Agenda in Filipino Traditional Medicine

Generation of Research Questions Development of Research Protocols Herbal medicine research Animal and mineral medicine research Inventory/survey of Filipino healers Bottom-up Code of Ethics or Standards of Practice

Challenges to the Research Community

1. Majority of Philippine medicinal plants with
centuries of ethnomedical history, remain untapped. 2. Evidence supporting Philippine traditional medicine practices is still in the early developmental stage and its potential has not been fully explored. 3. Lack of collaboration among research institutions, private sector and academe

More Challenges to the Research Community

4.Lack of investments in research and development, raw material production, post harvest processing and herbal manufacturing. 5.Low level of scientific technology in herbal medicine research and manufacture among small and medium enterprises. 6. Low support for traditional medicine research in the academic community.

More Challenges to the Research Community

7. Need for market and government incentives like the ones given to rice, corn, coconut, sugar, bananas, pineapples and mangoes. 8. Need for standardized procedures/ accreditation/recognition in Filipino traditional medicine practices.

Philippines - The Heart of Asia

Philippines - Islands of Wellness and the Center of Health and Wellness in Asia Philippines - The Global Capital for Tropical Medicinal Plants The Filipino Hilot Traditional Massage - a brand name in all spas of the world in the next 5 years Philippine Health Care - the Best of Asia with the Best of Europe and North America

The Future of Integrative Medicine in the Philippines

The Future is Good! The Future is Great!

MEDICINAL FRUITS & VEGETABLES

Jaime Z. Galvez Tan, MD, MPH Ma. Rebecca Marana-Galvez Tan, MAN, RN

Medicinal Fruits and Vegetables features 60 of the common fruits and vegetables available in the Philippines. Information on each fruit and vegetable includes the following: botanical family scientific name, other names in different dialects and language traditional uses research findings food values recommended medicinal use botanical and agricultural characteristics There are easy-to-follow instructions on how to prepare medicinal plants in ones home using methods such as decoction, infusion, and extraction among others. The book also presents the nutritional content of fruits and vegetables that serves as a guide to the ordinary person.

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Maraming Salamat Po! Thank You Very Much!

Jaime Z. Galvez Tan M.D., M.P.H. Mobile: 0928 507 4479 E-mail: jzgalveztan@gmail.com