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I. Introduction

As defined by World Health Organization (WHO), it is a "State of complete physical, mental, and
social wellbeing, and not merely the absence of disease or infirmity.” (Business Dictionary, 2018).
This WHO definition has been subject to controversy, as it may have limited value for
implementation (Wikipedia, 2018). Health is very important to us because it is one of the factors
that are needed to make an individual work properly and be able to do things appropriately. “Health
is wealth.” Making one’s health and wellbeing a priority is one of the signs that shows that a person
has a healthy lifestyle. It is a choice made by an individual, a commitment made for his own food
and that of his loved ones (Callo and Dajime, 2016).

The whole topic covers on the health systems, specifically in the Philippines. Health and health
systems are seen as a product of human experience. Body, nature and relations are involved in this
topic. The template that can be a playground for social forces and cultural practices is the body
(Contreras, Dela Cruz, Erasga, Fadrigon, 2016).

Under health systems are, sociology of health and illness, the health system in the Philippines, the
cultural constructs of health and their Filipino attributions, Filipino systems if diagnosis,
prevention, healing and health promotion, Filipino theories of illness, cultural health actors, and
health as a human right (Contreras, Dela Cruz, Erasga, Fadrigon, 2016). This written report also
tackles the issue of health as a human right and emphasizes its political facet.

In this written report, you will learn that you have your right to a proper healthcare. There are lots
of agencies related to healthcare wherein they are tasked to ensure that the people gets the health
care that they need without experiencing anything that can make them feel an outcast.

As you go through this report, you will learn the different beliefs of Filipinos and how culture
affects our illnesses and how society interacts with our health.
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II. Sociology of Health and Illness

Sociology of Health and Illness is the study of the interaction between society and health.
Particularly, the sociologists reviews how social life impacts morbidity and mortality rates and
shows how morbidity and mortality rates impacts society. The sociology of health and illness
covers the causes of disease and illness, reasons for seeking particular types of medical aid and
patient compliance or non-compliance. Sociologists found out that the spreading of diseases are
caused by the socioeconomic status of individuals, ethnic traditions and beliefs and other factors
that are related to culture. According to the research, health is attributed to biological or natural
conditions. The topic requires a global approach of analysis because the influence of societal
factors varies throughout the world (Crossman, 2017).

There are different views on diseases because there are different societies here in the world. For
example, HIV/AIDS, for some people, HIV/AIDS is a big deal wherein they think that it should
be cured immediately because a lot of them are prone to HIV/AIDS but for other societies, it
doesn’t really matter because it only affected a small percentage of their population. The sociology
of health and illness aims to explore the changes of diseases and illness as time goes by. There are
lot of studies that shows the different causes of illness. It may be a scientific belief or a superstitious
belief. According to the “father of medicine”, disease is the result of a person’s lifestyle habits
and the social environment in which they lived but for medical practitioners, diseases are caused
by infections, bacteria and viruses (Macionis, 2014).

According to the research, diseases and illnesses can be cured in two different ways, religiously or
scientifically. Diseases can be cured with the help of medicine, a social institution responsible for
treating disease and restoring the health of population. For some cultures, they believe in “humoral
medicine” which states that the body has four humours. The phlegm, blood, black bile, and yellow
bile. It was believed that these four liquids, or "humours," were related to health and balance in
the body. It was only when all four humours were in line that a person was healthy. It was also
believed that a person's personality was determined by their natural balance of humours. Each
humour related to a season, an element, an organ a quality, certain personality traits, and health.
(Holleran, 2018)
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III. Health Systems in the Philippines

In the Philippines, the health delivery system is headed by the Department of Health (DOH)
wherein they are considered as the regulatory authority. They are the ones who develop national
plans, technical standards and healthcare guidelines for all Filipinos. Aside from that, we have the
Local Government Units (LGUs) and other private sector agencies who acts as a helper or
apprentice. The Center for Health Department (CHD) is scattered in strategic areas of the country
and the Rural Health Units exist in municipalities in order to improve the access to health care
(Contreras, Dela Cruz, Erasga, Fadrigon, 2016).

According to the research, the Philippines has experienced dramatic changes for the past 20 years
because the government has established a variety of plans and policies to ensure that every Filipino
is provided with an easy access to health benefits (Depasupil, 2018).

Most hospitals provide efficient and affordable health services. However, the facilities are different
from the high-end hospitals. The equipment used in public hospitals are sometimes lacking.
Therefore, private hospitals in the country have better facilities than the public hospitals. If the
people will look at the bigger picture, a lot of people are aiming for private hospitals because they
see private hospitals as a hospital who assures the patient to get a high quality service. That is one
of the reason why there is an increase of mortality rare in rural areas because they lack of health
cares and the health care providers and health educators gives more attention to urban areas
(Depasupil, 2018).

IV. Cultural Constructs of Health and the Filipino Attributions of Illness

Culture is defined as the “totality of socially transmitted pattern of thoughts, values, meanings and
beliefs” (Purnell, 2005). In different cultures, they have various ways to explain the reasons behind
diseases and illnesses. Cultures around the world has different classification of illness. Thus,
illness is not just about the biological and medical conditions but can also be culture specific. The
Philippines is one of the best example because it has a set of language that is related to health and
illness. Some reflections of the nuances are “may nararamdaman ka”, “masama ang pakiramdam,
sakit ng katawan”. “May nararamdaman ka” is a sort of diagnosis which means “Do you feel
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anything?” The second one states that something bad happened to the body, either inside or ouside
(Contreras, Dela Cruz, Erasga, Fadrigon, 2016)

Aside from that, the Filipinos have their own culture – they have a specific syndrome and
attribution on illness called the usog and bughat. In revisiting usog, pasma and kulam, Tan explains
that “culture is inscribed in our bodies and in our minds.” (Tan, 2008)

Usog is a Filipino belief wherein the discomfort is brought by a stranger or a visitor who is believed
to have an evil eye and brings a bad atmosphere while bughat is a term that refers to ailments like
headache, dizziness, body pains, chills and muscle weakness (Contreras, Dela Cruz, Erasga,
Fadrigon, 2017).

There are seven Filipino cultural belief that is presented here in the report – namamana, lihi,
sumpa, gaba, pasma, namamaligno and kaloob ng Diyos (Abad, 2013)

An introduction is used for each of the cultural beliefs to further illustrate its concepts. When
compared with the worldview of the Philippines’ indigenous people, these common cultural beliefs
may not necessarily be the same (Baluyot, 2014).

Here are the following Filipino Cultural Beliefs:

 Namamana is the Filipino language translation of acquiring a behavioural or disease

trait from a parent. Gamboa explained that “the concept of namamana is not limited
only to the occurrence of cleft lip with or without cleft palate.” (Gamboa, 2010)
 Lihi is a concept used to explain why some children noted to have a certain specific
characteristics. According to Jocano, “an ethnographic study done in a municipality in
the Philippines referred to Lihi as a term for conception.” (Jocano, 1973). During the
lihi period, the pregnant women experiences a number of physical discomforts,
including feeling of dizziness, nausea, irritability and general weakening of the body
(Jocano, 1973).
 The basis of the Pasma concept is the interaction of hot and cold (Tan, 2008). It occurs
when a condition considered to be “hot” is attacked by a cold element and vice versa.
That is why it is roughly defined as an “exposure illness.” (Tan, 2008)
 Sumpa and Gaba is a Filipino cultural beliefs pertaining to a curse. In Sumpa, the
human beings are the ones who inflicts the curse, while in Gaba, the curse is inflicted
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by a divine being and it is usually God (Villa, 2014). The Sumpa and Gaba has a great
impact because the whole family shares with it and it extends to the next generation
(Tan, 2008).
 Namamaligno is a belief wherein the intervention of a supernatural or a mystical being
causes the disease to happen (Abad, 2013)
 Kaloob ng Diyos is defined as God’s will. It states that the event is typically attributed
to the grace of God when Filipinos experiences an unexpected event in their life,
whether it is negative or positive (Aldemita, 2014).

V. Filipino Systems of Diagnosis Prevention, Healing and Health Promotion

The Filipino beliefs are oriented toward protection of the body when it comes to health and
promotion and treatment concepts (Contreras, Dela Cruz, Erasga, Fadrigon, 2016). There are three
metaphoric ways of protecting the body – flushing, heating and protecting. For the Filipinos, it
was believed that the body is a vessel or container which can collect bad things or impurities. Thus,
the body can be polluted but because of the three metaphoric ways, these impurities can be
cleansed. They can be cleansed by vitalizing physiological events like sweating, vomiting,
expelling gas or menstruation (Contreras, Dela Cruz, Erasga, Fadrigon, 2016).

By releasing toxics out of our body, we get to cleanse it and make sure that the collected impurities
are out and we get to protect our body with the general procedure that acts to guard the body and
keeping it covere (Contreras, Dela Cruz, Erasga, Fadrigon, 2016).

Filipinos already got used to believing in superstitious belief. In some culture, when you are not
feeling well, you were cursed by someone or you passed by on a spirit that is why they created the
metaphoric ways because they were thinking that it is the only way to remove the impurities in our
body and to cure our illness but for some medical practitioners, there are medicines associated
with these kind of illnesses.
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VI. Health Beliefs and Behaviours

The principle of balance is the characterization of the Filipino Indigenous Health Beliefs
(Contreras, Dela Cruz, Erasga, Fadrigon, 2016). Hot and cold is a range of beliefs wherein the
balance is noticeably anchored. The following are the beliefs concerning to humoral balances
(Conteras, Dela Cruz, Erasaga, Fadrigon, 2016):

1. Shifting from hot to cold may lead to illness.

2. One of the ways to maintain an optimal health is having a warm environment.
3. There are foods that should be avoided in the morning: Cold drinks or foods.
4. A body that is over heated is vulnerable and shocks are generated when heated muscles or
body suddenly cools.
5. They prefer to maintain the layer of fat warm and protect the vital energy of the body.
6. Quality and balance relates to heating and cooling.
7. Changes in weather patterns may upset the body.

According to the research, “Filipino older adults tend to cope with illness with the help of family
and friends, and by faith in God.” As we all know, we Filipinos tend to ask help from our friends
and relatives thinking that they are the ones who can truly heal us. Most importantly, we always
strengthen our faith in God because we believe that the Almighty is always there and He will never
leave us even during the toughest times.

Filipino families tend to do their own research first before going to professional health cares. They
are usually the ones who makes a way to find out what disease they are encountering. Before they
seek for medical advice, they make sure that they manage themselves first (Geriatrics, 2018).
Seeking medical advice from our relatives who are professional in the field of medicine has also
become part of our culture (Anderson, 1983).

Along with how families response to illness, we also have the coping styles that are known to
Elderly Filipino Americans when they encounter illness or crisis (Geatrics, 2018). The following
are:

 Having patience and enduring uncertain situations.

 Being regardful and avoiding fraud.
 Being able to laugh even though things are getting complicated.
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 Believing that everything happens for a reason and that these challenges are inevitable.
 Maintaining unity and having group harmony.

Aside from that, there are also responses to mental illness and the common perceptions of Filipino
about Mental Illness. There are indigenous traits that are common among elderly Filipino
Americans when they face illnesses that are related to mental health conditions (Geatrics, 2018).
The following are:

 Ravage embarrassment
 Acuteness to criticism

The common perceptions of Filipino about Mental Illness are the following (Geatrics 2018):

 The fear of getting mocked and not accepting the fact of having a mental illness can lead
to avoidance of needed mental health services.
 Mental health services are not culturally oriented and it is lacking.
 Limiting the access to mental health awareness could actually lead to having a limited
knowledge on it too.
 Mental health services doesn’t get that much attention because they are prioritizing
financial and environmental needs.
 During usual hours, it’s arduous to utilize mental health services because of the
unavailability of working adult members.

Learning all these can help every individual cope and response with different illnesses.

VII. Filipino Theories of Illness

Explanatory models are used to further explain the theories of illnesses. Physical and mental health
and illnesses are seen holistically as an equilibrium model. Explanatory models includes: mystical
causes, personalitic causes, and viral/bacterial causes (Anderson, 1983; Tan, 1987; Tompar-Tiu &
Sustento-Seneriches, 1995). The following are:

1. Mystical Causes are often associated with awareness, experience and behaviours. Other
people believes that our soul goes out of our body and wanders. This is known as
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bangungot (Contreras, Dela Cruz, Erasga, Fadrigan, 2016). According to some research,
bangungot is caused by physiological occurrence, sleep apnea, asphyxia and acute
pancreatitis (Uratex, 2018). On other studies, Bangungot or nightmares after eating may
result to death (Contreras, Dela Cruz, Erasga, Fadrigan, 2016).
2. Personalistic Causes are often associated with social punishments by supernatural beings
like evil spirits, witch or mangkukulam (Contreras, Dela Cruz, Erasga, Fadrigoan, 2016).
To protect yourself from this sorcery, you have to have a strong faith in God and develop
a stronger spirit. When the forces are jealous or they dislike a person, they tend to cast a
spell on them to satisfy their own selves. Witch doctors and priests are the ones who makes
sure that the evil forces that was casted can be stopped. They do this through the help of
prayers, incantations, medical herbs and plants (Contreras, Dela Cruz, Erasga, Fadrigan,
2016).
3. Naturalistic Causes are associated with nature events like thunders, lightning, drafts, etc.
Naturalistic causes may also be caused by excessive stress incompatible food and drugs,
infection or familial susceptibility (Contreras, Dela Cruz, Erasga, Fadrigan, 2016).
Basically, the concept of health and illness is about prevention and restoring. Prevention
means avoiding behaviours that could lead to imbalance and developing impurities.
Restoring, on the other hand, is curing and getting back the energy (Contreras, Dela Cruz,
Erasga, Fadrigan, 2016).
4. Bacterial/Viral Causes are associated with the power of science. As we all know, many
people are already swayed by science. For them, the common reasons for getting diseases
or illnesses are because of the bacteria and infections in our body.

VIII. Cultural Health Actors

Flushing, heating and protecting are part of the activities that a cultural health actor
performs. Cultural healers are the ones who help to protect the body and treat it differently.
They treat the body supernaturally and they use herbal medicines to cure illnesses. The
hierarchy of the cultural healers can be categorized in their own right (Contreras, Dela
Cruz, Erasga, Fadrigan, 2016). The following are:
1. Albularyo also known as a general practitioner for they are knowledgeable in most of the
folkloric modalities and usually versed in the use of medicinal herbs (Contreras, Dela Cruz,
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Erasga, Fadrigan, 2016). Albularyos are commonly seen in rural areas and they are the
ones who are usually called when something bad happens like: na-nuno, na-dwende and
na lamang-lupa (Stuart, 2014)
2. Hilot refers to magpapaanak and manghihilot. Most hilots, as we all know, does not
undergo a formal education and training (Stuart, 2014). That is one of the reasons why a
lot of people are hesistant to go to manghihilot because they afraid that they might get
injured or because of the pain that they will endure. Mostly the skills that the manghihilot
ang magpapaanak gets are hand-me-down skills (Stuart, 2014).
3. Mangluluop are the one who diagnose the patient before they go to albularyo or
manghihilot. They are the ones who guides the patient where to go and what they really
need (Contreras, Dela Cruz, Erasga, Fadrigan, 2016).
4. Medico is a hybrid because it has crossovers if the different folkloric modalities.

These cultural health actors consider themselves as someone who are gifted and equipped with
skills of healing people without the help of education. They think they are gifted because they are
called by “God” or some supernatural being. Their healing procedures are associated with prayers
because they believe that prayer is your strongest weapon through thick and thin. They are always
seen in rural areas but there are some cultural health actors who’s living here in the Philippines.

IX. Health as Human Right

“The human right to health means that everyone has the right to the highest attainable
standard of physical and mental health, which includes access to all medical services,
sanitation, adequate food, decent housing, healthy working conditions and a clean
environment.” (Nesri Org, 2018).

Specifically, the human right to health covers every human being to the following:

 Every human being is guaranteed with protection.

 Everyone human being has their right to choose the life they want to live because
they have the right to have a living conditions that enables them to become
healthy.
 As a public good for all, health is provided finance, publicly and equitably.
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The design of health care system must be guided with the following key human rights standards
(Nesri Org, 2018):

 Universal Access – Health care must be guaranteed to everyone and it should be affordable
and comprehensive for every human being in this word.
 Availability – There should be an enough facilities and health care infrastructures available
in every community.
 Acceptability and Dignity – Respect should be every health care institutions and providers
foundation. They need to learn the concept of medical ethics and protect confidentiality.

There are also principle procedures entailed by the human right to health wherein it applies to all
human rights (Nesri Org, 2018). The following are:

 Non-discrimination – Anyone should have an access to health care and provided with the
proper services without any discrimination. Whatever status, culture, society language,
disability, income or sexuality do you have, you have the right to have an access to health
care.
 Transparency – In order to protect the health of the people and for them to be able to
claim quality services, health information must be easily accessible for everyone.
 Participation – The people in the community must participate in any implementations of
health care services.
 Accountability – The ones who are held accountable for protecting the right to health care
are the private companies and public agencies. They can protect through enforceable
standards, regulations and independent compliance monitoring.

Access to all medical services, sanitation, adequate food, decent housing, healthy working
conditions and a clean environment are some of the goals of every health care providers. Erasga,
Fadrigan, 2016).

X. Conclusions and recommendations

Health is very important for us Filipinos. In every community, we always believe that
something and someone can help us. We have different professionals who can help us take
care of our health. We learn that getting diseases are not just because off bacteria and viruses
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but it may also be from our genes and from creatures that are different from us. There is an
interaction between culture, health and society because our health may depend on the people
whom we are with, the society that we live in and the culture that we acquire. Lastly, every
individual has the right to receive a proper healthcare. We all have the right to ensure that we
get the health care that we need. Always remember that you are a human being and you should
not limit yourself on getting the health care that you need. Sociology of health and illness
helped us learn that social life has an impact on morbidity and mortality rates and vice versa.
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