Tuesday, October 12, 2010

Youngblood: Doctors and 'hilots'

by Gideon Lasco

(Note: This essay was published in Inquirer's 'Youngblood' column on October 12, 2010)

THE SEARCH for cures is one of the most important struggles of man. We have always endeavored to find ways to treat the illnesses afflicting humankind, be they biological, social, political or spiritual. We look up to doctors because they hold the promise of a cure. However, even before the arrival of Western medicine, our people already had their own ways of dealing with health problems. This collective experience combined with present-day medical science shapes the way we deal with our health.For our community immersion, my blockmates at the University of the Philippines College of Medicine and I spent six weeks in San Juan, Batangas. We served as doctors of the barangays, conducting clinics, paying home visits and assisting in their programs. More significantly, we lived with the people. We were assigned to live with “Nanay Nelly,” a senior citizen who ran a sari-sari store.

At the Philippine General Hospital, we see patients in the Outpatient Department by the hundreds, and it becomes a daily struggle to attend to all of them. But in Barangay Pinagbayanan, where we only had a few patients daily, we had more time to know our patients better. So we probed deeper into their health practices. They shared, and we listened.

Asked, for instance, why they do not go at once to hospitals for treatment, they said: “Of course, we want to go to the hospital. But what if we cannot afford it? Where will we go?”

Since lack of money is often the rule more than the exception among people needing medical attention, hilots provide an alternative. They charge P20 to P50 per consultation—and the service comes free if the patient is really poor. These hilots may not be always able to cure, and indeed we see many patients in the end-stage of serious ailments after relying on hilots for too long, but they at least offer some hope for many of our countrymen. Being part of the community, these hilots treat their patients with a compassion that sometimes cannot be found in the cold, clinical setting of modern-day hospitals.

We also encountered beliefs which are irreconcilable with modern science but which people strongly hold to this day. For instance, Dr. Jose Rizal wrote that the leading causes of illness in the Philippines are “winds, vapors and rain,” and to this day this thinking is very much alive in the community. One patient who had a skin disease he believed to have acquired during a flood refused an ointment, arguing that a “wet” ailment cannot be cured by another wet substance. As a compromise, we prescribed Amoxicillin, which proved equally effective.

Our group welcomed such encounters because they helped us understand better the attitudes of our patients at the PGH, many of whom come from the provinces.

One day, on my way to San Juan after a short visit to my hometown of San Pablo, Laguna, I dozed off in the bus. When I woke up and stood up, I felt a stabbing pain shoot up from my lower back.
When I arrived at Nanay Nelly’s house, I shared my problem with everyone. She suggested that I consult a hilot who happened to be making the “rounds” at the time. (Just like physicians who make daily rounds of hospitals, hilots pay visits to patients in their communities to see how they are doing.) She proceeded to tell me stories of successful cures done by this particular hilot, including the usual tale about someone getting well in her hands after being diagnosed with terminal cancer by his doctor. Seeing it as an opportunity to deepen my immersion experience, and wishing that indeed I would get some relief from the pain, I welcomed Nanay Nelly’s suggestion.

The hilot was initially reluctant to examine me when she heard that I was a doctor. “Surely you have better drugs for this!” her face told me. But when I told her I was really in pain and needed help, she seemed to settle down.

She began by asking me when and how I got the pain and to describe how severe it was and its quality. Then she examined my lower back, palpating my spine. After a while I saw her nodding her head, apparently arriving at her diagnosis.

She proceeded to massage my back with native oil. And then she took out a plaster, wrote some words in it, and patched it on my back. When I asked what she wrote on the plaster, she said they were Latin words: “SATOR AREPO TENET OPERA ROTAS.” I noted that the words formed a palindrome much like those in Dan Brown novels.

Immediately I felt a soothing sensation, probably because the plaster contained menthol. I thanked the hilot and promised that I would keep the plaster in place until I felt better, in accordance with her instructions.

And just as doctors don’t charge their colleagues, the hilot refused my offer of payment. “Maybe next week it would be my turn to consult you,” she said with a smile.

Later that day, I was feeling better; the pain was almost gone. When I told one of my batchmates about it, he wondered whether the cure was for real or it was merely another demonstration of the placebo effect.

But what is real and who can say for sure? Belief being subjective and experience-based, it is a personal choice. I could attribute my healing to inevitability (“it will heal by itself”), to the therapy (either working through scientifically explainable or mystical phenomena), to God (working by His sheer power or through circumstance which could include any of the above) or even to myself (the power of positive thinking). Or maybe a combination of all of these. But whatever the case may be, I definitely learned a great deal from the hilot and the community.

The experience made me realize that if we could learn from hilots, albularyos and other healers, we can develop a universal, holistic, culturally acceptable health care system in the Philippines.

Gideon Lasco, 24, is a graduate of the UP College of Medicine. He passed the board exams last August and is currently a resident physician at the San Pablo Doctors’ Hospital in Laguna.

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