This study examines the convergence and divergence of traditional and professional health systems among the B’laan communities in the municipality of Sarangani in the context of their child health care services. The B’laan is an indigenous tribe living in the southern island of Mindanao, in the Philippines.
Background of the Study
The Alma Ata Declaration in 1978 enunciated health as a basic human right. This reserves the right of individuals to access the highest attainable standard of health through the provision of basic health and social services. Specifically, the principle has defi ned access to health care as the affordability, accessibility, availability, and cultural acceptability of health care services amongst peoples across cultures. It also identifi ed the roles of governments, non-government organizations (NGOs), and international institutions in providing the health care needs to achieve a better health for all. This international pact also identified the basic elements of health that are vital to the management and provision of services to the people.
The Department of Health (DOH) reported that the most common diseases among children in the indigenous communities are curable but are not given adequate attention because of the social and cultural factors. Such factors present several challenges in the formulation of policies and programs to address the health care needs of indigenous children. Quite a number of health models have already been pushed forward; one of which is the integration of the modern or professional and the traditional or indigenous health care systems in the Philippines.
Integration of Traditional and Professional Health System
Bodekar (1994) introduced four main ways which traditional medicine has interfaced with modern medicine. These are: (1) Monopolistic – modern medical doctors have the sole right to practice medicine; (2) Tolerant – traditional medical practitioners are not officially recognized but are free to practice on the condition that they do not claim to be registered medical doctors; (3)Parallel – practitioners of both modern and traditional systems are offi cially recognized. They serve their patients through equal but separate systems; and (4) Integrated – modern and traditional medicine merged in medical education and jointly practiced within a unique service.
In the late 1990s, policy interest in traditional approaches to health care has led to a resurgence of interest, investment, and program development in many developing countries, (Bodekar, 1994). In fact, there are already 14 countries and areas in the region that have developed offi cial government documents that recognize traditional medicine and its practice. This is a welcome development since a decade ago, only four countries (China, Japan, the Republic of Korea and Vietnam) have done so. In the Philippines, the “Traditional and Alternative Medicine Act” was signed in 1997. It states that it is the policy of the State to improve the quality and delivery of
health care services to the Filipino people through the development of traditional and alternative health care and its integration into the national health care delivery system. The act also created the Philippine Institute of Traditional and Alternative Health Care to accelerate the development of traditional and alternative health care in the Philippines (World Health Organization, 2002).
Similarities and Differences in B’laan Health Care System
B’laan mothers view traditional and professional health system as a separate entity; each with its own ways and methods to identify and cure diseases. Both traditional and professional child health care services, however, are relatively accessible and are recognized among their communities. Such fi nding has been corroborated by WHO (2002) which claimed that the traditional health systems in the world are either recognized, supported, integrated or neglected in the mainstream health services.
In contrast, the professional health system is given more credence. Thus far, integration of the traditional and professional health systems has not been formally
recognized in the local government. Lack of support from the local and regional governmental level either impinges or disrupts the process of integrating both systems. In this study, convergence is examined in the light of the B’laan mothers’ perceptions.
In terms of the provision of services and/or service delivery system, findings also showed that both the traditional and the modern health care systems offer preventive and curative measures to address health problems accordingly using its own method and regimens. As such, it can be concluded that a convergence has been reached when it comes to this aspect. Curative nature of the traditional health care involves the provision of herbal medicine through ‘tayhop’ and hilot.
Preventive medicine is practiced through the provision of ‘anting-anting’ or special amulets to prevent untoward attacks from supernatural forces or evil spirits, as well as from witchcrafts. In the professional or modern health system, the curative care revolves around the provision of modern drugs while its preventive counterpart focuses on the free provision of immunization and vaccines.
Furthermore, the B’laan’s traditional health care system is characterized by its simple and informal nature. It is not time-bounded as compared to the professional health system where a system or a protocol has to be followed in the provision of services such as service providers’ specifi c work schedule and immobile work areas.
However, both systems of health care are seen in the context of which is best needed in a specific situation and which can offer immediate remedy.
Similarities and Differences in Concept of Health and Illness
B’laans view their children’s illness as caused either by sudden climate changes and by supernatural beings, or by dirty environment. As discussed by Tan (in Palaganas et al, 2001), using personalistic theories, people assume that illnesses are caused by a supernatural being or a non-human called witch. Similarly, results of this study indicated that the B’laan community still adheres to this mystical belief of supernaturalism. In addition, the hotcold paradigm is also very prevalent in the community of B’laans, which according to them, the sudden changes in the climate and incorrect transition from hot to cold temperature can cause illnesses in the children (Jimenez et al. 1999; Palaganas et al., 2001).
However, even with this perceived infl uence, B’laan mothers still see the traditional and professional health system as an integral part of their daily survival. Findings show that traditional health system serves as an alternative to the professional health system when it fails to address the mothers’ child health concerns and vice-versa. As Hammond (1994) argued, the utilization of indigenous healing methods appears rather to be a product of a perceived failure on the part of biomedicine to adequately identify and treat certain illnesses.
Conclusions
Generally, there is still an existence of divergence between the traditional and professional health systems and that there are signifi cant factors that sustain these differences. The convergence in the B’laan child health care system is demonstrated specifi cally with the presence of health and service providers in both health systems (as previously presented in the two tables ). Each system has its counterpart with that of the other. The traditional healers are seen in the same way as the medical professionals such as the nurses, midwives and other health workers. Divergence is more observed when it comes to service provision and the nature on how
respondents/patients avail of the services provided by both systems. Convergence is somehow demonstrated in their concept of health while divergence is more seen in the Blaan mother’s concept of illness.
Condensed by Katha Berza from the original study “Convergence/Divergence Between Traditional and Professional Health Care System: Case of B’laan Communities in Davao del Sur” by Anderson V. Villa, MA, MHSS, Social Science and Education Division, College of Arts and Sciences, Ateneo de Davao University, Philippines.
This article was published in Health Alert Asia Pacific newsletter (Issue 15) by HAIN. For copies of the newsletter, please write to hain@hain.org
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