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HEALTH PRACTICES AND BELIEFS AMONGSOME ETHNIC GROUPS IN BENGUET

Ericson J. Yang-ed, BSPT, PTRP, MAT SPED Elizabeth S. Samaniego, BSN, RN, MAN Josephine G. Minger, BSN, RN, BSED, MAN

ABSTRACT The main aim of the study is to determine the health practices and beliefs among some ethnic groups in the province of Benguet; considering some aspects of health, such as health practices, health conditions as well as health remedies, causes of human discomforts and health needs. Descriptive-survey was the research. There were 255 respondents of the study who belong to the Kankana-ey, Ibaloi, Ifugao, Kalinga, and other tribes. Findings revealed that the respondents rarely consult doctors, nurses, and other health workers concerning health practices and conditions. They believe that the causes of human discomforts are natural and climactic factors, spirits, and even modern scientific findings on the harmful effects of virus and bacteria. There is a felt need for more doctors, nurses, and other health workers in the communities inhabited by the ethnic groups.

I. INTRODUCTION
The maxim "health is wealth is popular among Filipinos. Filipinos assert that for as long as a person is in good health, he or she can bravely overcome seemingly insurmountable odds. With religious fervor, many of us believe that health is a blessing, a grace that comes from faith in the Divine. That is why seeking medical attention is usually interspersed with the healing power of prayer or an invocation to a patron saint. Filipinos, especially the rural folk, have different explanations for illness. Humans and the environment or nature are often viewed as being in need of equilibrium, thus the hot and cold syndrome in which an illness is thought to be due to the imbalance between the two. Another belief points to the supernatural beings or spirits as causes of illnesses. For these kinds of illnesses, it is not the medical doctors that the people would approach but the herbolarios. Health care professionals play a major role in the treatment of individuals who are in dire need of medical attention. In the rural areas though, traditional healers play an important role in the well-being of Filipinos. They offer alternative ways to treat illnesses and to promote good health and wellness. As stated by Tan (1987), to treat pilay sa hangin or sprains, many Filipinos in the rural areas resort to herbolarios and the hilot

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pilay. This shows that presently, many Filipinos still cling to traditional medicine or traditional healing practices. In a report on the consultation meeting on Traditional and Modern Medicine last November 22-26, 1999, at Beijing, China, the World Health Organization (WHO) acknowledged that traditional medicine is an ancient and culturebound medical practice which existed in human societies before the application of modern science to health, it refers to health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being. Furthermore, the WHO defined traditional medicine as the sum total of knowledge, skills and practices of holistic healthcare, which is recognized and accepted by the community for its role in the maintenance of health and the treatment of diseases. Traditional medicine, based on the theory, beliefs and experiences indigenous to different cultures, was developed and handed down from generation to generation. To be effective in the context of Philippine health situation, the knowledge of traditional medicine and medical sciences can be utilized in combination. However, western medicine in the rural areas is not accessible to the majority of the people; this is one reason why many Filipinos do not go to hospitals and medical doctors as a first resort. They self medicate first, then go to traditional healers. The people of the Cordilleras have a vast long-standing knowledge and beliefs with regards to rustic curative means of treating common ailments. Fiar-od (1999), shared one Igorot practice regarding medicine, which is the use of curative practices, through the Mansip-ok or the traditional doctor or nurse who can be a medium and talented enough to tell the cause of ones sickness. Health customs and beliefs among the indigenous natives of the Cordilleras are closely related to their perception of diseases based on folk beliefs and assumptions as well as the blending of western medicine. This amalgamation of views can be the result of the entry of medical facilities and personnel in the region, educational backgrounds of the younger generation of Igorots, and the deep-rooted experience and practice among the elderly natives. The primary purpose of this study is to find out what aspects of health are usually consulted to health care practitioners by some ethnic tribes in the Cordilleras when they are faced with any malady or ailment. The term aspect of health in this study refers to

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health practices, health conditions and health remedies. Likewise, health practices in this study take into account both the modern and traditional health practices. Moreover, this study not only sought to determine if the people of the Cordilleras consult health care practitioners when they have health complaints, but also tried to find out if they blend both modern and traditional elements of health and medical care practices. Aside form exploring and gathering information on what are the practices that the natives of the Cordilleras, this study tried to look as well into the usual preference that they employ in a particular health practice such as personal hygiene, sanitation, bathing practice, circumcision, pregnancy and others; a particular health condition such as painful urination, wounds, lacerations, arthritis, diarrhea, diabetes among others; the use health remedies such as herbal remedies, consulting folk healers, doctors among

others; and the beliefs regarding the causes of human discomforts, and eventually determine the particular and essential health needs of these groups of inhabitants in this part of the country. Moreover, there is little current research and literature on this theme and this study seeks to create awareness on the modern as well as traditional knowledge and spiritual beliefs of the natives of the Cordilleras regarding the causes of illnesses and physical and spiritual healing. As claimed by Fiar-od (1999), many of the traditional practices of non-western communities cannot be explained by conventional concepts. Generally the understanding and appreciation of spiritual practices is lacking and there is little theory related to spiritual phenomenon. In some countries, remedies used by traditional medicine have reemerged. Such techniques are usually known as alternative or complementary medicine, which as a form of medicine has evolved recently as a reaction to high technology medicine as cited in the website www.who.org. In addition, the same website mentioned that countries in Africa, Asia and Latin America use traditional medicine (TM) to help meet some of their primary health care needs. In Africa, up to 80% of the population uses traditional medicine for primary health care. In industrialized countries, adaptations of traditional medicine are termed Complementary or Alternative. In a survey conducted by Eisenberg et.al. (1998), the use of traditional / complementary medicine in industrialized countries has increased significantly. Studies conducted in the US show that complementary therapy usage increased from 34% in 1990 to 42% in 1997.

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In a survey conducted by the Philippines National Demographic and Health Survey (NDHS) (2003) conducted by the National Statistics Office and was supported by U.S. Agency for International Development (USAID), on the aspect of health care during pregnancy and childbirth and after delivery, although, it shows that most births are assisted by a health professional: 34% by a doctor, 25% by a midwife and 1% b a nurse and less than 2 in 5 births are delivered in a health facility, still, majority of births (61%) occur at home with the assistance of a hilot. Obviously, traditional medicine is commonly accepted by the society. Understanding their modern health literacy and especially traditional health culture can help all medical and nursing practitioners to be able to provide adequate care while taking into consideration their deeply-rooted and effective health practices and at the same time disregarding their inappropriate practices. Likewise, Determining the modern and traditional health practices and medicine amongst the people of the Cordilleras is important since the region is not only wealthy of customary health approaches and knowledge but also a common area of community immersions among nursing students from different nursing schools as part of their commitment of service to the community and conducting primary health care. According to Bautista (1999), Primary Health Care began in the 1960s and was adapted by the Department of Health in the 1970s. It is a holistic approach that included health education, promotion of food supply and proper nutrition, adequate supply of safe water and basic sanitation, maternal and child health care, family planning, immunization against major infectious diseases, prevention and control of locally endemic diseases, appropriate treatment of common diseases and injuries and provision of essential drugs. Primary Health Care can be used as a tool in health education among the people in the community. In the rural areas, Primary Health Care operates alongside traditional medicine. However there is little research on how many natives in a particular rural area really consult traditional healers, this was supported by the World Health Organization, as cited from the website, www.who.org, there are no solid data on the extent of usage of traditional medicine in the Western Pacific Region, however, data from several countries and areas in the region show that around 40% to 60% of the population of these countries and areas use traditional medicine. For example, traditional medicine accounts for around 40% of all health care delivered in China and in Hong Kong, approximately

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60% of the population has consulted traditional medicine practitioners at one time or another. Primary Healthcare can be seen as a method to introduce modern medicine in the rural areas, however, in order for traditional societies to accept modern views of health and health care, modern medical advocates must learn to accommodate these societies beliefs and practices. Understanding traditional medicine can add more knowledge to modern health care practitioners when confronted with certain discomforts that can not be explained through conventional means. Since both traditional and modern systems of health care coexist within the communities in the Cordilleras and serve the same target populations, collaboration between the two not only enhances the services being provided by each system individually, but also ensures transparency and trust benefiting individuals and the community as a whole. In a study conducted by Palaganas et al. (2000) about the health beliefs of the people of Barangay Badeo in Kibungan Benguet, it was revealed that their community health beliefs are influenced by the interplay of traditional perceptions and modern (western) medical views. Traditions are strongly observed in maintaining health. But because of continuous interactions with other communities and the inroads of recent western technological advances, scientific explanations have already begun to influence old customs and traditions in the management of health. The peoples traditional beliefs include an idea of the existence of supernatural beings and spirits that influence their day to day life. They believe that there are spirits as well as an ultimate being that guide them in every aspect of their lives. Good health, good harvest, success in work and business undertakings are recognized and attributed to the good relationship to Kabunyan. As stated by Fiar-od (1999) Kabunyan is the name of the supreme god. Prayers addressed to Kabunyan are with intercession of the spirits of ancestors. Just like any religious sect in the country, the natives of the Cordilleras communicate to their supreme being through prayers. Prayers are means of communicating to Kabunyan as god, and to Lumauig, the son of Kabunyan, who came down to earth to guide the people and who taught the people to pray. They believe in the spiritual power of prayers, if someone is physically sick, the am-ama who is a ritualist and have obtained a status through his broad knowledge in tradition and culture of his community communicates to Kabunyan through a prayer called lualo or sapu

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There are specific classifications and different purposes of prayers, There are prayers for healing, supplication, prayer of thanks, and prayers to communicate with animals believed as spiritual entities; prayers for healing includes a prayer for physical healing, prayers for spirit possessed, prayers for psychological problems, and prayers for preventive measures. One example, as cited by Fiar-od (1999), includes sibisib a prayer to stop bleeding caused by a wedge, bolo, knife or stone. The idea of the Igorots in line with health practices and beliefs can be understood and appreciated through the article of Ike Picpican on the Indigenous Knowledge on Health: Linking Practice and Beliefs. As cited in his article, Picpican (ND) claimed that whatever problems they meet, like ones poor health, misfortunes, can be due to a breach in relationship with the spirit beings. Successes or misfortunes in life are seen as twin experiences that can be sought or avoided. He further explained that, In the Igorots daily encounter with her/his environment, s/he is guided by her/his belief system on a hierarchy of gods and goddesses. The Igorots believe in Kabunyan of Maknungan as the supreme deity, or in lesser gods and goddesses who are believed to be in control of the various facets of human endeavor. For example, Lumawig is the God of War, Bangan as the goddess of agriculture, Balitok as the god of mines and mineral resources, Caruntugan as the god of the mountains and forests, Masiken as the god of the waters. Another realm in the hierarchy are the other spirit beings who are classified as to whether these are nature spirits, ancestral spirits, are spirits of the living. Nature spirits (anito) dwell in the natural environment (rocks, trees, caves, rivers, etc.). Ancestral spirits (ammed) are the spirits of ancestors, who are generally considered as benevolent, but would occasionally visit living relatives to ask for gift or offerings. The spirit of the living is referred to as the kadkadua, ab-abiik, or adia. When the spirit separates from the physical body, it will cause discomfort to the person. To the Igorots, physical discomforts can be caused by several factors. It can be due to a tala or padpadya. According to Fiar-od (1999), tala, kedet or padpadya or simply black magic is a power to inflict pain or illness to anyone, either innocent or not, through the power of prayer or through a ritual with prayer. There are other

traditional knowledge in the roots and causes of diseases and infirmities. Picpican further claimed that physical discomforts can be due to natural factors such as those arising from accidents or negligence (injury, bruises, fractures), climatic changes (cough and colds), exposure to or contact with virus or bacteria, indigestion, animal bites, insect

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bites etc. Or it can be due to some spirit related afflictions brought about by ones breach of social relations (sorcery, magic, or witchcraft) or infractions with ones relation with the spirits or deities, which demand for curative rituals. Just like any tribe in the Cordilleras, there are a lot of traditional practices that are being utilized in order to alleviate physical discomfort and suffering. A ritual can be performed as an antidote to the evil intentions of kedet. Picpican further stated that: Illness arising from natural factors can be remedied by indigenous pharmacology. Plants can be therapeutic. These can offer a number of remedies to various natural afflictions. Folk healers (the herbolario, man-ilut, mannultop, mannibisib, etc.) can also cure the sick. For afflictions that are induced by sorcery, magic, or witchcraft, these may take the form of physical discomfort, deformities or lingering illness that could be cured through the performance of rituals (gamud, sagawsaw, tala, anja). Sickness caused by spirits also requires the performance of curative rituals to remedy such afflictions. Palaganas (2000) also cited the use of guava leaves for bathing and cleaning of affected areas in cases of gaddil (sores) is a practice among different life stages, not only for children. Ripe guavas, on the other hand, are also used as an anti-diarrheal. Lelek (otitis media) can also be treated with benday or bulak manok by extracting the herbs juice to be applied on the infected ear; fever can be treated with boiled sangitan (eleusine indica) to be given to a child to drink. There are also some practical indigenous ways of taking care of pregnant women and women who have just given birth. Umaming (2007) noted that in one community in the Mountain Province, an unborn child is already counted as a member of the village. He or she already gets a share of village resources, particularly food. When a family prepares a chicken meal, a choice chicken leg is reserved for the unborn baby. It is given to the mother to eat and its nutrients passed on to the baby in her womb. One should always be willing to forgo his etag (salted meat) and green papaya in favor of lactating mother. He further stated that, tradition dictates that a pregnant mother should be prevented from carrying heavy loads, and the husband is required to do most of the work and the village elders sees to it that the husband goes home before sunset lest the wife might be tempted to do heavy chores. After giving birth, the mother is obliged to wear a traditional belt. She is regularly given a warm massage by the grandmothers of the village before and after giving birth. The husband s also trained in the art of massaging.

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Palaganas (2000) also cited some practices among the people of Badeo, if a mother is experiencing difficult labor, a mambunong is called to perform the dawdawak, a ritual where a pig is butchered, if the dawdawak performed was not successful, they then call a mansip-ok who, in turn, tries to determine the causes of the difficult labor being experienced by the woman. The mansip-ok is believed to know how to identify the possible reasons for the difficult situation. Moreover, during pregnancy, women go to a trusted hilot who possess the ability to determine a difficult delivery caused by suni, (breech position), through careful and skillful massage techniques, the hilot will then massage the pregnant womans abdomen to reposition the child. Moreover, Caneda (1979) claimed that medical beliefs and practices in Philippine tribal society persist because they answer instrumental and moral imperatives of the society and are found empirically effective there. This is not to say that such beliefs and practices are effective from the standpoint of western medicine, or that they always bring in the desired results. Caeda, referring to the study of Allan Young (1979), says, The empirical effectiveness of these practices has important ontological consequences, since it enables sickness episodes to confirm ideas about the real world. Various rituals and traditional prayers are therefore performed to cure an ill person, in order to appease some angered spirit, or to exorcise some demon from the patients body. Palaganas et al. (2000) in their Research project entitled, Mainstreaming Indigenous Health Knowledge and Practices shared some health beliefs among the natives of Badeo, a remote Barangay in Kibungan. Natives of Badeo believe that diseases are caused by supernatural beings and that the mambunong, mansip-ok, and mankutom still exist and their practices continue to flourish. Ceremonies and rituals are still being performed to cure sickness, enhance body functioning, promote health, secure good harvest and marriage, communicate with ancestors and even ensure that the dead make a safe trip to the unknown. There are other tribes in the Cordilleras that have traditional perceptions about health and wellness. The Isnegs, for example, believe that diseases and accidents are caused by supernatural beings or spirits who live in the house, in the woods, or in the heavens. Failure to observe certain prohibitions or to offer appropriate sacrifices could result in the occurrence of these unwanted situations. Similarly, the natives of Bontoc attributes the occurrence of diseases and accidents to the anito (The spirit of dead

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person that can cause sickness to a living person or it can help the living attain good fortune). Today with the convenience of modern health care providers and hospitals as well as health centers, the people of the Cordilleras ideas of health and illness has blended with western knowledge and orientation. The concept of health and illness is influenced by the interaction between traditional belief and modern medical views. There are changes in local practices as a result of education, the information and communication revolution, government health policies, and the continuing and intense exposure of indigenous peoples, like the Igorots, to information and communication technology. In present day Igorot society, there seems to be a trend toward consulting medical doctors. The trend does not imply, however, that the Igorots now believe less in the folk healers. Igorots resorting to the native healer is not entirely rejecting scientific cure, either. Reasons include inadequate delivery of social health care services and if there is it hardly reach the indigenous communities. In addition, there are no easy accessible roads to hospitals and health centers and medical personnel. Or simply no hospitals and health centers and medical personnel that are available. Cases in which the family may not afford the doctors fees and the prescribed medicine usually end up with the native healer, to whom only a kilo of meat or chicken is paid. As confirmed by Picpican, The accessibility of modern health providers as well as the appurtenances of modernity has their toll on indigenous healing practices. While some continue to practice folk medicine, others seek the amenities offered by modern science. The patient is first referred to the barangay health worker (BHW) or nurse in the community who gives the necessary remedies or referral. The patient is brought to a doctors clinic for consultation and treatment. Otherwise, the patient is brought to the hospital as a final resort. If the patient is not receptive to modern medicine and his sickness worsens, the patient is brought out of the hospital, even against doctors advise, brought to some other alternative healers (like faith healers, herbalist, etc.) or brought home as a last resort to perform some curative rituals. Sometimes after healing ritual the patient gets well. But put in dilemma when modern medicine cannot render effective cure or cannot explain certain illnesses, the Igorot reverts back to folk healing or traditional rituals as best alternatives. In some hinterland communities, the family of a sick patient usually exhausts all possible remedies such as herbs and healing rituals

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before the sick is brought to the clinic or the hospital. Sometimes the patient gets well but sometimes the illness worsens and when the patient is brought to the clinic or the hospital, it is already too late. Furthermore, Fiar-od (1999) added that the people in Besao, Mt. Province are rich in traditional knowledge, but they neither romanticize traditional knowledge nor condemn western knowledge. They are ritualistic like the people from the other municipalities of Mountain Province and at the same time see the importance of education and other external knowledge. Until today, in spite of the external knowledge as an influence of modernization or state-of-the-art technologies, rituals are still being practiced by majority of the Besao people including the highly educated and the regular churchgoers. Parts of the rituals are the indigenous prayers based on their spiritual belief. It is believed that there are powers of sprits in all creatures on earth, which affect the success or failure of people in their endeavor. To the people who are educated, who still adhere to the traditional spiritual healing through the power of prayers, volunteer, mensapu do the ritual for them. It is significant that the traditional knowledge on the spiritual beliefs is dominant in the lives of people who depend on the vagaries of nature in carrying out agricultural and health practices. To understand the health practices and beliefs of some of the ethnic tribes in the province of Benguet, the aspect of health such as health practices, health remedies, health conditions, causes of human discomforts and the different health needs were considered.

Statement of the Problem The study sought to determine the health practices and beliefs among some ethnic groups in Benguet, considering some aspects of health, such as specific health practices and health conditions as well as health remedies, causes of human discomforts and health needs. Specifically, the study sought answers to the following questions: 1. What aspects of health are consulted to health care practitioners by some of the ethnic groups considering certain health practices, and health conditions? 2. What are the health remedies of the respondents when they experience health problems?

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3. How do the respondents extent of consultation with health care providers and use of health remedies compare when they are grouped ethnic affiliation? 4. What are the primary health beliefs of the respondents as to the factors causing human discomforts? 5. What are the health-related needs of the respondents? II. DESIGN AND METHODOLOGY The study made use of descriptive research design using survey type. Gall, Borg and Gall, as cited by Fox (1969), identified research by questionnaire or survey as being systematic method of gathering data and analysis used extensively in educational research to collect information that is not directly observable. The survey instrument developed for this research was a questionnaire designed to gather and analyze data pertinent to the purpose of the study. Respondents are from the province of Benguet, the biggest province in the Cordilleras Administrative Region (CAR) in terms of population and land area. Specifically, the respondents are from the municipalities of Sablan, Kapangan, Atok, La Trinidad, Camp 8 and Balucas. These are the areas where the students of the University of the Cordilleras, particularly, the College of Nursing usually undertake their regular community outreach services. The respondents in this study were chosen through purposive sampling. The ethnic tribes are distributed as follows: K ankanaey tribe, 109 or 42.75%; Ibaloi, 81 or 31.76%; Ifugao,23 or 9.02%; Kalinga, 17 or 6.67 % and other tribes (Ilocano, Cagayano, etc) which makes up 25 or 9.80% of the total sample of 255. The particular areas were selected because of the greater chance of interaction between the students of the College of Nursing of UC and the local residents during their community health exposure. The researchers personally delivered the questionnaire to the clinical instructors. After an orientation on the mechanics of data gathering, the clinical instructors assisted their students in the administration of the questionnaire to the respondents in their area of responsibility.

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III. RESULTS AND DISCUSSION The health practices and beliefs of the respondents are tabulated, compared, and analyzed as follows: Respondents Health Practices Consulted to Health Practitioners Table 1 shows that the mean scores of the items, except on pregnancy, indicate that the respondents rarely consult a doctor, a nurse or a health worker. Pregnancy is sometimes consulted to the health practitioners by the respondents. The respondents realize the delicate condition of a pregnant woman that is the reason why among the mentioned health practices, it is pregnancy that is mostly consulted to health workers. Menstruation got the lowest weighted mean interpreted as rarely. This is due to the fact that females accept and acknowledge that there are different bodily changes that occur during menstruation. Apparently, the respondents from the different ethnic groups rely on the traditional ways by which they take care of their bodily health. One important aspect of health that they ought to consult with health practitioners is childbirth but this is also rarely consulted with the health professionals. Aside from the lack of opportunity to consult with health practitioners because they are unavailable, it could also be that the use of traditional medicines or techniques are still used and resorted to during childbirth with even with the advent of modern medicine. This is supported by a survey conducted by the Philippines National Demographic and Health Survey (NDHS) (2003) of the National Statistics Office (NSO) which was supported by U.S. Agency for International Development (USAID), on the aspect of health care during pregnancy and childbirth and after delivery. Although it was shown that most births are assisted by a health professional: 34% by a doctor, 25% by a midwife and 1 % b a nurse and less than 2 in 5 births are delivered in a health facility, still, majority of births (61%) occur at home with the assistance of a hilot.

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Table1. Health Practices Consulted to Doctors, Nurses or Health Workers by the Respondents Health Practices Weighted Mean Interpretation Personal hygiene 2.13 Rarely Home sanitation 2.11 Rarely Bathing practice 2.00 Rarely Circumcision 2.05 Rarely Menstruation 1.82 Rarely Pregnancy 2.65 Sometimes Childbirth 2.53 Rarely Nutrition 2.43 Rarely Palaganas (2000) said that there are different Filipino traditions in relation to health practices. For example, if a woman has difficulty getting pregnant, a mambunong is called to perform a dawak, a ritual requiring that a pig be butchered; if a dawak is not successful then they have to perform the ritual again. Clearly, traditional medicine is still highly regarded, as claimed by Caneda (1979). Traditional medical beliefs and practices in Philippine tribal society persist because they answer instrumental and moral imperatives of the society and are found empirically effective.

Respondents Health Conditions Consulted to Health Practitioners Table 2 reveals that generally, the respondents rarely consult health workers about their health conditions. This is evidenced by the mean scores of the identified 14 out of 15 health conditions identified. It is in cough and colds only that the respondents sometimes consult health practitioners. These findings imply that the respondents do not consult their health problems to doctors, nurses, or any other health practitioners because they are not available when they are needed. According to a publication by the United Nations Population Fund (2005) titled Community Perspectives: Our Views, Voices, and Challenges, it is claimed that financial constraints and the distance of hospitals and clinics, poor road conditions and bridges are the main reasons why people often resort to herbal concoctions to cure illnesses. Some consult local midwives (hilot) and folk healers, while others resort to prayer. Ethnic groups still resort to traditional ways of healing when confronted with illnesses. The kanyaw remains to be the most important ritual for driving away evil spirits believed to be causing their illnesses. The albularyo or quack doctor is also consulted by these northern ethnic tribes. The quack doctor is considered a general practitioner and is believed to heal a lot of

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ailments. The hilot is also popular among these groups and is usually called for bone related ailments. There is also the tawas who is called for snake bites. Others resort to using herbs that abound in the mountains.

Table 2. Health Conditions Consulted to Doctors, Nurses and Other Health Workers Condition Weighted mean Interpretation Painful urination 2.42 Rarely Wounds and lacerations 2.44 Rarely Abdominal Pain 2.45 Rarely Abscesses and Swelling 2.44 Rarely Arthritis 2.10 Rarely Asthma 2.43 Rarely Diarrhea 2.48 Rarely Coughs & Colds 2.70 Sometimes Diabetes 2.14 Rarely Dysmenorrhea 1.92 Rarely Fever 2.44 Rarely Headaches 2.33 Rarely Hypertension 2.58 Rarely Snake Bites 2.36 Rarely Toothache 2.04 Rarely Health Remedies The following discussion deals with the health remedies that are preferred by some ethnic groups in the Cordilleras. Table 3 shows the health remedies that are preferred by some ethnic groups in the Cordilleras. It is shown from the table that the use of herbal medicines is often preferred by the respondents as indicated by the mean score of 3.71. The use of herbal remedies is the most preferred remedy because the respondents reside in the mountain areas where many herbal plants are found. These plants are used by the residents to treat some kind of illnesses. The presence of these herbal plants provides a relief among the ethnic tribes in the Cordilleras. Palaganas (2000) cited that the use of guava leaves for bathing and cleaning of affected areas in cases of gaddil (sores) is a practiced by the residents. Ripe guavas, on the other hand, are also used as an anti-diarrhea. Lelek (otitis media) is treated with benday or bulak manok by extracting the herbs juice and then applied on the infected ear. Fever is treated with a concoction of boiled sangitan (eleusine indica) given to a sick child for him or her to drink.

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Table3. Health Remedies for Health Problems

Health remedies Use herbal remedies Consult folk healers like the herbolario,man-ilut, mannultop, mannibisib Consult ritual practitioners like diagnostic specialist such as manbuyon, mansip-ok, man-ila, manbuton Consult ritual practitioners like ritual performers such as manbaki /mumbaki, man-ated, manbunong Consult barangay health worker or nurse Consult a doctor for consultation and treatment Want to be brought to the hospital Weighted mean 3.71 2.52 2.20 2.25 3.43 3.33 3.00 Interpretation Often Rarely Rarely Rarely Often Sometimes Sometimes

Unavailability of health professionals in the barangay and the distance between their community and the hospital as well as financial constraint are also some of the reasons why they resort to herbal products. Again as cited from a study conducted by the United Nations Population Fund (UNFPA) in 2005, it is claimed that due to financial constraints and the distance of hospitals and clinics, poor roads conditions and bridges, people often resort to herbal concoctions to cure illnesses. Furthermore, this finding is supported by the World Health Organization (WHO) which claimed that countries in Africa, Asia and Latin America use traditional medicines to help meet some of the primary health care needs. If available, the respondents also often prefer to go to the barangay clinic for consultation. This implies that they also acknowledge the importance of going to a health professional if they are available. It is also noteworthy that consulting folk healers and ritual practitioners as well as ritual performers and relying on folk healers are rarely preferred by the respondents.

Differences on the Extent of Consultations on Health Practices and Health Conditions among the Respondents by Ethnic Group Table 4 presents the mean values reflecting the extent of consultations of health practices among the respondents considering their ethnic. As shown, the ethnic groups vary significantly in terms of their over-all mean. This means that some ethnics groups tend to consult health professionals more than the others. It appears that the Kalingas, for having the highest mean, are more likely to consult a doctor or any other health

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worker than the other ethnic groups. Those who are least likely to consult a health worker are the Kankana-eys. Specifically, it is revealed that the respondents when compared according to ethnic group vary significantly in their extent of consultation on health practices relating to personal hygiene, home sanitation, menstruation, and nutrition. Table 4. Mean values as to Extent of Consultation on Health Practices According to Ethnic Group
HEALTH PRACTICES Personal Hygiene Home sanitation Bathing practice Circumcision Menstruation Pregnancy Childbirth Nutrition Overall Mean ETHNIC GROUP

Ibaloi

Kankana-ey
2.01 1.98 1.88 2.09 1.58 2.52 2.40 2.33 2.11

Ifugao

Kalinga

Sig. level
.040 .020 .066 .400 .000 .512 .517 .026 .001

2.12 2.16 2.07 1.99 1.95 2.85 2.73 2.42 2.29 *Significant at. 05

2.52 2.76 2.81* 2.47 2.88 3.34* 2.43 2.59 2.43 2.22 2.56 .986 2.52 2.41 6.46** 2.83 2.76 .770 2.61 2.71 .761 3.13 2.71 3.15* 2.60 2.97 5.921** ** Significant at .01

The Kalingas are more likely to consult a health worker in comparison to the other ethnic groups on practices related to personal hygiene and home sanitation. On the other hand, those who are less likely to consult are the Kankana-eys. In terms of health practices related to menstruation, it is shown that the Ifugaos are the ones more likely to consult a health professional while those who are less likely to do so are again the Kankana-eys. In terms of Nutrition, the Ifugaos are the ones more likely to consult a health worker while the one who are less likely to consult are the kankana-eys. No significant difference was found among the mean values on bathing practice, circumcision, pregnancy and child birth. Table 5 reveals that generally, there is no significant variation on the overall mean scores of the 4 ethnic groups. Specifically however, a significant difference is noted in health conditions pertaining to painful urination, arthritis, and dysmennorhea.

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Table 5. Mean values as to Extent of Consultation on Health Conditions According to Ethnic Group
HEALTH PRACTICES Painful urination Wounds and Lacerations Abdominal Pain Abscesses and Swelling Arthritis Asthma Diarrhea Coughs & Colds Diabetes Dysmenorrhea Fever Headaches Hypertension Snake Bites Toothache Overall Mean Ibaloi 2.53 2.36 2.42 2.32 2.10 2.36 2.43 2.74 2.11 1.90 2.42 2.27 2.36 2.17 2.01 2.30 *Significant at. 05 Kankana-ey 2.27 2.49 2.46 2.46 2.03 2.39 2.51 2.70 2.21 1.80 2.56 2.43 2.70 2.57 2.07 2.39 ETHNIC GROUP Ifugao Kalinga 3.09 2.47 2.91 2.70 2.78 2.29 2.71 2.65 F 3.50* 1.85 .697 1.21 3.17* .973 1.68 1.15 1.26 2.75* 1.02 .470 1.35 1.56 .686 1.02 Sig. level .016 .138 .555 .306 .025 .406 .173 .330 .288 .044 .384 .703 .260 .201 .562 .383

2.26 3.00 2.43 2.94 2.14 3.00 2.35 3.06 2.04 2.71 2.35 2.47 2.22 2.18 2.26 2.18 2.78 2.76 2.70 2.47 2.17 2.41 2.48 2.62 ** Significant at .01

The Ifugaos and the Kalingas are more likely to consult a doctor regarding painful urination in comparison to the Ibalois and the Kankana-eys. The same can be said on arthritis and dysmennorhea. No significant difference can be gleaned among the mean scores in wounds and laceration, abdominal pain, abscesses and swellings, asthma, diarrhea, cough and colds, diabetes, fever, headache, hypertension, toothache and snake bites. Differences in the Extent of Use of Health Remedies by Ethnic Group Table 6 presents the extent by which the ethnic tribes in the Cordilleras differ in the use of the health remedies. As shown, the means of the ethnic groups significantly vary on the extent of use of herbal medicines, on consulting the barangay health workers, and wanting to be brought to the hospital. The differences are brought about by the distinct cultural values and beliefs of the ethnic groups. The kankana-eys use of herbal plants as a health remedy more often as compared to the other ethnic groups. They are followed by the Ibalois and the Ifugaos. The Kalingas use herbal medicines the least.

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Table 6. Mean Values as to Extent of Use of Use of health Remedies by Ethnic Group
Remedy Use Herbal remedies Consult Folk healers like the herbolario, man-ilut, mannultop, mannibisib Consult ritual practitioners like diagnostic specialist such as manbuyon, mansip-ok, manila, manbuton Consult ritual practitioners like ritual performers such as Ibaloi 3.29 2.17 Kankana-ey 4.07 2.66 Ethnic group Ifugao Kalinga 3.14 2.43 3.13 2.35 F 7.44** 2.23 Sig. Level .000 .086

1.88

2.23

2.35

2.41

1.92

.128

manbaki /mumbaki, man-ated, manbunong

Consult Barangay health worker or nurse Consult a doctor for consultation and treatment Want to be brought to the hospital

1.94

2.26

2.39

2.71

2.06

.107

3.14 3.19 2.75

3.66 3.42 3.16

3.00 2.96 2.43

3.25 3.29 2.88

3.67* 1.18 2.75*

.013 .320 .044

In terms of consulting barangay health workers as a remedy, the Kankana-eys also do these more often in comparison to the other ethnic groups. They are followed by the Kalingas and the Ibalois. The Ifugaos resort to this remedy the least. As far as wanting to be brought to the hospital as a health remedy is concerned, the Kankana-eys again resort to this the most. They are followed by the Kalingas and the Ibalois. The Ifugaos use this remedy the least. No significant variation is evident in consulting folk healers and ritual, practitioners, and consulting a doctor. This means that ethnic group does not influence the extent of use of the aforementioned remedies by the respondents. Beliefs as to Factors Causing Human Discomforts Table 7 shows the ranking of the factors believed by the respondents as causing human discomforts. The respondents were asked to rank the factors according to what they believe as the cause/s of illnesses besetting the people in their community. The individual ranks were added to come up with a sum of ranks such that the lower the sum of ranks, the higher is the overall rank. As reflected in the table, the first (1st) in rank is

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natural factors such as those arising from accidents or negligence; second (2nd) in rank is climatic changes causing cough and colds, etc; ranked 3rd is exposures to or contact with virus or bacteria, indigestion, animal bites and insect bites; followed by infractions with ones relation with the spirits or deities which demand for curative rituals and lastly due to spirit related afflictions brought about by ones breach of social relations. These findings mean that the respondents understand and are already aware of proven and scientific explanations of diseases or disorders. There are however some who still believe that illnesses are caused by spirits. Picpican (n.d.) claimed that problems, poor health, and misfortunes are still believed by some people of the tribes to be caused by spirits. He went on to say that successes and misfortunes in life are seen as twin experiences that can be sought or avoided. Fair-od (1999) also said that to the Igorots, physical discomfort is caused by a tala, kedet, or padpad-ya. These are practices associated with sorcery- a means to inflict pain or illness to anyone, an enemy or an innocent being through rituals and or prayers. Table7. Factors Causing Human Discomforts Factor Natural factors such as those arising format accidents or negligence (eg. injury, bruises, fractures) Climatic changes (eg. cough and colds) Exposure to or contact with virus or bacteria, indigestion, animal bites, insect bites etc. Infractions with ones relation with the spirits or deities, which demand for curative rituals. Due to some spirit related afflictions brought about by ones breach of social relations (eg. sorcery, magic, or witchcraft) Health-related Needs in the Community The health-related needs of the respondents from the different ethnic groups are presented in Table 8. It appears that health-care professionals such as doctors, nurses, and barangay health workers are the priority needs of the people in the community.

Sum of Ranks 601 602 680 938 955

Over-all Rank 1 2 3 4 5

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Table 8. Health-related Needs of the Respondents Need Doctor Nurse Barangay Health Worker Health Center Pharmacy Hospital Sum of Ranks 607 782 845 918 1008 1123 Overall Rank 1 2 3 4 5 6

This finding implies that there is a lack of health-care professionals to look into the health-related needs of the people. They would like to have a health-worker who can immediately respond to the needs of a sick or injured person in times of emergency. Doctors are also needed to diagnose diseases and prescribe medicines after the diagnosis. The lack of health-care professionals is not only true to the communities under study but to the nation as a whole. For example, results of the 2003 Philippine National Demographic and Health Survey revealed that 93% of the women- respondents reported problems in accessing healthcare for themselves and that 53% of them do not know where to go in case of pregnancy complications. IV. CONCLUSIONS AND RECOMMENDATIONS The study revealed that the various ethnic groups living in the communities under study rarely consult health professionals on matters relating to health practices and health conditions. Moreover, the use of herbal medicines is the most prevalent remedy resorted to by the people in the community in treating their ailments. Ethnic background significantly influences the extent of consultation of the people living in the communities in some municipalities of Benguet on matters related to health practices. The Kalingas tend to consult a professional health workers on matters related to health practices more than the Ifugaos, Ibalois and the Kankana-eys. The ethnic groups believe that natural factors are the primary causes of human discomforts. Also, the presence of health professionals is the most urgent need of the people in the community. It is recommended that educational and information campaigns should be conducted by the Department of Health (DOH) in coordination with the different Nursing Schools in Benguet and Baguio city to increase the awareness and knowledge of people in far-flung communities on the use of alternative medicines such as herbals in the treatment of some illnesses or disorders. This is because people in these communities

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rarely consult health care professionals due to their unavailability. Moreover, nursing schools should include in their extension programs the fielding of their doctor or nurse instructors to communities needing health-care assistance.

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Picpican I.: Indigenous knowledge on health: Linking practice and beliefs (ND)
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