By Penelope A. Domogo, MD
The Indigenous Peoples Rights Act (IPRA) gives indigenous peoples in the Philippines the right to promote and practice and develop their own indigenous health systems, values, knowledge and practices. This pertains to us, Igorots, and other indigenous peoples in the Philippines. Isn’t it magnanimous of government to grant us this right? Thank you so much! I say “us” because I am an indigenous person – full-bloodied Igorot. IPRA, though, is not only about this right to our rich indigenous heritage but also our right to access conventional health care services aka western medical care and right to ancestral domain, etc. For now, though, we focus on our right to health, our right to be healthy.
Our present health care services are patterned after big brother USA. Our medical and paramedical training is copied from big brother USA. Meaning our health training and our health system is WESTERN. In this set-up, indigenous health systems and practices are labelled as “complementary” or “alternative”. But wouldn’t you ask “Why should our own system be considered alternative or complementary when we are in indigenous territory?”. Apparently, when we were colonized by the West, that is by Spain and America, they not only changed our clothes and hairdo but also changed our way of thinking, our languages, lifeways, diet, spirituality, governance, health systems, etc. Take note that when these, our colonizers, didn’t yet reach our eastern shores, we had our own local systems of living with each other. I say “systems” because these ways of life in the “ili” (community) are systematic, have order and have meaning and are institutionalized – anybody in the community would know how to behave because there is a system. And in case of wellness and disease in the remote past, our indigenous health care system was mainstream and western medicine was non-existent. We survived those centuries in the mountains- taking care of ourselves, our families, tending our fields and our flock, overcoming diseases and tribal wars and natural calamities. Thus we have developed survival mechanisms based on our own indigenous wisdom (of course, with guidance from above even if we were not yet called Christians. God loves us all, you know.) And these were based on native science. Science is not a modern way of thinking- it’s a basic survival instinct since Adam and Eve.
So what’s indigenous peoples’ health? There’s no forthright answer to this question. We, Igorots, have no equivalent term for “health”. In the 1980s when we were translating training modules for volunteer health workers written in English to Igorot, we couldn’t find a term for “health”. Ama Felix Khensay, an expert in Bontoc language, offered the word “komedselan” as the closest term but he wasn’t contented with it and in the end, we adopted the Ilokano term “salun-at”. (What was important was that we were understood by the people.)
In the different Igorot languages, there’s no term for “healthy”, either. In Aplay/Kankanaey, we say “gawis” to answer the question “How are you?” and to describe a condition or trait or anything that is “good” or “well”. I learned from the funny, happy, multi-awarded Dr. Ryan Guinaran that the Ibaloi term for this is “diteng.” All these Igorot terms denote a wholistic view of a situation- very Asian, very eastern. As opposed to western thought that health is separate from wealth, work or whatever compartments that the West has chopped our lives into.
For us to appreciate the difference of our indigenous health systems as opposed to western health systems, we just observe how many different kinds of specialists there are. When I was a medical student in the late 1970s, there were only a few specializations that we could choose when we graduate – internal medicine, surgery, pediatrics, obstetrics-gynecology, psychiatry. This meant that diseases have been categorized into separate compartments and our body has been categorized into parts – the psychiatrist takes care of diseases of the mind, the obstetrician-gynecologist takes care of diseases of the reproductive system of women, the pediatrician takes care of diseases of children, the surgeon takes care of diseases requiring cutting the body and the internist takes care of diseases that does not involve the knife. (Wait, apparently, men had no particular diseases then as there’s no specialty for men.) Thankfully, there were other options that we can go into – public health or family medicine. Those going into family medicine become general practitioners who have a general knowledge (read “basic information ”) about diseases and would become your family doctor. Those going into public health are those who look into the whys and wherefores of disease so sometimes they will forget that they are doctors. Of course, just like anybody else, we had other options like going into farming or real estate.
Today, there are so many more specializations, called sub-specialties. We now have doctors who specialize in diseases of the different parts of the body – cardiologists for the heart, pulmonologists for the lungs, hematologist for the blood, etc. Our professor in medical school joked that in the future there will be a separate doctor for the left hand and a separate doctor for the right hand (he said that in 1978). So when you are confined in a medical center like St. Luke’s Medical Center you could have 5 doctors attending to you if you have a long-standing high blood pressure. Why? Because after a long time of coping with and tolerating high blood pressure, napagod na rin ang katawan mo – your heart would be complaining, your kidneys would be hurting, your eyesight would be fading and your liver would be tired of cleaning up all the wastes from your medicines and excessive foods. But wow, 5 doctors attending to you! That would make you really feel very special. Some people like it that way. But for those who don’t have the money to pay all that attention, such situation could be catastrophic to the family economy and community.
Now, where is indigenous health? Indigenous health is wholistic – it looks at our physical bodies not separate from the mind or spirit or environment. Whatever happens to a part affects the whole like a ripple in the lake or ocean- maybe the effect is not immediate but it does have, whether you believe it or not. That is an indigenous wisdom and it universal and it is Christian (read 1 Corinthians 12: 12-31). Thus we are taught in Igorot culture the values of “ayyew” (caring for, preserving/conserving), “inayan”(don’t do to others what you don’t want others do to you), “ten-en” (moderation), etc. With this paradigm of looking at ourselves as a whole and as part of others and the environment, our forefathers have developed theories and a body of knowledge and practices and skills that have made it possible for generations before us to survive and develop to be the sturdy, strong, intelligent and caring Igorots that we are proud of today. These have made it possible for generations of Igorots to carve those amazing rice terraces and create beautiful crafts and build the wonderful Igorot communities that we are proud of today and that we are part of today. We are reaping today the fruits of peace and caring and sturdiness and strength that our forefathers, individually and collectively, have worked for and nurtured. Our challenge now is that for the past many years, many of these bodies of knowledge and skills and values have been swept under the rug, as if they are dirty or unworthy. And now we are also reaping the fruits of our individual and collective devaluing and snubbing of our rich indigenous heritage – diseases of all kinds- mind, body and spirit and environment like high blood pressure, diabetes, arthritis, depression, climate change, etc. As we mentioned earlier, the East and indigenous peoples see the world and all that is in it as connected in the web of life. Do we, as descendants of a great people, rise up to the challenge?***
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“If one part suffers, every part suffers with it; if one part is honored, every part rejoices with it.” 1 Corinthians 12:26
