by Dr. Godofredo U. Stuart Jr.
▶︎ This is a response to Michael Tan’s Independence Day Inquirer column titled: “Nationalism and Medicine.”
Mr. Tan failed to make it to a symposium of the Philippine Association of Community Health Educators on the topic: “How do we install nationalism in the hearts of our medical students?”
While I'm glad he didn’t make it, alas, he was still able to quickly email his thoughts for the panel to pick up on. He warned the panelists “not to fall into the trap of exoticism … how quaint Filipino traditional medicine is … that when all is said and done poverty leaves them with few choices — medicinal plants, for instance, that mainly “work” because people urinate more and feel better temporarily."
I take great umbrage at that utterly uninformed remark; more so, coming from an “educator.”
After more than a decade’s work on my compilation of Philippine medicinal plants that has burgeoned to 1,100 plants, filled and updated with thousands of scientific studies, I was terribly dismayed to read Mr. Tan's denigration of Philippine medicinal plants dismissing it as being nothing more than a bunch of quaint and exotic diuretics.
Of the 350,000 species of higher plants worldwide, about 35,000 have recorded medicinal use, and thousands of animal studies and some human trials have shown support for many of their folkloric uses. The World Health Organization estimates that about 80% of total population in developing countries use plants for medicinal purposes.
There are hundreds of prescription and over-the-counter medicines derived from plants. In the U.S. of the top 150 drugs, at least 118 are from natural sources, of which 74 percent are plant based (Ecology Society of America, 1997). Many anticancer drugs are plant based: taxol, first isolated from Pacific yew, saves at least 30,000 lives per year in the United States; vincristine and vinblastine are derived from the alkaloids of periwinkle (Catharanthus roseus), known locally as tsitsirika. Today, about 40 percent of prescription and OTC medicines come from plant extracts or synthesised plant compounds. The use of medicinal plants have expanded as a natural source replacing synthetics in nanotechnology.
So. . . really.
Mr. Tan also writes of the UP College of Medicine exercise, which he espouses, to send students to the “Quiapo Medical Center” to look at the health-related stuff sold there. Yes, indeed, there you will find exotic herbs, roots, and leaves touting medicinal use, along with amulets that promise miracles for diseases and situations that prayers to St. Jude might have failed on.
But Quiapo is not the place for students to ponder the disconnect between the science of medicine and the alternatives to it. Quiapo, especially on a Friday, is where religion merges with the market and commerce of the alternative. To refer to it as Quiapo Medicinal Center is a facetious and denigrating analogy to Philippine alternative medicine. To think that it can be a teaching tool for medical students so they might realize there’s another medical system out there, is incredibly myopic to say the least.
I agree that medical students, many from upper class families, are far-removed from the daily realities of life and the medical health care system in the boondocks. But if you want to really connect the dots and bridge the horrible chasm between urban and traditional medicine, send the medical students to the boondocks for a semester of rural health care 101: to observe up close that "other medical system out there” for the poor, how they manage to survive with the minimum of Western medicine; to be educated on the rural “science’” of health and healing; to become familiar with the “exotic” treatment modalities and herbal decoctions and infusions of leaves, roots, bark, and fruits; to observe the healers, albularyos, and medicos; and to wonder at how the rural folk’s religiosity and faith guide them through sickness and health, living and dying.
There is much medical students and urban doctors can learn from such an immersion — not to embrace it, but to serve better. This exotic and quaint landscape embodies a cultural treasure trove of Philippine alternative medicine that is, sadly, slowly being lost to the commerce of western medicine.
But instead of working with these connections among medicinal plants, traditional healing practices, folk culture and heritage, Mr. Tan delivered a confusing spiel on medicine and nationalism. He lamented the decline of nationalism, invoked the Quiapo Medical School, was dismissive of our “quaint and exotic” indigenous medicines, and the dehumanising threat of poverty. He barked up the wrong trees, pointing a finger at poverty porn, instead of putting blame on the business of entertainment; discussing how future doctors may contribute to the tragic lives of the poor by overcharging and prescribing wrong or useless medications, instead of blaming the failure of education and the commerce that medicine has become. Eventually, he defaulted to Rizal, waxing poetic on his nationalism.
Alas, all this reveals about Mr. Tan is how removed he is from the state of the nation, where Rizal and his heroism is not exactly what inspires a majority, where few are even educated enough to read about the National Hero, even fewer have the time or energy to do so. Suffice it to say that Mr. Tan’s teaching points and cautionary lessons on what threatens nationalism is woefully disappointing. And before I stray further, I venture to advise.
On medicinal plants, he should do a fast read on Juan Flavier’s 1992 brochure on ten medicinal plants (akapulko, ampalaya, bawling, bayabas, lagundi, niyog-niyogan, pansit-pansitan, sambong, tsaang-gubat, yerba buena), which was a legitimising boost to the early Philippine herbal medicine movement. Today, a cursory search and minimum effort will add to that list of medical plants: banaba, ashitaba, and insulin plant, to name a few for diabetes, and papaya with its incredible potential for dengue treatment. Perhaps this will help convince him that plants are not just useless diuretics.
This small window of medicinal plants can open doors to the diversity of alternative healing modalities in the Philippines that he can come to appreciate — perhaps, not for its science, but, rather, for its history and for how it continues to play a role in the lives and healthcare of rural folk — embrace, preach about, and help preserve. Certainly, that can add a small measure to the nationalism that he seems so passionate about. ***
This is an edited version of Dr. Stuart's response to Michael Tan's article. The original unedited response is here. A (sanitized) version appeared as letter to the editor in the Philippine Daily Inquirer on June 28.
Dr. Stuart's list of Philippine Herbal Medicinal Plants is at 1100 plants so far, with up-to-date scientific research, traditional uses, and cultural references.