A study of alternative medicine in the Philippines is, inevitably, a study of the origins of its people and the amalgam of cultures and influences: Centuries of Spanish colonial rule and the indelible consequences of its religion, hundreds of years of trade with China and assimilation of its healing arts, tribal and provincial diversities with its profusion of folklore and mythologies, all redounding into the Filipino's easy disposition for superstitions and the allure for the esoteric, mystical, and fringe.

Certainly, western medicine prevails - in the metropolitan areas, with its heart centers and hospitals plush with the accoutrements of modern medicine, in the provincial capitals and cities equipped with the diagnostic machineries essential for the commerce of mainstream medicine. But for the majority of the rural poor - including the urban-suburban poor - there are the chronic crippling economic disabilities that make mainstream health care unaffordable, often accessed only as a debt-inducing last resort.

For so many in the rural areas, health and healing are consigned and relegated to alternative forms of treatment: hand-me-down herbal concoctions or some form of rural alchemy; prayer-based folkloric therapies; a visit to the faith healer; a consultation with the albularyo or hilot with their bagful of indigenous modalities, dispensing treatments often spiced with a bulong, orasyon or occasional doses of pharmacy-based therapies.

Returning to Pulang Lupa on recurrent subbaticals, my fee-gratis practice of western-based medicine, soon enough, showed to be cost-prohibitive in the prescriptive and maintenance therapies. I became the student, slowly drawn into the fascinating study of alternative rural health care: the frequent use of the hilot skilled in chiropractic manipulations and the albularyo (herbolario, village healer ) with his bagful of indigenous modalities; the rural folk with their hand-me-down familiarity with the use of wild-crafted herbal medicines and the self-prescribed pharmacotherapy, most notably the use of the "magasawang gamot." One might see them with small patches of papers scribed with esoteria of pig-latin prayers pasted or taped on ailing parts (orasyon). Or after having tried a variety of herbal medicines, pounded, decocted, or infused, they will seek "second opinion" from the the local medico or the provincial physician who might precribe some affordable mainstream treatment. Often, finding no relief, they will return to their wild-crafted alternatives or seek another consultation with the albularyo who will dispense a second dose of herbs, bulong or orasyon.

And they are not all rural-based. There is a separate bagfgul of urban-based therapeutic alternatives accessed by the rich and burgis : imported herbals and unapproved pharmaceuticals, cybermongered tonics and ephemeral snake oils, Chinese herbal alternatives, acupuncture, magnets, crystals, pranic healing and other new-age fringe. (See: Quiapo Market)

Indeed, a study of alternative medicine in the Philippines is a window to the complex and fascinating Filipino psyche, its cultures and folklore, laden with religion and superstitions, with its motley of saints and disease-inducing mythological creatures - kapre, tikbalang, nuno, asuwang and mangkukulam - all contributing to a unique system of health care beliefs.

But alas, the window also reveals the sad realities of healthcare for the rural poor, severely lacking in government beneficence, its healthcare coffers chronically thinned by the ravaging and clawing hands of graft and corruption. In its wake, a healthcare devoid of prevention and maintenance, its emergent treatments accessed only through usurious loans, sale of rainy-day livestock, pawning and selling of personal goods. Often, one can only wait out the illness, consigned with a martyrdom of faith to tincture of time and the possibilities of prayers.

This review presents the syncretic system of alternative healthcare in the Philippines: The healers, the herbs, and the folkloric treatment modalities and indigenous medicaments, from age-old folk medicine to new-age pyramids, from the center to way-out fringe. A section will present rural approaches to specific and more common conditions or ailments. I invite queries and comments with others interested in this subject.