Concept of
Health and
Kalusugan = “able-bodied”
Malusog vs.
Payat (not
meaning ill)
Full development, progressiveness (in
terms of vigorous physical
* HEALTH – a combination of maturative
processes or development in correspondence to the
ability to function properly, to be active.
* Being either PAYAT or TABA are not
considered as healthy, but not necessarily ill.
Kamusta ka na?
Mabuti naman.
Eto, buhay pa.
The tone of the response may insinuate
that there may be underlying physical,
psychological,or emotional problems
* Therefore, HEALTH cannot be translated as a mere
absence of fever, pain or even generalized feelings of
malaise. It is also loaded with notions of social
Illness vs. Disease
Illness – a single instance of “being
Disease – a diagnostic category, a
conceptual entity which classifies
particular illnesses, symptoms or
pathological components of illnesses
or stages of illnesses
Disease – an abstract biologicalmedical conception of pathological
abnormalities in people’s bodies
Illness – the human experiencing of
In Philippine society, only one word exists
to describe such phenomena – SAKIT
 The term sakit is closer to the meaning of
illness than to disease
 In many cases, ailments or illnesses are
◦ Ex. Usug, Bangungot (Western:
nightmare death syndrome)
Although recent studies try to increase knowledge on these
illnesses, it cannot be denied that there is still a void due to the
inadequate attention given to such illnesses.
SAKIT = Pain
Western medicine – pain as a symptom
Filipino medicine – sakit = pain in
several contexts (ex. sakit ng ulo, sakit ng
◦ Sakit also has different degrees (ex. hapdi for a
stinging type; kirot for a sharp, recurrent type;
antak for internal, continuous stinging type)
Sakit = illness
◦ Diagnosis involves the culmination of a process
of observing signs and eliciting symptoms that
are graded in terms of seriousness (often
associated with level of physical activity one
can still exert)
A normally strong person who suddenly
feels weak is said to be have the beginnings
of an illness. This weakness is close to the
English term lethargic
 Persistence of lethargy, accompanied by
other symptoms are monitored by family
and friends but the term MAY SAKIT will
only be used when the person is unable to
perform physical tasks (common criterion:
Filipinos on addressing illnesses
No matter what ailment, it is considered as
mild/slight at first notice. Patient is rarely
given treatment during this stage.
2. The gravity of the sickness will only be taken
into notice when patient starts to suffer more
and more.
3. If one complains of pain or great itching, this
is the first stage of malaise. If symptom
continues over a considerable period of time
accompanied by the intensifying of the
symptom, the patient and the family sees the
sickness as serious.
4. If patient starts to stay in bed than
continuing with his daily routine, this is
considered as another stage of severity.
5. Filipinos consider CRYING as the surest
indicator of severity
•This framework exhibits a common problem in the Philippines
which is most exemplified by a mother who is shocked to find her
child dead barely after a day she has recognized that her child
was ill.
•This also shows the perception of Filipinos on illness. Illness,
as exemplified by SAKIT, has many social dimensions – mainly
in terms of using pre-defined “normal” social activity as a
reference for diagnosis of illnesses
Medicalization by Western
Some illnesses are more than just physical
◦ More health professionals are starting to recognize
the important role of social relationships in
determining health and disease
“Syndrome” – slowly becoming a popular
term in medical literature but still reflects
the need to delimit the qualifiers used by the
western-oriented medical system
◦ Some illnesses/ailments cannot and should not be
immediately appropriated into biomedical or
psychiatric pathology
Some physicians quickly label some
problems as medical, when some are
actually more philosophical in nature.
◦ Ex. A person pondering on the meaning of
his/her life = depressive order = need for antidepressants
Few health professionals have the ability
to see that some “problems” may actually
be part of a healthy process of an
individual’s mental, emotional, and social
 Therefore, immediately attaching medical
labels and treatment on such conditions
may be detrimental as it medicalizes life’s
Theories of illness causation
Mystical Theories
Mystical Retribution
Soul Loss
a. Animate
Supernatural Entities
b. Magical
III. Naturalistic
a. Natural Phenomena
b. Humoral Pathology
c. Diet
d. Infections
e. Natural Processes
f. Stress
Attribute illness to the automatic
consequence of the victim’s acts and
Mystical theories: Life-Stuff
and Souls
Embodies the concept of basic forces as being
operational in illness and health, if not life
 Health and illness as natural consequences of
good and evil behavior
1. Contagion
“Contact with some purportedly polluting
object, substance, or person” (Murdock)
 Animatism – belief in a metaphysical life
◦ Some Phil. ethnic groups distinguish between a
“life force” and the “soul.”
- This “life force” is considered an attribute of
health and also a potential cause of illness
- A human being with a strong or potent life force
would be perceived as a potential cause of
illness, regardless of he/she has intentions of
causing illness. Those with weak life forces are
more susceptible to illnesses
2. Mystical retribution
Filipinos believe that a violation of a taboo
results in “punishment” by a supernatural
being in the form of illness or other
 Research has shown that most acts that
violate a taboo and result to misfortunes
may not necessarily have been caused by a
“supernatural being.” Some believe that it
is a natural consequence and is more
closely related to social propriety than
mystical retribution
◦ Best captured by karma
3. Fate
Illness as ascribed to astrological
influences, individual predestination, or
personified ill luck
 Filipino = PALAD (palm of the hand)
◦ Palmistry (mostly in Mindanao) -> predicts
one’s fate in life
◦ Sintas (the midline extending from the
umbilicus to the chestbone) -> predicts one’s
susceptibility to illnesses
◦ “Bahala na” attitude – manifestation of
Filipinos’ passivity and resistance to change by
leaving everything to the “will of God”
4. Soul loss
Belief that a soul is capable of leaving the body
temporarily and its prolonged absence may cause
illness to the owner with death, as the permanent
separation from the body.
 Different from “possessions” by spirits
 Ex. Ilongots – beteng (heart) may leave the body
during sleep and may get used to the company of the
dead – this leads to death
◦ Saving grace is knowledge, thus making infants more
susceptible to this illness because they lack this
◦ Some believe that souls are companions (ex. belief that
children have companion animals in Panay)
◦ Some believe that some souls feel compelled to free itself
from the body (compulsive soul) – ex. bangungot
Attribute illnesses to the active
intervention of sensate agents such as
supernatural entities or malevolent
human beings
Animate: Ghosts and other
supernatural entities
Ancestral spirits – most frequently cited
illness-causing ghosts
◦ Illness is perceived as retribution from
ancestral spirits for non-fulfillment of ritual
obligations or violation of social norms
Deceased traditional healers – may cause
illness when calling on a descendant to
take up his/her vocation
 Souls of unborn children – aborted
children, unbaptized children
◦ Parents are punished with illnesses due to
*Even “casual” encounters with ghosts, as in
being greeted (nabati) can be a cause of illness
 Discontented souls- potential malevolence of
ghosts may be determined by the character of
the individual at the time of death
- ghosts of suicide victims are believed to
be the most dangerous.
 Supreme deity- is generally conceptualized as
remote and detached from the human world,
only occasionally inflicting illness as
punishment for “sins”.
-Among Catholics, saints are believed to inflict
illness as punishment for social
transgressions, including non-fulfillment of
ritual obligations.
 Environmental Spirits- They are generally
perceived as benevolent and/or guardians for
shamans and other traditional healers.
-generally perceived as benevolent but
others inflict harm only when provoked
particularly by intrusions into their
“nabati, napaglaruan, nakatuwaan ng laman
lupa ”– used to describe relationship bet
humans and supernaturals, which results in
- Once “enchanted”, illness can only be cured by
the mananambal or the local shaman.
*Perceived power of ghosts and
supernatural entities is related to “social
space”, to their distance from the human
Magical theories are those “which ascribe
illness to the covert action of an envious,
affronted or malicious human being who
employs magical means to injure his
victims”. (Murdock)
SORCERER- uses the technique of magic and
derives his power from medicine
WITCH- acts without rites and spells and
uses hereditary psycho-psychical powers
Kulam- most popular term
 Among tribal groups, sorcery is usually
reported as the effort of the community to
inflict illness on a common enemy
 Among Christians and Muslims, sorcery is
often an individual affair usually spurred by
revenge motives
Sorcerers use incantations and prayers, even
incorporating ritual paraphernalia associated
with the Catholic church. Imitative and
contagious magical principles are used, such
as hair of the intended victim and voodoo-like
 Barang- uses “pet” insects and other animals
to poison the victim
--the insects and animals are used not
only to harm the victim but also to represent
the sorcerer’s power
Object Intrusion- sends objects into the
victim’s body, ranging from fruits to insects
and physical objects.
- Persistent abdominal pain may be attributed
to sorcery, with a ritual needed to remove the
intrusive object
 Soul abduction- the sorcerers abducts the
victim’s soul and cause illness
 “Possession”- a person may be possessed by
the sorcerer or a malevolent spirit is sent to
take over the victim
Some methods of sorcery may have empirical
basis, particularly in the use of plant poisons.
•Sorcerers are usually known and accepted
in their communities. They are perceived as
having legitimate roles and their practices is
socially sanctioned.
Seemed to be limited to Christian and Muslim
groups: Aswang and balbal for Christainas
and the balbalan for Muslims
ASWANG- a man or woman possesing
preternatural powers of locomotion and
metamorphosis and an inhuman appetite for
the voided phlegm sputum of the deathly sick,
as well as the flesh and blood of the newly
A person usually becomes an aswang by
 Suspected aswangs are less sociable: they
cannot look you in the eye, somewhat
individualistic and have self reliance. They
prefer not to seek advice for other people
 Witches are perceived to “enjoy everything
precious in life”
Manananggal- believed to have a power of
detaching the upper part of their body and to
fly around
 The idea of the aswang being a “vampire” is
probably of more recent vintage, a borrowing
of western demonology
•The aswang belief operates as a form of
social control. It discourages asocial attitudes
such as secretiveness, solitariness,
misanthropy and the like (Lynch)
Attribute illnesses to impersonal
natural forces or conditions such as
cold, heat, winds, or an imbalance
of the body’s elements
Naturalistic systems explain illness in
impersonal, systemic terms. Disease is thought
to stem… from such natural forces or
conditions as cold, heat, winds, dampness, and
above all, from an upset in the balance of the
basic body elements. (Foster)
1. Natural phenomena
Thunder and lightning – believed to be a cause of
illness among Negrito groups
◦ Illness is not attributed to the phenomena itself but to
a thunder god, who punishes humans for violations of
taboos (mythological)
Naturalistic – mixing two things that do not
naturally belong together
◦ Ex. Mixing different fruits and vegetables in one
basket (Negritos)
Hangin – perceived as being sent by supernatural
or human entities
◦ Different ethnic groups believe in “self-activated
winds” (may cause respiratory problems, muscular
pains, skin diseases)
◦ Each month has a predominant wind direction which
causes illnesses
Singaw ng Lupa – vapors are harmful when it
rains during particularly hot weather
◦ Contact between warm earth and rain = singaw =
unnatural = discomfort and illness
Seasons are associated with particular illnesses
◦ When it is relatively cool, sickness is not widespread
except those that are deep in the body and in the
advanced stage. When it is warm and humid, there
is a general feeling of malaise and irritability
◦ Seasons of hunger (food supplies are out) = seasons
of disease
2. Diet
“You are what you eat.”
a. Injunctions based on religion
Ex. Islamic prohibition on pork consumption
b. Deals with imitative magical principles – “like
produces like or that an effect resembles its cause”
Ex. Avoidance of slippery foods by pregnant women in
the belief that this would cause the uterus to slip
c. Those
based on theories of humoral pathology
Ex. Food items are classified into HOT and COLD
Fruits (cold) are avoided in the morning, the coldest
part of the day because it may intensify the cold
condition which could result to diarrhea and
respiratory problems
d. Other aspects
- overeating
- intoxicated (overeating of particular food)
which could cause allergies or itchiness
- indigestion (eating food that is hard to
digest) – usually occur in young children
- foods that are hiyang or compatible
3. Infections
Refer to illnesses attributed to microorganisms
such as bacteria and viruses
 KAGAW – pathogenic microorganisms
 Mikrobyo – Filipinos are starting to become
more germ-conscious due to the influence of
* The Germ theory may be recognized, not by overemphasizing it,
but by incorporating it into more substantial health-maintenance
4. Humoral pathology
Illness is believed to be caused by a disturbance of the
balance of forces within the body
This theory is found mainly among Christian groups
and is represented by the belief in the interactions
between the hot and the cold.
Hot/cold syndrome – known as pasma; believed to
be an attack of “cold” on someone who is too “hot” or
◦ Ex. A person who has just finished exercising will be
advised against bathing in cold water to avoid
◦ Hot/cold theory is said to be both allopathic (mixing
hot and cold), and homeopathic (adding hot with
more hot)
5. Natural processes
Blood is given much importance because it is
distributed throughout the body and its loss is
associated to weakness and death
◦ People with insomnia, anemia, and sickly = “thin” blood
◦ People with asthma, bile troubles, tuberculosis, and
malaria = yellowish blood
◦ Bathing in the morning adds blood and in the evening
lessens blood (low blood pressure)
Other parts of the body are given labels as to “hot”
or “cold”
◦ Illnesses are said to be caused by an imbalance
between external hot and cold influences on the
anatomical part
◦ Ex. The back (likod) is especially sensitive to cold and
rains; while the abdominal region (tiyan) is sensitive to
wind exposure = kabag
Displaced organs = illness
◦ Ex. Isabela – knotting up of intestines and resulting
in colic (hilot as the cure)
◦ Midwives massage the mother’s abdominal region
(post-partum) in order to restore the uterus in its
original position; failure to do so can lead to illness
6. stress
Exposure of the victim to either physical or psychic
strain such as overexertion, prolonged hunger or
thirst, debilitating extremes of heat or cold, worry,
fear, or the emotional disturbances which constitute
the province of modern psychiatry. (Murdock)
Lubat – illness caused by a frightening experience
especially being in contact with the dead
Ugma – emotional disturbance due to fear of a
person, object, animal, or situation
 Is related to the concepts of balance
 For example, when one has the “fright illness”, it is
not attributed so much to fright itself. A new and
unfamiliar environment disturbs the natural balance
of a person’s body and psyche, and this disturbance
becomes a source of stress.
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