Author: Alyanna Denise Chua is an undergraduate student specializing in socio-cultural anthropology and minoring in human geography at the University of Toronto. Find more about Alyanna on her blog.
Healing through tawas and hilot
Sheets of newspaper cover a portion of the floor of our house in Manila, and on top of those thin pieces of paper sit a white candle, a box of matches, a metal spoon, and a metal basin filled with water. The doors are locked. We’re huddled around the basin, and the room plunges into silence.
Rest assured, this is not some scene from a B-rated supernatural horror movie. This is just what happens whenever anyone in my family gets sick. We call an albularyo—Tagalog for witch doctor or folk healer—to come and conduct either tawas or hilot depending on the degree of illness (more on those in a bit).
I’ve known our albularyo since I was little, when she was still juggling between working for us and training to become a folk healer. She’s seen me grow up, and I’ve seen her grow older. Now, she always asks us how we’re doing whenever she comes into the house, beaming her wide chipped-tooth smile, always joking, always laughing.
But not during tawas. The air assumes a solemn and still quality as she cuts off a small piece from the candle and waves it in circles around the patient, eyes closed, concentrating, and chanting words under her breath. She then places the candle wax on the spoon, melts it, and drops it into the basin filled with water. As it cools down, the candle wax forms into an image which reveals the engkantos or evil spirits that have bewitched the patient. She does this five times so that by the end, we have five images forming a narrative. Having now identified the cause of disease, she anoints the patient with water from the basin and says a prayer to counteract these engkantos.
But for mild coughs, colds, or fevers, we turn to hilot. Slathering her hands with massage oil, she locates the cold spots in our bodies (those pesky causes of disease!) and massages them away, relaxing the muscles and curing our ailments. I’ve always loved this one because it makes me feel like I’m in a spa.
And if we’re still sick after all these interventions, maybe we’ll finally go to the doctor. The doctor is always the last resort.
Trust me, I know how this all sounds. How can wax images and massages cure something so biologically based, right? I used to scoff at these treatments when I was younger too, priding myself on my scientific outlook and “rational” mind.
All my life, I’ve never really understood nor tried to understand why my mom rarely sends us for check-ups, opting instead for tawas, hilot, and the occasional pharmaceutical drugs we self-medicate ourselves with.
That is, until I took an Introduction to Anthropology course, where I encountered the term “structural violence” and the whole world of medical anthropology.
When I finally asked my mom why she relied on indigenous healing to cure our illnesses, she said something so simple yet so profound. “Because it’s more convenient.”
And it is. All she has to do is call our albularyo into our house and pay her a small fee, transportation allowance, and a meal. On the other hand, the dense traffic in Manila and long clinic wait times can easily make physician consultations half-day affairs—costly in terms of both time and money.
Now, we may often think of violence as something physical and immediate—as something that someone does to directly injure another person. But there’s also structural violence, in which large-scale political economic forces systematically injure specific groups of people by preventing them from meeting their basic needs.
Structural violence is slippery and tricky because we can’t point to specific people who are causing harm, only to specific systems and institutions. It can therefore sometimes feel like jabbing at a cloud. But that’s also exactly what makes structural violence lethal — because it’s so hidden, we often take structural violence for granted as “just the way things are” when it’s actually the result of human-made unequal structures.
This is what I see in Manila. Because the Philippines is a lower income country, I used to think that the chronic lack of health resources and limited access to healthcare were “just the way things are.” But they’re not. They’re the result of corruption, increased migration of Filipino healthcare workers to more affluent countries, and neoliberal policies such as the privatization of government hospitals, among others.
These systems result in preventable injury as patients often experience treatment delays, are unable to attain their desired health outcomes, or are unable to access health services at all. So, to compensate for this limited access to biomedical healthcare, many Filipinos, including my mom, turn to indigenous healing methods to restore and rehabilitate their health. After all, they’re cheaper and more convenient.
Mixing indigenous healing methods and biomedicine
My mom, however, doesn’t just use indigenous healing methods to treat our illnesses. She uses biomedicine too. She buys over-the-counter drugs and corticosteroid cream for our eczema, and admits us to hospitals when we become ill for a longer period of time. A few years ago, for instance, my older sister suddenly had glaring red spots all over her body. When the spots were still there after three days, my parents brought her to a hospital where she was eventually diagnosed with idiopathic thrombocytopenic purpura.
Because there are inherent contradictions to the practices and beliefs of indigenous healing and biomedicine, I found it curious why my mom would partake in both healing systems at the same time. Naturally, as the nosy anthropologist I’m trying to become, I asked her about that too, and she said that it’s because she wants to get to the “best and fastest cure.”
So, while tensions exist between indigenous healing and biomedicine, my mom seems to view them as a collective network of medical resources that she can draw from to get to the best and fastest cure. She doesn’t mind resorting to both healing methods as long as the sick person will be healed.
It seems like my mom trusts biomedicine more, however, because she eventually turns to biomedicine when an illness persists for a long period of time, probably because at that point it seems to be potentially fatal. Hence, she seems to choose indigenous medicine to cure non-fatal illnesses as a compromise to the structural barriers that prevent her from conveniently accessing biomedicine.
It is here that I began to finally understand that choosing a healing method is not completely reliant on a person’s beliefs, but also on the accessibility of resources and whether there exist hurdles that discourage them from seeking their preferred method of treatment.
The strengths of tawas and hilot, the weaknesses of biomedicine
We may think of biomedicine as the gold standard in which other healthcare systems must be benchmarked against. But biomedicine also has its own epistemological and methodological shortcomings, and it can learn from indigenous healing systems as much as indigenous healing systems can learn from biomedicine.
For instance, the paradigm underlying tawas and hilot is that physical health intertwines with spiritual and emotional health, so emotions are often addressed in these rituals.
Whenever our albularyo performed hilot on my body and came across a cold spot, she would always ask me if I was constantly carrying heavy things on my back or if I was stressed out lately. Those conversations would eventually grow to talking about any frustrations I felt with my academic work, relationships, or any of the hundreds of feelings I feel on any given day.
Perhaps patients gain some sense of reassurance and comfort when they seek help from indigenous healers because of their emphasis on emotional healing; I certainly do. They perform therapeutic roles that are difficult for biomedicine to replicate.
Because biomedicine largely treats physical health separately from the spiritual and emotional, doctors tend not to dwell on emotions when making a diagnosis. While our family doctor does ask us about stress as well, he only gathers information he deems relevant to diagnosing his patients. He immediately utilizes his instruments and ends the conversation as soon as a diagnosis and a prescription are given whereas our albularyo encourages us to talk about our emotions more.
Hence, albularyos appear to show greater care and concern more actively for their patients compared to doctors, who are often criticized as treating their patients in an “assembly line fashion.” This isn’t necessarily a failing of doctors, however, but the larger culture of impersonality and detached rationalization embedded in biomedicine. Perhaps people feel dehumanized by the impersonality of biomedicine and are attracted to the warmth and human-centeredness of alternative healing systems, which treat them as flesh-and-blood humans instead of problematic bodies that need technological solutions.
Then, there’s also the spiritual dimension of tawas. In the Introduction to Culture & Truth, anthropologist Renato Rosaldo argued that cultural practices may not necessarily have hidden meanings or symbolic elaboration. Sometimes, he argued, the intensity of one’s emotions could already be enough to create and sustain a cultural practice.
At first, Rosaldo couldn’t fully understand the Ilongot practice of headhunting during his fieldwork in northern Luzon, Philippines. He couldn’t understand why after the death of a loved one, Ilongot headhunting troops would set up traps in enemy territories, behead the first person to fall into the trap, and then throw away the head in a spectacular fashion. It was only when his wife suddenly died that Rosaldo realized how powerful emotions can be in propelling a person to cope with whatever means necessary, including through cultural practices.
Accordingly, the underlying belief in tawas is that engkantos have bewitched the patient, which is why people become sick. Albularyos are then called on to identify these spirits and to pray for them. Just like how Christians may fear and love God even though they can’t see Him, my mom fears engkantos and the extent to which they can curse or harm someone even though she can’t see them. She partakes in tawas to make sure that such spirits are appeased and to cover all her bases. To her, there’s no deeper symbolic meaning to the ritual other than wanting to relieve an illness that may have been caused by something we can’t see.
Understanding non-biomedical practices
I used to understand none of these. When I was younger, I only rolled with these practices because I didn’t want to argue with my mom. But secretly, I’d tell myself that these Filipino indigenous healing practices were just “backwards” and borne out of “ignorance.”
Having now grown up and studied these practices, however, I now know that there are usually legitimate reasons why people choose not to partake in biomedicine (or any social convention really). Listening to their viewpoints as well as identifying the structural barriers they face are critical to understanding not just the healing method itself, but also the wider societal forces that give rise to it.
And like the good daughter that I am, I’ve already apologized to my mom about the dismissive comments I made in the past. Thankfully, she says she doesn’t remember any of those comments, and I still get my hilot from time to time.