Cebuanos Traditional Treatment Alternative

and rituals among dengue clients

INTRODUCTION

Rationale of the Study With the increasing costs of medications

and hospitalizations, Cebuanos have traditional treatment alternatives and rituals being practiced. They have been accustomed to this practice and it continued to be handed from generation to generation. With the rampant cases of dengue fever in Cebu City particularly in Barangay Guadalupe prompted to make an ethnographic study on traditional treatment alternatives and rituals utilized by dengue clients.

With the alarming case of dengue fever, it is important to know the traditional treatment alternatives and rituals in order to assess its impact to the health of the dengue client. Hence, the study is made with the end view to make a qualitative inquiry about the traditional treatment alternatives and rituals in the process of coming up with educational campaign program in the practice among the residents of Barangay Guadalupe, Cebu City.

we researchers came across in conducting the study to help provide significant qualitative information as to the traditional treatment alternatives and rituals being practiced, how it is done and how effective it is as perceived by knowing the view and perceptions of the key informants and that we would be able to draw significant similarities and differences of Cebuano traditional treatment alternatives and rituals to the medical-based practice. This may also serve as significant literature of reference in aiding the government and any other concerned agency in formulating a health care plan for both national and local level.

THEORITICAL BACKGROUND

The study was anchored on the theory of transcultural nursing theory by Madeline Leininger (1991) which served as an effective guide to explain the care uses and meanings. Transcultural nursing with established clinical approach to clients with varying cultures are relatively new. According to Madeleine Leininger (1987) founder of the field of transcultural nursing in the mid 1960s. The education of nursing students in this field is only now beginning to yield significant results.

In relation to the present study, there are still traditional beliefs and practices that continued to be handed down from generation to generation and still people adhere to these cultural or traditional beliefs and practices especially in the cure of illness. Understanding of the differences between traditional beliefs and practices are important with basis and reference to the modern method of treatment (Leininger, 1991).

THE PROBLEM The study aimed to conduct an in-depth

analysis on the Cebuano Traditional Treatment Alternatives and Rituals among Dengue Clients of Sandayong, Guadalupe, Cebu City for the year 2009 and 2010. Specifically, it sought to answer the following inquiries:

How were the Cebuano traditional treatment alternatives and rituals practiced among Cebuanos?

How effective was the use of Cebuano traditional treatment alternatives and rituals as perceived by dengue clients?

How could the traditional practice be integrated to nursing decision and actions in terms of:

3.1 culture care preservation or maintenance; 3.2 culture care accommodation or

negotiation; and 3.3 culture care repatterning or restructuring?

CHAPTER 2

REVIEW OF LITERATURE AND

STUDIES

A ritual is an action, a series of ceremonial acts, performed mainly for their symbolic value. It may be prescribed by a religion or by the traditions of a community. This could be done on specific occasions, like in the occurrence of illnesses, birthday or even harvesting; or at the discretion of individuals or communities. This can either be perform individually, by a group or by the entire community in a public or a private place. A ritual may be restricted to a certain subset of the community, and may enable or underscore the passage between religious or social states (Wikipedia, 2000).

Euphorbia hirta or mangagaw is popular plants in the Philippines. Despite stories that have circulated on the effectiveness of “mangagaw” plant in curing patients with dengue, tests showed that the herbal plant does not have sufficient clinical dose to treat dengue hemorrhagic fever. Dr. Jocelyn Abellana of the Department of Health-7 said mangagaw’s reported efficiency in the treatment of dengue fever is not backed up scientifically. Abellana, chief of the study on communicable diseases in the region, said that tests conducted by the Department of Science and Technology revealed that the mangagaw plant does not have enough amount of clinical dose sufficient to create beneficial effects

However, she pointed out that there is nothing wrong in using mangagaw as an alternative medicine. She explained that the rationalé behind an increase in platelet count after an intake of the concoction from the mangagaw plant is plainly volume replacement fluid. On the other hand, Health Secretary Francisco Duque III announces of the launching this month of the To-DOH Laban sa Dengue at the regional level. He also orders for the implementation of this program down to the lowest level of the community which is the sitio. Again, Duque urges local government officials to conduct extensive search and destroy operations of the possible breeding sites of the Aedes aegypti mosquito (Philippine Star Article, 2010).

Related Studies Dengue is caused by an arbovirus belonging

to the Flavivirus genus of the family Flaviviridae. There are four dengue virus serotypes and are maintained in a human-mosquito human cycle. Ae aegypti is the primary vector of these viruses and Ae albopictus is the secondary vector. Presence of transovarial or vertical transmission of dengue viruses may serve to retain dengue viral pathogen in nature during inter-epidemic periods of the disease (Joshi et al, 2002; Angel & Joshi, 2008).

Chapter 3

RESEARCH METHODOLOGY

AND PROCEDURES

METHOD The method that utilized in the study is

the ethnography specifically mini ethnonursing. This ethnographic study involved the description and interpretation of cultural behavior. The researchers had undertaken fieldwork to learn about a cultural group.

ENVIRONMENT

The environment of the study is Barangay Guadalupe. Barangay Guadalupe is Cebu City’s biggest and premiere Barangay

PARTICIPANTS

The participants of the study were dengue clients of Barangay Guadalupe. They were randomly selected through non probability sampling and purposive sampling. A group of ten individuals were randomly selected and served as general informants of this study and six of which served as key informants

ENABLERS

This study employed Leininger’s Observation-Participation-Reflection enabler.

DATA COLLECTION In the gathering of data, the researchers

made a letter addressed to the Dean of the College of Nursing for notification and to Barangay Captain of Barangay Guadalupe for permission to conduct the study entitled, “Cebuano Traditional Treatment Alternative Rituals among Dengue Client.” Then, the research instrument which is a structured interview questions were administered to key informants who are randomly selected.

DATA ANALYSIS In the analysis of the data, the

Leininger’s Phases of Ethnonursing Qualitaive Data Analysis were used. Data gathered from key informants, observations, field note taking and experts were collected, encoded, categorized, and analyzed to make a conclusion and generalization of the study.

Chapter 4

CEBUANO TRADITIONAL TREATMENT

ALTERNATIVES AND RITUALS

PRACTICED AMONG CEBUANOS

TRADITIONAL TREATMENT ALTERNATIVES

Mangagaw is a slender-stemmed, hairy plant with many branches that could grow till 40cm tall, reddish and purplish in color often found in open grasslands and waste places. This is plant are very accessible and cheap to attain for their immediate treatment on dengue through decoction of the leaves, sprout or even the roots. According to them “gihugasan pagkahuman gipabukalan, unya pagmugawas na ang duga mao natu siya ang inumun himu-un ug tubig” (we clean it with water and then boiled it and when the extract goes out then we will drink it as a replacement for water).

RITUALS “Da-ub” is burning of trash, which is

commonly done by the key informants that we have interviewed in Barangay Guadalupe Cebu. According to them “Uu, kadahapun magda-ub mi” (Yes, we burn our trash every afternoon). Some of them do burning in order to keep the surroundings clean and at the same time to keep the mosquito away.

Some are not bathing because according to one key informant “basta dili jud ta maligu ana kung gihilantan” (we should not take a shower if we have a fever). Because they felt cold and sometime with chill if they wet their body with water and all they want to do is lie down and take a good rest with the blanket on them.

OTHERS The other key informant used other alternatives

to treat dengue which they believed is effective, such as the papaya extract. According to the informant “U diay, nakapa-inum mi niya ug kanang juice bitaw sa kapayas nga dahun, udlut sa kapayas kay pwirti siya makapasaka sa platelet kay ni us-us man to iya platelet” (Yes, we gave her young papaya leaf extract, it rapidly increased her platelet because her platelet dropped). They said that they prepared the papaya leaf and get the extract and place it in a glass and added some juice to add taste and drank it.

Chapter 5

THE EFFECTIVENESS OF CEBUANOS TRADITIONAL TREATMENT ALTERNATIVES AND RITUALS PERCEIVED

BY DENGUE CLIENTS

MANGAGAW Mangagaw, a slender-stemmed, hairy

plant often found in open grasslands especially in remote places as a traditional treatment of dengue fever. Many folks believe that it helps increasing the platelet count of a dengue patient, “nakatabang siya kay nita-as man ang iyang platelet” (it helps because it increases her platelet count).

DILI PAKALIGU-UN (ADVISED NOT TO BATHE)

Nowadays, dengue fever is a rampant case which might lead to death to patients in severe cases (MedIndia, 2007). In line with this scary news, many Cebuanos tried to find cost-effective treatment in curing dengue fever. One of these treatments or adjunct therapy that is practice many years ago is dili pakaligu-un. Not bathing during episodes of fever is very common practice in either urban or rural areas for they believed it can further increase body temperature.

DA-UB (BURNING) Da-ub (burning) is usually practice especially in rural

areas where they burned their garbages as part of environment care. They usually practice this during afternoon to get rid of the mosquitoes that cause dengue fever in the surroundings. One key informant said, “nagda-ub mi diri sa amu kada hapun kay nahadluk mi nga na-a pay mapa-akan sa lamuk sa amung pamilya kay duha nami sa akung igsu-un nana dengue. Ug para pud mahawa ang mga lamuk dinhi sa amung lugar. Piru nag-amping jud mi kay daghan man mga balay dinhi” (We’re doing this because we’re afraid that the other family member will be bitten by the mosquitos because my brother and I have been experienced dengue fever.

KAPAYAS Papaya is found in tropical countries, also known

as the pawpaw or melon tree. The seeds, leaves, and fruit have all been used in folk medicine. Papaya is not really that popular in treating dengue fever. However, according to one of the key informant, “U, di-ay, nakapainum mi atu niyag kanang juice bitaw sa kapayas gikan sa udlut sa kapayas , pwirti siya makapasaka sa platelet kay ni us-us naman unta tu, pagpa-inum namo niya sa kapayas niya, nisaka sad ang platelet” ( we let her drink papaya juice and it really helps in increasing the platelet).

CHAPTER 6

INTEGRATION OF TRADITIONAL PRACTICE TO

NURSING DECISIONS AND ACTIONS

CULTURE CARE PRESERVATION

Preservation and maintenance of culture care should be one of the concerns a nurse must take into consideration, this part deals with facilitative, assistive and supportive actions and decisions that in a way, will help the Cebuano clients maintain their traditional health care practices in order to maintain health and well-being.

Cited below are traditional treatment alternatives and rituals to maintain Cebuano’s health.

CULTURE CARE ACCOMMODATION AND NEGITIATION

The use of Papaya, specifically the part termed as the udlot is believed to have the ability to increase the platelet count. “U, di-ay, nakapainum mi atu niyag kanang juice bitaw sa kapayas gikan sa udlut sa kapayas , pwirti siya makapasaka sa platelet kay ni us-us naman unta tu, pagpa-inum namo niya sa kapayas niya, nisaka sad ang platelet” ( We were able to give juice extracted from a papaya and it really increases the platelet count, because it decreased and dropped, that’s why we let her drank that).

CULTURE CARE REPATTERNING AND RESTRUCTURING

This section deals with the assistive, supportive and facilitative actions and decisions that will help revise or modify some of their traditional treatment alternatives and rituals into a more healthy and beneficial practice. The practice cited below which is being performed by our informants is perceived to be unhealthy and unhygienic.

Dili Maligu or the act of not taking a bath appears to be presently practiced as what has been reported by our informants. “ Dili man jud ku maligu basta hilantan ku” ( I don’t take a bath when I have fever).

CHAPTER 7

SUMMARY, FINDINGS,

CONCLUSIONS, AND RECOMMENDATIONS

SUMMARY

This study conducted an in depth analysis on Cebuanos traditional treatment alternatives and rituals among dengue clients. This identified Cebuanos traditional treatment alternatives and rituals on dengue illness. This also determined the efficacy of the traditional treatment alternatives and rituals as perceived by the dengue clients or their significant others. Finally, this study planned to incorporate the Cebuanos traditional treatment alternatives and rituals to nursing decisions and actions in terms of culture care preservation or maintenance, culture care accommodation or negotiation, and culture care repatterning or restructuring.

FINDINGS

This section summarized the findings of this qualitative mini ethnonursing study.

Cebuanos traditional treatment alternatives and rituals among dengue clients were identified and these include the use of the concocted slender-stemmed plant called “mangagaw”, the practice of not bathing during a peak or high fever, the burning of trash in the surroundings called “da-ub”, and the drinking of papaya extract.

These traditional treatment alternatives are believed to be effective in aiding diseases specifically dengue. According to Cebuanos, mangagaw helps increase platelet count of dengue patients, not bathing prevents further increase of body temperature, burning trash kills mosquitoes, and drinking papaya extract helps also increase platelet count.

CONCLUSIONS

With the use of Madeleine Leininger’s Culture Care theory, the researchers found important and relevant information on care based on culture which aid and help nurses on their professional practice. These information on Cebuanos traditional treatment alternatives and rituals on dengue are significant knowledge which is of great help in providing holistic care to Cebuano dengue patients. Being informed and familiar with Cebuanos traditional health care is substantial in uplifting and improving health care services rendered by the health care team particulary nurses.