A Case Study ..

CHAPTER I

INTRODUCTION

The Mandaya is "probably the greatest and best tribe in Eastern Mindanao
(Garvan, 2002)." Indeed, Mandaya culture continues to amaze and interest
many people as it becomes enduring and persevering generation after
generation. Mandaya means "inhabitants of the uplands". Quite interestingly,
areas occupied by the Mandaya in the Pacific rim are characterized by rugged
topography with few plains along the coastal areas. (Ompang, 2010).
According to the World Health Organization the top causes of death in the
world are ischaemic heart disease which causes 7.25 million or 12.8 percent of
deaths a year, stroke and other cerebrovascular disease which causes 6.15
million or 10.8 percent of deaths a year, lower respiratory infections which causes
3.46 million or 6.1 percent of deaths a year, chronic obstructive pulmonary
disease which causes 3.28 million or 5.8 percent of deaths a year, diarrhoeal
diseases which causes 2.46 million or 4.3 percent of deaths a year, HIV/AIDS
which causes 1.78 million or 3.1 percent of deaths a year, trachea, bronchus and
lung cancers which causes 1.39 million or 2.4percent of deaths a year,
tuberculosis which causes 1.34 million or 2.4 percent of deaths a year, diabetes
mellitus which causes 1.26 million or 2.2 percent of deaths a year, and finally
road traffic accidents which causes 1.21 million or 2.1 percent of deaths a year.
(World Health Organizaiton, 2011).

A Case Study .. 2

A study by the Department of Health in the Philippines in the determination

of the top diseases that required consultation showed hypertension with the
highest percentage of 8.82 percent. UTI ranks second leading cause of
consultation with 7.41 percent, followed by DM type 2 occupying the third rank
with 6.28 percent. LRTI with a percentage of 5.61 was the fourth and CAP is the
fifth most common disease seen with 4.32 percent. Other causes of consultation
are pulmonary tuberculosis, musculoskeletal disease, ischemic heart disease,
upper respiratory tract infection, and cerebrovascular disease. (Oropilla, 2012).
Chronic respiratory diseases are chronic diseases of the airways and
other parts of the lung. Some of the most common are asthma, chronic
obstructive pulmonary disease (COPD), lung cancer, cystic fibrosis, sleep apnea
and occupational lung diseases. Respiratory diseases affect all ages-children,
teens, adults and seniors.
The interest to conduct the case study was due to the fact that one of the
investigators was part of the Mandaya community. He presented the opportunity
to make a case study about the Mandaya community and we could not refuse the
opportunity of making such an interesting study.
The aim of this case study is to enrich the body of knowledge of the
Respiratory Therapy profession. It seeks to find out the home remedies of
common respiratory illnesses of the Mandaya community because there are a
limited number of literatures in regards to the indigenous tribes of Mindanao. The
Mandaya communitys home remedies may enrich our knowledge of treatments
for respiratory illnesses because the Mandaya community still endures even if
the country around them has changed.

A Case Study .. 3

Review of Literature
Mandaya Community
The ethnographic map of the Spanish colonizers shows Mandaya
existence in the present provinces of Davao Oriental, Davao del Norte and
Compostella Valley, and from Tago town of Surigao del Sur and Southern part of
Agusan del Sur. This colorful tribe since then has undergone many influences
from neo-political and economic systems. Other sub-groups emerge with names
taken from their locational self-ascriptions. During the Spanish time, the
Davaweo group emerged. Davaweos are the Mandaya converts into
Christianity baptized during the 1870's at the height of Spanish colonization of
the Philippines. The creation of Provincia de Caraga long before the Davao
province during the colonial period provides the historical and chronological
evidence that Davaweos are Mandaya descendants (Ompang, 2010).
A hill tribe in barefoot is identified through the colorful attire, artistic
embroidery, black sawed teeth and native jewelry. Being inherent in the culture,
the Mandaya observes rituals from birth to the grave. This rituals are often
performed by the balyan. In the tribal community, the elders socialize. They
dance, sing and play their music (Sayman, 2005).
The Mandaya tribe is found in the province of Davao Oriental, one of the
seven provinces of Region XI, Eastern Mindanao, Philippine Islands. The tribe's
greatest concentration is in the municipalities of Boston, Cateel, Baganga,
Caraga, Manay, Tarragona, Lupon and Mati, both from the highlands and the
lowlands. The tribe is known of its hospitality as one commonly hears a mandaya
salutation for "Welcome"-"Madayaw na Pag-abot!" (Sayman, 2005).

A Case Study .. 4

By practice, farming is very much influenced by deep religiosity. Rites and

rituals and other belief practices with lavish offerings are observed before, during
and after farming. Au-yon (cooperative farming) is a common practice. Postharvest pasawit (sharing) is valued to get more blessings the next planting
season (Ompang, 2010).
Undoubtedly, the Mandaya have one of the richest cultural heritage
among ethnic groups. They are very close to their families. Christianized
Mandaya still retain some of the past beliefs creating a syncretic form of religion
(Ompang, 2010).
In the hinterlands, the government imposed systems in the lowlands has
little effect on their practice of customary laws, however, Mandaya's have to
compete with migrants from Luzon and Visayas who were brought by Americans
and later, by government programs. Slowly, the ethnic people are being left
behind (Ompang, 2010).
The Mandayas believed in the twin principles: The principle of good
represented by Mansilatan and Badla, father and son; and the principle of evil
symbolized by Pundaugnon and Malimbong, husband and wife. Their cult was
maintained and preserved by the priestesses known as bailanes who officiated in
their various rituals and ceremonies. Their healing rites propitiated the principle
of good. When they wished to cure each other of sicknesses they invoked
Mansilatan and Badla to whom offerings were made; while the idols of evil
Pundaugnon and Manlimbong were ritually attacked with knives. Their most
important portent religious sacrifices were the balilic, talibong and pagcayag. The

A Case Study .. 5

balilic and the talibong both involve animal like pig sacrifice and both were
performed by a number of bailanes but all three satisfied the most important
purposes of religious activities: healing, divination, and propitiation of the
omnipotent supernaturals (Sayman, 2005).
Common Respiratory Illnesses
The lungs are part of a complex apparatus, expanding and relaxing
thousands of times daily to bring in oxygen and expel carbon dioxide. Lung
disease can result from problems in any part of this system. The trachea
(windpipe) branches into tubes called bronchi, which in turn branch to become
progressively smaller tubes throughout the lungs. Diseases that affect the
airways include: asthma, chronic obstructive pulmonary disease (COPD), chronic
bronchitis, emphysema, acute bronchitis, and cystic fibrosis (Karriem-Norwood,
2012).
The airways eventually branch into tiny tubes (bronchioles) that dead-end
into clusters of air sacs called alveoli. These air sacs make up most of the lung
tissue. Lung diseases affecting the alveoli include: pneumonia, tuberculosis,
emphysema, pulmonary edema, lung cancer, acute respiratory distress
syndrome (ARDS), and pneumoconiosis (Karriem-Norwood, 2012).
The interstitium is the microscopically thin, delicate lining between the
lungs' air sacs (alveoli).Tiny blood vessels run through the interstitium and allow
gas exchange between the alveoli and the blood. Various lung diseases affect
the interstitium: interstitial lung disease (ILD), and Pneumonias and pulmonary
edemas can also affect the interstitium (Karriem-Norwood, 2012).

A Case Study .. 6

The right side of the heart receives low-oxygen blood from the veins. It
pumps blood into the lungs through the pulmonary arteries. These blood vessels
can suffer from disease, as well. Mainly these diseases are: pulmonary embolism
(PE), and pulmonary hypertension (Karriem-Norwood, 2012).
The pleura is a thin lining that surrounds the lung and lines the inside of
the chest wall. A tiny layer of fluid allows the pleura on the lung's surface to slide
along the chest wall with each breath. Lung diseases of the pleura include:
pleural effusion, pneumothorax and mesothelioma (Karriem-Norwood, 2012).
The chest wall also plays an important role in breathing. Muscles connect
the ribs to each other, helping the chest to expand. The diaphragm descends
with each breath in, also causing chest expansion. These are the diseases
associated with the chest wall: obesity hypoventilation syndrome and
neuromuscular disorders (Karriem-Norwood, 2012).
Pneumonia is an infection of one or both lungs which is usually caused by
bacteria, viruses, or fungi. Prior to the discovery of antibiotics, one-third of all
people who developed pneumonia subsequently died from the infection. Some
cases of pneumonia are contracted by breathing in small droplets that contain
the organisms that can cause pneumonia. These droplets get into the air when a
person infected with these germs coughs or sneezes. In other cases, pneumonia
is caused when bacteria or viruses that are normally present in the mouth, throat,
or nose inadvertently enter the lung. Once organisms enter the lungs, they
usually settle in the air sacs and passages of the lung where they rapidly grow in
number. This area of the lung then becomes filled with fluid and pus (the body's
inflammatory cells) as the body attempts to fight off the infection (Schiffman,
2011).

A Case Study .. 7

Pneumonias signs and symptoms include fever, lower-than-normal body

temperature in older people, cough, shortness of breath, sweating, shaking chills,
chest pain that fluctuates with breathing (pleurisy), headache, muscle pain, and
fatigue. (Li, 2011).
Asthma is a disorder that causes the airways of the lungs to swell and
narrow, leading to wheezing, shortness of breath, chest tightness, and coughing.
Asthma is caused by inflammation in the airways. When an asthma attack
occurs, the muscles surrounding the airways become tight and the lining of the
air passages swells. This reduces the amount of air that can pass by. In sensitive
people, asthma symptoms can be triggered by breathing in allergy-causing
substances (called allergens or triggers). Common asthma triggers include;
animals (pet hair or dander), dust, changes in weather (most often cold weather),
chemicals in the air or in food, exercise, mold, pollen, respiratory infections, such
as the common cold, strong emotions (stress), and tobacco smoke. Aspirin and
other nonsteroidal anti-inflammatory drugs (NSAIDs) provoke asthma in some
patients. Many people with asthma have a personal or family history of allergies,
such as hay fever (allergic rhinitis) or eczema. Others have no history of
allergies. (Zieve, 2012).
Most people with asthma have attacks separated by symptom-free
periods. Some people have long-term shortness of breath with episodes of
increased shortness of breath. Either wheezing or a cough may be the main
symptom. Asthma attacks can last for minutes to days, and can become
dangerous if the airflow is severely restricted. Symptoms include; cough with or

A Case Study .. 8

without sputum (phlegm) production, pulling in of the skin between the ribs when
breathing (intercostal retractions), shortness of breath that gets worse with
exercise or activity, and wheezing. Emergency symptoms include; bluish color to
the lips and face, decreased level of alertness, such as severe drowsiness or
confusion, during an asthma attack, extreme difficulty breathing, rapid pulse,
severe anxiety due to shortness of breath, and sweating. Other symptoms that
may occur with this disease include; abnormal breathing pattern --breathing out
takes more than twice as long as breathing in, breathing temporarily stops, chest
pain, and tightness in the chest. (Zieve, 2012).
Bronchitis is an acute inflammation of the air passages within the lungs. It
occurs when the trachea (windpipe) and the large and small bronchi (airways)
within the lungs become inflamed because of infection or irritation from other
causes. The thin mucous lining of these airways can become irritated and
swollen. The cells that make up this lining may leak fluids in response to the
inflammation. Coughing is a reflex that works to clear secretions from the lungs.
Often the discomfort of a severe cough leads a person to seek medical
treatment. Both adults and children can get bronchitis. Symptoms are similar for
both. Infants usually get bronchiolitis, which involves the smaller airways and
causes symptoms similar to asthma (Cunha, 2010).
Acute bronchitis or chronic bronchitis signs and symptoms may include
cough, production of mucus (sputum), which can be clear, white, yellowish-gray
or green in color, fatigue, slight fever and chills, and chest discomfort. (Li, 2011).
Influenza, commonly called "the flu," is caused by viruses that infect the
respiratory tract. Most people who get the conventional or seasonal flu recover

A Case Study .. 9

completely in one to two weeks, but some people develop serious and potentially
life-threatening medical complications, such as pneumonia (Davis, 2012).
Home Remedies
If you have been diagnosed with viral pneumonia, you need to rest and
drink plenty of fluids. If you overexert yourself when you are sick, even with a
virus, you can prevent your immune system from fighting off the illness, and
possibly get even sicker. You can use over-the-counter medicines to reduce
fever, body aches, and cough. Although some medicines can help you feel better,
you still need rest. These medicines won't cure you, and your body still needs
rest to have the energy to fight the infection and to heal itself (Schiffman, 2012).
By far, the majority of cases of bronchitis stem from viral infections. This
means that most cases of bronchitis are short-term and require nothing more
than treatment of symptoms to relieve discomfort. Drinking fluids is very
important because fever causes the body to lose fluid faster. Lung secretions will
be thinner and easier to clear when the patient is well hydrated. A cool mist
vaporizer or humidifier can help decrease bronchial irritation. Natural treatments
for bronchitis include honey, lemon, ginger, bay leaf, and almonds. Each of these
foods has properties that reportedly reduce symptoms of bronchitis. Consult your
health care practitioner before taking or using any natural remedies (Cunha,
2010).
The goal of treatment for bronchitis is to relieve symptoms and ease
breathing. In most cases, acute bronchitis requires only self-care treatments such
as; getting more rest, taking over-the-counter pain medications, drinking fluids,

A Case Study .. 10

and breathing in warm, moist air. In some circumstances, a doctor may prescribe
medications, including; antibiotics, cough medicine, and other medications.
Bronchitis usually results from a viral infection, so antibiotics aren't effective.
However, a doctor may prescribe an antibiotic if he or she suspects that a patient
has a bacterial infection. If the patient has a chronic lung disorder or if the patient
smokes, the doctor may also prescribe antibiotics to reduce the risk of a serious,
secondary infection. It's best not to suppress a cough that brings up mucus,
because coughing helps remove irritants from the lungs and air passages. Overthe-counter cough medicine may help if the cough keeps the patient from
sleeping. If the patient has asthma or chronic obstructive pulmonary disease
(COPD), a doctor may recommend an inhaler and other medications to reduce
inflammation and open narrowed passages in the lungs. If the patient has chronic
bronchitis, the patient may benefit from pulmonary rehabilitation a breathing
exercise program in which a respiratory therapist teaches the patient how to
breathe more easily and increases the patients ability to exercise. (Li, 2011).
For Influenza, increasing liquid intake, warm showers, and warm
compresses, especially in the nasal area, can reduce the body aches and reduce
nasal congestion. Nasal strips and humidifiers may help reduce congestion,
especially while trying to sleep. Some physicians recommend nasal irrigation with
saline to further reduce congestion; some recommend nonprescription
decongestants. Fever can be treated with over-the-counter acetaminophen
(Tylenol) or ibuprofen (Motrin and others); read labels for safe dosage. Cough
can be suppressed by cough drops and over-the-counter cough syrup. If an

A Case Study .. 11

individual's symptoms at home get worse, their doctor should be notified (Davis,
2012).
Lemons are loaded with vitamin C, which is known to support the bodys
natural defenses. Lemon (and lime) juice is reported to decrease the strength of
the cold and flu virus in the body and reduce phlegm. Add lemon juice to your tea
or make hot or cold lemonade with honey to stay well, build resistance to cold
and flu, and speed up healing if you do succumb. (Cardillo, 2011).
Buyo leaves otherwise known as betel or which has the Latin name Piper
betle L/Chaciva Aurculata Miq is one yanng very popular plant in Indonesia and
become one plant that has a lot of good benefits for our health. Betel has many
types, such as betel Java, red betel, betel cloves, betel yellow and many other
types of betel is also rich in benefits. In the myriad of betel leaves contain
substances such as phenyl, essential oil, propane, estragol, kavicol,
hidroksivakol, kavibetol, starch, terpennena, diastase, tannins, cadinene,
cyneole, allylpyrokatekol, sesquiterpene and several other substances that are
required by our bodies. (Agam, 2012).
Sagbong leaves also known as sambong leaves are used as an herbal
medicine and is a shrub that grows wild in the tropical climate countries such as
Philippines, India, Africa and found even in eastern Himalayas. Sambong is
widely used in the Philippines as herbal medicine. Sambong leaves are known
for its ngai or Blumea camphor that is used as herbal medicine to treat kidney
stones, wounds and cuts, rheumatism, anti-diarrhea, anti spasms, colds and
coughs and hypertension. The Philippine Council for Health Research and

A Case Study .. 12

Development (PCHRD) has develop the technology for a sambong herbal

medicine tablet. (Medical Health Guide, 2012).
Calabo leaves also known as oregano is more popularly known for its
aromatic and balsamic flavor and is commonly used as mint flavoring in
Mediterranean and Mexican foods. Oregano as used as herbal medicine has its
earliest beginnings even in early Egyptian times and has been traditionally used
as herbal remedy for skin burns, cuts and bruises. Because of the minty flavor of
oregano, it is also used as herbal remedy for sore throat, asthma, colds, coughs
and flu. (Medical Health Guide, 2012).
Melissa leaves common name is lemon balm. Lemon Balm is anti-viral, so
the tea is great to drink if youre feeling under the weather. The hot tea brings on
a sweat that is good for relieving colds, flus and fevers and an anti-viral agent
has been found that combats mumps, cold sores and other viruses. (Wolsey,
2005).
Bayabas leaves also known as bawang leaves has been used as herbal
medicine in many cultures for thousands of years, dating at least as far back as
the time that the Egyptian pyramids were built. Bawang is claimed to help
prevent heart disease including atherosclerosis, high cholesterol, high blood
pressure, and cancer. Bawang contains antibacterial compound known as Allicin,
Because of this bawang or garlic is known as nature's antibiotic. Bawang juice
inhibits the growth of fungi and viruses and thus prevents viral, yeast and viral
infections. Preliminary test shows Bawang to have some positive results in the
treatment of AIDS. (Medical Health Guide, 2012).

A Case Study .. 13

Lagundi has been traditionally used as herbal medicine by Philippine folks.

The efficacy of Lagundi has also been verified by the Philippine Department of
Health and other Philippine based scientists which concentrated on its use to
ease respiratory complaints. Lagundi is generally used for the treatment of
coughs, asthma symptoms, and other respiratory problems. (Medical Health
Guide, 2012).
Luya or ginger has been used as herbal medicine in many cultures for
hundreds of years, Luya or ginger is claimed to have many medicinal value, from
antibacterial, anti- inflamatory to anti nausea and treatment of sore throat. Luya
or ginger is popularly used for sore throat prevention and treatment. Luya is also
widely used as herbal medicine to prevent or treat nausea and vomiting
associated with motion sickness. Luya is safe to use in pregnancy, and also
being used for treatment of nausea associated in cancer chemotherapy. Luya or
ginger is also used as support against inflammatory. Luya or ginger is also used
as digestive aid for mild stomach upset, to lower cholesterol level, anti viral and
anti bacterial properties and for the treatment of cancer. (Medical Health Guide,
2012). Gingers health benefits have long been touted. Steep several slices of
fresh ginger root in hot water and sip for an extra health boost or to soothe a
cough or scratchy throat. (Cardillo, 2011). Ginger's ability to combat a variety of
diseases and conditions is due in part to its impact on excessive inflammation,
which is a significant underlying cause of many illnesses. Inflammation is the
body's natural healing response to illness or injury, and its pain, redness, heat,
and swelling are attempts to keep you from moving a damaged area while it is
being repaired. Inflammation subsides as the body heals. (Hornick, 2006).

A Case Study .. 14

Lemon grass is reportedly has a wide variety of therapeutic application.

With limited research and studies conducted on humans, Lemon grass
effectiveness is based mainly on the results from animal and laboratory studies
as well as its reputation as a folk remedy. Lemon grass is used as an herbal
medicine for gastro-intestinal problems stomachaches, diarrhea, gas, bowel
spasms, vomiting, fever, the flu, and headaches. (Medical Health Guide, 2012).
Raw eggs, surprisingly, organic or at least from a known source of healthy
free-range chickens, are an excellent health tonic. The regular consumption of
raw eggs will do wonders for your overall health. Exceptionally easy to digest,
raw eggs provide a wonderful boost to the immune system, and a completely
balanced nutritional package. A good immune system is one of several things the
body needs to overcome cancer. (Hom, 2010).
The nutritional value of radish juice is a point of interest for many people.
Radishes typically contain 25 milligrams of calcium and 233 milligrams of
potassium, but most impressive is the amount of the antioxidant vitamin C in
radishes. Approximately 22.8 milligrams of vitamin C are found in a radish root,
with more in the radish leaf. A variety of the B vitamins are also found in radishes
including folic acid. Other beneficial components include phosphorus, potassium
and zinc. (Gamm, 2013). Radish is an anti congestive, i.e. it relieves congestion
of respiratory system including nose, throat, wind-pipe and lungs, due to cold,
infection, allergies and other causes. It is a good disinfectant and also rich in
vitamins, which protect respiratory system from infections. (Muckherjee, 2011).
Statement of the Problem

A Case Study .. 15

The study aims to explore the common respiratory illnesses and home
remedies of the Mandaya community in Davao Oriental.
Specifically, it seeks to answer the following questions:
1. What are the common respiratory illnesses in your community?
2. What are the home remedies for common respiratory illnesses in your
community?