Spiritual Sustenance

We find her by the side of the church, surrounded by Catholic altar pieces, Chinese incense and a full array of local roots, leaves and bark.

We could easily have missed her.

Unlike her fellow vendors, she is not actively peddling her wares, or incessantly asking, “Ano ang hanap niyo?” Instead, she is sitting serenely all the way inside her shop, packing crystals of tawas into tiny plastic bags, almost oblivious to the crowds.

Deep in the labyrinthine market surrounding the Minor Basilica of the Black Nazarene, more simply known as Quiapo Church, Ayeng Salazar is a healer—the only “real” one left in the vicinity of the church. She is somewhat of a local legend; every vendor we consulted mentions her name with deference.

I am making the rounds of Quiapo with my former professor, Dr. Jaime Galvez-Tan, who can’t wait to meet his unorthodox “colleague.” As soon as we confirm that she is indeed the famed Nanay Ayeng, he bounds excitedly into her shop and takes the only seat available, a child-sized Monobloc chair. After some quick pleasantries, he asks if she does pulse diagnosis. She takes his hand and closes her eyes, opening them a few seconds later in surprise—“You are a healer, too!”

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The Quiapo Church belfry looms high over the bustling market. A church has stood here since the 1500s, but it was only declared a minor basilica in 1988.

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Dr. Jimmy (as we know him) is impressed, and then elated when she tells him that all is well, he will continue to do good work, and live for a very long time. He is gushing with gratitude: “I hope you don’t mind–I will send patients to you in the near future.”

Again, that serene smile. She is a woman of faith and humor. When it is my turn and I ask her about the tree bark she’s selling, she gamely tells me to go ahead and give it a lick. She giggles at my discomfort. “Mapait, ‘no?”

I notice her shirt—a well-worn Black Nazarene memento—and the dog-eared stack of tarot cards beside her. People come here asking for all kinds of healing, she tells me. “I use whatever they know, and give whatever they need.”

The ironic juxtaposition of her practice and her medley of methods vis a vis her location is lost on her. This is Quiapo. Anything is possible.

It would be a typical Filipino market scene if not for the items on sale. Once you get past the vendors of shoes and cellphone screens, it’s stall after stall of the strange and the spectacular.

One hears and smells Quiapo before actually seeing it. Jeeps and tricycles chug and screech, and hundreds of slippers slap the concrete. As you near the church and Plaza Miranda fronting it, the sounds become more human. Vendors yell from their shops—“Pampa-swerte! Pampa-hilom!”—guaranteeing miracles of all kinds. Overhead, speakers blare out the day’s gospel, straight from the church’s hourly masses. Anywhere you go, there’s a whiff of human sweat, burning candles, fresh-cut herbs, and other wet market scents. It’s a sensory overload, and it’s hard to make sense of if you’re not from the area.

Quiapo exists for the locals; those who find its din familiar and its chaos comforting. When the occasional brave tourists do visit, they are rewarded richly: To get a glimpse of quintessential Manila in all its unfiltered glory, there’s no better place. Quiapo has been a seat of faith, commerce, and community for centuries. The minor basilica houses the famous Black Nazarene statue, for whom hundreds congregate every January in a 22-hour procession that stops traffic and closes down streets. Every Friday is still known as Quiapo Day, when Mass-goers ply the heavens with intercessions, as they have for years. And right outside, a monument marks the historical significance of Plaza Miranda, the center of anti-Martial Law sentiment in the 1970s.

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Clockwise, from top left: Tawas in all shades are sold alongside other minerals; A longtime patron of the Quiapo market goes about shopping; Different fresh and dried herbs are found around the Church; Taromancy is one of the many modes of healing.

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By now, these signs and scenes have faded into the fabric of everyday life for Manileños. It’s only the tourists who gawk, their fresh eyes taking in every conspicuous irony: Voodoo candles right outside the church. Abortifacients sold beside a Catholic monument. Folk medicine practiced within the vicinity of university hospitals. And a bustling market brazenly set up in the church plaza itself, selling everything from the mundane to the mystical.

It would be a typical Filipino market scene if not for the items on sale. Once you get past the vendors of shoes and cellphone screens, it’s stall after stall of the strange and the spectacular. They draw from every faith, every practice, and every science, the common thread being their promise of restoring health. For this, it could be nicknamed the “Quiapo Medical Center,” a tourist spot in itself.

Carriedo Street is the main pharmacy, well-stocked with bushels of herbs and plants: serpentina, makabuhay, sambong, lagundi, many of them selling out fast on church days. There’s also bark and roots, flowers and seeds, crystals and powder: sulphur, tawas, coal. Slower-moving but still staple items include bottles of blessed oils and murky liquid, twisted vines swimming inside.

The church plaza is the ‘burn unit.’ On sale are candles of every color, corresponding to every desire. High grades? Financial success? Love, luck, revenge? Blessings and curses are fair game here; the most macabre being the wax voodoo dolls you can attach names to. They all burn the same way.

In present-day Quiapo, modernity has taken over—at least on the surface. Most vendors are only there to sell, and don’t even venture a claim on the word “healer.”

The underpass is a relatively new expansion—a “basement wing” housing the psychiatric department and alternative medicine. “Totoong Hula” is available there, for those needing to ease their fears or get rid of anxiety. It’s right beside the ear candling and ventosa (cupping) “clinic,” a few flimsy curtains thoughtfully provided for privacy. (Only Php 100 for a massage!)

Back upstairs, the Evangelista Street wing is where the “specialists” are. A few sell agimat and anting-anting—local talismans, one for every wish or need—whose powers only the trained can unlock. Some retail Chinese incense and charms; others, Catholic statues and crucifixes. In the middle of it all is Nanay Ayeng, whose brand of healing traverses many, if not all, of these modalities. As the sole healer in the area today, Nanay Ayeng has learned to expand her repertoire, adapting to the needs of the community she serves.

Almost five decades ago, the area was full of albularyos like her—traditional healers who knew how to diagnose and treat diseases. In the provinces, they remain the front-liners for health concerns, and go by many names: manghihilot, mambubuga, mambubulong, manggagamot. “We recorded over 200 labels, some of them very specific to a certain dimension of their craft,” Dr. Jimmy tells me.

But in present-day Quiapo, modernity has taken over—at least on the surface. Most vendors are only here to sell, and don’t even venture a claim on the word “healer.”

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Nanay Ayeng is the last of the traditional healers in Quiapo, but even she is learning to adapt her methods to the ever-changing clientele.

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Take Aling Edang, one of the many ‘pharmacists’ on Carriedo. She has been minding her family’s store for over 20 years now. She knows every herb by heart. By smell, size, and shape, she identifies each one, prattling off litanies of indications like memorized prayers. But she knows her limitations: she fills out prescriptions, but doesn’t prescribe cures herself. “I just learned the herbs from my mother-in-law, she was the real deal. Most people come here knowing what they need, anyway,” shrugs Aling Edang. She points to the stall next to hers, which sells virtually the same wares. “These are her grandchildren, they learned the same way I did.”

Nanay Ayeng is a rarity. At 61 years old, she is the resident sage, and she plays the part without pretense. She claims to have been born with “the gift,” but reveals little else about her past.

Her reputation was earned through successful treatments and satisfied patients, not by any self-promotion. This is an unspoken rule among healers like her: to lord one’s powers is to lose it. Even consultation fees are taboo, so only token donations are accepted. The Gift is not a commodity, even in a place like Quiapo Medical Center.

One hears and smells Quiapo before actually seeing it. Jeeps and tricycles chug and screech, and hundreds of slippers slap the concrete.

I first visited Quiapo church as a medical student taking a class on “community medicine.” Back then, I thought that “community” meant we were visiting rural areas, not the urban mess of downtown Manila. It was an odd excursion with an odd mission: to find out how easy it was to purchase “pampa-regla.”

The term literally translates to “medicine to facilitate menstruation,” but it’s a euphemism for abortifacients for unwanted pregnancies. Right outside the church, it’s shockingly easy to get one’s hands on some mean substances.

“It makes sense, from the anthropological viewpoint,” says Dr. Jimmy. “Desperate women first go to the church to seek forgiveness. ‘Panginoong Diyos, umabot na ako sa hangganan, ako’y makasalanan, patawarin niyo po ako. Hindi ko na kaya, ilalaglag ko na talaga ang batang ito...’”

Once they exit the church, the vendors recognize the tear-streaked stereotype, and waste no time in giving the women what they seek, he says. “The problem is, they aren’t told what to do once the medicine makes them bleed excessively. The vendors just sell; they don’t proffer medical advice. That’s when they end up in our medical facilities,” he explains.

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Some dried herbs come pre-packed in parcels and tea bags; Health tonics, emollients, and multi-purpose oils are sold by the bottle.

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The exercise of sending med students to Quiapo Medical Center is meant to help them understand where the patients in government hospitals are coming from, literally and figuratively. The fact is, for many of them, western medicine is a last resort.

“Traditional medicine is so much cheaper and accessible,” explains Dr. Jimmy. It’s easy to see how people might patronize plant-based medicine for simple indigestion, common colds, occasional headaches, uncomplicated infections, or acute wound care. A single plant can have multiple uses; it can be boiled as tea to drink, decocted as medicine, or crushed with coconut oil for a homemade salve. For everyday ailments, it’s a system that works.

The herbs also offer a more palatable option for chronic conditions. A thick bunch of serpentina leaves costs only Php 20 to treat hypertension for a week; a whole plant goes for Php 200, with unlimited yield. In contrast, anti-hypertensives at a local drug store go for over Php 100 per week for generic medicine, and much higher for branded labels. “Also, patients tell me that traditional healers are far more gentle, even caring towards them. The doctors and nurses in hospitals? Ang susungit daw!” he laughs.

Like me, Dr. Jimmy first encountered Quiapo Medical Center in medical school; for him, that was way back in the ‘60s. He was fascinated by the extensive knowledge of the practicing albularyos then, and even wrote a term paper on it. In a way, the experience never left him.

Known professionally as Jaime Galvez-Tan, MD, MPH, Dr. Jimmy is a former health secretary who has been a strong advocate for Philippine medical traditions throughout his career. He spent years in the field, serving far-flung communities and seeking out local healers and documenting medical traditions along the way. Today, he serves the Philippine Institute of Traditional and Alternative Health Care (PITAHC). Part of his job is validating the efficacy of Philippine medicinal plants, and he has penned several books on the subject. In short, Dr. Jimmy stands right where science meets local tradition, and has spent a lifetime bridging the gap.

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Many herbs do have proven curing power, Dr. Jimmy argues. But using them correctly can be tricky. Unlike store-bought drugs in sterile foil and plastic wrapping, medicinal plants need freshness to retain potency. The vendors are upfront about this. “Anta na ‘yan,” one says, explaining that the leaves I was eyeing were already three days old. This, on the other hand, was just delivered this morning, she gestures. I grab a bunch and inhale the grassy scent. Fresh enough.

Regular deliveries happen daily, mostly from the nearby provinces of Cavite, Laguna, and Bulacan. Some specialized powder mixes are imported from Cebu, and still have their Visayan labels and instructions on the packet. In a sense, Quiapo is just a franchise of the provincial “pharmacies,” where demand is still higher. After all, Manila is the country’s bastion of western medicine. Quiapo thrives in the shadows of the Philippine General Hospital, the University of Sto. Tomas Hospital, and several private medical institutions, all within a few kilometers’ radius. That it thrives at all, given this fact, is the bigger mystery.

But is it, really? Physical and spiritual health were never separate for our ancestors, and many of their health concepts persist in some form today.

There’s no need to look far for examples—our personal histories are full of them. As a child, I was brought to Mang Tura, a hilot, whenever I had a bad fall or when my fever would not break. Many Filipinos grew up taking paracetamol for fever, while guarding against binat (an unproven concept in the West). Even medicine cabinets are telling—it’s not surprising to find Vicks Vaporub, White Flower, or aceite manzanilla in stock, right beside foil-packed NSAIDs and antacids.

Some beliefs are outgrown, but many are so embedded in culture, they’ve become mindless reflexes. Babies get dabbed with saliva by strangers to prevent usog; rain and hamog (night fog) are avoided lest they cause the flu. It’s still instinctively believed that exposure to “bad wind” causes stomachs to bloat with kabag, bathing after strenuous activity leads to pasma (tremors), and eating too much can cause deadly nightmares or bangungot.

To ask us Filipinos to choose between Western, “scientific” medicine versus local, “traditional” ways, then, is like asking us to deny a part of ourselves. We aren’t people of pure superstition or folk magic; neither do we exclusively ascribe to the rational and provable. We are somewhere in between.

Physical and spiritual health were never separate for our ancestors, and many of their health concepts persist in some form today.

Integration has long been talked about, but deep-seated biases are hard to remove. Even if in practice, most Filipinos mix and match healthcare methods, there is a sense that Western medicine is more “legitimate”. Initial resistance and suspicion eventually gave way to acceptance when academics and scientists started weighing in on the conversation.

Bangungot, for example, is now understood as Sudden Unexplained Death Syndrome, with theories that range from genetic to cardiac issues. Pasma, binat, and other phenomena have also been explored, but the easiest gap to bridge has always been in medicinal plants. In the 1970s, local universities and governmental research agencies collaborated to form the National Integrated Research Program on Medicinal Plants, in an effort to mitigate rising costs of Western drugs with more affordable, scientifically validated homegrown versions. In the late 90s, PITAHC, where Dr. Jimmy works, was created “to accelerate the development of traditional and alternative health care in the Philippines.”

By 2007, the Institute of Herbal Medicine was established, and in 2016, the first Philippine Herbal Medicine Summit was held, bringing researchers and consumers into dialogue. Just last year, the pharmaceutical industry formally jumped in, with the inauguration of the Sentrong Katutubong Yaman (Sekaya) Research and Development plant, an affiliate of local drug company United Laboratories. The facility is envisioned to become a collaborative center for local medicinal plant products.

Wishing candles are color-coded for their particular use: health, fortune, love, safe travels, high grades, and peace of mind.

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Even if not everyone is aware of these developments, most people know this much: Lagundi, sambong, and ampalaya can now be bought off the shelves in local drugstores, in pill and capsule forms. Many others are in the pipeline. Luyang dilaw—or turmeric, if you will—commonly finds its way into recipes and teas. Natural remedies are again becoming synonymous with health. Major strides are being taken and momentum is gaining, but it all feels like retrograde science. One can imagine the albularyos of old, watching the hullabaloo over herbal medicine with amusement—We already knew they worked. Back in Quiapo, common knowledge prevails; the science is just “nice to know”. Verified or not, the vendors’ wares and services have a constant market.

I thought I’d feel like fish out of water in Quiapo, my years of medical training like a life jacket floating me above the ignorant crowds. Instead, I was humbled by the stores of medical and cultural knowledge. More surprisingly, I actually felt at home. Quiapo is only a shock to the senses until you take a closer look. Examined without bias, it’s a mirror of culture, the other half of the Filipino health psyche.

There was no need to leave my Western medicine hat by the door when I consulted with Nanay Ayeng. By then, I had suspended my disbelief. Her kind demeanor was enough reassurance: Whatever my health issue, it could be addressed. She wrote me a script on a piece of scrap paper from her notebook and told me to burn it in the plaza. I felt my spirits lift, despite myself. Maybe we already know how to heal ourselves.