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A Research Protocol Draft for the Department of

Pharmacology

Subsection B1
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Introduction
Modern medicine vs Traditional medicine
 modern medicine improved health care, high
cost and unavailability of modern medicine led
to continued dependence on MPs.
“Albularyos” and their use of MPs are still
widely practiced in rural areas of the country.
DOH endorses “Sampung Halamang Program”
Still no systematic research strategy in
identification, characterization and evaluation
of MPs used by “albularyos”.

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Significance of the Study
Importance of the topic
Problem: Poverty; No access to health
care.
 Need alternative sources of medication.
Increased income for farmers and
significant contribution to the national
economy
Increased awareness and attention on
MPs
Results of the research
Characterization and evaluation of our
biodiversity
Serve as baseline or database for further
studies
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used by DOH to evaluate health
General Objective
 To document the different
medicinal plants prescribed by folk
herbalist and its relationships to the
Sampung Halamang Gamot
endorsed by the Department of
Health

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Specific Objectives

1. To determine the most common medicinal


plants being prescribed for common disease
indications

2. To determine the parts, formulations and


prepartions of medicinal plants being
prescribed for common disease indications.

3. To identify the plants used by folk herbalists


for common disease indications.
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 Specific Objectives

4. To determine the Informant Consensus Factor (ICF)


and Fidelity Level (FL) in relation to medicinal plant
use.

5. To determine which medicinal plants being used by


the folk herbalists belong to the “Sampung
Halamang Gamot.”

6. To determine the conformity of the folk herbalist


for the use of the “Sampung Halamang Gamot” to
its endorsed indications.
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Scope and Limitation
 Informants of the study
 “Albularyos” that prescribe medicinal plants as
means to cure diseases
 “Albularyos” necessitate credibility.
 Location of the study
 Pulilan, Bulacan.
 Indications of focus
 Fever, cough, bronchitis, ringworm, diabetes, gout,
kidney stone, diarrhea, sore throat, diuretic,
irregular menstruation, toothache, abdominal pain,
arthritis, skin disease, wounds and burns.

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 Medicinal Plants
 natural herbs from plants for the treatment or
prevention of diseases, disorders and the promotion
of good health

 Folk Herbalist
 person especially in rural areas who used medicinal
plants and other alternative materials and
procedures to heal
 any kind of alternative medical practitioner referred
by health care worker who is a resident of Pulilan
,Bulacan
 knowledgeable about medicinal plants and
prescribes and/or makes use of plants or plant parts
in his treatmentEthnopharmacological
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 They will be regarded as respondents in the course
 Sampung Halamang Gamot (SHG)
Akapulko (Cassia alata)
Ampalaya (Momordica charantia)
Bawang (Allium sativum)
Bayabas (Psidium guajava)
Lagundi (Vitex negundo)
Niyog-niyogan (Quisqualis indica L)
Sambong (Blumea balsamifera L.)
Tsaang Gubat or Wild Tea (Ehretia microphylla Lam.)
Pansit-pansitan Ulasimang Bato (Peperomia pellucida)
Yerba Buena (Mentha spicata)

 Common Disease Indications


 fever, cough, bronchitis, ringworm, diabetes, gout,
kidney stone, diarrhea, sore throat, diuretic,
irregular menstruation, toothache, abdominal pain,
arthritis, skin disease, wounds and burns.

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- Tested the curative effects of herbal
medicines

- Handed from generations to generations

- Moral support and psychological comfort


from patients

- High social status and are well respected

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Modern drugs
- cheaper
- decline of herbal medicines popularity

1992 - Administrative Order No.12


- Traditional Medicine Program
- Senator Juan Flavier
- Promotion of Traditional Medicine

RA 8423
Traditional and Alternative Medicine Act (TAMA)

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Philippine Institute of Traditional
and Alternative Health Care
(PITAHC)

“Traditional and alternative health care in the


hands of the people”
- A Government owned and controlled
corporation (GOCC)
- To deliver the traditional alternative health
care.

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Alternative Healthcare - used in the
prevention, diagnosis and elimination of
physical or mental disorder

Traditional Medicine
 Recognized by the people
 interrelations based on culture, history,
heritage and consciousness

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According to the DOH, the health sector falls
short due to:

- inappropriate health delivery system


- inadequate health regulatory mechanisms
- poor health care financing

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Herbal Plants Indications
Akapulko (Cassia alata) ringworms and skin fungal infections, expectorant
for bronchitis and dyspnea, mouthwash in
stomatitis, diuretic, purgative, anti-pyretic, laxative
Ampalaya (Momordica charantia) Diabetes Mellitus, rheumatism, gout, hypertension,
anti-pyretic, disinfectant, anti-diarrhea, enhances
immunes system, and remedy for cough
Bawang (Allium sativum) Hypertension, hyperlipidemia, cough and cold, sore
throat, toothache
Bayabas (Psidium guajava) Antiseptic, mouth wash, anti-pyretic, anti-
rheumatism
Lagundi (Vitex negundo) Asthma, cough, colds, removal of worms and boils

Niyog-niyogan (Quisqualis indica L.) Elimination of intestinal worms

Sambong (Blumea balsamifera) Urinary stones, dysentery, sore throat

Tsaang Gubat (Ehretia microphylla Lam.) Intestinal motility

Ulasimang Bato (Peperomia pellucida) Arthritis, gout, pimples, headache, abdominal pain

Yerba Buena (Clinopodium douglasii) Analgesic, indigestion

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scientific study that correlates ethnic groups,
their health practices, and how it relates to their
physical habits and methodology in creating and
using medicines

incorporates the social science of ethnology and


the medical science of pharmacology.

it explores medicinal plants in indigenous


cultures.

 methods of collection, extraction, preparation –


allowed safe usage of the substance and its safety
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- Documentation of indigenous medical
knowledge

- Scientific study of indigenous medicines

- Search for pharmacologically unique


principles from existing indigenous
remedies.

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- interviewing healers

- interpreting traditional terminologies


into their modern counterparts

- examining patients consuming herbal


remedies

- identifying the disease for which an


herbal remedy is used
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- Interpretation of signs and symptoms

- Clinical studies on herbs and their


interaction with modern medicines

- Advising pharmacologists

- Strengthen traditional system of medicine


in a community

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Collection of information from local population
concerning the use of regional medicinal
plants, identified the most important species
used and calculate the Informant consensus
factor (ICF). The collection of data relied on a
qualitative interview (Aburjai et al)

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- 92 traditional medicine
practitioners/healers were interviewed
to collect information on the use of
herbal treatments

- Information was also collected on the


method of preparation, dose and
duration along with the botanical
names, family and local names of the
medicinal plants (Hedge et al).
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- Performed door-to-door visits in order to identify
the local people with specialized knowledge on
the use of the medicinal plants.

- By using the snowball method, the names of


other specialists were obtained.

- Calculated the Informant consensus factor (ICF)


for the data analysis.

- The rural dwellers of the community helped in


collection of the information.
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People who have knowledge on
traditional medicine.

Individual Interviews

Open and semi-structured questions

More than one interview session took


place

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Local representatives help in identifying
folk herbalists (Gazzaneo).

The local people guide in locating the folk


herbalists (Akerreta).

The chosen folk herbalists have no


scientific knowledge on the medicinal
plants (Akerreta).

The interviewees are born or live most of


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their lives in the studied region (Akerreta).
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According to WHO, traditional medicine is still
being used by 80% of the world population as
part of their health care, especially those in
developing countries.

Many African countries including Tanzania,


depend on traditional healers who provide
primary health care by taking care of people
living with emerging diseases such as
HIV/AIDS (Kisangau).

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3 criteria of triangulation

Endorsement from Barangay Confirmation from folk Interview by


Health Care Office herbalists researchers

BHCO refers traditional medical Researchers divide themselves


practitioners/folk herbalists in the area to 5 groups, each group
interviewing 2 to 3 folk
herbalists

Health Care Officers (HCO) and Self assessment of folk herbalists


Barangay Health Workers (BHW) Following a standard
using rubric sheet facilitated by
verifies authenticity of referred folk questionnaire folk herbalists
researchers would be asked to provide
herbalists
information on indications,
parts of the plant used,
preparation and route of
HCOs and BHWs fills up rubric sheet to administration.
quantitatively assess the recommended
folk herbalists
Researchers will also fill up a
rubric sheet

Score of each folk herbalist from the 3 criteria will be averaged. A


score of < 75 would indicate unreliability, whereas a score of > 75
indicates reliability and gives credibility to the folk herbalist.
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Cross Sectional Study
Outline:
Description of Respondents
Description of Study Area
Triangulation
Data Collection Tool
Data Analysis

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Residents of Pulilan, Bulacan
Knowledgeable of medicinal plants
Endorsed by he HCO and BHWs

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Pulilan, Bulacan
19 Barangays
Industrially-competitive
No public hospital
Medical clinics, Private tertiary hospital,
folk herbalists
47 km away from Manila

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 Data Collection
 Triangulation Proper
1. Endorsement from the Barangay
HCO
2. Confirmation from the folk
herbalists
3. An interview will be conducted by
the researchers

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Verbal endorsement
Rubric Sheet

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Rubric Sheet

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 Researchers– 5 subgroups
 Subgroup– 2-3 folk herbalists
 Questionnaire
a) Indications
b) part of the plant used
c) preparation
d) route of administration
 Rubric Sheet

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Collection of Plant Samples
Documentation
 Proper handling
 Photograph

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• Indications will be grouped into 10-20
categories
• Based on the indications of the Sampung
Halamang Gamot
• Informant Consensus Factor (ICF)
• Fidelity Level (FL)
• comparison between the herbal plants used
by the folk herbalists and those included in
the Sampung Halamang Gamot

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• Informant Consensus Factor (ICF)
– will be used to identify agreements of the informants
on the reported cures for the groups ailments

ICF = (nur – nt) / (nur – 1)


where nur = number of use citations in each category
nt = number of species used

Teklehaymanot, T. et. al. Ethnobotanical study of medicinal plants used by people in Zegie Peninsula,
Northwestern Ethiopia. Journal of Ethnobiology and Ethnomedicine 2007,3:12.
Akerreta, S. et. al. First comprehensive contribution to medical ethnobotany of Western Pyrenees. Journal of
Ethnobiology and Ethnomedicine 2007,3:26.
Gazzaneo, L.R.S. et. al. Knowledge and use of medicinal plants by local specialists in a region of Atlantic
Forest in the state of Pernambuco (Northeastern Brazil.) Journal of Ethnobiology and Ethnomedicine 200,1:9.
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Kisangau, D.P. et. al. Use of traditional medicines in the management of HIV/AIDS opportunistic infections in
Tanzania: a case in the Bukoba rural district. Journal of Ethnobiology and Ethnomedicine 2007,3:29.
Ethnopharmacological Studies 49
• Fidelity Level (FL)
– percentage of informants claiming the use of a certain
plant for the same major purpose

FL(%) = (Np / N) x 100

where Np = number of informants that claim a use of a plant species


to treat a particular disease

N = number of informants that use the plants as a medicine to


treat any given disease

Teklehaymanot, T. et. al. Ethnobotanical study of medicinal plants used by


people in Zegie Peninsula, Northwestern Ethiopia. Journal of Ethnobiology and
Ethnomedicine 2007,3:12. Ethnopharmacological Studies 50
Table A. Medicinal Plants
Species Local Name Use Parts used Preparation Dosage and Administration

Table B. Frequency of plant parts used for the preparation


of remedies
Plant parts used Number of Medicinal Plant species Percentage

able C. Percentage forms of preparing herbal remedies


Method of preparation Percentage

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GAS ALLOWANCE 10000

TOLL ALLOWANCE 500

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BONDPAPER 500

PHOTOCOPY 100

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TOKENS 6000

MISCELLANEOUS 1000

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TRANSPORTATION 10500

SUPPLIES 600

OTHERS 7000

TOTAL 18100

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