A doctor's life: Pa-ursa

Measles - Rubeola, is one childhood illness that brings about a lot of stress and concern in the rural areas of Mindanao - Landasan not spared. One cause of the high mortality rate for this illness is the unfounded belief that the cause of death from measles is the inability of the rashes to come to the surface of the skin and complete the cycle of the disease, and therefore treatment should be initiated to bring the rashes out - "pa ursa," as they call it. Many of the rural folk also believe that giving the patient water, bathing and IV fluids will "drown" the rashes and prevent them from coming out hence the increased chance of dying.

As far as I'm concerned the belief of pa-ursa is limited to the uneducated bisaya ethnic group and some cultural minority tribes in Mindanao. I am not aware if the other people in non-bisaya regions in the Philippines have this belief. Instead of making the patient comfortable and seeing to it that enough nutrition and hydration is given, parents subject their children to treatment that pose more harm than good.

Some of the remedies that they use for pa-ursa are Bugayana herbs, a concoction of orange soft drink mixed with an uncooked egg, roasted goat dung, rolling the patient on the cool ashes of the stove, among others. The reader will note that not one of these remedies give comfort or nutrition to the patient. You add these to the symptoms of measles, which are fever, itchiness, dry cough, colds and poor appetite, and it is easy to understand why a lot of kids succumb to death under these circumstances. 

During one measles outbreak in Landasan, the ward was full of kids in the different stages of the illness when a mother came in with a weak and dirty 7 year-old girl bundled up in a stinking blanket. The mother said that they had just buried one of her 5 children who succumbed to measles and she wasn't taking any chance of having another child go. She related to me the different treatments that she already gave the girl - which was mentioned above, and that the girl refused to eat enough for 4 days now. I made the mother understand that she would have to consent to everything that I did even if it was against her beliefs, to which she reluctantly nodded the affirmative.

The first thing that needed to be done was for us to give the kid a nice bath with enough shampoo for the matted and muddy hair, and sufficient soap to take off all the black ash on her. While this was being done the mother looked on in shock, but restrained herself because she already gave her consent. After the thorough bath, with the patient now dry and in clean clothes, I asked her if she felt fine, and she smiled and nodded her head. We gave her a bowl of porridge and she wolfed it down much to her mom's delight. In two days she was discharged and her parents vowed to junk their beliefs in quack medicine.

A well and happy girl that was snatched from the grip of death was enough news in the neighborhood to bring other patients to the hospital and place their trust on medical science. It was a victory over superstition and it ensured the well-being of another generation.