An uphill battle (2)

Last week, I wrote about the controversy brewing around Dr. Adam Smith, a Tagalog-speaking Australian doctor. On his YouTube channel, where he gives health tips and debunks bogus medical advice and supplements masquerading as medicines, he recently got a lot of attention for coming up against a product that claims to be slimming and whitening at the same time, then for making a video about the supposed false claims of a famously litigious naturopath.

Supporters of both camps were vocal; on the one hand, we have those claiming that the products and the purported remedies actually work; on the other, we have stories of those disappointed by the products at best, devastated by illness and death at worst. For the last week, though, the furor has died down online. Funnily enough, it crops up once in a while in the form of cabbage memes on social media, recalling how a naturopath has advised application of cabbage leaves to address seemingly unrelated bodily complaints. Jokes aside, the outcome of any legal action that has been threatened against Smith, if indeed he has been sued, will have an impact on how we handle medical misinformation and efforts to combat it.

I feel the need now to add a few things which did not make it into the last column. Firstly, that support of evidence-based, so-called mainstream or “Western” medicine does not necessarily constitute a dismissal of complementary and alternative medicine, as well as easily accessible natural remedies and traditional cures. I feel that it’s important to mention this, as traditional and alternative medicine continues to have followers and practitioners in the Philippines, and some local medical complaints and remedies cannot be understood in the framework of the Western beast that we usually recognize as “medicine.” There have been efforts to integrate such practices into our mainstream health care, like promotion of and research on traditional medicinal plants, in part to address issues of accessibility, efficacy and expense of medications. Though there has always been some tension between “mainstream” Filipino doctors and practitioners of traditional, complementary and alternative medicine, and though much needs to be threshed out on what practices and remedies should or shouldn’t be incorporated into our mainstream health care delivery, to dismiss or deride all these practices outright is rash. There’s a risk of tarring all natural remedies with the same brush, and of being derisive of health practices which have a legitimate place in our culture and history.

In lamenting the difficulties of health advocates struggling against misinformation, I ought also to have mentioned that the vulnerable Filipino layman is not to be blamed for these defects in education, or for the circumstances which may push them to seek out and promote alternatives in health care. Dissatisfaction with conventional medicine and its limitations, as well as the challenges in accessing timely, appropriate care in a setting such as ours, make the sick Filipino a viable target for modern snake oil peddlers. We cannot expect Filipinos to consistently choose conventional health care without giving them the means to access it.

Lastly, I want to write and document an appreciation of the power of social media when it comes to spreading health information. I mean to talk again about the humorous “cabbage” memes that have arisen as a response to the Doctor Adam debacle, pointing at the vegetable as the solution to every problem. As of this writing, my social media timeline has been inundated with memes about Miss Universe Philippines candidates edited to look like they are wearing cabbage leaves, poking fun yet again at the idea of cabbage as a cure-all. One can never quite predict what content will go viral online, and what information efforts and advocacies will be able to reach a large receptive audience. Fortunately for those of us who have been trying for years to get patients to think twice about too-good-to-be-true remedies for serious illnesses, the cabbage memes have exposed the element of the ridiculous in proposed, “magical” cure-alls, in a way that I think many Filipinos can absorb and appreciate.

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