By Rhaydz B. Barcia
IRIGA CITY --- Seated alone in a dim and slightly tilting hut made of bamboo and nipa leaves, Claudia Vargas, 58, who belongs to the Agta-Tabangnon tribe that are found settled at the foot of Mt. Iriga here, is one of the indigenous people suffering from mouth cancer.
Claudia’s face is swollen with pus that discharges from a wound in her jaw. A shoal of flies normally swarms her nipa hut lured as they are by the decaying smell of her mouth.
She can barely talk and eat solid food in a day except porridge due to severe pain from mouth cancer, a disease afflicting the Agta-Tabangnon tribesmen.
Claudia is getting weaker everyday but she is trying to fight for her precious life for the sake of her three grandchildren orphaned by her son who was killed in a road mishap in Ragay, Camarines Sur a year ago. Her daughter-in-law also succumbed to death due to heart attack few months after her son’s demise.
“Claudia is one of the residents at Ilian Tribal Settlement bing assisted by the regional office of the National Commission for Indigenous People (NCIP) based in this city and of the city government of Iriga where three tribesmen have already succumbed to death due to tobacco chewing through a native concoction they call as nganga,” according to tribal chieftain Bartolome “Lome” Oafalas who also used to chew the tobacco concoction.
Prior to her illness, Claudia used to be nganga chewer who used indigenous leaves whose practice is popularly known among locals as “ma’ma” or “ogbas”, a tradition she learned from her parents and fellow tribesmen. Even farmers in the lowlands have learned to practice ‘nganga’.
When asked if she had been to a hospital for medical check up, Claudia she had once at the NCIP office but was unable to go to the hospital as recommended due to lack of money.
“Since my childhood until now, I never had gone to a hospital because we have our own herbal medicine to rely on; ma’ma alone can cure our illnesses -- curing our illnesses using herbal medicine is also our way to avoid meeting with and discrimination from the lowlanders,” she said.
We have no transportation money to go to the hospital in the first place, so how can we even afford to buy medicines prescribed by the physician after the check up? Claudia asked.
Nganga chewing, according to Chieftain Lome, has already claimed the lives of Ambrocio Alanis, Antonio Bulo and Romel Tadeo – all tribesmen, a few years ago here.
Oafalas is the overall tribal leader of four sub-tribesmen composed of Rumbang; Katabog; Natabunan and Ilian with more than 600 families or 1,300 people nestled in one-hectare settlement area here.
“We have four cases of mouth cancer that we believe were triggered by nganga chewing. This is attributed to local tobacco and lime ingredients as fusion for nganga,” he said.
Lome though also tried nganga chewing but quickly quit after suffering from severe dizziness.
The indigenous people use betel leaf locally called buyo, puti or apog (lime), areca nut (bonga) and raw tobacco as vital ingredients for “nganga”.
The practice of betel chewing is prevalent among the Bicolano tribesmen. For the indigenous people here a bag of tobacco mixed with betel is more valuable than a bag of food. Nganga chewing, they claimed, keeps them alert and warm, helps them withstand hunger and exhaustion, and serves as mometary pain killers or relievers.
Feliza Tolosa, 34, mother of five children also of Agta-Tabangnon tribe living at Sitio Talisay, Barangay San Ramon, in nearby Buhi town, said she can’t live without chewing or sniffing tobacco, which is the main ingredient for nganga.
Unlike Caudia who lives in a settlement of relatively accessible flat land, Feliza’s abode over a mountain in Barangay San Ramon, Buhi town can be reached through rigorous path. The first course was habal-habal motorcycle ride though dusty and rocky trails before crossing the 30-meter long single hanging wooden bridge.
After crossing the hanging bridge, it takes another hour to trek the rugged rolling terrain in order to reach the mountain’s peak, under the heat of the sun, where Feliza and the rest of the Agta-Tabangnon tribesmen reside.
Feliza and the rest of her fellow tribesmen are belonging to the so called Geographically Isolated and Disadvantaged Areas (GIDAs) community.
Feliza said nganga chewing is their way of life as it serves as their vital dose of medicine for stomach pain where the saliva of nganga chewing fellow tribesman is rubbed down like an ointment or a balm over the affected stomach.
“We can survive without eating but not without ma’ma to keep us alert and full. We’re stronger with tobacco quid,” she said.
Feliza said that nganga chewing has a sedative anaesthetic and euphoric effects.
The sedative anaesthetic effect according to her can cure headache; stomach and gastric pain; and itchiness, thus relieving diarrhea and other illnesses.
But when nganga and other herbal medicines fail to cure the ailment, Feliza said she brings her children to the rural health unit (RHU) where free medicines are given.
The NCIP, the frontline agency of the government that looks into the interest and welfare of the country’s indigenous people here, had noted the occurrence of mouth cancer among the IPs since the early 90’s.
Dr. Alex Quiñones, NCIP regional resident dentist, said that mouth cancer has been documented in early 90’s to be afflicting the Agta-Tabangnon tribesmen which he said has been regarded as a ticking time bomb if nganga chewing is not stopped and those already showing symptoms chose not to seek medical help and check up.
“We have four cases of oral cancer documented in Ilian Tribal Settlement for the past few years. But in early 90’s we also referred mouth cancer cases to the Bicol Medical Center (BMC). Medical findings found them positive of mouth cancer. These cases might be even higher if the tribesmen living in the mountainous areas would subject themselves to regular medical check up,” he said.
Quiñones said that the latest casualty of mouth cancer from Ilian Tribal Settlement was a certain Santiago Dela Cruz.
Quiñones believes that many cases of mouth cancer among the indigenous people in Bicol remain undocumented.
“We don’t have clinical x-ray in our office. So, oftentimes, we refer the case to government hospital for treatment but the problem is that indigenous people don’t go to the hospital because of their traditional beliefs and the difficulty to access them for medical assistance,” he said.
Quiñones said that aside from tobacco, younger generation of indigenous people are also engaged in cigarette smoking, exposing them, specifically children and the elderly, from second hand smoke that contains numerous toxic compounds.
“Nganga chewing causes mouth cancer due to chemical content from tobacco and apog (lime). The problem is that we cannot cure the disease because IPs rarely seek medical assistance or seek check up during late stage and already beyond remedy. Aside from using raw tobacco for nganga, IPs also adopted the vices of the lowlanders as young generation of tribesmen have adapted to cigarette smoking,” he said.
Dr. Consolacion Fragenal, 72, said that only 20 percent of the tribesmen sought medical assistance. Fragenal served for 22 years as NCIP resident physician who, although already retired, continues her service in the agency as volunteer doctor since 2009.
It was learned that at least 20 percent of the members of Agta-tabangnon who are seeking medical assistance are residing nearer the NCIP regional office, but majority of these tribesmen chose to remain living in the mountains and rely herbal and nganga chewing as part of their culture and tradition.
She said that majority of the Agta-Tabangnon tribesmen who went through medical check up in their office are found suffering from respiratory diseases; bronchitis; scabies due to poor sanitation; intestinal parasitism, and malnutrition, both for the elderly and children.
“If we encounter bronchitis we refer them to hospitals specifically at Sta. Maria Josefina Hospital run by nuns and at Bicol Medical Center in order to undergo advance medical treatment,” she said.
Majority of the tribesmen in Bicol are jobless while others work as farm laborers earning P100 to P150 a day when hired by the lowlanders.
Lome said families earning less than a dollar a day could not eat meals by at least three times a day.
“Root crops are the usual food in the table of the families who cannot afford to buy rice. We rely on environment as source of food but extreme weather events aggravated our plight. Typhoons and dry spell are badly affecting our food sustainability and survival,” he said.
But the Agta-tabangnon families according to him are benefitting from government’s 4Ps program that in effect is easing their burden as they can eat at least twice a day; send their children to school; and avail free medical check up and medicine,” he said.