Cut It With the ‘BUHO’
by Dr. Juan Flavier
I remember vividly a barangay deep in the hinterlands of the North. The main problem was the unusually high death rate to neonatal tentanus. I said let us eradicate that scourge! Just like that--- and I meant it, too. We studied the situation and found that the cause was the use of a piece of bamboo called ‘buho,” which is used for cutting the umbilical cord of new-born babies.
Thereupon, we launched a campaign to discard the ‘buho.’ In its place, we recommended the use of a pair of scissors. Why, I thought triumphantly, we will ‘innovate’ the traditional practice of the people before we are through. Women listened with respect and even nodded their heads in apparent approval. The message was simple, replace the ‘buho,’ and use the scissors to prevent tetanus in the newborn.
After six months, we assessed the results and found that not only were the cases of tetanus more frequent, but that the women were still using ‘buho.’ I was a bit more mellow by then, so I decided to stay in that barangay for a few months to understand why the people refused to change.
The explanation was not hard to find. It turned out that people in the barangay believed that when an unnatural instrument, such as a pair of scissor, is used in the delivery of a baby, the child will become disloyal to the family.AS child must be delivered by something indigenous to the barangay. ‘Buho’ satisfied the requirement, because bamboo grows abundantly in that place. Imagine, causing alienation and disloyalty to the family! This is sacrilegious. Family fidelity is a cultural value, which is cherished, preserved, and protected at all costs.
Eventually, we found that the ‘buho’ is more readily available and sharper than scissors. Additionally, it was free.
So we sat to reorient our thinking. What are we trying to correct? If it is tetanus, then we are after the cleanliness of the instruments. One bright colleague suggested that we retain the ‘buho,’ but teach the farmers to boil it before using it for cutting the umbilical cord. This solution avoided impairing valued family solidarity and, at the same time, reduced the tentanus.
QUESTION:
what kind of change did the group of Dr. Flavier want to take place in the barangay whose residents are using ‘buho’ to cut the umbilical cord of new-born babies? Is that change exogenous or endogenous? Why was that kind of change short-lived?