In some rural areas, mythological creatures - the duwende, nuno, kapre, tikbalang - reign supreme, too often contributing to the conundrums of disease etiologies and pathologies. Lamang-lupa or earth dwellers are believed to inhabit the mounds of earth and the underground, and accidentally disturbing these places, not obtaining leave or failing to apologize may cause a gamut of complaints ranging from abdominal distress, headaches, body pains, even insanity. Other earth creatures believed to cause illness are the dwarfs and elves (duwendeng itim) - na-nuno, na-duwende. Illnesses are also often attributed to sorcery (kulam, pang-kukulam), in its many forms, varying from region to region. Many of these creatures' boundaries of habitation are so geographically and ethnically defined, so that that up north, the Southern Luzon's kapre, tikbalang, nuno-sa-punso, and duwendeng itim become amusing creatures of the Tagalog imagination, while they drive away their evil spirits and other unwelcome supernatural beings with their bloodletting "kanyaw" ritual, the sacrificial chicken spurting and dripping blood from its gashed neck.

In some areas, the initial approach to therapy is directed towards the creature-induced maladies. Many believe that many of these illnesses are in the purview of the albularyo or the alternative specialists. Some believe that certain diseases, especially those caused by sorcery, can only be treated by an albularyo with an expertise in countering such illnesses, a fear sometimes instilled that the illness will not response to or will worsen or be possibly fatal with traditional therapeutic interventions by the physician.

Therapeutic approaches draw from a very varied bag of Philippine alternative treatment modalities: herbal-infused, prayer-based, from way-out fringe to near-mainstream, colored by rural mythologies and a profusion of indigenous rituals. Some are in sole purview of the village healers, the albularyos and the specialists.

There is a sundry of day-to-day complaints that rarely warrants a consultation with the village healers. There is an accumulation of folkloric therapeutics, hand-me-down remedies and rituals, and a basic herbology that is utilized by parents or a knowledgeable kin. Many have "libretos" - a collection of prayers for use with bulongs and orasyons - for use in countering the common maladies caused by bad winds, spirits and earth-dwellers.

Some treatments, dispensed or advised, are so absurd, way-out total-fringe, that it might even merit a bemused and amused frown, but at the end, there is tthe sheepish confession that "i tried it anyway."

Suob, ministered by the hilot-midwife, is a ritual of rural post-partum care that incorporates modalities of herbs, prayer, smoke, heat and massage. Although traditionally rural, it has been occasionally used by the urban-burgis in a modified new-age form.

The treatments for rabies and asthma, although quite fringe, are still utilized in some rural areas. Kudlit continues to be a mainstay in the rural management of of rabies and other 'poisonous' bites.

There are the occasional tragic stories; too late, realizing that the healers' treatment is not working, and too late, the harried effort to borrow money for the cost of the trip to the provincial hospital. And alas, in countless impoverished rural communities, there is no choice. For much of the marginalized poor, health care is not a right; it is lottery, healthcare-pachamba. Yet, bereft of health prevention, eking existences in the fringes of malnutrition, they survive.

Perhaps, in the end, the bad-winds, the black elves, the earth-dwellers serve a purpose. They allow for the therapeutic mechanisms of placebo and tincture of time; and, prayers. And when all else fails, the loss may be accepted as the doings of a spirit, more powerful than the healers' therapeutic modalities, beyond the ministrations of prayers, orasyons and rituals, and the last minute efforts of traditional medicine. And in the search for a final consolation, drawing on a matyrdom of faith, invariably: It was God's will.