Komunitas 8 (1) (2016): 39-50 DOI: http://dx.doi.org/10.15294/komunitas.v8i1.

4960

KOMUNITAS
International Journal of Indonesian Society And Culture
http://journal.unnes.ac.id/nju/index.php/komunitas

Acculturation in Javanese Traditional Medicine Practice

in Yogyakarta

Atik Triratnawati 1

1
Department of Anthropology, Faculty of Cultural Sciences,
Gadjah Mada University, Yogyakarta, Indonesia

DOI: http://dx.doi.org/10.15294/komunitas.v8i1.4960

Received : 29 January 2016; Accepted: 29 February 2016 ; Published: 31 March 2016

Abstract

The rampant practice of traditional medicine in the big cities in Java can not be separated from the influence of
globalization. It is advertised through flyers, pamphlets, signage, television and internet. Medical practice can
not be separated from the mixture of elements of the local culture, external/ foreign as well as modern practice
medical later adopted in order to enhance public interest in their treatment. The purpose of this article is to
analyze the practice of acculturation in traditional medicine related to methods, tools, advertising and meaning
behind the ways the adoption of other culture into the traditional practice. An integrative ethnographic study
was conducted in Bantul and Sleman, Yogyakarta, on traditional healers such as gurah, bekam, metaphysical/
spiritual, herbal, traditional massage therapy, as well as hemorrhoids. Other information was obtained from
interviews with the patients. Medical pluralism by wrapping traditional therapy combined with health culture
from the outside attracts consumers with a dogmatic way was made by Javanese traditional healers. They
advertise with testimony on local television with the aim of introducing methods, tools, disease cure rates, so the
number of patients increases. Acculturation appears that more and more people believe in the business practices
and their treatment.

Keywords: acculturation; traditional medicine; medical pluralism; Yogyakarta Special Province

INTRODUCTION century (Watkins & Lewith 1997). Pro-

The recent world-wide trend of back-to- fessional too appear sympathetic: in the
nature lifestyle has brought some impacts UK, close to half of General Practitioners
to traditional healing. Complementary Al- report a willingness to recommend (or di-
rectly offer) CAMs treatments to patiens
ternative Medicine (CAM) commonly be-
(British Medical Association 2000).
comes a choice for those who want to avoid
side-effects of pharmaceutical medicine.
In Indonesia, not only because it is
As a result, the development of alternati-
perceived as easier, cheaper and more effi-
ve medicine in the world has significantly
cacious, but traditional healing gains more
increased. As cited in an article by Hughes
popularity also due to its relevance with
(2006, p.550):
back to nature lifestyle. Traditional healing
is perceived to not only cure illness, but also
In European and North American count-
ries, estimates of CAM usage are normally give psychological therapy to patients by
put at between 10% and 40% of the adult “healing body, lighten soul, and grow so-
population (Goldbeck-Wood et al. 1996). cial relation” (Intisari 2004). This is in line
It was computed that the population of with the notion of health in Javanese, where
the US were spending $15 billion per year being healthy is interpreted as a result of ba-
on CAMs by the end of the twentieth lance between body and soul (Murniatmo ,

Corresponding author : © 2016 Semarang State University. All rights reserved
Address: Jl Sosio Humaniora 1 Fakultas Ilmu Budaya
p-ISSN 2086 - 5465 | e-ISSN 2460-7320
UGM Bulaksumur Yogyakarta
Email : [email protected] UNNES JOURNALS
Telp : 08122585670
40 Atik Triratnawati, Acculturation in Javanese Traditional Medicine Practice in Yogyakarta

Rostiyati, Mudjijono 1992, p.31; Triratnawati for men) indicate good health status of its
2011). Thus, traditional healers do not only population. Consequently, with high life
play the role of ‘doctor’ but also act as spi- expectancy, the number of senior citizen
ritual healing. The importance of such role also increases. Senior citizen is a population
increases as in this modern era moderni- group with higher risk of six chronic diseases
ty puts more emphasis on individualism. such as: hypertension, cancer, heart disease,
Consequently, a crave of story sharing (i.e. and diabetes and others (Russel 2011; Woer-
telling other people one’s problem, and re- denbag and Kayser 2014). Such degenerative
ceiving advises in return) has increased (Tri- diseases also target this population group in
ratnawati, Wulandari, Marthias 2013, p.37). Yogyakarta. A study by Dewi (2013) in Yo-
On the other hand, conventional doctors gyakarta revealed that non-transmittable
are only perceived to be able to cure one’s diseases such as mellitus diabetes were evi-
illness, but not able to heal one holistical- dent among people of lower class. Similarly,
ly (The Duke Encyclopedia of New Medici- in Kompas (2015, p.1-15), it is shown that Yo-
ne, 2006; http://www.oxfordislamicstudies. gyakarta population consumes more sugar
com accessed on 25 April 2015). and fat. As a result, the number of diabetes
The use of traditional healing now in- and cancer cases is also reportedly high.
creases along with population growth, par- In 2014, with the hype of national so-
ticularly those of senior citizens who com- cial insurance program through JKN (Na-
monly contract degenerative diseases, as tional Health System), more Indonesian
this group tend to trust traditional healing citizens are expected to receive such bene-
more than modern medicine (Triratnawati fit. The government expects every citizen is
2010). In addition, the high cost of modern included in this system. Nevertheless, not
medical treatment and Javanese common everyone prefers modern medical treat-
practice to look for simple and cheap treat- ment although it is provided with no cost.
ment as the first step in their health-seeking Complicated procedure, long waiting hour,
behavior generate more popularity for tradi- and worry of quality of its service results
tional healing. Accessibility in terms of low in shifting preference of modern medical
cost and the relative high number of tradi- treatment from those provided by the sta-
tional healer is a reason why patients opt to te to privately-owned medical enterprise
traditional healing, rather than modern me- (Ayuningtyas 2014). Therefore, people fre-
dical treatment. When this first step fails, quent traditional healing practices even
they move to modern medical treatment, though national social insurance program
and vice versa (Raffaetà 2013; Baer 2011; Lun- has existed for more than two years.
gelow 2011; Walker 2006). One of the media used by traditional
People living in cities such as Jakar- healer to be known is television. In public
ta, Semarang, Surabaya, Yogyakarta whe- and private broadcast centred in the capital
re life expectancy is relatively high are not Jakarta, traditional healing and testimo-
exempted from traditional healing as it also ny from a ‘successful patient’ has become a
enters their media landscape through the staple. Not only national broadcasting sta-
use of advertisement. Increasing life ex- tion, but local broadcast also adopts similar
pectancy is also related to improvement of approach. One television set per family is
healthcare facilities and adoption of healthy common in Indonesia which is the perfect
lifestyle (Roosita et al. 2008). The inclusion reason traditional healers use it to their be-
of life expectancy as an indicator of public nefit. Information about method of healing,
health level has made each regional go- tools, probability of actually being healed,
vernment strive harder to reach higher life cost, and opening hour is usually among the
expectancy in order to meet national agen- things advertised through television. These
da (Gutiérrez et al. 2007; Zhou et al. 2010; traditional healer use television to get the
Hasan et al. 2009). Yogyakarta Special Regi- sympathy of audiences in hope they become
on with the highest life expectancy (i.e.: 77 interested in using their services. Such pro-
years-of-age for women and 75 years-of-age mises are usually accompanied by an inte-
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 Komunitas 8 (1) (2016): 39-50 41

ractive discussion where traditional healers in order to fulfill demands of modern and
get to answer questions from prospective dynamic traditional healing. As an examp-
patients; hence making these programs po- le, traditional massage now comes in ‘hou-
pular among the sick. se of healthy’, which combines all kinds of
Traditional healing practices can res- massage method such as reflex, shiatsu,
pond to patients’ needs. Traditional healers and traditional massage. They are offered in
now also adopt new medical technological strategically-located places equipped with
improvement along with the use of suppor- young, skilful, and modern-looking thera-
ting devices such as medical laboratories pists. However, social interaction between
commonly used by doctors. Herbal medici- patients and therapist becomes non-exis-
ne now also comes in capsule form similar to tent. These therapists work in a mechanical
pharmacy-made medicine. system where interaction between healers
Such change is strongly related to the and patients is lost, and replaced by music
emergence of acculturation in Javanese tra- played in such places.
ditional healing. Acculturation here refers to The development of traditional hea-
a social process which emerges when a group ling has also continuously experienced a
of people with a particular culture encoun- process of acculturation, which is evident
ters foreign cultural element. This foreign in the adoption of modern medical devi-
element is then accepted and appropriated ces such as: stethoscope, use of laboratory
without losing its original culture (Koentja- result, sphygmomanometer, and X-ray to
raningrat 1990). Acculturation will not exist diagnose an illness. Religious healing now
without what is known as medical pluralism also changes its incantation into prayers fol-
(Hardon, Boonmongkol, Streefland 1995). lowing healer and patient’s belief.
In the interaction between traditional and This acculturation arises as a response
modern medicine, acculturation occurs. from traditional healer to get around chan-
Nonetheless, such process is not free from ges in the medical field, particularly as a re-
contradiction. The modern medicine party sult of modern medical penetration. Becau-
usually blames traditional healing, and vice se of the encounter between two different
versa; traditional healers often argue that elements, contradiction and conflict are
their patients used to be modern medicine bound to arise. Therefore, it is important
patients whose treatment fails. Such contro- to understand this acculturation crisis con-
versy leads to a crisis of acculturation. sidering its impact on traditional medical
Cities with a dominant Javanese po- system, healers, and patients in modern and
pulation such as Yogyakarta has witnessed traditional medical interaction. In many ca-
a harmony between traditional and modern ses, traditional healing which incorporates
medical system as each understands that modern medical method is perceived as
their different system (Hardon, Boonmong- malpractice. However, due to inexistence of
kol and Streefland 1995). Each understands strong organization and lack of watchdog,
that they have different market segment and such practices are left unattended. Rarely
complements each other. Thus, they co-exist is such practice brought to trials. Patients
in serving community healthcare needs. rarely complain when healing results in
Despite the non-existence of valid damage and even death. Similarly, Islamic
data, the number of traditional healers in healing (what is usually referred as “healing
Yogyakarta tends to increase. This is proven a la Mohammad The Prophet”) which re-
by the hype of advertisement in local tele- cently also receives immense popularity in
vision. The development of traditional hea- Java is increasingly becoming a new skill to
ling form is also related to influences from be mastered by traditional healers who ex-
foreign culture such as modern medicine, pect to turn it into business enterprise.
Chinese, Arabian and other foreign cultu- Old pattern in advertising traditio-
re of medicine. Traditional healing tries to nal healing known as “getok tular” (from
appropriate foreign culture without losing mouth to mouth) is now changed into mass
its roots. Change in methods is common media-based advertisement such as radio,
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42 Atik Triratnawati, Acculturation in Javanese Traditional Medicine Practice in Yogyakarta

television, internet, and other print media. perspective can be explained well as part of
Using new mode of advertisement, traditio- Javanese culture.
nal healing is more widespread.
This article focuses on answering this ResultS and discussion
question, i.e.: in what way Javanese tradi-
tional medical system appropriates foreign Interaction between traditional and
medicine? What element can easily accept modern medicine
acculturation, and which element cannot? Javanese traditional healing has a long his-
The aim of this study is to explore and ana- tory. Although there is no written evidence,
lyze the process of acculturation in Javanese various ancient manuscripts prove the exis-
traditional healing in order to grasp the tence of Javanese traditional healing through
form of acculturation, which occurs from written traditional medicine recipes as well
the mixture of two or more medical culture. as healing methods such as: cekok, pilis, and
rajah – all of which are popular among Ja-
research Methods vanese (Triratnawati, Wulandari, Marthias,
This paper is based on a research conducted 2014) and jamu (traditional herb medicine)
on Javanese traditional healing in Bantul (Soeratno et al. 2002).
and Sleman, Yogyakarta since both districts Dutch colonial rule, which lasted 350
have the largest number of traditional hea- years, brought many influences in tradi-
ling compared to other districts in Yogya- tional healing in Java. The Dutch colonial
karta. These two districts were also selected government introduced modern medicine
because of the number of local TV broad- through their health workers such as nur-
cast stations showcasing traditional healing ses who worked in Java to combat infectious
indicates high interest among local popu- diseases (Sciortino 1999). Since then, the
lation. Besides, there are many traditional government of Indonesia started to adopt
healing practices such as bekam and gurah it as part of its national medical system. As
in Yogyakarta. Moreover, gurah is known to a result, state-owned healthcare institution
be originated from Imogiri – a sub district in started to be built. Hospitals, healing clinic,
Bantul. Therefore, many believe authentic and primary health centers were built across
gurah is from Imogiri. the country. In addition, health-related edu-
Data collection is carried out by the cation such as medical and public health fa-
use of qualitative method, particularly in- culty, as well as nursing schools continued to
tegrative ethnography where observation develop; hence, modern medical experts are
is done to contextualize the studied cultu- continuously produced by the state. Private
re (Silverman 2006). Interviews were done parties also provide healthcare facilities.
with traditional healers, and their patients. Entering globalization era where in-
Observation and interviews were conducted formation and communication flow is st-
with healers in diverse aspects such as: be- ronger; there are two impacts for traditional
ham, gurah, traditional massage, haemorr- healing. First, traditional healing will be
hoid, water therapy and spiritual healing, as marginalized as it is considered irrational,
well as other herbal healers in Yogyakarta. full of superstition, and not evidence-based.
Spiritual healers are known to use superna- Second, on the contrary, with stronger flow
tural method, metaphysics and heresy. Ho- of information, traditional healing is able to
wever, some call them spiritual or religious continue existing due to its blending with
(agamais) (Praworo 2011). modern medicine. One of traditional hea-
Data was analysed using phenomeno- ling system, which is popular even overseas,
logical approach, in order to explore accul- is Javanese traditional healing. For centu-
turation crisis from both perspectives, i.e. ries, Javanese as a social unit has developed
healers and patients. By doing so, accultu- local knowledge related to healing system.
ration process between modern and tradi- Javanese healing system emphasizes on ba-
tional medicine from healers and patients’ lance related to strong correlation between

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 Komunitas 8 (1) (2016): 39-50 43

macrocosm and microcosm. Macrocosm According to Jean-Francois Sobiecki,

is outside of human bodies, while micro- traditional healing system tends to be deve-
cosm is inside the human bodies. Imbalan- loped from spiritual or religious belief sys-
ce on macrocosm will have bad influence in tem (Nurdiyana et al. 2010). The awareness
microcosm, which results in illness (Trirat- to accommodate Islamic values in healing
nawati 2010). practices is represented in various forms
Understanding medical issues and di- of Javanese healing methods. Without lo-
sease etiology among Javanese is not based sing their identities as Javanese, these hea-
on scientific evidence, but based on long- lers appropriate Islamic values along with
term experiences or experiences passed their healing practices. Javanese traditional
down from generation to generation (Mur- healers also start to change traditional in-
niatmo et al. 1992, p.70). The passing from cantation into Islamic verses (Triratnawati,
one generation to another renders such sys- Wulandari and Marthias 2014). In addition,
tem a local tradition which is empirically Javanese traditional healers also adopt other
proven. Healing methods such as kerokan, healing methods which are claimed to be
massage, balsam, suwuk and use of tradi- originated from hadits such as: bekam a la
tional herb drink (jamu) represent local The Prophet mixed with massage and Wa-
wisdom owned by Javanese, which aims to lisongo healing method which mixes medi-
balance microcosm and macrocosm (Trirat- tation, dzikir, and rajah.
nawati 2010). Adopting Islamic elements in Javanese
The Javanese keeps changing, and glo- healing concept creates new method called
balization has caused traditional healing to acculturation between Javanese and Islamic
adopt foreign cultural traits such as Chine- healing. This acculturation brings its own
se, Indian, and Islamic healing methods wit- color in traditional healing. The method
hout losing its original traits. In acculturati- emphasizes on spiritual aspect represented
on process, some of the changes in healing in prayers to bring in karomah although in
method are a direct way of fulfilling local de- practice these prayers are wrapped in Java-
mand. Such process is a way of strategizing nese healing method such as meditation,
with penetration of modern medical system rajah, gurah and massage. In addition to
(Triratnawati 2014). prayers, the factors influencing healing ef-
Among many foreign traits, Islamic ficacy is autosuggestion, certificate, and ti-
healing method has become one of the most rakat used by the healers as well as patients’
adopted traits in traditional Javanese hea- belief in undergoing healing procedure.
ling. This is understandable as Islam is a ma-
jor religion in Indonesia. Besides, Islam as a Modern medical method adopted by
religion as well as a system, which governs traditional healer
all aspect of human life, also provides a set As an effort to provide healthcare service to
of tool which functions as healing media for the public, traditional healers start to seek
its believers. Furthermore, in Islam, medical innovation in order to attract more clients.
discourse is integrated as part of its teaching They try to adopt modern medical methods
and written in its scripture, as cited in an ar- in their healing practices. Adopted techni-
ticle written by Al-Yousefi (2012, p.272): ques include use of sphygmomanometer, use
of laboratory results such as: blood pressu-
Many verses of the Qur’an (Islamic Hol- re, triglycerides, and blood sugar level, as
ly book) and Islamic prophetic traditions well as use of X-ray to diagnose broken bo-
contain both spiritual and physical met- nes, use of capsule (with jamu inside), use of
hods for treating psychological and phy- media advertisement, use of billboard, and
sical disease. Allah stated the following in
modern registration system (using serial
the Qur’an : And we reveal of the Qur’an
number). Thus, traditional healer practice
that wich is healing and a mercy for belie-
vers’. (Surah Al-Isra: 82) does not have much difference compared to
doctor practice.
Such adoption is not aimless since
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44 Atik Triratnawati, Acculturation in Javanese Traditional Medicine Practice in Yogyakarta

cultural acculturation occurs in line with illness through patient’s hand (rajah) and
the fast improvement of modern medicine through electric current. He is also able to
which results in marginalization of tradi- cure various kind of skin disease. Despite
tional medicine. Acculturation occurs to this, bekam and gurah are still his mainstay.
many medical elements, particularly those Similarly, AB and H also has prana. Prana
which are popular. Acculturation between is known as chi in Chinese healing (Ga-
traditional medicine and Islamic medici- lanti 2008). This ability is usually gained
ne is evident among traditional healers in by fasting, going through ascetic lives, and
Yogyakarta. Bekam and gurah therapists in obeying other taboos.
Giriloyo Village, Imogiri are usually males, Imogiri as a place known for people
but recently, female therapists are present looking for gurah also has many interesting
especially for female patients. It shows how facts. It is also a popular tourist objects as
traditional healing incorporates Islamic te- Islam Mataram kings (Surakarta and Yogya-
aching which usually separates male and karta Sultanate) were buried there. Imogiri
female. is thus full of good luck (Kasniyah 1994). As
In order to meet local demands, gu- an example, when planted in Imogiri, sirgu-
rah therapists not only work to do gurah, gu plant – main ingredient for gurah – shows
but also to do bekam. In addition, they also good result. On the other hand, if planted in
make their own medicine by putting gurah other places, it does not have similar effica-
herbal ingredients into capsules for home cy in gurah healing as the ones planted in
use. Sirgunggu plant as gurah ingredient is Imogiri.
packaged in capsules to emulate modern There was one case where N’s patient
medicine. Similarly, in Madura, jamu in could not discharge mucus after being given
powder form is not popular since it is bitter. sirgunggu water unlike other cases where
Pill and capsule are used to make it easier to patients normally discharge mucus after
take (Mudjijono, Herawati and Munawaroh only several minutes. There are several pos-
2014). sible explanations why such case happened.
Generally, bekam therapists are First, the patient had no mucus. Second,
trained informally through courses. They sirgunggu liquid was not thick enough. Las-
then transfer such knowledge to their fami- tly, the sirgunggu used was not from Girilo-
ly members. On the other hand, gurah the- yo, Imogiri. People in Giriloyo argued that
rapists usually learn from Islamic boarding the third one was the likeliest reason such
school situated in Giriloyo or from senior failure had happened. Sirgunggu plant in
therapists. An unwritten rule says that those Giriloyo is perceived to be the best in qua-
coming from Giriloyo should only be the one lity compared to other places. They argued
doing gurah therapy. However, considering that land fertility played an important fac-
many therapists now open their own gurah tor. Old generation in Giriloyo believed that
courses, students come from everywhere. the land of their village had extra value since
Upon graduating, these new therapists then The Nine Saint (Wali Songo) prayed there
open their own practices. Thus, gurah is not (wis mambu donga wali).
only found in Giriloyo. They argued that N had another experience where a pa-
being a therapist was difficult as the profes- tient seemed like he was possessed by spirit.
sion required many spiritual practices (laku He sounded like a raven. N’s father who was
prihatin). In addition, therapists should also also a therapist explained that such thing
be ready to help others. They cannot rely on was common. According to him, it happened
their profession, as it is not the ideal job, as because the patient had gaman in his body.
they may not always be paid. Therefore, the Gaman is a weapon to strengthen oneself,
sole reason to be a therapist should be a de- but it was invisible. This weapon is usually
sire to help others. given by Satan; hence it contradicts Islamic
Nowadays, therapists generally have teaching. As a result, the patient reacted ne-
more than one skill. One gurah therapist N, gatively towards Islamic prayers used during
for example, also has an ability to analyse an healing process. In a worse scenario where a
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 Komunitas 8 (1) (2016): 39-50 45

patient cannot receive prayers and/or effects Mixture of Islam, Javanese, and Modern
of sirgunggu plant, he/she can feel nauseous Medicine
or even pass out. In various traditional healing practices in
Not only does gurah work for respira- Giriloyo, Islamic prayer is a main element.
tory tract, it also works for chronic diseases. The healer H mentioned that sirgunggu
Chronic diseases such as cancer, diabetes plant was only a medium, but the most im-
(Russel 2011) can also be healed through gu- portant aspect is prayer. Scientifically spea-
rah. AB explained when he dealt with a pa- king, prayer has a positive influence due to
tient who had cyst. its power. It will connect and remind one to
larger being; God. It will also soothe one’s
A woman in her thirties came to me with mind. It gives one a perspective and hope
cyst in her back. It was the size of snake which cannot be obtainable in other ways.
fruit seed. As an expert in bekam I imme- The most important thing is prayer makes
diately did the procedure in four points in one surrender (Buttar 2014).
her body where cyst grew. We did the pro-
This is where prayer is inserted by tra-
cedure thrice until blood which initially
ditional healers. Healers usually say prayers
was discharged in large quantity became
thicker, and gradually decreased in quan- in Arabic. Illahiyah healer named GN com-
tity. Afterwards, white fluid was released. bines traditional massage, and water prayed
In the area where I did bekam we can spot by Wali Songo prayer. Patients are also asked
small bumps. I then did “kop” procedure to pray according to their beliefs. If a patient
(where blood is released by putting a glass is a Moslem, he will help the patient pray-
on top of the bumps). This was done twi- ing in Islamic way. For him, prayer acts like
ce. During the procedure, patient screa- sugesti (self-hypnosis) for patient to belie-
med aloud due to pain. Lastly, white fluid ve that he will be cured. Patient is also ex-
came out. I call it ‘mata bisul’. pected to believe that God listens to every
prayer. Besides, with prayers, patients be-
According to a doctor diagnosis, this come hopeful.
patient suffered from atheroma cyst. Me- On the other hand, one of the most
anwhile, traditional healer took it for an adopted modern medical elements by tradi-
ulcer due to consumption of seafood – that tional healers is the use of X-ray. X-ray result
is characterized as ‘itchy’. Post healing, AB is usually brought by patients to traditional
gave her a medication for ulcer, and asked helaers. X-ray result shows that patients
her to visit again after the ulcer broke. generally visit a doctor, and are suggested
According to D – the patient – she suf- to go to an X-ray examination. Despite not
fered from vertigo followed by an acne-like having formal education, traditional healers
ulcer on her back. However, it lasted for a claimed to be able to read X-ray examinati-
month. She went to a doctor, and was sugge- on result. Ways of doing X-ray examination
sted for a surgery. She also sought informa- is different between traditional healers and
tion about atheroma cyst from the internet doctors. M uses glass affixed to patient body,
where she got similar solution. However, she and then he uses a torch to light through the
was reluctant and scared to have a surgery. glass. Furthermore, the result can only be
Thus, she followed a friend’s recommenda- read by someone with inner power (tenaga
tion to come to AB place. dalam) ability.
Adoption of modern medicine is also In Sleman, AS who is a traditional
done by F who is a haemorrhoid healer. He massage therapist recounted a story whe-
uses capsules and ointment to make his me- re he cured a patient with bladder stone.
dicine more attractive. By doing so, he ho- He was successful in discharging the stone
pes traditional healing can appear modern, by traditional massage. He could also see
practical, and hygiene. Likewise, DP uses through patients heart, whether one is pa-
capsules for his herbal medicine so it can be tient or emotional. Mixture of traditional
more practical and shippable. massage and Islamic prayer is key to his hea-
ling method. In order to improve his skill,
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46 Atik Triratnawati, Acculturation in Javanese Traditional Medicine Practice in Yogyakarta

he also learnt Chinese massage technique. ral system, social system, and material cul-
This particular massage technique puts an ture into an acculturation between Java and
emphasis on energy power. Healers use this Islam. This also influences logic of thinking
technique for relaxation and stimulation in healing method, which previously was
purposes in order to achieve excellent health developed in Javanese values.
(Rianto and Sujono 2005). Good enculturation of Java-Islam syn-
Adoption of Islamic traits in Javanese cretism concept gained its currency from Ja-
healing concent gives rise to new method vanese kings. The spirit of Bhineka Tunggal
called healing acculturation of Java and Is- Ika also aims at spreading this syncretism
lam. This healing acculturation brings its values. This spirit is not only meant “alt-
own color in traditional healing. Its method hough different, but still one”, but is also
emphasizes on spiritual aspect in the form meant, “despite differences in religion, its
of prayers to incur karomah although in its nature is one” – aims for highest entity in the
practice such prayers are packaged in Java- universe, God (Amin 2002, p.90).
nese healing methods such as meditation, Enculturation processed by Wali Son-
rajah, gurah, and massage. In addition to go and the kings has formed syncretism bet-
prayers, factors which influence efficacy of ween Java and Islam into its current state.
a healing method include sugesti. Patients As a result, acculturation between Islam and
are encouraged by healers word and action traditional healing practices is not inter-
(Triratnawati, Wulandari, Marthias, 2014). preted as a pragmatic effort only to attract
Other ways of increasing patient trust is consumer through dogmatic way. Instead,
formal certificate (usually gained from cour- it is an inseparable part of each other. Islam
ses) and tirakat (effort) done by healers in is Java, Java is Islam; Islamic teaching is ac-
order to strengthen patient trust. cepted not as a reality which brings about
change, but as a reality which continues old
Islam Medical Element in Javanese cultural tradition. As N said in the following:
Perception
Java-Islam syncretism is not a byproduct of In principle, Javanese do not let go of his
recent globalization, but is a result of long Javaneseness, and Moslem does not let go
process of Islam entering in Indonesia. It of its Moslemnese. Because Islam and Java
reached its peak in 15th century. Orientation is inseparable and is related to each other.
shift in Islamic thought and science to Ta- Long before Islam came in, the Javanese
actually practice its values and teaching.
sawuf or Sufism made it easier for mubaligh
The concept of living, understanding, and
(Walisongo) in the midst of spreading Isla- practicing is owned only by the Javanese.
mic teaching in Indonesia. This was caused As they have practiced Islamic values for a
by Javanese character, i.e. Manunggaling long time, Javanese truly understands and
Kawula Gusti (anna al-haq), which was in believes in the unity between Allah and hu-
line with Sufism. man (self). In the context of healing, befo-
Javanese cultural values have a strong re gaining popularity for bekam, Javanese
religio-magic aspect. This is rooted deeply has practiced it for a long time too. Then,
since animism and dynamism period. On ruqiyah, what’s the difference from suwuk
the other hand, Javanese unique character – in Java? I think it is the same thing.
being flexible and open to foreign cultural
traits – has not caused Javanese to lose one- In addition, technological improve-
self in changes brought by foreign culture. ment demands combination. To obtain le-
Instead, the Javanese succeeds in maintai- gitimacy from the public, it requires three
ning its existence by ‘Javanisizing’ foreign aspects, i.e.: Islamic, Javanese and modern
cultural traits by using Islamic symbol in medicine. The three is interrelated. Javanese
its outer part, but keeping syncretic Java as healing without the other two elements
the soul. Islam is described as a vessel, while is considered improvident. There are too
Java is its content. The blend between these many rituals for one case. Besides, this form
two cultures leads the construction of cultu- of religio-magic now not only relies on Java-
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 Komunitas 8 (1) (2016): 39-50 47

nese values, but also on Islamic prayers. It ney. Social purposes like helping people in
is believed that effort without pray will not needs are lost.
result positively in healing. Physical effort The development of advertisement ac-
done as part of a healing method is only re- tually follows information and communica-
garded to be a healing medium. tion technology. The first way of advertising
is through gethok tular (mouth to mouth)
Advertising traditional healing through (Cokro and Sutarto 2009). Traditional hea-
media and testimony lers still use this method, but they add other
Advertisement in mass media aims similar- modern methods. Through getok tular, one
ly, i.e. for something to be widely known. gains popularity of his efficacy. Patient then
Old form of advertisement used to be done tell other people good things about this hea-
by traditional healers in the 1980s. They ler. The people who hear about this healer
used to use radio, brochures, and moving are then interested in proving for themsel-
advertisement using cars. During that era, ves. Although healing is a personal effort,
these forms were widely used. However, cur- but healer will gain popularity through this
rently there are many private and local tele- kind of advertisement. By doing so, patients
vision stations; hence, it makes sense to use who are healed also act as a traditional ad-
them for advertisement purpose. TV station vertising tool.
broadcasts patients’ testimony in order to Even though traditional healing is not
increase popularity of traditional healers. apt for everyone, many patients are still co-
However, not all traditional healers ming, including patients with chronic dise-
use TV as a media to advertise their servi- ases. Feeling of ‘wanting to try’ is done to
ce. Others like DP in Sleman who introdu- be cured, but they mostly do it due to cocok
ces his herbal healing based on his acade- (apt, suitable) concept (Geertz 1960). Pa-
mic research prefer not to use TV. Instead, tients think that perhaps traditional hea-
he uses brochures that are then distributed lers are well-matched for them. The content
to his network of university students, mere of advertisement in media usually informs
acquaintances, and neighbours. Internet is people about the kind of diseases a healer
also used via WA, Twitter, and e-mails to re- can cure, methods, tools, name of healer,
ceive orders from clients in different cities. address, contact number as well as price to
Using TV is considered to be more expensi- pay. Some advertisement often says, “not cu-
ve; hence, internet is seen as a cheaper op- red, money returned”, while others include
tion. former patients testimonies.
Traditional healers are aware that ad- The cost of consultation and traditio-
vertisement can improve their income. Not nal medicine as well as tools (e.g. holy water)
only individual healers, but also healers who is affordable by patients. It is usually called
own big business use advertisement as a “mahar”. The term used is also common for
promotion tool. DW – a traditional healing Islamic wedding. In Islamic wedding, mahar
for haemorrhoids, which has many branch is paid by groom to bride. However, in the
offices in Java and Bali – chose local TV sta- context of traditional healing, it is paid as
tion to promote their non-surgical healing a cost of consultation and therapy service.
method. All of this advertisement in local It always refers to a relatively high amount
TV is managed by its central office in Jakar- of money, for example 3 million rupiahs for
ta. Thus, local branch usually do not have cancer. It has to be paid in cash, and not in
any idea of how much TV advertisement instalment. Despite the expensive cost, pa-
costs. They are only asked to do their jobs tients are not discouraged. Some even have
in preparing for broadcast. This method of to owe money to pay the cost.
advertising demonstrates that in traditio- Healing package like that exists in hos-
nal healing, marketing is also an important pital or GP private practice is also adopted
thing. It also means they provide professio- by traditional healers. For example, non-
nal service, which should be valued by mo- surgical haemorrhoids treatment in Sleman
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48 Atik Triratnawati, Acculturation in Javanese Traditional Medicine Practice in Yogyakarta

offers seven (7) choices of healing packages Discussion: Crisis of acculturation in

ranging from low-cost (500.000 rupiahs) to traditional healing
high-cost (10 million rupiahs) which claims Wong Jawa ora ninggalake Jawane, wong Is-
to heal haemorrhoids with a size of chick- lam ora ninggalake Islame. This adage me-
en egg. Some traditional healing do not cost ans Javanese has always interrelated values.
expensive. AS who offers bekam therapy in The Javanese has practiced Islamic teaching
Imogiri offers 20.000 rupiahs or whatever very well in their lives proven by their strong
his client wants to pay him for his service. application of Islamic teaching in daily life.
He uses brochures affixed to walls or even The Javanese is known for their patience, ac-
power poles. However, in practice the more ceptance, introspective, vigilant and appre-
expensive a treatment cost, the more people hensive. These values are in line with Islamic
believe that the treatment will cure them. In teaching with regards to moral. Therefore, it
addition, if the healer appears many times can be said that the Javanese strongly follo-
on TV broadcast, expensive cost will not be wed Islam.
a problem. People will be mesmerized by TV The fast development in today’s Ja-
appearances. Such condition results in pri- vanese community does not let the Java-
ce competition without anyone doubting if nese leave their identity. Likewise, Javanese
this expensive price is all worth it. Moslem does not leave their Islamic root.
Evidence-based modern medicine This way of thinking is the reason of many
usually conducts a clinical trial to medicine acculturations happening in Javanese cul-
through laboratory examination. Trials are tural aspects, including in medical field. Ja-
usually done to rabbits, and then to human vanese will incorporate any element as they
to examine side effects of such medicine. are used to take the good from any foreign
Therefore, there are several steps to be done traits. If there exists any element in their
before medicine reach its human consumer. culture which seems ancient, the Javanese
Evidence-based modern medicine are not will not hesitate to change it into something
allowed to advertise. Thus, it is strange that else. This strong ability to adapt is the base
traditional healing can go without clinical of acculturation process.
trials but can be advertised widely in TV. Similarly, N stated that technological
TV with many audiences can be misleading improvement demanded a mixture of met-
if traditional healing broadcast only misin- hod. If healing relies solely on Javanese met-
form public. Audiences cannot think ratio- hod, not many people will believe. This is
nally, but directly go to traditional healers where Islamic and modern medicine comes
advertised in TV to get treated. in. Islamic element is evident in the way be-
F who advertised in local TV in Yogya- lief in God as The Healer from all illness and
karta and Solo mentioned that the following that only with His permission, illness can be
morning after his advertisement broad- cured (kun fayakun).
casted, the number of his patients increased In a globalization era, traditional hea-
significantly (even 50%). New patiens came lers acknowledged that without updating
from different areas near Yogyakarta such their healing methods, people would lose
as Magelang, Temanggung, and Purworejo. interest. Consequently, foreign medicine
People also came to get more information traits such as that of modern, Chinese, Ara-
eventhough they did not directly sign up for bian, Indian, Japanese and Korean are in-
treatment. After receiving more informati- serted into traditional healing system. It is
on, many visited again with the purpose of not surprising that many traditional healers
getting treatment. Thus, advertising on TV use modern means in their system.
brings in many benefits for traditional hea- Commercialization of traditional hea-
lers, for example: some healers even proceed ling through business advertised in televisi-
to open new branches in Semarang and on is inseparable from inexisting regulating
Denpasar. on television broadcast. Media, in all forms,
transfers significant meaning which facili-
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 Komunitas 8 (1) (2016): 39-50 49

tates communication between government, nal healers come with different ways, inclu-
advocacy groups and the public. Media is ding advertising in mass media. Regulation
a strong power in educating the public on is disregarded for the sake of increasing in-
current issues. The use of media effective- come. On the other hand, public is deceived
ly can give rise to advocacy efforts to beha- through advertisement in television. Public
vioral change and to social mobilization is led to falsely believe that if a healer often
(Ayuningtyas 2014). appears on television, it means he has a po-
Traditional healing advertisement in tent healing method. Even with only a case
television does not educate public since in- of cured patient, traditional healer dares to
teractive discussion where healers diagnose claim that his healing method suits everyo-
patients without physical examination and ne with similar symptoms.
laboratory check is not permitted in modern In the future, media should act its
medicine. In addition, traditional healing is role to educate people through firmly regu-
not allowed to advertise through television. lating traditional healing advertising and
Acculturation in traditional healing is broadcasting alike in TV broadcast. Pub-
also related to strong medical pluralism con- lic attitude in choosing healthcare services
cept among people living in cities such as Yo- should be directed towards services with po-
gyakarta. Medical pluralism acknowledges sitive impact.
that modern medical practice has its own
weakness; hence, traditional healing comes Conclusion
to play. Each medical system respects each Acculturation in Javanese traditional hea-
other. In medical pluralism, introduction of ling is influenced largely by the way medical
foreign medical system is well-accepted by pluralism is strongly evident in Java where
local medicine. This means traditional hea- local and foreign medical element influen-
ling with a long history of existence accepts ce each other. Technological innovation
modern medicine which comes later (Har- also demands a combination of the two ele-
don, Boonmongkol and Streefland 1995). ments. If healing methods only rely on Ja-
No health system is like water. The vanese way, many will not put their trust so
systems that interact will also influence each easily. The addition of Islamic and modern
other. Likewise, Javanese medical system is medical element is then used to perfect it.
a result of mixture between local and mo- Islamic element appears in the form of pray-
dern, which means traditional medicine, ing practice aimed to Allah as The Healer of
can adapt to the development of modern all diseases. It is also influenced by a belief
medicine. No conflict arises when both res- that only with Allah’s permission, a disease
pects each other. On the contrary, when a is cured.
system perceives itself to be the better, mo- Traditional healing acculturation in
dern, and more rational, conflict arises. In a Yogyakarta is thus perceived as inseparable
society with strong medical pluralism such from the process of maintaining old traditi-
as Java, conflict can be avoided. on where unification of God and self exists.
However, in recent development whe- The emergence of business in traditional
re business aspect of traditional medicine is healing practices results in many things –
further emphasized, the principle of helping one of which is increasing cost. Accultura-
each other is replaced with buying-and-sel- tion crisis occurs in the form of lost inter-
ling principle. By doing so, intensive com- action and verbal communication between
munication between healers and patients healer and patients; contradictions between
decreases. Healers act as if they are machi- doctors and traditional healers and the te-
nes which works mechanically without a levision that advertises them; adoption of
sense of humanity. Acculturation crisis will modern medical technique and method in
arise in a form of conflict between modern traditional healing without formal training
and traditional medicine. which result low skill.
In order to increase income, traditio-
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50 Atik Triratnawati, Acculturation in Javanese Traditional Medicine Practice in Yogyakarta

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