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Specialization of Skills and Traditional Treatment Methods
by Namalo in Batak Toba Community, Indonesia
Rizabuana Ismail*, Ria Manurung*, Devi Sihotang*, Hadriana Marhaeni Munthe*
and IvanaTiar**
*Universitas Sumatera Utara, Medan, Indonesia
**Universitas Negeri Jakarta, Jakarta, Indonesia
KEYWORDS Batak Toba Society. Herbal Treatment. Medicinal Plants. Namalo. Traditional Healer
ABSTRACT Traditional medicine in the North Sumatera province of Indonesia is found in many rural areas.
Traditional treatment by Namalo is known for using herbal medicines to treat internal diseases, as well as treating
broken bones and conjured diseases. This paper will discuss the specialization of skills and traditional methods of
treatment conducted by 12 Namalo practitioners in Toba Samosir and Humbang Hasundutan regency. The qualitative
approach of in-depth interviews and participant observation of the Namalo was used to obtain the data. Namalo
specialize in different treatment applications, depending on the illness or trauma suffered by the patient. In the
process of treating patients, Namalo perform massage techniques on patients and then give a medicinal herb. There
are 2 types of drug administration: either Namalo gathers medicinal plants and processes the plants, or secondly, the
patient gathers the medicinal plants and processes them according to the instructions given by Namalo.
Address for correspondence:
Rizabuana Ismail
E-mail: rizabuana@usu.ac.id
INTRODUCTION
Namalo is the term for traditional healers in
Batak Toba community in North Sumatera Prov-
ince, Indonesia. This traditional form of treat-
ment has undergone several changes, especial-
ly the treatment techniques performed to cure
the patient. These modifications occurred with
the entry of Christianity into the Land of Batak
(North Sumatera) and changed the mindset of
people to trust God. Traditional treatments that
had long relied on supernatural powers through
a worship ceremony and ritual offerings were
subsequently replaced with medicinal treatment
using herbs and massage (Manurung et al. 2017;
Ismail et al. 2019). Today traditional medicine
competes with modern medicine. Although mod-
ern medicine has increased significantly in re-
cent years, traditional medicine has not disap-
peared and has been united and in line with the
development of people’s lifestyles. Traditional
medicine is still an alternative treatment for com-
munity (Sermsri 2018; Merriam and Muhamad
2013).
Currently, traditional medicine is starting to
increase, especially in some countries. In 2005,
the Department of Traditional Medicine Devel-
opment and Alternative Medicine in Thailand
conducted a survey in 39 provinces in Thailand
and found 3,075 traditional healers still perform-
ing traditional medicine. In 2006 the survey was
conducted in 75 provinces and found 27,670 tra-
ditional healers (Suwankhong et al. 2011). South
Africa has around 200,000 traditional healers and
nearly 60 percent of the population has tradi-
tional medical consultations (Nene 2014). In In-
donesia, since 2004 that number has been in-
creasing drastically. According to records, about
72 percent of the population self-medicated, and
33 percent chose traditional medicine. Traditional
medicine in Indonesia reached 280,000 people.
In addition, the development of traditional med-
icine in Indonesia is supported by the discov-
ery of 950 plants species which can cure diseas-
es, from over 30.000 species of plants in Indone-
sia (Kamal 2017).
The results from the surveys above show
that people still need the existence of traditional
healers to get healthy. Traditional medicine and
modern medicine have different concepts on the
causes of “sickness” or “disease” and have dif-
ferent approaches in the methods of treatment
performed. Traditional healers also link pain with
cultural beliefs of religion, health and personal
conflict (Gessler et al. 1995). In Tehuledere com-
munities, North East Ethiopia the “causes” of
ill-health were constructed and negotiated with-
in the socio-cultural context of the study com-
munities. Tehuledere communities explained that
Ethno Med, 13(4): 207-216 (2019)
DOI: 10.31901/24566772.2019/13.04.593
© Kamla-Raj 2019
PRINT: ISSN 0973-5070 ONLINE: ISSN 2456-6772
208 RIZABUANA ISMAIL, RIA MANURUNG, DEVI SIHOTANG ET AL.
Ethno Med, 13(4): 207-216 (2019)
causes of ill health in three major themes: (i) su-
pernatural (almighty God/Allah, nature spirits,
and human agents of the supernatural) (ii) natu-
ral elements or physical causes: (iii) social ele-
ments such as mistrust, social support/ family
dynamics as well as violation of taboos and
moral injunctions (Kahissay et al. 2017). This
was also mentioned by Gruca who conducted
research in Sahara Africa. She further mentioned
that traditional healers often apply divination
and various rituals in order to understand the
overall significance of a healing process and
counteract its cause. As a consequence, tradi-
tional remedies are not merely used for curing a
disease, but are also used to obtain protection
or to overcome curses (Gruca et al. 2014).
Namalo play a role that is very important in
the world of health, especially for people who
are in rural areas. Namalo still have patients who
always consult them about diseases. The exist-
ence of Namalo is not fully accepted by the
community since supernatural powers are in-
cluded by some Namalo in the process, but their
treatment is an option for the community. The
existing traditional medicine in the Batak Toba
community conducted by a Namalo is discussed,
including the division of Namalo according to
ability and the treatment techniques performed
by Namalo to help patients recover from illness.
The extent to which Namalo uses rituals to cure
illnesses of his patients will also be described
so that Namalo maybe repositioned as tradi-
tional healers accepted by the general public.
METHODOLOGY
Research Locale
This research was conducted in two regen-
cies located in North Sumatera Province (Fig. 1).
Fig. 1. Map of North Sumatera Province
SPECIALIZATION OF TRADITIONAL MEDICINE IN BATAK TOBA COMMUNITY, INDONESIA 209
Ethno Med, 13(4): 207-216 (2019)
Toba Samosir Regency and Humbang Ha-
sundutan Regency became the selected loca-
tions for this study. These regencies were cho-
sen because many traditional healers are still
found whose knowledge and ability are re-
nowned by the community. Both regencies are
famous for their traditional healers; the majority
of them are Protestant Christians and ethnic Batak
Toba. According to people from this region, tra-
ditional healers are those who are able to cure
diseases either with herbs, through certain cere-
monies or rituals, and through other things that
cannot be scientifically studied. In this study
the traditional healers who became informants
are those who perform treatment processes us-
ing medicinal herbs as the main medium of heal-
ing. More specifically, the location of this re-
search was divided into several areas, namely:
in three subdistrict locations, Uluan District,
Laguboti District and Siantar Narumonda Dis-
trict in Toba Samosir Regency. Plus, one other
location in District Lintong Nihuta, Humbang
Hasundutan Regency consisting of two villag-
es namely: Sigumpar Village and Sitolu Bahal
Village.
Method
This research used a qualitative ethnographic
approach which is description of society and
natural phenomenon as it happens. Hammers-
ley and Atkinson (2007) stated that ethnogra-
phy is an exploration of a phenomenon that nat-
urally occurs and works with unstructured data,
analyzing data through interpretation of the
meanings addressed by respondents in the
study (Rice and Douglas 2005). Ethnography
also allows researchers to use a mix of methods,
theories, data sources, and even data analysis
through data triangulation.
Data collection was done by conducting in-
depth interviews with Namalo. A draft interview
was prepared by researchers to delve into the
treatment methods used by Namalo to cure dis-
eases; types of diseases that can be cured and
herbs given to patients were inquired about in
the interview. The findings in the field provided
answers about the potential of “Namalo” in the
Batak Toba community to continue their exist-
ence and the knowledge that they have. Data
collection methods in the form of interviews were
carried out at the homes of Namalo which is
where Namalo apply treatments. Interviews
ranged from 1-2 hours because the interviews
were done while the Namalo is doing the curing
practice. During the interviews the researchers
also observed the Namalo treatment room, the
medicinal plants used by Namalo, the process
of mixing medicinal plants, and the treatment
process. By these activities researchers also ex-
perienced the process of treatment conducted
by Namalo.
The major informants were those who con-
sult Namalo and are being treated by using herbs.
In addition to using purposive samples, snow-
ball techniques were also used to find key infor-
mants in accordance with predefined criteria. This
sampling method is a chain of sharing informa-
tion so that someone who is likely to have char-
acteristics appropriate to the research can be
found (Biernacki and Waldorf 1981). From the
research location using purposive and snow-
ball samples, 12 Namalo were found who had
traditional herbal medicine ability.
RESULTS
Each traditional healer has different treatment
modalities to cure his patients according to his
or her knowledge. Some of the traditional heal-
ers in the Toba Batak community known as Na-
malo can be grouped into 3 areas according to
their knowledge and treatment capabilities:
1. Namalo with the ability to cure internal
diseases
2. Namalo with the ability to heal broken
bones
3. Namalo with the ability to cure conjured
disease (witchery)
The Namalo grouping above demonstrates
the capabilities possessed by Namalo although
in reality, these groupings do not limit Namalo’s
ability to cure other types of diseases. Primary
results show that Namalo who has the ability to
cure internal diseases in general also has the
ability to cure conjured diseases. These inflict-
ed-by-others diseases (conjured) can also be
cured by using herbal ingredients and have a
treatment process that is not much different from
the treatment for internal disease. Namalo who
has the ability to treat broken bones only mas-
ters this treatment and usually does not have
210 RIZABUANA ISMAIL, RIA MANURUNG, DEVI SIHOTANG ET AL.
Ethno Med, 13(4): 207-216 (2019)
the ability to cure internal diseases or conjured
diseases.
Curing the patient’s disease with their spe-
cialized ability provides its own satisfaction for
Namalo. Namalo have no desire to learn other
skills; Namalo wants only to develop his or her
ability to cure various types of diseases experi-
enced by patients. This is also related to early
knowledge that the earliest treatment aptitudes
held by Namalo were passed down through
dreams of ancestors. Namalo only serve as tra-
ditional healers in accordance with the aptitude
given as a legacy. Patients who have recovered
from the disease are the measure of treatment
technique efficacy possessed by Namalo. Na-
malo has its own rules, one rule is, if Namalo
does not have the ability to cure a patient’s ill-
ness, then Namalo will retreat and declare his
incompetence to the patient’s family. From 12
Namalo involved in this research, their modali-
ties can be described as given in Table 1.
Some internal diseases that can be cured by
Namalo are cancer, ulcers, rheumatism, choles-
terol, heart disease, fever, menstrual pain, myo-
Table 1: Specialization of diseases treatments by Namalo
Name of Namalo Treatment capabilities Prescription system
Broken Internal Conjured
bones diseases diseases
Namalo 1
Patients receive herbs from Namalo.The
patients are not charged at all, but the
patients provide a voluntary treatment fee.
Namalo 2
Patients receive herbs from Namalo.The
patients are not charged at all and pay
voluntarily.
Namalo 3
Patients look for medicinal plants.Patients
process the medicinal plants by themselves
according to Namalo procedures.No charged
fee.
Namalo 4
Patients receive medicinal plants herbs from
Namalo.Patients provide a voluntary
treatment fee.
Namalo 5
Patients provide some medicinal plants
needed during treatment by themselves.
Some materials such as patchouli oil is
provided by Namalo.Patients provide a
voluntary treatment fee.
Namalo 6
Patients receive herbs from Namalo.Patients
are charged according to the type of disease.
Namalo 7
Patients receive herbs from Namalo.Patients
provide a voluntary treatment fee.
Namalo 8
Patients provide medicinal plants by
themselves.The patients are not charged at
all, and the patients provide a voluntary
treatment fee.
Namalo 9
Patients receive herbs from Namalo.The
patients are not charged at all, and the
patients provide a voluntary treatment fee.
Namalo 10
Patients look for medicinal plants needed by
themselves.The patients are not charged at
all, and the patients provide a voluntary
treatment fee.
Namalo 11
Patients receive herbs from Namalo.Patients
are charged with small fee for medicinal
herbs.
Namalo 12
Patients receive herbs from Namalo.Patients
are charged for medicinal herbs according
to fee specified beforehand.
Source: Depth Interview, 2017
SPECIALIZATION OF TRADITIONAL MEDICINE IN BATAK TOBA COMMUNITY, INDONESIA 211
Ethno Med, 13(4): 207-216 (2019)
pic eyes, kidney stones, coughs, paralysis, ear-
ly childhood autism, epilepsy, and so on. Nama-
lo with broken or fractured bones specialization
can heal fractured or shifting bones and treat
injuries resulting from accidents. Namalo with a
specialization of conjured diseases is able to cure
the illness of patients where the state of the pa-
tient’s soul is disturbed by others through su-
pernatural powers, and to cure existing diseases
in the patient’s body that cannot be categorized
as an internal disease or bone-related disease.
Namalo’s Method in Determining Disease
The initial stage in the treatment process is
discerning the disease of the patient. When
Namalo discovers the patient’s disease, then
Namalo can determine the next step that must
be taken. Each Namalo has his own way of di-
agnosing the patient’s illness. Namalo’s way of
determining the illness of his patients will be
discussed below based on data obtained from
patients and data from Namalo itself. The data
show some ways that Namalo cure the patient:
check on the facial features of the patient, use
other media such as kaffir lime (citrushystrix),
betel leaf (piperbetle) and eggs, observe the
patient’s physical condition, ask the patient’s
complaint, analyze the reaction of the potion,
and ask how long the pain has been persisted.
The method to determine the patient’s illness
conducted by Namalo is not much different from
modern medical practice. Asking for patient com-
plaints and the duration of the illness is com-
monly done by traditional healers and modern
medical practitioners to know specifically the
illness suffered by the patient. However, they
use the aforementioned media like betel leaf in
diagnosis process. As soon as Namalo hold the
kaffir lime and betel leaf in their hands, they are
able to figure out the illness. They can also give
correct diagnosis by rubbing the eggs over the
skin area of the patient.
Namalo who specialize in curing illnesses
determine the patient’s illness by the patient’s
facial features. In medical treatment this tech-
nique is also used sometimes but only at a pre-
liminary stage to make a temporary diagnosis
which will then be reinforced with the results of
examination through other medical devices, so
that the diagnosis can be accurate. Features such
as see face color, tongue color, lip conditions,
pupil of the eye and so on are included. In tradi-
tional medicine facial reading is often used by
Namalo to diagnose the patient’s illness. Through
facial features Namalo know complaints that are
usually indicated by pain and the specific body
parts of patients who experience pain. This tech-
nique helps Namalo to provide a treatment pro-
cess in accordance with the illness suffered by
the patient. The ability to determine the patient’s
illness through facial features is done by Nama-
lo by first asking for help from God Almighty.
Namalo pray to God in a special room wearing a
white robe and eating betel leaves. After per-
forming the prayer ritual, Namalo will see his
patient and observe the patient’s face to deter-
mine the illness that the patient suffers. Deter-
mining a patient’s pain from facial features is
also done throughout the world of medical health.
This diagnosis is done by looking at the face
line, lip color, cheek shape, and the area around
the face that undergoes changes. When the
body is unhealthy it will affect other body parts.
The mouth, for example, can show the condition
of the stomach. The lips show the condition of
intestinal health and the stomach. Through this
knowledge, a healer can determine the patient’s
illness easily. However, some not only diagnose
a patient’s illness from facial expression, but also
take other actions to support the temporary di-
agnosis obtained so it can be trusted. Other ac-
tions can include examining the body parts of
sick patients and asking the patients’ complaints.
Education on the technique of reading the dis-
ease by facial expression was originally known
in traditional Chinese medicine. Treatment tech-
niques with acupuncture make a healer able to
read important points that exist throughout the
human body.
In addition to the methods mentioned above,
other methods used by Namalo are through the
medium of kaffir lime. Patients are asked to bring
a kaffir give it to the Namalo. Through this kaffir
Namalo can know the type of disease suffered
by the patient. Kaffir lime has a certain meaning
for each tribe. For Batak Toba community, kaffir
lime or the so-called Utte Pangir in the commu-
nity is known as a symbol of cleanliness. Kaffir
lime is usually used by the Batak Toba people to
clean themselves by mixing the bath water with
lime juice. Kaffir lime is also often used in wor-
212 RIZABUANA ISMAIL, RIA MANURUNG, DEVI SIHOTANG ET AL.
Ethno Med, 13(4): 207-216 (2019)
ship ceremonies as offerings. In the traditional
medicine kaffir lime is used to begin the treat-
ment. Namalo also believe that this one fruit has
the efficacy of healing the patient from the in-
side by drinking the juice of this fruit. The abili-
ty to determine the illness of patients by using
these media is usually performed by Namalo with
the specialization of internal disease and illness
due to mystical things or conjured. In addition
to using kaffir lime, other media commonly used
by Namalo are chicken eggs and betel leaves.
Through this medium Namalo can determine the
patient’s illness whether it is a natural disease
that arises from organ damage or it is due to the
actions of others who rely on mystical power to
make others suffer. The technique of determin-
ing the disease by using this medium is usually
used by Namalo with the ability to cure internal
diseases and conjured illness.
Namalo’s Method in Treating Disease
The way treatment is conducted depends on
the type of illness suffered by the patient. Each
traditional healer has a different way of doing
the treatment process. In general, Namalo be-
gins treatment by using massage techniques
called dappol in Batak Toba. Massage technique
or dappol has long been known in the life of the
Batak Toba community. In daily life massage tech-
niques are often used by common people them-
selves when they feel their bodies are unhealthy.
However, not everyone can perform proper and
efficacious massage. According to the Batak
Toba community, not all hands own good man-
dappol skill, only the hands of certain people
can heal the pain. Namalo have the ability to
heal through massage techniques. Namalo have
the ability and knowledge about the core points
of the body which can reactivate body func-
tions. Massage techniques are commonly used
to help patients with internal diseases and bro-
ken bones. However, Namalo with this special-
ization have differences in their massage tech-
niques. What distinguishes the massage tech-
nique lies in the medium that Namalo used in
massaging the patient. Namalo specialized in
internal disease use simpler herbs and only uses
oil (patchouli oil, cooking oil, etc.) mixed with a
few spices. Namalo specialized in broken bones
use a lot of spices and other herbs to restore a
patient’s broken or shifted bone.
In addition to method of treating the patient
there are also several stages in the patient’s
treatment process. The stage of the treatment
process is intended to analyze the treatment pro-
cess undertaken by Namalo. The stage of treat-
ment performed by Namalo for some healing
process is done through the stage of praying to
God. This stage is an early one conducted by
Namalo before starting the treatment process.
Through this stage Namalo asks God to help
him or her in healing the patients. According to
Namalo praying to God is a must do activity
because without the help of God Namalo will
not be able to heal the patient. But not all Nama-
lo performs prayer or other rituals before curing
the patient, because some of them consider the
healing process itselfas the ritual activity.
Namalo’s Method in Processing and
Using Medicine
Traditional medicine is known for its tradi-
tional and simple treatment methods. Tradition-
al medicine can also be referred to as a treatment
that uses potions from herbs or medicinal plants.
In addition to having knowledge in determining
the type of disease and how to treat the patient,
other knowledge owned by traditional healers is
medicinal plants. It is not an easy thing for some-
one to learn to mix drugs; in order to concoct
drugs one must first know the anatomy of plants
and the properties possessed by chosen plants.
Besides having knowledge about medicinal
plants, healers should also be able to provide
the appropriate dose so that the drug can cure
the disease.
Medicinal plants usually have a certain part
that can be used as a medicine, for example only
leaves, fruit, roots, seeds, or other parts. In gen-
eral, medicinal plants are very easy to find and
are located around the home environment. How-
ever, there are also some plants that are not eas-
ily obtained and usually grow in the forest.
These plants are ultimately formulated in sever-
al ways to become a medicine. So, the medicine
is a processed mixture of several medicinal plants
that has the efficacy to cure a disease.
Not all plants can be used as medicinal herbs,
some of which can even be toxic when there is a
SPECIALIZATION OF TRADITIONAL MEDICINE IN BATAK TOBA COMMUNITY, INDONESIA 213
Ethno Med, 13(4): 207-216 (2019)
mistake in processing. Therefore, it is necessary
to know plants that are around us. There are
also medicinal plants that can only be used as
medicines when the plants are at a specific mat-
uration, if it exceeds that point in time then plant
has no efficacy. The ingredients used in a med-
icine are not only in the form of herbs from sev-
eral types of plants, but also a mixture of some
spices such as pepper, ginger, galangal, temula-
wak and so forth. The spice are usually mixed
with medicinal plants; this mixture is then given
to the patient.
There are several methods of processing or
mixing the drugs performed by Namalo namely:
a. Drying is done to reduce the water con-
tent in the plant so it can be nutritious.
One plant usually dried is God’s Crown
(phaleriamacrocarpa). Dried plants are
usually finely ground and mixed with oth-
er plants or herbs
b. Grinding is another process. Usually,
ground medicinal plants are dried in the
sun first. This method is done to facilitate
absorption of the ingredients to be digest-
ed by the body or to get liquid from the
plant. Crushed or ground plants can be
powder or liquid, plants in the form of pow-
der will be consumed by brewing while the
plants milled until the liquid or oil is re-
leased are used for rubbing or massaging
the body. For example, for the treatment of
diabetes, cempedak skin (artocarpus inte-
ger) is left in the sun, dried, and then pulver-
ized into powder, taken by brewing, twice a
day but must be adjusted to the patient’s
blood pressure.
c. Shredding is performed to make spices
easier to be cooked and to release the me-
dicinal ingredients contained in them.
There are some spices that are usually pro-
cessed using this method such as turmer-
ic, temulawak (curcumazanthorrhiza), gin-
ger and so forth.
d. Boiling is the most commonly used meth-
od of mixing plants or spices. This step is
usually done to extract the substances con-
tained in the plant by steaming it to the boil-
ing point. The water extract is as medicine;
however boiling is sometime used to soft-
en the plant and then the plant is con-
sumed. For example, aloe vera is cooked
until the texture is chewy then the aloe
vera is consumed to help remove the gas
that is located in patient’s stomach. In con-
trary, the kecibling plants (strobilanthesc-
rispa) are boiled but the part being used
afterwards is the water itself, which is use-
ful for cleaning the kidneys.
In order to mix medicinal plants and spices
into an efficacious medicinal that can heal other
things to take notice on is the dose of the con-
coction. In the medical world, the dose in mixing
the medicinal powder is measured in mg units,
whereas consuming it is measured with a dose
of one tablet or capsule usually taken after meals
or before meals. Not only that rule, there are also
rules of consumption 3 times a day or 2 times a
day and so on. The same thing applies in tradi-
tional medicine in terms of dosage or consump-
tion rules. The difference is, in concocting the
drug there are several types of dosage known
by Namalo such as sajopput (one pinch hand),
a handful, one space of phalanx and so on. The
medicinal consisting of several plants are dis-
pensed in an accurate ratio. In addition, the dose
to concoct the drug has to be precise, and in
taking the ingredients of the drug the rules of
consumption are also given. Consuming herbs
in the liquid form is usually subject to the rule of
2 cups a day or 1 cup a day. As for the medicinal
plants that are consumed, the herbs are usually
eaten according to the dosage given by Nama-
lo. Herbs in the form of oil are usually rubbed on
the patient’s body at the time(s) instructed by
Namalo, for example before sleeping.
The process of mixing drugs can be per-
formed by Namalo or by the patient. Patients
will receive directions or guidance from Namalo
on how to mix drugs and the doses that have to
be followed by the patient. However, there are
also drugs that are mixed directly by Namalo so
Namalo only need to provide rules about how
to take the herbs that have been made. The use
of medicines from traditional medicine is very
different from modern medicines; medicinal
herbs from these traditional healers do not cause
side effects and do not inflict addiction to the
patient.
Based on the type of diseases, the use of
drugs given by Namalo can be classified as giv-
en in Table 2.
214 RIZABUANA ISMAIL, RIA MANURUNG, DEVI SIHOTANG ET AL.
Ethno Med, 13(4): 207-216 (2019)
Primary data found in the locale show that
internal disease Namalo also perform massage
techniques onthe patient’s body as a reflexolo-
gy for the patient’s body. However, the use of
drugs through consumption is the main treat-
ment conducted by Namalo. Consuming potions
by drinking or eating is one way to help the
healing process to be more effective for patients
with internal disease. But, on fractured or bro-
ken bones, Namalo only gives herbs to mas-
sage the patients. Patients with fractured bones
do not consume or eat herbs. To help the heal-
ing process for fractured bones, Namalo only
lists food which cannot be eaten to help the
healing process from inside. As for patients with
skin diseases, herbs given to the patient to rub
over the skin surface of the patient’s body.
Prescription System
The process of giving medicine to patients
is divided into 2 systems. First, Namalo gives
medicinal plants that have been mixed to the
patient. In this case Namalo himself will get the
medicinal plants to be used, some ingredients
are bought in the market and some are found in
the forest. This system is chosen by Namalo
because there are some plants that are unknown
by the people and Namalo does not want to
make it hard for patients to seek drugs. Namalo
does not only get medicinal plants, but also pro-
cesses the medicinal plants himself. Provision
of drugs made by Namalo will usually be charged
for, or in other words, Namalo sells medicinal to
patients. Second, Namalo asks the patients to
seek their own medicine. Doing this does not
mean that Namalo wants a hands-off approach
with the healing process of the patient. Accord-
ing to Namalo this method is done so that pa-
tients and especially families of patients can be
independent and have knowledge about medic-
inal plants. Namalo usually writes the names of
medicinal plants that the patient should look for
and how to blend them. If the medicinal plant
needed by the patient is a rare plant and cannot
be found in the area, Namalo will help the pa-
tient to look for it and even order it from out of
town or outside the province. Namalo not only
helps the patient get the medicinal plant but for
some specific drugs Namalo himself will pro-
cess it himself. In this kind of system, Namalo
will not charge for anything because the medic-
inal plants are sought by the patient himself.
Pantangan or taboo is a prohibition given
by Namalo to the patient about what are allowed
and what are not allowed to be consumed by the
patient, or what should and should not be done
during treatment. In addition to taking medicinal
ingredients, obeying the taboos given by Na-
malo is one way to improve treatment. However,
not all traditional treatments performed by Na-
malo provide prohibitions to patients. Prohibi-
tions given by Namalo depend on the type of
illness suffered by the patient. From the three
specializations, each Namalo provides some re-
strictions for patients with certain diseases,
whether it is Namalo specializing in internal dis-
eases, broken bones or conjured diseases. Some
of the restrictions imposed by Namalo for his
patients include: Prohibition of eating certain
foods such as durian, saying certain words, go-
ing outside the house, and meeting other peo-
ple. For patients with internal diseases they are
generally asked not to consume some foods
mentioned by Namalo to prevent the disease
getting worse. Many patients with internal dis-
eases have no dietary restrictions.
Namalo with broken bone specialization also
impose prohibitions for some patients usually a
ban of consuming some foods. Foods that
should not be consumed by patients with bone
disease may make the wound on the patient’s
body more difficult to heal. Prohibitions also
apply to patients with illnesses inflicted by oth-
ers or conjured disease. The abstinence for this
is more diverse such as prohibition of saying
certain words, prohibition of going outside the
house and meeting someone. This prohibition
is given by Namalo to prevent the illness get-
ting worse.
Table 2: The usage of medicine based on types of
diseases
Types of diseases How to use
Internal diseases Drinking the medicinal herb
extract
Fractured or broken Massaging with medicinal herbs
bones
Skin diseases Rubbing with medicinal herbs
Source: Primary Data, 2017
SPECIALIZATION OF TRADITIONAL MEDICINE IN BATAK TOBA COMMUNITY, INDONESIA 215
Ethno Med, 13(4): 207-216 (2019)
Based on data found in the locale through
interviews it is known that the treatment dura-
tion with Namalo is shorter than modern medi-
cal treatment. When Namalo knows the type of
illness suffered by the patient then a further
treatment visit will be determined by Namalo.
Patients with mild disease conditions only re-
quire 1-2 meetings, whereas patients with se-
vere disease will do more than 2 visits in accor-
dance with the invitation from Namalo. Check-
ing the condition of the patient after regularly
taking the ingredients of the drug affects the
period of treatment that must be undertaken by
the patient. If the ingredients of the drug give a
good reaction to the patient’s body then the
patient no longer needs a treatment visit and
Namalo only recommend consuming and using
the medicinal herbs given regularly.
DISCUSSION
Traditional healers Namalo can be divided
into three specializations, which are Namalo of
internal diseases, Namalo of broken bones and
Namalo of conjured diseases. In general, some
of the traditional healers in some other coun-
tries are also divided into several categories, for
example Tanzanian traditional healers are
grouped into four classifications based on their
masteries, such as herbs, herbalists-rituals, ritu-
al-herbalists and spiritual (Gessler et al. 1995).
Thailand divides traditional healers known as
morbaan into several types based on the knowl-
edge of traditional healers such as tom yasa
moon prai (herbal medicine), morsa moon prai
(herbalist), mor du (forecaster), mornuat (mas-
sage treatment) and morwaiphom (treatment
through ceremony or soul healing) (Suwankhong
et al. 2011). Traditional Korean medicine catego-
rizes traditional medicine into 4 based on the
methods of treatment being used, which are
ch’im (acupuncture), hanyak (traditional herbal
medicine), d’um (moxibustion) and buhwang
(cupping) (Kim et al. 2002).
The classification results from the differenc-
es in some of the capabilities and methods of
treatment performed by traditional healers. The
data found indicate that Namalo always want to
improve their ability and knowledge in curing
the illness of patients, ranging from mild illness
to severe disease. Therefore, Namalo found at
the locale show that they do possess capabili-
ties to cure both of them. This research shows
that Namalo of internal diseases also has the
ability to cure conjured diseases. However, for
Namalo with fractured bones specialization,
these traditional healers are only able to master
the ability to heal broken bones and they have
no ability related to internal diseases and con-
jured diseases. The results of this study indi-
cate that Namalo has different specialization
skills and Namalo will only carry out the treat-
ment if they believe can do it. Namalo will just
do “their part” according to their ability.
Having knowledge about medicinal plants
and how to blend them is a major requirement to
become a Namalo. Namalo determines the pa-
tient’s disease through the reading of the facial
features of the patient. Namalo can know the
illness suffered by patient with only a glance at
the facial look of the patient. Unlike patients with
diseases caused by supernatural forces, tradi-
tional healers have different strategies. Tradi-
tional healers will use the betel leaf medium to
determine the disease with this supernatural
power as well as Namalo who also uses betel
leaves and kaffir lime.
This is slightly different with Thai medicine,
traditional healers whom do some checks to ob-
tain the diagnosis of the disease. Before start-
ing treatment, Thai’s traditional healer will ask
the patient about the illness, examine the record
of patient’s disease, listen to the patient’s com-
plaint, share information with the patient, and
observe the pathology of the patient’s body
(Maneenoon et al. 2015). The system of admin-
istering herbs made by Namalo to his patients
varies. There are some Namalo traditional treat-
ments that provide the medicinal herbs that the
patient needs. There is also Namalo who asks
his patients to find the medicinal plants Namalo
requested and then the patient will concoct by
himself according to the instructions given by
Namalo. It aims to share information about me-
dicinal plants to patients so that patients can
recognize and preserve plants that can be used
as medicine.
CONCLUSION
The treatment process undertaken by Na-
malo can be said to be very simple. Treatment
216 RIZABUANA ISMAIL, RIA MANURUNG, DEVI SIHOTANG ET AL.
Ethno Med, 13(4): 207-216 (2019)
performed by Namalo consist of determining the
patient’s disease, how or techniques to treat the
patient, how to make potions, length of treat-
ment and prohibitions given to patients. In gen-
eral, the way Namalo determines disease is very
diverse depending on the treatment capabilities
possessed by Namalo. In general, the tradition-
al treatment techniques performed Namalo are
the same, they use massage and herbs as a treat-
ment to cure the patient.
Traditional medicine contributes so much to
the medical world especially to the community.
The patient should understand what kind of dis-
eases that one endured and wisely choose the
treatment. The notion of “traditional” does not
mean this treatment is outdated and unfit for
use, but it is a treatment method that must be
preserved and protected because it is a cultural
heritage that still survives to this day.
ACKNOWLEDGEMENT
This paper is funded by the Directorate of
Research and Community Service, Directorate
General for Research and Development, Minis-
try of Research, Technology and Higher Educa-
tion Republic of Indonesia, 003/SP2H/LT/DRPM/
IV/2017 date, April 20, 2017.
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Paper received for publication in October, 2018
Paper accepted for publication in August, 2019
