Pills, potency and fertility: The illicit trade of male sexual enhancement products in Quiapo, Manila

by Gideon Lasco, MD

In a paradoxical and very graphic juxtaposition of the sacred and the profane, the Minor Basilica of the Black Nazarene in Quiapo, Manila – popularly known as the Quiapo Church – is surrounded by peddlers selling all sorts of products, many of which act as 'pharmaceuticals', in the sense that they are invested with notions of efficacy and potency in effecting cures and enhancing bodies. Given its “medical” function, anthropologist Michael Tan has aptly christened it the “Quiapo Medical Center” (Tan, 2009). He emphasizes the temporal dimension in his lectures about Quiapo, saying that “it changes every time.” (personal correspondence).  

Considering its reputation for selling products that are outside the sanction of the law, the church, and the medical establishment, I decided to focus on enhancers or male potency and fertility, which is one such gray area. I, together with my research assistant Ryan Tuiza, visited Quiapo several times from August to September 2012 to identify which products are sold for male sexual enhancement, to describe how they are sold, and to whom. I was also interested in how the vendors describe their products. 

Ideally, we ought to have embarked on survey of which products are sold for sexual enhancement across genders (heterosexual males and females, homosexual males and females). However, we were limited by our own genders, which, as we found, made it difficult to relate to products that were not deemed appropriate for our use. Moreover, as we observed during our field work, the Quiapo vendors are very suspicious of the people who pass by, even as they offer their merchandise with spiels such as:



Para saan po? (For what?)
Ano ang hanap nyo? (What are you looking for?) 

The first question is interesting because it invites an answer based on the [pampa + x form], which denotes function. e.g. pampaalis ng lagnat (Remover of fever), pampalaki (Enlarger). After the initial visits, we decided to come up with our own opening spiels: 

“Naghahanap po ako ng pampagana sa sex...” (I'm looking for a mood-enhancer for sex..."“May pampa-buntis po ba kayo?” (Do you have something to make someone pregnant?)

These two spiels also reflect the two categories of substances we were looking for, enhancers of potency, and enhancers of fertility. In this short note, I will describe several products that are used for these purposes. Later on, I will continue to reflect more on our Quiapo experiences by offering thematic insights. 

ENHANCERS OF POTENCY

In this category, I use the colloquial usage of the term potency, i.e. male sexual performance. In the context of Quiapo, the attributes of potency – which are also seen as effects of the products – including “harder” and “longer” penile erections, greater physical stamina during sex, and faster “recovery time”. 

1. “Peter Cream” – This white cream from China is said to be a very potent enhancer of sexual performance. The container of the cream is illustrated with Chinese characters, with only “Peter Cream” in Latin letters. We do not know whether the naming of this product has something to do with 'peter' being a slang term for penis in countries like the United States. The effect is described in vivid detail:

Kapag pinahid mo yan, titigas agad yung ari mo. Makakaramdam ka ng kakaibang init... tatagal ka ng tatlong oras, at kahit 5 rounds kayang-kaya. Maaawa ka sa babae. (If you apply it, your penis will become erect. You will feel a strange heat. You will last for three hours, and even 5 rounds is easy. You will pity the woman.)

The peddler is so confident about its efficacy that he even invited us to try it to feel the effect. He adds that he himself uses it, and so does his old uncle. “This is popular with the old men,” he says.

The cream is applied just once, and the effect should be experienced within five minutes. For maximal effect, it is advised that the man takes a shower first before he uses it. 

Peter Cream is sold in different quantities, with ¼ of a container selling for P200, and the whole for P500. 

2. “Five in One” - This tablet is said to combine five different types of desire-enhancers (“pampagana”). Like Peter Cream, it also produces body heat (“nag-iinit ang katawan”) and the effect is seen after five minutes. For maximal effect, the stomach must be full before this is taken. 

Also, testimonials were invoked when the vendors try to sell this product. Depending on the number of tablets, it is sold for PHP 300 -500. 

3. Lana ng ahas (Snake's oil) – This is a panacea that is being offered more openly by the vendors: it is said to cure a myriad of conditions, from “anemic” to rheumatisms. According to one vendor, having it massaged on your body will stimulate heat (i.e. pampainit) which is also a form of sexual stimulation (i.e. pampagana), and is effective for both men and women. 

4. Dugo ng cobra (Cobra's blood) – This is a kind of snake wine allegedly with the blood of cobra on it, and is also said to enhance sexual performance, among other aspects of masculinity (i.e. pampalakas sa trabaho, energy-booster at work). Placed in recycled bottles of Tanduay rhum and other local liquor, you can see the body of the snake inside the bottle, and the liquid is amber-colored. Other bottles have the added ingredient of ginseng, which is also a known Oriental aphrodisiac. It is to be drank an hour before sexual intercourse to have full effect. 

5. Viagra (Sildenafil) – According to at least one vendor, Viagra tablets are also “available”, and interested buyers are asked to wait for 30 minutes. This was picked up by my research assistant, but unfortunately, we were not able to pursue this lead. There is also no way of ascertaining whether the alleged 'Viagra' tablets are authentic. Nevertheless, even with incomplete data, I am including it here for its mere existence is a significant finding.

To recap our rundown of enhancers of Peter Cream and “Five-in-One” seemed to be the most popular options, and are offered by several vendors, but these products are hidden from view, and are covered with manila paper. The herbals, on the other hand, and the oil and wine bottles, are displayed prominently along with amulets, candles, and sachets of leaves. Western medicines, represented in our survey by Viagra, may also be more available than previously thought. 

ENHANCERS OF FERTILITY

In this section, fertility is used in its biological sense, that is, the “natural capability to produce offspring”. We found that there are also products in Quiapo that are being sold for this specific purpose:

1.”Root crops” - This is a liquid concoction sold in bottles, and is said to be made of roots, bark that were mixed with vitamins which serve to “revive the sperm cells”. The vendors say it is made in China. 
It is said to have an effect as soon as one week, and should be taken thrice a day before eating.

According to one vendor, many people have already tried it, and they can attest to its efficacy. He told the story of a couple who failed to conceive after five years of conjugal union. They tried all sorts of cures, but in vain, until the husband started using the root crops. In just two months, the woman got pregnant. 


However, this special liquid formula comes with a steep price: P500 for a small bottle (around 50 mL) and P1000 for a bigger one (100 mL).

2. Vitamix tablet – Other vendors offer “Vitamix Plus” as a cure for infertility. It is to be taken twice or thrice a day before meals, and takes two weeks to a month to take effect. There are no contraindications to its use, and it is sold for P1000-P1500 per blister pack.

Unlike the other products, this one was amenable to further inquiry by searching for “Vitamix” in the Internet. Curiously, although the vendors say it is made in China, the online search identifies its source as an Indian pharmaceutical firm. 

INSIGHTS 

1. The eclecticism of Quiapo – I was honestly expecting to see indigenous and traditional products to come up – the traditional expectation of Quiapo – but a majority of the products we saw were ascribed to China, although we also saw that this does not necessarily mean that the true source is China. Regardless of the origin of these products, however, there are regulatory implications of this trend. More so when 'Viagra' comes up as one of the consumer choices. Three different medical systems are represented in Quiapo: Chinese, Western, and Filipino traditional, and seemingly, all are beyond the reach of regulation.

2. A vast referral system. To follow Prof. Tan's language, “Quiapo Medical Center” is a 'tertiary hospital' with a vast network of specialists, which ironically leads back to the medical profession. The offer of a referral to a doctor, coming from a Quiapo peddler, is demonstrative of the complicity of at least some health professionals. My research assistant also recalls being offered pamparegla in case his girlfriend needs it, hinting at other services: 

May malalapitan tayo ng tulong kung kailangan nyo ng pampalaglag...
(“There are people we can ask for help if you need an abortifacient”)

3. Suspicion and surveillance. Perhaps as an adaptation to the efforts to curb the trade of illicit products, the vendors are visibly suspicious of passersby, and even those who claim to be looking for products. Personally, I felt that I was not able to fully act out the role of a “typical” customer looking for sexual enhancement, or a cure for infertility – hence my strategy of getting a field worker. As if to affirm the existence of the illicit trade, banners surround the Quiapo church warning the public that the trade of abortifacients like Cytotec will be dealt with severely (Postrado, 2009). However, even when these government moves are met with success, there are many other products out there that require regulation and control. 

4. The power of testimonials. To boost their case for their products, vendors usually invoke supposed testimonies of their past customers. The image of an old man, does a lot to boost their case, particularly in the absence of any objective parameter to evaluate the products. Pit against the “evidence-based” medicine of health professionals are the “anecdote-based” medicine of the vendors, which actually appeal more to the public.

CONCLUSION

There exists in “Quiapo Medical Center” a market for products that promise to enhance male potency and fertility. Sold at relatively high prices, these products likewise suggest that there is a substantial the number of people who are willing to buy them, and vendors are quick to offer connections to medical practitioners, suggesting that the "biomedical sector" and the "informal sector" of health care not parallel systems; there are links between them.

With little or no product information, it is not just efficacy, but safety, that is a major concern as far as these products are concerned. Viagra was initially a drug for pulmonary hypertension until  male study volunteers discovered its "desirable" side effect. But this goes to show that these products have systemic effects that can very well be harmful to its users, especially the elderly who are often the target of these drugs. Health authorities should take this matter seriously.  

Made in China, banned in the Philippines, and sold without regulation, these products reinforce the view that “you can buy anything in Quiapo.” If its vendors are to be believed, the price of pleasure ranges from 200 to 500 pesos, “satisfaction guaranteed”. 

Manila

September 2012

REFERENCES

Tan, Michael. “Quiapo Oracle”, opinion article, Philippine Daily Inquirer, January 1, 2009. Available at: http://opinion.inquirer.net/inquireropinion/columns/view/20090109-182286/Quiapo-oracle

Chua, Philip. “Is street Viagra safe?”, opinion article, Cebu Daily News, January 19, 2009. Available: http://globalnation.inquirer.net/cebudailynews/opinion/view/20090119-184254/Is-street-Viagra-safe

Postrado, Leonard. “Quiapo vendors warned anew”, news article, Manila Bulletin, August 15, 2009. Available: http://www.mb.com.ph/articles/216062/quiapo-vendors-warned-anew