What prehistoric bones bare about early Filipino caregiving

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March 19, 2026 | 8:28am

MANILA, Philippines — Long before hospitals or formal medicine, a community in what is now northern Luzon may have quietly practiced caregiving practices and sustained care for one of their own who could not fully care for himself.

The findings come from a new archaeological study of human remains from Nagsabaran, a shell midden site in Cagayan Valley, dating to the Philippines' Metal Period around 2,000 to 1,800 years ago.

Researchers from institutions in Australia, the Philippines and the UK, including scientists from the National Museum, analyzed one individual known as "Burial 4" whose bones indicate both physical impairment and signs of long-term care.

The Burial 4 remains—that of a young adult male—had signs of ankylosis in the left hip where the joint had fused, limiting his ability to move. He likely experienced periods of immobility and limping, the study noted, based on skeletal changes showing uneven strain on his legs.

The same skeleton also showed clear signs of scurvy, a Vitamin C deficiency, a condition associated with pain, inflammation and bleeding in soft tissue and bones.

"Severe pain is a near universally reported clinical symptom of scurvy," the researchers noted, suggesting the individual likely endured significant discomfort during life.

Evidence of care

Despite his physical impairments, the individual survived long enough for both the hip joint and scurvy-related lesions to show signs of healing. Scientists took this as a clue that he was not left to fend for himself.

His limited movement from hip fusion would have required help with daily activities. Researchers suggest the individual's limbs may have also been moved or repositioned to prevent pressure sores and maintain comfort.

"Having scurvy suggests that Burial 4 likely required direct care beyond catering for his hip ankylosis alone," they wrote.

Those around him may have also been mindful of his his food intake. With inflamed gums and facial pain from scurvy, eating would have been difficult for him, yet he survived. 

"It is likely his diet, prepared for him by others, was altered to softer foods that were easier to chew," the researchers added.

While with disabilities, the man may have also continued contributing to his community in other ways.

"Atypical wear on his anterior teeth suggests possible use of teeth as tools," the study noted, pointing to alternative forms of participation.

Extended into death

How Burial 4 was positioned also told researchers about how the individual was accommodated beyond his lifetime despite ancient norms for funerals.

"Burial 4 was buried differently to others from his age group. He was buried with his cranium and appears to not to have been wrapped tightly in a shroud like the others," they wrote.

The burial appears to have accommodated the fused position. Upon discovery, the bones were permanently locked in a flexed pose.

Taken together, the findings point to what researchers describe as a "bioarchaeology of care" — a framework that identifies evidence of sustained caregiving in ancient societies.

For the scientists, further studies can look at disability and nutrition together to understand early systems of care and coordination.

The study was published on the International Journal of Osteoarchaeology's January–February 2026 edition. The researchers were Chloe Boucher, Dominique Armelle, Justyna Miszkiewicz, Mary Jane Louise Bolunia, Alexandra De Leon, Antonio Peñalosa, Pablo Pagulayan, Adan Soranio, Marc Oxenham and Melandri Vlok.