Patients’ webs of relations in the medical landscapes of Central Ukraine

ABSTRACT

Village dwellers in Central Ukraine have access to various types of therapy that comprise diverse medical landscapes. Patients’ movements within these landscapes are possible thanks to each person's web of relations. Medical landscapes are not fixed, but vary and dynamically change for each person, depending on their fluid and interchanging, hierarchical webs of mutual relations with other people, personal bodies, institutions, discourses, political powers, other non-human organisms, or objects such as medicines. This paper was inspired by the medicoscape concept (Hörbst and Krause 2004) as well as Ingold's idea of meshwork analyses of relations between various actors: in this case, patients, healers, a weak state, official healthcare providers, pharmacists and medicinal plants, in the context of patients’ therapeutic choices. Self-medication based on herbal remedies is a very important feature of people's medical landscapes in Central Ukraine and usually the first therapy choice for most interlocutors. That is why this paper is focused on the presentation of the means through which people acquire knowledge about medicinal plants, and the ways they interact with plants and plants interact with them. In this way, showing the complexity of villagers’ webs of relations is possible. The analysis is based on ethnographic research conducted between 2009 and 2013 in the Vinnytsia region (Central Ukraine).

KEYWORDS:

• Medical landscape
• webs of relations
• self-medication
• therapy choice
• Ukraine

Ethical approval

This research did not require institutional ethical approval either in Poland or in Ukraine. The village council agreed to the research. An expression of consent was required before each interview. The research was done in accordance with both the American Anthropological Association ethical guidelines and International Society of Ethnobiology (ISE) code of ethics, where appropriate (The Code of Ethics 2008).

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. I use the official Ukrainian rules of transliteration based on Resolution No 55 of The Cabinet of Ministers of Ukraine ‘On Normalization of Transliteration of the Ukrainian Alphabet by Means of the Latin Alphabet’ of 27 January 2010 (United Nations Group of Experts 2011).

2. The emic term for official medicine is traditional medicine (tradyciina medycyna). I will use the term ‘official medicine’ as it emphasises the state support that this kind of medical care gets and the presence of an infrastructure supporting it. The term ‘biomedicine’ will be used to stress the connection to science, especially pharmaceutical science.

3. I use the term ‘doctor’ for official healthcare doctors working in the public healthcare system, although in the emic context it could also be used for other types of practitioners.

4. All interlocutors’ names have been changed.

5. Narodna medycyna is an emically important term. It is used for all kinds of local non-biomedical healing and self-medication based on folk tradition.

6. The local names of plants are transcribed from surzhyk (mixture of Ukrainian and Russian used in the research area; for more information on language issues in Ukraine see, for example, Bilaniuk 2005). For some plants, popular Russian names are widely used. I give the popular English name, and in italics, the most common locally used names and Latin name according to The International Plants Name Index (2014).

7. Kassam (2009) has made similar observations in Tajikistan.

8. The name romashka is sometimes also used for Leucanthemum vulgare but it is recognised as a different plant. Some interlocutors call chamomile romashka dika (wild chamomile) or rumianok.

9. At the time of my research many people from the area worked temporarily in Russia, especially in Moscow. All of my interlocutors knew somebody working there, usually people from their extended family. Information about medicines and herbal remedies was often brought back from such trips.

Additional information

Funding

This work was supported by the Narodowe Centrum Nauki [grant number 2011/01/N/HS3/03332]