Informal Healthcare in Contemporary Russia. Sociographic Essays on the Post-Soviet Infrastructure for Alternative Healing Practices
This volume deals with one of the most understudied aspects of everyday life in Russian society. Its main heroes are the providers of goods and services to whom people turn for healthcare instead of official medical institutions. A wide range of agents is described—from network marketing companies to 'folk' journals on health as well as healers, complementary medicine specialists, and religious organizations.
Krasheninnikova’s book is based on rich empirical observations and avoids both positive and critical assessment of the analyzed phenomena. Her investigation pays particular attention to the legal, social, and economic status of informal healthcare providers. She demonstrates that these agents tend to flourish in bigger towns rather than in small settlements, where public healthcare is lacking. The study reveals the important role of institutions that are generally not related to alternative medicine, such as pharmacies, libraries, and church shops.
The result is a vivid and thorough introduction to the world of self-medication and alternative healing in contemporary Russia. A special emphasis was made on the flexibility of boundaries between formal and informal healthcare due to the evolution of rules and regulations.
The paper aims to portray and to discuss the informal impact of drugstores on health in Russia today, taking into account their formal role in the health care system. The empirical study was conducted in 2013 in the Perm region. It was a part of the larger project on description of all informal providers of goods and services for self-treatment in Russia.
According to our suggestion, if the pharmacies are commercial organizations, they inevitably adapt their work to customers’ demands. As a result, the tasks not designated by state policy are taking a prominent place in their work. In the terminology of R. Merton it could be called the latent (hidden) functions, i.e. unintentional and unconscious consequences of their activities. In order to describe them, we analysed the legislation and general statistics of drug sales in Russia, conducted 30 in-depth interviews with pharmacists, inspected around 50 pharmacies in different towns and villages, and specially registered all customers’ demands during two days in one pharmacy.
The peculiarities of the healthcare system and pharmaceutical retail in Russia may create conditions for a high level of self-medication and the proactive role of pharmacies in it. Nevertheless, in the Russian legislation the main reason for the existence of pharmacies is to provide remedies which are prescribed by doctors. It seems to mirror the classical, paternalistic model of health care. The legislative framework leads to the conservation of the hidden social functions of pharmacies, because deviations are widespread although illegal.
In sum, the empirical research demonstrates three main latent functions of pharmacies: to take on the duty of physician, to provide remedies for self-medication (whether conventional OTC and prescription medicines or food supplements, or alternative medicine), to serve addicted people and to help them in maintaining a destructive dependence. Each of them reveals in the various aspects of communications and implicit behavior rules in pharmacy. All of them work against formal healthcare.
The monograph focuses on economic agents that substitute or complement the official healthcare system in modern Russia by serving alternative health maintenance practices. A detailed description of their activities is provided on the basis of an analysis of nationwide secondary data (public statistics, mass media, laws and regulations), as well as observations and interviews from the field research in the Perm region in 2013. The book consists of two parts. The first – introductory – chapter contains some generalizations and reflections on the subject matter in general. The following chapters are a series of independent sociographic essays that focus on selected "informal healthcare" phenomena classified by the principal product offered to the customers: goods, gifts of nature, diagnostic and treatment services, ideas/beliefs, or information. Among others, we consider direct selling of health products and itinerant trade in them; latent social functions of pharmacies; services of healers and doctors of alternative medicine; gathering and production of healing gifts of nature by private households; healing practices of religious organizations; and dissemination of self-treatment information in the mass media. The publication targets a wide audience, including professionals in healthcare management, social scientists, and everyone interested in health protection and the informal economy in Russia.
The article is devoted to police moonlighting in Russia. Despite the initial function of law regulation, in many countries police transformed in a destructive tool. In contemporary time police are highly involved in economic activity, which is embedded in business and political spheres. The authors describe the complicated intertwining of legal and illegal aspects of the activity, and bring light to fundamental causes of police moonlighting and socio-economic and political consequences of the phenomenon. The article is based on results of researches of key Russian teams in this field.
Several approaches to the concept of fatherhood present in Western sociological tradition are analyzed and compared: biological determinism, social constructivism and biosocial theory. The problematics of fatherhood and men’s parental practices is marginalized in modern Russian social research devoted to family and this fact makes the traditional inequality in family relations, when the father’s role is considered secondary compared to that of mother, even stronger. However, in Western critical men’s studies several stages can be outlined: the development of “sex roles” paradigm (biological determinism), the emergence of the hegemonic masculinity concept, inter-disciplinary stage (biosocial theory). According to the approach of biological determinism, the role of a father is that of the patriarch, he continues the family line and serves as a model for his ascendants. Social constructivism looks into man’s functions in the family from the point of view of masculine pressure and establishing hegemony over a woman and children. Biosocial theory aims to unite the biological determinacy of fatherhood with social, cultural and personal context. It is shown that these approaches are directly connected with the level of the society development, marriage and family perceptions, the level of egality of gender order.