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

The woman who chose the terreiro. Lay care and medical landscapes in mental health care in Rio de Janeiro

Brazilian mental health care reform understands mental health as a complex social process. There is a large literature production within the country focused on deinstitutionalization policy, social determinants of mental health and human rights, however, with little recognition beyond Latin American borders. In addition, cultural dimensions of mental suffering have been neglected in Brazilian debates which limits an expanded understanding of health care and users' inclusion. This paper aims to discuss the role of cultural determinants in mental health care in Brazil. We followed a patient in the city of Rio de Janeiro who opted for therapy based on her religious beliefs-using ayahuasca in the context of the Afro Brazilian religion of Umbanda-over the treatment-as-usual in mental health. We draw on the notions of autoatención (self, domestic, and group-care in lay contexts) and medical landscapes to examine how therapeutic negotiations reflect embodied cultural traits and both social and political determinants shaping therapeutic spaces. We argue that recognizing sociocultural differences and therapeutic negotiations are key elements in making a more inclusive health practice. Moreover, this recognition enables identifying and reasoning the broader social processes framing health practices. This debate is relevant to the Brazilian mental health context and to other scenarios, especially those where local and global knowledge and practices in mental health are entangled.

Green pharmacy at the tips of your toes: medicinal plants used by Setos and Russians of Pechorsky District, Pskov Oblast (NW Russia)

BACKGROUND

While the hybridization of ecological knowledge has attracted substantial attention from researchers, the coexistence of local and allopathic medicinal traditions in literate societies widely exposed to centralized schooling and medical services has not yet been investigated. To this end, we studied the current and remembered local ethnomedical practices of Setos and neighboring Russians at the border with Estonia.

METHODS

During 2018-2019, we carried out 62 semi-structured interviews in the Pechorsky District of Pskov Oblast, NW Russia. For cross-border comparison, we utilized the data from 71 interviews carried out at the same time among Setos in Estonia. The Jaccard Similarity Index and qualitative comparison were used to analyze the data.

RESULTS

The study participants mentioned 819 uses of 112 taxa belonging to 54 families. More than two-thirds of the uses (565) were quoted by 36 Russian interviewees, while the remaining third (254) were quoted by 26 Seto interviewees, with the top 3 in both groups being Viburnum opulus, Rubus idaeus, and Plantago major. The Seto intraethnic similarity index was lower (0.43) than the interethnic similarity in Estonia (0.52) and comparable to the interethnic similarity in Russia (0.43). Setos in Russia and local Russians rely more on wild plants (86% and 80% of medicinal plants, respectively), while Setos in Estonia and Estonians show less preference to them (63% and 61%, respectively). Nevertheless, Setos tend to source wild plants available in their gardens (33% of plants for Setos in Estonia and 38% in Russia), while Russians prefer to source them in the wild (38%).

CONCLUSIONS

The preference of both groups in Russia for wild plants over cultivated and purchased plants was inspired by the overall plant literacy, access to nature, and one-to-many knowledge transfer favoring wild plants. Setos in Russia reported a narrower and more homogenous set of plants transferred vertically. However, due to atomization and the erosion of horizontal connections, there are singular plant uses among Setos that overlap with the local Russian set of medicinal plants and differ qualitatively from that of Setos in Estonia.

Quantitative-Qualitative Method for Quick Assessment of Geodiversity

The article demonstrates a method for quantitative-qualitative geodiversity assessment based on core elements of abiotic nature (geology and geomorphology) according to a proposed weight multiplied by the area of spread through the studied region. The territory of the Coromandel Peninsula was selected as a case study due to its diverse geology and geomorphology. The north part of the Peninsula (Port Jackson, Fletcher Bay and Port Charles districts) was chosen because of the variety of rock types (sedimentary and volcanic groups) covering the region, while historical stratovolcano remnants and old sediments provide a good variety of meadow hills and weathered coastal cliffs. Meanwhile, the method utilizes easily accessible data (topographical and geological map) to assess slope angle (morphometry) and rock groups, including their age (geology) to identify areas in the sample region with significant geodiversity values. Moreover, the aim of this research is to make the assessment of geodiversity simpler and more accessible for various parts of the world with minimal required information. In this paper, we provide access to improve and utilize this method in geologically diverse territories to select the best areas for geotourism, geoeducation and geconservation planning.

The emergence of new medical pluralism: the case study of Estonian medical doctor and spiritual teacher Luule Viilma

Rather than the harmonious coexistence of different therapeutic practices and meaning systems, medical pluralism involves the contestation of norms and meanings related to legitimacy and authority. The implicit cultural norms that shape local understandings of health and legitimate healing methods become more during periods of social and cultural change. This paper demonstrates the contested nature of medical pluralism based on the case study of one significant figure, Estonian gynaecologist and spiritual teacher Luule Viilma. Well-known to the public as a trailblazer and prominent spokesperson for medical pluralism since the 1990s, Viilma's trajectory from doctor to healer reveals some implicit characteristics and mechanisms of power struggles as evidenced by the 'boundary work' carried out by biomedical specialists. By uniting and bridging biomedicine and spiritual self-help, Viilma became a figure whose presence and teachings gave responsibility and power to individuals and helped to legitimize pluralism in health practices. She had the ambition to redefine, in a fundamental way, perceived norms of legitimacy and authority, as well as the patient's position. From interviews with people who have used Viilma's teachings and material from internet discussion forums, it is apparent that the emergence of new forms of medical pluralism has brought several changes in health-related norms and understandings, including more active personal involvement in health-related information seeking and decision-making.

Knowledge transmission patterns at the border: ethnobotany of Hutsuls living in the Carpathian Mountains of Bukovina (SW Ukraine and NE Romania)

BACKGROUND

Cross-border research is a novel and important tool for detecting variability of ecological knowledge. This is especially evident in regions recently divided and annexed to different political regimes. Therefore, we conducted a study among Hutsuls, a cultural and linguistic minority group living in Northern and Southern Bukovina (Ukraine and Romania, respectively). Indeed, in the 1940s, a border was created: Northern Bukovina was annexed by the USSR while Southern Bukovina remained part of the Kingdom of Romania. In this research, we aim to document uses of plants for food and medicinal preparations, discussing the different dynamics of Local Ecological Knowledge (LEK) transmission among Hutsuls living in Ukraine and Romania.

METHODS

Field research was conducted using convenience and snowball sampling techniques to recruit 31 Hutsuls in Ukraine and 30 in Romania for participation in semi-structured interviews regarding the use of plants for medicinal and food preparation purposes and the sources of such knowledge.

RESULTS

The interviews revealed that, despite a common cultural and linguistic background, ethnobotanical knowledge transmission occurs in different ways on each side of the border. Family is a primary source of ethnobotanical knowledge transmission on both sides of the border; however, in Romania, knowledge from other sources is very limited, whereas in Ukraine interviewees reported several other sources including books, magazines, newspapers, the Internet and television. This is especially evident when analysing the wild plants used for medicinal purposes as we found 53 taxa that were common to both, 47 used only in Ukraine and 11 used only in Romania. While Romanian Hutsuls used almost exclusively locally available plants, Ukrainian Hutsuls often reported novel plants such as Aloe vera, Aronia melanocarpa and Elaeagnus rhamnoides. Knowledge related to these plants was transferred by sources of knowledge other than oral transmission among members of the same family. Therefore, this may imply hybridization of the local body of knowledge with foreign elements originating in the Soviet context which has enriched the corpus of ethnobotanical knowledge held by Ukrainian Hutsuls.

CONCLUSIONS

While ethnobotanical knowledge among Romanian Hutsuls is mainly traditional and vertically transmitted, among Ukrainian Hutsuls there is a considerable proportion of LEK that is transmitted from other (written and visual) sources of knowledge. This cross-border research reveals that despite a common cultural background, socio-political scenarios have impacted Hutsul ethnobotanical knowledge and its transmission patterns.

How practice in plant collection influences interactions with illustrations and written texts on local plants? A case study from Daghestan, North Caucasus

BACKGROUND

It is only recently that written sources of local knowledge on plants are not being ignored by scholars as not belonging to "traditional" knowledge. Ethnobotanical texts, however, if they at all focus on knowledge from written sources, hardly ever pay any attention to the actual processes of interaction with written texts and illustrations. During our research, we examined people's interactions with texts, illustrations, and herbarium specimens of plants they collect or are familiar with. We focused on a small community of Shiri people in the mountainous village and in the lowland settlements in the Republic of Daghestan, Russia. In the paper, we address the following questions: how do Shiri people interact with illustrations, written text, and herbaria specimens? How is this interaction influenced by the practice of plant collection? What are the methodological implications of the ways people interact with illustrations, texts, and herbaria specimens?

METHODS

Our research was based on long-term ethnographic fieldwork: co-designing of a booklet showing edible plants people collect in Shiri, semi-structured interviews, and video-recordings, and observing interactions between people and text/illustrations/voucher specimens.

RESULTS

We identified three kinds of interactions between individuals and text/illustrations: "text-wayfaring"-predominantly a bodily interaction between an individual and illustrations and text; "fact/spelling checking"-predominantly discursive and information focused; "between wayfaring and fact-checking"-the mix of the two. Using the idea of textual poaching, as well as the knowledge-making approach, we show that the mode of interaction with text/illustrations influences what is acquired, and how. This process influences readers' LEK. The mere presence of an information in the text available to people does not imply that they will acquire it, make use of it, and change their LEK. Photographs and pressed specimens of locally known plants are often not (or only partly) recognized by the interlocutors. Video-recording is essential for analyzing the above mentioned interactions.

CONCLUSIONS

In ethnobotanical research, it is important to pay more attention to people's interaction with their sources of knowledge, including text and illustrations. The discursive part of LEK is more easily influenced by written sources. The practice of plant collection is not as easily influenced. Ethnobotanists function in a particular context and are embedded in discourses oriented towards conservation of bio-cultural diversity that value heritage as such, so it is important to be aware of one's positionality. A methodology that relies on showing pressed specimens or photographs to interlocutors may be a very misleading way of collecting ethnobotanical data.

Multi-functionality of the few: current and past uses of wild plants for food and healing in Liubań region, Belarus

BACKGROUND

This study examined the use of wild plants in the food, medicinal and veterinary areas within a small territory limited to one village council in the Liubań district of Belarus. The objectives of the research were to document the current and past uses of wild plants in this region for food and human/animal medication; to analyse the food, medicinal and veterinary areas in the context of wild plants; and to qualitatively compare the results with relevant publications concerning the wild food plants of Belarus.

METHODS

Fieldwork was carried out as a practical part of a development cooperation project in May 2016 in 11 villages of the Liubań district. One hundred thirty-four respondents were selected randomly. Information about local uses of wild plants was obtained via semi-structured interviews and the folk-history method. Interview records were digitalized and the data structured in Detailed Use Records (DUR), which were divided into food, medicinal and veterinary areas and then analysed to ascertain local perceptions.

RESULTS

A total of 2252 DUR of wild plants were recorded. Eighty-eight wild plant taxa belonging to 45 plant families were used across all three areas. Of these, 58 taxa were used in the food, 74 in the medicinal and 23 in the veterinary areas. A relatively high percentage of the taxa were used in both the food and medicinal areas (55%) and an even greater percentage in both the medicinal and veterinary areas (87%). Comparison with earlier research on wild food plants shows the considerable difference among seldom-mentioned taxa or uses, showing possible regional differences despite the homogenization of the population during the Soviet era.

CONCLUSIONS

As the majority of taxa with overlapping uses belonged to the most utilized plants, there appears to be clear a tendency to use plants in several different areas once they are brought into the home. This may be due to the need to maximize the versatility of limited resources. While the number of wild taxa used is relatively high, the mean number of taxa used per person is quite low, which indicates the relatively minor importance of wild plants in the respective areas in the study region. The low importance of snacks signals that unintended contact with nature has been lost.