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Informal medicine goes where formal medicine does not

The markets for healing and witch doctors are often developed in smaller cities and also serve nearby rural areas as well. Such centres of “informal healthcare” most commonly thrive among individuals who have become disappointed with traditional medicine or among those who do not have access to traditional medicine, Yulia Krasheninnikova, Associate Professor in the Faculty of Management’s Department of State and Municipal Management at HSE Perm campus, said in the study “Beyond the Healthcare System: The Development of Alternative Health Services in Urban and Rural Areas.”

Witch doctors, herbalism, and occult and healing practices such as developing a person’s energy and creating a strong aura, are all part of “informal healthcare” that flourish where traditional medicine loses ground. In her work, Yulia Krasheninnikova looks at factors that spur the expansion of “paramedical” practices, as well as the particular activity of healers.

It is not yet possible to evaluate the scope of “informal healthcare” specifically because of its “informality,” Krasheninnikova says.

A significant number of people, in rural areas for instance, do not resolve health issues at all or do so themselves, the researcher adds. “They do not turn to alternative medicine services because it is not offered or because of a distrust in them,” Krasheninnikova explains.

Clients of healers are disappointed by formal medicine

Theoretical developments in “informal medicine” must enhance a number of factors such as the low level of access to quality medical care. The smaller the populated area, the fewer opportunities its inhabitants have for specialized medical care. Visiting a specialist is accompanied by expenses to travel to the centre of the region.

In addition, health conditions (incidence, bad ecology) force people to turn to healers, as does an adequate level of income, which allows people to invest time and money in maintaining their health. It is believed that people’s ideologies (religion, how they view their health, etc.) as well as specific resources (healing springs, natural anomalies, “power locations,” etc.) also play a role. It is on the basis of such factors that health services can be provided.

Research studies conducted in Perm territory in May-November 2013, however, only partially confirm these seemingly obvious points, Krasheninnikova notes.

Offering “informal healthcare” on markets firstly depends “on the critical mass of people with particular ideologies and social status,” the researcher says. This concerns those who have encountered the ineffectiveness of formal medicine, as well as those who value health, come to search for “hidden knowledge” and are interested in the esoteric. “Such individuals are simultaneously active consumers and suppliers of goods and services that are alternatives to formal medicine,” Krasheninnikova adds.

The research study included Perm, which has a population of over a million, three cities with populations of 50,000 or more, as well as three administrative centres of municipal regions, three rural settlement centres and five villages.

An alternative to pills

Healthcare treats alternative healing practices differently. Medical professionals without question negatively react to some “healing” ideas, such as using hydrogen peroxide. In addition, religious organizations’ healing practices – prayer, exorcisms, etc. – are perceived as actions that have a placebo effect, the author notes.

At the same time, several methods – yoga, phytotherapy, etc. – have already been integrated into formal medicine somewhat. “Doctors have monopolized some services (leech therapy, homeopathy), though they do not meet the criteria of evidence-based medicine and are far from used by all doctors,” Krasheninnikova says.

The government also assesses healing practices differently. Overall, very few organizations for alternative medicine meet all the regulatory requirements of the government. Among those requirements are licensing, specific conditions for facilities, employee education and advertising restrictions.

Informal healthcare as part of the informal economy

There is a considerable non-market component that exists in alternative medicine in which caring for the sick takes place at the level of neighbourly mutual support, or “a service for a service.” In particular, healthcare workers and witch doctors in rural areas offer advice to their neighbours. “They often do not recognize their work as a special kind of activity. But the likelihood of government set rules being broken grows with increasing clientele [and] the emergence of a fixed payment for services,” the researcher notes.

If specific services are advertised as treatment services, then the law says that medical professionals must be the ones administering them. Further, the company must have a license to provide such medical services. If these are not quintessential medical services, but “healing” services, then advertising them as “treatments” misleads the consumer.

The same concerns health products as well. If a product is said to be of medical use, then it must be registered with the government and meet trade regulations.

For this reason, it can be argued that “informal healthcare” can largely be classified as part of the informal economy if this is understood as being an economic activity that lacks the necessary government regulation.

“Networkers” take hold of the preventative care niche

Alternative healthcare organizations frequently offer their customers goods and services of a different nature, Krasheninnikova says. Network marketing companies do not just supply wellness products, but often aim to set up an entire system of health maintenance that serves as an alternative to formal healthcare. This system typically has its own way of diagnosing pathologies that is based on combining acupuncture with computer technology. In addition, there are consultants that replace doctors, but these consultants do not often have a medical education.

In addition to this, communication groups are created that bring together proponents of alternative treatment methods, as well as followers of various religions groups. Information is actively exchanged in these clubs. “In their advertising activity, distributors of healing services substitute the preventative work of medical institutions (they tell people how to eat correctly, for example). Large MLM [multi-level marketing] companies create their market for printed healthcare products, [such as] books, brochures and periodicals,” Krasheninnikova notes.

Yoga is thriving in metropolises

The increase of healing using oriental methods, Krasheninnikova says, is strictly a city phenomenon that is, above all, widespread in larger cities. The city of Perm has around 30 fitness centres and sports club where yoga classes are held. In addition, some 20 specialized oriental healing studios exist where these classes are given at the “advanced” level. There are also religious organizations that promote yoga as part of a healthy lifestyle.

In smaller cities, such as Lysva and Kungur, the opposite is true; there are only a handful of yoga instructors here.

Smaller cities as a healing 'mecca'

The spread of “informal healthcare” and the selection of paramedical goods and services are significantly higher in cities than in rural areas. The most substantial diversification and scale in commercial practices is seen in Perm, a city with a population of over a million, Krasheninnikova notes, adding that the condition of “official” medicine there is considerably better than in rural areas.

At the same time, there is no direct connection between the size of a populated area and the overall income level of its citizens with the market supply of “informal healthcare,” the researcher believes.

The research showed that cities with populations of 60,000-70,000 people serve as centres for healing markets. In the Perm territory, these cities are Kungur, Lysva and Chusovoy, which all serve as the nuclease for healing “agglomerations” that also service nearby rural areas.

In addition, transit routes for “traveling witch doctors,” proliferators of esoteric teachings and sellers of miracle balms and medicines often run through smaller cities, Krasheninnikova said.

Villages specialize in herbalism

The only area that is more developed in villages is the collection of natural means of healing.

The distribution and consumption of medicinal herbs are largely situational, however. There are only a handful of individuals in the municipal region who professionally practice herbalism or healing through beekeeping or with the help of animal derivatives, such as bear bile or badger fat.

The market for “spells against alcoholism” is full of traveling healers

Public health has little effect on the development of paramedicine, the author notes.

There is just one exception to this – alcohol and drug dependency. With this, the alternative medicine market reacts sensitively to the needs of the population and also to the lack of quality health care. A variety of options are suggested for getting rid of an alcohol or drug addiction. This situation can be explained by the weakness of the drug control service (a shortage of resources and an underdeveloped rehabilitation unit), and also by the goal of potential patients of drug treatment centres to avoid stigmatization, which is often accompanied by registration.

The problem of alcoholism is most serious in villages. There are usually healers in villages that cover several villages in a row – so called “traveling healers.”

In smaller cities, the circle of individuals who can offer a spell against alcoholism also includes “traveling psychotherapists” as well, Krasheninnikova notes. Dependency specialists come largely from cities with populations of over a million and rent a location once a month in local cultural or educational establishments. Generally, such psychotherapists work without a medical license in the field of addictions.

“Power locations” attract tourist traffic

Shrines, healing springs, natural anomalies and other tourist magnets for people seeking “hidden knowledge” markedly stimulate the development of “informal healthcare.” In the Perm territory, this was noted to a large degree in the Klyuchi Suksunskiy region, where there is a resort with mineral springs and curative muds. “Informal healthcare” is designed for vacationers to the region; the local population cannot afford the resort’s services. In addition, under the guise of physical healing, people give an additional significance, and naturally, an additional price to a variety of goods and services at the resort, the author says.

Overall, markets for health services are arising near locations with particularly large tourist resources, even if these resources are not related to medicine, Krasheninnikova says. A curious example is the village of Molyobka in Perm territory’s Kishertsky district, which thanks to UFO research since the 1990s, has been attracting people from all over Russia who are fascinated with natural mysteries. A local stalker organizes paid recreational hikes to Perm’s anomalous zone. This person has developed routes that allow one to “take in the special energy of these locations and resolve specific health problems.” In addition, people who are fond of the esoteric move to Molyobka to live.

Monasteries are meeting the demand for religious miracles

Religious individuals more often than not turn to physical shrines for healing. “Aside from [providing] spiritual care for the ill, monasteries are active participants in another segment – ‘informal healthcare.’ They produce and sell healing agents created from medicinal plants and bee products (herbal teas, ointments, oils and liquids,” Krasheninnikova emphasizes. Such pharmaceutics is consecrated, but completely removed from the government’s control system for product quality and safety, Krasheninnikova concludes.


Author: Olga Sobolevskaya, June 05, 2014