Papers by Danuta Penkala-Gawecka
Central Asian Survey, 2013
This article discusses spiritual healing in post-Soviet Kazakhstan with reference to changing dis... more This article discusses spiritual healing in post-Soviet Kazakhstan with reference to changing discourses about ‘shamanic illness’: a condition that afflicts the future healer. What had traditionally been identified as the call of spirits was seized in the Soviet period by biomedical discourse which ascribed those symptoms to mental illness. Whereas this attitude also influenced popular understandings of ‘shamanic illness’ at the time, traditional ideas have been gradually restored in the context of the political and social changes of the 1990s. Biomedical discourse on ‘shamanic illness’ has also undergone significant changes. I argue that this was induced by multiple interconnected factors, among which are the reappraisal and support of the government for Kazakh ‘folk’ medicine as a part of the national heritage, and a favourable attitude to local, traditional forms of religiosity. This allowed for collaboration between doctors and healers in the context of institutionalization of traditional medicine. Alongside these influences the strength of the tradition of remembering the spirits of ancestors prompted the re-establishment of this core experience in the process of becoming a healer: the call of spirits.
Social sciences and medicine in Poland have had a relatively long relationship. Nevertheless, thi... more Social sciences and medicine in Poland have had a relatively long relationship. Nevertheless, this relationship has long been limited to medical sociology, which has existed as a separate discipline and been under continuous development since the 1960s. In comparison, medical anthropology in Poland is a young discipline. Locally produced research and literature, both theoretical and empirical, are still modest. For a long time, only two universities took the trouble to look at medicine through the lenses of sociality and culture (research started and conducted since the late 1970s by Danuta Penkala-Gawęcka in Poznań and Adam Paluch in Wrocław). Today students from other universities have the opportunity to familiarize themselves with the issues of medical anthropology which is taught as a separate subject at some institutes. Even so, the curriculum consists mainly of international authors, while literature produced by Polish authors refl ects the early days of the discipline in the ...
Articles by Danuta Penkala-Gawecka
Lokalne i globalne perspektywy azjanistyczne. Księga jubileuszowa dla Profesora Sławoja Szynkiewicza, , red. K. Baraniecka-Olszewska, I. Kabzińska, O. Tangad, 2018
W artykule opisuję i analizuję stosunek państwa do medycyny komplementarnej w Kazachstanie i Kirg... more W artykule opisuję i analizuję stosunek państwa do medycyny komplementarnej w Kazachstanie i Kirgistanie, koncentrując się na zmianach, które uwidoczniły się w okresie od uzyskania przez te kraje suwerenności na początku lat 1990. do bieżącej dekady. Szczególnie interesuje mnie oficjalne podejście do lecznictwa „ludowego” czy „tradycyjnego” narodów tytularnych, czyli Kazachów i Kirgizów, w tym do metod uzdrawiania duchowego, włącznie z praktykami szamanistycznymi. Ukazuję źródła i dynamikę owych procesów, prowadzących od zainicjowania profesjonalizacji uzdrowicieli stosujących tradycyjne metody leczenia do zaniechania czy ograniczenia tej polityki i dążenia do oddzielenia „uzdrowicieli ludowych” od lekarzy praktykujących rozmaite formy medycyny komplementarnej. Stosując pojęcia „różnorodności medycznej” (medical diversity), „legitymizacji” oraz „wytwarzania granic” (boundary work), przedstawiam zmiany pozycji medycyny komplementarnej, a zwłaszcza medycyny ludowej i jej praktyków w omawianych krajach oraz wpływające na nie czynniki polityczne, ekonomiczne i społeczne. Tekst oparty jest na materiałach, które zebrałam podczas badań terenowych prowadzonych w Kazachstanie w latach 1995-2000 oraz w Kirgistanie w trakcie trzech sezonów badawczych w latach 2011-2013.
Etnografia Polska, 2009
The ethnic politics of the state government in post-Soviet Kazakhstan is marked by two main trend... more The ethnic politics of the state government in post-Soviet Kazakhstan is marked by two main trends. One puts stress on special role and privileges of the titular ethnic group – the Kazakhs, while the other emphasizes the idea of agreement and cooperation between different ethnic groups in this multi-ethnic society. In this article I present the old spring festival of Iranian, Zoroastrian origin, Nawriz (Nawrïz), which has become one of the central post-Soviet official celebrations in Kazakhstan, as well as in the other Central Asian countries, and is popular among the wide public as a holiday of joy, goodness, blessings and entertainment. This occasion is particularly interesting as an event which reflects both contradictory trends in the state ethnic politics. Nawriz celebrations in big cities, like Almaty, are a forum for promoting consensus between different ethnic groups, and the festival is presented as a secular event and a vehicle of universal values that appeal to all people irrespective of nation, religion, gender or age. However, the other features of Nawriz are stressed during its celebrations in the rural setting of southern Kazakhstan. In those Kazakh-dominated regions Nawriz has attained the status of the most important national Kazakh holiday and, moreover, it has come to be strongly identified with an Islamic heritage. The same festival in different social and ethnic contexts manifests different and even contradictory meanings and functions, and can be used for different purposes connected with ethnic interests and state politics.
Curare. Journal of Medical Anthropology, 2018
This paper focuses on relations between biomedicine and various segments of complementary and alt... more This paper focuses on relations between biomedicine and various segments of complementary and alternative medicine (CAM) in socioeconomic and political contexts of post-Soviet Kazakhstan and Kyrgyzstan. While medical diversity was already present in Central Asia during Soviet times, the collapse of the Soviet Union has contributed to the further diversification of therapeutic options in this region. The author discusses changes in the official attitudes towards various non-biomedical forms of treatment, which reflect changing economic and political conditions. Initially, in the 1990s, the official support for traditional/folk medicine resulted mainly from the efforts of the newly independent states to gain legitimacy on the grounds of the cultural heritage of their titular nations. Such legitimisation is not needed anymore and, in effect, those CAM branches which are practised by healers, not biomed-ical doctors, have lost government backing. In this light, it seems that first attempts at cooperation between bio-medical and complementary practitioners which had started in the 1990s turned out to be rather fragile. The boundary work, as the author's research revealed, is directed towards delimitation of what is perceived as scientific from methods and practices unconfirmed by "science." However, it should be stressed that despite such tensions various complementary therapies, including spiritual healing, enjoy great popularity among patients, which is partly due to the weakness of healthcare systems in Kazakhstan and Kyrgyzstan. The last part of the article addresses examples of cooperation between psychiatrists and healers in Kyrgyzstan, which proved to be fruitful in special circumstances.
Lud, 2020
In this article, I focus on the aspects of the COVID-19 pandemic which are connected with the def... more In this article, I focus on the aspects of the COVID-19 pandemic which are connected with the deficiencies of the politics of global health, unsatisfactory preparedness for global health emergencies, and the quest for an effective medicine which could stop the spread of the disease. I am interested in the perception of risk, which is different in particular socio-cultural contexts, but often leads to uncertainty, fear and even panic. Hope may lie in developing a vaccine – which is a distant perspective – and finding an effective medicine. I describe the attempts to apply several previously used antiviral pharmaceuticals in the treatment of COVID-19 patients; the successive waves of hope and disappointment. The feeling of emergency results also in people’s individual search for medicines and protective means, which is influenced by the emotional aspects of the pandemic perceptions, by the increasing mediatisation, as well as by the situation of healthcare systems in particular countries. In addition to self--medication with available pharmaceuticals, people use the resources of local traditional medicines and new “miraculous” remedies promoted in popular social media. Also remedies of Chinese and Tibetan traditional medicines, officially accepted in China for treatment of the COVID-19 patients, gain importance. However, as anthropologists point out, even in the state of emergency Western biomedicine resists against other knowledge systems and guards its epistemic borders.
Myśli - pasje - działania. 100 lat etnologii uniwersyteckiej w Poznaniu, 2020
Antropologia medyczna wydaje się już na tyle okrzepłą, również w Polsce, subdyscypliną antropolog... more Antropologia medyczna wydaje się już na tyle okrzepłą, również w Polsce, subdyscypliną antropologii społeczno-kulturowej, że drugą część tytułu tego tekstu można by uznać za zbędną. Uważam jednak, że krótkie omówienie jej specyfiki i znaczenia jest potrzebne, ponieważ nadal-mimo że już sporo polskich antropologów uprawia badania z tego zakresu-spotykam się ze zdziwieniem i wątpliwościami dotyczącymi naszych (nie)kompetencji w zajmowaniu się medycyną. Czasem takie wątpliwości wyrażają także przedstawiciele środowiska antropologicznego. W niniejszym artykule, po krótkim wprowadzeniu do problematy-ki antropologii medycznej i jej specyfiki, ukażę jej "polskie drogi", ze szczególnym podkreśleniem wkładu poznańskiego ośrodka etnologicznego do rozwoju tej subdyscypliny. Nie będzie to szczegółowa historia jej pierwocin, których można dopatrywać się w badaniach nad medycyną ludową. Skoncentruję się na tych nurtach, które wydają się najistotniejsze dla wyłonienia się polskiej antropologii medycznej, omówię jej współczesne ukierunkowania i dalsze perspektywy. Moim celem jest również pokazanie praktycznych pożytków, jakie płyną/mogą płynąć z uprawiania antropologii medycznej.
Ethnologia Polona, 2019
Healthcare in post-Soviet Central Asian countries, and mental healthcare in particular, has still... more Healthcare in post-Soviet Central Asian countries, and mental healthcare in particular, has still preserved many characteristics of the previous Soviet system. In the Kyrgyz Republic, a wide-ranging reform of the
healthcare system, which started in the second half of the 1990s, has not included psychiatric services in its priorities. In the face of severe deficiencies in the system, such as an over-institutionalisation of mental healthcare and a lack of adequate financing, a group of local psychiatrists, aware of the standards of contemporary psychiatry, have tried to implement an approach promoting culturally sensitive and community-based treatment of mentally ill patients. They notice a great popularity of traditional healers and their role in local communities, based on a worldview shared with their patients and competence in values and norms of social life. Moreover, these psychiatrists understand that healers’ interventions can be effective in the cases of non-psychotic mental health disorders, and attempt to develop some kind of cooperation with Kyrgyz healers, especially in crisis situations.
In this article, grounded in the publications of this group of psychiatrists and my own fieldwork in Bishkek between 2011 and 2013, I discuss these achievements and show how globally promoted ideas
and directives of contemporary psychiatry have been adapted to the local conditions.
Введение: Представления о здоровье и бо-
лезни значительно влияют на выбор людьми
стратегий сохра... more Введение: Представления о здоровье и бо-
лезни значительно влияют на выбор людьми
стратегий сохранения и поддержания здо-
ровья. В этой статье показана устойчивость
традиционных представлений о здоровье
и болезни, бытующих среди кыргызов. Дан
анализ роли кыргызских народных целите-
лей, которые временами пользовались под-
держкой, а временами сталкивались с без-
различием или пренебрежением властей, но
сейчас могут свободно работать на рынке.
Методология: Статья основана на этногра-
фическом полевом исследовании, прове-
денном в период с 2011 по 2013 г. в Бишкеке,
Кыргызстан. В работе использовались
такие качественные методы, как неструк-
турированные или частично структуриро-
ванные интервью, беседы и наблюдение за
участниками.
Результаты: Выяснено, что популярность кы-
ргызских целителей в значительной степени
объясняется согласованностью представ-
лений населения о причинах и проявлениях
болезни с теми методами, которые предлага-
ют для борьбы с недугами те, кто практикует
целительство. В числе иных факторов, обу-
словливающих прочное положение целите-
лей в обществе, следует назвать недостатки
в работе системы здравоохранения, весьма
распространенное недоверие врачам,
а также нестабильность политической, эко-
номической и социальной ситуации. В Кыр-
гызстане роль народных целителей высоко
оценивается частью сообщества психиатров
и предпринимались попытки сотрудничать
с целителями в рамках конкретных проектов.
Выводы: Основываясь на результатах ис-
следования, автор делает вывод о важной
роли целителей в кыргызском обществе. При
определении политики, направленной на
охрану здоровья населения, организаторы
здравоохранения и медицинские работники
должны учитывать культурные особенности
и их влияние на выбор людьми вариантов
лечения.
Introduction: Beliefs about health and illness
greatly influence people’s health‑seeking
strategi... more Introduction: Beliefs about health and illness
greatly influence people’s health‑seeking
strategies and practices. In this article, I show
the persistence of traditional views on health
and illness among the Kyrgyz. I discuss the
role of traditional Kyrgyz healers, who have
experienced waves of support, indifference
or neglect from the authorities, but can now
work freely in the market.
Methods: This paper is based on ethnographic
fieldwork carried out in Bishkek, Kyrgyzstan,
between 2011 and 2013. I used qualitative
methods, namely, unstructured or partly
structured interviews, talks and participant
observation.
Results: I found that the popularity of Kyrgyz
healers is due in large part to the congruity
between people’s ideas about the causes and
manifestations of illness, and the methods of
dealing with health problems offered by these
practitioners. Other factors that influence
the strong position of healers in society are
serious shortcomings of the health‑care
system, common mistrust of doctors, and
unstable political, economic and social
conditions. The role of traditional healers has
been appreciated by a part of the psychiatrists’
community in Kyrgyzstan, and attempts
have been made to collaborate with them on
particular projects.
Conclusion: Based on these findings, I argue
for considering an important role of healers in
Kyrgyz society. I appeal for more efforts on the
part of health policy‑makers and public health
practitioners to take into account cultural
particularities and their impact on people’s
treatment choices during health‑related
policy‑making in order to achieve the aim of
improving population health.
This paper deals with processes of gaining legitimacy and constructing authority of practitioners... more This paper deals with processes of gaining legitimacy and constructing authority of practitioners of complementary medicine in post-Soviet Kyrgyzstan. The collapse of the Soviet Union brought about proliferation of various unconventional therapies which coexist with the official healthcare in the Kyrgyz Republic. Apparently, people's distrust of doctors' skills and moral qualifications strengthens the authority of non-biomedical practitioners. However, the role of tradition in building authority of such practitioners, especially Kyrgyz healers, is of great importance. It is addressed in this paper what " tradition " they approach as a source of their legitimacy and authority, and how they use it. The concept of three types of legitimacy, grounded in Max Weber's typology, proved useful in the analysis. As I observed, traditional legitimacy remains crucial for healers whose practices are based on Kyrgyz folk medicine. Bureaucratic legitimacy is more important for medical doctors who practise traditional Chinese or Korean medicine, but they also build their authority on references to tradition, in this case " the ancient wisdom of the East ". In addition I examine some objects and products used in treatment, which contribute to the practitioner's authority, but can be also treated as endowed with authority themselves.
Food and Identity in Central Asia, 2017
Uncertainty, Risk and Trust. Reforms of Health Care System in Post-Soviet Kyrgyzstan and Health-S... more Uncertainty, Risk and Trust. Reforms of Health Care System in Post-Soviet Kyrgyzstan and Health-Seeking Strategies of the Inhabitants of Bishkek
This paper, based on fieldwork conducted between 2011–2013, deals with the attitudes of the inhabitants of Bishkek to the health care system and its reforms implemented in post-Soviet Kyrgyzstan, and focuses on emotional factors that influence people’s health-seeking strategies in the context of medical pluralism.
I outline the aims and results of the reforms and their evaluation by international and local experts, and confront their opinions with assessments made by the “ordinary” people. In my view, an apparent discrepancy between the official and popular views is due mainly to uncertainty and anxiety related to political instability and economic difficulties of the country, paired with general distrust in medical institutions and, particularly, in professional and moral standards of doctors. Corruption, greed and incompetence of physicians are mentioned among the causes that make therapeutic encounters risky. Such common approach leads to the often observed “doctor-avoiding strategies” and contributes to the increase in popularity of complementary medicine. I discuss some tactics and strategies employed by the people when coping with health problems in those circumstances. As I argue, despite some evident success in reforming health care system, it is important both to recognize its faults and deficiencies, and to take into account emotional factors that significantly shape people’s choices.
Pilgrimage as cure: shrines in Afghanistan, 1992
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Papers by Danuta Penkala-Gawecka
Articles by Danuta Penkala-Gawecka
healthcare system, which started in the second half of the 1990s, has not included psychiatric services in its priorities. In the face of severe deficiencies in the system, such as an over-institutionalisation of mental healthcare and a lack of adequate financing, a group of local psychiatrists, aware of the standards of contemporary psychiatry, have tried to implement an approach promoting culturally sensitive and community-based treatment of mentally ill patients. They notice a great popularity of traditional healers and their role in local communities, based on a worldview shared with their patients and competence in values and norms of social life. Moreover, these psychiatrists understand that healers’ interventions can be effective in the cases of non-psychotic mental health disorders, and attempt to develop some kind of cooperation with Kyrgyz healers, especially in crisis situations.
In this article, grounded in the publications of this group of psychiatrists and my own fieldwork in Bishkek between 2011 and 2013, I discuss these achievements and show how globally promoted ideas
and directives of contemporary psychiatry have been adapted to the local conditions.
лезни значительно влияют на выбор людьми
стратегий сохранения и поддержания здо-
ровья. В этой статье показана устойчивость
традиционных представлений о здоровье
и болезни, бытующих среди кыргызов. Дан
анализ роли кыргызских народных целите-
лей, которые временами пользовались под-
держкой, а временами сталкивались с без-
различием или пренебрежением властей, но
сейчас могут свободно работать на рынке.
Методология: Статья основана на этногра-
фическом полевом исследовании, прове-
денном в период с 2011 по 2013 г. в Бишкеке,
Кыргызстан. В работе использовались
такие качественные методы, как неструк-
турированные или частично структуриро-
ванные интервью, беседы и наблюдение за
участниками.
Результаты: Выяснено, что популярность кы-
ргызских целителей в значительной степени
объясняется согласованностью представ-
лений населения о причинах и проявлениях
болезни с теми методами, которые предлага-
ют для борьбы с недугами те, кто практикует
целительство. В числе иных факторов, обу-
словливающих прочное положение целите-
лей в обществе, следует назвать недостатки
в работе системы здравоохранения, весьма
распространенное недоверие врачам,
а также нестабильность политической, эко-
номической и социальной ситуации. В Кыр-
гызстане роль народных целителей высоко
оценивается частью сообщества психиатров
и предпринимались попытки сотрудничать
с целителями в рамках конкретных проектов.
Выводы: Основываясь на результатах ис-
следования, автор делает вывод о важной
роли целителей в кыргызском обществе. При
определении политики, направленной на
охрану здоровья населения, организаторы
здравоохранения и медицинские работники
должны учитывать культурные особенности
и их влияние на выбор людьми вариантов
лечения.
greatly influence people’s health‑seeking
strategies and practices. In this article, I show
the persistence of traditional views on health
and illness among the Kyrgyz. I discuss the
role of traditional Kyrgyz healers, who have
experienced waves of support, indifference
or neglect from the authorities, but can now
work freely in the market.
Methods: This paper is based on ethnographic
fieldwork carried out in Bishkek, Kyrgyzstan,
between 2011 and 2013. I used qualitative
methods, namely, unstructured or partly
structured interviews, talks and participant
observation.
Results: I found that the popularity of Kyrgyz
healers is due in large part to the congruity
between people’s ideas about the causes and
manifestations of illness, and the methods of
dealing with health problems offered by these
practitioners. Other factors that influence
the strong position of healers in society are
serious shortcomings of the health‑care
system, common mistrust of doctors, and
unstable political, economic and social
conditions. The role of traditional healers has
been appreciated by a part of the psychiatrists’
community in Kyrgyzstan, and attempts
have been made to collaborate with them on
particular projects.
Conclusion: Based on these findings, I argue
for considering an important role of healers in
Kyrgyz society. I appeal for more efforts on the
part of health policy‑makers and public health
practitioners to take into account cultural
particularities and their impact on people’s
treatment choices during health‑related
policy‑making in order to achieve the aim of
improving population health.
This paper, based on fieldwork conducted between 2011–2013, deals with the attitudes of the inhabitants of Bishkek to the health care system and its reforms implemented in post-Soviet Kyrgyzstan, and focuses on emotional factors that influence people’s health-seeking strategies in the context of medical pluralism.
I outline the aims and results of the reforms and their evaluation by international and local experts, and confront their opinions with assessments made by the “ordinary” people. In my view, an apparent discrepancy between the official and popular views is due mainly to uncertainty and anxiety related to political instability and economic difficulties of the country, paired with general distrust in medical institutions and, particularly, in professional and moral standards of doctors. Corruption, greed and incompetence of physicians are mentioned among the causes that make therapeutic encounters risky. Such common approach leads to the often observed “doctor-avoiding strategies” and contributes to the increase in popularity of complementary medicine. I discuss some tactics and strategies employed by the people when coping with health problems in those circumstances. As I argue, despite some evident success in reforming health care system, it is important both to recognize its faults and deficiencies, and to take into account emotional factors that significantly shape people’s choices.
healthcare system, which started in the second half of the 1990s, has not included psychiatric services in its priorities. In the face of severe deficiencies in the system, such as an over-institutionalisation of mental healthcare and a lack of adequate financing, a group of local psychiatrists, aware of the standards of contemporary psychiatry, have tried to implement an approach promoting culturally sensitive and community-based treatment of mentally ill patients. They notice a great popularity of traditional healers and their role in local communities, based on a worldview shared with their patients and competence in values and norms of social life. Moreover, these psychiatrists understand that healers’ interventions can be effective in the cases of non-psychotic mental health disorders, and attempt to develop some kind of cooperation with Kyrgyz healers, especially in crisis situations.
In this article, grounded in the publications of this group of psychiatrists and my own fieldwork in Bishkek between 2011 and 2013, I discuss these achievements and show how globally promoted ideas
and directives of contemporary psychiatry have been adapted to the local conditions.
лезни значительно влияют на выбор людьми
стратегий сохранения и поддержания здо-
ровья. В этой статье показана устойчивость
традиционных представлений о здоровье
и болезни, бытующих среди кыргызов. Дан
анализ роли кыргызских народных целите-
лей, которые временами пользовались под-
держкой, а временами сталкивались с без-
различием или пренебрежением властей, но
сейчас могут свободно работать на рынке.
Методология: Статья основана на этногра-
фическом полевом исследовании, прове-
денном в период с 2011 по 2013 г. в Бишкеке,
Кыргызстан. В работе использовались
такие качественные методы, как неструк-
турированные или частично структуриро-
ванные интервью, беседы и наблюдение за
участниками.
Результаты: Выяснено, что популярность кы-
ргызских целителей в значительной степени
объясняется согласованностью представ-
лений населения о причинах и проявлениях
болезни с теми методами, которые предлага-
ют для борьбы с недугами те, кто практикует
целительство. В числе иных факторов, обу-
словливающих прочное положение целите-
лей в обществе, следует назвать недостатки
в работе системы здравоохранения, весьма
распространенное недоверие врачам,
а также нестабильность политической, эко-
номической и социальной ситуации. В Кыр-
гызстане роль народных целителей высоко
оценивается частью сообщества психиатров
и предпринимались попытки сотрудничать
с целителями в рамках конкретных проектов.
Выводы: Основываясь на результатах ис-
следования, автор делает вывод о важной
роли целителей в кыргызском обществе. При
определении политики, направленной на
охрану здоровья населения, организаторы
здравоохранения и медицинские работники
должны учитывать культурные особенности
и их влияние на выбор людьми вариантов
лечения.
greatly influence people’s health‑seeking
strategies and practices. In this article, I show
the persistence of traditional views on health
and illness among the Kyrgyz. I discuss the
role of traditional Kyrgyz healers, who have
experienced waves of support, indifference
or neglect from the authorities, but can now
work freely in the market.
Methods: This paper is based on ethnographic
fieldwork carried out in Bishkek, Kyrgyzstan,
between 2011 and 2013. I used qualitative
methods, namely, unstructured or partly
structured interviews, talks and participant
observation.
Results: I found that the popularity of Kyrgyz
healers is due in large part to the congruity
between people’s ideas about the causes and
manifestations of illness, and the methods of
dealing with health problems offered by these
practitioners. Other factors that influence
the strong position of healers in society are
serious shortcomings of the health‑care
system, common mistrust of doctors, and
unstable political, economic and social
conditions. The role of traditional healers has
been appreciated by a part of the psychiatrists’
community in Kyrgyzstan, and attempts
have been made to collaborate with them on
particular projects.
Conclusion: Based on these findings, I argue
for considering an important role of healers in
Kyrgyz society. I appeal for more efforts on the
part of health policy‑makers and public health
practitioners to take into account cultural
particularities and their impact on people’s
treatment choices during health‑related
policy‑making in order to achieve the aim of
improving population health.
This paper, based on fieldwork conducted between 2011–2013, deals with the attitudes of the inhabitants of Bishkek to the health care system and its reforms implemented in post-Soviet Kyrgyzstan, and focuses on emotional factors that influence people’s health-seeking strategies in the context of medical pluralism.
I outline the aims and results of the reforms and their evaluation by international and local experts, and confront their opinions with assessments made by the “ordinary” people. In my view, an apparent discrepancy between the official and popular views is due mainly to uncertainty and anxiety related to political instability and economic difficulties of the country, paired with general distrust in medical institutions and, particularly, in professional and moral standards of doctors. Corruption, greed and incompetence of physicians are mentioned among the causes that make therapeutic encounters risky. Such common approach leads to the often observed “doctor-avoiding strategies” and contributes to the increase in popularity of complementary medicine. I discuss some tactics and strategies employed by the people when coping with health problems in those circumstances. As I argue, despite some evident success in reforming health care system, it is important both to recognize its faults and deficiencies, and to take into account emotional factors that significantly shape people’s choices.