Ethnologia Polona <p>The journal Ethnologia Polona publishes academic articles in the disciplines of social anthropology, cultural anthropology, sociology, cultural studies, history, interdisciplinary studies, ethnology, ethnography, methodology, qualitative research, as well as interdisciplinary research.</p> en-US <p>I declare that the manuscript sent is original, has not been published before and is not currently being considered for publication elsewhere.<br>I confirm that the manuscript has been read and approved by all the authors mentioned and that there are no other persons who would meet the criteria for authorship but were not mentioned. In addition, I confirm that the order of the authors listed in the manuscript has been approved by all the authors.<br>I confirm that the correspondent author is the only contact with the Editorial Board in the editorial process, and is responsible for communicating with other authors and informing them about the progress, corrections and final approval of the article.</p> (Agnieszka Halemba) (Firma Magis) Sun, 15 Dec 2019 00:00:00 +0100 OJS 60 Health Matters, Patients and Doctors Through the Lens of Medical Anthropology. <p>The articles included in this thematic section of “Ethnologia Polona” are written mainly by Polish anthropologists whose work has made medical anthropology an important and well visible sub-discipline of socio-cultural anthropology in Poland. In addition, we have invited two medical anthropologists from abroad (working in Saint Petersburg and Oslo) to submit their papers which complement the topics raised in this issue.</p> Danuta Penkala-Gawęcka Copyright (c) 2019 Institute of Archaeology and Ethnology - Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100 The Hormone of Growth and Hope. The Case of Turner Syndrome <p>Turner Syndrome (TS) is a condition that affects only girls and women and involves a partial or complete absence of the X chromosome. It is a well recognized medical condition and a multidimensional cultural fact that has appeared in specific historical, social and geographical contexts. TS is characterized by, among others, short stature, and ovarian failure. Girls with TS are put on estrogen replacement therapy and growth hormone treatment, which means a daily injection, starting at around 5 years of age or later and usually continuing until around 15. Without this treatment, girls suffering from it would be on average 20 cms shorter than women unaffected by it. In this text, I intend to look at the biosocial work of the growth hormone. I examine the purpose of it, and describe the work of hope being carried out in reference to hormone treatment. It is a technology, which is adaptable and flexible and from my perspective, hormones are “fluid objects”. I present both the daily regimes and the regular biomedical controls taking place regarding GH treatment, describe the private and public histories of growth hormone therapy, and analyse an experience of the materiality of hormones, focusing on a pen injector device.</p> Magdalena Radkowska-Walkowicz Copyright (c) 2019 Institute of Archaeology and Ethnology - Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100 Silent Subject: The Child in the Debate on Assisted Reproduction in Poland <p>This article explores the social construction of the “IVF child” in Poland. In this country where Catholicism is the dominant religion, attitudes towards in vitro fertilisation (IVF) and, more generally, assisted reproductive technologies (ARTs) are clearly mirroring and reproducing the nation’s values. Based on official church teachings, the “IVF child” is a new subject of concern. Research conducted with children who were conceived in this manner proves that they are important actors, whose voices need to be included into the anthropological analysis of ARTs. The ways in which they articulate their understanding of ARTs shows both the pervasiveness of anti-IVF voices and the active roles children play in producing their own meanings.</p> Ewa Maciejewska-Mroczek Copyright (c) 2019 Institute of Archaeology and Ethnology - Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100 Curing Disability in Contemporary Russia: Rehabilitation Practices and the Placebo Effect <p>The paper is based on the materials of an ethnographic research project involving interviews with parents of children with developmental disabilities, primarily intellectual disabilities, multiple disabilities, and autism. Though in contemporary humanistic pedagogy and psychology developmental disabilities are viewed in terms of difference and diversity, Russian public and professional discourse on disability is<br>dominated by a medicalised approach and the majority of parents adhere to this view. This article analyses the patterns of rehabilitation and treatment of children with disabilities in the family context. It views the effectiveness of various popular therapies offered to children with disabilities through the lenses of the placebo effect theory. It shows that the assessment of both biomedical and alternative treatment outcomes<br>by parents of children with disabilities are subject to the placebo effect, and this effect is maximized by various symbolic elements of treatment, such as price, prestige, or popularity of a certain drug, method or institution. The placebo effect, together with other factors, accounts for the commercialization of the disability services sphere.</p> Anna Klepikova Copyright (c) 2019 Institute of Archaeology and Ethnology, Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100 Neurotechnology Goes to Polish School. An Ethnographic Story About Scanning ADHD <p>In a public primary school in a middle sized Polish town, research was conducted in which a number of children were diagnosed with a new tool for identifying ADHD. This situation serves as the point of departure for an ethnographic reflection devoted to contemporary practices of diagnosing children’s mental health. The screening programs, which are more frequently permeating Polish schools, generate a category of “patients-in-waiting”, who can be defined as children, who remain in an intermediate position between illness and normalcy. It is they who are the potential recipients of further diagnostic acts and therapies and they co-constitute a dynamically developing area of neuroeconomy.</p> Anna Witeska-Młynarczyk Copyright (c) 2019 Institute of Archaeology and Ethnology, Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100 Normalised Eating And Dietary Guidelines in LCHAD Deficiency <p>Dietary guidelines have become a ubiquitous feature of nutritional landscapes in a growing number of countries. Issued by departments or ministries of health and implemented by dietitians and health professionals, such guidelines are intended to govern the health of children and adults by regulating both the content and quantity of what they eat. While these dietary guidelines are intended for kids and adults who can and want to eat, they often serve as a reference point for the dietary treatment of patients whose appetites are considered abnormal, and/or who do not or cannot eat. Drawing from ethnographic research being carried out in Finland and Poland on LCHADD, a rare disease, this article juxtaposes dietary treatments prescribed for this disease with state and biomedical rationalities that govern “normal” dietary patterns and normalised eating. Treatment for LCHADD differs from general dietary recommendations for “normal” growing children. Despite stringent dietary guidelines for LCHADD, dietitians admit that there are no global standards in place regulating the consumption of prescribed nutrients; thus, recommendations<br>may vary by country.</p> Małgorzata Rajtar Copyright (c) 2019 Institute of Archaeology and Ethnology, Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100 Anthropological Research on Autism. Reflections from the Field <p>For a long time, people on the autistic spectrum were doomed to social marginalisation. They often spent their entire lives kept in homes or were sent to closed institutions where they were treated like passive objects of custodial care. Their developmental potential and creative possibilities were generally questioned. Since the 1950s, this has slowly been changing. Individuals with autistic syndrome and their relatives have obtained access to a variety of forms of aid. A network of specialist institutions supporting them through early diagnosis, therapy, care and education have been expanding as well. One such facility, located in Łódź, became for two years my research field. Stepping over the threshold of this institution I was not a novice since I had already met autistic people in the context of my private life. Still, I had never met such an abundant and diversified group of individuals on this spectrum (in terms of symptom level and age). During the course of my research, a number of issues needed to be addressed such as issues related to research method, my behaviour towards people with autism, some organisational matters as well as professional and ethical dilemmas, all of which will be written about in this article.</p> Aleksandra Rzepkowska Copyright (c) 2019 Institute of Archaeology and Ethnology, Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100 Fallen Agents: Negotiations of Patient Agency in Norwegian Opioid Substitution Treatment <p>Based on an ethnographic fieldwork, this article explores how patients in a Norwegian heroin-addiction treatment program negotiate their agency, navigating between policies, medical guidelines, and their own lived experiences as they seek what they perceive as appropriate medication. Outlining these patients’ participation in treatment inside and outside the clinic, I illustrate that different types of agency are involved across these domains. I argue that patient agency is not something one has or does not have, but rather involves the institutional interpretations of these mobilised elements: What kind of agency is appropriate to exert in the Norwegian healthcare system? The analysis highlights the social constructions of the “addicted patient” and raises questions of the value of patient subjectivity and the politically tinged ascriptions of agency manifested in patient rights and guidelines for clinical decision-making.</p> Aleksandra Bartoszko Copyright (c) 2019 Institute of Archaeology and Ethnology, Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100 Between the Substance Agency and the User’s Control. Instrumental Drug Use Among Drug Users in Warsaw <p>The focus of this article is on instrumental drug use and the problem of agency in interaction with psychoactive substances. Most of the Euro-American discourse formed around drug use stresses the individual loss of self-control related to drug use. This paper is located within those critical studies of drug use, which challenge the notion that regular drug users are deprived of agency in their interaction with psychoactive<br>substances. During my fieldwork among drug users in Warsaw, I got the impression that psychoactive substances can be treated as a tool for altering the state of the human mind, which can be employed in various ways and controlled by the user. Still, this tool is a dangerous one and cannot always be fully subject to human agency. Based on case studies, I analyse the functions of drugs for the users and their intentions regarding use. The ethnographic exploration of individual drug use trajectories is a starting point for the further consideration of the process of negotiating agency with psychoactive substances.</p> Zuzanna Sadowska Copyright (c) 2019 Institute of Archaeology and Ethnology, Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100 Are Polish Primary Care Practitioners Social Entrepreneurs? <p>In this article I explore the range of entrepreneurial roles played by doctors working in Polish Primary Health Care [Podstawowa Opieka Zdrowotna – POZ]. I use the division into social and strictly business entrepreneurship – whose source comes from economic sciences – in order to examine<br>what entrepreneurial values rural/small town doctors and their city colleagues recognise and use in their practices. POZ is mainly carried out in private clinics contracted by the National Health Fund [Narodowy Fundusz Zdrowia – NFZ], therefore I look at the values associated with entrepreneurship. I consider these values as visibly altering doctor–patient encounters, thus I analyse doctor’s strategies for establishing his/ her formal and informal relations with patients. I focus my attention on the specific forms of experiencing time in primary care, namely short and long time structures, which I recognise as crucial for interactions between practitioners and their patients. Finally, I put forward the thesis that much of the interaction in POZ offices has the characteristics of symbolic exchange – the reciprocal forms of doctor–patient interactions transfer these encounters beyond purely medical interventions to spaces of mutual cooperation, attachment and trust.</p> Hubert Wierciński Copyright (c) 2019 Institute of Archaeology and Ethnology, Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100 “New Psychiatry” and Traditional Healing in Kyrgyzstan: Attempts to Develop Culturally Sensitive and Community-Based Treatment <p>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.</p> Danuta Penkala-Gawęcka Copyright (c) 2019 Institute of Archaeology and Ethnology, Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100 Different Systems of Knowledge Found in the Reproductive Health of Ashaninka Women from the Peruvian Amazon <p>Indigenous Ashaninka people from the Peruvian Amazon operate within their communal reserve and autonomous native communities, where biomedical health posts and biomedical practitioners are present. This article analyses how the two systems of knowledge and practice i.e., indigenous medicine and biomedicine, coexist in the Ashaninka territory and how they are articulated in childbirth, birth control and other aspects of reproductive health. Their medicinal cosmology privileges the medicinal plant use and midwifery. At the same time, these practices are compatible with biomedical thinking. The childbirth techniques widely shared by the Ashaninka women and midwifes do not change substantially<br>after biomedical training. Instead, Ashaninka women complementarily add new practices to their own pre-existing array of contraceptive and labour techniques, without shifting their ontological basis. The Ashaninka seem a resilient society, one which is capable of “absorbing” novel biomedical knowledge, practices and technology into their medical landscape, while remaining within their cultural boundaries and thus preserving their specific features.</p> Monika Kujawska Copyright (c) 2019 Institute of Archaeology and Ethnology, Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100 Polish Roma Migrations – Transnationalism and Identity in Anthropological Perspective <p>Until recently, the migration of Polish Roma has not been a subject of an academic inquiry. This article aim is to shed light on some issues related to transnational living and identity of Polish Roma in anthropological perspective1. The findings of our research suggest that Roma migrations from Poland are not categorically different from non-Roma population and in fact are integral and socially connected part of history of migrations from Poland on local and national level, determined by same processes of structural forces rendering people to seek opportunities abroad. Our study has demonstrated how crucial and important is for Polish Roma their connection to Poland – on social, personal, cultural and economic level. This calls for a more careful and nuanced approach in future research to Polish Roma identity seen in relational terms. Finally, our article calls for a need to a more ethically informed research with the Roma whose Polish identity needs to be recognized in its own right, in particular in migratory context.<br>This means also few policy recommendations that we offer at the end of the article.</p> Kamila Fiałkowska, Michał P. Garapich, Elżbieta Mirga-Wójtowicz Copyright (c) 2019 Institute of Archaeology and Ethnology, Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100 Sudan’s Tea Ladies and the Legacy of Slavery <p>This paper presents the institution of roadside mini-cafes run by women – mostly poor migrants from peripheral or war-torn regions of Sudan – on Forty Days Road Street, one of the main streets of Omdurman. These cafes are not only one of the many examples of women’s informal activism in an urban environment, but also an institution in which the legacy of slavery is present. This dates back to precolonial times when the peoples of the Nile valley were slave-raiding and slave-owning. The author looks at the institution of roadside mini-cafe as something particularly important for the urban iconography of power, in which – using the terms of structural anthropology – a series of oppositions are materialised: formal/informal, male/female, dominant/subordinate and Middle Eastern/African. The relations to slavery hidden in this particular institution help city dwellers (mostly men from the Muslim majority and Arab culture) in arranging hierarchies, rivalry and legitimating status. Gender and informality are particularly meaningful in this context as both strengthen the situation of radical inequality, intensify and constitute politics of dominance on the one hand and of subordination on the other. This paper is based on ethnographic research which was undertaken in the Khartoum agglomeration in 2013.</p> Maciej Kurcz Copyright (c) 2019 Institute of Archaeology and Ethnology, Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100 Izabella Main. 2018. Lepsze światy medyczne? Zdrowie, choroba i leczenie polskich migrantek w perspektywie antropologicznej <p>The book review</p> Elżbieta M. Goździak Copyright (c) 2019 Institute of Archaeology and Ethnology, Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100 Michał Wróblewski, Medykalizacja nadpobudliwości. Od globalnego standardu do peryferyjnych praktyk <p>Book review</p> Anna Witeska-Młynarczyk Copyright (c) 2019 Institute of Archaeology and Ethnology, Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100 Anna Witeska-Młynarczyk (ed.) 2018. Antropologia psychiatrii dzieci i młodzieży. Wybór tekstów <p>Book review</p> Marta Rakoczy Copyright (c) 2019 Institute of Archaeology and Ethnology, Polish Academy of Sciences Sun, 15 Dec 2019 00:00:00 +0100