Witches and Physicians: A Post-COVID Retrospective on Health in The Russian Review

Black and white poster. The left side depicts an elderly woman preforming a folk remedy on an infant, held by its mothers. The text reads "ne khodi k babkam." The right side depicts that same mother instead taking her child to a clinic, where many other mothers have also brought their infants to be cared for by medical professionals. The caption reads "nesi rebenka v konsulʹtatsiiu."

“Don’t go to folk healers / take your child to a clinic”—a poster from a series by Narkomzdrav’s Department for the Protection of Mothers and Infants, part of a larger Narkomzdrav effort to urge citizens toward modern medicine.

The concept of health has been at the forefront of public discussion since the onset of the COVID-19 pandemic in 2019–2020. Although the world has slowly begun to move beyond the COVID era, the ramifications of the outbreak can still be seen and felt today: the normalization of online work and course meetings, people instinctively still observing the lines of tape spaced approximately six feet apart in countless stores and waiting areas, or the absence of a person who was taken too soon by the virus. While life does indeed go on, it is difficult to say that the COVID-19 pandemic is truly behind us, and it will be difficult to place the pandemic squarely “in the past” for years to come.

It is in this context that I have curated the present collection of articles. Over its 82-year lifespan, The Russian Review has published dozens of articles, essays, and shorter pieces that investigate health and its social determinants in Eastern Europe and Eurasia from the pre-Petrine era to Putin’s Russia. At the heart of this collection are five articles in which the most prominent themes and trends related to health in this area of the world can be observed.

Folk beliefs and beliefs in witchcraft are the first phenomena we must discuss when investigating health in this region. The early Soviet state had to face these beliefs head-on, as we can see in the poster at the beginning of this collection, taken from Frances Bernstein’s “Envisioning Health in Revolutionary Russia.” They existed for centuries before the advent of modern medicine and health research and there were many strong believers up to and through the twentieth century, with some continuing to hold these beliefs today.[1] When it comes to health, the village “folk healer” is a crucial figure. Villagers believed that these people had the knowledge—spiritual or otherwise—to heal ailments, and they would visit them the way a person today visits a physician. In effect, the folk healer’s home served as a clinic of sorts throughout much of history.

The folk healer was responsible for the health of the people in their village. However, folk beliefs around health sometimes were connected to notions of witchcraft. The belief that certain individuals could wield otherworldly power to harm others was common to cultures around the world, and this witchcraft was believed to threaten individual and societal well-being. Like other folk beliefs related to health, it proved remarkably persistent over time.

Christine D. Worobec, “Witchcraft Beliefs and Practices in Prerevolutionary Russian and Ukrainian Villages,” The Russian Review 54 (April 1995): 165–87, https://doi.org/10.2307/130913.

In this article, Worobec explains how beliefs about witchcraft were deeply intertwined with personal and societal health: contagious and hereditary diseases, miscarriages, stillbirths, impotence, droughts, and bad harvests could be blamed on witchcraft and an associated witch (or sorcerer, though most often a female witch). With Russian and Ukrainian health science and education so underdeveloped, witchcraft served as a plausible culprit for worrisome health problems. As a result, the best way to combat health problems was to get the accused witch to undo their alleged witchcraft. This sometimes resulted in violence and even murder, though according to contemporaries the ailment was occasionally (coincidentally) alleviated. Worobec argues that blaming witchcraft functioned as a way to personify individual or community misfortunes, shifting responsibility onto an evil enemy even in cases where there was no blame to assign. By blaming their ailments on the evildoer, as opposed to germs, genetics, or random chance, peasants were able to assert some level of control over their highly volatile lives.

Worobec analyzes social determinants of health, including food security, access to healthcare, socioeconomic status, education, and literacy.[2][3] The volatility of their lives rendered prerevolutionary Russian and Ukrainian villagers vulnerable in all of these categories, leading to negative health outcomes. The targeting of a “witch” was a form of self-empowerment that was meant to compensate for what villagers lacked.

The beliefs and systems that Worobec analyzes coexisted with systems of medicine and scientifically backed beliefs related to health. This coexistence can perhaps best be seen in the practice of bathing. For a large portion of the population of imperial Russia, bathing occurred at a public bathhouse (bania). For over a century, scientists have debated the medical benefits of bathing. More recently, this debate has been taken up by scholars of Russia and Eurasia.

Konstantin Kashin and Ethan Pollock. “Public Health and Bathing in Late Imperial Russia: A Statistical Approach,” The Russian Review 72 (January 2013): 66–93, https://doi.org/10.1111/russ.10681.

Kashin and Pollock present a scientific study of the effects of bathing on health in late imperial Russia. There were many who believed that the bania was helpful to public health, but others thought it detrimental—with physicians and laypeople on both sides. This study analyzes the density of banias in urban areas across the Russian Empire in relation to mortality and morbidity rates while considering a multitude of other metrics in order to isolate the effect of the banias. Kashin and Pollock find that the bania did not benefit public health in the period and, in fact, contributed significantly to the spread of at least one disease. They conclude by proposing several areas for future research, including expanding the study into the Soviet period and improving upon their own research with more data, should it become available.

Kashin and Pollock’s study reveals that neither the pro- nor anti-bania group had a monopoly on the truth. Modern bathing practices were generally beneficial to health, but they were not implemented successfully. As a result, proponents of the bania had the right idea, but the practices were not carried out to fruition. Likewise, opponents of the bania were correct that it could lead to negative health outcomes, though this was only true when it came to dysentery—a disease that was spread through infected water. Even within the scientific community, where folk beliefs were largely put aside, there was still widespread misunderstanding when it came to health.

The early twentieth century was, of course, a time of political turbulence for the Russian Empire, which would collapse within two decades. A region’s political stability is yet another social determinant of health, and in Eastern Europe and Eurasia the political instability was clear and ever-increasing. Political strife, and the violent responses that often accompanied it, placed enormous psychological stress on the region’s inhabitants. Psychiatrists of the time attempted to understand the mental ailments that arose, and even went so far as to advance political claims based on psychiatric medicine.

Julie V. Brown, “Revolution and Psychosis: The Mixing of Science and Politics in Russian Psychiatric Medicine, 1905–13,” The Russian Review 46 (July 1987): 283–302, https://doi.org/10.2307/130564.

Brown begins with a history of Russian psychiatric practices from the late 1800s and quickly moves into the state of the field as of the 1905 Revolution, at which point psychiatrists began to see a connection between mental ailments and political unrest. Living through the traumatic events erupting during this period caused people to experience symptoms that we would today relate to Post-Traumatic Stress Disorder. While psychiatrists believed that medicine should be apolitical, psychiatry still became highly politicized; psychiatrists on both sides of the revolution deployed their expertise to comment on political upheaval. By World War I, most psychiatrists stood in opposition to the tsarist regime, which they felt was responsible for past and present damage to the “psyche” of Russia’s population. Because they believed that revolution and political reform would benefit the national psyche, they considered the mental damage caused by political upheaval a lesser, necessary evil.

The situation would get worse before it got better. Emerging from simmering political strife and World War I—which itself led to countless health issues among soldiers and non-combatants alike—came the revolutions of 1917, the Bolshevik seizure of power, famine and civil war, and the eventual triumph of the sprawling, multiethnic Soviet Union.

In the 1920s, the Soviet regime tightened its hold on society. The new government aimed to modernize and industrialize its territory, including in the fields of health and health education. Narkomzdrav—the People’s Commissariat of Public Health—was primarily responsible for this effort. Throughout the Commissariat’s existence, it undertook many politically charged public health campaigns to “enlighten” the Soviet people.

Frances L. Bernstein, “Envisioning Health in Revolutionary Russia: The Politics of Gender in Sexual-Enlightenment Posters of the 1920s,” The Russian Review 57 (April 1998): 191–217,  https://doi.org/10.1111/0036-0341.00018.

This article examines the intersection of two important aspects of Narkomzdrav’s “sanitary enlightenment” initiative of the 1920s: the health propaganda poster and “sexual enlightenment.” Bernstein explains that in handling sexual health, Narkomzdrav treated men and women very differently. Posters that featured women focused primarily on sex and/or the role of women in society, and these posters made clear that “passive wifely sexuality,” as opposed to “aggressive prostitute sexuality,” was necessary for the health and safety of all Soviet people. Women, Narkomzdrav determined, were primarily responsible for the spread of sexual illness, which harmed the regime’s revolutionary goals. Posters targeting and featuring men, by contrast, focused on their education: they urged men to be more committed to making and keeping the revolution healthy. Bernstein concludes that men’s health was shown in a heroic light, whereas women’s health was a subject believed to be in need of correction.

The Soviet regime had an ambiguous relationship to the liberation of women: its programs called for liberation from capitalism and its vestiges but stopped short of full sexual liberation, which itself was often associated with prostitution.[4] Moreover, the regime openly retained sexist elements from the past. In the imperial period, witchcraft was generally associated with women, and when villagers needed someone to blame for negative health outcomes, they scapegoated women. Narkomzdrav’s poster campaigns did much the same, as they put the blame for negative sexual health outcomes on women.

Bernstein shows how Narkomdzrav posters directly engaged folk beliefs, including a series that used motherhood and motherly responsibility as a means to lead women away from folk medicine. Moreover, while fighting centuries-old folk beliefs among the Russian population, Narkomzdrav also had to combat similar entrenched folk beliefs among the USSR’s non-Russian population. Kazakhstan was the second largest Soviet Socialist Republic by territory. As might be expected, folk beliefs of Central Asia were distinctive, and so Narkomzdrav had to act differently when it came to forming campaigns in this region.

Paula A. Michaels, “Medical Propaganda and Cultural Revolution in Soviet Kazakhstan, 1928–41,” The Russian Review 59 (April 2000): 159–78, https://doi.org/10.1111/0036-0341.00115.

The Soviet regime’s newly adopted “germ theory,” Michaels argues, left no room for the folk beliefs of Kazakhs. Soviet medical propaganda sought to tear down old beliefs and build up new practices, promoting the idea that “the plight of the workers” was the primary detriment to health. Propaganda emphasized women’s health, as gynecology and prenatal care were seen as especially neglected from a historical standpoint. Narkomzdrav described elements of Kazakh life as “filthy” and “backward.” Accordingly, Kazakh culture was targeted directly in the name of medical “progress.” Michaels claims that the Kazakh population’s dependence on Soviet healthcare was encouraged as a means to tie them more closely to the state. While reliance on the Soviet medical system in Kazakhstan did indeed grow significantly, the Kazakh cultural beliefs about health did not in turn disappear. To the surprise of the Soviet regime, the two could coexist.

As in other areas of the Soviet Union, Narkomzdrav’s campaigns in Kazakhstan particularly targeted women. However, there was a clear distinction: women in Kazakhstan were not cast as “witches” and blamed for negative health outcomes, but instead as a group that the regime saw, in a paternalistic sense, as needing better medical care.

Belief systems that had been held for hundreds of years were challenged by modernization in twentieth-century Eastern Europe and Eurasia. The Soviet government that controlled the vast majority of the region undertook a concerted effort on behalf of modern medicine but linked its efforts to ideological and political goals that bolstered its authority and marginalized longstanding local practices. After the 1991 collapse of the Soviet Union, each autonomous successor state became responsible for its own progress in medicine and public health. Today, Eastern European and Eurasian health and medicine practices are much more aligned with the methods established in Western Europe and the United States.

The COVID-19 pandemic challenged these established health standards and practices around the world, exposing grave weaknesses in existing systems. Russia was no exception. Despite implementing lockdowns and being among the first nations to develop a vaccine, Russia suffered catastrophic effects from the pandemic. In many ways, this exposed longer-term historical legacies in contemporary Russia.

Take, for example, the reporting of COVID-related deaths. One study found that officials in the Russian Federation underreported COVID-related deaths at rates four to six times greater than elsewhere in Europe and North America. However, this phenomenon was not prominent in the Moscow and St. Petersburg regions of Russia, but instead the territories of Chechnya, Tatarstan, and Bashkortostan, among others.[5]

These territories are home to the three largest ethnic minority groups in the country: Chechnya is over 90% Chechen, Tatarstan is over 50% Tatar, and Bashkortostan is over 30% Bashkir. Just as Narkomzdrav faced unique health hurdles in Soviet Kazakhstan, so too does the Ministry of Health of the Russian Federation—a multiethnic state, like its predecessors—continue to face them in areas with a large non-Russian population. Dmitry Kobak states that a lack of support from Moscow for proper testing may be partially to blame, though he also notes that election fraud on behalf of Putin’s United Russia was especially high in these regions, and suggests that there may be a connection between these issues.[6] This connection between public health and the politics of an authoritarian state is another aspect reminiscent of the Soviet period.

In another situation similar to that faced by Narkomzdrav, Russia’s Ministry of Health has also encountered difficulties in convincing the population to embrace modern medicine—specifically the “Sputnik V” COVID vaccine. Before the vaccine became available, over half of Russia’s adult population was either hesitant or strongly resistant to the idea of getting vaccinated; a variety of factors such as “trust in institutions” were shown to correlate with these stances.[7] The Ministry of Health had to resort to tactics practiced by Narkomzdrav to educate the Russian population about both COVID-19 and Sputnik-V, while simultaneously building more “trust in institutions.” It took nearly a year (and a government mandate) to convince only 36% of the population to get vaccinated, though today approximately 60% of the population have received at least one dose of a vaccine series.[7][8]

That is to say nothing of Russia’s current war against Ukraine. Just as it seemed that normalcy was being restored in the wake of the pandemic, the full-scale invasion in February 2022 plunged the region back into chaos. The death and destruction that Russian forces unleashed against the Ukrainian people has greatly impacted health in the region. Food insecurity runs rampant, and Russia’s war has particularly afflicted many Ukrainians with physical disabilities. The psychological trauma caused by conventional warfare and Russia’s criminal targeting of civilians also cannot be understated. Establishing the extent of war’s impact on physical and mental health is impossible at present, as Russian forces refuse to allow organizations like the Red Cross into the portions of Ukraine they have illegally occupied. As history unfolds before our eyes, we are left to wonder about the extent of these tragedies, which will take years to document fully.

Additional References

[1] Zguta, Russell. “Witchcraft and Medicine in Pre-Petrine Russia.” The Russian Review 37 (October 1978): 438–448. https://www.jstor.org/stable/128509.

[2] For more information, see Smith-Peter, Susan. “Educating Peasant Girls for Motherhood: Religion and Primary Education in Mid-Nineteenth Century Russia.” The Russian Review 66 (July 2007): 391–405. https://onlinelibrary.wiley.com/doi/10.1111/j.1467-9434.2007.00450.x.

[3] For more information, see Timasheff, N. S. “Overcoming Illiteracy: Public Education in Russia, 1880-1940.” The Russian Review 2 (April 1942): 80–88. https://www.jstor.org/stable/125275.

[4] For more information, see Engel, Barbara Alpern. “St. Petersburg Prostitutes in the Late Nineteenth Century: A Personal and Social Profile.” The Russian Review 48 (January 1989): 21–44. https://www.jstor.org/stable/130252.

[5] Kobak, Dmitry. “Excess Mortality Reveals Covid’s True Toll in Russia.” Significance 18, no. 1 (February 2021): 16–19. https://doi.org/10.1111/1740-9713.01486.

[6] Kobak, Dmitry, Sergey Shpilkin, and Maxim S. Pshenichnikov. “Integer Percentages as Electoral Falsification Fingerprints.” The Annals of Applied Statistics 10, no. 1 (March 2016): 54–73. https://doi.org/10.1214/16-AOAS904.

[7] Roshchina, Yana, Sergey Roshchin, and Ksenia Rozhkova. “Determinants of COVID–19 vaccine hesitancy and resistance in Russia.” Vaccine 40, no. 29 (16 September 2022):5739 –5747. https://doi.org/10.1016/j.vaccine.2022.08.042.

[8] GOGOV. Статистика вакцинации от коронавируса. 2023, June 30. https://gogov.ru/articles/covid-v-stats.

About the Author

Jordan Zaugg is a Ph.D. student in the Department of Slavic, Germanic, and Eurasian Studies at the University of Kansas, where he also works as the Editorial Assistant for The Russian Review. His primary area of interest is Ukrainian language, literature, and culture, with a specific focus on Chornobyl’s place in Ukrainian society. He also studies Slavic queer literature and East European cinema.