Back to my master’s, I remembered a conversation with the professor about the PhD project on informality in health care I was applying to. She was intrigued by the informality concept explaining she has never encountered it before. What is informality? Is it about the unofficial labour market? Is it about grey economies? I hesitated to answer and mumbled, ‘‘well, it covers all these things’’. Reflecting on this conversation later, I was still uncertain how to explain the origins of informality as a field in social sciences, but I kept digging in.
At first glance, it seems that the concept has been widely used among scholars who studied post-socialist spaces. Informality interestingly sticks to the borders: if personal negotiations in a Russian hospital are called ‘‘informality’’ (Borozdina & Novkunskaya, 2019; Rivkin-Fish, 2005; Temkina & Rivkin-Fish, 2020), the same practices in an American hospital transform to ‘‘the negotiated order’’ (Strauss et al., 1973). How did it happen? In his recent article on informality, Abel Polese (2021) argues that although studies of informal practices can be found among different disciplines and regions, there is a significant cluster of literature on informality in post-socialist states. He identifies three reasons for that: a homogeneous starting point, congruent findings and opportunities (Polese, 2021, p.13). If the first two relate to similar research findings due to the political and social closeness of post-socialist spaces, the opportunity explanation brings us back to bourdieusian struggles for recognition in academia (Bourdieu, 1988). Studying post-socialist space and its rapid transition to the market economy was a unique and attractive opportunity for young ambitious researchers aimed to build academic careers. As Polese put it, informality became fashionable and further disseminated between Cambridge and Max Planck Institute of Social Anthropology.
Along with these explanations, I keep thinking about another one – the political origins of the concept. I believe that informality has emerged as a response to the widely accepted practice to blame corruption for the failure of new “democratic” initiatives. Right after the dissolution of the Soviet Union, many international initiatives and programmes were launched in post-socialist countries with the idea of bringing the best political and economic institutions to the new space. Many of these initiatives were implemented only partially, while some failed dramatically. International bodies quickly blamed corruption and the strong resistance of local authorities for the failure. However, in practice, the issue seemed more complicated and attracted much scholarly attention.
For instance, anthropologist Michele Rivkin-Fish (2000, 2005) studied how the WHO’s maternal health project launched in St. Petersburg to promote women’s health and empowerment failed to accommodate the changes. She argues that the reason for that was not primarily the strong reluctance of medical professionals to reduce their power over patients – the reason WHO insisted on – but the failure of foreign experts to integrate local knowledge and structural hierarchy deeply rooted in the hospitals' operation. Rivkin-Fish points out the structural constraints and cultural differences that hindered the changes WHO was hoping for. In the post-socialist context, the hospitals were lacking hot water and disposable gloves, doctors were deprived of professional autonomy and ‘‘felt robbed by the poverty and bureaucratic rigidity’’ of the health care system (Rivkin-Fish, 2005, p.29). As a result, both patients and professionals experienced vulnerability and hopelessness for any changes in the nearest future.
To cope with the given structural constraints, Rivkin-Fish (2005) demonstrates, both patients and medical professionals were engaged in the informal personal networks to get access to better care and eliminate the dehumanizing power of the hospital bureaucratic system. These networks were commonly based on kinship ties or friendships creating safe personal circles. Unlike corruption, those informal practices – gifts, unofficial payments, and informal negotiations – fulfilled the moral obligations to health care providers. Women believe that paying extra for the doctors’ care and attention will enhance their economic wellbeing. Doctors, on the other hand, accepted these ‘‘gifts’’ as compensation for the system’s injustice to them. Rivkin-Fish argues that although the informality did not fully compensate for the structural gaps in the health care system, it nevertheless smoothed the existing hierarchies and served as the new moral ground to renegotiate neoliberal changes.
To conclude, I want to stress that to understand why informality became ‘‘a thing’’ in a post-socialist context, it is important to understand political behind it. The work of Rivkin-Fish is one of the many examples of informality scholarship in which researchers debunked notions of bribes and corruption providing a more nuanced and local perspective of informal practices. Informality hence served as a political tool to rethink and redefine the notion of corruption imposed widely by international bodies. Informality, hence, has become not only an approach to study workfloor practices but an argument against the devaluation of local complexities.
But do we need ‘‘informality’’ today? I would leave it as an open question.