Ethnobotanical studies are crucial in South-Eastern Europe for fostering local development and also for investigating the dynamics of Traditional Environmental Knowledge (TEK) related to plants in one of the most crucial European hotspots for biocultural diversity. The current medico-ethnobotanical survey was conducted in rural alpine communities in Kosovo. The aims of the study were twofold: 1) to document the state of TEK of medicinal plants in these communities; 2) to compare these findings with that of similar field studies previously conducted among local populations inhabiting the Montenegrin and Albanian side of the same Alpine range.
Methods
Field research was conducted in 36 villages on the Kosovar side of the Albanian Alps. Snowball sampling techniques were used to recruit 91 elderly informants (≥ 50 years-old) for participation in semi-structured interviews and structured surveys regarding the use of the local flora for medicinal and food purposes. Standard ethnobotanical methods were employed and prior informed consent was obtained for all study participants.
Results and Conclusion
The uses of 98 plants species belonging to 39 families were recorded; the most quoted botanical families were Rosaceae, Asteraceae, and Lamiaceae. Mainly decoctions and infusions were quoted as folk medicinal preparations and the most common uses referred to gastrointestinal and respiratory disorders, as well as illnesses of the uro-genital system. Among the most uncommon medicinal taxa quoted by the informants, Carduus nutans L., Echinops bannaticus Rochel ex Schrad., and Orlaya grandiflora Hoffm. may merit phytochemical and phytopharmacological investigations.
Comparison of the data with other ethnobotanical field studies recently conducted on the Albanian and Montenegrin sides of the same Alps has shown a remarkable link between the medical ethnobotany of Montenegrin and Kosovar side of the Albanian Alps. Moreover, folk uses of the most quoted wild medicinal taxa recorded in Kosovo often include those recorded both in Albania and in Montenegro, thus suggesting a hybrid character of the Kosovar local plant knowledge. This may be also explained with the fact that Montenegro and Kosovo, despite their differences in the ethnic composition, have shared a common history during the last Century.
The online version of this article (doi:10.1186/1746-4269-8-6) contains supplementary material, which is available to authorized users.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
BM and AH conceived the study, and participated in its design and coordination. AH and HA carried out the field study; EH and FK verified the identification of the plant taxa; AH, AP, and CLQ performed the data analysis and drafted the discussion. CLQ edited the manuscript. All authors read and approved the final manuscript.
Background
Ethnobotanical studies in South-Eastern Europe are seen as a crucial initial step for local rural development based on eco-tourism, small-scale trade of local medicinal plants, high-quality local foods, eco-museums, and community-based bio-conservation strategies [1].
However, this region is also considered very special for conducting studies having a human ecological focus, since it represents a unique hotspot of biological and cultural diversity in Europe, thus allowing cross-cultural comparisons of traditional environmental knowledge (TEK) concerning medicinal plants. In very recent years, the Western Balkans have been the focus of a remarkable number of ethnobotanical studies [2‐9], mainly focused on mountainous communities [10‐15].
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In this study, we investigated the Kosovo side of the Albanian Alps (in Albanian known as Bjeshkët e Nemuna or Alpet Shqipëtare; in Serbo-Croatian known as Prokletije), which extends within a triangle among the Dinaric Mountains in the North-West, the Sharri (Šar) Mountains in the South-East and the Rhodope Mountains in the East and North-East. This covers a very pristine, and sometimes, remote area of ca. 3,500 km2, which is geo-politically divided among the sovereign states of Albania, Kosovo, and Montenegro.
About 1,000 km2 of these mountains belong to the Kosovo territory. The Albanian Alps system consists of 24 groups of mountains with 152 peaks higher than 2,000 m a.s.l. (the highest altitude in the Kosovo territory is reached by Maja e Gjeravicës at 2,460 m a.s.l.), with a large number of gorges, canyons, valleys, which make them among the most inaccessible [16], but also magnificent areas of the Balkans [17].
Due to the rich levels of biodiversity characteristic to this region, three national parks were established in the past in the Albanian Alps: one in Montenegro (Prokletije National Park) and two others in Albania (Theth and Valbona National Parks). A fourth national park in the area has been proposed to be located in Kosovo. Furthermore, Kosovo, Albania, and Montenegro are planning to join these parks and to create the cross-border Balkan Peace Park [18].
In general, Kosovo is characterised by a continental climate and in higher altitudes it is influenced by Alpine features [19]; for this reason, it has cold winters and hot summers, with an average temperature of 11.4°C. The Alpine area of Kosovo is characterised by total annual precipitation levels exceeding 2,000 mm. Specific geo-morphological, soil and climatic features provide an interesting richness and diversity of plant life in the Albanian Alps massif, with a flora belonging to three different bio-geographic zones: the Mediterranean, the Central-European and the Central-South European regions [17, 20‐22].
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These unique features are reflected in the high plant biodiversity, which includes 1,609 taxa and ca. 150 vegetation units [23]. The most representative vegetation unites are: oriental hornbeam forest (Carpinetum orientalis scardicu), hop hornbeam mixed and with oriental hornbeam forest (Ostryo-Carpinion orientalis), thermophilous oak forests community (Quercus frainetto Ten., Quercetum frainetto-cerris scardicum, and Quercetum petraeae-cerris), chestnut forests (Castanetum sativae), beech forests (Fagetum montanum), and pine forests (Pinetum heldreichii typicum, Pinetum heldreichii thalictretum, Pinetum peucis, and Pinetum mughi typicum) [22, 24].
People have withstood the extreme conditions of these areas for centuries - including very harsh winters. Until very recent decades, limitations in infrastructure and communication forced local residents to be self-sufficient in the provision of their healthcare. As a result, their primary pharmacopoeia consisted of local medicinal plants.
While recent studies on the Albanian and Montenegrin sides of the Albanian Alps have reported findings on TEK of wild medicinal and food plants [10, 12, 13, 15], no ethnobotanical surveys have been conducted thus far in Kosovo, with the exception of a very recent work carried out by our research group in the Gollak area [9], and a review on folk botanical names in diverse Albanian-speaking areas in South-Eastern and Southern Europe [25].
The aims of this study were twofold: 1) to document the ethnobotanical knowledge related to the use of local medicinal plants in the Albanian Alps region of Kosovo; and 2) to compare the recorded data with the ethnobotanical studies recently conducted in the Albanian and Montenegrin sides of the same Albanian Alps. This was done with the overarching goal in mind of elucidating the role played by cultural/ethnic components in shaping use patterns of wild medicinal plants.
Methods
Field study
Ethnobotanical field research was conducted in 36 villages belonging to the municipalities of Pejë and Deçan, located close to the Koprivnik and Strellc mountains, and which represent the central group of the Albanian Alps located in the western part of Kosovo (Figure 1).
Figure 1
Study area in Kosovo.
×
The settlements and villages investigated are relatively small in terms of inhabitants (≤ 500 inhabitants per village). The native residents are ethnic Albanians, who speak Gheg varieties of the Albanian language. The exact population is currently unknown, as no population census has been conducted in Kosovo since 1981. Most recently, the area populations have been negatively affected by migration due to displacement and harsh economic conditions caused by the last Kosovo War (1998-1999).
Field studies were conducted from May to October 2010. TEK was recorded using semi-structured interviews and a questionnaire [26]. In particular, we sought the following information: respondent name and community of residence; local botanical names of useful plants; plant part(s) used; preparation/administration; local folk medicinal uses of plants.
Data were collected from 91 informants (67 male and 24 female) older than 50 years (50 to 79 years old). The respondents were mainly engaged in agricultural activities and typically inherited their ethnobotanical knowledge from their direct ancestors (parents, grandparents) via oral traditions. Study participants were selected using the snowball sampling method [2], and we particularly focused on local people who regularly use plants for medicinal purposes.
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Prior informed consent was obtained conducting interviews and researchers adhered to the ethical guidelines of the International Society of Ethnobiology [27]. During the interviews, fresh plants were collected to create voucher specimens for the herbarium and the informants were followed into the field to show us the quoted species. Most plant species were collected while flowering.
Taxonomic identification was done using relevant standard botanical literature of the area [28‐31]. Plant nomenclature largely follows the Flora Europaea [32], while plant family assignments follow the current Angiosperm Phylogeny Group guidelines [33]. Voucher specimens of the wild taxa were deposited at the Department of Biology (Herbarium code DE/10), University of Prishtina.
Data analysis
Despite the fact that it is always problematic to compare ethnobotanical data recorded from studies conducted using different field methods and at different times, we have attempted to compare the wild medicinal plant uses recorded in Albanian Alps in Kosovo with those recorded in previously conducted ethnobotanical studies on the Albanian and Montenegrin sides of the same alpine range [11‐14]. The Jaccard similarity index among the considered studies has been calculated as in the recent comparative analysis of the circum-Mediterranean medical ethnobotany [34].
Results and Discussion
The Kosovar medico-ethnobotany of the Albanian Alps
The results of the field survey are presented in Table 1; plants are arranged in alphabetical order by genus. For each species, the botanical name and family, local names, English name, botanical status, preparation/administration and folk medical or food uses are reported.
Table 1
Medicinal plant uses recorded on the Kosovar side of the Albanian Alps in the current study.
Botanical taxon, botanical family and voucher specimen code
Folk name(s) quoted by respondents
English name
Status
Quotation frequency
Part(s) used
Administration
Treated disease(s) or folk medical uses(s)
Abies alba Mill. (Pinaceae) 13/DE/10
Bredhi i bardhë
European silver fir
W
+
Resin
Boiled in oil
Stomach pain
Eczemas
Topically applied
Skin infections
Mixed and boiled with milk butter
Skin hematomas
Skin infections
Achillea millefolium L. (Asteraceae) 03/DE/10
Hajdukati
Yarrow
W
++
Areal parts
Infusion
Anti-diarrhoeal
Stomach pain
Anti-diabetic
Eczema
Tincture topical used in wound
Antibacterial
Aconitum divergens Pančić (Ranunculaceae)
04/DE/10
Pelini i egër (i zi)
W
++
Areal parts
Infusion
Stomach disorders
Oral cavity antiseptic
Anti-haemorrhoidal
Whole plant
Infusion
Anti-cholesterolemic
Leaves
Squeezed and topically applied to the wound
Anti-bacterial
Skin infections
Adiantum capillus-veneris L. (Adiantaceae)
01/DE/10
Majdanozi i egër
Southern maidenhair fern
W
+
Areal parts
Decoction
Bronchitis
Sour throat
Expectorant
Aesculus hippocastanum L. (Sapindaceae) 06/DE/10
Gështenja e egër
Horse chestnut
W
++
Leaves
Infusion
Expectorant
Anti-rheumatic
Fruits
Decoction
Antitussive
Anti-hypertensive
Tincture
Anti-rheumatic
Agropyron repens (L.) P. Beauv. (Poaceae)
08/DE/10
Pirrovina
Couch grass
W
+
Roots
Decoction
Anti-rheumatic
Anti-anaemic
Stomach and hepatic disorders
Lithontriptic
Infusion
Lithontriptic
Allium cepa L. (Amaryllidaceae) 11/DE/10
Qepa
Onion
C
+
Leaves
Decoction
To treat influenza
Bulb
Extracted with cold mineral water
Anti-hypertensive
Allium porrum L. (Amaryllidaceae) 09/DE/10
Purrini
Garden leek
C
+
Leaves and stem
Eaten fresh
Anti-cholesterolemic
Allium sativum L. (Amaryllidaceae) 10/DE/10
Hudhra
Garlic
C
+
Bulb
Leaves
Tincture
Improve blood circulation
Anti-diabetic
Antibacterial
Anti-hypertensive
Decoction
Tooth ache
Alnus glutinosa (L.) Gaertn. (Betulaceae)
05/DE/10
Verri
Black alder
W
+
Cortex
Decoction, used to wash whole body
Anti-rheumatic
Leaves
Extracted with cold water
Disinfectant on wounds
Althaea officinalis L. (Malvaceae) 07/DE/10
Mëllaga e bardhë
Marshmallow
W
++
Roots
Extracted with cold water
Expectorant
Decoction
To treat lung disorders
Oral cavity antiseptic
Expectorant
Arctium lappa L. (Asteraceae) 12/DE/10
Bullushtra
Greater burdock
W
+
Areal parts
Decoction
Gastrointestinal disorders
Bronchitis
Lithontriptic
Leaves
Boiled in milk (used externally
Skin inflammation and ulcers
Aristolochia clematitis L. (Aristolochiaceae)
14/DE/10
Fiku i egër
Birthwort
W
+
Fruits
Decoction
Anti-haemorrhoidal Eczemas
Areal parts
Decoction
Infected wounds
Ulcers
Artemisia absinthium L. (Asteraceae) 02/DE/10
Pelini i butë
Wormwood
W
+
Areal parts
Infusion
Stomach disorders
Anti-diabetic
Beta vulgaris L. (Amaranthaceae)
17/DE/10
Sveklla
Common beet
C
+
Roots
Decoction
Anti-anaemic
Betula verrucosa Ehrh. (Betulaceae) 16/DE/10
Mështekna
Silver birch
W
+
Cortex
Decoction
Kidney infections
Leaves
Decoction
Lithontriptic
Brassica oleracea L. (Brassicaceae) 18/DE/10
Lakra
Cabbage
C
+
Leaves
Fermented leaves topically applied
Anti-bacterial
Bryonia alba L. (Cucurbitaceae) 15/DE/10
Stërkungulli
White bryony
W
+
Roots
Extracted with sunflower oil, apply topically in pain place
+ quoted by less than 5% of the participants; ++ quoted by more than 5% and less than 30% of the participants; +++ quoted by more than 30% of the participants
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We found that 98 species (belonging to 39 families) are employed in the traditional medicine of the area. These includes three fern species, three gymnosperms and 92 angiosperms (84 dicotyledonous and 8 monocotyledons); 74 taxa are wild. Of these species, Achillea millefolium L., Cornus mas L., Hypericum perforatum L., Juglans regia L., Juniperus communis L., Malus sylvestris Mill., Plantago major L., Sambucus nigra L. were cited more then 30% of the informants. From 98 species presented in Table 1, 23 species are also included in the official Pharmacopoeia of Europe [35].
The predominantly quoted botanical families were Rosaceae (12%), Asteraceae (10%), and Lamiaceae (5%). These same three "top" families were found to be also predominant among the wild medicinal taxa used in the folk medicine of the Alps in Montenegro, Albania, and in the Gollak region in Kosovo [9, 11‐14].
The most frequently quoted manner of preparation of medicinal plants was represented by decoctions (51%) and infusions (26%). The most frequently cited medicinal uses referred to gastrointestinal (26%), respiratory (19%) troubles, and illnesses affecting the urogenital system (12%). The first two categories were also the most frequently quoted in the ethnobotanical studies conducted on the Montenegrin and Albanian sides [11‐14].
Most uncommon medicinal plants
Upon analysis of the bio-pharmacological literature on the quoted medicinal species available on PubMed, we found that it could be worthwhile to further investigate the following reports:
1.
The internal use of cold water macerates of the inflorescences of Carduus nutans L. in the treatment of eczema (this taxon is scarcely known in the phytochemical and pharmacological literature). In 2000 a Turkish research group pointed out the hepatoprotective effects of extracts from this plant [36];
2.
The internal use of decoction of the roots of Echinops bannaticus Rochel ex Schrad. for kidney stones (despite a few studies on other species of the genus Echinops, this Balkan species is largely under-investigated); and
3.
The internal use of decoctions of aerial parts of Orlaya grandiflora Hoffm. for its laxative effects (the plant is completely unknown in the phytopharmacological literature).
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Comparison with the Albanian and Montenegrin Alpine ethnobotanical literature
Table 2 and Figure 2 show the sites and field studies that have been compared with the data gathered in the Kosovar Alps.
Table 2
Summary of the field ethnobotanical studies considered in the cross-cultural data analysis.
Location of the study area in Kosovo and of the sites where previous ethnobotanical works have been conducted in Albania and Montenegro [11‐14].
×
Figure 3 and Table 3 illustrate the similarity between the wild medicinal plants used and recorded in the current study and those recorded in the Montenegrin and Albanian sides of the same Albanian Alps.
Figure 3
Representation of the commonalities among the wild medicinal species quoted on the Kosovar, Montenegrin, and Albanian sides of the Albanian Alps [data from the current study and [11‐14]].
×
Table 3
Jaccard similarity index of the wild medicinal plants used in the Kosovar, Albanian, and Montenegrin Alps.
Group I
Group 2
Species used in both groups
Species used in one group only
(Group 1/Group 2)
Jaccard Index
Albanians in Albania
Albanians in Kosovo
13
24/45
15.9
Albanians in Albania
Serbs and Bosniaks in Montenegro
21
16/94
16.0
Serbs and Bosniaks in Montenegro
Albanians in Kosovo
32
83/36
21.2
Comparison of the most quoted folk medicinal uses of wild taxa in the current study and in ethnobotanical studies previously conducted in Albania and Montenegro [11‐14].(Same or similar uses are underlined.)
The link between the medical ethnobotany of the Montenegrin and Kosovar sides of the Alps - despite the different ethnicity/language of the local populations - appears stronger than the link between the ethnobotany of these two locations and the ethnobotany Albania.
This apparent paradox could be explained in a number of ways:
1.
Different sampling techniques may have been adopted during the field survey in the three locations or the socio-economic background of the interviewees could have been different. For example, on the Albanian side of the Alps, the previous ethnobotanical studies selected local informants from very remote areas, which remained quite isolated during Communist times and with very limited access to urban environments and culture. It could be especially worthwhile to further assess the influence of the popular phytotherapeutical literature on folk medicine in Montenegro and Kosovo, since during the Yugoslavian time this kind of popularised knowledge was said to be "en-vogue". For example, this is very evident in the Montenegrin data, where a number of possible "modern" uses of local medicinal plants (i.e. Hypericum perforatum used as an anti-depressive) were recorded.
2.
The study sites chosen in Kosovo and Montenegro are on average located at lower elevations than the sites selected in Northern Albania, thus resulting in a partially different ecological setting and availability of certain species in the environments.
3.
Both the Montenegrin and Kosovar side of the Albanian Alps have had a common history for the most part of the 20th Century, since belonging to the same country (former Yugoslavia). This may have "homogenised" eventual pre-existing differences in plant perceptions/uses between the Albanian and Slav communities. Moreover, a few South-Slav communities (i.e. Bosniaks [2‐4, 7, 8]) could be surely considered much more "herbophilic" than the Albanian ones, and this may have influenced the folk medicine of the Kosovar population to a certain degree during the last century, who have always lived in contacts with the Slavs.
4.
The Montenegrin study included self-declaring Serbian and Bosniak communities. However, a large part of the Bosniak community living in the Gusinje area is represented also by "bosniakised" Albanians, whose Catholic tribes settled on this side of the Albanian Alps and converted to Islam a couple of centuries ago [37]. This could mean that the ethnobotanical data of Montenegro and Kosovo may actually refer to the same core of Muslim Albanians.
Despite the commonalities found on the quoted medicinal plants, Table 4 shows the different uses of the wild taxa, which have been most quoted in all three sides of the Alps.
Table 4
Comparison of the most quoted folk medicinal uses of wild taxa in the current study and in ethnobotanical studies previously conducted in Albania and Montenegro [11‐14] (Same or similar uses are underlined
Botanical taxon
Used part(s)
Pathologies treated in the folk medicine of the Kosovar Alps
Pathologies treated in the folk medicine of the Montenegrin Alps [15]
Pathologies treated in the folk medicine of Albanian Alps [11‐14]
Centaurium erythraea Rafn.
Aerial parts
Stomach-disorders
Diabetes
Fever
Kidney stones and UTIs
Stomach disorders and loss of appetite
Diabetes
Fever
Cornus mas L.
Fruits
Stomach disorders
Diabetes
Rheumatisms
Anaemia
Dhiarroea
Intestinal troubles
Gentiana spp.
Roots
Blood circulation- related diseases (including hypertension)
Bronchitis and asthma
Stomach disorders
Rheumatisms
Stomach-ache
Cardiovascular diseases
Hypericum spp.
Flowering aerial parts
Stomach disorders
Bronchitis and asthma Hypertension
Skin infections, sunburns, and eczemas
Haemorrhoids
Anti-cholesterolemic
Gastritis
Anxiety and depression
Skin inflammations and burns
Stomach and digestive disorders
Anxiety
Respiratory diseases
Fever
UTIs
Origanum vulgare L.
Aerial parts
Respiratory diseases
Digestion
UTIs
Respiratory diseases
Digestive
Respiratory diseases
Digestive
Diuretic
Plantago spp.
Aerial parts
Stomach-ache
Respiratory diseases
Wounds
Haemorrhoids
Back-pains
Respiratory diseases
Mouth and skin inflammations
Fever
Haemorrhoids
Abdominal pains
Wounds
Diuretic
Urtica dioica L.
Roots
Haemorrhoids
Alopecia
Haemorrhoids
Fever
Arthritis
Anaemia
Alopecia
UTIs
Rheumatisms
Alopecia
Genital problems
UTIs: Urinary Tract Infections
From Table 4 it is interesting to underline that the folk uses of the wild medicinal taxa recorded in Kosovo often include both the uses recorded in Albania and those in Montenegro. It would then appear that the medico-ethnobotany of Kosovo - because of its history in the last century and the exposure to the South-Slavic ethnobotanical traditions - has possibly incorporated both Albanian and Slavic plant uses.
Conclusions
Medicinal plants still play a crucial role in the sphere of human health in the Albanian Alps, not only in the Montenegrin and Albanian territory, but also on the Kosovar side. Oftentimes, these mountainous communities have limited or non-existent access to Western biomedical modalities, and are instead self-reliant on their TEK. The local flora is thus incredibly important to provide the first health care within the households of the Albanian Alps.
Moreover, the biodiversity richness and unique bio-cultural heritage of the local people here is something to be highly valued. Steps towards this end are evident in the formation of protected parks for biodiversity conservation - but further efforts in conservation of the human TEK diversity and cultural heritage are necessary as well. TEK-dependent activities such as sustainable gathering of wild medicinal taxa, their small-scale trade, and production of local high quality plant-based foods and dairy products can all contribute to the growing eco-tourism initiatives. Thus, TEK is a critical component to success in the future economic development and biocultural conservation efforts of the region.
Acknowledgements
Special thanks are due to all the inhabitants of the Kosovar Alps who participated in this study.
Open Access
This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution License (
https://creativecommons.org/licenses/by/2.0
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
BM and AH conceived the study, and participated in its design and coordination. AH and HA carried out the field study; EH and FK verified the identification of the plant taxa; AH, AP, and CLQ performed the data analysis and drafted the discussion. CLQ edited the manuscript. All authors read and approved the final manuscript.
