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ABIY TSOM
The Great Lent

Observed by followers of the Ethiopian Orthodox Church. It lasts 56 days and the fast involves:

• it is applicable to all persons older than 13 years of age
• total abstention from: meat, dairy products and eggs
• instead, cereals and vegetables will be consumed
• only one meal a day, taken in the evening or after 2:45pm
• starting on Good Friday to Sunday, there is total abstention from everything taken orally. Nothing is to be consumed.

Medical Implications

• doses of medications scheduled to be taken multiple times a day will either be missed or worse, some will try to make up for missed doses by doubling or tripling dosages.
• illnesses dependent on regular meal intake for their control, will be difficult to control, i.e., DM, PUD.
• Diabetes and most patients with chronic systemic illnesses will be at increased risk the last 3 days of the fasting season, Good Friday to Sunday.

Health care providers should be vigilant and question their patients whether they intend to observe regular or modified fasting. When in the judgment of a provider, patient is considered at risk, provider can remind the patient of the exemptions stipulated by the Ethiopian Orthodox Church and if necessary refer the patient to the Head Priest for counseling.