| Ethiopian |
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| Cultural Profile |
Located in the horn of Africa, Ethiopia is the tenth largest country in Africa. The country is agrarian and the economy depends on subsistence agriculture. In recent years, crops have been poor because of drought. Approximately 85 percent of the population lives in rural areas. The settled population is scattered, making delivery of health and social services difficult.
Ethiopia traces its history as a country back 3,000 years and is the only African country that has never been colonized. In the mid-1970's, the government of Haile Selassie was overthrown and a repressive regime was established. Recent years have seen internal wars for liberation and ethnic conflicts. Many families left the country as refugees.
The population includes many ethnic groups with nearly 80 languages and approximately 200 dialects. Major groups include the Amhara, Oromo and Tigre. Smaller groups include Afad-Isa, Somali, Wolaita, Sidama, Kimbata and Hadiya.
Update, Jan 2003
This section has been written by a community member of Tigray
Community Association and reviewed by Tsehay Demowez (Harborview Medical
Center, Seattle, WA.)
Naming in the Tigray province and Ethiopia, in general, is different from naming in the US. The use of a first name and a family name is unknown in Tigray and the rest of Ethiopia. Everyone in Tigray has his/her own name and also uses his/her father's name, which comes after the personal name. Occasionally, the paternal grandfather's name can be added if needed. There was a lot of confusion when newly arrived Tigrean or other Ethiopians immigrants in the US were asked for their first name and family name. When asked for a last name, many immigrants asked, " You mean my father's or my grandfather's name?" Now when they have settled in the US, most Tigreans and other Ethiopians use their fathers' name as their last name, although some use their grandfathers' name as their last name.
Traditionally, women in the US have changed their family name when they marry. If a woman remarried several times she might have to change her family name accordingly. But women in Tigray and in the rest of Ethiopia do not change their names when they get married.
No document on topic available to EthnoMed.
No document on topic available to EthnoMed.
No document on topic available to EthnoMed.
No document on topic available to EthnoMed.
Women are considered to be subordinate to their husbands and girls receive less education than boys. Families tend to be large (seven or eight children). Knowledge and use of family planning is extremely limited.
No document on topic available to EthnoMed.
Family structure typically includes the extended family. Family ties are strong. Households in the Ethiopian community include from one to six persons, half of whom are children under age 10. The divorce rate is high and mothers have a hard time raising children as single parents. In times of crisis, the family will take full responsibility for the family member's problems, whether it is financial, health or social.
Disputes are settled by elders of the community. The society respects elders and accepts their admonitions or advice. Interaction is personal, informal and intimate; a great deal of interdependence is needed to accomplish a task or solve a problem.
No document on topic available to EthnoMed.
Women in rural areas are assisted in childbirth by female relatives or midwife. The new mother and baby stay at home for 40 days after birth, with female relatives and friends helping to care for them.
Ethipian women prefer female doctors and interpreters, especially for child birth. Many think that American doctors are too quick to perform Cesarean sections for what Ethiopians consider to be normal variations. For this reason, they may wait at home until well into labor in order to avoid unwanted procedures. Because of school, work and other obligations, Ethiopian women in the United States are not able to take the traditional 40 days of rest after childbirth. They also worry that nursing in public is inappropriate or find that work or school interrupts the feeding schedule. They have trouble maintaining breast- feeding as long as they would like. Most are unfamiliar with pumping and storing breast milk.
A shortened period of breast-feeding is contributing to high fertility rates in Seattle's Ethiopian community, since breast-feeding an infant up to three years was the most common form for birth control. Although not much information is available to Ethiopian women in Seattle about family planning methods, they are starting to take oral or other contraceptives.
No document on topic available to EthnoMed.
Male and female circumcision is practiced by most people who are Muslim, Christian and Ethiopian Jews.
In Ethiopia the majority of women breast-feed; breast- feeding in public is acceptable. Mothers introduce other foods to the infant at four months of age but continue breast-feeding up to three years or until the woman is ready to have another child.
No document on topic available to EthnoMed.
No document on topic available to EthnoMed.
Ethiopian Food:
Teff
The preferred staple in the Ethiopian and Eritrean diet is engera
(pronounced en-jer-a, and sometimes spelled injera), a flat sour-like
fermented pancake that is used with "wot", a stew made with spices, meats
and pulses, such as lentils, beans and split peas. In Ethiopia and
Eritrea, teff is the most common cereal crop used to make engera.
See The Traditional Foods of the Central Ethiopian Highlands, a research report published by the Scandinavian Institute of African Studies, 1971.
No document on topic available to EthnoMed.
There are two dominant religious: The Ethiopian Orthodox Church (Christian) and Islam. Some estimates put the Orthodox at just over half the population, while other estimates suggest that the Muslims are in the majority.
Abiy Tsom - The Great Lent: Dietary and Medical Implications of Fasting for followers of the Ethiopian Orthodox Church by Dr. Tesfai Gabre-Kidan, MD, Seattle, WA.
Ethiopian Orthodox Christian Encounter offers a perspective about death taken from conversations with community members.
Illness is often considered a punishment from God for a person's sins or as the anger of spirits. Rural Ethiopians depend primarily on traditional healers, who treat illnesses with local herbal and animal remedies. Spiritual healing, such as prayer, is the preferred treatment for many diseases. Mental illnesses are seen as the result of evil spirits and are treated with prayer. Rural Ethiopians who come to the city often keep their traditional beliefs and attitudes towards health.
Where Western-style medical care is available, antibiotics are used frequently. Ethiopians who consult doctors usually receive a medication for every illness.
Most Ethiopians in Seattle get health care at Harborview, Providence, Group Health and Swedish medical centers. Refugees from urban centers in Ethiopia have experience with Western-style medicine, but rural people have trouble understanding the concept of disease and the causes, means of transmission and methods of prevention. They also don't understand the practice of withholding treatment until diagnostic work is done. Because Ethiopians are accustomed to receiving antibiotics or other medications for every illness, they feel it is a waste of time to go to a doctor if no medication is given, even for a minor illness. This is a common point of dissatisfaction with health care in Seattle.
The businesslike and direct approach of Western doctors is in contrast with the more interpersonal approach of Ethiopian doctors. For example, an Ethiopian doctor will never inform a patient of a terminal diagnosis. Instead the doctor will tell a close relative. This protects the patient from being discouraged; encouragement from relatives gives the patient hope and protects him or her from despair.
Language is also a problem. Ethiopians who come from rural areas have very limited English language skills. Although interpreters may be provided, the interpreters are not always appropriate. Patients are not comfortable with interpreters because of gender differences (women prefer female interpreters; men prefer male interpreters) or political/ethnic differences (for example, some Amharic- speaking Ethiopians are not comfortable with Oromo interpreters, some Oromos with Tigreans, and so forth). Because of these differences, patients often feel they cannot express all their needs and may not trust the medications prescribed.
The cost of health care is a problem for many Ethiopians. Those who cannot afford to pay are afraid to use the health care system. Little information is available about the Basic Health Plan or other options.
The Ethiopian Community Mutual Association (ECMA) is an organization representing all Ethiopians in the Seattle area. The ECMA's Board includes individuals from various ethnic groups, including Tigray, Oromo, Amhara and others. The ECMA uses the languages of these three groups as well as smaller ethnic groups for its programs. Programs include ESL and literacy classes, referrals for employment and social services, legal advice, and counseling for families with dependent children.
Other Seattle organizations serving families from Ethiopia include the Oromo Community Organization, the Tigray community Center, and the Horn of Africa Services.
For more cultural information: Oromo Cultural Profile and Voices of the Community.
Ethiopian refugees began arriving in the Seattle area in the 1980's and increased from 1989 to 1993. The total Ethiopian population in the greater Seattle area is estimated at between 6,000-7,000 with women and children highest in number.
Most of the Ethiopians settling in Seattle came from rural areas and have had little formal education. Those from urban areas are educated and worked as health professionals, engineers, teachers and social workers. Unemployment or underemployment are leading problems for many Ethiopians in Seattle.
Ethiopian Community Mutual Association, 464 12th Ave, Suite 201, Seattle, WA 98122 (206) 325-0304.
Oromo Community Organization, 2718 S. Jackson St., Seattle, WA 98122, (206) 324-7039.
Tigray Community Center, 1902 E. Yesler, Seattle, WA 98122, (206) 328-8307.
Horn of Africa Services, 7500 Greenwood Ave N, Seattle, WA 98103 (206) 784-4144.
Most of Seattle's Ethiopian population lives in central and south Seattle (Rainier Valley, Yesler Terrace, Holly Park and in High Point in West Seattle. But a number of families also live in north Seattle, Ballard, Redmond, Bellevue and Kent.
Some suggestions from the community that would help access to health care: