Go Global to
Ityop'iya---Ethiopia!
Blain Mamo, MPH and Blen Shoakena
Minnesota Department of Health
Volunteers, Ethiopian Community in Minnesota Health Board
February 25, 2009
Around Ethiopia in 60 minutes…
• … a quick overview of its land, diverse
people, centuries of history and culture.
• This is just a perspective of two Ethiopians
Geography
•
•
•
Capital City: Addis Ababa •
(population approx. 3
million)
Location: East Africa,
landlocked
•
Area: 435,071 square
miles (1,127,127 km²)
almost twice the size of
Texas (or Britain and
France combined)
Terrain: desert in the east,
tropical forests in the south,
Highlands in the North and
SW. Highest point 15,157
ft, lowest 410 ft
Climate: Rainy season
June to Sept. ; showers in
February to March, dry the
rest of the year.
Around Addis Ababa
Around Addis Ababa
First postal office in Piassa neighborhood
Addis Ababa University, Est. 1950
Around Addis Ababa
Early…early history
• There was Lucy or
“Dinkinesh”
• One of the oldest
country in the worldhuman settlement in
prehistoric time (human
ancestors dating ~4
million discovered in
Ethiopia… “Lucy” is the
most famous
recognized hominid
fossil
Early History
•
Traces its history back at least 3000 years
D’mt Empire
700 B.C- 650 B.C.
5,0002,000
BC
•Obelisks in
Axum Region
•Evidence of
semitic
languages
(proto-Ge’ez)
Solomonic Dynasty 1268-1974
Axumite Empire
400 B.C- 960 A.D.
Zagwe
Dynasty
1137-1268
•Center of International trade
King Lalibela
•Conversion to Christianity
under Emperor Ezana (325
A.D)
(1141-1181)
builds 12
rock-hewn
churches
•Islam introduced in 615 A.D.
(refugees from Mecca settled
in Negash)
•Evolution of Ge’ez
15291542
Imam
Ahmed
Invaded
Ethiopia
16351855
Gondar-capital
of Ethiopia under
Emperor
Fasilides
17301855
•“Era of Princes”
16 different rulersrife with conflicts
for power and
control
•Decentralized
18551868
•King Tewodros II
(1855-1868) united
and controlled all
Ethiopia
•Beginning of
Modern Ethiopia
D’mt Empire ( 700 B.C.-650
B.C.) Yeha ruins
Sabean tablet
(read L-R-L & with no vowels)
Axumite Empire
400 B.C- 960 A.D.
Zagwe Dynasty (1137-1268)
Churches at Lalibela
Bete Emmanuel
Bete Gabriel
Gondar
Capital city (1635-1855)
Modern History & Current Politics
•
“Battle of Adwa” :defeated Italy in 1896 during “Scramble for Africa”; one of two
African countries never colonized (Italian occupation 1935-1941)
King Menelik II
Zewditu I
(1889-1913(d))
(1916-1930 (d))
• Father of Modern
Ethiopia (railway, car,
bank, postal service,
electricity, plumbing)
•
Est. trade w/ Europeans
Unified kingdoms of
Ethiopia
•
Est. “Cabinet of
Ministers” to govern
Empire
•
Menelik II’s
daughter
H.I.M. Haile Selassie I
(1930- 1974)
“Zewditu I” and Iyasu V
cousin
•
•
1st written Constitution,1931
Abolished slavery as
condition to join “league of
nations, 1932
•
1961- Start of Eritrean War of
independence
•
Com. Col. Mengistu HaileMariam P.M Meles Zenawi
(1974-1991)
•Derg;
led coup in 1974. (ordered
deaths of 61 ex-officials and
Patriarch)
1975/8- “Red Terror” ~1/2
million deaths
•
Introduced Marxism/Leninism
(land and property nationalized)
•
•Equality
of all religions
1963- formation of OAU
(active in decolonization mov’t)
•National
Literacy Campaign (60%
1973- famine, oil crisis, high
unemployment, military
mutinies, student activism led
to decline
•Improved
•
•
•
Symbol of Rastafarian Mov’t
by 1984)
•1984/5-
health care
Famine & internal wars
Exiled in Zimbabwe, convicted of
Genocide & death penalty in 2006
•
(1991-Present)
•TPLF
led coup in
1991
1993 Eritrean
Independence
•
Redrew map along
ethnic lines & Ethnic
federalism
•
Peoples of Ethiopia
•
Population estimate (2008): 78,254,090
– Total fertility rate: 5.3 births per woman (UN data)
– Life expectancy (women/men): 54/52 years (UN data)
•
Major ethnic groups: Oromo 32.1%, Amhara 30.1%, Tigraway 6.2%,
Somali 5.9%, Guragie 4.3%, Sidama 3.5%, Welaita 2.4%, other (over
50 groups) 15.4% (1994 census)
– Many people are of mixed heritage.
•
Religion: 60% Christian, 40% Muslim
•
Languages: Amharic (Official), Oromiffa, Tigrigna, Guragegna, and
over 84 indigenous languages and 200 dialects
•
Occupation: 80% agrarian (subsistence), 6% industry, 13.2% services
– More than 15 million people derive their livelihood from the coffee sector.
Ethiopians in the Diaspora
• Around the World: 1.5 - 2 million Ethiopians live in the
US, Canada, England, Sweden, Australia, and the
Middle East.
• In the US (migration started in the 70s): est. 450,0000
(much greater with descendants)
– Little Ethiopia in Los Angeles
– 25th annual soccer tournament, Washington D.C.
– Gathers ~70,000 from around the world
• In Minnesota: 10-12,000 (Census/ACS)
• Remittances from the Diaspora are significant to the
Ethiopian economy.
Cultures & Customs of Ethiopia
• Diverse!!!
• Religion-based (Judaic, Christian, Islam)
or Animist
• Core elements: respect for elders &
authority figures, modesty, being humble,
pride, losing face…
Customs an example:
Greetings & social distance
• Greetings:
– Formal: “Endemen Not?”
• Respect: Avoiding eyes of and bowing to elders,
teachers and persons of authority
• Many Ethiopian languages have a grammatical form to
call elders- like French, formal “You”
– Informal: “Selam”, “Tadias”
• Kissing both cheeks, hugging, touching is
normal among family, friends for both male
and females
Food
• Grains (tef, corn, sorghum, barley wheat and millet)
• Legumes (chickpeas, field peas, lentils and broad beans)
• Vegetables (kale and other greens, carrots, potatoes,
onions tomato)
• Fruits (bananas, oranges, limes)
• Meats & Dairy (goat, sheep, cow, chicken, camel, milk,
eggs)
• Spices (chili peppers, garlic, ginger, etc..)
Coffee & coffee ceremony
• Origins of coffee plant can be traced back to Ethiopia.
• Word coffee is said to derive from the Kaffa region of Ethiopia.
• Coffee ceremony is important part of Ethiopian culture.
Religious Practices
• Two major religions
– Ethiopian Orthodox
• Fasting: Lent, Christmas, Wednesday & Friday (Vegan Diet)
– Islam~ 5 Pillars
• Fasting: Ramadan, Monday & Thursday
Naming
• Concept of “Middle Name” & “Family Name” are Western
• Naming is
– Given Name, followed by
– Father’s First Name
– Grandfather’s First Name (to differentiate 2 persons with the same
name)
• ex: Blain Mamo (Kifle)
– When applying for official U.S. document, many are required
to identify a “Middle & Family Name”
– (ex: Blain M. Kifle) a source of a lot of confusion and
discomfort
• Women do not change their names when they get married.
• In the U.S.
– Most women keep their maiden name
– Some families follow traditional naming methods while others choose
to assign a family name.
Clothing
• Urban areas: Traditional dress often worn on
mostly holidays, weddings otherwise western
Language & Literature
•
Language
– Semitic: Northern highlands
(Geez, Amharic, Tigrigna, Gurage,
Harari)
– Cushitic : Southern /Eastern lowlands
(Oromiffa, Somali, Sidama, Afar)
• Literature
o Kebre Nagast “Glory of Kings”: written
~ 800 years ago in Geez; 117 chapters
chronicling the Solomonic Dynasty and
Menelik 1st (Son of King Solomon and
Queen Sheba, 950 BC), Ethiopian
religions and national life
o Zera' Yaekob (b. 1592)
thinker/philosopher who critically
examined teachings from the Bible,
Koran, and Torah.
o Proverbs & metaphors are commonly
used in everyday language.
“When spiders unite they can tie up a lion”
Ethiopic alphabet
Music, art & jewelry
•
•
Traditional Music:
o St Yared (4/25/505 -5/20/571 AD) – invented Ethiopian church or sacred
music (chant) and Ethiopian system of musical notation.
o Manzuma ~ Islamic music From NE Ethiopian, spread to the South and now
sang in Oromo
o Secular- Griots, unique musical notations & instruments
Modern Music
Gender Roles
• Women are considered to be subordinate to
their husbands; sociocultural & economic
dependence
• Girls receive less education than boys
– Literacy rate: overall population 43%
• Male: 50.3%; female: 35.1% (2003 est.)
• Daily tasks include carrying loads over long
distances, grinding corn manually, working in the
homestead, raising children, and cooking
Marriage & Family
• Marriage:
– Rural Areas: girls continue to get married when 12-14 years of age
(menarche), usually arranged
– Urban areas : at least 18 years of age
• Family ties are strong and having extended family at home is
common (personal space or privacy don’t have exact definitions)sharing everything is expected
• Elders often are the first to attempt to settle disputes
• Important events: births, marriages, deaths, and religious
holidays
• Community support systems:
– “edirs”: supports grieving families (emotionally & financially)
– “mehaber”: structured social, religious, or family groups which typically
meets monthly
– “equb”: financial network through which members save money
dispersed monthly
Ethiopian calendar & time
“13 Months of Sunshine”
• 12 months of 30 days and 1 additional month of 5 or 6
days (leap year)
• New Year: Sept 11 or 12 of Julian Calendar
• Now 2001 (E.C.)
• Time: 7 a.m = 1 morning
Noon = 6 lunch
3 p.m = 9 afternoon
6 p.m = 12 evening
7 p.m = 1 evening
etc,….
Health Beliefs & Traditional
Medicine
•
Health is balance between the
body and the outside (avoid
excess heat, cold, food, water,
draft, to keep equilibrium)
•
Concept of “contagious
disease” is understood
Bad news not disclosed to
patient- partially disclosed
(psychosocial reasons) or family
members involved.
Almost all men and women are
circumcised
Many disease causation beliefs
(ex: syphilis caused when
urinating under a full moon)
•
•
•
•
“Injections work better than pills”
•
Traditional healers and
procedures are sought regularly
– Holy water often used to
treat many ailments, esp.
mental health
– Common use of herbal
medicine
– Scarring, cupping, “Burning”
or wearing amulets to
protect against “evil spirits”,
prevent disease or treat
disease
– Uvulectomy (to prevent
presumed suffocation during
pharyngitis in babies)
– Extraction of lower incisors
in infants (to prevent
diarrhea)
– Incision of eyelids (to
prevent or cure
conjunctivitis)
Ethiopian proverb
“He who conceals his disease cannot expect to be cured.”
Health Care System & Basic Statistics (2006/7)
• One of the least developed
in the World; unable to
handle basic health care
needs of growing
population.
• Government is the primary
health care provider
• Expenditure: $1.55 per
capita
• Facilities:
– Government
•
•
•
•
143 hospitals,
690 health centers,
9,914 health posts,
1,376 health stations
– Private
• <50 hospitals & 2153
clinics
– 320 pharmacies
• Providers:
– One physician for 42,636
– One nurse for 4,243
•
Buying medications without
prescriptions is common (antimalarials, antibiotics)
Major Health Concerns
•
•
•
Infectious diseases: TB, HIV, Intestinal
parasites, Hepatitis A & B, & malaria
Under- or malnutrition: Aggravated by
widespread poverty, low education levels,
inadequate access to safe water, sanitation
facilities and health services:
Health Indicators
– Infant mortality (97 per 1000); under 5
morality (140.1 per 1000)
– Maternal mortality (871 per 100,000)
antenatal coverage (2005) ~ 50%
– Life Expectancy: 54 years (expected to
decline to 46 with current HIV infection
rates)
2006/7 Report
2006/7 Reportable Disease Report
To sum up…
Ethiopia,
diverse, &
beautifully complex!
Thank you!