Clinical Topics — Ethiopian Etiology

The importance of personal well-being in Ethiopian culture is attested to by the Amharic greeting, tenastalegn — literally, “may you have tena,” the state of harmonious well-being and proper functioning of the body. While no single set of descriptors can encompass the health-related beliefs of Ethiopia’s many cultural groups, certain conceptions of health are sufficiently widespread that they can be integrated into a general perspective on health and disease.

The Heart

The heart’s constant pulsing invigorates all other organs and its physical extension, the circulatory system, controls bodily motion.1,2 An overactive heart causes overheating and fever, and fatigue results as the exhausted heart loses control of the other organs. Because the heart is also the seat of the intellect, intense emotions can cause overactivity of the heart and obscure clear thinking.2 The heart is referenced in a wide variety of Amharic somatic idioms, such as the following:

English Amharic
My heart is burnt. Libehn tekatele.
My heart melted. Libehn kelete.
My heart is pulled down. Libehn gotetegn.
My heart is rough. Libehn shakere.

In the Ethiopian capital of Addis Ababa, the heart is the organ most often associated with generalized symptoms of weakness, fatigue, and fever.3

The Stomach

The stomach is considered to be an inert organ populated by wosfat, roundworms of the genus Ascaris.1 The wosfat must be continuously placated by food, which they convert to waste.1 When inadequately fed, the worms become restless and begin to attack each other and the lining of the stomach, resulting in feelings of pain, nausea, and bloating.1,2 Wosfat may also refuse to eat, resulting in loss of appetite.1

Beshita

Beshita is the physical quality of a disease that results in acute sickness. Its use in Amharic encompasses a wide variety of illnesses.2 Jaundice is yelelit wof beshita (lit. “night bird disease,” from the belief that a bat hovering around one’s head causes jaundice) or woyebo beshita (“yellow disease”). Rabies is ebid wusha beshita (lit. “mad dog disease”). Epilepsy is yemitil beshita (“falling disease”).

Gerifta

Gerifta is both a miasma associated with sunlight and the name of the resulting illness.2,3 Exposing oneself to the direct sun during a bout of excessive perspiration or without washing one’s mouth properly after eating results in gerifta, as does exposing a nursing breast to sunlight or sleeping on ground moisted by rain or urine. Symptoms include scabies, rash, and boils.3

Mich

Mich, loosely translated as “sunstroke,” results when an unclean body part is exposed to sunlight.1-3 Symptoms include irritation, rash, or herpes labialis.1 In Amharic, the word mich is also associated with pneumonia, which is known as yesamba mich (lit. “mich of the lung”).

References

1.) Hodes RM. Cross-cultural medicine and diverse health beliefs — Ethiopians abroad. West J Med 1997; 166:29-36.
2.) Young A. Internalizing and externalizing medical belief systems: An Ethiopian example. Soc Sci & Med 1976; 10:147-156.
3.) Teshome-Bahiru, W. Concept of health, disease, illness, and therapy among the people of Addis Ababa. Ann Afr Med 2004; 3(1):28-31.