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[PANEL] 1207 HEALTH, RELIGION, INEQUALITIES AND DEVELOPMENT.
Dan LEVENE, Reader in Semitic Languages, University of Southampton, UK
MIRGISSA Kaba, Department of preventive medicine, School of Public Health, Addis Ababa University, Ethiopia
David PHILLIPS, Professor, MRC Lifecourse Epidemiology Unit, University of Southampton, UK
Pino SCHIRRIPA, Associate Professor, Dept. of History, Cultures, Religions, Sapienza - University of Rome, Italy
Marta Camilla WRIGHT, Study of Religions, University of Bergen, Norway
WOSENSGED Kidane; KALD Beshir Tuem; WORKINEH Shibeshi; Marta Camilla WRIGHT;
ZEWDIE Aderaw Alemu; AHMED Ali; FACIL Tesfaye; Pino SCHIRRIPA; EYOB Derillo;
Joachim Gregor PERSOON; Dan LEVENE; David PHILLIPS; ZUFAN Gebrehiwet Hagos;
ABINET Abebe Hayleyesus; Karri BHARATHI; ZELALEM Tadesse; SEARE Hadush; TEBABER Chanie Workneh;
MIRGISSA Kaba; Virginia DE SILVA
From different disciplinary perspectives, researchers have pointed out as the conceptions of health and disease vary form a context to another. Especially medical anthropology has tried to give back a more complex idea of the processes concerning health and diseases by linking them to a broader social and cultural context. In so doing it has focused on particular phenomena like the link between religion and health. This is a central nexus in Ethiopia, where different ideas, practices and cultural constructions from different religious traditions live along and are interconnected with various perceptions of health, disease and healing.
At the same time, in the last decades, medical anthropology has focused on issues such as inequality and development. By studying the health policies as well as concrete example in their fieldwork, anthropologists have shown some odds in the development policies related to health, that produce new types of inequalities.
Our panel would like to focus on these two topics, trying to find a way to merge the attention to the religious dimension with a view which take into account specific social dynamics.
This panel invites researchers from a wide range of disciplines, including medicine, history, social and medical anthropology, sociology and religious studies. The panel is open to any historical periods and topics, but we would like to see papers based upon empirical research that can contribute to advancing theoretical and analytical perspectives.
ETHIOPIAN MEDICINAL MANUSCRIPTS AND THE BUDGE TOWARDS THEIR REVIVAL [Abstract ID: 1207-06]
The research scientifically investigates the philological and anthropological aspects of herbal medicine. It yokes philological analysis of Ethiopic Medicinal manuscripts. The study aims at elucidating the Ethiopian medicinal system of knowledge based on the Ethiopian Medicinal Manuscript of ᑦǝṩä däbdabe. The research employed philological and medico-anthropological research methods. It explored Ethiopian manuscript and manuscript microfilm collection museums in Ethiopia, Germany and the United States. In addition, it surveyed almost all printed and online catalogues of Ethiopian manuscripts worldwide and conducted key informant interview with traditional medicinal practitioners.
EVALUATION OF WOUND HEALING, ANTIBACTERIAL AND ANTI-INFLAMMATORY ACTIVITIES IN LEAF EXTRACT OF BECIUM GRANDIFLORUM L. [Abstract ID: 1207-03]
Based on traditional claims, leaves of Becium grandiflorum were investigated for their potential wound healing activity using excision and incision wound models. In addition histological analysis, anti-inflammatory and antibacterial activities of the leaves were performed. Wound healing activity was studied by topical application of simple ointment of the leaf extract at a concentration of 5% and 10% (w/w) after it was extracted by maceration using 70% ethanol. Toxicity of the formulated ointments was studied by a skin irritation test on Swiss albino mice. For the anti-inflammatory study, the carrageenan-induced hind paw edema model was used at a concentration of 100, 200 and 400 mg/kg. The antibacterial activity of the extract was examined using disk diffusion technique against several pathogenic bacterial strains that commonly occurr in wounds at a concentration of 50, 100 and 200 µg/µl.b. The ointment formulation of the extract was found to be non-irritant at 5% concentration. However, continuous application of 10% showed skin irritation. Treatment of the wound with the ointments exhibited significant (p< 0.001) increase in wound contraction rate, shorter epithelization time, higher skin tensile strength that was supported by considerable deposition of collagen, fibroblast proliferation and vascularization form histological analysis. The plant extract also showed significant (p
HEALING SPACES: HOLY WATER HEALING AMONG ETHIOPIAN ORTHODOX CHRISTIANS [Abstract ID: 1207-09]
Ethiopian Orthodox Christians who are ill seek help at holy water places. To be ill means to have a disease, experience a crisis or feel a need for protection against negative experiences and evil spirits. The ultimate cause of disease and misery in life are spiritual, be they evil spirits or God. What then heals people? And what does it mean to be healed among Ethiopian Orthodox Christians? Looking at illness narratives from Addis Ababa, this paper discusses the healing process and the role of the holy water healing places in the healing process.
HEALTH DISPARITY BASED ON GEOGRAPHICAL LOCATION: EVIDENCE FROM EDHS 2011 DATA ON CHILD UNDERNUTRITION IN ETHIOPIA [Abstract ID: 1207-16]
Child undernutrition shows geographical inequalities due to variations in contextual determinants from area to area indicating that location is an important factor in child undernutrition. However, there are limited studies on spatial epidemiology of child undernutrition in Ethiopia so this study aims to identify the SaTScan spatial clusters of child undernutrition in Ethiopia. Nutritional indices of children (0–59 months) with Global Positioning System (GPS) location data were accessed from the 2011 Ethiopia Demographic and Health Survey (EDHS) after getting permission from the MEASURES Demographic and Health Survey (DHS) Program. The Bernoulli Model was fitted using SaTScan™ software, version 9.4. The Log Likelihood Ratio (LLR) test was used for each SaTScan cluster and size of the scanning SaTScan cluster to test the alternative hypothesis that there is an elevated risk within the SaTScan cluster compared to outside the SaTScan cluster. Less than 0.05 for LLR was considered as a statistically significant level. The SaTScan spatial analysis result detected Liben, Afder and Borena administrative zones around the South East Ethiopia as the most likely primary spatial SaTScan clusters (LLR=28.98, p
HEALTH, DISEASE AND RELIGION IN PRE-19TH CENTURY ETHIOPIA [Abstract ID: 1207-12]
A continuation of previous research in which my colleagues and I attempted to trace the histories of medicine and healing in the IOW. We will argue that medical knowledge and healing practices existed in the Indian Ocean World (including Africa), both in the medieval/early modern period but also in the modern period with a focus on the very important role that a religious educational institution - the Ethiopian Orthodox Tewahido Church - played in compiling and disseminating medical knowledge and various healing practices. The aim is to link health, disease and religion in Ethiopia.
MARKET OF HEALTH IN TIME OF CRISES. BIOMEDICAL DRUGS, TRADITIONAL REMEDIES AND PLURAL MEDICAL SYSTEM IN MEKELLE, ETHIOPIA. [Abstract ID: 1207-14]
A drug can be seen as any organic or mineral compound which is considered - by a certain community in a specific social-historical situation - as able to face-off, and often to defeat, what in that context is thought of as sickness. We can define a drug as the material output of any therapeutic relationship. Analyzing the role of pharmaceuticals in a the growing urban reality of Mekelle and sketching Mekelle's medical system in its plurality (biomedical, traditional and religious sources), using the bourdean concept of field of forces, the different social actors in the arena can be seen as competing against each other to gain a position. All resources use something that can be considered as a drug (pills and injections; mineral and organic compound; holy water and soil). Analyzing the role of these diverse pharmaceuticals within the field of forces stresses their role in defining the different position of any actor. Further focus is on how it affects the way different actors perceive different drugs, and the changes that are going on (i. e. industrial production of “traditional” drugs). Focusing on the current financial crisis and the effects of the global pharmaceutical market on the local context, the A. will describe how it builds diversification in production and use, as well as inequalities.
MATERIAL MEDICA PLANTS IN MÄṢHAFÄ MÄDḤANIT (BRITISH LIBRARY OR. 828) [Abstract ID: 1207-18]
Traditional herbal remedies have always been commonly used in Ethiopia. There are traditional pharmacies and medical practitioners in Addis Ababa that ubiquitously sell medicine authoritatively and in clandestine. Those looking for “authentic” traditional medicine pharmacy/dispensary will only go the places that are family or friend recommended, owing to fear of getting sold medicine which contains dangerous ingredients that could have harmful effects. Ethiopian traditional medicine is vastly complex and diverse and the medical practitioners have a long history. These medical practices draw on both the “mystical” and “natural” causes of an illness and employ a holistic approach to treatment (Bishaw, 1991). The Ethiopians have cultivated and used many kinds of plants, and animal products as medicinal. There are over 600 species of medicinal plants thought Ethiopia. Many of this plants and their uses have been written down in Ge’ez and Amharic, preserved in manuscripts dating to the 16th century. This paper will analyse a selected plants in Ma?hafa Mad?anit (British Library Or. 828) a medical working dating to the early part of the late 18-th to early 19th century. Although usually assumed to be a translation of the Arabic version of ‘ Treatise of Therapeutics’, MM strongly demonstrations indigenous knowledge and skills of traditional medicine. It contains a wide array of plats (herbal), animal parts and techniques of treatments used to for therapeutic.
NILE: ETHIO-EGYPTIAN UNENDING DISCOURSE [Abstract ID: 1207-19]
Egyptians say; he who drinks of the Nile cannot avoid returning. The Nile is the essential artery, the source of life which links Ethiopia
and Egypt. However, more than being a source of physical sustenance, the Nile is the source of mythology, spirituality, time reckoning and identity of the two countries. One Ethiopian reporter when describing the sacrificial customs which are carried out on the banks of the Nile, said that ancient Egypt lives on in a unique way in Ethiopia. Like-wise with the traditions of the Orthodox Christianity, narratives about the Nile abound in both countries. Coptic sources describe in detail the trajectory of the Holy Family visiting Egypt following the route of the Nile. The Ethiopian Dirsane Uriel likewise continues the narrative, describing the visit of the Holy family to Ethiopia miraculously transported on a silver cloud accompanied by lions, also following the course of the Nile. Cosmological ideas constitute primary inspiration for works of art, especially the visual arts. They also inform the way people relate to their environment, and thus their ecological ideas. This presentation seeks to pursue different trajectories to explore the inter-relatedness of themes connecting Ethiopia (Sudan) and Egypt associated with the Nile River.
NON-COMMUNICABLE DISEASES: WHAT CARE, WHO CARES? [Abstract ID: 1207-17]
We have limited understanding of how Ethiopians make choices about healthcare particularly in the context of chronic, non-communicable diseases (NCDs). A particular problem is default from NCD clinics especially in rural areas where traditional medicine and practices are prevalent. This is a poorly studied area which threatens to undermine efforts to manage important diseases. We have studied clinic default in 99 patients with epilepsy and 94 with hypertension and compared them with 248 non-defaulting controls. All were recruited from five rural clinics around Jimma, Ethiopia. The analysis of an interviewer administered questionnaire exploring the impact of demographic and social factors as well as traditional and religious beliefs on clinic default will form the content of this presentation.
PSYCHO-SOCIAL VALUE OF TRADITIONAL STEAM IN WEJJERAT ISRA ADDI [Abstract ID: 1207-15]
The traditional steaming in Wejjerat is the skin cleansing cultural practice which is undertaken by females above 15 years old. The respondents stated that the steaming is supposed as it was originated with the society itself. There are two types of steaming practices: the first is a steaming which is usually practiced by women for beautification, massaging, healthy blood circulation and for having attractive smell, etc. The second is a long-term steaming beginning from 2-12 months, practiced by girls above 14 years age for a transitional purpose from childhood(girl) to adult(womanhood). This practice is related with the Holy Bible (in the Book of Esther 2:12-14) where beauty treatments are described. Thus, this study is dealt with the second stage and its socio-cultural and psycho social influences for the practitioners. Regardless of its cleansing value, the practice has various psycho-social well beings: if a girl is ready for the long term steaming, she is considered as someone who is late to marry Deacon (white wedding), hence, the practitioner and her family feel humiliated of it. Another, the girl after the attendance of the steaming is supposed as an old aged. Thus, she cannot participate on childhood cultural holidays like Ashenda, Goywo, ћannIs etc. In addition, if the girl is from the poor family, she does not attend the steaming in the supposed age, then she gets ashamed of her being physically matured and the society insults her as late attendant. Related to this, Allport G. (1985:5) states, social psychology studies how people’s thoughts, feelings, and behaviors are influenced by other people. This study is designed using the descriptive research. It is aimed at announcing as steaming is a good culture of the society and is not related to virginity, religion, and the psycho-social well being of the society. The primary data of the research were collected using interview and observation from the randomly selected respondents, and the secondary data were collected from reviewing written documents. The collected data were later analyzed using the qualitative type of data analysis. The result of this study shows as the steaming practice is the cheapest and healthy and everlasting skin cleansing compared to the modern cleansing cosmetics and steaming. The study recommended that although the practice is good to continue due to its immeasurable functions,to its cleansing, the attendants must not be religiously, psychologically, and culturally influenced to practice other irrelevant activities because of it. The society must wisely manage the raw woods which are used for the steaming through reforestation.
PUBLIC PERCEPTIONS OF COMMUNICABLE DISEASES AND HEALTH CARE PRACTICES: THE CASE OF LEPROSY IN BAHIR DAR CITY, NORTHWEST ETHIOPIA [Abstract ID: 1207-08]
Communicable or infectious diseases constitute the leading causes of health and health related problems in Ethiopia. From infectious diseases, leprosy belongs to the category of chronic contagious disease which has been known as a major public health problem for more than half a century. In Ethiopia, leprosy is believed to have been eliminated. However, the new incidence of leprosy in eighty-seven districts in the Amhara region is an issue that calls for special attention. Health care practices or research on leprosy are largely found under the sphere of clinically based research. Still, these research have limitations in giving due emphasis for emic perspectives. The main objective of this study is, thus, to investigate public perceptions of leprosy and health care practices in Bahir Dar city. To this effect, a cross sectional case study design has been used through employing qualitative approach. Purposive sampling technique was used to select participants. The major methods of data collection were systematic observation, unstructured interview and focus group discussion. Interviews and group discussions were conducted with thirty-seven individuals from the public, persons affected by leprosy and experts who are working on the issue at hand. The study reveals that individuals are largely aware of leprosy from family, relatives and friends in their locality. In addition, mass media and interpersonal communication are sources of information. Marriage and living with persons affected by leprosy are considered causes and agents of transmission of leprosy. Moreover, the cause of leprosy is associated with elephantiasis through the account of both disease complications. In general, leprosy is still perceived as a genetic disease. In fact, the treatment preference of leprosy patients is not only dependent on illness causation beliefs; social responses of the community highly influence treatment seeking behaviors of the patients. Health care practices to manage leprosy have been carried out by such organizations as Bahir Dar city health department, GLRA and Heal TB. Stigma, discrimination, and less attention given to the role of the community, the absence of a separate rehabilitation center and the general notion held to be leprosy is reduced. Major constraints for the effectiveness of leprosy control are less attention is given to control leprosy and its social dimensions are not adequate. In conclusion, sociocultural factors bent public knowledge of the causes, transmission and treatment of leprosy, but the healthcare practice has not been adjusted in line with the sociocultural beliefs of the public.
ROLE OF ANTHROPOLOGISTS IN HEALTH AND DEVELOPMENT [Abstract ID: 1207-10]
Health problems and practices of any community are influenced by the interplay of complex social, economic and political factors (Sahu, 1986). Health and disease are the measures of the effectiveness with which human groups, combining biological and cultural resources, adapt to their environment (Lieben, 1973). Due to beliefs in supernatural elements and religion in matters concerning health, different ethnic groups are almost invariably found to repose faith in diviners or traditional medicinal men, sorcerers and shamans. However, they are not averse in accepting western medicine whenever available (Chaudhury, 1986). Many of the health and social problems faced by the poor populations is in fact not only due to endogenous cultural factors but rather a complex series of pull-push forces that undermine small scale economies. However, integrating poor communities into national and international economies does not necessarily improve the living conditions. In order to bring equitable distribution of health facilities to the individuals, it is necessary to focus on the underlying political and economic forces that affect the distribution and experience of a disease. Participatory approach, enhanced by the primary health care becames a corner stone to conduct and evaluate development programs. This people-centered development became one anthropological approach to economic development (Pillsbury, 1986), which helps to remove such inequalities. However, critical medical anthropologists explore the socio-economic and political processes to examine the health and illness representations monitored by power relations within a society and try to identify these structural forces that undermine the health of poor and marginalized groups. The health needs of the people can be addressed by employing anthropological research methods. However, the researcher used ground-level ethnographic approaches in the consideration of the political economy of health, and the effects of social inequality on people’s health. This approach will help the researcher to understand the relationship and challenges between medical providers with political structures and individuals. Further, the empirical data presented will support the significance of the cause and effect of the disease prevalent.
THE PROCESS OF HOLY WATER THERAPY AND THE INSTITUTIONALIZATION OF MENTAL ILLNESS [Abstract ID: 1207-13]
Many Ethiopians emphasize supernatural explanations for illness, especially in the case of mental illness. The most common indigenous therapy is the use of holy water, in the context of an institutionalized system. The application of modern biomedical approaches to illness is hampered by the lack of knowledge of traditional therapies, consequently, it is important to understand and analyze traditional healing techniques, in order to be able to harmonize the different systems in a way which will bring maximum benefit to those suffering from illness. My research was focused on understanding indigenous therapy techniques from the patients’ perspective, through intensive participant-observation fieldwork at an important recently emerged holy water site on the outskirts of Addis Ababa. Psychological praxis and the health establishment in general has to take into account indigenous perceptions of illness and healing techniques, in order to develop holistic therapies which are appropriate to the local context. One of the Ethiopian Millennium goals is the appropriate treatment of the mentally ill; this can only be achieved by integrating traditional therapies with modern biomedicine approaches, which is the ultimate aim of my research.
THE ROLE OF HEALTH EXTENSION WORKERS IN ASGEDE TSIMBLA DISTRICT, A CASE OF LIMAT TABYA HEALTH POST [Abstract ID: 1207-02]
Health Extension Workers are the health service providers to the community in delivering integrated preventive, promotive and basic curative health services. Hitherto no studies have been carried out in Lim ‘at T’abya health post focusing on the role of health extension workers. Thus the researcher has randomly selected 263 participants in order to achieve the intended objectives of the study. The researcher used both quantitative and qualitative approaches. The result of the study identified the major Health Extension Program services which are delivered by Health Extension Workers in the health post to seek malaria treatment, child immunization and Antenatal Care followed by Postnatal Care, family planning, referral for delivery, diarrhea treatment and health education. The challenges of Health Extension Workers hindering their performance for the unsuccessful health service provision identified as strong societal cultural beliefs, remoteness, and poor relation with supervisors, communication system and road construction, low remuneration, lack of refresher courses and improper attention by T’abya administrators to health agendas. Attitude of community towards Health Extension Workers communication skill, quality of service provision and social behaviors is over all positive but the following up of referred patients and the skill to diagnosing community health problems that Health Extension Workers need to work sensitively which are answered negatively by the respondents. Ton increase community’s health post utilization, health posts should be equipped with minimum essential medical equipment with particular focus on malaria treatments, family planning, deliver, treatment of common illnesses and immunization services in the study area.
THE ROLES OF INDIGENOUS MEDICINE IN THE PRIMARY HEALTH CARE DELIVERY SYSTEM AMONG THE KONSO [Abstract ID: 1207-07]
In Ethiopia, about 80 percent of the population still prefer to solve their health problems consulting indigenous healers. Although public patronage is sustaining and even fostering their growth both in developing and developed countries, there still exists gaps between public choice and national, institutional efforts for integration. The study, therefore, aims to investigate the roles of indigenous medicine for primary health care delivery, factors affecting the resort and challenges of the integration of indigenous medicine to the biomedical health care system. In order to meet the objectives of this study, mixed research design was used. Pursuing primarily the qualitative research methods such as direct observation, in-depth interview, Focus Group Discussions (FGDs), survey method was also employed as a supplementary. Thematic analysis was employed to analyze, and at times synthesize the qualitative data and data survey was entered into Statistical Package for Social Science (SPSS), Version 20 for analysis. Findings indicated that indigenous healing tends to be their first preference. The survey data supported that the majority (59%) of the respondents used indigenous medicine. The main reason explaining this preference is that indigenous medicine is culturally acceptable and financially affordable. The study also indicates that medicine for malaria is prepared by grinding and mixing ginger, Moringa leaves, garlic, and black seed (tikur azmud), and then the patient is made to drink the infusion. Interpretative approach in relation to indigenous medicine and healing can be reflected and understood in connection to how one can produce meaning from symbols, which facilitate relationships between indigenous health practitioners and patients. Understanding the cultural context of health, illness and healing and the involvement of indigenous healers in the primary health-care systems is imperative in the study area for prevention and treatment of diseases. Thus, in order to maximize the benefits of indigenous medicine, the legal frameworks and service facilities for the use of indigenous medicine for primary health-care service should be re-examined in light of addressing the needs and interests of the local people.
“THE MOTHERS OF SICK CHILDREN”: PARENTS OF CHILDREN WITH DISABILITIES, BETWEEN CAREGIVING AND VULNERABILITY IN MEKELLE AND WUQRO (TIGRAY- NORTHERN ETHIOPIA) [Abstract ID: 1207-11]
Based on ethnographic fieldwork carried out in Mekelle and Wuqro (Tigray) between October 2014 and August 2015 focused on disability from an anthropological perspective, aiming to explore the double role of the parents of children with disabilities as caregivers and vulnerable citizens. Due to the shortage of residential care and rehabilitation services and to the lack of home help, the caregiver role falls on the family, especially the women of the family, and the parents of children with disabilities face many challenges in managing the situation. After in -depth interviews with mothers and relatives of disabled children it emerges that they experience forms of stigmatization from the community that relates disability with some religious and “traditional” perceptions related to “fault” and “punishment”. They also do not receive governmental aid or help because they are not “ill” or “disabled” themselves. Taking care of disabled children means to have difficulties in carrying out normal daily and working activities. In this way the spiral of poverty and the inability to provide for better care for their children increases. Through the life stories of the informants and the evidences collected in the field, I would like to shed light on the vulnerability of these social actors and on the “disabling” effects that caregivers of disabled children experience in the everyday life.