Abstract
The unique health-related traditions, perceptions, and communication patterns of Ethiopian immigrants are challenging to Israeli healthcare providers who are trained in western medicine. The aim of this review was to conduct a survey of traditions, beliefs, and symptom reporting by Ethiopian immigrants and culturally oriented interventions to improve the care of Ethiopian immigrants. We used the keywords “Ethiopian immigrants Israel" and “Ethiopian Jews.” Of 418 articles initially retrieved, 35 satisfied the inclusion and exclusion criteria. We described health-related traditions and their possible complications. Possession syndrome was frequently misdiagnosed as a neurological or psychiatric disorder. The medical staff was unfamiliar with these health and illness beliefs, somatization patterns, and the communication style of Ethiopian immigrants. There were successful interventions that involved liaisons from the Ethiopian community and community-based educational activities. Medical professionals working with African immigrants worldwide can use the Israeli experience to develop effective, culturally oriented interventions to optimize the health care for these immigrants.
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Abbreviations
- EI:
-
Ethiopian immigrants
- CCD:
-
Cultural concept of distress
References
Appiah, A., & Gates, H. L. J. (2010). Encyclopedia of the Africa. Oxford University Press. https://doi.org/10.1093/acref/9780195337709.001.0001
Arieli, A., & Aychen, S. (1994). Mental disease related to belief in being possessed by the “Zar” spirit. Harefuah, 126(11), 636–642.
Belmaker, R. H. (2012). Successful cultural change: The example of female circumcision among Israeli Bedouins and Israeli Jews from Ethiopia. The Israel Journal of Psychiatry and Related Sciences, 49(3), 178–183.
BenEzer, G. (2006). Group counseling and psychotherapy across the cultural divide: The case of Ethiopian Jewish immigrants in Israel. Transcultural Psychiatry, 43(2), 205–234. https://doi.org/10.1177/1363461506064849
BenEzer, G. (2012). From Winnicott’s potential space to mutual creative space: A principle for intercultural psychotherapy. Transcultural Psychiatry, 49(2), 323–339. https://doi.org/10.1177/1363461511435803
Cohen, J. B. (2016). Ethiopian-Israeli community. BMJ Case Reports, bcr2016216074. https://doi.org/10.1136/bcr-2016-216074
Danino, D., & Amar, Z. (2008). Ethiopia in Israel—An ethnopharmacological study of Ethiopian immigrants in Israel. Harefuah, 147(7), 597–601.
Davidovich, E., Kooby, E., Shapira, J., & Ram, D. (2013). The traditional practice of canine bud removal in the offspring of Ethiopian immigrants. BMC Oral Health, 13, 34. https://doi.org/10.1186/1472-6831-13-34
Delbar, V., Tzadok, L., Mergi, O., Erel, T. O., Haim, L., & Romem, P. (2010). Transcultural mental health care issues of Ethiopian immigration to Israel. Advances in Mental Health, 9(3), 277–287. https://doi.org/10.5172/jamh.9.3.277
Durst, R., Minuchin-Itzigsohn, S., & Jabotinsky-Rubin, K. (1993). “Brain-fag” syndrome: Manifestation of transculturation in an Ethiopian Jewish immigrant. The Israel Journal of Psychiatry and Related Sciences, 30(4), 223–232.
Erez, G., & Shani, M. (2008). The untold story–the stories of Ethiopian women. Harefuah, 147(12), 975–977.
Ehrlich, M. A. (2009). Encyclopedia of the Jewish Diaspora: Origins, Experiences, and Culture, Volume 2. Bloomsbury Academic. https://books.google.co.il/books?id=NoPZu79hqaEC
Finklestein, M., & Solomon, Z. (2009). Cumulative trauma, PTSD and dissociation among Ethiopian refugees in Israel. Journal of Trauma and Dissociation, 10(1), 38–56. https://doi.org/10.1080/15299730802485151
Grisaru, N., Budowski, D., Ayecheh, S., & Witztum, E. (2016). Functional somatic syndromes among Ethiopian immigrants in Israel. Harefuah, 155(12), 741–744.
Grisaru, N., Budowski, D., & Witztum, E. (1997). Possession by the “Zar” among Ethiopian immigrants to Israel: Psychopathology or culture-bound syndrome? Psychopathology, 30(4), 223–233. https://doi.org/10.1159/000285051
Grundman Shem-Tov, R., Zubery, E., Loevy Hecht, N., & Latzer, Y. (2019). “A full stomach”: Culturally sensitive diagnosis of eating disorders among Ethiopian adolescents in Israel. Israel Journal of Psychiatry, 55(2), 22–30.
Guttman, N., Gesser-Edelsburg, A., & Aycheh, S. (2013). Communicating health rights to disadvantaged populations: Challenges in developing a culture-centered approach for Ethiopian immigrants in Israel. Health Communication, 28(6), 546–556. https://doi.org/10.1080/10410236.2012.702643
Halladay, C. W., Trikalinos, T. A., Schmid, I. T., Schmid, C. H., & Dahabreh, I. J. (2015). Using data sources beyond PubMed has a modest impact on the results of systematic reviews of therapeutic interventions. Journal of Clinical Epidemiology., 68(9), 1076–1084. https://doi.org/10.1016/j.jclinepi.2014.12.017
Heim, E., Karatzias, T., & Maercker, A. (2022). Cultural concepts of distress and complex PTSD: Future directions for research and treatment. Clinical Psychology Review, 93, 102143. https://doi.org/10.1016/j.cpr.2022.102143
Horvitz-Lennon, M., Donohue, J. M., Lave, J. R., Alegría, M., & Normand, S. L. (2013). The effect of race-ethnicity on the comparative effectiveness of clozapine among Medicaid beneficiaries. Psychiatric Services (washington, d.c.), 64(3), 230–237. https://doi.org/10.1176/appi.ps.201200041
Holan, G., & Mamber, E. (1994). Extraction of primary canine tooth buds: Prevalence and associated dental abnormalities in a group of Ethiopian Jewish children. International Journal of Paediatric Dentistry, 4(1), 25–30. https://doi.org/10.1111/j.1365-263x.1994.tb00097.x
World Intellectual Property Organization. (2014). Israel Penal Law. https://www.wipo.int/wipolex/en/legislation/details/15336
Jaffe, A., Farda, Y., & Guttman, N. (2002, November 12). Health promotion in the Ethiopian immigrant community in Israel: The Tene Briut Program. [Poster Abstract]. The 130th Annual Meeting of American Public Health Association (APHA), Philadelphia, USA. https://apha.confex.com/apha/130am/techprogram/paper_41145.htm
Kaplan, E. H., Soskolne, V., Adler, B., Leventhal, A., & Shtarkshall, R. A. (2002). A model-based evaluation of a cultural mediator outreach program for HIV+ Ethiopian immigrants in Israel. Evaluation Review, 26(4), 382–394. https://doi.org/10.1177/0193841X02026004002
Kohrt, B. A., Rasmussen, A., Kaiser, B. N., Haroz, E. E., Maharjan, S. M., Mutamba, B. B., de Jong, J. T., & Hinton, D. E. (2014). Cultural concepts of distress and psychiatric disorders: Literature review and research recommendations for global mental health epidemiology. International Journal of Epidemiology, 43(2), 365–406. https://doi.org/10.1093/ije/dyt227
Lapidoth, M., & Aharonowitz, G. (2004). Tattoo removal among Ethiopian Jews in Israel: Tradition faces technology. Journal of American Academy of Dermatology, 51(6), 906–909. https://doi.org/10.1016/j.jaad.2004.07.028
Levin-Zamir, D., Keret, S., Yaakovson, O., Lev, B., Kay, C., Verber, G., & Lieberman, N. (2011). Refuah Shlema: A cross-cultural programme for promoting communication and health among Ethiopian immigrants in the primary health care setting in Israel: Evidence and lessons learned from over a decade of implementation. Global Health Promotion, 18(1), 51–54. https://doi.org/10.1177/1757975910393172
Lewin-Epstein, N., & Cohen, Y. (2018). Ethnic origin and identity of the Jewish population of Israel. Journal of Ethnic and Migration Studies, 45(11), 2118–2137. https://doi.org/10.1080/1369183X.2018.1492370
Marazziti, D., Mucci, F., Avella, M. T., Palagini, L., Simoncini, M., & Dell’Osso, L. (2021). The increasing challenge of the possible impact of ethnicity on psychopharmacology. CNS Spectrums, 26(3), 222–231. https://doi.org/10.1017/S1092852920000073
Meir-Glitzenstein, E. (2011). Operation Magic Carpet: Constructing the myth of the magical immigration of Yemenite Jews to Israel. Israel Studies, 16(3), 149–173. https://doi.org/10.2979/israelstudies.16.3.149
Menachem, S., & Portugheiz, E. (1997). Uvulectomy and blue gingiva tattoo among Ethiopian immigrants in Israel. Harefuah, 132(2), 128–130.
My Jewish Learning. (2023). The Written Torah and the Oral Torah. https://www.myjewishlearning.com/article/the-formation-of-the-oral-torah/
Nudelman, A. (2011). Culture and health behaviour: The case of adolescent ethiopian immigrants in Israel. International Journal of Adolescent Medicine and Health, 11(1–2), 3–20. https://doi.org/10.1515/IJAMH.1999.11.1-2.3
Ostrer, H., & Skorecki, K. (2013). The population genetics of the Jewish people. Human Genetics, 132(2), 119–127. https://doi.org/10.1007/s00439-012-1235-6
Ponizovsky, A., Ginath, Y., Durst, R., Wondimeneh, B., Safro, S., Minuchin-Itzigson, S., & Ritsner, M. (1998). Psychological distress among Ethiopian and Russian Jewish immigrants to Israel: A cross-cultural study. The International Journal of Social Psychiatry, 44(1), 35–45. https://doi.org/10.1177/002076409804400104
Ravid, C., Spitzer, A., Tamir, B., Granot, M., & Noam, R. (1995). Internal body perceptions of Ethiopian Jews who emigrated to Israel. Western Journal of Nursing Research, 17(6), 631–646. https://doi.org/10.1177/019394599501700605
Reiff, M., Zakut, H., & Weingarten, M. A. (1999). Illness and treatment perceptions of Ethiopian immigrants and their doctors in Israel. American Journal of Public Health, 89(12), 1814–1818. https://doi.org/10.2105/ajph.89.12.1814
Şar, V. (2022). Dissociation across cultures: A transdiagnostic guide for clinical assessment and management. Alpha Psychiatry, 23(3), 95–103. https://doi.org/10.5152/alphapsychiatry.2022.21556
Schreiber, S. (1995). Migration, traumatic bereavement and transcultural aspects of psychological healing: Loss and grief of a refugee woman from Begameder county in Ethiopia. British Journal of Medical Psychology, 68(Pt 2), 135–142. https://doi.org/10.1111/j.2044-8341.1995.tb01820.x
Shtarkshall, R. A., & Soskolne, V. (2000). Migrant populations and HIV/AIDS. The development and implementation of programmes: Theory, methodology and practice. United Nations Programme on HIV/AIDS (UNAIDS). https://data.unaids.org/publications/irc-pub01/jc397-migrantpop_en.pdf
Shtarkshall, R. A., Baynesan, F., & Feldman, B. S. (2009). A socio-ecological analysis of Ethiopian immigrants’ interactions with the Israeli healthcare system and its policy and service implications. Ethnicity and Health, 14(5), 459–478. https://doi.org/10.1080/13557850902890522
Soskolne, V., & Shtarkshall, R. A. (2002). Migration and HIV prevention programmes: Linking structural factors, culture, and individual behaviour–an Israeli experience. Social Science and Medicine, 55(8), 1297–1307. https://doi.org/10.1016/s0277-9536(01)00282-9
Spitzer, A., Kesselring, A., Ravid, C., Tamir, B., Granot, M., & Noam, R. (1996). Learning about another culture: Project and curricular reflections. Journal of Nursing Education, 35(7), 322–328. https://doi.org/10.3928/0148-4834-19961001-09
Stein, D. J., Palk, A. C., & Kendler, K. S. (2021). What is a mental disorder? An Exemplar-Focused Approach. Psychological Medicine, 51(6), 894–901. https://doi.org/10.1017/S0033291721001185
Tandeter, H., Grynbaum, M., & Borkan, J. (2001). A qualitative study on cultural bloodletting among Ethiopian immigrants. The Israel Medical Association Journal, 3(12), 937–399.
Tene Briut. (2021). About Tene Briut. Retrieved June 3, 2021, from https://tene-briut.org.il/en
Teshome, A., & Assefa, B. (2019). The dental complications of canine tooth bud removal in 2–12 years old children in Northwest Ethiopia. BMC Research Notes, 12(1), 701. https://doi.org/10.1186/s13104-019-4743-9
Treister-Goltzman, Y., Alhoashle, A., & Peleg, R. (2021). Infectious diseases among Ethiopian immigrants in Israel: A descriptive literature review. Pathogens and Global Health, 115(4), 224–234. https://doi.org/10.1080/20477724.2021.1890888
Ulman, A. M., & Bar, F. (2011). Idiom of distress or delusional state? Cultural clash as the cause of misdiagnosis: A case report. The Israel Journal of Psychiatry and Related Sciences, 48(1), 60–64.
Witztum, E., Grisaru, N., & Budowski, D. (1996). The “Zar” possession syndrome among Ethiopian immigrants to Israel: Cultural and clinical aspects. British Journal of Medical Psychology, 69(Pt 3), 207–225. https://doi.org/10.1111/j.2044-8341.1996.tb01865.x
Yaphe, J., Schein, M., & Naveh, P. (2001). Ethiopian parents’ perception of their children’s health: A focus group study of immigrants to Israel. The Israel Medical Association Journal, 3(12), 932–936.
Yirdaw, B. W., Gobeza, M. B., & Tsegaye Gebreegziabher, N. (2022). Practice and associated factors of traditional uvulectomy among caregivers having children less than 5 years old in South Gondar Zone, Amhara Region, Ethiopia, 2020. PLoS ONE, 17(12), e0279362. https://doi.org/10.1371/journal.pone.0279362
Youngmann, R., Zilber, N., Kaveh, N., Zere, M., Workneh, F., Bekele, Y., & Giel, R. (2002). Development of a culturally sensitive psychiatric screening instrument for detecting emotional problems among Ethiopian immigrants in Israel. Harefuah, 141(1), 10–16.
Youngmann, R., Zilber, N., Workneh, F., & Giel, R. (2008). Adapting the SRQ for Ethiopian populations: A culturally-sensitive psychiatric screening instrument. Transcultural Psychiatry, 45(4), 566–589. https://doi.org/10.1177/1363461508100783
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All authors contributed to the study conception and design. Study conception, preparation, and literature search were performed by YT-G and RP. The first draft of the manuscript was written by YT-G, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Treister-Goltzman, Y., Peleg, R. Cultural Aspects of Health care for Ethiopian Jewish Immigrants in Israel: A Literature Review. J Relig Health (2023). https://doi.org/10.1007/s10943-023-01975-5
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DOI: https://doi.org/10.1007/s10943-023-01975-5