Peace in the Clinic: Rethinking “Global Health Diplomacy” in the Somali Region of Ethiopia

Abstract

Drawing on ethnographic research with Somalis, within aid organizations, and within health care facilities in the Somali Region of Ethiopia, this article argues that what is called “global health diplomacy,” despite its origins and articulations in interstate politics, is fundamentally local and interpersonal. As evidence, I outline two very different health programs in the Somali Region of Ethiopia, and how, in each, existing animosities and political grievances were either reinforced or undermined. I argue that the provision of health care in politically insecure and post-conflict settings like the Somali Region of Ethiopia is precarious but pivotal: medical encounters have the potential to either worsen the conditions in which conflicts and crises recur, or build new interpersonal and governmental relations of trust. Effective global health diplomacy, therefore, cannot be limited to building clinics and donating medicine, but must also explicitly include building positive relationships of trust between oppositional groups within clinical spaces.

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Notes

  1. 1.

    “Habesha” is an ancient term that previously referred to persons who were part of the Axumite then Abyssinian Empires, but today is colloquially defined as persons of Amhara or Tigrynia ethnicities residing in Ethiopia or Eritrea, or persons who speak either Amharic or Tigrynia languages as a first language. In eastern Ethiopia, the term “Habesha” is the most common signifier for Amharic-speaking individuals.

  2. 2.

    No one I spoke with could provide an exact figure of the number of persons killed, and the available archival data did not detail violence or military activity in the Somali Region at this time.

  3. 3.

    All personal names have been changed to ensure anonymity.

  4. 4.

    Tuberculosis medications were not available and DOTS was not possible given the limited mission of the mobile team. I did not investigate further why Yonis received amoxicillin, but in the Somali Region, it is the most common and expected treatment for acute respiratory illnesses.

  5. 5.

    The highlands of eastern Ethiopia are known for the cultivation, consumption, and export of high-quality khat (jaat in Somali language, scientific name Catha edulis). Khat is an evergreen flowering plant picked for consumption of its mildly narcotic leaves.

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Correspondence to Lauren Carruth.

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Carruth, L. Peace in the Clinic: Rethinking “Global Health Diplomacy” in the Somali Region of Ethiopia. Cult Med Psychiatry 40, 181–197 (2016). https://doi.org/10.1007/s11013-015-9455-6

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Keywords

  • Global health
  • Humanitarian assistance
  • Post-conflict reconciliation
  • Peace
  • Horn of Africa