Today the Ethiopian Israeli community numbers over 120,000 with new immigrants still continuing to arrive. For many, immigration led to the disintegration of traditional family and social structures with traumatic results for the community and further impeding absorption into Israeli society.
A report issued in 2008 by the Prime Minister's Office states that 68% of Ethiopian families live under the poverty line and the Adva Centre advises that "Ethiopian immigrants ranked lowest on the quality of life index, which considers per-capita income, per-room housing density and basic spending". A study on the community funded by the United Jewish Communities in 2008 found "The lack of skills training, employment readiness and preparation combined with racism has resulted in high rates of unemployment and underemployment. The patronizing approach to service delivery and community has denied them self-determination.." Unfamiliar and uncomfortable with Israeli bureaucracy, many Ethiopians do not adequately receive the basic social services due to them as citizens of Israel.
Chronic illnesses were virtually unknown in rural Ethiopia, but aliyah to Israel and the associated changes from an active agrarian lifestyle to a sedentary western lifestyle with increased consumption of processed and sugar-rich foods resulted in the emergence of chronic diseases, in particular diabetes, at an alarming rate. The Ethiopian immigrant community has a prevalence of diabetes of 18% within 7 to 10 years of immigration; triple the frequency in the general population. http://22.214.171.124/easd/customfiles/easd/37th/Abs01/403.html
Studies in Israel revealed that Ethiopian-Israeli diabetics use less health services than their counter parts and do not undergo routine follow-up tests:
Only 48% of Ethiopian patients say they understand medical staff, compared to 92% of others surveyed.
82% of Ethiopian patients understand little or nothing of the pharmacists' instructions, compared with 20% of others
55% state they understand little or nothing of the advice given by dieticians.
Only 17% of Ethiopian diabetics own a glucose meter for self-monitoring with the remainder stating that the main reasons for not getting one were either not having enough money to purchase one or lack of recommendation by their physician. http://www.tene-briut.org.il/poster-toledano.pdf
Never having encountered the condition in their native land, Ethiopian immigrants are slow to recognize diabetes in themselves and others. In addition, the concept of an illness that a doctor cannot cure, and that has few external symptoms, goes against commonly held beliefs of what constitutes an illness. This lack of understanding of the nature of the condition, and the subsequent poor compliance with disease treatment and management, can cause debilitating complications such as vision impairment and blindness, kidney failure, nerve damage and stroke.
Through operating at a grassroots level within the community, the Tene Briut team is acutely aware of the impact of poor disease management, often encountering:
• Patients trying to save money by taking only half their prescribed dose of medicine - the poor result reinforcing their lack of confidence in modern medicine and the belief that there is no quality of life with chronic disease
• Older patients who are dependant on their local health clinics for routine glucose monitoring and supervision of medication, thus placing a heavy burden on the health services and incurring transport expenses that the patient can scarcely afford
• Patients who view their illness as totally debilitating and withdraw from family responsibilities, negatively impacting family relationships and further contributing to the challenges faced by children and youth of the community.
• Families that have an unwell elderly relative move in – traditional culture pressures women to stop working outside the home and care for the aging, unwell parent – increasing the financial hardship of the family as well as compounding the crowded living conditions experienced by most Ethiopian-Israeli families.
Poor management of diabetes and other chronic diseases is a tremendous obstacle to the well being of the Ethiopian community.