Medical traditions and chronic disease in Ethiopia: a story of wax and gold?

摘要

Effective medical care for non-communicable diseases (NCD) remains lamentably poor in Ethiopia and many low-income countries. Consequently, where modern medicine does not reach or is rejected, traditional treatments prevail. These are fragmented and esoteric by nature, and their understanding of illness is so fundamentally different that confusion proliferates when attempts are made to introduce modern medical care. Ethiopia is host to a variety of longstanding medical belief systems that coexist and function together, where modern medicine is often viewed as just another choice. This multiplicity of approaches to illness is accompanied by the Ethiopian custom of weaving layers of meaning, often contradictory, into speech and conversation - sometimes referred to as 'wax and gold', the 'wax' being the literal and the 'gold' the deeper, even hidden, meaning or significance. We argue that engagement with traditional belief systems and understanding these subtleties of meaning could assist in more effective NCD care.