Anita Spring, Professor

Dept. of Anthropology University of Florida

The Body: Health, Food, and Fitness in Ethiopia

Tadesse Mesfin: Here We Are

Source: UNDP Human Development Report 2006

Corruption Perceptions Index 2006 (/163) 130

Source:Transparency International

Press Freedom Index 2006 ( /168) 160

Source: Reporters Without Borders

Source: UNDP Human Development Report 2006

Corruption Perceptions Index 2006 (/163) 130

Source:Transparency International

Press Freedom Index 2006 ( /168) 160

Source: Reporters Without Borders

Population (m) 75.6

Per-capita GDP (PPP US$) 756

HDI rank ( /177) 170

Life expectancy (years) 47.8

Combined gross enrolment (%): 36

% of population under $2 per day 77.8

Cellular subscribers (per 1000) 3.0

Internet users (per 1000) 2.0

:

Corruption Perceptions Index 2006 (/163) 130

Source:Transparency International

Press Freedom Index 2006 ( /168) 160

Source: Reporters Without Borders

Questions

What are the body aesthetics? Traditional, conventional Contemporary

What is the healthy body? What is the unhealthy body What body variations are there by

Types of societies, rural-urban, poor-wealthy What are the multiplicity of body-related

customs?

Some of the multiplicity of body configurations

The beautiful coffee server or entertainer

“The tribal exotic”

The result of famine and starvation

The body augmented though FGC, etc.

The rural poor: farmer and laborer

The urban wealthy: professional, housewife

The Olympic runner

Body problems for girls and adolescent females

FGC: Infibulation, excision, clitoridectomy

Early marriage

Pregnancy at young age

Fistula and incontinence

Marriage by bride capture and rape

Domestic violence Eshetu Tirunch: To Live or Not to Live

(women experience men’s war and violence)

The body: traditional

Low Body Mass Index (BMI) for women Small body size High female morbidity and mortality

Female Genital Cutting (FGC) Parturition: obstructed labor Uvulectomy, tonsillectomy: venesection HIV AIDS

The body, food, diet, nutrition

Gender-differential diet Poor girls and women may get

Less protein Fewer calories Fewer meals Restriction on foods during pregnancy

No effect for better income and food-secure farmers

“La Bella Figura” Well dressed and coifed

Body and figure well presented

         

The “tribal” exotic: Hamer, Arbore, Afar, Borena, Mursi, Bume, Karo, Bodi, Ari

Mursi Woman lip plates: Cut for marriage girlRemove bottom front teeth

(FGC-not practiced)

The face & body of famine

Refugees & displacedWomen and children: 75%-80% Poorly nourished Poor health conditionsHigh morbidity and mortality

Large numbers of internally displaced Ethiopians More women and childrenSame poor health and nutritionhttp://www.reliefweb.int/rw/RWB.NSF/db900LargeMaps/SKAR-64GEP7?OpenDocument

Reproductive health and the

body

Total fertility: 6.1 (2000 - 2005)

• was 7.0 in 1970s

Population growth rate: 2.7%

The female body augmented: FGC

Cultural aesthetic: clean, smooth, beautiful

Childbirth obstruction, can result in: fistulas tearing of vaginal and/or bladder wall chronic incontinence

Ethiopian school girl in meeting organized by NGO campaigning against FGC

She is worried about getting a husband if she refuses to be circumcised

Credit: IRIN

POSSIBLE PHYSICAL SIDE EFFECTS•Pain, Shock•Hemorrhage•Damage to surrounding organs•Bladder/ Urethra Stones•Kidney Damage•Reproductive Tract Infections•Infertility•Excessive Scar Tissue•Urinary Tract infections•Intermittent Bleeding•Abscesses•Keloids & Dermoid Cysts

Women and menrefusing FGC: Donor projects

I m p r o v i n g t h e p e r f o r m a n c e o f p r i m a r y p r o v i d e r s i n f a m i l y p l a n n i n g a n d o t h e r r e p r o d u c t i v e h e a l t h c a r e a r o u n d t h e w o r l d

E T H I O P I AE T H I O P I A

U S A I D

C D C

U N I C E F

M i n i s t r y o f H e a l t h

H I V / A I D S P r e v e n t i o n a n d C o n t r o l O ffi c e ( H A P C O )

R e g i o n a l H e a l t h B u r e a u s

R e g i o n a l H A P C O

R e g i o n a l T e a m s

H a r e g P r o j e c t P a r t n e r s H a r e g P r o j e c t P a r t n e r s

I m p l e m e n t i n g a g e n c i e s :

P R I M E I I ( I n t r a H e a l t h , S a v e a n d A C N M )

J H P I E G O

J H U / C C P

S a v e t h e C h i l d r e n / U S

L I N K A G E S

U N I C E F

M S H / R P M +

I - T E C H

Early Marriage—12 yr old

http://www.unicef.org/infobycountry/ethiopia_early_marriage.html

Her mother asked that the Marriage Contract state a delayin consummation of the marriage until she was 15 years old

but the elders omitted it

Addis Ababa Fistula Hospital treated >25,000 women since opening and 1,200 women a year

Obstructed labor: Childbirth injury leading to incontinence

Causes: Early marriage and pregnancy

FGC

Oprah discussion on TV

Variables that affect to greater or lesser degree

AGE AT MARRIAGE

TYPE OF FGC (AGE

AFFECTS)

HEALTH ENHANCERS

HEALTH DETRACTOS

20’s and older Adequate calories Famine—little or no food

17-19 Infibulation

Adequate protein Female get less food

14-16 Excision Safe water, etc. Female gets less protein

12-13 Clitoriodectomy Pre-natal care No pre-natal care

9-11 None Obstetric Care Obstetric complications

Health

What about HIV and AIDS?

Eyes on the Prize Averted infections are the ultimate goal

Total population 70.7 million

Living with HIV/AIDS 3 million Adults 15-49 2 millionChildren 230,000

Overall prevalence 6.6%Urban 13.7%Rural 3.7%

AIDS orphans 1.2 million

Life expectancy Fallen to 45 years

Hospital beds >50% to AIDS patients

HIV/AIDS overwhelming Ethiopia

91% of infections in adults 15-49 years 21.1% prevalence in women 15-24 years As high as 25% among pregnant women in

urban areas

HIV/AIDS Infection in Ethiopia HIV/AIDS Infection in Ethiopia

170,000 HIV+ women give birth each year

60,000 of their newborns infected through MTCT

HIV/AIDS theater group in Awassa

Practices that involve blood, cause additional vulnerability for the spread of HIV/Aids

Harmful Traditional Practices in Oromiya

FGC: after birth, at the time of marriage1997/98 survey: 80% of females in Oromiya

Milk tooth extraction: sometimes involves drilling the gumTo treat diarrhoea & fever at time of milk tooth eruption, &

poorly growing older children

Uvulectomy: uvula removed with a knifeTo treat oropharyngeal blockage, prolonged swelling of thethroat, vomiting & coughing.

Tonsillectomy: removed by healer’s index finger To treat sore throats & difficulties in swallowing

Related practice: scrape a sore throat with a long finger nail until bleeds

Venesection: blood letting through stabbing veins or arteries

To counter tissue swelling & deteriorating health

POTEN-TIAL MODES OF TRANS-MISSION

WOMAN

MAN

FEMALE ADOLESCENT 10--19 YEARS

MALE ADOLESCE

NT 10--19

YEARS

CHILD 5--9 YEARS

INFANT UNDER 5 YEARS

SEX WITH INFECTED PERSON Unprotected

Marketing Traders Rape Widow

Inheritance Extramarital Polygyny

Marketing Traders Daily Laboring Seasonal Migration Widow

Inheritance Extramarital Polygyny

Dancing, Weddings Marketing Urban Migration Abduction Rape Early Marriage Secondary School

Dancing, Weddings Casual Laboring Urban Migration Secondary School

CONTACT WITH INFECTED BLOOD

Uvulectomy Tonsillectomy Female Genital Cutting (FGC)

Uvulectomy Tonsillectomy

Milk Tooth Extraction Tonsillectomy

Tonsillectomy Circumcision

MOTHER TO CHILD TRANSMISSION

Pregnancy, Birth, Breast Feeding

HIV/AIDS risks

Physical activity: traditional, rural

Walking, carrying--water & fuelwood

Agriculture Planting Weeding Harvesting Marketing Herding

Food processing

Dancing!!! Shoulder Neck rolls

Water and fuelwood carrying on back (not on head)

Back injuries & deformations with age Bent, not upright posture

Diet: Grains: more famine–prone

(draught) Enset: more famine–proof

Draught, poverty, distribution systems

Malnutrition: mothers and children

Ethiopia faces 300,000 malnutrition deaths

Enset: Anti-famine crop

60 trees feeds 6 people

for a year

Wealth determines diet and health

Degene (Rich)

10+cattle, some to poor to share-raise

Self-sufficient: clothes, school fees, food

Use contract land plus own holdings

Harvests 100 enset plants/ year

Owns 3 houses

Hires labor to plant, weed, and process enset

Sells chat, coffee eucalyptus trees

15%

Gibtose (Middle-class)

5 cattle -no share-raise to poor

Self-sufficient in food, clothing, school fees

Harvests 50 enset plants/ year

Owns 2 houses

35%

Zega

(Poor)

No cattle but share-raise them

Sells his/ her labor

Harvests 10 enset plants/ year

Sells hay from own land for income

Owns one house

35%

Gurmasa (Poorest of the poor)

Payment in cash or kind for labor and food

Share-raise cattle for milk and manure

Harvests a few enset plants/ year

Very small plot of land

Owns very small house

15%

Women and agriculture

Old techniques No access to land No access to credit or

capital Labor for their

husbands

New techniques Microcredit and

microfinance projects New income projects Farming techniques Improved food

processing and animal husbandry

EntrepreneurshipMicro to Global

Global business womenMicro-entrepreneurs

Street vendors, craft makers

Small businesses

Merkato Addis Ababa Largest open air market in Africa

Most women are in informal, micro-sector

Some are large, informal sector traders

Informal sector: women vendors in towns, urban areas, rural markets

Women-owned small industries related to the body Textiles, Clothing and tailoring, Food products (injera), Feminine hygiene, Beauty salon and products

Retail: Restaurant, Groceries, Super markets

Konimix Business Center Import-Export trading

                                                        

                   

Crafts: Kembetta potters, Weaver

Agricultural Projectssome Microfinance & Microcredit

43

Medium and Large-scale

Traders in the

Informal sector ___________________

Ethiopian Women Exporters’US$250,000 to $1.2 Million Per year in goods

44

Formal Sector small-medium textile

manufacturer--Ethiopia

Contracts with Ethiopian Airways

and DHL

Regional Enterprise Networks

WAEN: 350 members

West African Enterprise Network

SAEN: 100 members

Southern African Enterprise Network

EAEN: 60 members East African Enterprise

Network

WAEN 1993

SAEN 1998

EAEN 1998

46

In October 2000, Delegates from 31 Countries met in Ethiopia to form the

Africa Enterprise NetworkAfrica Enterprise Network (AEN)

Characteristics of Ethiopian AEN Members

All escaped political turmoil in Ethiopia and lived/were educated in the U.S.

All are men Keep in close contact with each other Upper class socioeconomic status

Types of Businessesin EAEN

Rose exporter CEO of Ernst & Young-Africa Thread making factory Coffee factory Retail store: electronics &

appliances Bottled water Transportation company,

commercial buses

49

Old factory thread and textile factory from socialist days taken over by EAEN

member

Business Enablers

Relative domestic political calm

Entrepreneurial culture

Overseas contacts/networks esp. in U.S., Europe, and Canada for marketing and supply

Business Constraints

Continuing war with Eritrea

drains resources & govt’s attention

Very low income levels

History of state involvement in business

Poor physical infrastructure

Land-locked country

Running and Women Athletes

2004-06: The Great Ethiopian Run: 5 kilometer race in Addis Ababa

8,000 girls and women-2006

“By running they can be ‘known people’ and they can get money. They can get anything”

Marathon coach Yilma Berta

High altitude enhances oxygen carrying capacity

Teff Easily metabolized

Running a “take-off” on everyday existence and activities

World champs: win 5,000 and 10,000m

Ethiopian take all 6 medals

25-35 elite runners 50-100 in training

Walking is transportation for girls; high altitude

Runners are celebrities

Change the notion that women should lead marginalized lives

Walk to school

Walk to collect firewood and water

Berhane Adere,Olympic gold-medal world champion in 10,000-meter

Girls and boys running at school

New role models

Running Start built new classrooms

The new physical exercise

40-50 girls in club, but 200 run Some without shoesKids go to local hotels to watch TV

Tirunesh Dibaba: age 21First woman to win both 5,000m and 10,000m

2006: 5000 meter Brussels 2007

Boston Jan. 27Madison Square Garden Feb 3

Favorite 2007 world track, Osaka

2008 summer Olympic, Beijing

Drives a BMW 750, Earns US$.5 million/year

The new fit and de-robed female body

Tirunesh Dibaba set a world indoor record in the women’s 5,000 meters in Boston February 1, 2007

Women athletes as role models

Girls being educated and running

Will these change ideas about the female body?

Questions to be asked:

Will running: Reduce FGC? Reduce severest FGC? Reduce domestic

violence/harm? Be linked to greater AIDs

awareness? Reduce birth rate? Increase general fitness?

Will running increase girls’ and women’s Education?

Primary Secondary Tertiary

Political participation? Economic activities? Self-esteem?

Thank you

Female circumcision             

Merkato,Addis Ababa, the largest open air market in Africa