Ethiopian Israelis face major hurdles when it comes to healthcare

The rate of suicides in the Ethiopian Israeli population in 2021 was nearly four times as high as in the general Israeli population, and in 2022 this rate was still more than twice as high, according to a Knesset report on the health of Ethiopian Israelis prepared in July at the request of MK Tsega Melaku.

The report also showed that between 2019 and 2022 Ethiopian Israeli women sought out abortion at much higher rates than women in the general Israeli population.

In 2019, Ethiopian women made 26.3 requests to Israel’s abortion committee per 1,000 women between the ages of 15 and 49, compared to 8.4 requests in the same cohort in the general population.

In 2022, this figure remained significantly higher than in the general population, with Ethiopian Israelis making 19.6 requests per 1,000, compared to 7.2 in the general population.

Ethiopian Israelis faced slightly higher infant mortality than the general Jewish-Israeli population between 2020 and 2022, and the top 10 causes of death in the Ethiopian population were different from those in the Jewish population, the report also noted.

Overall, the report painted a picture of a population facing health needs different from those faced by other Israeli populations, and in some cases different healthcare crises.

Melaku, who has been a leading figure in the fight for healthcare for this population, pointed to two of the hurdles Ethiopian Israelis are facing when it comes to healthcare – a lack of trust in Israel’s institutions and neglect by the healthcare system.

A MAJOR flashpoint for the loss of trust in Israel’s institutions in general, including the healthcare system, was the infamous blood affair, said Melaku.

In 1996, the Ethiopian community found out that its blood donations were being thrown away at the blood bank.

“We were so angry we went out in protest,” said Melaku, who added that the community brought 30,000 people out to the streets.

“A whole community – elderly, children, young people, even soldiers in their regular service, came to protest,” she said.

The throwing away of the blood donations was seen as murder, said Melaku. “Blood symbolizes life.”

Adding to the hurt and anger felt by the community was the fact that many of the donors were Ethiopians doing their IDF service – leaving the community feeling that their blood was good enough to be shed in war, but not to be shared among other citizens.

Prior to the blood affair, trust in Israel’s institutions and the Health Ministry was already hurt, following negative interactions with ministries such as the Religious Services Ministry.

But the blood affair was the straw that broke the camel’s back when it came to trust in Israel’s institutions, she explained.

“And so the community stopped believing at all in the institutions of the State of Israel – in all its institutions,” she emphasized.

The damage done by the blood affair was compounded by reports that Ethiopian women were being pressured by Israel’s medical officials to get birth control shots. While the exact details of the case remain in contention, the damage to the trust of Ethiopian Israelis was drastic.

“This caused another crisis,” explained Melaku.

This left the community without any trust in the medical system and unwilling to seek treatment, she said.

Members of the community thought that if they sought medical treatment, they would be experimented on, she explained.

This lack of trust and its dangerous implications were clearly reflected in the Ethiopian community’s reaction to the coronavirus pandemic, said Melaku.

The pandemic

During the pandemic, Ethiopians said that they would rather “die at home” than go get treatment, said Melaku. “People hid that they were sick.”

They also did not get vaccinated, out of fear and distrust, she said.

Melaku led a campaign to try to raise awareness and trust, telling her community that her own mother was vaccinated against COVID-19, and bringing a doctor onto her radio show when she was working as a journalist.

It didn’t help, she said.

The Knesset report reflects the devastating impact of the coronavirus on the Ethiopian community in Israel.

While mortality among those born in Ethiopia was slightly lower than in the general population between 2019 and 2023, in 2021 morbidity of those born in Ethiopia jumped, surpassing morbidity in the general population, before returning to lower levels in 2022.

This jump in morbidity is in great part due to deaths from the coronavirus, said the report, citing Health Ministry information.

THE LACK of trust and its health implications are compounded by a negligent lack of action by the ministry, said Melaku.

The Health Ministry has received a NIS 5 million budget to address health needs in the Ethiopian community from the Prime Minister’s Office, and has returned this budget three years running due to not using it, said Melaku.

She believes that “this is because the Health Ministry doesn’t submit a plan” for the budget, she added.

Commenting on the statistic from the Knesset report that shows that suicides rates in the Ethiopian community were so much higher than in the general population, Melaku questioned the lack of tailored resources offered to the community.

“There is nothing on the radio, nothing on TV, in the community; there are no workshops. What is this?

“They can’t tell us they are lacking the budget; they gave the money back,” she added.

“The Health Ministry has no reason to say no [to offering resources]. What excuse do government offices make? Budgets,” said Melaku. “But when there are budgets, they don’t use them.”

The Health Ministry said it is “aware of challenges that arose for making use of the intended funds.”

“The Health Ministry is committed to transparency and continual improvement, and so we are learning from the experience we have gained to improve the use of budgets in the future,” a representative for the ministry added.

“In order to do so, the Health Ministry has founded a special committee and is working diligently to advance the program that was raised this year in committee meetings.”

Melaku also touched on the fact that other populations have administrators who work under the Health Ministry director-general and whose job it is to oversee health in these populations, while the Ethiopian community does not.

The ministry has agreed to appoint such an official for the Ethiopian community and is expected to do so by November.

“Our number is small. We don’t have economic power; we don’t have political power. We don’t have an educated community. Add in skin color. All of this complexity is not in our favor,” Melaku said.

She doesn’t want an apology from officials; she wants treatment for the community.

Practically speaking, what Melaku wants to see is the appointment of an administrator for the Ethiopian population, increased healthcare hasbara (public relations) efforts for the community, and increased awareness of the problem.

The Knesset report also discussed issues that should be addressed and suggested different courses of action.

There is a lack of consistency in how the Ethiopian community is defined among Israeli institutions, making gathering data hard. There are also a lot of out-of-date data, meaning tracking certain chronic diseases in the Ethiopian community is challenging, the report said.

The report also pointed to the challenges raised by the lack of a central official tasked with coordinating healthcare for the community.

Melaku came to the Knesset to address the issues facing the Ethiopian community that she has been exposed to her whole life – through personal experience, and through hearing stories as a journalist in the community.

We won’t let up, she said.

“If they don’t start working, we will not leave them alone, and the whole community will go out [in protest].”

“The Health Ministry sees great importance in promoting the health of Ethiopian Israelis and in building mutual trust with the community,” said a ministry representative.

“The ministry runs specialized programs, such as training cultural mediators, cultural sensitivity courses for medical staff, preventative medicine programs for chronic illness, and translators for providing care. These actions are meant not only to improve the medical services, but to strengthen the relationship and trust between the medical system and the community.”