A 12-year-old girl from an Ethiopian immigrant family presented at the emergency department of the Hillel Yaffe Medical Center. She was suffering from severe abdominal pains, and the tests showed that her glucose levels were extremely high, but although the staff explained to her family how serious her condition was, she did not return for treatment. The interpreter – herself a member of the Ethiopian immigrant community – who was brought in to facilitate communication with the young patient’s parents did not understand why the girl had to monitor her blood sugar and to inject insulin on a daily basis, and it is not clear whether the message came across. The concept of chronic disease in general, and of diabetes in particular, was new to the Ethiopian immigrant community, and the staff soon realized that if they wanted their message to get across, they would have to work with the community. This young girl’s case was soon to spur them to action – to the founding of Tene Briut.
Aliyah (immigration) from Ethiopia to Israel and the transition to a sedentary lifestyle has resulted in the emergence of chronic diseases, in particular diabetes. The very concept of chronic illness had been virtually unknown in Ethiopia and is difficult for older members of the Ethiopian-Israeli community to grasp, particularly as over 70% of adults who left Ethiopia were functionally illiterate in their native Amharic.
While only 0.4% of the new immigrants were diagnosed with Type 2 diabetes upon arrival, by the time they had lived in Israel for ten years the figure had risen to 18% – three times as many as in the general population. The incidence of hypertension, obesity, asthma and Type 1 diabetes had also increased dramatically.
Tene Briut was founded in 1999 by Dr. Anat Jaffe, Head of the Endocrinology Unit at the Hillel Yaffe Medical Center. Her experience with Ethiopian patients made her realize that medical treatment could not succeed without culturally competent communication. Working with a team of Ethiopian-Israeli healthcare professionals who were closely familiar with Ethiopian social and cultural history and traditional medical beliefs, she launched a program for the dissemination of health promotion materials and later, for the provision of Amharic-Hebrew interpreting. Over the past eleven years, this modest beginning has developed into a small but dedicated NGO, operating out of its own offices in Hadera and delivering services throughout Israel with the backing and cooperation of a wide range of local and national bodies, including the Ministry of Health, the Ministry of Immigration, the absorption services, municipalities, the HMOs and hospitals.
Today the Tene Briut team comprises eight Ethiopian-Israeli healthcare professionals, three Amharic-speaking medical interpreters and four health promotion specialists familiar with the Ethiopian immigrant community. Organizations within Israel and beyond now look to Tene Briut’s programs for inspiration in their efforts to develop meaningful prevention strategies for improving the health of immigrants and minority communities. Thanks to its work in the healthcare system and throughout the Ethiopian immigrant community, it has succeeded in underscoring the crucial importance of culturally competent methods of healthcare delivery.