Written by Abebe Haregewoin
Ethiopians share with the rest of humanity that propensity for excessive preoccupation with oneâ€™s health.Â This condition is often referred to as hypochondria.Â The person who exhibits this syndrome is referred to as a hypochondriac.Â Â People with this condition are excessively worried about getting a disease, even after there is no supportive medical evidence.Â Such people often misinterpret minor health problems or even normal body functions as symptoms of serious illness. Since the sufferer does not have total control of their understanding perceived disease, it is usually difficult to dissuade them that their illness has no physical basis. An abdominal cramp for such a person is the beginning of a cancer in the belly, and a headache, the start of a brain tumor.Â It is a major feat of accomplishment for a medical person to convince the sufferer that they are in no immediate danger from any kind of illness.Â As a matter of fact the patient might lose confidence in their medical care giver, and as is often the case go shopping for a more sympathetic ear elsewhere or go to the witch doctor or other non-medical healer.
The symptoms a hypochondriac describes can range from general complaints, such as ill defined pain or excessive tiredness, to concerns about normal body functions such as breathing, change in eating pattern, bowel motion or urination.Â The affected person is obsessed with the selected symptom and really believes that it is the manifestation of a dire illness.
Â Although there are technical descriptions and diagnostic criteria for this abnormality, the manifestations of hypochondria are often culturally determined.Â All physicians who have practiced in the major cities of Ethiopia or who have a major Ethiopian inventory in the Diaspora spend a lot of time with patients who have a uniquely Ethiopian manifestation of the condition, such as the ubiquitous yebird beshita.It is difficult to find any Ethiopian who has not suffered yebird beshita at one time or another. Ethiopians believe in it.Â Variations of the illness are found in other parts of the globe, but Ethiopians are by far the winners of the Marathon of this illness if there was an international contest.Â Just like the famous long distance runners the average Ethiopian has a Herculean endurance in describing their recent or past struggle or that of a relative or somebody thy know with yebird beshita.Â It is usually a passing malady for most and sometimes a universal explanation for a variety of minor aches and pains.Â Â As such it may not be considered a manifestation of hypochodria.Â However, there are those who believe that they are chronic sufferers and are convinced that their life is threatened by this dire condition.Â They trudge from clinic to clinic, tsebel to tsebel,Â but to no avail!
But what is yebird beshita?Â Â The etiology of as the name implies is a malady caused by the malevolent and adverse effect of exposure to a stream of cold air usually coming from two directions.Â The condition usually occurs when the alleged victim is sitting in a narrow and confined space where there is a wind tunnel effect, or in a wider space when there is air current coming from two directions such as a door and a window and the victim is in the direct path and trajectory of the pathogenic air currents coming from opposite directions.Â Â It is alleged by some that it might also be due to a clash of hot and cold air with the victim at the site of the clash of the two presumably titanic forces.Â Occasionally it is a sliver of air that came through a crack in the window or under the door or window sill while the victim was unwittingly struck by the evil current while undressed or partially dressed and thus exposed.Â There are many variations on this theme depending on the capacity and expertise of the person describing the ordeal.Â Â The victim often describes a stabbing pain usually in the back or chest or some other muscle or bone and can sometimes trace the path of the cold air in the viscera and the damage done to specific organs.Â The avoriteÂ organs of yebird beshita are the lungs, even when there are no signs of pleural pain, cough or sputum production, many sufferers are convinced that their lungs have been weakened by this serious malady.Â Others are leg muscles (quanja), or a condition known as tnan or torticollis.Â But any organ may be affected.
Socially there is a lot of sympathy and no lack of advice on how to prevent or treat yebird beshita. These range from strategies on what and how much to wear and where to sit or not sit to inhalations of the vapors of boiling leaves such as eucalyptus, decoctions, salves, tsebel, and even scarifications.Â A chronic sufferer may bear the scars of many scarifications and brandings with hot metal either on the chest or the head depending on where the malady has struck. It is generally believed that yebird beshita is one of those maladies that are not amenable to modern medical treatment. Modern medicine is believed not to have developed the sophistication that is needed to diagnose or effectively treat yebird beshita.Â Â But there are charlatans and swindlers in the major cities who have specialized in the treatment of this disease.Â There are even certain physicians who write the diagnosis of â€œcold traumaâ€, in patient charts and give the hapless patients some sort of injection.Â An old favorite was calcho merfe or intravenous calcium solutions, which seemed to work like magic for some of these patients. This treatment wasÂ made popular by the old European doctors who more than likely were theÂ stragglers of the defeated Italian army during the second world war and who did not want to go back home and remained behind and instantaneously dubbed themselves doctors.Â Â In the old days people like the famous Professor Moratti (perhaps Moriarty) and other French physicians planted this concept firmly into the mind of a previous generation.Â For reasons that are not clear when this condition disappeared from the culture of Europe, where it most likely originated, and was disseminated in Africa by the likes of Professor Moratti, yebird beshita found the perfect fertile soil for survival and found a perfect home in Ethiopia where itÂ continues to thrive to this day.Â The medcial qualifications of these old time famous French and Italian doctors as physicians are questionable.Â It is not clear how Moriarty became a professor.Â
The author of this article suspects that he might have been the fictional nemesis and enemy of Arthur Conan Doyleâ€™s Sherlock Holmes, the indestructible Professor Moriarty who may have escaped to Ethiopia and recreated himself as a physician away from the relentless pursuit of the famous detective and his friend Dr. Watson.Â This is the best explanation that can be given to the mystery of why Yebird beshita became a national illness.Â Most Ethiopians and even those who are educated and should know better will defend its reality and stake their reputation on it. They will be offended if they are seriously challenged on a disease with which they have personal experience and most likely somebody close to them.Â For some it is a feared disease that they were convinced caused the death of a relative.Â Case closed and end of discussion!
Yebird beshita is a usually a recurrent malady.Â Surprisingly it seems to disproportionately affect men more than it does women.Â It is a condition that is widespread and seems to affect people in all strata of society.Â Â But it seems to be a particular affliction of the urban middle class.Â The alleged sufferer usually overdresses, even when the temperature is torrid.Â It is not unusual to see people wearing heavy woolen or thick overcoats, worthy of winter in Greenland or ascending Mt. Everest.Â Under these over-garments there will be layers of sweaters, undershirts and in some cases long johns. It is not unusual to see men walking with an apparent hunch back from the pile of protective shemma worn under their overcoats and bunched up over their shoulders.Â The neck which is considered a vulnerable point of entry for cold air is wrapped in all manners of garments.Â Â In the countryside and in the less sophisticated members of society, the condition might call for a swaddling in thick shemma on top of which a blanket might be thrown for added protection. The proverbial towel over the head is another strategy to cover the head in order to prevent the head from being an entry point.Â Covering the nose and mouth with either the shemma or even stuffing the nose with a piece of gauze or a wad of cotton is another ounce of further prevention.Â No wander that people wearing such heavy garments in a tropical environment are sweaty and feel febrile.Â This ill feeling of self induced hyperthermia, thus becomes further justification for yebird beshita.Â
Physician, beware of the overdressed patient where the mysterious yebird beshita is lurking.Â Beware also not to think that all who presumably suffer from yebird beshita are to be dismissed, as some may be suffering from a very serious disease indeed.Â Alas, medicine is both an art and a science!
Ethiopian Medical History
Photo: Dr. Melaku Beyan. Dr. Melaku Beyan became the first Ethiopian medical doctor to complete his education in the United states in 1935 (Dr. Workneh Eshete became the first Ethiopian doctor to obtain a modern medical education in 1882)
The non-governmental organization, People to People, has just released The Manual of Ethiopian Medical History by Enawgaw Mehari, Kinfe Gebeyehu and Zergabachew Asfaw. The purpose of the publication is to teach the future generation of Ethiopian medical students and health care professionals about Ethiopiaâ€™s medical history.
Mekele University and Bahir Dar University have reportedly agreed to incorporate the study into their medical education curriculum.
Enawgaw Mehari, MD
Kinfe Gebeyehu, MD
Zergabachew Asfaw, MD
Senior Graphic Editor: Matthew I. Watt