Welcome to “Cross-Cultural Massage in Seattle: Ethiopian Communities”
The State of Washington requires that you certify continuing education requirements, and produce documents to the Department of Health if they request them. The certificate that you receive for this evening’s course is valid for 2 of those credit hours; you still need 6 more for the year, and 14 more for 2 years, in order to meet the state continuing education requirement.
“We are a species, not a race or a nationality, a political or ethnic group, or a class; as members of that species, each one of us carries the codes of its past and future success deep within our cells.”—Deane Juhan, author of Job’s Body: A Handbook for Bodywork
Our Neighbors: Ethiopians in Seattle, in Their Own Words
“Half of my body is missing.”
Yet, sitting on the examination room table, he looked like a perfectly normal young man.
The patient was an Ethiopian immigrant who had served in the military in the war between Ethiopian and Eritrea. He had been referred for massage by his physician, who was at a total loss for how to help him regarding his conviction that half of him had disappeared. Explaining to him that everyone else saw both halves of his body, showing him the X-rays and CT scans that testified to the normal presence of anatomical structure inside, having medical professionals and trusted members of his family and community talk to him about it—none of these measures had any effect.
Psychological evaluation had yielded various diagnostic terms: “reaction formation” (an exaggerated manner of coping with disturbing emotions by insisting on their opposite), and “somatization” (experiencing distressing or traumatic emotions as physical symptoms), among others—but no relief for the man himself.
Discussion questions:
1. If this man presented himself in your practice, what would come to mind for you?
2. How would you try to help him?
Don’t worry if nothing is springing immediately to mind. This is a much more complicated situation than we were able to get to in massage school, and even practitioners with years of experience may not have seen a client like the one in this case report. We will discuss various points that may touch on what was going on for this man, and we will return to this discussion, after learning some things about Ethiopian, its history and culture, and Ethiopians and Ethiopian-Americans in Seattle.
Who are the Ethiopians and Ethiopian-Americans in Seattle?
There is a thriving community, with TV, radio, and newspapers in the various languages of Ethiopia.
Just like any other community in the region, they need everyday services.
They come together for community celebrations—this festival is the anniversary of defeating the Italians at the battle of Adowa in 1896, a victory which kept the Ethiopians from being colonized.
And weddings, as well as other happy events.
They team up with other communities for philanthropic causes—the advertisement below is for the 2009 Gala at St. Mark’s Episcopal Cathedral on Capitol Hill to raise money for the Blue Nile Children’s Hospital to build a clinic to serve orphaned children in Addis Ababa.
They are honors students:
as well as at-risk students, whose parents fear gangs and drug use.
They are refugees
http://www.daylife.com/photo/03Lo0mTaH52Ur
And they are immigrants; they are doctors, lawyers, and entrepreneurs.
They are our neighbors.
Our neighbors organized an exhibition of Lucy, a partial skeleton of a hominid (early human) almost 3.5 million years old, in order to show the historical and cultural richness of their homeland.
Lucy has been extremely well-received throughout her world travels; she did, however, run into a little bad luck in Seattle. The crash of the economy made people think twice about spending money on non-essential expenses, and the weather in December and January cut way down on travel and opportunities to visit during the holidays.
This class is my way of saying “thank you” to the Ethiopian community for sharing their treasures with us. I waived the fee for the class for anyone who presents a ticket that shows they attended the Lucy exhibit in the hopes of promoting attendance during her last weeks at Pacific Science Center.
To get back to the previous case report from the community, it is very important to understand the effect that decades of war, forced emigration as a refugee or displaced person, and low socioeconomic status and language and cultural barriers in the new homeland can have. Lots of people make it through those hurdles every day, and others need some help.
An additional piece of information that you did not have before about the man is that the war between Eritrea and Ethiopia was fought over Eritrea’s desire for independence. Ethiopians consider Eritrea to be a part of Ethiopia; Eritreans consider themselves a separate people and country. When Eritrea won its 31-year-long war in 1991, Ethiopia lost its access to the sea, and became a land-locked country.
http://en.wikipedia.org/wiki/File:LocationEritrea.svg
Does that new information help you with answers to the questions before?
Respect through Language
The Ethiopian languages are difficult for Westerners to learn. They are not related to any of the languages of Europe, so even if you’ve studied Spanish, French, or German, Amharic or Oromo or Tigrinya, or any of the other Ethiopian languages will remain a challenge to learn. It can be done, but it will take a big investment of time to study and practice.
Most people understand that Westerners find the languages difficult, and will expect to speak English with you. Still, making the effort to learn even a little of someone else’s language, before having to switch to English for most of the communication, goes a long way to communicating that you respect the other person, and you are interested enough to take the time to learn something about them.
English: Amharic (phonetic)
Hello Selam
How are you?
(To a man) Dehna neh
(To a woman) Dehna nesh
(To a group) Dehna nachu
Thank you Ameseginalehu
Excuse me Yikerta
Yes Awo
No Ai
Bye Ciao (like Italian or English slang)
Our Roots: What Lucy and Other Early Humans Teach About the Terrain Under Our Hands
“…as members of that species each one of us carries the codes of its past and future success deep within our cells.”—Deane Juhan
Learning Objectives
Comparisons—feet to hands, species to species, primates and earlier humans to us—provide valuable clues about
Interaction between environment and anatomy: morphology
Scientific knowledge never complete, always provisional—meaning that it can be upset by better knowledge that comes along later
Article: Sooriakumaran 2005
Summary: Humans have a muscle in the foot called quadratus plantae. It originates in the calcaneus, and inserts into the posterolateral surface of the tendons of flexor digitorum longus.
Image source: http://www.latrobe.edu.au/podiatry/myofasc/quadratusplantae.html
Clinical significance:
· Heel pain
· Diabetic polyneuropathy
· Claw toe deformity
Although Lucy is almost 3.5 million years old, and of a different species from modern humans, look at how her radius and ulna are almost identical to that of any of us.
Lucy’s rib cage tells us about how breathing changed from walking on all fours to walking on two legs, and the changes in her pelvis and leg bones shed significant light on what adaptations our ancestors had to make to their environment. Those trade-offs exact a price from modern humans, in chronic conditions such as low back pain and sciatica, especially when our lifestyle is much more sedentary than Lucy’s was.
Ethiopian Medicinal Plants and Massage
Learning Objectives
· Traditional medicinal plants
· Traditional foods handout
o Valuable information contained within
o Also makes larger communication point—see “Note to Our EthnoMed Readers”. To be a good ally, communication does not have to always be perfect; if you listen to community members, you can work out issues such as these.
Heliotropium ovalifolium: Scorpion stings
http://fleurs.cirad.fr/fleurs_d_afrique_tropicale/h/heliotropium_ovalifolium
Kalanchoe lanceolata: Skin ailments
http://www.zimbabweflora.co.zw/speciesdata/species.php?species_id=124910
Pterolobium lacerans: Tuberculosis
http://www.zimbabweflora.co.zw/speciesdata/image-display.php?species_id=127190&image_id=1
Stephania abyssinica: Flatuence
http://www.zimbabweflora.co.zw/speciesdata/image-display.php?species_id=123640&image_id=1
Withania somnifera: arthritis
Ashwagandha, an Ayurvedic tonic
http://www.horizonherbs.com/product.asp?specific=329
Artemisia afra: Stomach pains
http://www.plantzafrica.com/plantab/artemisafra.htm
Myrrh and frankincense—Ethiopian medicinal usages; I have a case report of a severely burned young man, with whom I worked with myrrh and frankincense oils to regain some flexibility in heavily-scarred wrist. We had a medium amount of success; he will need surgery to cut through all that scar tissue—but we did get a few degrees of ROM back, and he pronounced himself pleased with results.
Making Other Herbal Topical Oils
This method is a synthesis of what was taught to me by Terry Maresca, who teaches the Indian Health Pathways course at the University of Washington School of Medicine, and by Elise Krohn, who is a botanical educator for the Northwest Indian College Diabetes Prevention through Native Plants Program. I pass it along in the hope of paying forward what I owe them for their teachings.
Because herbs are plant materials, and have to fight off micro-organisms in their day-to-day lives, once they are harvested, they are no longer living and defending themselves against those micro-organisms. So herbal oils can run the risk of bacterial and fungal growth, as well as of the oil becoming rancid, due to oxidation. This method is intended to lower those risks, by
Chop the herb very finely, and cover it with about half an inch of oil in a saucepan for simmering. Put the oil over low heat, but do not bring to a boil. The oil should be moving and turning over gently, but should not be bubbling. Simmer the oil for hours over that low heat to remove as much water as possible, so that the herbal material left in the oil will remain fresh for a longer time.
In traditional times, when people were at home all day long, it would be left on the stove to simmer all day long. Nowadays, when people work outside the house, and do not want to leave the stove on while nobody is home, it is ok to cover it and leave the saucepan on the burner with the heat off while you’re gone. When you get home, turn on the heat again, and continue the process. As long as you’re there to supervise the stove, just let it simmer, and turn it off again whenever you go to bed, or leave the house, or otherwise cannot keep an eye on it.
After a week of simmering the herbs for several hours in the evening, the herbal constituents should be nicely infused into the oil. Strain the plant material out of the oil with cheesecloth or a strainer, and the oil is ready to use.
In keeping with the Ethiopian theme of this class, you can try this with some of the herbs we mentioned above, but it works for many other herbs as well. Try rose, blackberry, and raspberry for some medicinal plants which Ethiopian and European medicinal plant traditions, among others, have in common.
Lentils
Lentils du Puy, black lentils, brown lentils, green lentils, and red lentils can all be used in Ethiopian cooking; you’ll find them at Ethiopian groceries around town.
Keeping Lentils Firm (from Cook’s Illustrated, Winter 2009, p. 58): “Sweating the lentils in the presence of salt and acids (from canned tomatoes) retards the conversion of pectinlike compounds to a gel. Once sweated, these lentils easily remain intact during a long simmer in broth, while becoming tender on the inside. Lentils simmered without first being sweated fall apart if overcooked.”
Ethiopian Lentil Stew
http://www.saveur.com/article/Food/Ethiopian-Lentil-Stew
(Misr Wot)
SERVES 4 – 6
The small lentils (variously called red lentils, pink lentils, Egyptian lentils, and, in South Asia, masoor dal) used for this dish turn yellow when cooked. The recipe for this version comes from an Ethiopean cook, Alemtshaye Yigezu, who cooked this dish for us while visiting her home.
1 cup red lentils
4 tbsp. nit'r qibe (Ethiopian Spiced Butter)
or unsalted butter
1 small yellow onion, finely chopped
4 cloves garlic, finely chopped
2 tbsp. berbere (Ethiopian Spice Mix)
1 small tomato, cored and chopped
Kosher salt, to taste
1. Rinse the lentils in a sieve under cold running water and set aside.
2. Heat the butter in a medium saucepan over medium heat. Add the onions and cook, stirring occasionally, until golden brown, about 10 minutes. Add the garlic and cook, stirring constantly, until fragrant, about 30 seconds. Add the reserved lentils, 1 tbsp. of the berbere, tomato, and 4 cups water to the saucepan. Reduce heat to medium-low and simmer, stirring occasionally, until thick and the lentils are tender, 45–50 minutes. Stir in the remaining berbere and season generously with salt. Serve immediately.
This recipe was first published in Saveur in Issue #110
Ethiopian Spiced Butter
http://www.saveur.com/article/food/Ethiopian-Spiced-Butter
(Nit'r Qibe)
MAKES ABOUT 3⁄4 CUP
This seasoned, clarified butter is a key component of many Ethiopian dishes.
1⁄2 lb. (2 sticks) of unsalted butter
1⁄4 tsp. ground black cardamom seeds
1⁄4 tsp. fenugreek powder
1⁄4 tsp. ground nigella seeds
1. Heat butter in a small saucepan over medium-low heat, skimming the foam off the surface. Once the butter has begun to simmer gently, continue removing the foam until the butter is completely clear, about 30 minutes. Strain the butter through a fine sieve set over a bowl, leaving behind the milk solids at the bottom of the pan.
2. Stir cardamom seeds, fenugreek powder, and nigella seeds into the butter and mix well to combine. Cool and transfer to an airtight container; store in the refrigerator for up to 3 months. Use the nit'r qibe to make Doro Wot, Misr Wot, or Ayib Be Gomen.
This recipe was first published in Saveur in Issue #110
Spicy Chicken Stew
http://www.saveur.com/article/food/Spicy-Chicken-Stew
(Doro Wot)
SERVES 4
This stew of chicken and hard-boiled eggs is one of the most recognized dishes of Ethiopia. The key to making its delicious, sweet-and-spicy sauce is to cook the onions slowly until they've caramelized to make a deeply flavored base. This recipe is based on one used by Elizabeth Goshu at her restaurant, Nyala, in Los Angeles.
4 tbsp. nit'r qibe (Ethiopian Spiced Butter),
or unsalted butter
2 large yellow onions, roughly chopped
1 tbsp. finely chopped garlic
1 tbsp. finely chopped peeled fresh ginger
1 1⁄2 tbsp. berbere (Ethiopian Spice Mix)
plus more as needed
4 chicken legs (about 2 1⁄4 lbs.),
skinned and divided into drumsticks and thighs
Kosher salt, to taste
4 whole hard-boiled eggs
Injera (Ethiopian Flatbread)
1. Heat butter in a large straight-sided skillet over medium-low heat. Add onions and cook, stirring occasionally, until deeply caramelized, about 25 minutes. Add garlic and ginger and cook, stirring, until softened, 6–8 minutes. Add berbere and 2 cups water; stir well. Season the chicken all over with salt; nestle the pieces in the skillet. Reduce heat to low and simmer, covered, turning occasionally, until chicken is cooked through, about 40 minutes.
2. Uncover skillet and raise heat to medium-high; simmer to reduce the liquid until it has a thick, gravy-like consistency, about 5 minutes. Add eggs; stir to warm through. Taste and season with more berbere and salt, if necessary. Serve hot with the injera.
This recipe was first published in Saveur in Issue #110
Cottage Cheese with Collard Greens
http://www.saveur.com/article/food/Cottage-Cheese-with-Collard-Greens
(Ayib Be Gomen)
SERVES 4
To learn more about cottage cheese, see Cottage Industry.
1 1⁄2 lbs. collard greens, stemmed and
roughly chopped
1 lb. cottage cheese
1 1" piece peeled and sliced fresh ginger
3 garlic cloves
2 tbsp. nit'r qibe (Ethiopian Spiced Butter)
or unsalted butter
1 small yellow onion, chopped
Kosher salt and freshly ground black pepper
to taste
1. Bring a large pot of salted water to a boil and add greens. Cook until tender, about 25 minutes. Drain in a colander; press with bottom of a ladle or measuring cup to extract liquid. Finely chop greens; set aside.
2. Put cottage cheese into a strainer over a bowl; let drain.
3. Combine ginger and garlic in a mini food processor with 3 tbsp. water; purée. Set paste aside.
4. Heat Ethiopian spiced butter or unsalted butter in a large skillet over medium heat. Add onions and cook until translucent, 6–8 minutes. Add ginger–garlic paste; cook, stirring, until fragrant, 3–4 minutes.
5. Add greens and season with salt and pepper to taste. Cook, stirring, until hot. Transfer to a bowl; stir in cottage cheese.
This recipe was first published in Saveur in Issue #110
http://www.saveur.com/article/food/Ethiopian-Spice-Mix
Ethiopian Spice Mix
(Berbere)
MAKES ABOUT 3⁄4 CUP
Berbere, whose name means hot in Amharic, is a chile-spice blend that's essential to many Ethiopian dishes, including Doro Wot and Misr Wot.
2 tsp. coriander seeds
1 tsp. fenugreek seeds
1⁄2 tsp. black peppercorns
1⁄4 tsp. whole allspice
6 white cardamom pods
4 whole cloves
1⁄2 cup dried onion flakes
5 dried chiles de árbol, stemmed, seeded,
and broken into small pieces
3 tbsp. paprika
2 tsp. kosher salt
1⁄2 tsp. ground nutmeg
1⁄2 tsp. ground ginger
1⁄2 tsp. ground cinnamon
1. In a small skillet, combine coriander seeds, fenugreek seeds, black peppercorns, allspice, cardamom pods, and cloves. Toast spices over medium heat, swirling skillet constantly, until fragrant, about 4 minutes.
2. Let cool slightly; transfer to a spice grinder along with onion flakes and grind until fine. Add chiles, and grind with the other spices until fine.
3. Transfer the mixture to a bowl and stir in paprika, salt, nutmeg, ginger, and cinnamon. Store in an airtight container for up to 6 months.
This recipe was first published in Saveur in Issue #110
http://www.saveur.com/article/Food/Kitfo
Kitfo
SERVES 4 – 6
This classic Ethiopian dish may be served either raw or cooked. In our cooked version, sautéed chiles, ginger, and Ethiopian spices perfume the dish. Be sure to serve it warm or at room temperature because when it's cold the flavors become muted.
1 1/2 lbs. beef tenderloin
1/2 cup spiced butter (see recipe for Nit'r Qibe)
1 small onion, finely chopped
2 cloves garlic, finely chopped
1 tbsp. finely chopped serrano chile
1 tbsp. finely chopped peeled ginger
1 tbsp. Berbere Spice Mix
Kosher salt and freshly ground black pepper,
to taste
Fresh lemon juice, to taste
1. Finely mince the beef with a large knife, transfer to a bowl, cover with plastic wrap, and set aside.
2. Melt the spiced butter in a 10" skillet over medium heat. Add the onions and cook, stirring frequently, until onions are translucent, about 4 minutes. Add the garlic, chile, and ginger and cook, stirring frequently, until soft and aromatic, about 2 minutes. Stir in the berbere until well combined, then add the meat and cook, stirring frequently, until just cooked through, about 2 minutes. Remove from heat, season with salt and pepper and lemon juice, and serve with Injera.
http://www.saveur.com/article/food/Ethiopian-Flatbread
Ethiopian Flatbread
(Injera)
MAKES 18 FLATBREADS
Injera, the spongy, crêpe-like sourdough flatbread usually made from tef, a hardy Ethiopian grain, can be easily replicated at home with all-purpose flour, yeast, and a nonstick skillet. (See Making an Ethiopian Staple, for the traditional method.)
1 cup warm water (about 105°)
1 1⁄4-oz. packet of active dry yeast
3 cups flour
1⁄2 tsp. kosher salt
1. Pour warm water into a small bowl, sprinkle with yeast, and let stand until foamy, about 10 minutes.
2. Sift flour into a large bowl; add the yeast mixture along with 2 cups water and whisk until a very smooth batter has formed. Cover tightly with plastic wrap and let sit at room temperature for 4 hours.
3. Briskly whisk the bubbling batter until smooth; add salt and whisk to combine.
4. Heat a 6" nonstick skillet over medium-low heat. Pour in 1⁄4 cup of the batter, tilting and swirling the skillet to coat it evenly with batter. Cook until just set, about 1 minute. Cover and cook until the edges pull away slightly from the sides, about 1 minute more. Using a heatproof rubber spatula, transfer injera to a paper towel–lined plate, cover with another paper towel, and repeat, stacking the flatbreads as you go. (Whisk the batter while each flatbread cooks.)
5. Let injera cool completely; wrap with plastic wrap until ready to serve. (The injera may be stored overnight in the refrigerator; bring to room temperature before serving.)
This recipe was first published in Saveur in Issue #110
Seattle Cheap Eats recommends kitfo at Habesha Ethiopian:
Getting Involved, Building Bridges
“The profession of bodywork has much to give, and there is a great deal of work to be done, both within our profession and without, in order to open the doors through which it can be delivered. Why, for instance, are there so few people of color in my own classes or in the conventions I have attended? However it is we came to be in this group, how can we make it richer and more diverse, better able to address wider varieties of ills? How can we avoid playing into a system in which something so simple and beneficial as healing touch turns out to be easily available only to those who can afford it? If our cultural biases have made it relatively difficult for bodywork to flourish, how can we reach those whose means are even slimmer, or whose ethos is even sterner, and whose needs are proportionately greater? How can we touch everyone, bringing each person into the process of discovering our evolutionary solutions before conflict and isolation annihilate us? Truly successful self-interest must always learn to acknowledge this larger self. I do believe that bodywork is a way to get in touch with it. A great deal may, in fact, be up to us.”—Deane Juhan
Discussion questions to leave you with:
1. What can we do, as massage practitioners, to build bridges with the Ethiopian community?
2. What can we do, as American citizens, to build those bridges?
3. What is the role of allies to a neighboring community?
Read! Then”
Go out, meet, interact
Invite
Dialogue
Resources
http://www.globalwa.org/
“Global Washington is a membership association that supports and promotes the global development industry in the state of Washington. A broad-based, statewide coalition of nonprofit organizations, large corporations, government, small businesses and both public and private academic institutions, members of Global Washington share the goal of building a better world.” Includes a Health Calendar, Poverty Calendar, Education Calendar, and Environment Calendar of events in the area
http://ethnomed.org/ Written in large part by members of the communities, EthnoMed is “contains information about cultural beliefs, medical issues and other related issues pertinent to the health care of recent immigrants to Seattle or the US, many of whom are refugees fleeing war-torn parts of the world.”.
http://ethnomed.org/ethnomed/voices/oromo.html
http://ethnomed.org/ethnomed/voices/ethiopian.html
http://www.ethiopiareads.org/ Promotes literacy in Ethiopia
http://www.fistulafoundation.org/ Gynecological medical care for women suffering from chronic fistulae (holes) between birth canal and other internal organs
http://www.ahopeforchildren.org/ Care for HIV/AIDS orphans
http://www.kmgselfhelp.org/ Women’s self-help groups in Ethiopia
http://plant-trees.org/projects/ethiopia.htm Trees for the Future Greener Ethiopia project
