The information presented is taken from paraphrased notes of a recording of a 1-hour meeting held October 24, 2001 which was facilitated by Bria Chakofsky-Lewy, the Coordinator of the Community House Calls program; with Yodit Wengel-Mengst and Tsehay Demowez, HMC’s Ethiopian and Tigrean Caseworker Cultural Mediators (CCMs); and, Richard Harruff, Chief Medical Examiner Public Health Seattle & King County. Other attendees included Medical Examiner administrative staff, radiologists and pathologists.
What happens when there is a death in your community?
In Ethiopia, we have burial societies that operate when there is a death in a neighborhood community. Members of a burial society pitch in money every month for membership. When there is a death, the society is responsible for making the announcement and for taking care of all the organizational details of the funeral. In this way, death is a community responsibility. For three days after a death, a family doesn’t have to do anything except to mourn. The society members prepare food.
Back home, the news of death is orchestrated very carefully. If someone dies late in the day, the news is kept quiet, because there is not enough time left in the day to organize the burial. The announcement of the death is made the next morning when there is enough time for people to prepare for the burial. Sometimes, family members may know of a loved one’s death but remain quiet if it happens late in the day, in order to give enough time for people to organize. Burials don’t happen after 4:00 PM, so a person who dies later in the day will be buried the next day. A burial may happen on the same day as death when the death happens early in the day. The services may last all night long.
Delivery of news about death is one of the largest issues of difference for the Ethiopian community as compared with other communities. Back home when there is a death, the immediate family usually isn’t told right away. An elder is called upon to deliver the news. The Ethiopian CCM explained, “If a death happened in my family back home, my husband or my husband’s family would be informed first, and they would tell me at the right time, early in the morning before I left the house.”
Here in the United States, this news-telling tradition is not quite the same. A close friend or family relation, other than an immediate family member, is still told first. Often, this person is an elder.
Back home, the family will wash the body. Here, the funeral home washes the body and the family brings the clothing.
What happens if the Death was a suicide?
For the family, a suicide death is treated the same way as other death. The family mourns the same. However, the suicide death is different for the church. They don’t do the church service. For other deaths, they pray sometimes the whole night, they do a special service, a special ceremony. For suicide deaths, they don’t do any of that. They say God made you and will take you, so it is a sin to kill yourself. The family decides how they want to deliver the news to the priest. The family decides what to tell the priest. No social stigma is attached to suicide. It is for the family’s satisfaction of having the traditional ceremonies that they may say it is a natural death even if it is a suicide, knowing the priest will not see the paperwork. When a suicide does happen, there still would be burial in the cemetery of the community, even without church participation.
What should the medical examiner team do when encountering a death or suicide from your community?
The best action is to go to deliver the news with someone the family knows. It is better to contact someone from the community to help deliver the news than to go alone. If there is a situation where a parent passes away and the Medical Examiner can notify either the daughter or the son, it is not really important which one is chosen. However, a woman may handle the news more emotionally than her male counterpart. Delivering the news to the man instead of the woman would be because of this emotional difference between the sexes, not because he is any more important or responsible.
The following example was given by the Ethiopian Caseworker Cultural Mediator to illustrate the importance of calling upon community members to help deliver news of death:
“The ME office needed to know who to contact, and when we saw the patient, we knew who he was and we knew their family and we asked permission to deliver the message. We called the community board members to help us, and we delivered the news in the traditional cultural way. We contacted the father first, and we gathered the community, neighbors, close friends of theirs, and found someone to take care of the baby while we delivered the news. Several weeks later, the mother of the victim called to say thank you for delivering the news that way. She was home alone with the baby, and if the police had come to tell her that her son was dead, she doesn’t know what she would have done, maybe hurt the baby, out of control, she doesn’t know. She was very grateful.”
What is the best way to ask for and get information during this difficult time?
Ask family members directly and with respect or enlist the help of the community leaders.
What are the cultural beliefs about autopsies?
Beliefs about autopsy vary family to family. Some people may say, let the body rest. Some people may want to find out what happened. For this cultural group it is hard to generalize about autopsy. Some people think it is very helpful to understand the cause of death.
There is not a cultural or religious basis for objecting to autopsy. It is a family or an individual decision.
People may think the autopsy is done for medical reasons like for the doctor to know how someone dies. An understanding that autopsies performed by the medical examiners are done for legal reasons, rather than medical reasons, is not commonly understood, but the concept could be easily communicated.
What are the cultural beliefs about organ donation?
Organ donation, like autopsy, is also an individual or family’s decision and not influenced by culture. The family may be shocked if asked about organ donation at time of death because it may be hard to process that decision.
An idea is out there in the community of new immigrants, that taking organs might be like killing someone before they are dead in order to take their organs. Also, when a body is sent to Ethiopia and there has been a need to embalm the body, some people may think they (the doctors, authorities) are taking the organs.
Are there practices that maintain respect for the deceased and the family?
Shaking hands is common, even with women. A person can bow to show respect. In general, greetings common in America are used also by this immigrant community.
Body preparations require special care. For a deceased person from this community, it is better for the body to be cleaned and dressed by a person of the same-sex as a way to show respect. If a deceased person is a priest, the washing is done with his group of priests and no one else can touch the body.
The practice of delivering the news to a family with the assistance of a community member who knows the family is an important way of showing respect.
What resources can we access for cultural clarification, guidance and translation?
Community House Call Program
Supervisor, Bria Chakofsky-Lewy, pager 206-680-6862
Caseworker Cultural Mediator (CCM), Amharic-speaking, Yodit Wongele-Mengist 206-744-9266
CCM, Tigrinya-speaking, Tsehay Demowez 206-744-9264
Ethiopian Community Mutual Association (ECMA)
2301 South Jackson Street
Seattle, Washington 98144 Office Phone: 206-325-0304 ; Office FAX: 206-352-0304
“We help bridge the gap created by language and culture barriers, which often prevents Ethiopian immigrants and refugees access to basic government services, such as health care, education, and housing. We promote and strive to instill social and cultural identity and values to Ethiopian youth through cultural gathering, sports and recreation activities.”
Ethiopian Orthodox Churches:
Saint Gebriel Ethiopian Orthodox Tewahedo Church – 940 26 Ave. S Seattle, WA 98144; Tel: (206) 720-0827
Emmanuel Ethiopian Orthodox Church – 1317 S Hill St Seattle, WA 98144-4281; (206) 324-9958
What Funeral Homes and Cemeteries are used by your Community?
The most used funeral home is Columbia Funeral Home, Seattle, WA.
Comments by Abba Haddis Gedey, Ethiopian Orthodox Priest
After having read your paper entitled “Medical Examiner Ethiopian Orthodox Christian Encounter” I am glad to say that Yodit Wengele Mengst and Tsehay Demowez have done their best and I would like to thank them for the efforts they made.
As I see it, in this dimension of importance, culture and medical essentiality in the contemporary world should not be seen as separate entities.
We all acknowledge the cultural and religious values on one hand, and the medical essentiality on the other. Both are fundamentally vital and universal. Generally speaking as medical essentiality is universal, free-will and faculty of thoughts are also pre-eminently processed as make-up of birth right of mankind.
On the other hand, the medical knowledge mankind applies today will inevitably provide a new union of hope to humanity that could inspire the consciousness of man as to acknowledge the sacrosanctity of life. Another perspective to discern in culture is also unique and pragmatic factor: mutual harmony is obvious method of serving the application of medical and cultural values. It would be utterly wrong to separate the one from the other because both are part of the human expectations. In the very notion of creation, man is not only a being of physiological, physical, psychological and sociological function but also as a citizen of God’s kingdom. Therefore, his sacred life involves eternal values and God Himself. A visionary theologian once said, “We must be careful to retain the individuality of the individuals and the personality of the person or else the humanity of the human may be lost.”