Using Traditional Burial Societies Iddirs for Referrals in Ethiopia

Worldwide Hospice Palliative Care Alliance & Hospice Ethiopia

Photo credit: Zelalem Gizachem

Merht (not her real name) a 30 year old married woman was diagnosed with HIV three years ago. She is currently on antiretroviral medications and lives in government housing in Gulele, a sub city of the capital. The house is made of corrugated iron sheets; electricity is intermittent with no piped water. She has to collect water from a communal pump five minutes away from her house. Merht suffered from side pains, had difficulty urinating and had a smelly discharge. She was left by her husband because of her health condition.

She was referred to Hospice Ethiopia by a community volunteer Dawit who was working with one of the local traditional burial society called iddir.  An iddir is an Ethiopian financial and social institution. Originally groups were formed to help bury their dead; however, the groups are now more wide-ranging including financial and material assistance to group members. Hospice Ethiopia is using iddirs to create awareness about palliative care and the services that they provide for the local community. Because of this initiative, the local iddirs help Dawit identify needy patients and they referred Merht to him.

Merht was given pain medication and put on antibiotics for urinary tract infection and vaginal discharge. She was given financial and emotional support. This lead to an improvement in her condition, and consequently her husband returned home and they now live as a family again. Hospice and palliative care work is very limited in Ethiopia. Hospice Ethiopia is the only organisation providing this service in a country of 85 million people, 78 % of whom are living below the poverty line. Without the help of iddirs, identifying beneficiaries like Merht would have been difficult. By working with culturally appropriate groups, Hospice Ethiopia is better able to deliver much needed palliative care.