1. The Ethiopian –Israeli Jewish Community and Its Health Care Issues By Seffefe B.Ayecheh, M.P.H., Ph.D.

2. Tene Briut The main objectives of this organization can be summarized as a. strengthening community health care promotion, research and documentation and b. health care advocacy for improved heath care for the community by calling for appropriate and pragmatic health policy developments.

3. The size of the Ethiopian –Israeli Jewish Community in Israel to-day is estimated to be 110,000, of which about 30% were born in Israel. The majority of Ethiopians are settled in permanent housing in the larger cities. The migration process is still continuing; however, only a very small number of people (about 300 persons on the monthly quota basis) are allowed to come. They are waiting to come

4. In general, our life has changed drastically from its traditional village life style to an urban –westernized style of life: the change of the familiar extended family, and its hierarchical structure and customs, the changes of the role play in the families, and even the gap created between the parents and the younger children (due to children's capacity for faster adaptation),and to certain extent the discrimination, aggravated the problem and led to a state of cultural shock To these effects the divorce rate, violence in the families, the youth delinquency and even suicides and homicides are increasing.

5. T he tremendous resource investment and efforts done by the government, the general society and the overseas donors has of course brought about mid-term successes for the younger- aged population of the community. To cite a few, the integration in the Israeli defense force by achieving even higher military ranks, the higher education opportunity in universities and colleges growing to over 3500 students and graduates, and the establishments of several social, educational and political lobbyist organizations of the community are vivid and encouraging examples that can give very optimistic feelings for all the devoted actors.

6. However, regarding the health of the community, all those compounding factors mentioned above as a whole, have brought about negative changes in the community's health conditions. In their past health experiences, the main health problems of the Ethiopians were infectious and parasitic diseases due to uncontrolled environmental conditions, and diseases and conditions caused by under-nutrition and lack of health care services.

7. The Tene Briut Health Care Association was formed with new concepts and perceptions and developed a culturally sensitive model and approach which could also brought about the direct and active involvement of the community and the health and other professionals from with in the community, aiming at empowerment purposes..

8. The Tene Briut Health Care Association has accomplished the following key objectives 1. Held National Health Conference of Ethiopian-Israeli professionals in the year 2001 with 220 participants to develop new initiatives and establishment of network for professionals. 2. Recruited and trained more than 25 Ethiopian-Israeli professionals as “health trustees” to improve community based diabetes improvement activities and advancement of health promotion missions. 3. Installed personal responsibility and increased community awareness of health promotion and its importance to disease management, and disease prevention. We provided lectures in Amharic to more than one hundred groups all over the country. 4. Developed culturally sensitive instructional materials such as educational booklets, educational film, posters, computerized lecture slides etc. to facilitate health promotion activities. 5. Developed a monthly radio program in Amharic language running regularly to address the community on selected diseases and heath conditions

9. Our specific objectives in the coming year are 1. To strengthen and continue those achieved goals mentioned above, by broadening the coverage and increasing the quality of the services. Specifically, we are placing “health trustees” in one community and, in cooperation with the health system, plan to follow five hundred diabetics (in cooperation with the local Kupahs) with the objective of improving their understanding of the disease together with its management. 2. Once we are able to document the cost-effectiveness of the health trustee intervention in several sites, we plan to work collaboratively with the government and health care system to disseminate this key way of preventing and managing the emerging epidemic of chronic disease in our community.