In the absence of other treatments, most Ethiopians rely on traditional medicine. Ethiopian healers are of two kinds: ones sanctioned by the church, and faith healers. Healers employ plant, animal and mineral products honey for chest ailments, rosewood for tapeworm and jasmine for an upset stomach. Many Ethiopians also believe that a zar (spirit) can cause mental and physical illness. Spiritual healers use a variety of techniques to drive out the invading force. Childbirth usually occurs at home, supervised by a midwife. Women are supported through labour by other women.
Western medicine was introduced to Ethiopia in the 19th century. Throughout the 20th century, governments initiated programs to train healthcare staff and establish care facilities. Since1977, free medical care has been available to the needy, and there are many private hospitals. Yet the country still has a severe shortage of physicians and nurses. Most facilities are in urban areas, where only a minority of the population lives. Consequently, people often seek care from local pharmacists, who have training in identifying diseases and prescribing medicines.
Ethiopia has one of the world's lowest life expectancy rates: only 44 years. Infant mortality is high, at 100 deaths for 1,000 live births. Many health problems in Ethiopia are related to poor sanitation. Three-quarters of the population has no access to clean drinking water. Dysentery, gastrointestinal infections and parasites are widespread. Malnutrition, linked to the famines of recent decades, has also made the population more vulnerable to epidemics; consequently, communicable diseases such as tuberculosis and hepatitis affect many. Particularly in the cities, AIDS and other venereal diseases have become a serious concern.
International organizations such as UNICEF and the World Health Organization have been working in Ethiopia for decades to provide relief and help build the country's healthcare infrastructure. With foreign assistance, the government has been able to launch preventative programs, including vaccinations. Yet people's isolation from facilities makes effective immunization programs difficult. Furthermore, low literacy hampers the dissemination of information on sanitation strategies, such as preventing well contamination and preserving food. However, smallpox has been eradicated, and the incidence of malaria, typhoid and other diseases greatly reduced.