How Did the Derashe Illness Last for Years?

Introduction

The Derashe outbreak is one of Ethiopia’s best-documented examples of a prolonged community illness that researchers describe as mass psychogenic illness rather than an infectious epidemic. Beginning in 2012 in southern Ethiopia, the episode reportedly affected around 120 women over several years after the death of a well-known local woman from complications of breast cancer. What made the event unusual was not simply the number of people involved, but the way grief, fear, rumours and uncertainty became woven into everyday community life. Rather than disappearing within days or weeks, the illness persisted because many people believed it was contagious or caused by supernatural or environmental forces, while early official communication failed to provide convincing explanations.[PMC]pmc.ncbi.nlm.nih.govtional study - PMCJune 7, 2018…Published: June 7, 2018

The Derashe case is important because it illustrates how genuine suffering can become socially reinforced even when medical investigations find no evidence of a shared physical disease. It also demonstrates why respectful communication and community engagement are as important as clinical investigation during unexplained illness outbreaks.

The death that preceded the first reported cases

Researchers traced the beginning of the outbreak to the death of a 43-year-old socially respected and active woman who had suffered complications from breast cancer. Soon afterwards, other women began reporting symptoms that resembled what they believed she had experienced. The illness spread gradually through two neighbouring communities in Derashe Woreda rather than appearing suddenly as a conventional epidemic.[PMC]pmc.ncbi.nlm.nih.govtional study - PMCJune 7, 2018…Published: June 7, 2018

By the time investigators carried out a detailed community study in 2015, approximately 120 women had reportedly been affected. Ninety-seven women participated in the main quantitative investigation, while focus groups and interviews with community members, local health workers and officials explored how people understood the illness.[PMC]pmc.ncbi.nlm.nih.govtional study - PMCJune 7, 2018…Published: June 7, 2018

The women consistently described physical symptoms rather than vague feelings of anxiety. Common complaints included:

Medical examinations, however, did not identify breast cancer or another shared physical condition that could explain the pattern across the affected women.[Springer Link]link.springer.comSpringer LinkChronic mass psychogenic illness among women in Derashe Woreda, Segen Area People Zone, southern Ethiopia: a community based…

How symptoms became embedded in community life

Unlike many school-based episodes of mass psychogenic illness, the Derashe outbreak continued for years. Researchers argue that several interacting factors helped sustain it rather than allowing it to fade quickly.[PMC]pmc.ncbi.nlm.nih.govtional study - PMCJune 7, 2018…Published: June 7, 2018

Rumours spread largely through conversation rather than official information. Nearly 90% of participants reported first hearing about the illness through gossip or indirect discussion, while very few initially received information from health professionals. As stories circulated, many women became increasingly alert to ordinary bodily sensations that could be interpreted as signs of the feared disease.[Springer Link]link.springer.comSpringer LinkChronic mass psychogenic illness among women in Derashe Woreda, Segen Area People Zone, southern Ethiopia: a community based…

The study also found that many participants had experienced significant personal stress before developing symptoms. Bereavement, illness within the family, financial hardship, family conflict and other psychosocial pressures were commonly reported. Researchers did not suggest that stress alone “caused” the illness, but concluded that these pressures likely made the community more vulnerable to developing and sustaining shared illness beliefs.[PMC]pmc.ncbi.nlm.nih.govtional study - PMCJune 7, 2018…Published: June 7, 2018

Importantly, the symptoms were experienced as real. Mass psychogenic illness does not imply deliberate deception or fabrication. Physical pain, dizziness, weakness and other symptoms can arise through complex interactions between stress, expectation, attention and social influence without conscious intent.[PMC]pmc.ncbi.nlm.nih.govtional study - PMCJune 7, 2018…Published: June 7, 2018

Why fear spread beyond the affected women

One of the most damaging consequences was not the symptoms themselves but the belief that the illness could spread through ordinary social contact.

Researchers recorded a range of explanations circulating within the community. Some women believed the illness represented divine punishment. Others suspected environmental pollution, toxic chemicals, witchcraft, ancestral curses or other causes. More than half said they simply did not know what was causing the condition.[PMC]pmc.ncbi.nlm.nih.govtional study - PMCJune 7, 2018…Published: June 7, 2018

Because many people regarded the illness as contagious:

These responses reinforced fear. As more people avoided affected women, the apparent seriousness of the illness seemed confirmed, making rumours more persuasive and recovery more difficult.

Community responses and treatment seeking

The response of affected women reflected uncertainty rather than blind acceptance of a single explanation.

Around three-quarters sought care from modern health services. Nearly two-thirds also consulted traditional healers, and many used both systems. Smaller numbers sought religious healing, while a few pursued modern medicine, traditional healing and religious treatment simultaneously.[PMC]pmc.ncbi.nlm.nih.govtional study - PMCJune 7, 2018…Published: June 7, 2018

Traditional treatments reportedly included herbal preparations and cauterisation with heated metal. These approaches reflected attempts to relieve genuine suffering rather than rejection of modern medicine. In practice, many women moved between different forms of care because no single explanation appeared convincing or consistently effective.[PMC]pmc.ncbi.nlm.nih.govtional study - PMCJune 7, 2018…Published: June 7, 2018

Interviews also revealed widespread frustration. Participants repeatedly asked authorities to explain what was happening, illustrating that uncertainty itself became part of the crisis.[PMC]pmc.ncbi.nlm.nih.govtional study - PMCJune 7, 2018…Published: June 7, 2018

What a more humane public-health response required

The Derashe study is notable because it criticised not the community but the initial response.

Researchers concluded that the outbreak lasted far longer than necessary because health workers themselves were uncertain how to respond. Local services often referred cases onwards without providing clear explanations, leaving rumours to fill the information gap. Extensive investigation without effective communication sometimes strengthened the belief that an undiscovered disease must exist.[PMC]pmc.ncbi.nlm.nih.govtional study - PMCJune 7, 2018…Published: June 7, 2018

The authors argued that a more effective response required several elements working together:

The researchers emphasised that simply telling people “nothing is wrong” would have been ineffective. Successful management depended on recognising real distress while explaining how genuine physical symptoms can occur without a contagious disease.

Why the Derashe outbreak remains significant

The Derashe outbreak occupies an important place in Ethiopia’s history of collective illness because it shows that prolonged community health scares do not require a malicious rumour campaign, a charismatic movement or sensational media coverage. Instead, they can emerge from ordinary social processes when grief, uncertainty and incomplete information reinforce one another.

For historians, psychologists and public-health specialists, the episode demonstrates how social memory can shape bodily experience. The death of one respected woman became the reference point through which many others interpreted their own symptoms. For public-health practitioners, it illustrates that early, compassionate communication is not an optional addition to outbreak management but a central intervention in its own right.[PMC]pmc.ncbi.nlm.nih.govtional study - PMCJune 7, 2018…Published: June 7, 2018

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Endnotes

1. Source: pmc.ncbi.nlm.nih.gov
Link:https://pmc.ncbi.nlm.nih.gov/articles/PMC5992694/

Published: June 7, 2018

2. Source: link.springer.com
Link:https://link.springer.com/article/10.1186/s13033

3. Source: pubmed.ncbi.nlm.nih.gov
Link:https://pubmed.ncbi.nlm.nih.gov/38478508/

4. Source: pmc.ncbi.nlm.nih.gov
Link:https://pmc.ncbi.nlm.nih.gov/articles/PMC9302037/

5. Source: pmc.ncbi.nlm.nih.gov
Link:https://pmc.ncbi.nlm.nih.gov/articles/PMC9210177/

6. Source: pubmed.ncbi.nlm.nih.gov
Link:https://pubmed.ncbi.nlm.nih.gov/34970651/

7. Source: pmc.ncbi.nlm.nih.gov
Link:https://pmc.ncbi.nlm.nih.gov/articles/PMC8712503/

8. Source: pmc.ncbi.nlm.nih.gov
Link:https://pmc.ncbi.nlm.nih.gov/articles/PMC7396040/

9. Source: pubmed.ncbi.nlm.nih.gov
Link:https://pubmed.ncbi.nlm.nih.gov/32775400/

10. Source: pubmed.ncbi.nlm.nih.gov
Link:https://pubmed.ncbi.nlm.nih.gov/28496370/

11. Source: ouci.dntb.gov.ua
Link:https://ouci.dntb.gov.ua/en/works/4Kpj5p3l/

Additional References

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Link:https://drpress.org/ojs/index.php/EHSS/article/view/6439

13. Source: youtube.com
Title: Understanding Contagious Belief and Unexplained Illness
Link:https://www.youtube.com/watch?v=yRwFilSEGQ0

14. Source: youtube.com
Title: Collective Trauma and Community Health Response
Link:https://www.youtube.com/watch?v=VC-wx6-R0h8

15. Source: youtube.com
Title: The Tanganyika Laughter Epidemic: How Social Illness Spreads
Link:https://www.youtube.com/watch?v=sbBuqrW6BHw

16. Source: youtube.com
Title: Grief, Stress and Mass Psychogenic Illness in Ethiopia
Link:https://www.youtube.com/watch?v=Fw910y8u4Dk

17. Source: researchgate.net
Link:https://www.researchgate.net/publication/325637909_Chronic_mass_psychogenic_illness_among_women_in_Derashe_Woreda_Segen_Area_People_Zone_southern_Ethiopia_A_community_based_cross-sectional_study

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Link:https://doaj.org/article/89c31f37d8254cddafa7ed9e24d8b3f7

20. Source: frontiersin.org
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21. Source: youtube.com
Title: Communicating during Medical Mysteries: Lessons in Community Engagement
Link:https://www.youtube.com/watch?v=u0fFIJapsRY