Health and safety in Ethiopia



With Dr Felicity Nicholson. For up-to-date information on health issues across Africa, click here.

Ethiopia, like most parts of Africa, is home to several tropical diseases unfamiliar to people living in more temperate and sanitary climates. However, with adequate preparation, and a sensible attitude to malaria prevention, the chances of serious mishap are small. To put this in perspective, your greatest concern after malaria should not be the combined exotica of venomous snakes, stampeding wildlife, gun-happy soldiers or the Ebola virus, but something altogether more mundane: a road accident.

Within Ethiopia, adequate (but well short of world-class) clinics and hospitals can be found in Addis Ababa and a few other major centres, while functional doctor’s rooms (known as ‘higher clinics’), laboratories and pharmacies are available countrywide. Wherever you go, doctors and pharmacists will generally speak passable English, and consultation and laboratory fees (in particular malaria tests) are inexpensive by international standards – so if in doubt, seek medical help.


Ethiopia is generally a very safe country. Casual theft and pickpocketing are fairly commonplace in parts of the country, most notably Addis Ababa, but this sort of thing is almost never accompanied by violence. In Addis, pickpockets might operate anywhere, but favoured areas are the Mercato, and in the vicinity of government hotels in the city centre. Violent crime isn’t a cause for serious concern, but as in any large city one should not wander around at night with a large amount of money or important documents.

In other parts of Ethiopia, the risk of encountering pickpockets is mainly confined to bus stations and markets, and even then only in larger towns. At bus stations, this is most likely to be a loner operating in the surge of people getting onto a bus. In the streets, a favoured trick is for one person to distract you by bumping into you or grabbing your arm, while a second person slips his fingers into your pocket from the other side. It’s advisable to leave valuables and any money you don’t need in a hotel room, to carry the money you do need in a relatively inaccessible place, and to always turn quickly in the other direction if somebody does bump into you or grab you. A useful ruse is to stuff something bulky but valueless (a bit of scrunched-up tissue or an empty cigarette pack) as a decoy in a more accessible pocket. If you need to go out with important documents or foreign currency, carry it in a concealed money-belt, and carry some cash separately so that you need not reveal your money-belt in public.

Thieves often pick up on uncertainty and home in on what they perceive to be an easy victim. In Addis Ababa, where there are plenty of experienced thieves and con artists, always walk quickly and decisively. When you arrive in a new town by bus, stroll out of the bus station quickly and confidently as if you know exactly where you’re going (even if you don’t). Avoid letting the kids who often hang around bus stations latch on to you. Once through the crowds, you can sit down somewhere and check your map, or ask for directions.

One area of risk that is difficult to quantify is that of armed bandits – shifta – holding up a bus. This was quite commonplace a few years ago, but is no longer a serious cause for concern, except perhaps in eastern areas near the Somali border. That said, the sporadic anti-government protests that have broken out in various parts of Oromo and Amhara since 2016 have forced the temporary closure of several roads and have resulted in several attacks on buses and fatal clashes between different ethnic groups or the militia and civilians. Tourists are not likely to be the direct target of any such violence, but there is a risk of being caught in the crossfire, or of having one’s travel plans disrupted by road closures, such as occurred between Awash and Harar in December 2017 and between Dessie and Weldiya in February 2018. Keep your ear to the ground.

It is easy enough to let warnings about theft induce an element of paranoia into your thinking. There is no cause for this sort of overreaction. If you are moderately careful and sensible, the chance of hitting anything more serious than pickpocketing is very small. Far more remarkable than the odd bit of theft, especially when you consider how much poverty there is in the country, is the overwhelming honesty that is the norm in Ethiopia.

Women travellers

We get very mixed feedback from female visitors to Ethiopia. Broadly speaking, most actual travellers, even those on a tight budget, regard it to be a safe and hassle-free country for women by international standards. All told, the risk of rape or seriously threatening harassment is probably lower than in many Westernised countries. Teenage boys yelling obscenities at women, though unpleasant, is ultimately a less innocuous variation on the sort of verbal crap that all single travellers have to put up with from time to time in Ethiopia. Even so, it is not an everyday occurrence (unless perhaps you settle in Shashemene), and it is most unlikely to occur in the company of a respected guide or another local person. Women travellers are less likely to hit problems if they refrain from drinking alone, avoid staying in local hotels at the brothel-cum-barroom end of the price scale, and turn down any invitation that could be construed as a potential date.

Dress may also play a role in how you are perceived. In rural areas particularly, both Muslim and Christian, it is good sense to look to what local women wear and follow their lead. To quote a former volunteer: ‘If I wear sleeveless clothes then I tend to get a constant stream of comments and stares, even in Addis Ababa, so I wouldn’t dress in this manner in smaller towns where faranjis are few and far between.’ Another reader adds: ‘We came prepared with skirts and headscarves, but there was no need to wear them. We wore pants/trousers and that was acceptable. I saw some women travellers wearing shorts, but I’m not sure that I’d feel comfortable with that unless they extended below the knee – even then I’d think twice.’

A couple of readers have highlighted the problems specifically facing black female travellers in Ethiopia, where women retain a somewhat subservient role by Western standards. European women are not expected to fit the mould, but nobody seems quite certain on which side of the chasm to place black Western women. Black women who travel alone in Ethiopia are in for a strange time, and they will often experience African sexual attitudes at first hand. The obvious area of solution is to dress and carry yourself in a manner that precludes confusion: don’t come with a rucksack full of flowing African dresses and bright blouses, but rather wear jeans or preppy clothes, things that would rarely be seen on an Ethiopian woman.

LGBT travellers 

Homosexual activity, both male and female, is illegal in Ethiopia, and punishable by up to 15 years’ imprisonment. Homosexuality is also regarded as sinful by the Ethiopian Orthodox Church and by Islamic law, for which reason the vast majority of Ethiopians (as many as 97% according to a 2007 Pew Global Attitudes Project)  consider it to be unacceptable behaviour. In 2008, a group of prominent religious figures, including the heads of the Orthodox, Protestant and Catholic churches, urged the government to enact a constitutional ban on homosexual activity, likening it to bestiality and blaming it for a perceived rise in sexual attacks on children and young men. None of which necessarily amounts to an obstacle for gay or lesbian travellers wishing to visit Ethiopia, provided they are willing to be discreet about their sexuality. Note, too, that most hotels forbid two men (and in some cases two women) from sharing a room with a double bed.