How much do you know about the place called Ephrathah in the Bible? The ancient name for Bethlehem and the region around it, Ephrath or Ephrathah first appears in Genesis 35:16-20 as the place where Jacob’s beloved wife, Rachel, died.
The only Ephrathites mentioned by name in Scripture are Elimelech, his wife, and their two sons in Ruth 1:2 and David’s father, Jesse (“that Ephrathite of Bethlehem Judah”) in I Samuel 17:12.
The most famous mention of this region is Micah 5:2’s prophecy of the Messiah’s birth:
But you, Bethlehem Ephrathah, though you are little among the thousands of Judah, yet out of you shall come forth to Me the One to be Ruler in Israel, whose goings forth are from of old, from everlasting.
What does this have to do with chronic illness? When I recently saw this region mentioned again in the blessing of Bethlehem’s people on Boaz and Ruth at the end of her namesake book (“The LORD make the woman who is coming to your house like Rachel and Leah, the two who built the house of Israel; and may you prosper in Ephrathah and be famous in Bethlehem”), curiosity led me to a small study on the place, its name, and its meaning.
What I found showed me a beautiful new aspect of God’s character with a life-giving promise for those of us in chronic illness or any valley of affliction.

A Place of Ashes
If you’re familiar with the Hebrew language at any level or have sat under exegetical preaching for any length of time, you’ll know that the Old Testament is full of puns, plays on words, and multiple meanings that both God and His people used for humor, emphasis, or creativity.
As I discovered, the place name Ephratah has one of those double meanings. If you look it up in Blue Letter Bible, you’ll see that the place name eprat means both “ash-heap” and “place of fruitfulness.” How can this be? The name eprat comes from the root para, meaning “fruitful” or “to make fruitful,” which is similar to the word eper, translated “ashes.”
So in the place name Ephrathah we see a juxtaposition of two opposite ideas: fruit and ashes.
Let’s look at ashes first. How are they used in the Old Testament culture, what do they symbolize, and how does that meaning carry over to us today? Here are some verses that will give you an idea:
Then Abraham answered and said, “Indeed now, I who am but dust and ashes have taken it upon myself to speak to the Lord.”
Genesis 18:27
When Mordecai learned all that had happened, he tore his clothes and put on sackcloth and ashes, and went out into the midst of the city. He cried out with a loud and bitter cry.
Esther 4:1
And he took for himself a potsherd with which to scrape himself while he sat in the midst of the ashes.
Job 2:8
“Therefore I abhor myself, and repent in dust and ashes.”
Job 42:6
For I have eaten ashes like bread, and mingled my drink with weeping.
Psalm 102:9
He has also broken my teeth with gravel, and covered me with ashes.
Lamentations 3:16
Then I set my face toward the Lord God to make request by prayer and supplications, with fasting, sackcloth, and ashes.
Daniel 9:3
Then word came to the king of Nineveh; and he arose from his throne and laid aside his robe, covered himself with sackcloth and sat in ashes.
Jonah 3:6

My Nelson Study Bible says that putting ashes on one’s head and tearing one’s clothes “were traditional signs of grief and mourning among peoples of the ancient Middle East” (529). Sackcloth and ashes together “were used as a visible sign of mourning, indicating a sense of desolation” and lamentation (816, 1498).
Is this symbolism any surprise? Ashes are all that’s left after a fire, be it intentional or unintentional–good for nothing, no better than dirt, a handful of crumbled powder the only remnant of a cooking fire, a house, a city, a forest, a once-living body.
In vivid imagery Scripture gives us ashes as a symbol of mourning, loss, and humiliation.
If anyone can understand mourning, loss, and humiliation, it’s those of us with chronic illness. Are you, like Job, sitting in ashes of the life you once had? Have the flames of chronic illness swept through your body, your activities, your dreams and consumed them, leaving you with nothing but a handful of dry, gray powder that smudges everywhere and floats away on the wind?

If this is you, take heart: it turns out that ash (wood ash in particular) is a remarkable fertilizer for garden vitality and plant growth.
What kind of growth exactly? Let’s look at the second meaning of Ephrathah for the answer and some much-needed hope.
A Place of Fruit
As we’ve seen, Ephrathah means not just “ash-heap” but also “place of fruitfulness,” from the Hebrew word para. This root word translates into the terms “to bear fruit, be fruitful, branch off,” “to cause to bear fruit,” and “to make fruitful.”
Where else is this word used in the Old Testament, and what do these passages tell us about God and life?
And God blessed them, saying, “Be fruitful and multiply, and fill the waters in the seas, and let birds multiply on the earth.”
Genesis 1:22
I will make you exceedingly fruitful; and I will make nations of you, and kings shall come from you.
Genesis 17:6, God’s promise to Abraham
So Israel dwelt in the land of Egypt, in the country of Goshen; and they had possessions there and grew and multiplied exceedingly.
Genesis 47:27
“Little by little I will drive them out from before you, until you have increased, and you inherit the land.”
Exodus 23:30
Your wife shall be like a fruitful vine
Psalm 128:3
In the very heart of your house.
There shall come forth a Rod from the stem of Jesse, and a Branch shall grow out of his roots.
Isaiah 11:1
“Yet gleaning grapes will be left in it,
Isaiah 17:6
Like the shaking of an olive tree,
Two or three olives at the top of the uppermost bough,
Four or five in its most fruitful branches,”
Says the LORD God of Israel.
“Rain down, you heavens, from above,
Isaiah 45:8
And let the skies pour down righteousness;
Let the earth open, let them bring forth salvation,
And let righteousness spring up together.
I, the LORD, have created it.”

In these passages (not an exhaustive list) we see this idea of fruitfulness used to indicate children, populations, plants and trees, and life.
Ashes symbolize and can come from death, yet fruit means and comes from life.
God is a God of life. He is the ultimate life-giver, of physical life and eternal life, even in–and from–the ashes of our mourning.
I think we see this idea most beautifully expressed in the Messianic passage of Isaiah 61:1-3:
“The Spirit of the LORD God is upon Me,
Because the LORD has anointed Me . . .
To console those who mourn in Zion,
To give them beauty for ashes,
The oil of joy for mourning,
The garment of praise for the spirit of heaviness;
That they may be called trees of righteousness,
The planting of the LORD, that He may be glorified.”
But that’s not all. My word study took me to one more name, nestled inside one of Scripture’s most powerful stories of fruit given by God in the ashes of affliction.
Come back next week!