Traditional medicine in Tanga today : the ancient and modern worlds meet

IK Notes Traditional Medicine in Tanga T Tanga oday Today The Ancient and Modern Worlds Meet F or centuries, traditional healers have been the main providers of primary health care to most Tan- ter death. The mummified Pharaohs were preserved by using plants, herbs, spices, and minerals. Up until 150 zanians. Today, healers in Africa, espe- years ago, the sciences of botany and cially in Tanga, still play crucial roles medicine were the same. since — in addition to their roles as Plants have medicinal qualities due primary health care providers -- they to the substances they produce to pro- carry the burden of care for treating tect themselves from insect pests and people with HIV/AIDS. In Tanga, the pathogens. We just "borrow" these sub- Tanga AIDS Working Group (TAWG) — stances to treat our own viral, fungal, situated in historic Cliff Block of and bacterial infections. Many medi- Bombo Hospital — has been success- cines are extracted from the roots, fully collaborating with traditional root bark, and bark of plants since healers since 1990. This is the story of these areas are the most vulnerable a promising partnership between the and provide a plant's first line of de- ancient and modern worlds to combat fense against an invader. HIV/AIDS. Within seconds of an attack, plants No. 51 begin producing and excreting a potent December 2002 A thumbnail sketch of medicinal IK Notes reports periodically on plants Indigenous Knowledge (IK) initiatives in Sub-Saharan Africa and occasionally Plants have been used as primary on such initiatives outside the Region. sources of medicine for thousands of It is published by the Africa Region’s Knowledge and Learning Center as years and were our very first medi- part of an evolving IK partnership cines. Over 4,000 years ago, the Red between the World Bank, communi- Emperor of China published a list of ties, NGOs, development institutions and multilateral organizations. The 4,000 medicinal plants. Literature views expressed in this article are World Bank about Babylonian medicinal plants was those of the authors and should not be compiled in 1770 BC. The ancient attributed to the World Bank Group or its partners in this initiative. A Egyptians even placed medicinal plants webpage on IK is available at // in Pyramids to treat their Pharaohs af- www.worldbank.org/afr/ik/ default.htm 2 array of substances that are lethal or toxic to the invading cristine (first choice drugs treating Hodgkin's Disease, Acute virus, bacteria, fungus, insect — or even mammal. Individual Leukemia, various lymphomas, Advanced Breast Cancer, and plants can produce up to approximately 1,000 unique chemi- now HIV related Kaposi's Sarcoma) from the rosy periwinkle cals. Hence a natural anti-viral produced by a plant to defend — which grows right here in Tanga — and now cotexin from itself can also be used by a human as an anti-viral. Artemisia annua for treating malaria. Traditional healers in Tanzania have been identifying, ex- perimenting, and using these substances to treat patients for A thumbnail sketch of traditional healers in Tanga millennia. By combining forces with them, we have access to thousands of years of research results. This is commonly Tanga District has approximately 670 traditional healers known as indigenous knowledge (IK). (Waganga). 337 are in Tanga Urban District and 333 are in Many of today's modern medicines are derived from plants. Tanga Rural. The average age of a healer is 52. Most are Over 120 pharmaceutical products are derived from plants, Muslim and have been practicing for an average of 19 years. and 74% were first used by native cultures! The correlation There is one healer for every 343 residents of Tanga town between healer use and positive lab results is clear. Data and one healer for every 146 rural residents. There is only clearly indicates that plants collected from healers provide one western trained medical doctor in Tanzania for every more solid leads toward developing new drugs than random 33,000 residents. Therefore, many more people receive screening. Twenty-five percent of our present perscription health care from healers than from conventional health drugs are derived from plants. The best known are quinine workers. Many healers have participated in TAWG Seminars. from the cinchona tree, morphine from the poppy, aspirin These figures positively correlate with data from Sub Sa- from the willow, digitalis from foxglove, vinblastine and vin- haran Africa. Healers are already in place; health ministries do not have to assign them since virtually all villages have residential healers and traditional birth attendants. This is IK Notes would be of interest to: especially true in rural areas where modern medicine is much less available than in towns. Hence, combining forces with healers to combat HIV/AIDS and promote public health makes very good sense. Name Healers in Tanga are mostly herbalists, diviners, mediums, Institution surgeons, midwives, and traditional psychiatrists. The major- ity use some of the many medicinal plants available in this biologically diverse region. The Eastern Arc range of moun- Address tains, which includes Amani in Muheza district, is one of only 20 biological hotspots in the entire world. A hotspot is a re- gion characterized by an unusually diverse range of species, many endemic to the area. Amani has the second highest amount of biodiversity in Africa — a site in Cameroon is Letters, comments, and requests for publications first. should be addressed to: Healers have specialized knowledge for treating physical, Editor: IK Notes cultural, and psychological ailments. Healers are accessible, Knowledge and Learning Center affordable, usually have credibility, and in Tanga have a trea- Africa Region, World Bank 1818 H Street, N.W., Room J5-055 sure trove of biological diversity from which to collect effica- Washington, D.C. 20433 cious plants. E-mail: pmohan@worldbank.org  3 Healers and doctors join forces in Tanga The original three plants - along with others that have been added — are still used to treat a variety of opportunis- In order for public health goals to be realized in Africa, heal- tic infections commonly caused by HIV/AIDS. Waziri was a ers should be active participants in the health system. This real pioneer. He readily shared his knowledge and gener- makes good sense, since each community has it's very own ously agreed to have his plants scientifically identified by indigenous healers. In Tanga, TAWG has received interna- botanists from the Lushoto Herbarium in Lushoto, Tanga tional recognition of its innovative work with traditional Region. healers, and has received support from OXFAM, the World TAWG eventually developed a home care service to deliver Bank, and USAID. the plant remedies to HIV/AIDS patients and their families. Today in Tanga, traditional healers and modern physicians Home visits are the foundation of the TAWG's day-to-day and health workers have combined forces in an exciting and work. Activities include monitoring general health, adminis- promising program implemented by TAWG. TAWG is an inno- tering traditional remedies, and providing counseling for pa- vative non-governmental organization (NGO) that links tra- tients and their relatives. ditional healers, physicians and health workers, botanists, In 1994, TAWG was officially registered as the Tanga AIDS social scientists, and people living with AIDS (PLWAs). Working Group (TAWG) with the Ministry of Home Affairs. TAWG's goal is to bridge the gap between traditional and TAWG is the leading HIV/AIDS NGO in Tanga Region. Its western biomedicine by treating PLWAs with traditional staff are highly qualified, dedicated, and committed to im- medicine. proving the quality of PLWAs lives. Members have expertise TAWG evolved from meetings that a German physician and in counseling, psychology, medicine, education, botany, re- his Tanzanian colleagues initiated with traditional healers in search, medical anthropology, and management. TAWG's Pangani, a coastal town 50 kilometers south of Tanga in work is an outstanding example of how positive results can 1990. The health workers observed that many patients — be achieved in the fight against AIDS by synergistically com- this is true throughout sub-Saharan Africa — visited both the bining local expertise, indigenous knowledge, and modern hospital and traditional healers. Hence, they decided to health workers to provide effective low cost treatment for make contact with local healers in hopes of initiating a refer- people living with AIDS. ral network. They were successful, and their network evolved into TAWG. Healers responded enthusiastically to the initiative. They Thumbnail sketch of TAWG's treatment program relished being taken seriously and treated like fellow profes- TAWG's signature activity is treating patients in the hospital sionals. The initial dialogue evolved into meetings where or at home with medicinal plants. In the newspaper Nipashe participants discussed how to treat various ailments, when to dated February 23, 2002, TAWG has reported that its treat- refer a patient to the hospital, public health issues, and how ment generally lengthens patients' lives and that some pa- to cooperate with biomedical personnel. One day the subject tients who were in bad shape clearly improved after taking was HIV/AIDS. the traditional medicines ( Dr. Samuel Mtullu, Nipashe, Feb- Waziri Mrisho, a 84-year-old healer, asked if he could try ruary 23, 2002 ). The medicines are more effective, however, treating HIV/AIDS in-patients. The group agreed, and Waziri if treatment is initiated during the early stages of HIV/AIDS. treated a few confirmed HIV+ patients with three plants The medicines are low cost, effectively treat selected oppor- TAWG still uses today. tunistic infections, readily available, are provided to patients Bio-medical personnel soon observed that patients treated free of charge, and have been used for Tanzanian healers for with Waziri's three plants generally had improved appetites, centuries. Given in the proper form and dosage, they are gained weight, suffered from fewer and less severe opportunis- very safe. tic infections, and enjoyed improved health and well being. The TAWG's medicines increase appetite, help patients gain plant remedies soon became the hospital's standard HIV/AIDS weight, stop diarrhea, reduce fever, clear up oral thrush, re- treatment for patients who preferred herbal medicine. 4 solve skin rashes and fungal infections, treat herpes zoster, and clear ulcers. Treating patients extends their longevity, improves the quality of their lives, and reduces the number This article was written by David Scheinman. of orphans since parents remain alive. TAWG welcomes inquiries and visitors. See for yourself or TAWG also works closely with the government, runs semi- call TAWG for more information. TAWG's coordinates are: nars for traditional healers, and has an effective education Location: Cliff Block Bombo Hospital Tanga and HIV/AIDS prevention program. Address: Box 1374 Tanga It currently treats around 400 patients in Tanga, Pangani, Phone/FAX: 255-27 264-2266 and Muheza Districts. Since TAWG began in 1990 they have Email: Tawg@tanga.net treated around 2,000 patients. During the last six months, Website: http://user.tanga.net/tawg the amount of patients treated has doubled, indicating the Contacts: Dr. Samuel Mtullu — Coordinator rising number of HIV/AIDS cases. Dr, Anna Chaze —Chairperson TAWG's collaboration with traditional healers and the Min- Dr. Firmina Mberesero — Former Chairperson and istry of Health has created a small island of hope in this sea- Board Member side town. Patients are now living longer and better lives, Ken Down — Project Advisor and consequently there are fewer recently-orphaned chil- dren. Healers have taken the prevention and public health messages back to their villages and many know when to refer a patient to the hospital. Though not a cure, the traditional medicines prolong life by combating pathogens similar to those that attack plants. At least now, patients in Tanga region, and Tanzania, have a low- cost effective alternative to expensive imported therapies. Incidentally, these expensive new therapies often tend to lose their knockout punch over time. Hence, treating pa- tients with traditional medicines has as much validity now as it did thousands of years ago. By having healers and doctors synergistically combine forces, new trails are being blazed which benefit everybody.