251 q H Traditional Medicine in Tanga Today The Ancient and Modern Worlds Meet ZF<1 or centuries, traditional healers ter death. The mummified Pharaohs have been the main providers of were preserved by using plants, herbs, primary health care to most Tan- 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 "borrov.' these sub- TangaAIDS 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 - plants IK Notes reports periodically on Indigenous Knowledge (II) 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 years and were our very first medi- Knowledge and Learning Center as - part of an evolving IK partnership cines. Over 4,000 years ago, the Red between the NVorld Bank, communi- Emperor of China published a list of ties, NGOs, development institutions 4,000 medicinal plants. Literature and multilateral organizations. The +~~O 4,000 medicinal plants. Literature views expressed in this article are about Babylonian medicinal plants Nvas those of the authors and should not be S compiled in 1770 BC. The ancient attributed to the WVorld Bank Group compiled in 1770 BC. The ancient 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- wwwworldbank.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). (ATaganga). 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. `wventy-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 especially true in rural areas where modern medicine is IK N o tes much less available than in towns. Hence, combining forces would be of interest to: with healers to combat HIV/AIDS and promote public health makes very good sense. Name Healers in Tanga are mostly herbalists, diviners, mediums, Instituition surgeons, midwives, and traditional psychiatrists. The major- ity use some of the many medicinal plants available in this Address biologically diverse region. The Eastern Arc range of moun- 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 sure trove of biological diversity from which to collect effica- 1818 H Street, N.W., Room J5-055 Washington, D.C. 20433 cious plants. E-mail: pmohan@worldbank.org 3 Healers and doctors join forces in Tanga The original three plants - along wvith 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 inf e still used by of opporis- tic infections commonly caused by HIVT/AIDS.IAWitziri wvas a ers should be active participants in the health system. This makes good sense, since each community has it's very own ra ine.H edl hrdhskoldeadgnr maesgooenoushe,l. sIn each commun has it'sivedinterynow ously agreed to have his plants scientifically identified by indigenous healers. In Tanga, TAWbG has received interna- botanists from the Lushoto Herbarium in Lushoto, Tanga tional recognition of its innovative work with traditional R gi healers, and has received support from OXFAM, the World Region. Bank, and USAID. TAWG eventually developed a home care sevice to deliver Todan in Tandga,D traditional healers and modernphysicians the plant remedies to HIV/AIDS patients and their families. Today in Tanga, traditional healers and modern physicians HoevstarthfuntinfteTAGsdyo-y ' ~~~~~~~~~~Home visits are the foundation of the TAWVG's dav-to-dav and health workers have combined forces in an exciting and andohealth wrogrke havleominted forces iAWGAnV an etingnd- work. Activities include monitoring general health, adminis- promsingproram mpleentd byAWG.TAXG isan ifo- tering traditional remedies, and providinlg counseling for pa- vative non-governmental organization (NGO) that links tra- tintraditir relaties. tients and their relatives. ditional healers, physicians and health workers, botanists, In 1994, TAWG vas officially registered as the Tanga AIDS social scientists, and people living with AIDS (PLWAs). Working Group (TAWG) wvith 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, medidlne, educatioit, 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.~ ~ ~ ~ ~ ~ ~~ ~ ~ ~wr ise anlt outstndin exampled ofa howy postivireultsca 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 hospital and traditional healers. Hence, the), decided to bnn oa xets,idgnu nweg,admdr hosptalandtraitinalheaers Hece,the~ dcidd t health workers to provide effective low cost treatment for make contact wvith local healers in hopes of initiating a refer- ral network. They were successful, and their network people living Nvith AIDS. 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- sionals. The initial dialogue evolved into meetings where TAWG's signature activity is treating patients in the hospital or at home with medicinal plants. In the newspaper Nipashe participants discussed how to treat various ailments, when to refer a patient to the hospital, public health issues, and how m dt Ferar2 0, tAWG has r td that iso ta- to cooperate with biomedical personnel. One day the subject me tients wvho were in bad shape clearly improved after taking was H1Vr/AIDS. Waziri Mrisho. a 84-year-old healer, asked if he couldtry the traditional medicines (Dr. Samuel Mtullu, Nipashe, Feb- Waziri Mrisho, a 84-year-old healer, asked if he could try treating HIV/AIDS in-patients. The group agreed, and Waziri ruarv 23, 2002 ). The medicines are more effective, howvever, if treatment is initiated during the early stages of H1-1/AIDS. TAtedG still uses today. The medicines are low cost, effectively treat selected oppor- Bio-medical personnel soon observed that patients treated tunistic infections, readily available, are provided to patients with Waziri's three plants generally had improved appetites, free of charge, and have been used for Tanzanian healers for centuries. Given in the proper form and dosage, they arc gained veight, suffered from fewer and less severe opportunis- tic infections, and enjoyed improved health and well being. The very safe. plant remedies soon became the hospital's standard HIV/AIDS TAWG's medicines increase appetite, help patients gain treatment for patients who preferred herbal medicine, weight, stop diarrhea, reduce fever, clear up oral thrush, re- 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. Seefor yourself or TAWG also works closely with the government, runs semi- call TAWGfor 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: 255-2 7 264-2266 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://usertanga.net/tawg the amount of patients treated has doubled, indicating the Contacts: Dr Samuel Mtulu - 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- BoardMember 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.