TANGA AIDS WORKING GROUP (TAWG) USING TRADITIONAL HERBAL PLANTS TO BENEFIT PEOPLE LIVING WITH HIV/AIDS PRESENTED AT THE GLOBAL DISTANCE LEARNING CENTRE DAR-ES –SALAAM – TANZANIA MARCH 29 TH, 2005 AUTHORS: DR.F.J. MBERESERO DR S. MTULLU Tanga Aids working group Tel/Fax P.O.Box 1374 Tanga – Tanzania

Brief History TAWG is a local non profit NGO TAWG is basically a group of professional Health Workers who organized themselves into a team of Voluntary counselors. HIV/AIDS educators and Home Care Providers. In 1997 a Medical Officer in Pangani District observed people coming late to hospital even for treatable condition. He further learned that those people were attending Traditional Healers services. Monthly meeting were organized under umbrella of PHC to exchange knowledge and know who treats what best.

Brief history …. Collaboration was initiated between Health Workers and THs aiming at early referral and recognition of danger signs and symptoms. One TH offered herbal remedies to treat AIDS patients in Hospital Following the treatment it was observed by Bio- medical health personnel that patients tend to gain weight and register general improvements. In association with TH’s, 3 efficacious plant remedies were developed for treatment 01 associated with HIV/AIDS (oral thrush, diarrhea, persistent fivers, skin rashes and Hyper Zoster) There after Home Based Services was developed on voluntary basis

Vision and Mission Tanga Region communities implement HIV/AIDS/STI control measures and care improved for PLWHA To reduce the spread of HIV and other STIs through Community based educational activities and to provide Care and support for PLHA through home-based Care and the provision of Traditional plant remedies, in association with Traditional Healers.

Specific Objectives To provide home Based Care and Support to people living with AIDS and their families. To prevent the spread of HIV through Community Based Educational program targeting vulnerable groups. To collaborate with Traditional Healers in prevention, care and research on Traditional Medicinal plants. To provide guidance and assistance to other NGOs’ working on HIV/AIDS.

Main Activities Care and support Treatment of opportunistic infections associated with HIV/AIDS using traditional remedies as well as modern medicines. Providing Home Based Care Services Voluntary Counseling and Testing Services. Treatment of STIs Training Community Home Based Care Providers.

Prevention Awareness and sensitization campaign aimed at behavior change prevention in collaboration with CTG. IEC material distribution including.condoms. Community outreach programs to schools, colleges, workplaces, villages and special groups. To run HIV/AIDS Information Centers.

Collaboration With Traditional Healers Training THs on Basic HIV/AIDS knowledge, infection control referral criteria and care and support to affected people, community mobilization, record keeping and counseling. Knowledge exchange meetings between THs in an attempt to identify new treatment options. Identifying new herbal plant remedies Conduct research on medicinal plants Involve Traditional Healers on TAWG Care and Treatment.

BENEFICIARIES IN THs PROGRAM 1. Direct People living with HIV/AIDS Traditional Healers who attends training and those who provide their herbs for Care of PLHA Trained Health workers 2. Indirect All communities served by Traditional Healers People living with HIV/AIDS in area served by THs Peers working with Traditional Herbs.

WHY COOPERATE WITH TRADITIONAL HEALERS Traditional healers command respect in the community Insufficient and inadequate Health facilities Traditional Healers are always available to the community. The ratio of healer to the population in Tanzania is 1:350 while that of medical doctor is 1:33,000. Herbal medicines are affordable readily available and culturally appropriate and economical at community level The collaboration provide opportunities for sharing approaches in Health Management

AREAS OF TAWG TRADITIONAL HEALERS COLLABORATION 1.Care and Treatment of PLHA 2.Training program to influence awareness, safe practice and referral 3.Community to community knowledge exchange programs 4.Involve THs in community based education program including distribution of IEC materials and condoms 5.Research

METHODOLOGY IN TAWG HERBAL TREATMENT PROGRAM 75% of patients are referred to TAWG clinics from other hospitals Counseling is provided before initial HIV testing Patients are given options to enroll Clients use Traditional medicines collected by a healer and distributed by TAWG Patients are treated for free – we pay healer to collect.

METHODOLOGY IN TAWG HERBAL TREATMENT PROGRAM…… Patients can also be treated directly by a healer, Medicine given to patients in powder form to make tea, or mix with coconut oil/water for topical application On request, we distribute medicines throughout Tanzania Clients are monitored by Physicians and Nurses every two weeks at the clinics Serious patients are followed up at their homes by our Home Care Providers The standard treatment is 3 plants medicines. Major side effect is increased appetite.

WHAT DO THE HERBS HELP Increase appetite Gain weight Stop diarrhea Reduce fever Clean up oral thrush Resolve skin rashes and fungus Cure herpes Zoster Heal ulcers

PATIENT RESULTS Patient begin seeing results/improvements between one week and 4 weeks after entering treatment. Many patients are treated with modern and traditional medicines before visiting TAWG. Patient appreciates the yielded result Patient who survive for 6 months generally live for 2-5 years. Some patients have 11 years now Medicines have not proved very helpful in advanced stage of HIV/AIDS. Some patients go on and off treatment. Patients uses the herbs treatment and for prevention of opportunistic infection

PATIENTS RESULTS…… Patients on treatment throughout remain health though the immune status may be down. This type of patients normally dies of a short illness and there is no bed ridden for them. Patients who leaves treatment after recovery won’t benefit from the same herbs in the second session opportunistic infection. Our goal is effective treatment, We provide any treatment, traditional or conventional, that contributes to patients well-being ( patients improvements has priority over research).

ACHIEVEMENTS TAWG have cumulatively treated 4,500 AIDS patients with opportunistic infections with herbal medicines Presently we treat 1,300 patients free of charge at six sites and Home Care Services. Built capacity of healers to assess patients progress, by training 329 healers so far. We effectively link modern and traditional medicines The quality of life of PLHA using TAWG herbs have been improved.

ACHIEVEMENTS.. Successful conducted community to community exchange with support of the World Bank IK program THs are now powerful Community educators and strong partners in IEC materials distribution including condoms. Conducted 48 Knowledge exchange meetings during which 8 potential herbal medicines were disclosed by healers. Conducted one observational clinical study. We are pioneers in developing innovative collaboration programs with healers.

AWARDS TAWG was awarded a Merit award by the President of the United Republic of Tanzania in August,2004 for its innovative collaboration in providing low cost treatment to PLHA

OUTCOME OF TAWG TREATMENT PROGRAM Through this program we have helped the Government in respective districts to reduce:  The patients load for hospital  The cost of patients management  The resources spent in Care Keeping more people alive have automatically maintained the workforce hence reducing the newly orphaned children

LESSONS LEARNED Patients enjoy the mix of traditional and western medicines. Individual herbalists/healers are easy to work with group are not Generally most healers are eager to collaborate. Most healers fear of stealing their knowledge and herbs. Need to make more traditional medicines available for more people

CHALLANGES Increasing number of clients seeking services from TAWG – leading to strain on the available inadequate resources. Fear of cooperation from the Traditional Healers Environmental destruction Lack of strong cooperation between Traditional Health system and Modern Health system. Lack of Laboratory facilities to monitor patients progress and in conducting clinical observational studies

FUTURE PLANS (WAY FOWARD  Scaling UP Traditional Healers program to be more community based.  Establishing a clinical Laboratory  Conducting more observational clinical studies for the promising herbs.  Conducting community exchange aiming at improving services

FUTURE PLANS (WAY FOWARD  Develop and promote partnership between the Traditional Health system and the modern health system,  Produce more easily potable tablets to reduce stigma.  Develop botanical gardens, grow and produce selected plants.

CONCLUSION Traditional Healers are influential, respected and culturally accepted HIV/AIDS symptomatic treatment providers in developing World, Through systemic research Traditional medicines have yielded clinically useful drugs such as ant - malarial quinine and artemisinin, collaboration with them will improve treatment, research, referral of patients and information exchange on HIV/AIDS.

AHSANTE SANA THANK YOU