Tanzania

Clear Stream Integrative Medicine in Tanzania

In January of 2012 my wife and I moved to Tanzania for six months. This was an incredible new adventure for us. She continued her research on ecology, economics and development and I began a new project. It was my intention in Tanzania to work towards one of my life's goals: making Oriental Medicine and acupuncture universally available to everyone, regardless of ability to pay. 

Why Tanzania?
Tanzania has an average annual per capita income of $980. According to the World Health Organization, "the mortality rate for children under age 5 is a startling 76/1000" (2010). Approximately "6% of the adult population is living with HIV/AIDS" (2009). Annual per capita spending on health is $83 USD. Countrywide, there is less than one doctor and 2.4 nurses and midwives per 10,000 people.

Oriental Medicine, acupuncture and moxibustion treatments often produce immediate, positive results thus motivating patients to return to the hospital or health clinic for further treatments. They also improve compliance to conventional medical regimens so often acts as a gateway to conventional medicine, encouraging and supporting proper management by medical providers. Throughout its thousands of years of clinical use, acupuncture has successfully addressed many of the symptoms associated with Malaria, TB, HIV, malnutrition, high blood pressure and many other debilitating illnesses. 

During our time in Tanzania we were given an intimate introduction to the country’s history, culture, politics, economics and ecology from many wonderful friends and community elders. Through my work and research there I came to understand firsthand that the medical system in Tanzania is very different than what we are used to in the US. It is totally overburdened, under staffed, and lacks access to many of the technological tests and pharmaceutical drugs that it relies on. Most people cannot even afford the rudimentary care offered in local clinics and hospitals. What care they can provide in the small local hospital is often held back until bribes are paid to the doctors. I have known several people who have either died or become seriously ill because they could not afford to bribe the doctors to do their jobs. 

Most medicine in Tanzania is provided in government clinics and hospitals, which are based on a modern Western medical model. Unfortunately that model does not take into account best practices or the technical and financial capacities of its healthcare practitioners and patients. This model of care does not always utilize appropriate technology for the Tanzanians, the majority of whom are incredibly poor subsistence farmers who do not have access to, and cannot afford, expensive tests and imported medications. Given its history and capacity to treat most illness directly or as an adjunctive, Oriental Medicine could be a perfect support for rural Tanzanians. Because of the immensity and immediacy of their need for effective medicine, it was exceedingly simple to find patients to treat and there was a high level of interest in learning more about Oriental Medicine.

Exploring the potential for Introducing the Training Program From the Pan African Acupuncture Project in Tanzania

In the mountains in North of the country I set up a treatment room at the house of the local village chief  His name is Mze Mbaga and he is a sweet and intelligent man who had run the hospital next door to their home for 25 years. I treated him for oral cancer, his wife for chronic lung infections and many of his friends and family with difficult medical conditions. In order to explore the viability of introducing the acupuncture training program from the Pan African Acupuncture Project to local healthcare practitioners, he and I both spoke with doctors and health care workers at the hospital and at several local clinics. Based on interest expressed prospects looked good, but despite promises and intentions, none of the doctors ever followed through on coming in to train. In the main urban center of Dar Es Salaam I also worked to set up a training through a local doctor and a clinic, but circumstances conspired against us and formal trainings did not manifest during our time there. Instead the doctors I worked and communicated with about trainings referred clients to me for treatment. Meanwhile I decided to teach basic acupuncture techniques to two Tanzanians who seemed dedicated, and one made it all the way through a round of basic training and some supervised treatment of patients. 

Julius copy

Julius giving a treatment to Mze Mbaga

The difficulty in teaching acupuncture in Tanzania comes in making it sustainable, and not solely reliant upon practitioners or funds from outside the country. Towards these ends I found a few medical workers and other highly capable individuals who had the desire to learn Oriental Medicine. I held classes and supervised treatments with them over a number of months to ensure that they had the training to provide simple treatments using acupuncture and moxibustion  However without the support of Tanzanian medical institutions, Oriental Medicine cannot be utilized over the long run in a sustainable and integrated manner.  Without finding adequate Tanzanian institutional support we would just be introducing another form of foreign medicine that they do not culturally understand, cannot afford, and don’t have access to. This is not an insurmountable obstacle but it is an incredibly complex and difficult one. I hope in the future to continue working with local medical workers, elders, and health NGOs to find possible solutions.  

MoxaAfrica!

I also had the opportunity to teach more than 20 patients how to use moxa, both direct and indirect, to treat a variety of ailments. The area we were in was in the mountains and moxa worked wonderfully for the many cold damp conditions that prevailed there. In my work in Tanzania I found that teaching patients direct moxa self-care, especially using MoxaAfrica's protocols, was incredibly effective for both immediate and long-term health, even with patients suffering from TB and HIV. This experience has greatly reinforced my already strong belief in the immediate and long-term benefits of moxibustion. In future local and international projects I will focus my efforts on teaching these simple, affordable, and incredibly effective moxa protocols.

The Value of Acupuncture in Tanzania

One thing that made my time in Tanzania interesting from a medical perspective was the opportunity to treat patients with illnesses that we seldom see practicing in the US. Some of the more interesting conditions I worked with with were; non-healing infections and sores, facial cancer, drug resistant bacterial lung infections, HIV, TB, stroke recovery, uncontrolled high blood pressure, a variety of other strange bacterial and viral infections, Malaria, and a wide variety of lung problems. Many of these issues either do not exist in the US or when we do see patients with these patterns they are already taking strong Western pharmaceutical medicines. In an ideal world patients would have access to both natural and pharmaceutical medications, but so many Tanzanians are desperate for any medicine, that they are totally open to trying Oriental Medicine. We were able to get very good results with most patients in the several months I got to treat them. I am saddened by the thought that they will not have continued access to treatments, but I hope to be able to facilitate more training of healthcare workers there in the future.

Finding the Roots of Medicine

In rural Tanzania I learned that there is a simple elemental beauty to conversing with friends around a fire in an earthen hut. One evening I found myself listening entranced to the earthy roll of Swahili vowels as an elderly albino woman and our farmer friend talked while cooking a dinner of corn porridge over a fire. It was wonderful, but a little sound of coughing from the 8 year old next to me and my own burning eyes and lungs kept me distracted. Looking through the haze of smoke I realized that everyone in the hut was in some sort of respiratory distress, and that this happened in every hut, every time they cooked a meal over a wood fire. For most people in this country their daily worries start at finding clean water, fuel for cooking, and food. Due to factors from climate change and high levels of deforestation, there has been a drought for much of the past 7 years. Our friends who are subsistence farmers have lost their crops and many people have to struggle just to get enough to eat. The situation is desperate. Farmers have no money to purchase food, and even if they have a little to eat they cannot afford to buy coal to cook with and boil water for drinking. The inability to afford coal causes them to rely on harvesting firewood for use on their simple indoor stoves. As a natural result from indoor wood fires the most common ailments for women and children are lung related. Every woman I treated in Tanzania had lung issues including asthma, frequent bronchitis, lung infections, lung cancer and many other manifestations of a life breathing in smoke most of the day.

Also tied in with this problem is a skyrocketing rate of deforestation in the few remaining forested parts of the country. In the mountains we lived in, only 5% of the rainforest remains. To counteract this problem the government has made it illegal for people to cut down trees, but has provided no viable alternative fuel source. People need fuel to cook and boil water for drinking but don’t have a healthy or ecologically viable option available. Due to poverty and drought many people in the few remaining forested areas are desperate for money to buy food and they see no other option besides cutting down trees to sell firewood and wood coal to urban centers. In this vicious cycle both the environment and health are quickly spiraling downward.

I find that it is easy to get stuck in the narrow mindset of thinking that my job as a doctor is taking care of people with medical interventions like herbs and acupuncture. Yet I am learning that these are not the limits of my responsibility. Our bodies are not islands. We are never for a moment separate from environmental causes and conditions in the world around us. Indeed it is often unbalanced interactions with our environment that are the prime causes of disease. The variety of socially, economically and environmentally caused suffering I encounter every day continually reminded me that, as a holistic doctor, it is my responsibility to address health issues in a balanced and holistic manner. This means that if I were to only treat the rampant lung problems I see in Tanzania with medicine, I would be doing nothing to treat the root or causative factors of this disharmony. We all know that much like human lungs, trees function as vital planetary sources of air filtration and oxygen production. Without these precious ecosystems, and without healthy human lungs, I cannot see a healthy and sustainable future for any life here in Tanzania.

One Monumental Small Part of a Solution - Introducing Biomass Charcoal

I thought long and hard about ways to address this pervasive problem and came to the conclusion that I needed to find a way to get to the root of the problem rather than trying to just treat the branches with medicine. I did some intense research during which I stumbled upon a great TED talk on biomass charcoal production by Amy Smith from MIT. This method of charcoal production uses ‘appropriate technology’, which means it only uses materials and skills that can be found locally, affordably and sustainably. This sounded like a great start in addressing both rampant lung issues, because charcoal produces a lot less smoke and toxins than firewood, and environmental issues, since it only uses farming wastes and other unneeded biomass.

From the moment I discovered biomass charcoal and decided to create a project to introduce where we were living in Tanzania, things began to come together almost effortlessly. I began by thoroughly educating myself on the variety of biomass charcoal production techniques being used in Uganda and elsewhere throughout Africa. Next I called a Peace Corps volunteer who lived in the heart of the forest where illegal wood harvesting was taking place and asked him what he knew about biomass charcoal. He laughed and said he was on a bus back to his village from a workshop on that very topic. It turns out he had just been contemplating how he could teach this technique to a group of mamas he worked with who were caring for 90 orphans, many of whom have HIV. We decided to roll with this wave of serendipity and over the next few weeks developed a plan to teach local farmers and development workers how to make biomass charcoal kilns. Our goal was to then have them continue to present this simple and accessible technology to as many interested groups as possible in their own communities.

Towards these ends we built a kiln, compiled simple sets of instructions, planned and executed a local workshop. Luckily we had met many local Tanzanians interested in helping their community, many of whom worked in government, schools, NGOs, church charities and other community groups. We organized workshops and demos for them and helped them come up with their own plans for introducing this technology to farmers and villagers where they lived. With the help of a local environmental and farming ministry official I wrote up a proposal for the district commissioner to request governmental support for this project. Rather than ask for funds, which seldom come, we request that they encourage schools and government offices to purchase biomass charcoal instead of continuing to support the illegal timber trade by purchasing black-market fire wood and charcoal.

Waiting to see the fuits of our labors at our first Biomass Charcoal Workshop


I was and am amazed at how organically and naturally this project unfolded. It had an incredible momentum to it from the very beginning and in the weeks after our workshops we watched it spread through the region and become incorporated in farmer co-ops and agricultural and development projects. My Peace Corps friend became very skilled at teaching how to make and use the kilns and as we traveled my wife and I set up opportunities for him to teach all over the northern part of the country. Since my wife was researching economic and environmental issues, we met a few local leaders and environmental groups interested in adopting this technology. When we left Tanzania the project was still unfolding, and at that point was primarily being taught and implemented by Tanzanians in their own communities.

Biomass Charcoal Production in Tanzania

As a doctor it felt incredible to have been able to facilitate this process. It was also great to see our subsistence farmer friends and many of my patients with lung issues learning to make smokeless charcoal.

Through this project I learned that being a doctor isn't always about offering treatment or medicine, but is best expressed by teaching people how to care for their own health. 

I still am amazed and humbled by the incredible amount of generosity and support we received in order to make this project possible. The support of the PanAfrican Acupuncture Project, MoxaAfrica, CSTCM, Lhasa OMS, Blue Poppy and so many wonderful individuals was instrumental in bringing together the supplies and funds for this endeavor. Daniel and Ewa at Yao kindly gave me a large amount of Yincare  which we found to be truly amazing for many tropical ailments such as toxic boils, skin infections, strange bug bites, mouth cancer and non-healing facial sores.

I want to sincerely thank everyone who has supported our work in Tanzania.

With Gratitude,

Spencer Ames MS, L.Ac., Dipl. OM.

501(c)(3) EIN 45-4338056                    E-mail:  info@ClearStreamMedicine.com                    Phone: (720)334-8646                   © Spencer Ames 2014