She is wearing her finest dress, shaded light green and splattered bright with white, yellow and fuchsia flowers that jump as if to greet you as she sits down. Around her neck she has carefully tied a bright blue and green scarf, bringing her ensemble together with fuchsia lipstick matching the flowers in her dress.

She sits with poise on the health clinic chair, located near her home in Tanga, Tanzania. Only her slight stature and a dress that is several sizes too big offer any hint that she may not be well. Like many of her fellow Tanzanians, Rose Kika is HIV-positive and showing signs of a disease that kills hundreds of Tanzanians every day. However, with the support provided by Tanga AIDS Working Group, 42-year-old Rose is optimistic about her future.

In Tanga, located on Tanzania's east coast, the Tanga AIDS Working Group works to reduce HIV transmission and assist people living with AIDS through health education, counseling and testing services, and home-based care—all done in collaboration with traditional healers. Prior to 2003, this non-profit organization sensed program gaps as it struggled to find ways of working more closely with traditional healers and to help community members infected with HIV. Unable to access expensive anti-retrovirals, patients increasingly looked to traditional healers for support.

Traditional healers—called Mganga wa Kienyeji in Swahili, herbalists or folk healers in English—serve as the primary health care providers for millions of people around the world. The AIDS epidemic has brought forth not only new patients to traditional healers, but also new frustrations to find cheaper ways of treating them. In 2003, a grant from the Rapid Funding Envelope (RFE), established by the Tanzanian Commission for HIV/AIDS and eight international donors¹ with management support from Management Sciences for Health’s Management and Leadership Program and Deloitte & Touche, enabled the Tanga AIDS Working Group to initiate a research study to monitor the efficacy and identify pharmaco-active ingredients of traditional herbal medicines in treating opportunistic infections in HIV-positive patients. Building on existing partnerships between traditional healers and clinical practitioners, the study has become a model for how to use local knowledge to offer cost-effective support for HIV-positive patients. One of these patients is Rose.

After her partner died in 1999, Rose was left with four children and a nagging suspicion that he had died of AIDS. It took several years before she could face the fact that she too might be infected. In August 2003, after she began losing weight and fighting constant illness, Rose visited the Tanga AIDS Working Group clinic to seek the advice of HIV counselor, Bibiana Francis; she then decided to get tested. When Rose was told about this unique project to test herbal remedies to HIV-positive patients like her, she signed up immediately. Since September 2003, Rose and more than 100 others visit the clinic twice weekly to receive their medicine—a mix of local herbs carefully prepared by traditional healers.

Project Outcomes   Forged links between traditional healers and medical practitioners   Initiated unique research project on traditional herbs to treat HIV/AIDS   Improved treatment knowledge of traditional healers and medical practitioners to better serve HIV-infected patients   Renewed hope among poor, HIV-infected patients through access to treatment

Just outside the clinic where Rose talks about her progress, traditional healer Mohammed Omari stirs a boiling pot of herbs, the first step in preparing the plants he has used to treat a variety of ailments for many years. For the first time, the plants' active ingredients are being documented, their toxicity monitored and their use with patients documented. Mohammed, who is also called Bongo Mizizi, or "root genius" in Swahili, reflects on his first experiences with HIV and his face is grim: "I was sad and felt disturbed...sometimes I wept...when I saw some [HIV] patients alive a few years later, it gave me hope. We needed this research project." Today, Mohammed works closely with two medical doctors to implement the study. Their relationship is a close one and built on mutual respect: "I am so happy that now we have a relationship between modern doctors and traditional healers. Our aim is the same: to look after people who are sick."

Meanwhile, Mohammed has learned more about HIV from the doctors and in turn, is able to serve his patients better. As his colleague, Dr. Mberesero echoes: "The hopelessness of AIDS patients is global. There are [sophisticated] drugs that can help them...but [these patients] are poor, they cannot afford them." While study organizers have documented health improvements in about half of the 108 patients participating in the study, all of the patients appreciate access to remedies that might help them. Since beginning the treatment, Rose, for example, has gained three kilograms and is coughing less. She wishes she had visited the clinic earlier and her face lights up as she describes her health: "I feel so well, nowhere on my body is there suffering." Most importantly, however, the study participants' outlook on life has changed for the better. As Rose puts it: "We are grateful for the medicines we are getting. They are helping us to have a better world."

¹ Canadian International Development Agency, Embassy of Finland, Ireland Aid, Royal Danish Embassy, Royal Netherlands Embassy, Royal Norwegian Embassy, Swiss Agency for Development and Co-operation, USAID

For more information about the RFE, please contact:
Grant Manager, Deloitte & Touche
10th Floor, PPF Tower PO Box 1559
Dar es Salaam, Tanzania
Email: RFE@deloitte.co.tz

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