The Reality...

Village clinic… 6 hours… 15 patients… 1 birth… 10 cases of severe untreated hypertension… a few upper respiratory infections diagnosed as “malaria”(a common misdiagnosis) treated with strong quinine drugs… 1 case of undiagnosed congestive heart failure that was diagnosed as the flu… a lot of women with back pain after working 14-16 hour days at home making 3 meals a day over a woodfire stove, cleaning the house, and taking care of the children (maybe up to 8 of them)… also tending to the village farm, carrying buckets of water, baskets of maize, and bushels of bananas on their heads… and not complaining for a minute about their physical pain or emotional exhaustion… I think they all need a vacation in Zanzibar… that’s my vote… a vacation for all the African Mamas!

And sweet little 2 year old sister Karyn… what a doll… with a gaping wound on her leg that is finally healing, probably after an infection and subsequent treatment with the wrong antibiotic… which leads me to the point of this blog…

Medication given out like candy… improperly managed… and frightfully dosed with as many as 5-10 medications at a time… just in case it’s the common cold… just in case its malaria… just in case it’s a bacterial infection… and to top it off… let’s throw in a mix of pain-killers… take your pick… why is this okay?… a country so desperate for healthcare… they will “take” anything they can get… and where is the medication coming from?... where is it manufactured?... hmm?

The frustration is mounting… but I knew this before I came to Tanzania… but the reality, when faced with it on a daily basis is frightening… I have asked myself the same question every day for 5 months… what is the point?... does Tanzania or Africa actually benefit from foreign aid?… Is there a way to actually help through empowerment so the country can stand on its on two feet one day?... Tanzania only received its independence 40 years ago… it is very much a “developing” country… but developing toward what? 

So as a native Oregonian, from possibly the most granola, tree hugging city in North America--Portland, I admit that I am a bit of an idealist… where is the recycling?… even more so, where is the waste disposal system?… how about compostable toilets?… where is the solar power?... where is the bio-gas?... where is the “green” building?… organic farming?... good live music?... I will get off that soap box for now…

As a doctor here, it is impossible to not pay attention to everything that affects health which in turn means you learn about politics, religion, history, infrastructure, technology, business, natural resources, socioeconomics, agriculture, water, human nature, and the value of life… wherever you live on earth…

So for now, I will stop the rant and move forward with eyes and ears open to the truth… I am here to learn and see about the long-term potential to integrate natural medicine, rooted in prevention and education, in Tanzania—where there is profound need and abundant natural medicine resources...

Paving the way for the return to natural medicine in Africa and integration into an otherwise failing medical system here in Tanzania is like trying to move Mt. Kilimanjaro with a shovel… That being said, I am working on doing what I can… I can only hope my colleagues have the opportunity to experience this in the future after more groundwork is done in the village here in Moshi… I am honored to be among one of the many volunteer doctors here… and congratulate all of those in the pursuit to improve global health standards…

moja kwa moja (one by one)…

"Let food be thy medicine, and let thy medicine be food." Hippocrates

Chakula ni Dawa or Food as Medicine

On a 2 mile walk to work at a clinic in the nearby village called Kidia, I noticed an “alien” looking tree amongst the forest canopy.  Turns out it was a papaya tree, and they happen to grow here natively throughout the village amongst banana, mango, and avocado trees to name a few.  It’s truly the Garden of Eden here. 

I have started teaching classes once per week to the mamas here about how to use foods that grow locally as medicine to treat and prevent infectious disease and several other chronic ailments.  Papaya is well known for treating parasites, worms, and other gastrointestinal infections—one of the main health problems in Sub-Saharan East Africa.  Papain is the main active constituent in Papaya, an enzyme that digests proteins in the gut when eaten without causing harm to the intestinal lining.  The papain breaks down the protein in worms, physically denaturing and killing them while helping to flush them out of the body.  The unripe fruit and the seeds contain the most papain. 

“Green” or unripe papaya can be made into a salad commonly made in Thailand with tomato, carrot, peanuts, lime, chili, and usually fish sauce.  In the version of the salad I made with the village mamas, I left out the fish sauce and added crushed fresh garlic, ginger, and a little honey for added health benefit.  The garlic is antibacterial and ginger stimulates appetite and is known as nature’s best nausea treatment.  The mamas and the watoto (kids) loved the new recipe.

The plan is to start creating local affordable medicinal food recipes like this to incorporate in the diet of school age children who most commonly have gastrointestinal infections, especially worms.  Intestinal infections can cause a lot of damage to the health and development of children due to problems with malabsorption of nutrients and subsequent malnutrition leading to poor immunity. 

Using food as medicine in Tanzania makes more sense than throwing drugs at a problem where they are often not affordable or available and may cause of number of adverse reactions.  Furthermore, there are not enough doctors or qualified healthcare workers to manage medication so health education to prevent disease naturally makes more sense. 

Mebendazole, a relatively harmless drug, is the common treatment for intestinal worms.  It is given to most children every few months and is quite affordable here but not always available and does not prevent further infestations.  The drug works by poisoning the worms.  I have noticed here that the medication has been incorrectly dosed several times.  Incorporating healthy antimicrobial foods into the diet can further prevent worms from making their home in the gut and can help clear them from the body between doses of Mebendazole.  Papain is also available in many digestive aid supplement formulas but are not available in Tanzania—yet!

Future Food as Medicine classes in the village:

Processed Foods:  The Effects of a “Civilized Western Diet” in Tanzania

Table Salt vs. Sea Salt:  Thyroid Problems in Tanzania

Food Sanitation and Hygiene:  From Seed to Mouth

Diet for Diabetes and Hypertension:  The Reality in Tanzania

Future Public Health Education Classes:

HIV/AIDS prevention:  “Prevention is Better than Cure”

Malaria, Immunity, and Artemesia

Women’s Health in Tanzania:  The Foundation of the Family

What’s in the Water?

More to come!