Reaching Our Roots: An Interdisciplinary Approach to Promoting Sustainability of the African Blackwood Tree

Prized by instrument makers for its tone and resiliency since the early nineteenth century, the African Blackwood tree (Dalbergia melanoxylon), also known as granadilla or mpingo (Swahili), faces an uncertain future. Often overharvested and inefficiently used, African Blackwood has been on the International Union for Conservation of Nature’s “near threatened” red list since 1998 and is categorized by CITES (Convention on International Trade in Endangered Species of Wild Fauna and Flora) in Appendix II, which restricts and controls trade. As instrument manufacturers, makers, and musicians continue to purchase the wood, there is little recognition of the sustainability issues around the tree. Furthermore, many communities that harvest the wood are unaware of the musical nature of the product. The purpose of this presentation is to introduce an interdisciplinary approach to conservation of and education about African Blackwood. Since 2010, Daraja Music Initiative (DMI), a 501(c)3 nonprofit and a Tanzanian NGO, has provided music and conservation education in the Kilimanjaro Region of Tanzania, where mpingo is the national tree. By bridging seemingly divergent disciplines, DMI has raised awareness of sustainability issues both in Tanzania and internationally through the global clarinet community. This presentation will give a brief historical overview of African Blackwood trade, highlight the major conservation issues, and provide information about developing partnerships for increased sustainability in a community setting.

A qualitative study on perspectives of pregnant and postnatal mothers on accessing Tetanus Toxoid vaccine in Hai District Kilimanjaro region Tanzania

Background: Antenatal care for pregnant and postnatal mothers is the main entry gate for maternal Tetanus Toxoid (TT) vaccination. In developing countries including Tanzania, pregnant and postnatal mothers especially in rural communities have been experiencing barriers to maternal vaccination. The study aimed to explore perspectives of pregnant and postnatal mothers on accessing TT vaccine in Hai District Kilimanjaro Region Tanzania. Methods: A descriptive qualitative study was conducted during baseline assessment from October 2020 to May 2021, in 10 remote villages. Pregnant and postnatal mothers attending antenatal and postnatal services were selected purposively based on their availability and convenience, A semi-structured interview guide relevant to the study objectives was used to guide the interviews. Focus Group Discussion (FGD) and In-depth interviews (IDIs) were conducted; and thematic analysis was used to obtain themes and subthemes. Results: A total of 15 mothers aged 18 to 40 years participated in the study. Most of the mothers were Christians, married with 1 to 5 children. Majority had completed primary level education engaged in small-scale farming. Main themes were extracted namely: Unreliable vaccine information, Healthcare workers attitude, Overworked with household activities, adherence of appointment dates for vaccination after delivery and role of Traditional medicine during pregnancy. Conclusion: The role of healthcare providers are critical component for the appropriate transfer of vaccine information to the mothers and their spouses during clinic visits, to eliminate vaccine misconceptions hence improving overall tetanus vaccine uptake. Quality of information from reliable sources could be an important factor to upgrade the awareness of pregnant mothers on maternal vaccination.

Readiness to Administer First Aid to Casualties of Fire Disasters in Secondary Schools in Kilimanjaro Region, Tanzania

This study was conducted to determine how secondary schools in Kilimanjaro region were prepared to administer first aid to casualties of fire disasters. This study was guided by the Protection Motivation Theory (1975) and employed a convergent research design under mixed methods research approach. The study sample was obtained through stratification. The study revealed among other things, that most schools had first aid kits facilities, offered guidance and counselling services and respondents were confident enough to administer first aid. The study concluded that secondary schools had to a great extent prepared to administer first aid to casualties of fire disasters, if such menaces occurred in schools. The study recommended inter alia, for more training on first aid in secondary schools.

The Urbanizing Frontier, Change and Continuity

Uchira, in Kilimanjaro Region, provides an exception to the chapters in this book which record rising prosperity. Uchira’s economy has declined after the cattle market that it hosted collapsed, and as agriculture has become less and less productive. This chapter charts the growth and development of the village, the changes to its development projects and service provision, and the growth in its real estate market as migrants from Moshi seek relatively affordable houses well connected to the town and with good water supplies. The chapter explores two broad-brush aspects of change in Uchira during this period: livelihoods patterns and public and private infrastructure. It provides a contrasting example of persistent disadvantage compared to other chapters in this collection.

Knowledge, attitude and practice of physical activity among patients with diabetes in Kilimanjaro region, Northern Tanzania: a descriptive cross-sectional study

IntroductionDiabetes mellitus is one of the most common non-communicable diseases and is the fifth leading cause of death in most developing countries. Regular physical activity (PA) is strongly recommended for individuals with diabetes for its beneficial effects in improving blood glucose control and insulin sensitivity, prevention and reduction of morbidities and complications, and its cardiovascular benefits.ObjectiveTo assess the knowledge, attitude and practices of PA among patients with diabetes in the Kilimanjaro region, Northern Tanzania.Research design and methodsA cross-sectional study was conducted from June to September 2020 among 315 patients with diabetes aged 18 years and above receiving care from diabetic clinics in the Kilimanjaro region, Northern Tanzania. A systematic random sampling technique was used to select study participants who were interviewed using a modified version of the WHO-STEPS Survey for non-communicable diseases. Data were analysed using SPSS V.20. Categorical variables were summarised using frequencies and percentages, and continuous variables using means and SDs. The Χ2 test was used to compare the proportion of PA across participant characteristics.ResultsThe vast majority (94.3%) of the participants were physically active, and from our findings, most of it was contributed by work (70%) and transport-related (20%) activities. Participants had high levels of knowledge (98.4%) and positive attitudes (95.6%) towards PA. These were mainly contributed by a healthcare provider or doctors’ advice (96%) on PA benefits to patients with diabetes. There was a strong statistical association (p<0.001) between knowledge and attitude towards PA with PA practice.ConclusionThe vast majority of the participants were physically active. High levels of PA were associated with a high level of knowledge and positive attitudes towards PA. Healthcare provider or doctors’ advice in diabetic clinics is essential in promoting PA practice in this population and in diabetes management.

A one-year prospective study on the occurrence of traumatic spinal cord injury and clinical complications during hospitalisation in North-East Tanzania

Background: Clinical complications following spinal cord injury are a big concern as they account for increased cost of rehabilitation, poor outcomes and mortality. Objective: To describe the occurrence of traumatic spinal cord injury and associated clinical complications during hospi- talisation in North-East Tanzania. Method: Prospective data were collected from all persons with traumatic spinal cord injury from North-East Tanzania from their admission to discharge from the hospital. Neurological progress and complications were assessed routinely. Data were captured using a form that incorporated the components of the core data set of the International Spinal Cord Society and were analysed descriptively. Results: A total of 87 persons with traumatic spinal cord injury were admitted at the hospital with a mean age of 40.2 ± 15.8 years. There were 69 (79.3%) males, and 58 (66.6%) of the injuries resulted from falls. Spasms (41 patients, 47.1%), neuropathic pain (40 patients, 46%), and constipation (35 patients, 40.2%) were the most commonly reported complications. The annual incidence rate in the Kilimanjaro region was at least 38 cases per million. Conclusion: The incidence of traumatic spinal cord injury in the Kilimanjaro region is relatively high. In-hospital compli- cations are prevalent and are worth addressing for successful rehabilitation. Keywords: Rehabilitation; pressure ulcer; spasm; urinary tract infections; low income countries.

Cultural Adaptation of a Brief Intervention to Reduce Alcohol Use Among Injury Patients in Tanzania

Background Harmful alcohol use is a leading risk factor for injury-related death and disability in low- and middle-income countries (LMICs). Brief negotiational interventions (BNIs) administered in emergency departments (EDs) to injury patients with alcohol use disorders (AUDs) are effective in reducing post-hospital alcohol intake and re-injury rates. However, most BNIs to date have been developed and implemented in high-income countries. The efficacy of BNIs in LMICs is largely unknown as few studies have undertaken the rigorous task of culturally adapting these interventions to new settings. Given the high prevalence of alcohol-related injury in the Kilimanjaro region of Tanzania, we culturally adapted a BNI to reduce post-injury alcohol use for implementation in this patient population. Methods We used an iterative, multiphase process to culturally adapt a high-income country standard of care BNI to the Tanzanian setting using the Intervention Mapping ADAPT framework. Our team consisted of local healthcare professionals with extensive experience in counseling patients who use alcohol, as well as an international team of academic and clinical professionals. Focus groups were used to inform culturally appropriate changes to the standard of care BNI protocol. Objective assessment of BNI delivery was performed to ensure adherence to the FRAMES model of motivational interviewing. Results We developed the Punguza Pombe Kwa Afya Yako (PPKAY); a one-time, 15-minute nurse-led BNI that encourages safe alcohol use and motivates change in alcohol use behaviors among injury patients in the Kilimanjaro region of Tanzania. Adaptations to the original intervention protocol include changes regarding the interventionist, how a patient is greeted, how the topic of alcohol use is raised, how a patient is informed of their harmful alcohol use, how graphics are visualized within the intervention protocol, how behavior change is motivated, and which behavior changes are encouraged. Conclusions The PPKAY intervention is the first BNI to be culturally adapted for delivery to injury patients in an LMIC population. Our study demonstrates a unique approach to adapting substance use interventions for use in LMICs, and shows that cultural adaptation of alcohol use interventions is feasible even in settings where community knowledge regarding harmful alcohol use is limited. Our study prompts the need for further research and cultural adaptation of BNIs for other low-income communities at increased risk of alcohol-related harm.