Full Steam Ahead Inhalation as Tanzania Fights Covid-19

On 22nd April, Tanzanian President John Magufuli surfaced from his home in Chato, Geita region to provide some direction on the country’s fight against Covid-19. He has been holed up at Chato since 28th March as Covid-19 infections started rising in East Africa.

His address, live-streamed on Tanzania Broadcasting Corporation (TBC), was bizarre. To start with, the heavy presence of heads of security organs was curious, given that this is a matter that falls mostly in the domain of the Ministry of Health. This did not escape the notice of opposition stalwart, Tundu Lissu who reminded the president in an exasperated tweet:

Your Excellency, President Magufuli, The war against Corona cannot be fought using the police, intelligence service and other covert agents. This fight is won by following the advice of experts. Restrict mass gatherings. Perform screening. Acknowledge the reality of the problem. Come out of your hideout in Chato. Lead the country!!!

From the outset, it was clear Magufuli is concerned that the statistics are being communicated in a way that does not reassure Tanzanians.

We also need to say the truth about recoveries. In the statistics shared, of 284 infections according to the prime minister, 100 have already recovered. We need to avoid panic in the citizenry. As far as I know, only 10 people have died. Not everybody who is infected with Corona virus dies.

It says a lot about Magufuli’s leadership style that he did not address that with his people, away from the cameras, right from the start of the Covid-19 crisis. Tanzania recorded its first case of Covid-19 on 16th March. Did it take Magufuli over a month to recognise that something was off with the way the statistics were being reported or is his new-found diligence triggered by the (credible) perception that the situation is steadily deteriorating? Perhaps it is not such a coincidence that the president showed up not long after Minister of Health, Ummy Mwalimu, announced 84 new cases in one day.

If the number of recoveries is accurate, that is encouraging and it needs to be reported. Still, the president misses the point by a mile. It is well known that not all infections lead to death. However, it can reasonably be expected that more infections, in a country that is not well equipped to deal with the pandemic, will logically translate into more deaths. It is a simple matter of proportions and that is the reason his East African neighbours are putting in place various measures to avoid the spread of infection.

If anything, 10 deaths are 10 too many. There are 10 families that have lost their loved ones and the president has a duty to protect all Tanzanian lives. One would imagine that the president and his government would be demonstrating all they are doing to ensure not a single additional death occurs, as opposed to downplaying the issue purely on statistics.

The president is very sensitive about any type of reporting that shows him in less than positive light. In 2016, he fired the Director General of the National Institute for  Medical Research (NIMR), Dr Mwelecele Malecela. Her offence – making public findings that showed the Ziqa virus was present in Tanzania. Three years later, Magufuli laid bare what transpired and the manner in which he handled the matter.

I didn’t want to delay. I fired that person at around 1AM…shortly thereafter, they gave her a job as a boss. They had sent her to announce we have the disease so that tourists would not come to our country…it’s a trick used by imperialists.

Dr Malecela has a stellar CV spanning over 30 years and had been in charge of research in Lymphatic filariasis, a debilitating condition that affects a number of areas in Tanzania. She is now Director of the Department of Control of Neglected Tropical Diseases at WHO. It did not cross the president’s mind that an official of such caliber would have certain professional and ethical obligations to disclose a matter of such magnitude. It is a crass policy of shoot the messenger unless the messenger has a message that makes the president look good.

In times such as these, it is all too easy to blame outsiders – a tactic the president is not shy to use. If it is not imperialists implanting Directors of research to publish findings that scare away tourists, then blaming the jealous neighbours will do. Magufuli believes that the panic about Covid-19 is being fuelled through social media and he also suspects the culprits are in neighbouring countries.

I have discovered that some of the people spreading panic on social media are not even Tanzanians. They are based in neighbouring countries. They are just messing up the Tanzanians…they are creating panic for their own selfish intentions.

He moved on to the quarantine processes and if there was one section of the address that showed that Magufuli is out of his depth, it is his remarks regarding isolation of people suspected to have been exposed to Covid-19.

On the issue of people quarantined in hostels, we need to reevaluate. There is no reason to isolate a person for 14 or 20 days when you can see he is OK. It does not make sense keeping the person in quarantine yet you know chances are that when he is finally released, he might just continue interacting with other infected people out there. Let such a person go. Instead focus on the ones who are sick…we are wasting our resources.

By that statement, Magufuli shows he has not grasped the essence of quarantine and thinks a person appearing OK is a green light of sorts. It is bewildering that he did not define what counts as OK. The concept of incubation period of the virus is essentially not in the president’s mind.

Secondly, if his argument is that the released persons will anyway interact with other infected people, that effectively amounts to an admission that his government has not got a handle on this, and is not willing to invest effort in changing that. If that charade is the approach to quarantining individuals, then it makes sense to just do away with the pretence and close quarantine centres. The president is anyway worried about wasting resources. By his logic, he will then have more than enough resources to deal with perceptibly sick cases if quarantine facilities are closed.

The economy is never far from Magufuli’s mind as he has built his whole reputation on “unparalleled” economic growth. Perhaps that is what has blinded him to the human cost and causes him to wince when resources are used for the welfare of the people. This address also presented an opportunity for him to contradict himself. While he has been painting Covid-19 as a needless panic, manageable through prayers, now he admits he needs help.

Let me also address international financial institutions. This disease has affected the whole world. It has also affected Africa. I would like to advise you and also to make a request to the likes of World Bank. Instead of lending us money to deal with the disease, cancel our debts so that we can redirect the amounts that were set aside for repayments to the fight against Corona virus.

For example, here in Tanzania, our loan repayments are TZS 700 Bn per month and of this, about TZS 200-300 Bn goes to World Bank….now would be a good time for the World Bank to provide cancel repayments, even if just by a certain percentage…This will be a good gesture towards poor countries.

Magufuli has previously insisted that Tanzania is not poor. Barely a year ago, in this clip for example, he says that he has commissioned over 352 health centres all financed from internal revenue sources. He promises the audience that during his presidency, Tanzania would be known as a rich country and would in fact be in a position to be a lender to other countries. He further says the notion that Tanzania needs assistance should be discarded because begging is a major disease and the country has borrowed too much since independence. Now we see him begging for a good gesture towards his poor country.

The president’s thin skin would not let him ignore the criticism on social media that has escalated over the past few days. He circled back to the matter, giving an indication of how much the criticism is rankling him.

I am calling on security organs. IGP [Inspector General of Police], you are here. Deal with [those who are misusing social media] by working with TCRA[Tanzania Communications Regulatory Authority] and other security intelligence services

As is his nature, he failed to understand that one cannot fully deal with perceived disinformation by deploying security organs. The flak he has been receiving was naturally triggered by a combination of his noticeable absence at the helm, a sore lack of preventative measures in the face of the pandemic topped off by a weak and uncoordinated communication strategy.

Tanzanians have been treated to a circus where health experts, the Minister of Health and the Regional Commissioner of Dar es Salaam, for example, have been talking at cross purposes. The people are also aware of measures being undertaken in neighbouring countries to stem the spread of the virus. Yet they do not see similar efforts on the part of their leadership. To assume that arresting the people behind the voices which are calling out this state of affairs would deal with the problem go away is naive.

The time for solutions was nigh. Magufuli called on Tanzanians to use traditional methods, for example steam therapy.

I am calling on the Ministry of Health to emphasise steam therapy because it is scientifically clear. The water vapour is at a temperature higher than 100 degrees centigrade. Since the virus is fat-based, it will melt. All the viruses in the nose and mouth will be melt.

Steam therapy is carried out in many African households. For example if one has a cold or flu, some eucalyptus leaves, mint plants and lemon will be boiled in a pot. The person huddles over the pot and covers himself with a blanket so that the steam does not escape. This is simply a makeshift sauna and the inhaled steam helps to alleviate symptoms by clearing the air pathways. The effect is largely palliative and buys time as the body fights the infection.

There is no way the person is inhaling steam at 100 degrees centigrade – that would simply result in serious injury or death. There is a temperature gradient between the release of the steam from the pot and the time the person inhales it. Logically, the inhaled steam will not be at the same temperature as boiled water. While some relief is provided, that is not necessarily evidence of “melting viruses”.

Morever, as to whether this works just as well for Covid-19 symptoms, it is unclear which research the president was using to back his assertions. He would need to establish the temperature at which the virus melts and the steam inhaled would need to be at that temperature – and safely so. In any case, this would only work if the virus is contained wholly in the areas that will be reached by the steam. This is quite a stretch. The president is given to flying by the seat of his pants but he would do well to draw the line on public health during a pandemic.

In fact, claims that steam therapy can cure Covid-19 appear to be wholly unsubstantiated. This fact-check article, which examined claims of healing corona by steam therapy, quotes the American Burn Association and the US CDC. It concludes:

These posts claim that inhalation of steam from boiling water, sometimes with various infused ingredients, will kill the coronavirus. This is false. While it may help ease symptoms like congestion, steam inhalation also carries the risks of burns.

As a man of science (PhD in Chemistry), it is possible Magufuli disagrees with the conclusions above, as is his right. The appropriate thing to do would be to draw lessons from reputable research to counter the prevailing view on steam therapy before offering it as a safe remedy to his people in the midst of a global crisis. Certainly it would save the world a lot of money if we could all turn to steam therapy and vanquish Covid-19. There would be little (or much reduced) need for vaccine trials.

Hopes of anybody correcting the president’s pedestrian approach to public health medicine are dim. The shrinking democratic space in Tanzania is not helping and fear pervades all spheres of the society. Since Magufuli took over in 2015, intellectuals have been cowed and some are falling over themselves in order to be seen to agree with Magufuli. A surprising supporter of Magufuli’s steam therapy doctrine is Anna Tibaijuka.

Tibaijuka holds Doctorate of Science in Agricultural Economics from the Swedish University of Agricultural Sciences in Uppsala. She is a former under-secretary-general of the UN and also held the position of Executive Director of the United Nations Human Settlements Programme (UN-HABITAT) until 2010.

Between 2010 and 2014, she was an MP and also served as Minister of Lands, Housing and Human Settlements Developments. That she is highly accomplished is not in doubt. Her education and experience aside, Tibaijuka enthusiastically agrees with Magufuli and praises him effusively.

In this matter, the president has truly done something very good and I think he has reiterated our views. Now that he has spoken, people now know about the matter. With regard to steam therapy, it is possible for some people to get hurt but that would only result from failure to standardise steam therapy practices….steam therapy is scientific and was used mostly for the children and the elderly…if there are people ridiculing this, I would like to assure them that this is high school chemistry. The practice of our traditional medicine is not sorcery or witchcraft. It is science.

If truly science is a systematic enterprise that builds and organizes knowledge in the form of testable explanations and predictions about the universe, then Tibaijuka has loosened that definition somewhat specifically with regard to the element of steam therapy in curing Covid-19 or alleviating its symptoms. How does Tibaijuka expect people to “standardise” steam therapy? It seems she has confused hallway banter with high school chemistry. Tibaijuka would definitely know that even the science community allied to her former employer also does not view steam therapy as the cure. Stamping it with the label of “African heritage” does not make it more effective.

Neither the U.S. Centers for Disease Control and Prevention (CDC) nor the World Health Organization (WHO) suggest steam therapy with any ingredient as a cure for the coronavirus.

As if that is not enough, Tibaijuka took time to demonstrate how to use the various herbs, including some that need be stuffed into the nose. 

This should not surprise us much. Even in Magufuli’s cabinet, at various points , there have been ministers who are eminently qualified but  completely unable to rein in the boss’ madness. Since 2015, the Tanzania cabinet has been one of the most erudite in the East Africa region. Magufuli has enlisted distinguished academics who hold PhDs in Law, Psychology, Geology, Economics, International Relations, Forestry and Marine Engineering. At one point, there were 8 PhD holders in a cabinet of 19 ministers. The president’s leadership skills have not been able to bring out the best in these people or he has simply hired weaklings who cannot stand up to him and guide his agenda.

Suffice it to say that on Covid-19, Magufuli’s claims are long on unfounded hopes but short on testable explanations and predictions. As such the whole matter seems to be about believing the president simply because he knows best. He has made wild claims. They have not been tested and people who should call him out on this do not have the courage to do so.

It should not surprise many that Magufuli is given to cultic healing practices.

Barely ten years ago, hordes of people started visiting Ambilikile Mwasapile, better known as Babu wa Loliondo. Mwasapile, a retired pastor, is a medicine man who rose to fame by offering people mugariga. This was a concoction of herbs served in a cup, costing TZS 500 (equivalent to 21 US cents) that was rumoured to cure AIDS among other ailments. Mwasapile described how he started the practice of traditional medicine thus:

God appeared to me in a dream and told me people were dying of AIDS. He told me he would give me medicine which would treat AIDS. Then he showed me a tree. I was very surprised that God shared this with me. The white men had pursued a cure for this disease for so long, to the point of despair. I wondered how this tree would cure the disease.

I did not do anything for the moment. I waited until 2009. God appeared to me again and told me the time was ripe for me to begin the work he had assigned me.

Complying with God’s instructions, Mwasapile began his medicinal practice and people traveled from far and wide to partake of the miracle cure that was billed to be the silver bullet for all types of ailments.

Among prominent people who visited Babu wa Loliondo is John Magufuli and Babu wa Loliondo proudly shows journalists a picture of Magufuli drinking the miracle cure.

At the time, Magufuli was Minister of Livestock and Fisheries Development. He took time off his busy schedule to join the masses flocking for a cure. Outside, queues formed for kilometres and the sick were waiting by the roadside for days.

Before Tanzania put a stop to the sojourns for miracle cure, it was recorded that 52 people died as they waited for the cure – no doubt the tribulations of their journeys to Loliondo were too much. At one point, there were 4,000 vehicles snaking their way up to Mwasapile’s homestead and an estimated 24,000 people were in the queue for the miracle cure. Some died on the queue, waiting for a taste of mugariga, so near, yet so far.

However, these pilgrimages resulted in riches for Mwasapile. When Citizen TV visited him in 2019, his homestead had received a complete transformation: “from the mud and wattle single room house that used to be his house to a newly constructed three-bedroom self-contained bungalow. Parked in the compound is a truck and a four-wheel-drive land cruiser…”

It is unclear for what ailment Magufuli was seeking mugariga but it seems his belief in alternative medicine is unwavering.

Back to the president’s address, in delivering his final instructions, it was clear the prominent role the president has given to security teams at the expense of objective measures grounded in principles of managing a pandemic.

To my heads of defence and security, as I spoke to you and in accordance with the briefings you gave me, I am happy with the steps you are taking. You have informed me that you are treating Corona as a battle. Go and fight it so that you can save Tanzanian souls. Let us use all might and expertise so that no external enemy can ever use Corona as an entry point.

The Ministry of Health came second and essentially, Magufuli sees the role of this ministry as purely public relations.

Ministry of Health, continue driving cooperation. Continue educating the people. I have made a few organisation changes in the ministry in order to improve response and this will be fruitful.

As the president, Magufuli holds a position that makes people (want to) believe him. In a matter of life and death, he has chosen to be absent for 3 critical weeks, leaving his government rudderless. When he finally shows up, he offers solutions that are dodgy at best and potentially dangerous. He uses the same event to show where his focus is – using State apparatus to crush those who dare to hold him to account.

As if Covid-19 is not enough threat for Tanzania, the country has to deal with a pandemic whilst under the yoke of an incredibly shaky leadership. It is Magufuli’s private right to experiment with mugariga and steam therapy in his free time. Tanzanians however need to draw a line when his experimental approach sneaks into the policy for dealing with a pandemic that has so far claimed over 200,000 people worldwide. For now, if he does not abandon his (un)stable genius tactics, he remains a clear and present danger to himself, his country and the East Africa region. In the final analysis, this region can ill afford a black Donald Trump.

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