IMG 1233

TB testing in Mbagala, Dar Es Salaam

MUKIKUTE as a national patient organization is based on voluntarism as main important element of engaging community in TB control. That´s why we are always looking for motivated volunteers willing to work under the same spirit.
MUKIKUTE welcomes all interested specialists in all fields of work in volunteer themselves in working with our staff in the communities of Tanzania. We are creating opportunities for IT specialists, medicals, youth and interns interested in social work from all over the world. The aim of providing this opportunity is to give our interns a chance to contribute to the improvement or change of patients´ life. By doing that, volunteers will gain relevant skills in this line.
For those national and international students who wish to do an internship at MUKIKUTE, please look for more options and explanations under the Training and Research Program on our website

LHL International received the sad message that Ms. Rehema Mpili, unexpectedly and so early in life passed away October 7th.

Ms Mpili was an engaged human being, with a warm heart of understanding for other people. She was a driving force in Mukikute in ensuring access to care and treatment for the most-at-risk population. Ms. Mpili shared her story as an inspiration for others. She also utilized the opportunities she got through courses and trainings to improve the situation of women and other vulnerable people in her community, and to claim her rights.

Reheema was energetic and positive, and said "welcome" in an enthusiastic manner to visitors and patients. She managed to complete her education as a nurse, and used her own life experience to create an atmosphere of confidence and trust among those who are used to being ignored and asked to get away. She managed to mobilize others to engage in the fight against TB and Hiv in the community.

Reheema at Mukikute Gender workshop October 2014

Reheema Mpili will continue to be an example in the stories LHL International uses in promoting peer work and health communication in the fight against stigma and discrimination. Openness and trust are key factors in fighting the global TB epidemic. When former TB patients and Hiv positive people come forward and tell openly that life is good if you get help from the health care system, and that treatment is available free of costs, this creates hope and access for others. Openness is also a powerful tool against stigma, misconceptions and discrimination.


Reheema with one of her clients that she followed up very closely so that he could complete his TB treatment uninterrupted.

Reheema and others from the TB Club in Rangitatu 2011.


We are sorry for Reheema Mpili's family members, patients and for Mukikute who lost one of its experienced volunteers. Let us all work together to bring Reheema's spirit and values further in the fight against tuberculosis in Tanzania.

Knowledge, Attitudes and Practices on TB and TB/HIV in Tanzania

In 2009, the MoHSW (through the NTLP) collaborated with PATH to conduct a
knowledge, attitudes and practices (KAP) study in ten districts across the regions
of Arusha, Mwanza, Dar es Salaam, Pwani, Morogoro and Mbeya. The aim was to
identify factors that infl uence communication to effectively promote combined TB and TB/HIV services in Tanzania. The study revealed a range of knowledge gaps, attitudes and sub-optimal health behaviours.

Accurate knowledge on the causes, symptoms, treatment and prevention of TB was low in communities, although much higher regarding HIV/AIDS. The relationship between TB and HIV/AIDS was poorly understood. For example, most people did not know that TB was a common opportunistic infection for HIV and many believed that responding well to TB treatment proved one did not have HIV. Most TB patients themselves had quite good knowledge about TB and HIV transmission, treatment and prevention, which was obtained only after they started attending TB and HIV care services at health facilities. While there were vigorous mass media campaigns and community based education about HIV, TB education was only seen in health facilities. Health education and promotion materials were insuffi cient and poorly distributed and the limited print materials available did not target the highest risk groups in the community.

Although people poorly understood the connection between TB and HIV, they feared both diseases and discriminated against those who had either disease. Individuals with TB or HIV are likely to be isolated and viewed as immoral and unworthy of resources. TB patients reported that stigma was widespread in households,communities and among healthcare workers in non-TB health facilities. While stigma attached to HIV/AIDS was regarded as worse, presenting symptoms of wasting, persistent cough and fever similar for both diseases are often misread as a sure indictor for AIDS. Stigma about HIV led to feelings of shame and lack of motivation to seek treatment for TB symptoms.

In general, the onset of symptoms like cough, weight loss, fever, etc. does not trigger timely search for TB or HIV care. Instead, patients delay seeking appropriate health care due to:
• Attempts at self-medication through local drug shops.
• Belief in traditional healers (who refer patients to health facilities only after their condition becomes serious).
• Slow referrals from health facilities to TB clinics.
• Lack of knowledge about TB and HIV, the importance of early diagnosis, and the
availability of free services for both TB and HIV treatment and care.
• User fees
Delayed or denied permission from husband or family elders. (among women)

People used a variety of media and communication channels to get information,
depending upon where they lived. Urban leaders preferred the use of radio, TV, and printed materials and those living in towns preferred to limit their involvement in community activities. People from rural areas, however, preferred direct involvement in awareness campaigns and the use of local entertainment groups.

Flavian was one of the founding members of Mukikute – the first registered

TB Patient organization in Tanzania. Unfortunately he passed away in October
2015 after worsening health condition. As one of the initially elected leadership
in Mukikute, he served as the finance responsible for many years. He tirelessly
worked to build Mukikute stone by stone from a small, informal, group of 20 individuals assisting the Temeke Municipal TB programme, to become independent and recognized nationally and outside the country.

Flavian pushed on as a key player for the thematic and geographic development of the organization. In the later years he focused on the establishment of new groups around Tanzania, "Mkuta" groups which would unite all TB patient organizations in Tanzania in a competent network of technical and practical support from the main office. The aim was to include former TB patients as peers actively everywhere in aspects of TB control and awareness raising based on the positive experiences from Temeke. This brought him around the country to visit the mining sites in the Kilimanjaro region, fishermen at Lake Victoria, Masaii in Chalinze, border areas towards Zambia, and urban slums in Dar es Salaam. When the LHL president visited Tanzania, Flavian said: "Before it was TB in every house hold, but we did not know that it didn't have to be like that. This was seen as a normal part of life. You can never understand the importance of your efforts for us here in Tanzania". Like other Mukikute members he knew from experience what it took to stand up and confront stigma and discrimination against TB and Hiv. Flavian assisted as a translator and facilitator for external visitors, film makers, and in the booklet process. He took initiatives and wanted things to materialize from talk to action. Increased knowledge and awareness on TB and HIV in the Tanzanian population is highly needed still, and we will honor Flavians spirit by focusing on key areas of empowerment of individuals and communities.
In sympathy with the family and friends of Flavian Makaranga, we will keep the good memories with us, and continue the important work against tuberculosis in Tanzania.

Flavian handing out TB-information material at the market in Kibaha. Flavian with TB Club Tokiuki, Kinondoni, Dar es Salaam Flavian with Mama Esther Laban Moretu, leader of a Masaii group from Chalinze.

Flavian handing out TB-information material at the market in Kibaha. Flavian with TB Club Tokiuki, Kinondoni, Dar es Salaam Flavian with Mama Esther Laban Moretu, leader of a Masaii group from Chalinze.