A pioneering methadone programme treats drug users in Dar es Salaam

Every morning, hundreds of Tanzanians make their daily sojourn to a breezy open-air methadone clinic at Muhimbili National Hospital. The journey is not always smooth. Some travel on overcrowded local buses, and others walk for hours in Dar es Salaam’s sweltering heat.

One by one, the patients are called to a window, where a nurse behind a metal grate offers a plastic cup filled with liquid methadone. They drink the viscous concoction under her watchful eye, after which they can continue their day without craving heroin. “For a long time, I couldn’t live without heroin,” said Stamil Hamadi, a 34-year-old woman with a heart-shaped face and calming presence. “I decided to try methadone to become a new Stamil. My health began improving, and I started gaining weight.”

Muhimbili’s methadone clinic is the first of its kind in mainland sub-Saharan Africa. Few governments, donors or nonprofits in Africa work with heroin users. Médecins du Monde (MDM), an international nonprofit that serves heroin users in Tanzania, estimates that fewer than 1 percent of drug users on the continent have access to support services, let alone treatment plans like methadone.

Tanzania is a striking exception. In 2009 the national government publicly declared that its drug users needed evidence-based treatment options. With aid from the United States and Canada, Tanzania’s Ministry of Health approved a comprehensive plan to help prevent and treat heroin addiction.

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