The Uganda link had arisen from communication with the Pan African Acupuncture Project (PAAP), a voluntary organisation based in the USA and led by Richard Mandell. PAAP have been working in Uganda for several years, training nurses and midwives to carry out simple protocol-based acupuncture with remarkable results. On learning of  Moxafrica's aims and objectives, Richard felt that they fitted in well with his own, and invited us to join PAAP’s next trip to Uganda.

It proved to be of huge benefit to be under the wing of someone with such extensive experience of working in Uganda with well-established contacts in the medical field. We owe Richard our deepest gratitude for the success of this trip and for the potential that has arisen from it.

Our week was spent mainly in Lyantonde, a small but busy town some 4 hours drive from Kampala. Being a truck stop on the main route connecting Rwanda and the Eastern Congo to the whole of East Africa, Lyantonde has gained an unfortunate reputation as a focus for prostitution and HIV/AIDS, the town being hometo the first ever recorded case of AIDS in Africa.

The hospital, at the edge of the town, comprises a collection of single storey buildings with only very basic facilities and little evidence of any sort of organisation. Patients and their families seemed to wait around aimlessly inside and outside, and nurses and doctors were rarely to be seen. There was no running water at the hospital for several days. The wards were dirty and furnished with beds covered only with thin foam mattresses on which patients lay fully clothed or covered with cloths they had brought themselves, seemingly fed and cared for mainly by their families. Medicines were in short supply; in fact there were long lists pinned up in the wards indicating which medicines were out of stock.

Our first few days were spent observing and assisting with the acupuncture training program supervised by Richard. We were very impressed by how quickly the African trainees had acquired acupuncture skills, and how most of them had embraced this “new” therapy with such enthusiasm. The patients came from the surrounding area, attracted by advertising on the local tannoy and by word of mouth. Probably the idea of some kind of free treatment was enough when so little medical help is available. They came with all sorts of problems, many of them  suffering from complications arising from malaria, TB and HIV/AIDS. Almost all had accompanying musculoskeletal problems from the hard physical work of subsistence farming. There were many sick children and mothers with childbirth problems. The trainees treated them all, sometimes with astonishingly successful results. We concluded that, to survive beyond infancy, Ugandans must have extraordinary powers of recovery and this was evident in their response to so few treatments. 

During the last two days at Lyantonde, Richard generously allotted some time for us to introduce the eighteen Ugandan trainees to direct moxa.

Our aim was to assess how they would feel about the idea of burning something on the skin, and whether they would consider it an acceptable therapy to try out in their own work places. Additionally we wanted to assess how easy it might be to teach African health workers basic moxa skills. On all counts we were encouraged. After explaining that this was a treatment that might be used for TB, and giving them brief practical instructions, we soon had them all rolling moxa, both making and burning tiny cones with impressive dexterity. They asked a lot of questions and all seemed enthusiastic to learn more.

The following day we were invited to demonstrate moxa treatments on two patients, one of them a very sick man co-infected with TB and HIV. He was terribly wasted by the two diseases, cared for by his sister who was vainly trying to administer his daily medication. After we had finished treating him, using the minimum possible stimulation of moxa because of his dreadful condition, we used a trainee to help us explain to his sister how to use moxa and how to locate a treatment point, leaving her clear instructions on a simple protocol to follow every day, building up dosage if he strengthened.