idjwi island, DRC

Moxafrica in Democratic Republic of Congo

Our introduction to DRC came through Michele and Albert Losseau, a Belgian couple who have lived much of their lives in Africa and had contact with a doctor in the huge city of Goma, close to the border with Rwanda. Working there would mean dealing with an unstable political environment and gaining the trust of medics and officials to introduce an unknown therapy. Hospitals lack basic diagnostic equipment and even standard TB drugs, and the difficulties caused by widespread poverty and lack of infrastructure make it hard for patients to sustain long term adherence to TB treatments. Added to that, the active Nyaragongo volcano remains a continual threat. During an exploratory visit by Michele and Albert last year it became clear that it was not going to be feasible to work there. Undeterred by this, the Losseaus followed another lead south of Goma to the island of Idjwi, situated within Lake Kivu. Idjwi is a tropical island of 131 square miles with a population of 300,000, several small hospitals and clinics with poor infrastructure. There were at that time no TB drugs available. Although also under military rule, its isolation from the main land and lack of mineral resources leaves it mostly abandoned, and our proposal to set up a trial moxa program in the context of the tuberculosis pandemic was greeted with enthusiasm. The Losseaus visited health centres, spoke with doctors, demonstrated moxa treatment and learnt as much as they could about life on the island and the challenges facing patients, health workers and any potential moxa programme.

In November they returned to Idjwi and set up an initial trial. There was much work to do in preparation for this: Michele, a shiatsu practitioner, had little experience of moxa and underwent an intensive learning curve to develop the skills and confidence to train health workers and explain it to patients. Albert got himself in the logistics and together we worked on protocols and developed a training manual specifically for Idjwi.

The aims of this initial trial were to:

Check interest and willingness to adhere to the project by the local authorities
Understand how the administrative health structure functions while being under the power of the armed forces of the M23
Organise a workshop to train healthworkers
Perform a first screening of TB patients in the area with a medical follow up including blood tests and sputum tests
Start first moxa treatment on the small sample of screened TB patients using Doctor Hara’s protocol.
Learn from this initial experience to envisage the possibility of setting up a larger scale research

Specific challenges for Idjwi

A major problem is the general poverty, the distance of the patients from the health centres and the lack of “moxa buddies” to assist patients with their daily moxa application.

Reaching patients is difficult due to the lack of transport. There are no tarred roads on Idjwi and the only transport is by motorbike on dirt roads which, during the lengthy rainy seasons, makes communication between patients and health centres unreliable. Many patients have to walk 1-2 hours to a clinic. Due to these problems, we have to consider funding the patients and health workers to be part of our trial.

Another major issue is the general lack of organisation in screening and selecting TB patients. Suspected TB patients are confirmed by the sputum test, which is limited and unreliable. The standard GeneXpert machine used worldwide for TB detection and identifying drug-resistant strains is unavailable and desperately needed. TB infections remain undetected and therefore untreated. Nobody really knows how much TB there is on the island (we were told they see around 100 new cases per year, but they do not know whether any of these are MDR-TB).We suspect that there may be a high incidence of MDR-TB because of erratic drug supply and we have already come across patients who have had repeated infections. Standard drugs, when they do become available, will not help in cases of drug resistance, and moxa could offer such patients some hope. From the point of view of a successful moxa program, it would be a huge advantage to be able to identify drug resistant infections and give special attention to these patients. We are currently trying to address this issue by sourcing a second-hand GeneXpert machine to donate to the Idjwi Health Zone. This is a big expense beyond the usual remit of our charity, but we believe it is essential for the progress of our work on Idjwi.

The expense would involve an estimated price of 8,000 USD (new equipment would cost 15,000 USD)

If you can help us to pay for a Genexpert and support the patients of Idjwi, please donate here. Every donation counts and will help towards our goal!! thanks

The outcome of this visit was that 14 health workers from the reference hospital and from 5 different health centres were trained and 13 patients have been started on the daily moxa program. Their progress is monitored monthly by Dr. Zephyrin, the intern doctor of the reference hospital. The Losseaus are in regular communication with the health workers, doctor Zehyrin and Frank Ndakala (Idjwi zone Health TB Supervisor) using WhatsApp. After 3 months it is anticipated to return to Idjwi to assess the whole process.

This is a small beginning to something we hope will grow. Just as one small moxa cone is only the start of a long term process to heal a chronic condition, so our small but very energised Moxafrica team attempts to help people in chronically poor parts of the world.

As Merlin put it: “Idjwi offers us a unique opportunity to further our investigations looking at moxa with MDR-TB while at the same time potentially saving some lives and preventing further destitution for some families in Idjwi. In other words, it has 'MoxAfrica' stamped all over it. Whether it's within our capabilities is, of course, up for debate and is dependent on some uncertainties (not least of which is funding). But at its heart it comes with the commitment, goodwill, and sound common sense and experience of Michele and Albert, so has as good a chance as anything else we've ever attempted” (Merlin Young, 2025 )

(Monvu Hospital. From left, Franck Ndakala, ( Participants of the Workshop)

Idjwi zone Health Tb Supevisor Michèle, Dr … Monvu hospital,

Dr Aimé Nkemba, Idjwi zone Health Director,

Sister Alexandria, Hospital Logistician.)

Workshop (First Moxa application demonstration on a banana

Moxa training of family assistant General view of Monvu Hospital

Visit at Kisiza Health center, from left, Franck Ndakala, , Michèle, Albert and Ladislas Ndegeyi, Nusrse assistant.

Supervision mission at Nyakalengwa, Franck on the left, Dr Zephyrin Musaka second on the right

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