By Fathya Chambo and Kuduishe Kisowile
Dar Es Salaam. In the year 1997 in the streets of Ilala, a teenage girl wanders with her friends in clubs and bars. Her mother had just passed away, and a few years later her father too, and she was now an orphan. Forced to live with her aunt who had five children of her own, she felt neglected and sought solace from the world outside home. Little did she know how her life was about to turn around. Her name is Lisa Samson Maganga.
Lisa was 16 years old when she met a foreign man who promised to marry her and take her to America. He was 61 years old. Her family disagreed but Lisa was desperate to escape poverty, so she married him anyway. In no time, they flew back to Philadelphia, and she began a new life. A child bride in a foreign land, with her passport and green card hidden away by her old husband who wouldn’t let her speak to anyone outside; she felt isolated.
In the spirit of youthfulness and longing for human interactions outside her husband, she began to sneak out and ended up making friends with people with risky behaviors. Many of her friends worked in strip clubs and took her with them while her husband was at work. This is where she snorted cocaine for the first time. In no time, she tried heroin, and it was downhill from there.
One day she met a man in the strip club, he was a few years older than her; early 20s and she told him about her ordeal. The man alerted the police about her situation and her marriage was annulled by the court. When she turned 18, he married her. He was in college and during holidays, they went back together in Tanzania to formally introduce him to her family. He loved the country and made sure he got a job in a company that works in Tanzania; they officially moved back.
Figure 1; Lisa Maganga taking Methadone during her clinic visit at MAT Clinic Mwananyamala Regional Referral Hospital. Photo by Joancen Kagombora, Dar es Salaam
Lisa was still using illicit drugs without her husband’s knowledge. They rented a house in Mikocheni, got a car and she had her own driver to take her around. In no time, she was pregnant; but that did not stop her from using drugs. She used all the allowance given by her husband to buy drugs. When that was not enough, she sold her pieces of jewelry and electronics to feed the habit.
Months passed and she was about to give birth, her doctor who knew about her drug use advised her to give birth at Nairobi Hospital for better newborn care. Her mother took her there and Lisa carried a stash of drugs with her. After a safe delivery, her daughter had to be admitted for a few weeks because of Neonatal Abstinence Syndrome, a condition caused by exposure to drugs in the womb before birth; with a child presenting with tremors, irritability, vomiting, diarrhea, and fever
When the child recovered and they were ready to go back home, the doctor advised her to not breastfeed to prevent the baby from more exposure to drugs. Eventually, her husband found out and took her to a therapist, but that did not help her.
One fateful day, the husband came back home to find her passed out on the floor with their 9-month-old daughter crying beside her. That was the last straw. He called the police, and she was charged with child endangerment. She was jailed for 21 days and by the time she was out, he was gone. He left for the United States with their daughter, and she was back in Ilala at her aunt’s house.
Filled with guilt and regret, Lisa’s life went downhill from there. “I was in so much pain, I buried myself further in drugs. I went to clubs and had sex with strangers to get money for drugs, I would get 1,000 to 2,000 Tanzanian shillings per man because of how I looked, no man would pay more than that”, she narrated. “I was malnourished, so bad that it reached a point where when I walked on the street no man would call me. I looked old, lost so much weight that I became like a skeleton”, she added.
She found herself homeless because she kept on stealing from her aunt to buy drugs. “I found myself sleeping outside on boxes, I was living like a mad woman”, she said. “I stole from men, jumped from moving motorcycles to avoid paying fare because I needed that money for drugs since the men I slept with did not pay me enough”, she added. She was hopeless and helpless; she did not care if she lived or died.
From time to time, at the place where she would do drugs with her friends; an organization named Methadone Family Against Drug Abuse (MEFADA) visited them to educate them about Methadone. One of the peer educators knew her, he had been an addict and knew her life story. “He told me that if I take Methadone, I will be able to find and speak to my daughter”, she said. That was a turning moment for Lisa, there was nothing she wanted more than reuniting with her daughter.
Figure 2: Lisa Samson Maganga at her home Mwananyamala. Photo by Joancen Kagombora, Dar es Salaam
MEFADA is a civil society organization launched in 2015 that works to educate youths and families about drug abuse. It also links people who abuse drugs to health facilities for therapy and treatment while also providing family therapy with their families.
Lisa took that advice and began attending the MAT clinic at Mwananyamala Regional Referral Hospital, but not for long before she relapsed. Her friend whom she went with the first time did not give up on her. She kept on bugging Lisa to restart treatment again and eventually, she was successful. After a few months, Lisa restarted treatment again and has never missed a day since then.
Her treatment journey was not a smooth tarmac road, she had to come face to face with many things that she was using drugs to escape from. From the guilt of losing her daughter, it was the hope of reuniting with her that kept her going. That was her only goal, to get clean so that she can reunite with her long-lost daughter.
Today, Lisa who is in her early 40s has been sober for over 7 years; a married mother of two and a peer educator who helps other addicts in their journey to recovery. She works with Life and Hope organization which works with the community and MDH to educate and link people with drug addiction to treatment facilities. “In a month, I can reach out to at most 40 people with drug addiction and maybe 7 or 8 of them will accept treatment and I link them to MAT clinic”, she said. She is in touch with her now 16 years old daughter who lives in the US, they talk and chat all the time. She is yet to physically meet her, but she hopes soon she will meet her. Lisa and her husband have built their house at Vipawa, Bagamoyo and plan to move in soon.
Figure 3: Lisa Maganga explaining to Mr Gerald Kusaya, the former Commissioner General, Drug Control & Enforcement Authority (DCEA) on Methadone during World AIDS Day 2022, Lindi. Photo by Joancen Kagombora, Lindi
Lisa is one of peers that are supported by the U.S Centers for Disease Control and Prevention (U.S CDC) through the partner Management and Development for Health (MDH) as part of their initiatives in Medical Assisted Therapy (MAT). She still attends MAT clinic at Mwananyamala Regional Referral Hospital. MDH supports 7 clinics in total in Dar es Salaam. 3 of them are “mother clinics” or clinics that enroll clients from the community with the help of civil social organizations (CSOs). MDH has supported MAT services since 2015.
MDH with funding from PEPFAR through the U.S CDC, supports MAT clinics in various ways including technical assistance to MAT clinic and CSO on program implementation, capacity building on documentation and M&E (Monitoring and Evaluation), supporting facility-led outreach activities, resolving supply chain issues and provide training to Health Care Providers (HCPs). By the end of March 2023, a cumulative of 10,137 clients have been enrolled to MAT clinics, and 4,172 are actively receiving care. Those who have successfully recovered from drug use like Lisa, have been crucial in strengthening prevention through community outreach and telling their stories to the world and their peers, especially those at risk and vulnerable to drug use. MDH supports the efforts of the Government of Tanzania through the Ministry of Health by strengthening MAT services in the country. As the theme for this year’s International Day against Drug Abuse and Illicit Trafficking says, “People first: stop stigma and discrimination, strengthen prevention” it is a reminder that drug addiction is a complex issue and behind the user is a person looking for an escape. Preventing stigma and discrimination towards people who use drugs (PWUDs) is key to helping them recover.
