There are close to 100 ethnic groups in Tanzania with distinct ways of caring for people who are dying. Not every community or group has high HIV prevalence, and some of the traditional herbalists have access to analgesics while others do not. Kristopher Hartwig describes the traditional medical approach:

[The traditional approach]…was not to tell people about their terminal condition, but rather prescribe something and do a referral, and that’s still done to a large degree with cancers, which are very obviously cancer and… very obviously uncurable to anyone with a medical background, but it’s very difficult and it’s not within the training still to talk about, openly about the disease, except for HIV/AIDS where it is now, there is a prescribed avenue which I think we all understood, and in a way that has opened the door for a kind of truth-telling which has not been in the medical culture before.⁵³

A reliance on both traditional and allopathic medical systems often results in late presentations for treatments. There are only three referral hospitals in the country that can diagnose cancer, and cancer patients from all over Tanzania have to travel to ORCI in Dar es Salaam for treatment. Biopsies taken at another centre can take up to six months for a result. The capacity for biopsies is around 2,000 specimens per year, but over 10,000 samples are received. Specimens sent to Europe are often diagnosed in three weeks. A biopsy can be ‘fast tracked’ at ORCI within two weeks but costs the equivalent of US$ 25 which many patients are unable to afford.