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World Premier: Compassion Connects

Compassion Connects MarqueeAcupuncture Relief Project presents a world premier screening of

Compassion Connects: Ancient Medicine for Modern Health Care

Hollywood Theater, Portland Oregon, June 13th 2012, 7:30pm

Free Admission • Donations Appreciated

In 2011, film-maker Tristan Stoch followed a team of Acupuncture Relief Project volunteer practitioners during their stay at the Vajra Varahi Clinic in Chapagaon, Nepal.
In this short film he successfully illustrates many of the complexities of providing primary medical care in a third world environment.

Since 2008 Acupuncture Relief Project has provided over 100,000 treatments to patients living in rural villages outside of Kathmandu Nepal.  Acupuncture offers an inexpensive, sustainable method of providing communities access to medical evaluation and basic care.

Please join us Wednesday, June 13th for a celebration of Acupuncture Relief Project’s work in Nepal.  Between the two screenings of the film, Project Director Andrew Schlabach will give a brief talk about the organization’s accomplishments.

7:30 pm :Premier Screening of Compassion Connects

8:00 pm: Presentation by Andrew Schlabach: Acupuncture as Primary Care in the Third World

8:45 pm: Second screening of Compassion Connects

Compassion Connects: Synopsis

Against tremendous obstacles of poverty, in regions where the struggle to survive often usurp basic medical needs, five volunteer  acupuncturists, set up a health clinic in Nepal. Through providing basic primary health care, a connection emerges between patient and practitioner that act as a vehicle for exploring fundamental questions about what it means have compassion, and elementarily, what it means to be a good human being. These relationships have long-lasting effects both personally and socially, bringing waves of compassion to all communities, at home and in Nepal, creating meaning, changing lives, changing communities.

For more information please visit: www.CompassionConnects.org

Click here to watch the Compassion Connects theatrical trailer: How far would your go to inspire hope?


Good News Bad News

Jessica Maynard Acupuncture Volunteer

These past six weeks have been a whirlwind!  Treating patients in Chapagaon, Godhavari, Champi, and Sipadol has been wonderful, challenging, gruelling, a test of patience, endurance, ingenuity, and yes, a test of using the art of language and communication.  “But you have interpreters!” You say.  And I agree.  They are incredibly capable at what they do, and they make this operation go round.  But the art of communication is a tough one, and as practitioners, part of our responsibility is to make the message we want to give to the patient communicable, and clear.  However.  This isn’t the end of the story.  What happens when you must tell someone something that even in English is a challenge to say?  This takes on a whole new level of skill, compassion, and of course, truth. 

One of my regular patients has Parkinson’s disease. She has come in faithfully to the clinic, 4 and 5 days in a row, for six weeks straight, for acupuncture.  On the first visit she was told that her hand and facial tremors could perhaps be decreased by regular treatments, but that they would never completely go away.  However, throughout the entire duration of her coming to the clinic she has been anxious to have her disease ‘cured’ so that she can return to her village.  In almost every intake  her reply to “how are you doing today” is some kind of wry answer like “well, I’m still shaking”  or “look at me.  How do you think I am?”  But her commitment to stay in Chapagaon, live with her son, daughter-in-law, and grandson, and make the trek to the clinic on foot on a daily basis is strong.  Because she has believed that she will, in fact, be cured.

As a new medical practitioner, and one who hasn’t dealt yet with terminal and permanent illness to a great degree, I am discovering that the line between contributing to a sense of hope for a patient, and giving them the honest, hard truth is a fine one.  Add to that a culture of people who haven’t heard the terms ‘Parkinson’s’ and ‘Alzheimer’s’ and the tendency is very attractive to keep a patient in ignorant bliss, thinking that if they come in every day (or as instructed) to get their treatments, that they will someday be free of their afflictions and life will go back to the way it was. I am sure this is a common feeling underlying all practices of medicine.  We all want to breed hope.  But if the truth underlies the hope, and the level of wellbeing and awareness of a patient as to his or her condition is under threat due to dishonesty, then what we have as primary care practitioners (as we acupuncturists are considered here in Nepal), then we have a tremendous responsibility.  And it isn’t our responsibility to give diagnostic news to our patients in the US, so. Here comes a grand opportunity.

And so, a few treatments in, it started to become apparent  that nobody had yet given her the news, the honest truth, about her disease(or so I thought.  I later learned that it had not been explained with clarity, nor had the patient or the family assimilated, either through lack of understanding or perhaps acceptance, the information that her disease was progressive, and without cure) .  So I asked.  “Has anyone ever talked to you about Parkinson’s disease?” she and her daughter-in-law looking back at me with a blankness that whispered, “they have no idea.”  And so, in one moment, it became my responsibility to tell her about her disease and its implications for her life. 

Acupuncture Patient Nepal

The beauty, and irony, of this moment, is that it was inextricably linked in my mind to my father.  I stole the title of this blog from him, from his book about communication and the deliverance of news in a clinical setting, written in sociological, ethnomethodological, conversation analysis language and code.  I hope he doesn’t file for copyright...!  But in all seriousness, I knew that this very moment  in my life was a moment that my father has dedicated years of study and passion to understanding.    As I explained what Parkinson’s disease is to the patient and her family member (mind you, this is also in a room full of other patients, and hardly a private space), split-second thoughts ran through my head.  Am I doing a good job?  Am I saying enough?  Am I delivering this news in the best possible way, showing honesty, clarity, and of course, compassion? And I hope to whatever I can hope to that I am doing it well.   Partly to honor the studies that my father has done, but most importantly for this patient, for her hopes, her life, and for her understanding of what is happening to her body. 

She seemed to understand, albeit with a stubbornness that I could sense, both she and her daughter-in-law listening and silently passing a moment to process the news that her condition is ‘irreversible’.  They showed no signs of having heard this news before.  I delved into explaining simple idiopathy, and suggested that she, the patient, could elect to continue treatment with acupuncture, seek allopathic care and pharmaceutical therapy, or both.  Ultimately, it was up to her.  When all the needles had been taken out, she stated that if I cured her illness, she would give me a prize.  I believe that I was as clear as possible, but the hope of the human heart is astounding.  And in some ways, who knows.  Miracles happen.

As it turned out, she in fact had been to see a western doctor, and also had been prescribed Levodopa.  She returned to the clinic following our discourse with records from the hospital, stating her condition as Parkinsonian.  It was now revealed to me that she had taken pharmaceuticals, went off of them, and decided to try another course by putting her sole efforts to return to health into treatments at our clinic.  The interesting thing is, if she has records stating her disease, and medications to potentially help alleviate the symptoms,  how could she and her family not know what is happening to her?

It has become readily evident that communication in the hospitals and clinics here is scanty, if not absent.  In Nepal, we as Chinese medicine practitioners are considered on par with allopathic care.  Our opinions matter equally to patients, and the faith given to our medicine is perhaps as much or beyond that given to the Western form of medicine.    Working at the clinic we consistently see patients on medications who have no idea what their medications are for (not always the case, to be clear, but enough of the case to note).   Surely there is a mix of educated  (doctors) vs uneducated (patients), and a communication gap that occurs due to many factors that exist in the interplay of the two sides.  Over the course of treating in our clinic, it appears as well that the communication that we are providing to the patients goes above and beyond what they are getting from allopathic doctors, and also surpasses patients’ expectations. 

The interesting thing is that the first day that I told my patient about her illness wasn’t the last.  She and her daughter-in-law at various times have continued to ask about the possibility of cure.  So I’ve gotten to practice delivering a compassionate and truthful message a few times over!  Progressive, irreversible, brain, nervous system, acupuncture may help, no guarantees, the most important thing is for you to be happy...these are the nuts and bolts.  When I am not at the main clinic they have asked other practitioners, as if they may tell them what they want to hear. They get the same answer... One day my patient with Parkinson’s told me that she liked me very much.  This was such beautiful news, as her moods are variable, and sometimes, honestly I just can’t tell. 

Working with her over these weeks has been beautiful, and tough.  Her symptoms do improve sometimes, which is incredibly encouraging.  But they also go in waves.  Although her symptoms do fluctuate, both in what she states, and in what can be observed, the most remarkable thing is her personal aspect.  She is smiling much more, her eyes are brighter, she is quite a bit more chatty.  She even cracks jokes, a dry sense of humor that makes others in the room laugh.  Another practitioner described her as “glowing” just the other day.  She has, what we call in Chinese Medicine, Shen.  Her Shen is bright.  I can tell she has done much in her life, and cared deeply for her family, for whom she has taken care until she began to lose her dexterity, her clarity of speech, and with it, her identity.  A few weeks in, she began walking to the clinic by herself on a daily basis.  She would announce it as she sat down, “I came by myself today”.  She had a gleam in her eye and a shining smile under her hesitancy to show it. --- Jessica Maynard

Communal Healing

Seven Crow | Acupuncture Volunteer Nepal

Now that I have been in clinic for a couple weeks, I am able to observe the effectiveness of the community style of acupuncture that I am giving. Treating multiple people in the day turns out not to be as hard as I thought it would be, but rather I have found I have a limit to how many people I can see, at this point in my life, without losing quality of care. Going beyond my magic number creates a fast food assembly line aspect that requires a very similar treatment each time. Some practitioners, such as Miriam Lee, swear by using the same few points over and over again. I, on the other hand, do not find that to be specifically helpful to the various patterns of disease I am seeing. So what to do?

My magic number does tend to fluctuate depending on the day of the week (for example later in the week I have begun to tax my energy reserves), how many new patients I am seeing, which clinic I am working in, how complicated the cases are, do I need to constantly reassess in great detail or is it a repeat treatment case, am I adding in more than needles, and so on. Plus, treating nearly 20 patients a day, six days a week is a new phenomenon for me. So far I have seen more patients in 2 weeks than I had in one quarter at OCOM (Oregon College of Oriental Medicine)! I am humbled and amazed at the skills I seemed to have acquired along the way in order to treat in such a fashion (and make people happy with my care)!

Seven Crow | Acupuncture Volunteer NepalSomething else I have noticed is the patients expectations are more realistic here than in the west. Back home people want miraculous results after one treatment and do not want to come back multiple times in a week. Sometimes this is due to cost, other times it is due to time availability. Here they come multiple times a week, walking great distances, and get results very quickly, even though they have limited opportunities to change their daily habits, or take herbal medicines long term. I am yet again astonished by the dedication the Nepali people have to their own, and their families, healthcare. I cannot tell you how many times I have heard the story of trying other forms of medicine and pills, but not getting results, it being too expensive or difficult to understand, then coming for acupuncture and end up feeling heard and healed! My heart swells to know they have found one part of the puzzle, and that I have the honor to help!

I have also witnessed the community style offering a chance for social healing. People from different castes, age groups, and language dialects  all sit around together, talking, making jokes, helping the doctors or each other’s children, all the while with needles sticking out of various parts of their body. This type of medicine is invaluable to care! However with any great thing there will be difficulties.

Earlier this week, a man came in to the clinic to get help for his family. There were a few things going on and while I consulted with him it became clear that he was looking for acupuncture to help his mother come back from Alzheimer’s. While I have been in many end stage situations, including suicide, I have never had to tell a patient (in this case the son of someone) that acupuncture could not make them better. I explained that acupuncture could offer relief of some symptoms and medication side effects, but not reverse this particular condition. The man looked lost and turned to one of my colleagues for a different answer or confirmation to my words. I could feel tears welling up in my eyes delivering the news , while also feeling frustrated I could not follow through with the conversation. I had to leave him in the care of another due to the three patients I had upstairs with needles in for Bells Palsy. Thankfully, my fellow colleague, Jessica Maynard, had the afternoon off and was able to visit the family and explain the situation with greater care.

Seven Crow | Acupuncture Volunteer Nepal

It was in this moment that I suddenly felt the weight of being a doctor and primary care physician. People come to us with their health and trust that we can help them, or at the very least inform them of what is happening and offer some suggestions. Back home this responsibility is neither required of us or given to us, and when opportunity presents itself we rarely take it on due to liability, or scope of practice. Yet, we pierce their skin with needles, manipulate muscles, joints, qi and blood with massage, cupping, or gua sha, and give them internal medicines with light, severe, or no side-effects, all which should be followed up with adequate care. On top of this, they get miraculous results for diseases they were told had little to no cure! It is because of my trip here that I feel very strongly that we Chinese medicine practitioners should be considered doctors and primary care physicians throughout the world. Not just because our medicine deserves this respect and recognition, but because our patients deserve the same respect, trust and care they give us with their permission to treat.

Seven Crow | Acupuncture Volunteer NepalWhile I had come to this decision living in the United States, it is here in Nepal, where my knowledge, wisdom, skills, and compassion has been tested, and what we do reveals just how effective these intricate (and yet simple) techniques can create a better quality of life. Being depended on as the go-to care because other avenues have failed to provide adequate solutions, or cost-effective medicines with minimal side-effects, is not a burden, rather a great honor. It is not that Chinese medicine is just cheap, therefore making it effective (although that does contribute to the answer), but rather it works with the individual body to create homeostasis and health for that person. While some people may present with the same pathology, they do not necessarily share the same symptoms 100% due to underlying conditions or constitutions. Treating here has taught me these skills more than 4 years of education; however the chance to study the medicine in the first place, and pass it on, leaves me with an extreme sense of gratitude.

On a lighter note, the same day I was met with the reality of having to deliver bad news from time to time, a woman patient of mine came back to tell me with glowing, shen filled eyes that she was healed and could now travel back to her village. She bowed several times, saying “Namaste” over and over, and then handed me a bag of fresh fruit as a parting thank you gift. Nothing could have pleased me more. She felt remarkably better, and completely empowered, to tell me she felt our healing sessions had come to an end. That simple exchange reminded me why I became a “doctor”, and instilled in me a profound thankfulness for all that I learn from my patients. As one patient said to me “you do what you do, I do what I do, but we both make the world go round”. Truth to that! --- Seven Crow

The Return

Brad Carroll | Massage Therapist Voluntteer | Nepal

“Dhanybhad” and “dukhchha” are two of the first Nepali phrases I learned during my stay as a volunteer practitioner at the Vajra Varahi Healthcare Clinic in the village of Chapagaon. The first phrase is defined as "thank you" while the second is translated as "pain". Although the definitions of these two phrases can be interpreted universally, my perception of the meanings of these words has changed, transformed and evolved during my experience.

Brad Carroll | Massage Therapist Voluntteer | NepalWhat I once believed to have been two words that were easily defined and observed, they now present in a more abstract way that has lead me to reflect upon and seek a deeper understanding. In this pursuit, many questions have surfaced relating to my observations of pain, gratitude and the results of care based on the effectiveness of the overall patient/practitioner relationship. For example, how is pain determined and processed individually and how does a single condition effect people so differently? How much does physical pain effect an individuals emotional health and overall quality of life? How is quality of life for an individual defined and do I have a role in judging and or determining this for a patient? Why, as a practitioner is it so easy to accept the appreciation, gratitude and praise from patients when its them who is providing the opportunity to learn, grow and practice skills and utilize knowledge. Overall, how can one learn to understand and empathize with another’s pain in order to communicate more effectively how a treatment can effect a condition? How much does culture effect perceptions of pain and the ability to humbly provide and receive thanks? And finally, how does this information help practitioners in the field of therapeutic massage?

Brad Carroll | Massage Therapist Voluntteer | NepalAlthough I may never have adequate or thorough answers to these questions, the thoughts provoked from them have come to symbolize my experience in Nepal and provide a pleasant reminder of my mission as an individual and practitioner in the healing fields. As I prepare to leave Nepal my own form of “dukhchha” has developed from the thoughts of missing the wonderful people and culture that welcomed me into their community. For all the patients, interpreters, staff and practitioners that helped cultivate this experience allowing professional and personal growth for me, I wish to express with all sincerity......”dhanybhad!” ---Brad Carroll

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