• Building relationships

    Learning to understand each other and truly listen is the first step in building trust and lasting friendships.
  • Professional Development

    Acupuncture Relief Project offers opportunities for volunteers to gain valuable field experience and earn continuing education credits.
  • Effective Treatment

    Frequent, focused treatments allow us to see positive changes in a patient's condition quickly.
  • Cultural Immersion

    Before we can provide effective medical care we must first learn to understand how our patients live.
  • rural nepal

    Home to eight of the highest mountains in the world including Mt. Everest, Nepal remains one of the poorest countries in the world.
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Our Mission

Our unique model provides effective, efficient, primary care in rural Nepal. Read More
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Our Clinics

Since 2008, our clinics have provided over 350,000 primary care visits. Read More
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Our Partners

Influencing government policy and achieving educational goals. Read More
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Volunteer With Us

We need your help. Serve others while learning new skills. Read More
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Our Evidence

Case studies and field research helps us analyze our efficacy. Read More
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VOLUNTEER COMMUNITY CARE CLINICS IN NEPAL

Nepal remains one of the poorest countries in the world and has been plagued with political unrest and military conflict for the past decade. In 2015, a pair of major earthquakes devastated this small and fragile country. 

Since 2008, the Acupuncture Relief Project has provided over 300,000 treatments to patients living in rural villages outside of Kathmandu Nepal. Our efforts include the treatment of patients living without access to modern medical care as well as people suffering from extreme poverty, substance abuse and social disfranchisement.

Common conditions include musculoskeletal pain, digestive pain, hypertension, diabetes, stroke rehabilitation, uterine prolapse, asthma, and recovery from tuberculosis treatment, typhoid fever, and surgery.

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Featured Case Studies

  • Rheumatoid Arthritis +

    35-year-old female presents with multiple bilateral joint pain beginning 18 months previously and had received a diagnosis of Read More
  • Emotional Depression +

    40-year-old woman presents with depression, emotional stress and dream-disturbed sleep. She presents with a secondary complaint of chronic Read More
  • Ischemic Cerebrovascular Incident +

    60-year-old male presents with sudden onset of motor deficit of right hand, tingling and weakness of right foot, Read More
  • Palliative Care of Parkinson’s Disease +

    62-year-old male was diagnosed with Parkinson’s disease 8 years ago and has been receiving treatment in this clinic Read More
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Compassion Connect : Documentary Series

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    In the aftermath of the 2015 Gorkha Earthquake, this episode explores the challenges of providing basic medical access for people living in rural areas.

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    Episode 1: Rural Primary Care

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    Acupuncture Relief Project tackles complicated medical cases through accurate assessment and the cooperation of both governmental and non-governmental agencies.

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    EPISODE 2: INTEGRATED MEDICINE

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    Cooperation with the local government yields a unique opportunities to establish a new integrated medicine outpost in Bajra Barahi, Makawanpur, Nepal.

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    EPISODE 3: WORKING WITH THE GOVERNMENT

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    Complicated medical cases require extraordinary effort. This episode follows 4-year-old Sushmita in her battle with tuberculosis.

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    EPISODE 4: CASE MANAGEMENT

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    Drug and alcohol abuse is a constant issue in both rural and urban areas of Nepal. Local customs and few treatment facilities prove difficult obstacles.

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    EPISODE 5: SOBER RECOVERY

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    Interpreters help make a critical connection between patients and practitioners. This episode explores the people that make our medicine possible and what it takes to do the job.

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    EPISODE 6: THE INTERPRETERS

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    This episode looks at the people and the process of creating a new generation of Nepali rural health providers.

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    EPISODE 7: FUTURE DOCTORS OF NEPAL

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    In this 2011, documentary, Film-maker Tristan Stoch successfully illustrates many of the complexities of providing primary medical care in a third world environment.

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    COMPASSION CONNECTS: 2012 PILOT EPISODE

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From Our Blog

 


Tara Gregory MAcOM LAc
Decmeber 2012
OVERVIEW

Acupuncture Case Study62-year-old male was diagnosed with Parkinson’s disease 8 years ago and has been receiving treatment in this clinic since 2009. This case explores the positive role that Chinese medicine can play in providing palliative care to patients living with a chronic degenerative disease.

Subjective

62-year-old male presents with a burning sensation in the body and bilateral trembling of the legs and arms. The burning sensation is felt in the head, knees and soles of the feet. It begins when he wakes in the morning, increases in severity during the day and subsides when he goes to bed. Patient reports that during flare-ups, his trembling and other symptoms decrease.

He experiences bilateral trembling of the legs and arms and trembling of the mouth and tongue. Symptoms began 8 years ago with trembling in the 5th finger on the right hand. It progressed up the arm and eventually lead to bilateral trembling of the arms and legs. Patient’s family reports a lack of tremors during sleep, which resume upon waking. He notices a feeling of stiffness in the whole body, especially pronounced while walking. Patient expresses difficulty in remembering words and completing sentences, and that other people have difficulty hearing him when he speaks. Symptoms get worse with stress, sadness, fatigue, hunger and goat meat.

Associated symptoms include: day and night sweats, vertex headache, positional dizziness, vertigo, excessive salivation, constipation, thirst, pain and hesitancy with urination, mouth sores and difficulty with sleep. Patient expresses an understanding of the chronic nature of his condition and is sometimes overcome by sadness, worry and fear.

Objective

The patient presents with visible bilateral trembling of the arms and legs, and trembling of the mouth. Trembling is more severe in the patient’s arms in comparison to his legs. His voice is noticeably diminished in both strength and volume, demonstrating signs of hypophonia. Patient exhibits bradykinesia of the upper and lower limbs while walking, a slightly unsteady gait and rigidity in movement.

Patient’s tongue is purple with horizontal central cracks and a greasy yellow coat. His pulse is slightly rapid and wiry

Assessment

DX: Parkinson’s disease

The patient presents with the 4 cardinal signs of Parkinson’s disease: resting tremors, rigidity, bradykinesia and postural instability. Associated autonomic dysfunction is also present as seen in the patient’s propensity to suffer from constipation and urinary difficulties. Laryngeal dysfunction and dysphasia, commonly seen in Parkinson’s patients, are observed with softness of voice, vocal tremors and excessive salivation. Relief from symptoms with the use of Levodopa is often used as confirmation of a Parkinson’s diagnosis, and the patient has experienced relief with this medication.

TCM DX: LR and KD yin deficiency leading to fire and internal wind

Prognosis

The prognosis for this patient must bear in mind the chronic and degenerative nature of his disease. The goal of treatment is to provide palliative care to help relieve the symptoms of the disease and the side effects of his medication. Treatment is also aimed at prolonging the effectivenes of his medication and to slow the progression of his disease. Additionally, the goal of treatment is to help the patient psychologically cope with his condition, and will at some point transition into providing a form of hospice care. Given these conditions, there is a good prognosis as Chinese medicine is effective at meeting these goals

Plan

Treat 3 times per week to help moderate symptoms and slow the progression of the disease. Focus on reducing the burning sensation in the body by clearing heat and nourishing KD and LR yin. Internally, use the formula Zhi Bai Di Huang Wan in a dosage of 8 pills TID. Acupuncture point selection includes KD2, KD6, LU7, SP6, LI11, LR2, GB20 and Jiao’s scalp tremor line.

As treatments progress and the burning sensation disappears, expand treatments to focus more on settling wind and helping with speech. The patient is switched to the formula Tian Ma Gou Teng Yin in a dosage of 8-12 pills TID. Acupuncture points are expanded to include TW5, DU15, DU16, CV24 and Jiao’s scalp speech zone.

Treatments can last indefinitely so long as the patient continues to experience positive symptomatic relief. Reevaluate every 12 visits to assess progression of his condition.

Outcome

After 3 treatments, the patient reported a 2/3 reduction in the burning sensation in the head and a complete absence of burning sensation in the knees and soles of the feet. He also exhibited a visible reduction in bilateral trembling during and after treatment. The patient reported that the effects of treatment last for about 2 hours, and extend the effectiveness of his medication. His demeanor and affect became visibly lightened after treatment

Conclusion

The difficulty of and question brought up by this case is understanding the role that Chinese medicine can play for patients suffering from chronic progressive diseases. This case demonstrates that the use of acupuncture and herbs can provide palliative care and help to increase the quality of life for patients by mitigating the symptoms associate with Parkinson’s disease.

Additional questions arise due to the nature of side effects caused by Levodopa, which can help to control trembling associated with Parkinson’s, but also causes trembling and other symptoms normally experienced by Parkinson’s patients. It is difficult to assess how much the treatments address the symptoms associated with Parkinson’s diseases versus the side effects of the patient’s medications.

Ultimately, the effects of treatment are beneficial, as they provide symptomatic relief for the patient, and may help keep the patient on the lowest dose of medication possible for the longest period of time. Furthermore, the effect of acupuncture and tri-weekly treatments to help patients cope psychologically with the reality of their condition, cannot be understated, as many patients with Parkinson’s disease are susceptible to depression. The patient expresses that while he has an understanding of the progressive nature of his condition, coming in for treatment not only provides him with relief from physical symptoms, but also provides him with a sense of hope.

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