• more than acupuncture

    Our volunteers include massage therapists, chiropractors, physical therapists, naturopaths, as well as nurses, nurse practitioners and allopathic physicians.
  • Research Focused

    Conducting research studies and documenting patient cases helps us analyze the efficacy of our clinic and contribute to the body of evidence that supports our project model.
  • Primary Care

    Since 2008, Acupuncture Relief Project volunteers have delivered over 300,000 primary care visits in rural Nepal.
  • objective outcomes

    Our volunteers hone their clinical skills by properly assessing their patient's condition and setting achievable outcome goals.
  • Cultural Immersion

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

Read More

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
  • Chronic Abdominal Pain +

    31-year-old male presents with chronic abdominal pain. The patient has suffered from abdominal pain for the past 11 Read More
  • Neck Pain with Radiation +

    40-year-old male presents with right-sided neck pain, without nerve radiculopathy, down the arms bilaterally. He has seen his Read More
  • Psoriasis with Neck and Shoulder Pain +

    45-year-old male presents with psoriasis for 5 years, possible psoriatic arthritis for 2 years, and idiopathic neck pain 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.

    Watch Episode

    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.

    Watch Episode

    COMPASSION CONNECTS: 2012 PILOT EPISODE

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From Our Blog

 


Natalie Gregersen MAcOM LAc 
December 2012
OVERVIEW

Acupuncture Case Study52-year-old male presents with right-sided, burning head and ear pain, right-sided hearing loss and anosmia. It is determined, after an initial ear examination with an otoscope, that the patient has a severe right-sided ear infection. After 12 treatments, which includes the use of acupuncture, internal and external Chinese herbs and antibiotics, the patient reports a significant reduction in the burning sensation. Objectively, the right side tympanic membrane shows a 90% improvement. There is no change in the anosmia and hearing loss.

Subjective

The patient presents with right-sided, burning head and ear pain that started 6-7 months ago. His symptoms also include right-sided temporal headache, an itchy sensation deep in the right ear, tinnitus that comes and goes and right-sided hearing loss. He reports he can hear people talking, but can not clearly understand what they are saying. Anosmia started 2-3 months after the burning head/ear pain started. The patient reports that it feels like he has a ‘fire’ inside his right ear, and prior to the pain starting, he heard a bug-like sound. He has moderate pain (4/10), which doesn’t interfere with work when he is concentrating on a task. When he is not distracted, the pain is constantly present. Nothing makes the pain better or worse. Although he has loss of smell, he can taste his food.

Objective

The patient appears to be in good health for his age and environment. He’s always in good spirits and maintains eye contact during the interview. He is often joking with the other patients in the room while waiting his turn for treatment.

An initial right ear examination with an otoscope shows a purulent and inflamed tympanic membrane. The entire membrane is ringed with redness with bright red streaks throughout it. There is pus along the superior border and the entire tympanic membrane is severely scarred and cloudy. The left membrane appears normal and healthy.

A strong smelling substance, called Tiger Balm, is held under the nose while the patients eyes are closed. He reports that he is unable to smell it. Both sides of the nose are checked by holding the balm under one nostril while the other is plugged. Anosmia appears to be bilateral.

Hearing loss is checked by using a 128 hz tuning fork. Patient reports that he is able to hear the sound until it is 6 inches away from the right ear. The left ear is also checked. He can hear it until it is 1 foot from his ear.

Pulses are wiry, slippery and rapid, especially in the Liver position. Tongue shows a pale center with red sides and a greasy yellow coat.

Assessment

DX: Severe, right-sided ear infection with anosmia and auditory deficit

TCM DX: Damp-heat in the Triple Burner and Gallbladder channels

PROGNOSIS: Using oral antibiotics, herbs, antibiotic ear drops and acupuncture, a complete recovery from the ear infection is expected. With the treatment of the ear infection, there is a possibility the patient may recover his sense of smell, but the outcome is uncertain. Due to the severe scarring of the right tympanic membrane, full recovery of hearing is unlikely.

Initial Plan

Treat with acupuncture and herbs 3 times per week for 10 treatments before reassessing. Include western pharmaceuticals, such as oral antibiotics and antibiotic ear drops, to clear heat and reduce inflammation.

Focus on clearing dampness and heat in the Liver, Gallbladder and Triple Burner channels.

Typical acupuncture points include: GB20, R-TB17, GB43, TB2, TB5, GB40, GB34, LV3, LI4, ST36, SP10, LI11

Continuing treatment

Initial treatment: Includes oral antibiotics of amoxicillin 3TID for 5 days plus Huang Lian Jie Du Tang 3TID for 6 days

Treatment 4: It was determined that the pus was reduced by 75%. Therefore, the patient was switched to Long Dan Xie Gan Tang 3TID.

Treatment 2-9: External solution was made of 1 Huang Lian Jie Du Tang pill, crushed and mixed with rubbing alcohol. 15 drops of this herbal solution was dropped into the patient’s right ear after his acupuncture treatment.

Treatment 9: It was determined that the patient had plateaued. Therefore, the external herbal solution was discontinued, and antibiotic ear drops at a dosage of 3 drops TID, administered by the patient, was added. Treatment 12: Due to the significant reduction in the patient’s symptoms, the herbal formula Long Dan Xie Gan Tang was discontinued. The patient continued the use of antibiotic ear drops for 2 more weeks.

Outcome

After 12 treatments, the burning sensation was reduced by 80%. Patient reported a constant, mild burning and itchy sensation deep inside the right ear, but it no longer felt like he had a ‘fire’ in his ear.

His tinnitus and temporal headache still came and went, but he also had hypertension, which could be contributing to these symptoms.

Objectively, the tympanic membrane improved by 90%. It was no longer purulent and the redness was concentrated to the upper right quadrant of the membrane. There were no longer streaks and the redness had changed from bright to dark red and looked like a scab.

There was no change in the hearing loss, though the patient was seen talking on his cell phone with his right ear. He was able to make out what people were saying if the phone was held close to his ear. There was no change in the anosmia.

Conclusion

By week 10, the patient’s visits were reduced to 2 times per week. He seemed much less concerned about his head/ear pain and asked to work on other conditions. The patient is using antibiotic ear drops during a 3 week break from treatment and his condition will be reassessed when the new team of practitioners arrive.

This case demonstrates the importance of understanding how to use diagnostic tools, such as an otoscope, in the treatment of certain conditions. This is especially relevant in Nepal where the acupuncturist is often the patient’s primary care physician. The diagnosis and objective observation of an inflamed tympanic membrane provided a clear picture of the patient’s presenting symptoms, guiding the treatment plan. The use of Chinese herbs, in conjunction with western pharmaceuticals, greatly improved the outcome.

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