• 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.
  • Effective Treatment

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

    According to the World Health Organization, Nepal's healthcare system ranks 150th in the world with less than one doctor per 6000 people.
  • Primary Care

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

  • Bilateral Hip and Low Back Pain +

    19-year-old male presents with trauma-related chronic hip and low back pain with limits in range-of-motion that interferes with Read More
  • Low Back Pain with Radiation +

    30 year old male presents with severe back and left leg pain, exhibiting postural deviation as a way Read More
  • Stroke Sequela +

    50-year-old male presents with post-stroke sequelae symptoms manifesting as severe right-sided paralysis. After 10 treatments starting in September Read More
  • Chronic Non-Healing Ear Ulcers +

    15-year-old female presents with purulent, non-healing ulcers in the right ear canal. After 20 treatments, using an integrative 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

 


Jasmin A Jones MAcOM LAc LMT
February 2013
OVERVIEW

Acupuncture Case Study

42-year-old female presents with an inability to walk due to slow-onset, partial bilateral leg paralysis occurring over a 15 year time span. After 23 treatments focusing on strengthening the DU and Kidney channels with acupuncture, electro-stimulation and moxibustion, the patient gained a significant degree of improvement in both sensory and motor function in her lower limbs.

Subjective

Patient believes her condition originally started 15 years ago while she was living in the mountains in freezing cold weather for a year and a half. Often, she would become so cold that her limbs would go numb. Symptoms started 12 years ago while she was 5 months pregnant with her second child. She had a difficult time walking up hills and would have to stop regularly because she was experiencing low back pain, and her whole body felt heavy, especially her left leg and arm. After the birth of her son, she considered seeking help for these symptoms because the severity was increasing and slowing her daily chores that she couldn’t stop doing due to her responsibility to her family. Her strength progressively decreased over the next few years until she had to start using a cane to walk due to the weakness in her legs and arms.

Patient reports she had treatment from a Korean medical practitioner, which ended 30 days prior to beginning treatment at the Vajra Varahi Medical Clinic. Treatment consisted of massage with heat daily for 60 days, which according to the patient resulted in a significant recovery of strength in both arms.

She initially sought medical help 9 years ago. A complete x-ray, CT scan and MRI were performed at the Blue Cross in Kathmandu. Patient reports she misplaced the CT scan and is only able to produce her MRI reports, of which the attached paperwork is mostly eaten by rats.

She occasionally experiences cold hands and feet. Her urination and bowels are appropriate and regular. She sleeps easily with mild fatigue in the mornings. She has no headaches, dizziness or ringing in the ears. She has a 30 day menstruation cycle, with mild breast tenderness for 2 days prior, a 4-5 day flow, and dime-sized clots
with no cramping before, during or after the cycle. Her vital signs are normal.

Patient also has a sharp, local pain, bilaterally, at the lumbosacral area, which rates a 7 in accordance with the standard NRS-11, and posterior knee pain, which rates at a 5.

OBJECTIVE

Patient is about 5’5”, 130lbs, with a happy-go-lucky attitude. When she speaks she has a sweet, high-pitched voice, reminiscent of a small child. She is extremely proud, not accepting any assistance in or out of the treatment room. She appears optimistic that acupuncture will help her.

At this time, she cannot stand on her left leg or flex from that hip or knee while walking, as it drags behind her while she walks. She can stand on her right leg, as well as flex the right hip about 5 degrees to take a small step, but has to gain momentum using a twisting, swinging motion and her upper body strength and gravity to kick forward. Her legs tremble slightly while attempting to stand still.

Comparing the left leg to right, patient can feel light touch bilaterally on all dermatomes, with no differentiation between sharp/dull or hot/ cold sensations from L5-S1 dermatomes ,bilaterally, up to patient’s knees.

While lying supine, she cannot actively flex, extend, adduct or abduct the hip, knees or ankles, bilaterally, or flex the abdomen to perform a sit-up. While seated, she can actively flex the knees 15 degrees, as well as extend the knees 45 degrees. Patient cannot wiggle toes bilaterally while seated or lying supine.

Active and passive range-of-movement is normal in the shoulders and elbows. Active wrist flexion is normal, with active wrist extension compromised at 5 degrees. All passive ROM in upper limbs is normal. Active finger movements are inhibited with the left index and middle finger, and right index finger flexion is decreased to 15 degrees.

Patient is also unable to straighten these 3 fingers. Grip strength is decreased by 50% on the left compared to the right.

Patellar reflex: 1+ bilaterally

Achilles reflex: 0 bilaterally

Testing passive proprioception of the big toe shows no differentiation between flexion or extension. Babinski test is unresponsive.

Pulse is thin and deficient on left, disappearing with strong pressure. Stronger on the right with a slightly wiry quality, especially in the middle position.

Tongue is thin, pale, especially in the center with red dots on the tip.

ASSESSMENT

Acupuncture Case StudyDX: The MRI performed by the Blue Cross of Kathmandu shows no evidence of inflammation or lesions in the brain or spinal cord or evidence of upper motor neuron damage. She was diagnosed with a probable primary demyelinating of L5-S1 nerve root, of which the cause is unknown. According to the Merck Manual, primary demyelinating disorders are suggested by diffuse or multifocal deficits, and demyelination should be considered in any patient with unexplained neurological deficits.

TCM DX: Kidney yang deficiency, cold stagnating the DU channel

PROGNOSIS: Due to the fact that she has been untreated for 12 years, it is unlikely this patient will fully recover from acupuncture alone. Being that this patient reports that she has recovered significant improvement in function of her arms with massage/heat alone 1 month prior to consultation at this clinic, it is hopeful that with acupuncture treatment, this patient will regain some degree of motor function in her lower limbs, as well as a decrease in the sensory deficit associated with her neuropathy. It is also hoped that she will experience some reduction in knee and back pain.

INITIAL PLAN

Patient is to receive acupuncture 3-4 times per week, re-evaluating at treatment 20. Typical points include KD3 with UB58 with moxa to tonify the Kidney and warm the DU channel. UB40 to bring qi and blood to the knees, SI3 with UB62 to open the DU channel. Hua Tou Jia Ji points from L4-S2 to KD 3 with electro-stimulation at 100hz continuous for 20 minutes to stimulate S1 nerve root.

Lower 1/3 of scalp motor points are used in the first few treatments with strong stimulation.

OUTCOME

After 20 treatments, this patient reported being able to stand for a few minutes without a cane or leg trembling. She could also stand for a few seconds on her left leg and a few more seconds on her right leg compared to her initial presentation. Patient’s back pain reduced to a 2 compared to previously being a 7.

She was able to slightly flex her left hip 5 degrees and extend the knee while walking, whereas before she had to swing her leg completely from the right hip to take a step. Her right hip was able to flex 30 degrees to take a larger step. No change in ankle flexion or dorsiflexion. Both knees became free of pain, and active global ROM became normal in the knee while seated.

Sharp/dull tests still showed no change in sensory deficit from the dermatomes L5-S1. However, patient reported being able to feel temperature changes in her first and second toes on the left side, as well as having gained more feeling in general in both legs.

CONCLUSION

Even though it is unlikely that this patient will regain full strength in her legs again, it is recommended she continue acupuncture 2x weekly for at least another 2 months or until patient reaches a plateau. After 20 treatments with acupuncture, she has experienced a 100% reduction in knee pain, 90% reduction in back pain, and regained some ability to feel temperature changes. She has experienced improvement in strength and ROM in both legs. The patient feels lighter in her body. All of these changes add to the quality of her life. As a result of the improvement so far, it is quite possible she will continue to regain further sensory and motor function in both legs.

 

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