• 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.
  • 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.
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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

  • Sequelae of Osteoarticular Tuberculosis +

    Rachael Haley BAppSci (TCM)December 2014 OVERVIEW A 58-year-old man, of rural Nepal, presents with left hip pain, reduced Read More
  • Spinal Trauma Sequelae with Osteoarthritis of Right Knee +

    60-year-old female presents with spinal trauma sequela consisting of constant mid- to high grade pain and restricted flexion Read More
  • Chronic Gastritis +

    52-year-old female presents with chronic, burning epigastric pain accompanied by acid reflux, nausea, belching and decreased appetite. The 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
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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

 


Andrew Schlabach MAcOM EAMP
December 2008
OVERVIEW

Acupuncture Case Study32-year-old female presents with left-sided paralysis of upper and lower limbs. At age 12, the patient suffered from a fever due to Typhoid that caused convulsions and coma. After a 20-year history of paralysis, this patient recovered most of her upper limb function and some lower limb function with acupuncture treatment.

SUBJECTIVE

Patient presents with left-sided paralysis of the upper and lower limbs. She has no pain in the effected limbs, but reports numbness and tingling in the fingers and toes of the effected side. This condition started at age 12 after suffering a high fever, due to Typhoid, which caused convulsions and a 5-day coma. She was treated at the local hospital for Typhoid, but has received no treatment for the paralysis. Patient also reports right-sided knee pain, likely due to poor structural alignment and asymmetrical walking posture. Patient reports persistent low energy, sadness and is easily moved to tears. Patient has 3 children and works as a farmer. Menstruation is regular at about 30 days with scanty flow of pale color for 2-3 days. No menstrual pain or PMS symptoms.

OBJECTIVE

Patient appears to be in good health for age and environment, but has a slow affect and appears somewhat mentally diminished. Her demeanor is of a person in her early teens.

The left arm is held closely to the chest and the fingers of the left hand are tightly contracted. The fingers can be passively extended with little force, but they return to a contracted condition immediately upon release. The patient can move the shoulder normally, but cannot actively flex or extend the elbow. The hand lacks active response. All joints can be passively moved through all ROM without pain or difficulties. Sharp/dull test on the fingertips shows no objective numbness. DTR on bicep and tricep tendons is normal. DTR on brachioradialis is unresponsive.

The left leg is normal in size and coloration. The left foot is inverted at rest and requires some force to passively evert. Hip flexion and extension have normal ROM and are well coordinated. Muscle strength is similar to the well side. Leg flexion and extension has normal AROM but are poorly coordinated, taking about 15 seconds of concentrated effort to complete the motion. Muscle strength is about 20% of the well side. Patient does not have any active control of the left foot. DTR on patellar tendon and hamstring is sluggish and weak. DTR on the calcaneal tendon is unresponsive. Sharp/dull test of the toes shows no objective numbness.

Pulses are deep and weak and tongue is pale and deeply scalloped.

ASSESSMENT

DX: Motor paralysis of several major muscle groups in the upper and lower limbs likely due to febrile damage to the central nervous system

TCM DX: Wei syndrome due to qi and blood deficiency; Obstruction of the channels and meridians

PROGNOSIS: Due to the fact that this condition has been left untreated for 20 years, it is unlikely to expect significant response.

INITIAL PLAN

Treat with acupuncture 3 times per week for 10 treatments before reassessing. Focus on the Yang Ming to stimulate qi and blood. Make heavy use of electro-acupuncture crossing multiple joints, especially concentrating on anterior and lateral compartments of the leg and flexor/extensor complexes of the forearm. Internally, use Dang Gui San 4g TID to tonify and move blood.

Typical treatment: Left: ST36 electro to LR3, GB34 electo to GB41, LI10 electro to LI4, HT3 (distal) electro to HT8, Ba Xie (with heavy stimulation), Ba Feng (with heavy stimulation); Right: ST36, SP6, KI7, HT7, DU 20, 24

Alternative treatment: Pi Ci needling of hand and foot Yang Ming channels, scalp motor sensory (leg, foot and arm zones x3) on well side with electro-stimulation

OUTCOME

After 10 treatments, the patient reported no change in condition. The patient was informed that due to the long-term nature of the condition and the lack of response to treatment, it was unlikely that acupuncture treatment would be beneficial. The patient opted to continue treatment, but after 18 treatments she still reported “no change.” At this time, the patient was encouraged to discontinue treatment. The patient immediately broke into tears stating that she wanted to continue treatment because when she started, she was unable to carry the water bucket. Now, she could. Before she started treatment, she could not walk to the clinic. Now, she could. This was a major revelation of change in condition, which brought to our attention the concept that culturally, “no change” often means “I’m not cured.” After a more thorough objective examination, it was observed that the patient now had weak, uncoordinated active movement of the fingers. She could also actively evert the foot. After this discovery, the patient was treated every other day for 4 weeks, during which time she made rapid improvement. Eventually, she was given exercises to teach both the well and ill hands how to isolate individual finger movements. She was instructed to use her eyes to observe her well hand through a series of individual digital movements before trying to replicate the movements with her ill hand. Progress was slow, but continual. The patient was continuously encouraged to exercise. In every treatment session, the patient was reminded of how far she had progressed. After 48 treatments over 3 months, the patient had full, active dexterity of the left hand even though the left arm remained 10-20% weaker than the right. The left foot did not respond as well and remained 50% weaker than the right. Dexterity of the toes was not recovered. However, the patient could dorsiflex and plantar flex the foot.

CONCLUSION

This patient was nearly released from care due to poor communication, objective observation and subjective reporting. When dealing with paralysis recovery, careful objective observation and measures are imperative as the patient is not always aware of the slow changes that are taking place. Visual exercises, in addition to the acupuncture treatment, significantly accelerated the recovery process. Paralysis patients need constant encouragement as the course of treatment is slow. Often, the condition seems to plateau before new changes take place.

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