Acupuncture Relief Project | News from Nepal | Acupuncture Relief Project | Volunteer Community Health Clinic | Nepal

Acupuncture Relief Project  | Good Health Nepal | Kyndl Mueller

After clinic one day I had the opportunity to experience a wonderful delve into the down country culture of the local folks I've befriended over the last couple weeks. Gunaraj, one of our interpreters, invited me to his house in the village just north of town, and so I joined him on his walk home, along with his cousin Sita who is also our receptionist, and our clinic manager Ritesh. 

Acupuncture Relief Project  | Good Health Nepal | Kyndl Mueller

It was about a half hour walk through the sunshine and the agricultural terraces blooming with the springtime harvest; cauliflower, pumpkin, leafy greens, potato... and peas for days! The white flowers on the shoots looked as sweet as I know their fruits will taste, and it was so tempting to snap a pod from a stalk; however I was reminded to stay respectful of the land in which I was invited to cross. The air becomes cleaner as we climb higher and higher through the fields, taking the 'short cut' paths used by so many as the way to get their heavy loads to where they need to go. 

Acupuncture Relief Project  | Good Health Nepal | Kyndl Mueller

We arrive at Gunaraj’s house and are greeted by various family members. All but myself are bantering in their native tongue, although it doesn't make me uncomfortable or give off the feeling of being an outsider. Everyone is warm and welcoming and it’s almost like I’m one of the crew, not just a foreign visitor in a strange land. 

Acupuncture Relief Project  | Good Health Nepal | Kyndl Mueller

Gunaraj brings out a ground apple, a native fruit of the area, and peels and slices it for us all to share, while his older brother brews us a nice spiced tea which when ready, arrives in their finest glassware, stickers still on, must be brand new. We chat and hang out in the yard on a log bench under the pumpkin trees, until the tea is done and it gets to be time to move on. We depart and head further into the hills, the trail leading us through more terraced fields and then up a steep pathway towards Sita’s house. It is the first hot day of spring and we are all sweating by the time we arrive to find a nice spot in the grass. We pop a squat and rest for a moment in the shade, long enough for Sita’s youngest brother to come by and join us for the rest of the walk to the farm.

Acupuncture Relief Project  | Good Health Nepal | Kyndl Mueller

The weather was perfect, the people were great, I got to be the semi-silent observer of the normal way of life for the younger generations in Nepal. It was completely due to the company and the positive vibes, here I was happy. We arrived at Sita's in time to see her other brother, who I had been treating in the clinic, coming up the path with fresh greens for the goats who are all tethered to posts in the yard, the two babies running energetically and acrobatically free. We sat outside in the early evening air, just a touch of chill to it, and chatted some more, while we watched the kids run about, and took selfies (as is the new age custom for the nepali millennials and real millennials all around the world). 

Acupuncture Relief Project  | Good Health Nepal | Kyndl Mueller

Gunaraj brings out a white rabbit and plops it on my lap. I bite my tongue on my Watership Down feelings towards these communist creatures and pet its soft pelt, thinking of Blacks, my cat back home, and wishing it was her I was holding. I was relieved to give up the rabbit when Sita invited us inside for fresh popped corn her sister had prepared at the hearth in the corner of the big open room. 

Acupuncture Relief Project  | Good Health Nepal | Kyndl Mueller

There was no where else I'd have rather been at that moment in time; these folks were my new found friends and even if I didn’t have a lot to add to the foreign conversation that surrounded me, I felt perfectly at home. I realized that no matter what the language, a laugh can be shared by anyone with it's simple meaning shining through in perfect understanding.  Time is of no essence in a place like this, hardly a need for urgency, and work seems to get done in a way that keeps things stress free, aside of course, from the back-breaking labor of farming, with little else than the means of one's own body power. We depart as dusk gets closer and walk home through a steep forest trail that reminded me of walks in the canyon near my home. Everywhere you go you can find little bits of familiarity that balance out the peculiarities of being a stranger in a foreign land. “Aaja malai dherai kushi lagyo” –Today, I am very happy. ---Kyndl Mueller

Acupuncture Relief Project  | Good Health Nepal | Jessi Brown

Today I fitted my elderly patient with her (hopefully) semi-permanent shoulder cast. This woman came into the clinic a few weeks ago. I remember treating her knee pain and when the visit was finished, she said, “What about my bone problem?” and pointed at her shoulder. 

This is a classic pattern at our clinic. Right as patients are leaving, they add on a few extra problems and ask for medicine for it. I have to tell them to talk to me about it next time they come in. So, I told this patient to bring her x-rays and we would treat it next time. I assumed it was just arthritis in the shoulder. WRONG. 

Acupuncture Relief Project  | Good Health Nepal | Jessi Brown

The next time she came in, she removed her sweater. Her humerus bone jutted up through her skin every time she moved her arm. We looked at all the info she had. A couple of months previous, she had fallen with her arm out to the side. She’d broken the bone at the elbow and the shoulder. The humeral head had actually split in half. 

Acupuncture Relief Project  | Good Health Nepal | Jessi Brown

I still look at the films a lot and I even now, can’t tell if the spine of the scapula and glenoid cavity was broken as well. There is no complete x-ray series here. Nepal operates on a ‘get what you get and don’t throw a fit’ imaging policy.

When I saw the patient again, I tried to talk her into going back for surgery because her bone is floating loose in her arm.  Even with my insistence, it became very clear that she was not going to go. Her heart is not strong enough to go through the procedure. Her family is worried about her age and possible complications. In addition, the surgery could cost between 1,500 to 7,000 US dollars, depending on what connections the family has. 

I shifted my thinking to a non-surgical, management solution for this woman. I had our reception staff call her to come back into the clinic. Drawing on literally one afternoon of Ted Lauer’s class, I made a Plaster of Paris cast that will hopefully stabilize her shoulder. In addition, this should protect her arteries and veins from being punctured by the humeral shaft fragment if she bumps it or falls again. 

Acupuncture Relief Project  | Good Health Nepal | Jessi Brown

The cast is not fancy and my technique wasn’t great. A few parts of the cast stayed softer than I wanted but I think it will hold up for at least a year. I showed her and her elderly sister how to tie it. I also tied knots in the too large sling that she was given at the hospital. I showed them both how to close it the right way so it won’t fall off all the time. Hopefully it helps her pain a little by preventing so much movement of the humeral fragments.

This patient is so sweet and so small. Earlier this year, my grandma broke her wrist in a FOOSH (fall on an outstretched hand) injury and I happened to be there for her doctor visit. The doctor did not explain her options to her very well and just pushed her into the surgery. She did not understand that she had the option for the doctor to put her into a hard cast and let it heal, probably as well as it would heal after a surgery.

Thankfully the procedure with my grandma was successful and seems to have worked. Regardless, I hadn’t wanted her to get the surgery. Hardware fails in young healthy bones. In old, osteoporotic bones, it is even more likely to fail or the skin cannot heal from the incision. It was frustrating to watch this doctor just push her right to what he knew would “fix” the problem. 

Acupuncture Relief Project  | Good Health Nepal | Jessi Brown

Here in Nepal, I turned around and tried to do the same thing to this patient. I wanted to help her get the treatment that I thought was right but it wasn’t what she wanted at all. The solution I came up with is far from adequate but at least I can feel that she is a little more safe and that she is happy. Eighty years is a good life here in Nepal and I don’t want to risk what she has for a surgery that she doesn’t even want.

Aside from that, I have been getting a lot of counseling from my friends to hang in there for this last week. I am anxious to be back to the life I have created at home, but I want to try to enjoy my time here as much as I can.  I came here to help and to work and it will be over soon enough. I am excited that after this last week of work, a couple of us will be traveling to the village of Bandipur. It will let me see a more of this country before I head back out.

Acupuncture Relief Project  | Good Health Nepal | Jessi Brown

Being here is helping me get more clarity about what I want out of my work and home. It’s making me take a look at some of the people in my life who are not showing up for me in the way that I need. It’s painful for me to think about exerting a little bit more control over what happens in my own life. 

For various reasons, I’ve grown accustomed to getting along with people and just being happy with whatever others ask of me. I am starting to find a freedom in knowing that I have control over my own needs. Currently I’m frustrated at how impatient I’m being with everything but I know that when I get back I will be able to show up better for my patients and friends. I’m trying to stay focused on the work. Even though I feel a little burnt out, I want to keep learning whatever I can from the people I’m here with. I’m glad I was here to help this woman with her shoulder. I’m glad to be strengthening a friendship with Bex and to have met the others on my crew. These are good things. My anxiousness to go home is mainly because of the good things waiting for me there but I can be patient. I hope. --- Jessi Brown

Acupuncture Relief Project  | Good Health Nepal | Jessi Brown

Acupuncture Relief Project  | Good Health Nepal | Hong Lu

Having lived my whole life in a developed country, with most of my needs magically looked after for me, it was a cultural shock to see the many inadequacies the Nepalese people experience. From the pollution in the air to the chaotic traffic conditions everywhere; from toddlers roaming the roads unsupervised to stray dogs scouring the streets searching for food; it seems there is little regulation among the people yet somehow, they find a way.

Acupuncture Relief Project  | Good Health Nepal | Hong Lu

I have had much to learn about the healthcare in Nepal. I have a young, female patient I have been treating in the Bhajrabarahi clinic. She has suffered from epigastric pain for over 15 years. In my first week in Nepal, I had a glimpse of her suffering having had a bout of dysentery from eating the wrong food. I experienced one night of diarrhoea yet she has suffered intermittent diarrhoea for so many years. I could only imagine how she continues to survive. Yet she finds a way.

Acupuncture Relief Project  | Good Health Nepal | Hong Lu 

I had another profound experience where a patient was exhibiting stroke like symptoms in the clinic. It was difficult to tell if he was in fact having a stroke at the time so the ambulance was immediately called. I was in fear for his life but compassionate in supporting him all the way. I discovered the ambulance would take an hour to arrive and the nearest hospital was a three-hour trip away. I was shocked beyond belief at the circumstances and questioned how he would ever survive. We finally determined that he had had a seizure and not a stroke. Two days later, he was back into our care. Somehow, despite all obstacles, he found a way. 

Acupuncture Relief Project  | Good Health Nepal | Hong Lu 

As I walk through the farming fields in Bajrabarahi, I am greeted by hardworking women carrying large baskets of heavy compost strapped to their foreheads. They focus their eyes on the ground in front of them and bend their upper torsos forward, to soldier on to their destination. I am in awe of their physical strength and stamina. However, the daily demands also mean that many of these women develop chronically painful knees and necks. I am grateful to have the opportunity to treat some of these women in the clinic. Their knees will never fully recover, yet they continue to work and they find a way.

Acupuncture Relief Project  | Good Health Nepal | Hong Lu 

These are some of the experiences I have thus far glistened in the clinic. I feel like a seed that’s in the perfect environment to grow. My growth is not limited to my work as a practitioner, but also as a human being. I honestly felt I was grateful for all that I was blessed with back home in Australia, but I am now infinitely more aware of how much I have. My admiration of the Nepalese people lies in their capacity to adapt to life’s circumstances and their amazing resilience to endure. The warm gratitude and friendly respect I receive from everyone here makes any sacrifice to be here absolutely worth it. --- Hong Lu

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