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

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

Acupuncture Relief Project  | Good Health Nepal | Zoe Nash

In Bimphedi, a small remote village in the hills south of Katmandu where the Acupuncture Relief Project has a clinic. There is also an orphanage. The children that are there are coming from the streets in Nepal, from broken families, from families where the parents died, from village around the country that get sent to Katmandu to get allotted around the country to different orphanages. 

It is a small community of children from the ages of 8-18, where they sleep in bunk rooms together, they eat together, they play together, they working the garden planting their vegetables and there is small school inside.  

Acupuncture Relief Project  | Good Health Nepal | Zoe Nash

The education curriculum provides the basic fundamentals of education. However basic level ‘sex’ education is not included. It is not subject that is comfortably spoken about in Nepal. This is partially problematic in an orphanage and these children do have a family unit in which they express themselves or discuss such topics with any close family member. 

This isolation and taboo matter that is an experience that all human being will go though can cause a suppression of emotions leading to either confusion or un-integrated ways of relating to others as they develop and move though adolescents.

We connected with the orphanage and together made a plan to give the children there an extra-curricular class on puberty.  

We entered the compound and children where playing football and other games in the field, enjoying their time to be free from duties. 

Acupuncture Relief Project  | Good Health Nepal | Zoe Nash

We walked about the garden, saw that they are growing their own vegetables that all the children have to out their hand into to. The area where they eat and large kitchen with pots of rice and dahl baht were being boiled in preparation for dinner time. We saw the rooms where they sleep, the simple bedrooms with no material possessions, toys or posters, just bunk beds and one small cabinet.

We went to the room where we were to teach to wait for the children to arrive. They came in and looked eager to hear what we had to share.  

Acupuncture Relief Project  | Good Health Nepal | Meghan Keysboe

We began to share through Tsering Sherpa interpreting, (one of the directors of the Acupuncture Relief Project). Meghan Keysboe a practitioner on the project began discussing the physiological changes that occur during puberty. What to expect in these times of change, or growth, how their bodies will change, their hair, their skin, their interests, and how normal all of this! Not to be alarmed or ashamed of any of these physical and physiological changes that are occurring that everyone goes though this and its totally normal and does not last for forever!  Some where already going puberty and found this communication about what was happening to them so refreshing and insightful, knowing they are not alone and that what is happening to them is healthy and a positive moment and change in their life. 

I spoke to them about diet and nutrient and how important it is to eat a balanced diet of fruit and vegetables and how junk food leads to illnesses such a diabetes, high blood pressure, and depression. 

Junk food is making its way to the remote areas of Nepal, biscuits, crisps and soft drinks which are causing nutritional deficiencies and sugar addiction in these areas. 

Acupuncture Relief Project  | Good Health Nepal | Jesse Jory

Lastly Jesse Jory the other practitioner on the project spoke to them about mindfulness at this time. How to take care of themselves emotionally like writing down their emotions, communicating to their teachers about what’s happening to them on a personal level, spending time in nature, and the importance of getting enough sleep. These are all very important tools to use in this time of turbulence and to find their centre point within themselves at this time in their lives will support them always though all the transitions in this lifetime. 

This experience was one of rich reward, seeing the children’s facial expressions of interest and understanding up as we spoke to them about matters that no one had addressed to them before.. 

This story is another example of how the Acupuncture Relief Project is building the community base and how we can broaden our positive impact in the areas and provide the missing pieces of education is really exciting for the development of the project and how it can continue to expand to serve the communities reaching out to these children.  --- Zoe Nash

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