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

Acupuncture Relief Project  | Good Health Nepal | Sugandhi Jordan

When we open the clinic doors at 8:30, there are usually already a handful of patients waiting outside in the crisp morning air. Patients arrive throughout the day. There are no fixed appointment times. Locals are encouraged to come in the afternoon so that patients who have to travel further can come in the morning and have time to get home before dark. If its busy, they may wait up to a few hours. The Nepali interpreters call out the names of patients and show them in. You never know what story or problem is going to present itself that day. At this point in the camp, the majority of patients are returning and on a treatment plan, but new patients filter in each day. The following is just a brief peek of the people I have the pleasure of treating on any given day.

Acupuncture Relief Project  | Good Health Nepal | Sugandhi Jordan

My first patient of the day is U, who comes 2-3 times a week. She has pain in her elbow and forearm due to a fracture years ago. It was never properly reset and didn’t heal right. She experiences constant pain and an inability to fully flex or extend her arm. There is spongy depression where part of her ulna should be and her elbow is knobby and stiff due to calcification. She’s been coming to the clinic for a long time. The long term solution to her pain and inability to move is much more than what I can offer her, she probably needs to see an orthopedist and get surgery. She insists that the acupuncture helps reduce the pain and has allowed her more range of motion. I’m just not sure how much more progress we’ll realistically make, though continue on anyway trying to keep her below a certain threshold of pain. I remind myself she’s been living with this for over 20 years and still manages to work as a farmer. 

Acupuncture Relief Project  | Good Health Nepal | Sugandhi Jordan

Today we get our usual busload of ladies from Chitlan, another village an hour up the road. They come 2-3 days a week and are a hoot! There are usually 10-15 of them. This Friday they inform us that since they are only 7, they convinced an ambulance driver to drop them off so that they wouldn’t have to wait for the bus and could come earlier. Myself and the other clinicians wonder how they pulled this off. These ladies are clearly bosses.  

Acupuncture Relief Project  | Good Health Nepal | Sugandhi Jordan

One of these women, L. is in her 60’s and injured her knee in a fall years ago. Her patella won’t move at all and her knee pain causes her to limp, though she’s been limping less since starting treatment. I often use warm-needle moxa with her, which involves lighting a cone of mugwort at the end of the needle. She jokes that she’s burning and her pyre is lit, even though she is still alive. In Nepal, the dead are traditionally burned in a pyre on a river bank. All the other Chitlan ladies, who are sitting nearby with their needles in, laugh hysterically.  I try to help another women, in her 70’s who also has knee pain, up from the chair after her treatment.  She jokingly keeps squatting and hunching over as she walks out of the clinic, eliciting another round of laughs.     

Acupuncture Relief Project  | Good Health Nepal | Sugandhi Jordan

Most of the Chitlan ladies are older, but S. is only in her late 20’s. She gets low back pain from muscle strain due to working bent over in the fields all the time and carrying heavy baskets of produce on her back. Despite her aches and pains, she is always cheerful. In addition to offering acupuncture, I teach her some stretches that she does enthusiastically and with lots of giggling. 

Another woman, K. comes to the clinic from another town a couple hours away with her friends. She came seeking treatment for her knee pain, but when I take her vitals and do a review of systems, I find that she has much bigger problems. Her blood pressure is 180/110. She says that she has a history of having blood pressure over 200 systolic (read: major hypertension!). At least once a week, she gets dizziness that lasts 3-4 days and ends with an episode of vomiting.  She is nauseous all the time and has frequent migraines. High blood pressure can either cause or aggravate many of these symptoms. I ask her if she’s on any medications, “No, I manage it with my diet. I’ve been told I need meds before, but I don’t want them.” I explain that what she is experiencing is unmanaged hypertension and that she really should consider medication as a possibility. She is resistant. I give her herbs that can be helpful in reducing blood pressure, do acupuncture to treat some of her symptoms and then write her a referral letter to the small regional hospital in Palung, a couple hours away. I never thought I would be a drug pusher, but I worry she could be a ticking time bomb for a stroke. Many studies have shown acupuncture and herbs to be effective in quickly lowering systolic blood pressure, but diastolic is more stubborn. I don’t want to risk the time in her case. I encourage her to come three days a week to continue to monitor her blood pressure and try to work on her symptoms, though its difficult since she lives far away.

Acupuncture Relief Project  | Good Health Nepal | Sugandhi Jordan

My last patient on Friday was new, an old man in his early 70’s. N. begins by describing his leg pain then suddenly starts explaining how he keeps getting a weird movement in his stomach and then can’t breath. After some dancing around with my interpreter, I finally figure out that he’s referring to his abdominal aortic pulse. I take his vitals and they aren’t good. His respiratory rate and pulse rate are extremely high, his oxygen saturation is extremely low. He’s basically suffocating before my very eyes. The “movement” in his belly he is experiencing is the flutter of his heart rate increasing to try to distribute what little oxygen he’s inhaling to the cells of his body. I listen to his lungs and review his medications: a steroid inhaler, a diuretic, and a bronchi-dilator. It doesn’t take much to infer that he has advanced COPD and probably emphysema, a very common condition in this part of the world. 

There is very little I’m equipped to do for this man. The nearest hospital is a couple hours away and the health post next door is closed, all the health care workers are gone for the day. There are no doctors in this village and medications are limited. Only short-acting bronchodilators are available in Bhajra and any stronger medications or procedures that could help him breath are only available at the regional hospital in Palung. They are also closed for the day, but could possibly open for an emergency. Even then, there may not be a doctor available. At the very least, he needs oxygen asap. With the help of the Nepali ARP staff, we are able to arrange access to the health post to use their oxygen machine. 

Acupuncture Relief Project  | Good Health Nepal | Sugandhi Jordan

When N. bends over to put his shoes one, he becomes severely out of breath and then has to stop three times as we walk the 15 meters up a small hill to the health post next door.  Someone I don’t recognize unlocks the door, turns on the oxygen machine and disappears. After an hour of breathing pure O2, his vitals stabilize a bit. His grandson comes to pick N. up and take him home on his motor-bike. I press them to go to Palung as soon as possible. 

(Follow up: N. came in two more times, his condition continuing to deteriorate. Finally on Monday, we were able to convince the family to send him to the hospital a couple hours away. His grandson called an ambulance that picked him up from the health post where we had taken him for more oxygen).

Acupuncture Relief Project  | Good Health Nepal | Sugandhi Jordan

As with anything, some days are more challenging than others. Each day in the clinic I feel more and more grateful to be here and to have this medicine as a tool. It’s a pleasure and an honor to get to bear witness to the stories that unfold and the progress that’s made. I can only hope that each patient who passes through my little corner of the clinic gets the best that I have to offer. -- Sugandhi Jordan

 

Acupuncture Relief Project  | Good Health Nepal | Sugandhi Jordan

In the foothills of the Himalayas, Bhajra Barahi is made up of steep hills, the slopes of which have been terraced for farming. These plots of rice, cauliflower, mustard, squash, corn and radish cascade down toward the deep valleys with houses dotted all along the way. The main Bazaar of town has a busy road with busses and trucks rumbling through, but within a short distance the roads stops. Many homes and communities and their surrounding farmlands are accessible only by foot. Narrow foot-paths or rock walk-ways traverse through the forest and fields between the terraces. These paths are frequented by women carrying huge baskets resting on their backs and strapped over their foreheads that are full of vegetables, grass for animal feed, or wood from the forest that they will use for cooking fires. 

Acupuncture Relief Project  | Good Health Nepal | Sugandhi Jordan

People work very hard putting in long hours almost everyday. Most of our patients are farmers from the surrounding communities. Some live very close, others walk more than 3 hours to make their appointments. 

Acupuncture Relief Project  | Good Health Nepal | Sugandhi Jordan

One of the most common complaints in the clinic is knee pain. I’d wager that it’s the chief complain of at least 1/3 of my patients. Most of the knee patients are older ladies who’ve worked their knees hard their entire lives. These ‘knee-ladies’ are the same ladies who carry the baskets. At first myself and the other acupuncturists were curious why knee pain was so common here. After just a few walks exploring the surrounding country side, we wondered no more as we passed these ladies in flip flops with basket loads that looked bigger than their bodies. No wonder!

Acupuncture Relief Project  | Good Health Nepal | Sugandhi Jordan

During my first week of clinic as the knee-ladies, and a few knee-gents kept rolling in, I remember thinking “okay, more knee pain, no big deal, pretty straight forward…” It was interesting to treat, but I was waiting for the more ‘exciting stuff.’ At first the knee pain just didn’t seem as interesting or challenging as internal medicine complaints like COPD or stroke recovery. That all quickly changed! 

Acupuncture Relief Project  | Good Health Nepal | Sugandhi Jordan

Much work here is done squatting in fields or on roof-tops cleaning the day’s harvest. Toilets here are all the squat style as well. Healthy knees are essential in order to walk and to squat. One of my patients commented, “I have to stand to use the toilet like a dog.” Having your knees give up on you has major consequences here. 

Acupuncture Relief Project  | Good Health Nepal | Sugandhi Jordan

As the knee patients kept filtering in and I got to know them better, I started to have much more respect and reverence for the knee. Managing the osteoarthritis of a 60 year-old women who is still carrying heavy baskets of wood and grass up and down steep hillsides all the time is more challenging that I first imagined! 

Acupuncture Relief Project  | Good Health Nepal | Sugandhi Jordan

Although a complete resolution of symptoms is unlikely for all of these women, regular acupuncture combined with herbs helps to reduce the pain and inflammation and slow down disease progression. Some progress quickly, and others more slowly, but I’m happy to say that most of my knee patients are making at least some progress. It’s heartening to see them come into the clinic smiling because they were able to walk further without rest or they recently could start squatting again. Hopefully by the end of the camp I’ll have become a master of the knee! -- Sugandhi Jordan

Acupuncture Relief Project  | Good Health Nepal | Sugandhi Jordan

 

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

The day started like most days, a brisk late-autumn morning with a light frost on the ground and clear blue skies. A breakfast of churra (beaten dried rice), chickpeas and a boiled egg. Together the team is talking over a patient case regarding an eighty year old woman that we had visited the day before. She lives in a remote village within our catchment area and we heard from her brother (one of our patients) that she is blind and is having breathing difficulties. Collectively we agreed that we should have a look at her, so we dispatched one of our volunteer practitioners and an interpreter on a motorbike. They returned after several hours to report just how remote her house actually was and that she was in poor condition with weakening vital signs. Today we decide that we should dispatch an ambulance out to her and see if we can get her to a regional hospital. This is where the day started to go sideways.

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

The ambulance arrived at our clinic about mid-morning. Like most rural ambulances in Nepal it is nothing more than a long-past-its-prime four wheel drive vehicle with a basic stretcher and oxygen tank in the back. The driver is an irritable middle-aged man wearing disheveled clothing and has a half smoked cigarette in his mouth. I busy myself briefing the two practitioners who are going with the ambulance and make sure the oxygen tank is full and operational. No sooner than I see the ambulance bump it’s way out of our compound and on to the main road I hear a call from our clinic that we have an emergency. “Chitō ā'unuhōs” means come fast!.

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

I hurry into the clinic to see that a practitioner has started CPR on a man who looks to be about forty years old. Her interpreter provides assistance with artificial ventilation, blowing deep breaths into the man’s lungs. I stifle a wince as I hear the man’s ribs fracture under the heavy chest compression and quickly look around the room. The clinic is filled with about twelve patients all curiously looking at the activity and there are four men (presumably the man’s friends) huddled closely around the scene. I call for a scissors and rapidly cut the man’s shirt off. No signs of trauma, no pulse, no respiration and his pupils are dilated and unresponsive, I ponder our options; we are hours from the nearest hospital and maybe further to the nearest defibrillator. I question the men that are standing near and they tell me they found him collapsed nearby. They did not see him go down and did not know how long he had been unconscious. Minutes pass… I take one final look into his lifeless eyes with a pen light and reluctantly tell the practitioner that she can stop CPR. He’s gone. 

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

After ten years of working in the rural areas of Nepal, this was a first; someone had died in our clinic. We cover the man and pull the privacy curtains around him and slowly the clinic returns to its normal buzz of activity. I step out of the clinic to consult with the local health post about the procedure for documenting the death but then hastily retreat to my office. My head is suddenly spinning with a post-crisis adrenaline rush and I wonder if we had handled the situation correctly. “What do we think we are doing out here?”  

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

We are not an emergency room, we are a primary care facility. Between our two clinics, we see 100 to 130 patients everyday. We use acupuncture to treat chronic pain, injuries, gastrointestinal complaints and many women’s reproductive health issues from uterine prolapse to infertility. We have helped many patients walk again after debilitating strokes. We counsel patients on managing their diabetes and high blood pressure and educate them on the proper use of their medications and diet. We catch complicated things like tuberculosis, skin cancer and thyroid disorders and help manage referrals to other facilities through a our follow-up procedures. With children we treat many ear infections and fevers. That said, because we are open when other facilities are closed, our services are free and accessible to all—we never know who will come into our clinic or what will be wrong with them.

Acupuncture Relief Project  | Good Health Nepal | Andrew SchlabachSince we began ten years ago we have spent about $1.2 million USD. For that money we have provided over 350,000 patient visits to over 25,000 individual patients. That is at cost of about $3.50 USD per visit. That number does not cover many costs that are borne by our volunteers so let’s say $4.00 USD per visit. That is a fraction of the cost of other medical camps which often cost more that $50 per visit, are more resource intensive and accomplish less. Even at that, I think this is the worst way to look at the value of what we do. 

If we look at the efficacy of our clinic only from the standpoint of cost and benefit to the patient we might miss the real value of our project which in many ways is unquantifiable.

Let’s start al the beginning. 

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

In the Fall of 2008, our first team arrived in Nepal. Of course we did not know this was going to be the beginning of a lifelong project involving ten different clinic locations, dozens of volunteers, staff and students, the founding of an acupuncture school, construction of a permanent clinic facility and the influencing the entire field of acupuncture in Nepal. We were just a team of recently graduated acupuncturists who had experience in Nepal and wanted to see how our medicine worked. We had no idea about the depth and width of clinical problems Nepal was going to throw at us. 

Acupuncture Relief Project  | Good Health Nepal | Andrew SchlabachBefore we even opened our clinic and saw our first patient, I met a young man by the name of Satyamohan Dangol. A skinny, but handsome, twenty-two year old Newari who lived next door to our clinic. His father brought him to see us because he had injured his back and was having debilitating sciatic pain. He had visited many hospitals and had undergone several different therapies without relief and he was not particularly hopeful that we could help him. But we did. And like many of us that have become interested in Traditional Chinese Medicine, we began with our own experience of it. Satyamohan began his journey with us by joining our team as an interpreter. I working side by side with him for many months that first year during which time my own skills slowly became more confident and refined. Together we had many successful patient cases and as the weeks went by our trust in one another grew. I remember being awestruck by Satyamohan’s gift in handling patients. His gentle and compassionate nature made him an extraordinary partner in the treatment room and we made a very effective team. 

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

In the years that followed Satyamohan became a quick study of the medicine. As a senior interpreter he helped train new interpreters and closely observed each and every visiting practitioner learning new techniques and theory that he could put into practice. Though still a novice, Saytamohan was showing tremendous promise towards the Nepali doctor that we know today.

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

In 2010, we were joined by Tsering, a twenty-four year old Sherpa who’s father was killed when he was six years old on a climbing expedition to Dhaulagiri I (one of the most difficult of the 8,000 meter peaks in Nepal). Tsering had been sent from his home in the Solukhumbu Region to a private boarding school in Kathmandu (payed for by his late father’s climbing client). Speaking eight languages, Tsering was a talent to behold, however, to his detriment Tsering had acquired a taste for alcohol and a partying lifestyle which attracted unreliable friends.

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

In a later conversation with Tsering he reflected to me that in the beginning he was not at all impressed with us or our medicine. It was just a job which was often very boring. So what changed? Tsering met Satyamohan. Tsering was living far from our clinic and had to commute many hours by bus to reach us everyday. Somewhere along the line, Saytamohan invited Tsering to stay at his house. This would result in the most amazing friendship that I have ever witnessed. Now, Tsering is regarded as part of the Dangol family. He is invited to sit for Baitika, a celebration in which the family’s women (sisters) pledge themselves to the long lives of their brothers. 

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

Tsering told me, “One day, I was working in the clinic and I suddenly became very emotional over a story that a patient was sharing. The old man was telling how he had suffering for many years and had gone to many hospitals but no one seemed to care about him. Only after coming to our clinic did anyone listen. In that moment, I came to know how important our clinic was to the man and I knew that this was the work I wanted to be doing.” Evidently it was a powerful moment because Tsering dedicated himself to the continuance of the project and the support of all of the practitioners and patients he interacted with. He became one of my favorite interpreters to work with because of his incredible ability to match the tone of the patient. I felt like I was having a seamless conversation with my patients and that I could feel their needs and they could feel my concern. That is what makes an extraordinary interpreter. 

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

In 2013, our project took on a major transition which was to move our operations to a more needed and remote region of Nepal. I had a desire to work more closely with the government health system and wanted to explore the establishment of a more integrated clinic model which would combine preventative education, palliative care, acupuncture, Ayurvedic medicine and allopathic medicine. I thought that if we could concentrate more on determining what was “best” for a patient rather than on what “we had” for medicine we would have more success in solving complex problems. Of course this would mean we would actually have to get to “know” our patients. This would be a model that would rely on frequent visits over time rather than on miraculous cures. 

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

To facilitate our relationship with the government we needed to establish a local organization and legitimatize all of our activities through various government authorities. Over a cup of tea in his small one room flat, Tsering and I discussed my ideas for these next steps. Tsering, now twenty six, said he had been wanting and waiting for an opportunity like this and he jumped on it. Tsering now serves as the Executive Director of our local NGO called Suswaasthya Nepal or Good Heath Nepal. We assembled a board of directors and retained an attorney to begin our quest. 

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

At the same time we began to think about our long term sustainability, which would rely upon our abilities to train and properly license Nepali practitioners. I knew that with my unique clinical experience I had many things to share with new practitioners but I didn’t have any training or experience in teaching. To this end, in 2014, I joined the faculty at the Oregon College of Oriental Medicine to learn how to teach. It has been an amazing and illuminating experience which has given me great insight into the needs of students and has inspired many to join me as volunteers in Nepal. At the same time we partnered with the Rural Health Education and Service Center (RHESC) to establish a school of acupuncture in Kathmandu and they invited me to serve their board of directors as a curriculum developer and advisor. Through their efforts we were able to establish a path to limited licensure in Nepal for our trainees and in 2015 we enrolled Satyamohan in their three year program to solidify his credentials. Two years later we were able to send five more students to school in Kathmandu for acupuncture training and we expect to receive them back to our project in 2020 for further mentorship.  

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

Flying home from Nepal after my tenth clinic season, I’m drawn to reflect on the incredible journey it has been. It is easy to count all of the numbers like the 150 volunteer practitioners who have worked with our project. We dunked them all into the deep end of the pool and it turns out most of them could swim. Over time we learned how to better support our volunteers and how to facilitate their understanding our our clinical model. I’d like to think we run one of the most organized and well-executed programs of its kind and that most of our providers leave with new skills and a better understanding of comprehensive patient care. 

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

We have also trained over fifty medical interpreters. I would like to credit our first Clinic Director, Nicky Glegg for establishing a program which would successfully transform young English-speaking Nepalis into truly competent language interpreters. We still utilize much of the training she shared with us. Many of our trainees have used this experience to leverage better jobs across Nepal and abroad. During the 2015 earthquake, we were able to respond by offering our interpreters to other emergency medical teams who were desperately in need of their skills. For some of our interpreters, working with us is just an interesting job for a couple of years. Others learn to love what we do and decide they would like to study the medicine too. Every year, I think I derive the most amount of joy out of interacting with our family of enthusiastic interpreters—without whom we would be completely ineffective.

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

Also in 2015 we were invited by the District Health Office of Makawanpur to establish an integrated care center in Bajrabarahi. The municipality there would grant us a thirty year lease on a patch of land within their healthpost compound at no cost. There was an existing building which sustained some damage in the earthquake and we took to renovate and expand it into a 2400 sq. foot building which includes a clinic, dispensary, reception, classroom, kitchen, office and living quarters. The clinic became operational in October 2015 and we had a dedication ceremony for the community on December 6, 2015.    

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

In 2017, we are now recognized through Nepal’s Ministry of Health, Social Welfare Council and the District Health Office of Makawanpur (where we operate). These partnerships have given us a greater voice in advocating for policy in rural health and has established a better referral network benefiting many of our patients. I am alway so proud when I visit a hospital and a doctor tells me that he has read our case studies and is very excited about our work. This year we were also able to approve a research study through the Nepal Health Research Council which will be conducted in 2018. This research will help assess risk factors and prevalence of non-communicable diseases in Nepal and will be the first of its kind. 

After all of this… in my mind, the value of the project can be best measured in this tale of these three brothers. 

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

Tsering, now married, has completely given up alcohol in order to be a good example for our staff. He casually walks in and out of government offices and hospital facilities like he was born there. No longer begging for the attention of government officials, Tsering is often called on to consult on future development plans or special project participation by our organizations. Tsering is the overseer of all things. He is the McCartney to my Lennon always putting an upbeat smile on patients and staff and he runs from one meeting to the next, trying his best to realize my esoteric vision. Many times, I think Tsering does the best medicine of all as I often task him to escort illiterate patients to the hospital in Kathmandu. Tsering does this with extreme patience, diligence and compassion, often spending many hours or days talking with doctors and coordinating care. One could not meet a more kind and dedicated partner to share this dream with.

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

Satyamohan, also now married to one of our lovely interpreters (who is in school studying to join him as an acupuncturist), has retuned to our clinic fully qualified to wear his white jacket and be referred to as the “Nepali Doctor” by our patients. Satyamohan has transformed from a quiet introvert into a robust leader. Whether working with patients, practitioners or interpreters, he exudes a relaxed confidence and grace that I rarely see in other practitioners. Trust me on this one—you would want this man to be your doctor. Tsering and Satyamohan rarely do anything without consulting one another. They are brothers in the true sense of their trust, respect and love for each other. 

Acupuncture Relief Project  | Good Health Nepal | Andrew Schlabach

Then there is myself. I started this project as a novice and forged my skills through thousands of patient cases. I’m still far from where I would like to be as a physician but I can recognize that I have come a long way as a care provider. I have also come a long way as a teacher—something my friends have always recognized in me but nothing I ever aspired to. Now, I find so much joy in helping others find new depth in their practice of medicine. I have mentored several Nepali students and have marveled at how they embraced the knowledge and propelled themselves to greater heights. I often hear from past volunteers about how our program changed their approach to patient care and reinvigorated their confidence in the efficacy of their medicine. For that experience I am humbled and grateful. 

This year I had the unfortunate experience of blowing out my knee and needing reparative surgery while in Nepal. Let me tell you, it is really different being on the receiving end of care and I found myself often overwhelmed by the support of my brothers and friends. I had to spend four nights in the hospital, most of which I spent in a post surgical stupor of pain killing drugs but I would often wake in the middle of the night to see Satyamohan and Tsering sleeping on the cold tile floor along side my bed huddled in light blankets. I know this is the Nepali way when family members are in the hospital but I wondered if I would do this? If I would spend four days and four nights sleeping on a tile floor. They never left my side the whole time—I will never forget that.  

And with that, I leave you with the unquantifiable justification for our ten years in Nepal. 

Author: Andrew Schlabach, MAcOM EAMP
Director, Acupuncture Relief Project
Bhimphedi, Makawanpur, Nepal

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