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By Alyssa Baser

Created: 04 November 2015

At our clinic in Bajra Barahi, Nepal each practitioner sees up to 20 patients a day. At the beginning of my stay there I was meeting all new patients. I knew some cases would be challenging and others would be a bit more familiar. I know right now, that some will need long term treatment and have slow progress, whereas some find relief in only a few treatments.  I do hope however, to have as many successes as I can in the short amount of time that I am here. And it's the successes, little or big that keep me inspired to moving forward to help people.

The first time I met this patient he presented with low back pain, painful urination and red coloured urine. He complained that he experienced the back pain when bending over and had some frequency of urination. I thought he may have been experiencing a kidney infection but he did not have a fever nor was his pain severe. 

I consulted with a colleague and he clarified that this was not a kidney infection but more likely kidney stones. After doing a kidney punch test confirming the presence of stones and taking his temperature (which was normal), my recommendations were to drink five to six liters of water, quit drinking alcohol, chewing tobacco, and come for acupuncture to move the stones. Expecting him to argue with me, he surprisingly agreed saying if that is what it took to pass the stones, that is what he would do. 

Within a week he visited the clinic every day and every time I saw him he looked better and better. The pain kept decreasing as he held his side of the agreement to drink six liters of water! I enjoyed his energy a lot, he was a very positive man and grateful for the work I did on him. I especially appreciated that he wanted to get better as much as I wanted him to!

I predicted it would take about 6 appointments of checking in and doing acupuncture to resolve the stones. When appointment 6 approached, he came back saying he was having frequent urination but no red urine, urgency, or back pain. How could he be urinating ten times a day after all the work we had done? It was because he was still continuing to drink 6 liters of water per day because I had advised him to when he had the stones! Laughing at the very uncomplicated explanation, I told him he could now return to half that amount since the stones had finally passed. What else was there to do for him now? I could not think of anything to say but that he did not have to come to the clinic anymore unless something else came up. It does not seem like a big deal but for me, it was the first time I told a patient that our work here was done and I did not require him to come back again! It felt rewarding to know that this case was for now closed successfully. It enforced a reminder to me that it is great thing to give a patient the help they need with the intention of eventually seeing them less and less because they are improving. On the other hand, if we are constantly seeing a patient for several months/weeks without seeing any changes in their condition, what good are we doing? 

I do believe that this patient did more than half of the work because he truly wanted to get better and was willing to put in the effort for that to happen. Patients and us practitioners have to work together as a team! I am hopeful for more experiences like this in the future. Specifically, I am looking forward to more successes as well as overcoming challenging cases. Even more so, having the right to say, "Great work! You don't have to come anymore unless something else happens!" and send them on their way. -- Alyssa Baser

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By Kimberley Shepherd

Created: 29 October 2015

A lady came through the clinic doors on our first week, assisted by her daughter in law, she crumpled in to a blue plastic clinic chair. She spent no time in presenting me with a huge bag full of scans and empty packets of pain killers explaining that she had terrible lower back pain, radiating down her legs. This would have been a typical sciatic nerve impingement presentation however the lady was fearful that the doctor might have to do surgery, and the pain was visible in every line on her face indicating this was much more severe.

On inspection of the scans, she had a severe bulging lumber disc which meant surgery would have been her only option in terms of long term pain management and reestablishing normality in her day to day life. I offered a simple distal treatment along with auricular acupuncture to help manage her acute pain and advised that she mustn't delay in seeking medical assistance from her doctor, to bring forward the date of surgery. 

After 3 home visits trying to encourage her to take action, the lady was now bed bound and suffering with what appeared to be bed sores, using a bed pan with the assistance of two of her family members. Bound to a hard mattress in a small, partially ventilated room, she leans up on her right arm to sip tea with us, insisting she is now feeling much better and is opting out of surgery. On further questioning, it transpired she had been visited by the local shaman the night previously who had stayed up with her all night conducting a spiritual ceremony. 

Shamanic healing is thought to be one of the oldest healing practices in Nepal, aiming to address the spiritual aspects of illness, to restore balance and harmony in the emotional and physical self. Jhar-Phuk (to cleanse, energise and blow in healing spirits) is initiated with singing, chanting, dancing, drumming, rice grain scattering and the burning of incense, aiming to dispel the root cause of pain, suffering and illness.  

Intrigued by the sheer power that this one evening ritual had on my patients perception of pain and wellness posed a number of questions. Can belief and faith be transformative enough to instil a state of wellness in someone with debilitating pain? 

It is not for me to question or judge but rather take a step back and admire these traditional forms of medicine deeply rooted in such communities, to grow and learn from these experiences. Be it placebo or not, I have now witnessed the power of belief that people place in shamanic culture generating positive change to people's lives, which leads me to question if this form of medicine is  truly any different to our Eastern and western philosophies that we have come to live by? Are we all not working towards the same goal, to improve the lives of those who are sick or in pain? And if this is the case, why do we place so much emphasis on "cure"?

In this instance, the patient knew the consequences of opting out of medical intervention but found peace in the fact she was going to be in constant pain and would likely not be able to move again without the help of her family. Yet, her positivity was inspiring. She insisted that one day soon she would walk back down to our clinic for treatment. I wait for this day with optimistic anticipation and welcome the powerful benefits that this strength of faith offers to so many. -- Kim Shepherd

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By Rachel Hemblade

Created: 11 October 2015

When I decided to go to Nepal to work on this project I knew that I would experience difficult situations that would challenge me in ways that I could never imagine. However, I wasn't quite so emotionally prepared as I had thought. It was our second day treating in the Bhimphedi clinic, and I was treating a young girl who looked no older than 3 or 4.  She had been brought in earlier that morning with what looked to be an infected puncture wound behind her ear and she was distressed and crying. Perhaps frightened by the white coats and unfamiliar faces she would not let us near her to inspect the wound properly so she was dragged outside, which prompted all the patients outside to crowd around unnecessarily. This made the situation even more stressful. Despite the stress, noise and lack of communication, I could see that something was not right – her lymph nodes on her neck were visibly swollen and there was something unusual about the wound. I was feeling completely out of my depth but was expected to have this knowledge. I was relieved that the team leader was there who identified it as extra-pulmonary Tuberculosis (TB). Having experience in this environment and familiarity with such cases makes the difference in getting someone the right care. 

I’m not sure what affected me more that day; the situation itself (that this child was clearly sick and had been for weeks, yet the parents didn't appear to be doing more to make sure she got better) or the fact that they had gone to see various healthcare professionals and still none of them had recognized this as TB. With each day that passes and as we get used to living in this culture, I realize that it is not that people don't love and care about their children – it’s that in some situations they don't know how to care for them or that there’s nothing else they can do. The lack of basic healthcare education means that a lot of children are really sick and nothing can be done about it. 

What we have also come to realize and what makes me feel more disheartened is that even if and when they get to the hospitals or health posts, we cannot guarantee or expect that whoever sees them will be anymore qualified or knowledgeable than ourselves. This sense of frustration that I have found myself feeling over the past weeks occupies my thoughts most of the time and makes me wonder what can be done to help with the situation. 

This is why I am so grateful to be here: To be working alongside such caring professionals who are collectively developing trust in this community so people can have the confidence to come to us with these concerns. The Acupuncture Relief Project clinic is perfectly placed to spot these serious health issues and drive positive change in the community through proper action, education and awareness. -- Rachel Hemblade