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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 

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By Andrew Schlabach

Created: 01 June 2015

I would like to thank everyone who so kindly offered support and donations to help us respond to this terrible event. 

One month after what is now known as the Gorkha Earthquake, our organizational attentions are returning to our primary mission. The 7.8 magnitude earthquake that occurred on April 25th, 2015 killed more than 8,800 people in Nepal and was followed by days of heavy aftershocks, some as strong as 7.3M_w. 

In the first few days following the initial quake, we scrambled to make contact with our friends, staff and villages. Our foreign volunteers and volunteers of other associated organizations were escorted to their respective embassies who assisted in evacuating them to their countries of origin. We learned that no one associated with our project had been injured though several of our staff members homes had sustained damage. The villages of Bhimphedi, Kogate and Ipa, where we operate our clinic projects, sustained significant damage but only minor injuries. 

After making an initial assessment, Acupuncture Relief Project and our local host organization, Good Health Nepal, started looking at emergency response plans. We made contact with USAID, Mercy Corps, Chokgyur Lingpa Foundation, several embassy officials and other organizations. We were strongly encouraged not to try to place a team in Nepal until receiving permission from governmental, military and police organizations. Instead we collected our Nepali staff and opened an office in Kathmandu.  Lead by our ARP coordinator and Director of Good Health Nepal, Tsering Sherpa and his wife Sera Sherpa, this office staffed a 24-hour hotline where organizations could access our interpreting staff to support medical teams being sent to the field. 

Interpreters were sent to Sindupalchowk and Nuwakot to support doctors and nurses in these remote villages. Other Good Health Nepal volunteers surveyed villages and distributed dust masks and tarpolines. More importantly, the office served to coordinate the efforts of several organizations in the distribution of medical and emergency supplies. They were able to provide government agencies critical data about the needs of the villages where we operate. We were even able to provide some funding and support to a group that was sheltering animals that had been traumatized and displaced during the earthquake. 

I am so very proud of our staff for there efforts over the last few weeks. I think it is testament to the work we have done over the past several years that we had a trained group of young men and women ready and able to organize and provide practical, effective skills in the aid of their own communities. What we were able to accomplish with a few thousand dollars was truly amazing. 

At this point, with the monsoon season starting, things are returning to some form of normal for Nepali’s.  There are still many people living in temporary shelters and tent cities however schools and businesses are reopening and crops are being planted. Most people are turning their attentions to rebuilding their lives. We too are looking on to what happens next. 

As of June 1st, we are closing our “emergency office” and sending our staff back to their home villages to help their families. Our first order of business is to assess the damage to our clinic building in Bajra Barahi and to prepare for a clinic team to resume our operations when the monsoon ends (early September). Tsering is traveling to Makawanpur to check on our clinic and also assure the District Health Office and our communities that we are eager to return to our work there. We know that the buildings and infrastructure may take many years to repair but we intend to address the trauma and emotional scars that fear and loss inflict as soon as possible.  Our challenges will also include many health concerns due to damage of sanitation systems and healthcare facilities in our region. Currently the World Health Organization is projecting a major outbreak of Typhoid and other infectious diseases over the summer months. 

Personally I am looking forward to being back in Nepal in September to reestablish our momentum in the training of healthcare providers in Makawanpur. The longer that we operate in Nepal, the more I see that the future depends upon inspiring and enabling Nepal’s young people to take responsibility for their community’s social welfare. Of course, this is always what we think in times of crisis. What we really need to think about is how rural areas of Nepal need access to compassionate, competent healthcare and social workers all of the time. -- Andrew

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

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