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By Liz Kerr

Created: 25 December 2013

The inevitable gastrointestinal irritation happens when traveling and especially when living in rural Nepal, and I was the target this week. As I laid there staring at the ceiling between the bouts of bodily functionings, I was trying to recount all of the possible causes for it. Was it something I ate? Or the water when I washed my toothbrush off under the spigot? Was it that yogurt that the lovely couple offered to me and then poured for me on that house call the other day? Or was it all those school children at the satellite clinic in Ipa who were holding my hands and playing with my hair? Did I remember to wash my hands? Regardless of the reason, it was happening. And although being sick is never fun, this time it allowed me to see a different side to health care. A type of care that is apart from the allopathic anti-diarrheal, anti-nausea pills, and is unlike the rebellious stomach qi (the medicine we have been practicing here each day). I went to a witch doctor.

Three days of the sickness nonsense is just not pleasant, so I was willing to give anything a go. When our native Nepali ARP officer Tsering suggested that I go to the local Shaman I leaped (slowly) at the opportunity. He explained that in the culture here it was important to heal the spirit because sickness is the result of something attacking the person's spirit. The translation of the attacker is a witch. A witch bite is a bruise or unexplained mark on the skin. For me, it was a little more than a bite, I was attacked. A witch had attacked me from in the jungle surrounding our village, or from in the river water, or from a spirit of someone who had passed, and as a result, I had fallen ill.

The Shaman (who happens to be the father of one of our interpreters) conveniently lives just up the hill. He is not like the Disney'fied' witch doctors that one might imagine, with wild hair and a wild outfit, he is a down to earth father, husband, and worker of the land who is also a talented Shaman. He took my pulses, asked a few questions, just as we as acupuncturists practice, then went into the house to get his supplies. The supplies included a bowl of dry rice and red powder, another small bowl of ash, two cigarette-like sticks of herbs burning, a knife, and a cup of hot water mixed with salt and turmeric. As daunting as these sound the process was quite calm. He performed what I can only describe as a cleansing type ritual with the burning herbs, and tossing of the rice and red powder. I drank the salty water, and the knife was only used to stir it. At the end, I was told to rest and sleep for about an hour before returning back to the clinic house. And that was that. I returned feeling a little dazed and curious about what had just happened. It seemed a little surreal at the time, but as I sit here three days later feeling a whole lot better, I smile to myself, and think there must have been something to it.

Remembering the spirit is an important lesson. The medicine that is found in pills, or from acupuncture needles is effective, and does heal, but these medicines are not everything. Watching the ebb and flow of the three medicines - allopathic, traditional Chinese, and traditional Nepali intertwine and crisscross over one another here in Kogate is such an amazing dance. They support one another. It's a shame that we try so hard to keep them separate. -Liz Kerr

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By Haley Merritt

Created: 27 November 2013

I’ll always hold space for Nepal in my heart, my soul and my hands.  My hands because my hands are my tools, they are the hammers that deliver the nails (or the needles in my case) and they got a lot of action let me tell you. All of my experiences, including and probably especially the hard ones, have changed me in many ways. Some ways that I can see now and some ways that I think will continue to unravel as my life goes on. I didn't just improve my acupuncture skills, I became a primary care provider. Mostly, the experience taught me about myself. 

It taught me about different ways of living or being that make it easier to understand what happiness is. I learned that I just need to relax and breathe it in. Be open and let it flow me. To cherish what I have and the people around me. It taught me a lot about cultivating true relationships and friendship.

In Nepal, there is no hiding who you really are when you live with the only other five people for miles around who can speak the same language as you and you are totally cut off from the outside world. There's no getting all made up and putting in a cute outfit to look your best. There is no going home when you're tired, grumpy or uncomfortable. You show up everyday with grease in your hair and dirt on your face and you bear it all, good or bad. And you know what? People will still love and accept you for who you really are. I got closer to my clinic team than I have to many of the people who have come in and out of my life throughout the years.

Thank you Nepal for bringing these people into my life. Not only did this experience teach me about making true connections with the people I lived with; it taught me about connecting with people that don't speak the same language as I do, my patients and all the other people who live in Kogate.

Nepal has some of the sweetest kindest people I have ever met. I felt so loved in Nepal. I was welcomed with open arms and opens hearts wherever I went. Something that I will never forget are the smiles of those people. They smile with their eyes, which offers you a glimpse into who they really are. A vulnerability, most people in the United States are unwilling or unable share. But its something that means so much and helps me to see how truly connected we all are.

We don't always need words to express compassion and love and kindness as long as we are willing and able to be open enough to connect with one another. The people of Kogate take care of one another they share and barter and feed each other. They drum and dance and sing together. They live off the land and appreciate what they have even if its not a lot and they make the best of it. Patients would come in so happy and excited that we where there to help them they would bring flowers, pumpkins, mustard greens spiny cucumbers whatever they could afford to give away. Most of all they gave us their love and kindness.

Although many of my memories of Nepal are silver lined, it wasn't always rainbows and sunshine. Literally it rained for most of the first month we were there. Some days where a real struggle for me. Living without all of the comforts of home took some getting used to I won't lie... I had to let go a lot of fear. Especially my fear of of bugs because they were everywhere including my hair. They existed in all shapes and sizes but I especially remember the giant ones. I had to sacrifice my ankles to leeches and bed bugs as a peace offering to the insect community.  I had to let go of some of my  control issues as nothing in Nepal seems to work right or on any sort of time schedule. Plans are just an outline for what you'd like to have happen but Nepal defies any sort of structure you may lay out. 

This lesson made itself apparent even into my last days there as Nepal is having its first elections since the end of a long civil war that only ended a few years ago. There was a mass transportation strike around the country and I wasn't sure if I would make it to the airport in time to catch my flight home. And as much as I rant and rave about the people and my patients and their kindness, there’s always an exception to the rule.

This was made apparently clear to me by one of the patients that I treated the most. He came into the clinic everyday. He was suffering from the effects of a stroke that he had last February. He lost his ability to say anything but the phase la in Nepali, which means ok. He had also lost most of the mobility of the right side of his body. He was a very angry man and rightly so. I can only image how frustrating it would be to lose so much of who you are. He got frustrated easily with my treatments because they were often painful and his anger and pain was palpable in my heart. I found it so difficult to treat him as I absorbed his frustration and I quickly became physically and emotionally drained. I found myself dreading the thought of treating him everyday. I discovered that I have a habit of looking to my patients for acceptance and I wasn't getting that from him. I began to close myself off from him, but of course this only made my treatments with him more uncomfortable. 

I spoke to Andrew (our project director and team lead) and he talked to me about the importance of just holding good space for people and keeping an open heart. That sometimes the largest role we can play in our patient’s lives is just showing them that we care and are there for them. This really resonated with me. Suddenly, it all made sense. All I really had to do was show him that I cared about him, that I wasn't trying to hurt him. I was really trying to help and that I was invested in him getting better. Once my attitude changed toward him, he changed his attitude about his treatment and me.  He was no longer so angry. He was actually pretty happy when he came in which the whole team noticed because previous to my change in heart, he would often yell out in anger. He was also making great progress in his recovery. He regained the ability to walk on his own, he had started saying more words and he had an increase in active and passive movement of his right arm.

This was an incredibly important lesson for me to learn about patient-practitioner relationships and it was also one of the hardest and most uncomfortable experiences I had in Nepal. It just goes to show that from suffering comes growth. 

Nepal has taught me countless lessons. First and foremost, I want to remember that humanity is beautiful, don't ever give up on it. There is an incredible amount of people in the world ready and willing to freely share their kindness and love with you if you’re willing to share yours with them. Nepal has also taught me to "Harden the Fuck Up!" (a phrase we would commonly tease each other with when someone was whining a little too much). I don't need every luxury in the world to survive or to even be happy and often what I think I need is what ends up impeding my happiness. I am a lot stronger than I ever thought I was and that is truly empowering and liberating thought. As reflected on all that my Nepal experience has taught me, I can’t wait to bring these lessons home and apply them to my new life as an acupuncturist... and most of all as a human being. - Haley Merritt

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By Allissa Keane

Created: 24 November 2013

For the record, this is my second time writing this blog post. I wrote one a couple of weeks ago and Andrew had politely given me some feedback on it, called it fluffy, and asked me to consider rewriting it. Something about me not realizing how much I had grown here in Nepal, and sort of missing the boat on that in my first attempt. Needless to say, I was disheartened by his comments and stewed for a few days over them. I had already been through so many challenging experiences at that point and I wasn't really up for delving deeper anymore. But as I have learned (a few times over) there really is no where to run and nothing to distract you here in Kogate, Nepal. It's like acupuncture bootcamp, complete with mental, emotional and physical components.

So what do I write about then? I still had about a week and a half here, and to be honest I wasn't feeling particularly inspired by anything. Don't get me wrong, I have had many many amazing experiences while in Nepal that I will cherish forever. But sometime in this past year I stopped connecting with my heart. I felt exhausted, and therefore I would remain emotionally detached from pretty well everything to avoid the exhaustion. Unfortunately this detachment showed up in clinic, and I was having a hard time connecting with patients. I didn't recognize this disconnect until it was brought up via my initial blog post. So a few good cries and emotional talks later, I had arrived. Now this still is no big, ah ah, blow my mind, breakthrough moment. It did however spark a little something that I only expect will grow with time. But maybe those are the best kinds of insights.

I have written about Bim before in my personal blog, I've treated him a few more times since then and gotten to know him a little more. He is a man that we see on our way to the village of Ipa, where our outreach clinic is. Bim is actually the reason that ARP is here in Kogate. He initially started travelling seven hours to the Chapagoaon clinic for treatments when ARP was practicing there. His family told ARP that they should come to Kogate to practice, and 9 months later here we all are. Thanks to Bim, he is the reason so many people have received medical attention. 

One of the last days that I was to go to Ipa, Andrew gave me one of his insightful speeches. He told me that this man is surely dying, he will not live much longer, and he really hasn't had the best quality of life these past four years. So today, your charting and point selection really doesn't matter. What matters is that you make connection with him. I'm thinking to myself...is this about me? Or is everyone getting this inspirational speech? No, I was right, it was specifically for me.

The treatment went as usual. How are you feeling today? Any noticeable changes? How's your sleep, breathing, bowel movements? Bim began telling me about how tighten and painful his legs were, and when I touched them I could feel the bow strings that were his tendons. I learned that he has been in a contracted sitting position pretty well ever since his disease became debilitating. Bim is always seated outside when we come so I started asking his wife how she gets him in and out of the house. He has a large family, but they are not always around to help them, so it is up to her to care for her husband of 42 years. She looks to weigh about ninety pounds, and is not in optimal health herself. She says that she has to drag him in and out of the house when she has no help, so he spends his days on the front porch. I was sitting there beside Bim listening to this, wishing that his family would be of more help to them, but who am I to judge this family. They are as supportive as they can be. 

Then an idea struck me as I was listening to Suman, my interpreter, change my English words into Nepali. Suman looks pretty strong, and I've got some muscle on me to, what if we took Bim on a walk? Right now? Why expect the family to do this if were fully capable? So that's what we did. With one of Bim's arms over each of our shoulders we picked him up and walked him around their small courtyard. Because he was only able to use his tip toes we were pretty well carrying dead weight. It was substantially more challenging than I would have thought. It was only a short walk, but here's the best part; when we sat Bim back down in his spot, his face was beaming. I have truly never seen such gratitude on someone's face. In that moment I was more than humbled. 

This story isn't about this cool thing that I did to make a sick man smile, and it sure isn't a pat on the back for myself either. Actually anytime that someone has told me how proud they are of me for what I am doing for the people of Nepal I want to say, thank you, but it's quite the opposite of what you think. It's more like this: I've been changed by the people and experiences here in Nepal. So be proud of Nepal and people like Bim for giving me the opportunity to come back to my home and be able to share with you all how to become more heart connected to oneself and others. - Allissa Keane