A COMMUNITY-BASED APPROACH TO IMPROVING MATERNAL AND INFANT WELLBEING
MIH Can is working with communities to implement several evidence-based strategies for improving maternal and infant wellbeing in India. These strategies include: 1). Training through seminars with our partners in India to share ideas and knowledge about best practices in improving MNCH (maternal and child health) and the development of a reproductive health manual for one of our partner organization; 2. Research by carrying out one study with one of our partners to build capacity and encourage new and novel approaches to ameliorating MNC; and 3. Innovation, by tackling low birth weight baby deaths through the creation of a thermal sleeping bag that is made of culturally appropriate fabric, which keeps babies’ temperature consistently high. Once designed, these sleeping bags will be sewn by local women’s groups and sold to those who can afford them and given freely to others.
Ultimately, MIH Can’s vision is to plant the seeds for a sustainable, long-term initiative that can be adopted by the local government to improve infant and maternal health across the country.
Acupuncture Relief Project in Nepal
I arrived in Chapagoan, Nepal with two large bags overflowing with medical supplies thanks to an exceedingly generous donation from John Stan and the Eastern Currents team. I was appointed the sole available doctor for the monsoon season in the ongoing rotation of healthcare practitioners organized by the Acupuncture Relief Project, which provides services at the Vajra Varahi Health Centre.
The Vajra Varahi Health Center has been open for two years now and offers a myriad of health services. These services are available for an optional 5 rupee donation (equivalent to around 7 Canadian cents), which allows the clinic to accept everyone and anyone who walks through its doors.
After hundreds of treatments I have had the opportunity to get a glimpse of the conditions the people of Nepal live with on a daily basis without consistent medical care and supervision. Although there are hospitals and basic primary care options available, in many cases not only is it too far to travel, but the cost of services deter many from seeking the assistance they so desperately need and deserve.
I recall at one point begging an older gentleman to go to the hospital to seek treatment for what appeared to be the early stage of a second stroke. He was reluctant because not only were the treatment and diagnosis costs far out of his financial range, but the expense of the journey to the hospital alone was too much for him. This scenario is not uncommon at the Vajra Varahi clinic, which acts as a primary health centre, a general care facility and unofficially, a triage for the hospital.
Once the word got out that I was in town and open to treat patients, some people walked hours to get to the clinic to have their ailments looked at, others commuted considerable distances, staying with friends or distant relatives for weeks, leaving their families behind in order to receive their long overdue treatments. Ailments included paralysis, reoccurring seizures, extremely severe varicose veins, uncontrolled asthma, TB, severe rheumatoid arthritis, Bells Palsy, Parkinson’s, hernias, vaginal pro-lapse, malaria, un-abetting fever, dysentery, and a multitude of gastric complaints.
Patients were incredibly thankful to have the clinic available to them and offered tokens of their appreciation continually, despite my polite decline and explanation that it was my job and they needn’t give me anything.
The other project I participated in while in Nepal was the training of eight HIV/addiction centre staff in the “Five Needle Protocol” for substance withdrawal. The Sathi Samuha centre offers live-in care for HIV-positive clients and their families as well as detoxification services for substance abusers and a safe house for sex trade workers. They have three other facilities, which also offer outpatient substance abuse prevention and harm reduction safe injection sites. The training went exceptionally well, as the centre’s staff had been asking to be trained in the Five Needle Protocol for years and were excited to finally have a new tool to help with withdrawal symptoms, relapse prevention and program retention. The eight Sathi Samuha trainees were diligent students and learned the material very quickly. Finally armed with a cost-effective tool to battle the growing problem of substance abuse, they finished the training excited and determined to help as many patients as they could.
My final impression at the end of the journey is that the Acupuncture Relief Project, the Vajra Varahi Health Centre and the Sathi Samuha Centre are three honorable and genuinely effective programs serving the impoverished, disenfranchised Nepalese population. I feel incredibly privileged and grateful to have been a part of this project.
For more information on the Acupuncture Relief Project, please visithttp://www.acupuncturereliefproject.com/
The Pan African Acupuncture Project in Uganda (2008)
| In August 2008, as a part of a group of six North American acupuncturists and TCM Practitioners,I traveled to Uganda to teach healthcare workers basic acupuncture protocols.The focus was to address symptoms of HIV, TB and Malaria. Thanks to Eastern Currents and other donors, the PanAfrican Acupuncture Project was able to successfully train 56 nurses and Traditional African Practitioners and provide them with needles and treatment supplies.
“As we approached the Kisoro hospital on our fourth day in town, we could see a lineup of patients winding through the courtyard and reaching around the building right up to the exit. It was 8:30 in the morning and already about two hundred people had lined up for acupuncture; the group at the front of the line had even slept overnight to ensure they received treatment. It was clear that it would be a busy day.
Kisoro is located on the southern tip of Uganda, bordering Congo and Rwanda. The cultural influence of its neighbours is very apparent in the area, who for over two decades have been escaping their turbulent homes in favor of the stability of Uganda. What is also apparent in the region is the toll that the mental and physical trauma of war, genocide, displacement, poverty and a general struggle for survival has taken upon its inhabitants.
The Pan African Acupuncture Project (PAAP) has now trained 162 healthcare workers throughout nine districts around Uganda. The healthcare workers have then introduced acupuncture as a new treatment tool into their small, rural health centres, clinics and hospitals. Kisoro Hospital was one of the largest and most advanced centres we had trained in to date, although its lack of functioning equipment demonstrated the great need for new, affordable and sustainable treatment tools such as acupuncture. The hundreds of patients who traveled from all around the district to receive treatment only emphasized this void in the current healthcare system.
The hospital superintendent was ecstatic about our training week in his hospital. He mentioned that although he had initially been unsure about what acupuncture actually was, the fact that our acupuncture clinic had managed to clear all of his hospital wards of patients certainly cemented his support for our work.
Pain was a very common complaint among patients, including chest pain, abdominal pain, headaches and musculoskeletal pain. Because of the strenuous way of life and limited healthcare in rural areas, many injuries had been left untreated for years. We also encountered many patients suffering from cysts, STDs, fungal infections and malaria whose health issues had long been without medical attention. In fact, we were often the first medical professionals to address the complaint.
As the word on the efficacy of the treatments spread throughout the community, so did the growth of our line of patients. The word was out, the acupuncture clinic was here, and its doors were open to everyone!
Upon our departure, as we had done the week prior in Mukono, a town just north of the capital, we informed our patients on the location of the clinics where the newly graduated ‘acupuncture protocol specialists’ were working. This way, patients could continue their treatments once we left. So, with smiling trainees, a very pleased hospital staff and the head of district health services bidding us farewell, the PAAP team headed off on our mountainous 14-hour, 300km journey back to the capital.
Two more districts, another 52 acupuncture trained healthcare workers later, my second trip with the Pan African Acupuncture Project in Uganda was a fabulous success.”
The Pan African Acupuncture Project in Uganda (2007)
This December 2007, as part of a group of five acupuncturists from North America, I was privileged to spend three weeks in Uganda teaching local healthcare workers acupuncture. The response from all parties was incredibly positive. The Pan African Acupuncture Project (PAAP) training system is based on highly successful models such as the ‘Barefoot Doctors’ in China and ‘GUAMAP’ in Guatemala. PAAP is a very practical training system that is geared towards getting healthcare workers from training to treating patients with acupuncture as fast and as safely as possible. December was round one of three training intensives the two groups of medical professionals involved would receive throughout the next year. The response from the healthcare workers was one of curiosity, excitement and relief that they would have another tool to treat the myriad of patients they see everyday. This allowed them to treat not only their regular patients, but also patients who could not be treated with allopathic medicine, patients who had no access to medication, and patients who were not willing to see allopathic medical professionals.“Acupuncture is like the bridge between our traditional medicine and Western medicine,” one trainee commented. The trainee was referring to the observation that certain patients who were only willing to see Traditional African Medicine Practitioners (TAMP) felt comfortable having acupuncture and were more willing to listen to advice given by their acupuncturist or TAMP, including advice about HIV testing. A benefit noted with the use of acupuncture was that it was sustainable and affordable. In a country where fraudulent placebo medication has sometimes found its way into pharmacies, and where availability of medication is not always guaranteed, acupuncture is proving to be a promising addition to the Ugandan medical system. Patient response was nothing short of phenomenal. It was often the response of the patient that convinced the healthcare worker to implement acupuncture into their rural health centres.Reaction to the acupuncture, for reasons we can only start to imagine, was much faster and more drastic than in North America. Often what took 4 or 5 treatments in North America to see effect would take one treatment in the village clinic. We had people literally jumping off the treatment tables dancing with relief. I would estimate that 85% of the patients my trainees and I saw marked at least a minimal feeling of improvement after the first treatment, if not greater. To imagine a series of such treatments is simply exhilarating. The most common diseases seen were HIV related opportunistic infections, keloids, malaria and pain, all of which responded very well to treatment. As someone who spent five years studying Chinese Medicine full time, I must admit I was skeptical of how much could be taught in such a short period of time. Fortunately, with the use of the training manual which each trainee took away with them, this simplified, very pragmatic, ‘no frills’ program allowed the healthcare workers a way to start treating some of the most common diseases immediately, even with pattern differentiation. Once treatments had begun, the patient results were enough to convince me of the efficacy of the point prescription in the manual. The best part was that the trainees, now equipped with a new treatment tool, were incredibly excited about acupuncture and very curious to learn more.With over 170 Ugandan healthcare workers trained in acupuncture, and interest from neighboring countries like Kenya and Malawi, the Pan African Acupuncture Project is proving to be an invaluable addition to Uganda’s already progressive effort in treating and caring for its people. As a recent volunteer trainer, it is without hesitation that I say the trip was undoubtedly the most inspiring, satisfying and enriching practical experience I have had.Emilie Salomons is a Practitioner of Traditional Chinese Medicine in Vancouver, BC. She has a private practice in Yale Town and also works for Vancouver Coastal Health Authority doing acupuncture detoxification.
Other volunteer positions held:
Acupuncturist: Palliative ward- St Paul’s Hospital
Acupuncturist: Friends for Life