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Acupuncture or Hiking Boots?

Updated: May 10

There have been a handful of moments in life where I've been acutely aware I was witnessing a life-changing experience. This moment, right here and now, most definitely joins that handful.

Three times a week I ride out to the satellite clinic about 35 minutes from our base camp, in the remote village of Markhu with Satyamohan - an accomplished ARP acupuncturist and delightful human . A couple of days ago I was riding out to Markhu in the early morning. The giant, purple mountains in the distance were shrouded in a light fog, the forest was bustling with delighted feathered creatures and a long tailed blue bird swooped down to say hello. I was listening to some great tunes and with all that sensory delight, I felt a little salty one welling in my eye.

Apart from breathtaking mountain scenery, we also pass many small villages and clusters of mud-brick houses. My jaw literally drops when I see the locals carrying hefty loads up rocky mountain paths, loads full of animal feed, rocks and logs. Stone walls are all the rage here - apparently the rate for filling a bag of stones using a sledgehammer (seriously tough work) is 30 rupees per bag which is equivalent to about 39 cents. The roads are unpaved and the porters wear these plastic flipflops and I can't help but wonder whether they need acupuncture or just some descent hiking boots. When the day is done and we ride back home around 4:30, I enjoy seeing the groups of women sitting out on their front porches, chatting and laughing loudly, surrounded by goats, dogs and adorable children.

The majority of cases I've seen in clinic thus far have been musculo-skeletal conditions - osteoarthritis, bursitis and tendonitis which makes sense considering the arduous daily activity of the locals. Most patients I've seen also have high blood pressure, one woman I saw the other day had a reading of 208/135! I took her straight to the Health post for some emergency Furosemide. I've been surprised at how common readings of around 160/100 are, (considering a normal blood pressure reading is around 120/80). I'm wondering what the cause of these high readings could be taking into account the common diet is a quite healthy mix of dhal, rice and vegetables? Perhaps a combination of the high altitude mixed with a bit too much rice, salt and alcohol? Alcohol is a bit of a problem here. Rice beer and Rakshi (a distilled alcoholic drink commonly made from Kodo -a variety of millet found in Nepal) are commonly given to farmers and tradespeople throughout their shift, in much the same way we give tea and biscuit to ours back home.

The other concerning issue I've encountered over the past few weeks is the over prescribing of antibiotics. I had an elderly woman come into the clinic a couple of days ago complaining of a dry cough, she was given Amoxicillin from the Health post that morning. I took her temperature, there was no fever, so why would she need antibiotics? I told her to refrain from taking it and instead gave her a Chinese Medicine formula Sheng Mai San and told her to return in a couple of days for re-assessment. She returned, her cough had eased and I continued to treat with acupuncture and monitor her vital signs.

Another patient came into the clinic, she had moderately high blood pressure and she handed me her "bp medication" that turned out to be antacids ¯\_(ツ)_/¯.

Many patients have never (or very rarely) consult a General Practitioner and therefore rely solely on the local health post or pharmacy for medical care and advice which can be a little dubious at times. This is where ARP has been filling in the gaps in the healthcare system here in the municipality of Manikapur. ARP volunteers are primary healthcare practitioners with the responsibility of monitoring vital signs and medication, treating and assessing progress and/or refering patients on when necessary. The well-being of the patients is the objective and primary concern. It's an honour to be part of this seemingly endless chain of formidable humans working tirelessly and patiently to ensure each patient is looked after and no patient is ever turned away (unless they've had a Rakshi shot of course ;)).

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