My guest today is Richard Mandell, Executive Director of the PanAfrican Acupuncture Project. Welcome to OpEdNews. Please tell our readers about the project.
photo credit: PAAP
I created The PanAfrican Acupuncture Project (PAAP) in 2002 in response to the growing HIV/AIDS epidemic on the African continent. Previously, in 1989, I been a member of a group of acupuncturists who had developed The AIDS Care Project here in Boston. This was a public-health clinic where those who were HIV positive could get free acupuncture treatments. So when the US press finally began to cover the epidemic in Africa, I had a very visceral response: I was going to go to Africa to provide acupuncture. Of course, it didn't take long for me to realize that no matter how hard I worked, my efforts would not help enough people. So I chose to mirror a model of which I was already aware--by training others how to provide the treatments, access to acupuncture would increase greatly. With the input of supportive colleagues, I wrote a training manual and began to look for a way to implement the project.
I'll bet most of our readers are pretty unfamiliar with acupuncture. Mental images of human pincushions undergoing surgery without anesthesia immediately spring to mind. Can you explain how acupuncture works before we go any farther?
Approximately 4000 years ago, Taoist monks described lines that traversed the body, through which something called Qi (pronounced "chee") flows. These lines are called pathways or meridians or channels. The channels are all interconnected, creating a web on the front and back of the body. I like to envision this web as that which gives form to the body. The Qi that flows through the channels nourishes the tissues and organs, helping to create proper relationship between all of them. Harmony and balance. When there is enough Qi, it is moving in the proper direction, and there are no blockages, the individual experiences good health free of pain and suffering. When this is not the case, due, for example, to injury, illness, bad diet or lifestyle, or constitution, the Qi gets blocks, is insufficient in quantity, or flows in the wrong direction, and the result is pain and illness. Acupuncture treatments help the body rectify the problem. Most of the acupuncture points are along a channel, and each one has a particular function or action. The practitioner chooses which acupuncture points to stimulate based on the specific diagnosis and desired effect.
Acupuncture works because the body has the incredible ability to heal itself. Sometimes, because of an existing imbalance or disharmony, it needs to be "re-educated" or supported. Inserting needles into the proper points is one way to do this.
How can acupuncture work for something as serious and systemic as HIV/AIDS?
Two important aspects related to acupuncture are that it uses the body's own healing abilities and that treatments reflect how the particular individual responds to illness and disease. Although the body may be in a weakened state or its healing abilities buried beneath signs and symptoms, it maintains that innate inclination to achieve balance. Through thousands of years of clinical experience, we know how to use acupuncture points to urge the body towards that state of equilibrium. The other aspect, that each individual manifests an illness in a particular way, means that treatments truly reflect each person. No matter which illness afflicts a person--HIV, malaria, TB--the symptoms that surface reflect the individual's unique nature. Thus, acupuncture addresses an individual's underlying condition as well as the presenting symptoms.
That being said, acupuncture is not meant to be a substitute for conventional medical treatment. This is particularly true when it comes to how we employ acupuncture via PAAP. Acupuncture works well alongside conventional medicine, addressing symptoms and thereby improving quality of life and helping to instill a greater sense of optimism and hope. (Acupuncture can also treat the unwanted side effects caused by some drugs.) In addition, acupuncture improves compliance to medical regimens, such as ARVs for HIV and antimalarials for malaria. In a country such as Uganda, access to medicines is often limited and/or inconsistent. Although not a substitute for the medicines, acupuncture can support an individual when other treatments are not available.
waiting for acupuncture in Kyazanga, Masaka, Uganda
photo credit: PAAP
Okay; now we're ready for the nuts and bolts of PAAP. How does it work? How many of you are there at any given time? For how long? Flesh this out for us, please, Richard.
PAAP is a training program that teaches local medical providers how to use a simple form of acupuncture. Most of the Trainees are nurses, midwives, and nursing assistants, though we have also had the fabulous opportunity to train a group of 23 traditional Healers. At the core of the trainings are two training manuals that provide all the information needed to be able to provide safe, effective treatments. Thus, the trainings focus on teaching the providers how to use the manual. The original motivation for PAAP came from a desire to bring acupuncture--a treatment modality that I knew could bring much relief and support--to the people as quickly as possible. Thus, we could not afford to spend many months if not years teaching theory. Although the manuals do include some theory, what PAAP teaches is very practical and clinically based. The manuals become the Trainees' "bible," holding all of the information they need to help their patients with acupuncture. Thus, after the first 1 1/2 to 2 days of the training, which are more didactically focused, most of the rest of the time is learning through clinical supervision while patients are being treated.
Each training is one week, during which time hundreds of patients are treated. Each Trainee participates in a minimum of three one-week trainings spread out over a period fo one year.
PAAP relies on the volunteering of licensed acupuncturists and acupuncture students from acupuncture colleges. These individuals raise the money to be able to travel to Uganda or other African country to serve as Trainers. Thus far, over 50 individuals have worked with PAAP, coming from the US, Canada, and Great Britain. A number have volunteered a number of times. At each training, our goal is to have between four and six volunteers.
Okay; now we're ready for the nuts and bolts of PAAP. How does it work? How many of you are there at any given time? For how long? Flesh this out for us, please, Richard.
PAAP is a training program that teaches local medical providers how to use a simple form of acupuncture. Most of the Trainees are nurses, midwives, and nursing assistants, though we have also had the fabulous opportunity to train a group of 23 traditional Healers. At the core of the trainings are two training manuals that provide all the information needed to be able to provide safe, effective treatments. Thus, the trainings focus on teaching the providers how to use the manual. The original motivation for PAAP came from a desire to bring acupuncture--a treatment modality that I knew could bring much relief and support--to the people as quickly as possible. Thus, we could not afford to spend many months if not years teaching theory. Although the manuals do include some theory, what PAAP teaches is very practical and clinically based. The manuals become the Trainees' "bible," holding all of the information they need to help their patients with acupuncture. Thus, after the first 1 1/2 to 2 days of the training, which are more didactically focused, most of the rest of the time is learning through clinical supervision while patients are being treated.
Each training is one week, during which time hundreds of patients are treated. Each Trainee participates in a minimum of three one-week trainings spread out over a period fo one year.
PAAP relies on the volunteering of licensed acupuncturists and acupuncture students from acupuncture colleges. These individuals raise the money to be able to travel to Uganda or other African country to serve as Trainers. Thus far, over 50 individuals have worked with PAAP, coming from the US, Canada, and Great Britain. A number have volunteered a number of times. At each training, our goal is to have between four and six volunteers.
Dannielle Metcalf, US Acupuncturist Trainer, supervising Trainee and Traditional Healer Sauda; photo credit: PAAP
Fabulous. Did you tell me how long the acupuncturists go for? Is there a standard or recommended length? I imagine it would be a life-changing experience.
Each trip is for two weeks, meaning that we work with two different groups of Trainees each time. One of our long-term goals is to find out how we can maintain an on-going presence to be able to have consistent supervisory availability.
I believe that for many it is a profound experience. We have seem and heard about immediate and dramatic changes in patients' conditions. And this occurs using very simple acupuncture protocols. So, the acupuncturists often get to see first hand how this simple treatment modality can make significant differences in people's lives. And this includes seeing how those we train are committed to and very excited about acupuncture. Of course, just being with the African (Ugandan) people is life changing, in that it provides an opportunity to gain important perspectives.
It sounds wonderful, Richard. Anything you'd like to add before we wrap this up?
I can't think of anything else at the moment. Thank you so much for providing the opportunity to be interviewed.
Thanks so much for talking with me. Good luck to you and PAAP.
Thanks for everything.
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Thank you, Naomi Eisenberger of the Good People Fund for suggesting this interview.
The PAAP web site is www.panafricanacupuncture.org
