Interview with Andrew Schlabach - Co-Founder & President of The Acupuncture Relief Project
By Emma Suttie, D.Ac, AP
Andrew Schlabach, who is co-founder and president of the Acupuncture Relief Project, kindly agreed to sit down and answer a few questions about his organization and all the good things they are doing with their clinic in Nepal.
For those who don’t know about your organization, could you tell us a little bit about it?
Acupuncture Relief Project (ARP), along with our local partners, operates a small primary care clinic in a rural village of Nepal. Founded in 2008, Acupuncture Relief Project provides healthcare practitioners of various disciplines an opportunity to gain valuable field experience while making a positive impact on the local community. Our efforts include the treatment of patients living with HIV and AIDs as well as people suffering from extreme poverty and social disenfranchisement. We are a completely volunteer-based project and rely on a grassroots approach to sustainability and community support.
Why did you choose Nepal? Did you have a personal connection to it, or did you think it would be the place that would most benefit from this type of clinic?
I had the privilege of working as a mountaineering instructor at the notorious Himalayan Mountain Institute in Darjeeling India and participated in several expeditions in Nepal, Tibet and Northern India. Through this experience I fell in love with Nepal and its people. Later when I trained as an acupuncturist I envisioned a program which would not only provide service to a community that had very little access to medical care but would also provide an opportunity for healthcare practitioners to experience the complexities and hardships of the developing world. Hopefully providing an experience which challenges practitioners to connect to a deeper understanding of their medicine and foster the growth of compassionate wisdom.
Were the local Nepalese people open and receptive to coming to the clinic to get acupuncture, or did it take some time for them to warm up to it?
We don't characterize ourselves as an "Acupuncture" clinic even though we are primarily staffed by acupuncture physicians. Mostly we are just a primary care clinic... a place where anyone can come to get medical care and advice. Like anywhere in the world, some people are very open-minded about acupuncture and some are very skeptical. Once we establish trust, it doesn't really matter whether we are using acupuncture or allopathic medicine, people know they can come in and we will do our best to help them. It is very difficult to describe to people in developed countries what it means to live without access to care. Many times our job is more about patient education, assessment and referral than it is about any particular treatment modality. Just the fact that we can assess whether a child's fever is manageable or an emergency provides the community with a priceless resource.
Did the locals have any prior knowledge of what acupuncture was?
Not really. We get asked many times a day "what kind of medicine is on the needle". We explain that there isn't any and that we are simply assisting their body in healing itself. That is probably a bit mystifying but then, after couple treatments, they start getting better. Then they bring their whole family.
You have a group of wonderful local interpreters who work with the practitioners. Is the language barrier still difficult?
Our interpreters are world class professionals and they continue to improve. Several of them have worked with us since the beginning. The difficulty for both us and the interpreters is the limitation of the language itself. There are three common languages in the area in which we operate. Nepali, Newari, and Tamang. Each language has it's own unique limitation. For example in Newari there is only one word for the torso which translates in English to "heart". A patient may come in complaining of "Heart Disease" which for us only narrows it down to the torso. They could be suffering from anything from indigestion to angina to hepatitis. They don't have specific words or an understanding of internal organs so our interpreters do the best they can and we rely on many non-verbal cues and diagnositics to direct our assessments.
What are some of the conditions that you treat most?
People in the village are mostly subsistence farmers and they work very hard throughout their lives. About 65% of patients that we see are coming in for chronic pain. Low back, neck and knees particularly. This is something acupuncture is quite good at addressing and we see very good results in getting people back to work so they can take care of their families. We also see a multitude of other conditions including digestive disorders, hypertension, diabetes, stroke, febrile stroke, uterine prolapse, asthma, tuberculosis and typhoid. We also sometimes deal with social issues like domestic violence and substance abuse.
Do you only use acupuncturists?
No. We primarily use acupuncturists because this treatment modality allows us to treat a large number of people for very little money or overhead. The clinic also hosts herbalists, Tibetan traditional practitioners, homeopaths and massage therapists. We have also had several allopathic and naturopathic physicians work with us. We try to provide as much care as possible and we find that we do very well without the overhead of a pharmaceutical dispensary. We do utilize a small stock of antibiotics and other drugs when we need to but we will try to get a patient to an appropriate facility a patient has a serious or emergency condition.
What were some of the things that surprised you about running the clinic in Nepal?
I think what continues to amaze me is how much impact a small clinic can have on so many people. Not only our patients who of course benefit from our care but also our interpreters who have meaningful jobs supporting their own communities. Additionally our volunteer practitioners continuously report to us the effects of their experience in Nepal. Many have shared how they have gained a new appreciation for patient care and that has carried forward into their own practices and communities.
About how many people do you treat a day?
The clinic sees about 80-120 people per day. We also conduct several outreach clinics in outlaying villages each week.
Do you have any idea how many patients you have treated since the clinic began?
Well over 100,000 patient visits.
Is the clinic operational full time, or only at certain times of the year when you can bring volunteers?
Yes. There are practitioners at the clinic year round, however the clinic runs at varied capacity depending on the availability of volunteers and other resources. Organizationally, we focus particularly on our training program which operated from September to March every year. During this time the clinic opperates is at it's maximum capacity. The availability of healthcare in the winter months is particularly critical to the village so we prioritize our efforts for this time of the year.
Acupuncture is very cost effective compared to Western medicine. How much does it cost to run the clinic?
Again, we characterize ourselves as a primary care clinic and not an "acupuncture" clinic. We utilize a variety of modalities (including Western medicine) and attempt to determine the "best" care for a particular patient. In many cases, acupuncture is the "best" care. The total cost of operation including all of our herbal and western dispensary, we provide primary care year round for about $4.80 USD per patient visit. I don't wish to take anything away from other types of service projects but for sake of comparison, you can compare us to a visiting medical/dental camp which operates in Nepal for a few weeks each year which costs $24-30 USD per visit. I will say that the dental services that they provide are worth every penny to the communities they serve.
What is the most difficult thing about running the clinic?
I think with any service project there are constant stresses around resources. There is never enough money, time or volunteers to accomplish everything you might envision. Also, as a US based non-profit there are many logistical complexities of operating a clinic half way around the world. All of these are relatively minor in the grand scheme but they must be constantly addressed in order to insure our long term sustainability.
What would you like to see the Acupuncture Relief Project do in the future?
Training local practitioners is our ultimate goal and one that we are actively trying to solve. In 2011, we fully funded a scholarship for one student only to be setback as the only Oriental Medicine school in Nepal became defunct. We have now adopted an apprenticeship program for two students and we are also exploring the possibility of sponsoring a student to study in the US, Canada, Australia or China. Our major obstacle is a lack of legitimate accreditation and licensure in Nepal so obviously this issue will be on our list for awhile.
Here is some more information about Andrew from the Acupuncture Relief Project website...
Andrew Schlabach MAcOM EAMP
Andrew Schlabach is the co-founder and President of the Acupuncture Relief Project having received his Masters in Acupuncture and Oriental Medicine from the Oregon College of Oriental Medicine in 2008. His master’s research project founded a Practice Based Research Network for Oriental medicine practitioners and researchers in Oregon and Southwest Washington in collaboration with the Helfgott Research Institute. Now practicing at Healthwerks - Acupuncture Wellness Clinic, Vancouver Washington he is the author and publisher of the Acupuncture and Chinese Herbal Medicine - Clinic Survival Guide. Mr. Schlabach also served as President and Creative Director of Split Diamond Media, Inc. of Portland Oregon for 15 years. Specializing in business-to-business advertising, Split Diamond Media pioneered digital publishing technologies and internet services for a variety of regional and national companies. Mr. Schlabach is also an accomplished mountaineer with expedition experience in the Himalayas, distinguishing himself as an instructor at the prestigious Himalayan Mountain Institute in Darjeeling India. Having travel extensively in central Asia, Mr. Schlabach has become a student of world theology, Tai Ji and yoga. As a veteran of the U.S. Army, he received an Army Commendation Medal for distinguished service to his unit.
To learn more about The Acupuncture Relief Project and the wonderful work they are doing, please visit their website at www.acupuncturereliefproject.org
And be sure to watch the 30 minute documentary, Compassion Connects about their clinic in Nepal. It is incredibly inspiring!
