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Welcome to Chinese Medicine Bristol's official blog! Here, Acupuncture and TCM pracitioner Sandra Arbelaez will share information about Acupuncture and Chinese Herbal Medicine, how they work, and the latest research and developments related to TCM. You will also find knowledge and ideas on how to enjoy a full, healthy life that she has picked up over the course of 15 years of exploring the world of natural health

Wednesday, 17 July 2024

TCM Causes of Disease: Damp

In Chinese Medicine theory, it is understood that each part of a whole plays an important role in maintaining the integrity of the whole. What constitutes the “whole” depends on the context, it could be the planet, a specific ecosystem, or an individual living organism. When we take the human body as the “whole”, this concept means that all of the organs, tissues, fluids and systems in our body work in conjunction with each other in order to maintain the balance and health of the whole body. At the same time, anything that happens to one part of the body, can eventually affect other parts, and even the whole system.

This also works at a bigger scale. As we are ourselves part of larger system which is nature, we are under the influence of the environment we live in and our bodies are in constant interplay with its changing qualities, while at the same time our environment is affected by how we interact with it. Simply put, the elements, seasons, and climate as well as the pollution and toxicity in our environment influence the workings of our bodily systems.

In Chinese medicine, we identify specific pathogenic factors that result from our interaction with our environment. These are referred to as 6 External causes of disease which consist of natural climatic and environmental factors that can become pathogenic and cause disease when they “invade” the body. I gave a brief account of each of these pathogenic factors in a previous post which you can read here

In this post, I am going to focus on the Damp pathogen, which I have found to be one of the the main factors contributing to symptoms during my 20 years of practice in the UK.

 

DAMP

Mould growth is a result of Damp
According to the publication  Indoor Environmental Quality and Health Risk toward Healthier Environment for All, indoor dampness is related to the growth of mould and bacteria and chemical degradation of building materials, and it is a risk factor for respiratory symptoms and infections, asthma, rhinitis, lower lung function, dermatitis, a host of non-respiratory symptoms, sensory effects, irritation of the mucous membranes and inflammation. 

I have seen all of the issues mentioned above, and more, in my clinic as a result of Damp pathogens. To understand how Damp affects our bodies, let’s start by defining the characteristics of Damp as we observe it in nature:

  • It tends to penetrate matter and eventually cause its decay
  • It produces heaviness, swelling, and puffiness- like the doors that we can’t get to close, the walls with blistering plaster, the soggy ground when it's very humid
  • It is pervasive and easily becomes stagnant and mouldy- where there is damp, there is that smell that seems to never go away no matter how much ventilation we give to a place. Oh, and those mouldy patches in our Victorian houses which always seem to come back no matter how much we clean them
  • It tends to sink- unless everything is so soaked that it has nowhere else to go or something is blocking its way causing it to move upwards instead, dampness tends to go downwards because of its heaviness.

 

 On the whole, pathogenic Damp shares the exact same characteristics of environmental dampness as outlined above:

  • It can penetrate matter: Damp can be found practically everywhere in the body: the skin, the muscles, the joints, the organs, the mucus-lined tracts throughout the body, the sensory organs. It can cause decay: In long term Damp-related skin conditions, we can easily see how the stagnant fluids stop blood circulation to the external layers causing them to become scaly and eroded.
  • It produces heaviness, swelling, and puffiness- heavy feelings, bloating, puffiness, and swelling are common signs of Dampness 
  • Long term Damp is difficult to get rid of: though not impossible, it can take root in places we can’t imagine, and when it has been present for a long time, it can become stuck, thick and pervasive
  • Damp tends to sink- the most common symptoms of Damp manifest in the lower part of the body- bowels, urinary tract, and lower limbs. However, just like in nature, it can rise to the chest and head when there is an excess of it in the lower and the is no room for more Damp, or if there is a blockage that doesn’t allow it to sink, causing it to move upwards. We can see this in people who develop symptoms of Damp in the upper body (cough with phlegm, mucus in the nose, blocked ears) as a result of constipation or after eating excessively and clogging up their digestive systems.


EXTERNAL AND INTERNAL DAMP

According to Chinese Medicine, there are two types of pathogenic Damp: External and Internal. This post was meant to discuss External Damp but it’s impossible to talk about it without discussing Internal Dampness as well.

Damp can appear in the body as a result of a relentless exposure to External Damp as well as Internal production of it coming from either the excessive consumption of damp- or mucus-producing foods and/or a propensity for the body to accumulate it due to an impairment in the digestive process. Once in the body, Damp can obstruct the flow of substances including the blood, disrupt organ function, produce inflammation, and - if left over a long period of time- become thicker and even solidify into soft lumps and nodules.

 External Damp

The UK is an area of high humidity which makes us prone to developing symptoms which in TCM are classified as Damp-related. We are painfully familiar with damp walls and ceilings, the smell of damp clothes which never seem to dry properly, and mouldy basements and cellars. Damp environments easily breed fungus and this is why we often see mould and mildew growing over all sorts of materials and plants that have not had the opportunity to dry out for a long time.

Frequent rain is a form of External Damp

When External Damp invades the body, it will affect at least one of the superficial layers of the body: skin, muscles, joints, ligaments or tendons. Damp will cause puffiness, inflammation, heavy feelings, skin conditions with fluid-filled eruptions, stiffness in the joints, achy feelings. It may be that our symptoms are better when we are outside moving around, and worse when we have been static for a long time. The joint stiffness, headache, and foggy head we can experience when we wake up, and which clear up as we move around, are often due to pathogenic Damp. Damp-related symptoms can be exacerbated by rainy days and damp environments, by certain foods, and may become chronic and difficult to shift.

Just to make it more confusing, Internal Damp can affect the superficial layers of the body if it has nowhere else to go, and cause the same symptoms as External Damp. This is often the case in children with eczema who are intolerant to dairy. Their inability to digest dairy can cause an accumulation in their digestive systems that the body eventually starts to send upwards and/or outwards resulting in chest or ear infections and skin conditions. For this reason, it is common for these children to experience childhood asthma and eczema at the same time. This kind of pattern can also be seen in adults and it is common to see people in clinic whose conditions involve both Internal and External Damp creating and exacerbating each other.


Internal Damp

Internally, Damp manifests as an accumulation of fluids of varied thickness and viscosity such as water retention, excess mucus, and phlegm. This can occur in any area of the body: in the digestive or respiratory tracts, the urinary tract, the reproductive system, the head and sense organs, etc. The famous candida overgrowth and all the different types of bacterial overgrowth causing digestive, Small and Large intestinal issues, and urinary issues are all manifestations of Damp in the interior.

The main underlying cause of internal Damp lies in the digestive system. There are two main ways in which this happens:

1. Depletion of the digestive organs, the Spleen and Stomach, resulting in an inability to process correctly all the food and fluid that we ingest. There may be sluggishness in the digestion which creates a back-log of undigested food and/or undischarged waste products. These accumulations can clog up the system, further impairing the digestive function, resulting in further accumulation and in an unhealthy cycle of worsening digestive power and increased accumulation.

The excess accumulation is initially stored inside the digestive tract but, as it increases, it can seep through other areas to affect the urinary and reproductive systems and also start to creep up to the chest and head, and even outwards to affect the joints and skin, thus producing systemic symptoms. As an example of this: I have treated several people who, despite having no appetite and eating very little, continuously put on weight and felt heavy and sluggish with headaches, foggy head, achy muscles and joints. This is what we would call Damp accumulation which is rooted in depletion. As the body becomes more depleted, more Damp accumulates until eventually it affects different parts of the body. The treatment involves warming and strengthening the body and encouraging the body to expel excess Damp using acupuncture and herbs, supported by a diet consisting of nutritious foods that are easily digested.

When our system is healthy, the excess Damp is expelled through the urine and stools. Thus, how we are excreting may show us the presence or absence of Internal Damp.


Damp forming foods can affect our health
2. The second main cause if Internal Damp is an excessive intake of Damp-forming (the same as mucus-forming) foods. It may be that our Spleen and Stomach are strong, but our diet consists of foods that are difficult to process. Our digestive organs may be overwhelmed by this after a while, resulting in an accumulation of Damp. This eventually can cause difficulty to the digestive organs as they cannot process or excrete efficiently, making them lose energy and become depleted. This means that long-term, this type of pattern ends up becoming the first type involving depletion of the digestive organs.

 The diet now prevalent in our society consists mostly of Damp producing foods:

Dairy products (milk and all its derivatives), wheat products, refined sugar, processed foods, chemical additives, alcohol. Think of the common UK diet of cereals (usually processed and full of refined sugar) with milk for breakfast, a sandwich and piece of cake for lunch, and pasta, pizza or something microwaved for dinner. To this we add snacks of milk chocolate bars, cereal bars, or biscuits, the fizzy drinks charged with additives and sugar, the teas and coffees with milk and sugar and the alcohol to relax in the evenings. With a diet like this, the constant consumption of mucus producing foods will eventually clog us up and prevent the digestive system from processing anything at all. We may think this is not doing us any harm but it’s just a question of time before we start to develop at least some of the symptoms outlined below.

 

SYMPTOMS OF DAMPNESS

The heavy, clogging, puffing, nature of Damp accounts for a variety of common symptoms that range from allergic reactions and inflammation to digestive difficulties, menstrual issues, and chronic headaches.

Below, there is a list of some of the possible symptoms that can be caused by Damp. Some of these symptoms may also be caused by other pathogenic factors or disfunction of the organs so this is not meant to be a diagnostic aid but just an informative list:

General:  Heaviness, fatigue, pain that is improved with movement and worsened by being still and by humid weather, numbness, water retention, oedema, stiff puffy joints, rashes particularly those with fluid-filled eruptions.

Digestive: Bloating, sluggish digestion, abdominal discomfort and fullness, nausea, loose stools, rumbling stomach, acid, mucus in stool, excess saliva, poor appetite.

Urinary: Frequent, difficult, urgent, painful, interrupted urination, night time urination.

Respiratory: Chest oppression, wheezing, cough, panting, rattling sounds, phlegm in the chest or throat.

Head: Nasal discharge, eye discharge, post nasal drip, blocked ears, sinus issues, headaches- particularly frontal ones

Mental/Emotional: Brain fog, depression, low motivation, feeling disconnected, excessive worry, anxiety, confusion, lack of concentration.

Skin: Rashes, itching, scaling, fluid-filled eruptions, some types of hair loss.

Damp-related symptoms often get worse when it’s rainy or humid outside or after we have consumed too much bread, dairy, sugar, alcohol.


Damp Heat

Just as it happens in nature, where stagnant water eventually starts to putrefy and becomes thick, slimy and smelly, long-standing Damp accumulation in the body can eventually heat up and turn thicker, turbid, and even putrid. This is called Damp Heat and it can present with the same symptoms as Damp but they will be more severe with the addition of thick, yellow, smelly discharges that become infectious, with pus, inflammation, hot sensations (including fever), and pain. Damp Heat is a development from Damp towards more severe conditions which are more difficult to treat.

In addition to the foods that create Damp and mucus, which will also contribute to Damp Heat if it is present, someone presenting this pathogen will need to avoid or reduce heating practices and foods including spicy food, alcohol, smoking, and sweating excessively.

 

 PREVENTING THE EFFECTS OF DAMPNESS IN THE BODY

In the UK, it is difficult not to be exposed to environmental Dampness. In addition, the fact that there is so much Exterior Dampness can eventually make us prone to develop Internal Dampness. I have seen this when treating people who were originally from drier climates like Spain, Greece, and Somalia. In these countries, the traditional diet contains a lot of Damp-forming foods such as wheat, dairy products, and large amounts of oil. In their original setting, these ingredients caused no issues as they help the body retain moisture, thus counteracting the effects of excessive dryness on the body. In Bristol, however, eating this diet resulted in weight gain, digestive issues, chest issues, and allergies. The type of weight gain I have seen mostly affects the middle and lower parts of the body with evident water retention and often a kind of wobbliness that resembles a water-filled balloon. This is the accumulation of Dampness that is sinking from the middle (the digestive system) into the lower abdomen, hips, legs, and feet.

I myself started to develop mild respiratory allergies to different agents, skin rashes, and wheezing after living in my house in Bristol for 3 years. I wasn’t sure why this was happening since I am always careful with my diet and lifestyle. Eventually, I discovered that mould was growing behind my bedroom furniture and that the V-shaped roof of my house was creating an accumulation of damp in the ceiling. I had to get rid of some of my furniture and constantly clean my walls and ceiling as well as getting a dehumidifier. Short of moving house, some heavy building work finally saved the day and after getting rid of all the materials that where completely water-logged and half rotten, I got to breathe freely again. I also developed a pattern where I would get clogging in my nose and ears just a few hours after eating bread. This was showing me that my digestive system had become very sensitive to Dampness as a result of overexposure to External Dampness, Herbs, acupuncture and reducing to a minimum the consumption of Damp-forming foods helped me restore my balance.

The experience I had in my house made me highly aware of the impact of External Dampness on our health. I recommend to everyone displaying severe Damp symptoms with no known cause, to do the following:

  • Check of mould and damp walls in your home
  • Any sign of Damp? – get a dehumidifier and then get a builder to check if anything needs to be done to fix it
  • Ventilate your home as much as possible
  • If there is Damp already, don’t dry your clothes on radiators and, if possible, not in the house. I use a dehumidifier to dry my clothes, although I get told off for over using it!

 

Diet and Lifestyle

Because Dampness is so sticky and it can hide inside the body for a long time sneakily clogging up the system and impairing our organ function, it can be difficult to get rid of it. By the time symptoms show and we seek treatment, we may need long term assistance to expel the accumulated Damp and help the organs recover their normal function. Cutting down or even out completely all Damp-producing foods from the diet is the simplest way to support a system that is getting congested with Dampness. 

The main Damp and mucus producing foods that a person displaying symptoms of Dampness needs to avoid are: 

All wheat products, cow’s milk and all its derivatives, refined sugar and all processed sugars and sweeteners, all processed foods, all refined fats, alcohol, and chemical additives.

 In addition, excessive amounts of raw and cold foods, and drinking fluids straight out of the fridge are considered practices that can conduce to Damp formation in the body. You can find out more on healthy eating according to Chinese Medicine here.

Regular stretching of the whole body can be helpful to improve flexibility and encourage the movement of stuck Dampness away from joints and muscles and to promote digestive function. Moderate exercise is often recommended, taking into account that the right type and right amount of exercise will depend on each person's condition. A way to know if the exercise we are doing suits us is to observe how we feel a a few hours later and the day after exercising. If we feel exhausted or our symptoms increase, this is a sign that we are doing too much or the wrong type of exercise. You can find more on health cultivation and the essentials of health here.

 Acupuncture and Chinese herbs are very effective at treating Dampness and its symptoms. With acupuncture, we can treat the most External manifestations of Dampness such as swelling, stiffness and pain. Internal Dampness that is not too severe, manifesting as respiratory, digestive and urinary issues can also be effectively treated with acupuncture and moxibustion. More severe, chronic, and stubborn Damp symptoms can be addressed with Chinese herbal medicine, often combined with acupuncture and moxibustion. Treatment can help the organs expel the excess Damp and also strengthen body as a whole to prevent excessive Damp from accumulating so easily in the future. 

Phlegm is a more congealed type of Dampness, it is originated in the same way and it is considered to be the cause of many illnesses in Chinese Medicine. Preventing Damp and Phlegm formation in the body can be regarded as essential to prevent chronic illness and improve our chances of a healthy mind and body in our mature years. 





 

 

 

Sunday, 16 July 2023

Fifth visit to Lesvos to give acupuncture at the refugee camp

 

I have just returned from my fifth trip to Lesvos to give acupuncture to refugees living on the island, hosted by the wonderful local organisation Earth Medicine.

I spent three weeks there, the first two giving treatments at Earth Medicine’s container inside the refugee camp, the last one giving a few treatments and helping my hosting organisation with other tasks that needed doing. This included receiving and supporting the work of two acupuncturists from Switzerland sent by the organisations ASF and MDC to help out for two weeks.

I arrived in Mytilene on Monday 19th June, late at night. I started work at the camp the next morning, and had to get up before 7am - which would be 5am in the UK and in my body clock. Thankfully, I had my planning head on the day before and I had "practised" getting up at this time, otherwise it would have been quite a difficult task. My first day wasn’t too busy which was a blessing, I had time to adapt to the heat and the rhythm. After this, days got steadily busier and hotter.

 

Earth Medicine's container inside Lesvos refugee camp 


 

WORKING IN THE CAMP

Earth medicine’s container is set slightly higher than the main part of the camp. You get a good view of the camp and the sea as well as some of the sea breeze which feels blissful when you come outside. The container is divided into three spaces, at the entrance there are some chairs which serve as reception and as space to fill in the registration form for new comers. To the right there is a room with a door which serves as the area to treat the men, to the left there is a partition that creates a room to treat the women. On the initial session, we would do a short consultation to find out about the person’s main symptoms, medical conditions, medication and the general workings of their different bodily system. This information would help me determine how best I could treat their symptoms. I had both rooms going at the same time which allowed me to treat two people per hour, although at very busy times on the second week I managed to see three per hour.

 

There was only one person I had met before, during my last visit six months ago. Everyone else was a new arrival, mostly from the previous 1-3 months. Because our only translators were from Afghanistan, I only treated people from this country. It seems people are still fleeing Afghanistan in droves but I was told there are also many arriving from Sudan, Eritrea, Somalia, and Palestine.

 

Most people came to the container for help with pain in different parts of the body. Most of them also had additional issues with digestion which included pain after eating, loss of appetite, acid reflux, constipation, and diarrhoea. There was also a lot of fear, anxiety, stress, sadness, memory loss, insomnia, and nightmares in both adults and children. As a practitioner, I have to bear in mind the importance of listening carefully to what people report about their mental and physical condition and I have to know the right questions to ask to refine my treatments. If I were to focus just on treating muscular-skeletal pain without taking into account that the person has been weakened by fear, shock and an exhausting journey as well as not being able to eat or absorb nourishment from food; I could potentially cause more harm to their system. In some cases, when a person was particularly weak, I had to tell them I would first focus on their digestive system for a few sessions to strengthen their body before properly addressing their joint or muscle pain. What often happened was that as the digestion and appetite improved, so did the physical pain which was rooted in a deep weakness rather than a purely wear-and-tear situation.

                                                 










As usual, I drew from all the techniques I have learned over the years: scalp, ear and body acupuncture, massage, cupping and moxibustion as well as using the TPD lamps regularly. Despite the extremely hot weather, there was so much cold lodged in people's bodies causing physical pain- a left-over of the days and nights spent hiding in cold forests and in the water during the journeys to get here- that a lot of moxa and the use of heat lamps were still necessary and an important part of treatment.

At the beginning of my stay, I could feel how everyone’s body was carrying a lot of fear, stress, and anxiety. I could only imagine this was the result of a journey full of hardships, of leaving everything familiar behind and having an uncertain future in front of them. It was not my place to ask questions about this, which could potentially have made people feel uncomfortable or even triggered in some ways. However, as everyone became more relaxed and comfortable in my presence, the stories started to flow during our sessions without me asking anything. I heard about the ordeal of a 62-year-old woman who is here with her son, and how they attempted to come from Turkey many times over several months and their boat got pushed back to Turkey eight times by the coast guard. Another woman in her 50s told us she lost her husband on the way here, he fell off the boat and drowned, nobody could help as nobody on the boat could swim. Another woman in her 40s who talked about being sad a lot, had lost one of her sons in Afghanistan and another son had stayed back because he’s a doctor and he felt obliged to stay and help. A young 16-year-old boy showed me the scar on his back which was the result of a beating he received by police in Turkey. There are so many stories of abuses by different types of authorities in the different countries people have been through, countries portrayed as “safe” by politicians and media outlets. 

I also met a 7-year-old child whose extremely sad eyes struck me, his mother said he was crying all the time and scared of playing with other children. As he waited for his treatment with one of the Swiss acupuncturists, I got some paper and pens to draw together. We drew mountains, trees, birds, and he drew his family consisting of his parents and two smaller siblings. He was loosening up and then got the black pen and filled the space at the bottom of the page with terrifying blackness. This was his depiction of the sea which he had recently crossed on a flimsy boat with his family.

 

Earth Medicine's staff and three visiting acupuncturists

By the time I finished giving treatments, most of the people I started treating during my first and second weeks were showing significant improvement. Many were symptom-free with no pain, sleeping well, with stronger appetite and better digestion. In general, the experience for all of us is a type of communion created by the therapeutic space we share, which helps us all to soften and feel at ease with each other. Beyond the treatments that we offer, it is this human touch and genuine care that makes a difference here.

Unfortunately, I didn't manage to say goodbye to anyone as I succumbed to sunstroke in my last couple of days when the temperature rose sharply and caught me without a hat while I was doing my usual 90 minute walk after swimming in the sea, so I couldn't make it back to the camp. The camp itself is a sunstroke-inducing place where there is no shade and the white ground burns your eyes if you're not careful. Fortunately, acupuncture treatments continued to be available for another week thanks to two colleagues from Switzerland. It makes a big difference to have continuity of treatment and we hope there will be more practitioners hearing the call from Lesvos.


SOME ANSWERS FOR UK FRIENDS

Since my return from Lesvos early this week, many people have asked me about those I was treating in Greece. Are they mostly single men? Are they thinking of coming to the UK? I am asked these questions without malice, with real concern because the powers that be have successfully implanted in our minds a stereotypical image of the “refugee” or what they call the “migrant” as a single man who comes here driven by greed or a desire to live for free. I think many people I know have similar questions so I will write about this here. All I can do is talk about the flesh-and-blood people I have met during my visits to Lesvos.

 First of all, the refugee camp in Lesvos is not inhabited solely by single men. There are people of all ages including elderly and children. There are whole families, couples with children, sometimes with one set of grandparents, or a grandparent (often a female) with their grandchildren, as well as, yes, some single men and women. Why are they coming to Europe? Because in their countries there is war, violence, famine, and like you or I, they don’t want to die or see their children die.

From what I have seen, no refugee wants to treated like a beggar, like a child, or like a victim, they are not aiming to be fed and dressed for free, and they want to be treated like human beings, with respect. Nobody I have spoken to actually wants to come to the UK. A quick Google search will show you that from the reports by different organisations, those who decide to come here do so because they already have links to this country through family or culture.

 Why are there so many single men? I have indeed met many young men in my visits to Lesvos. Some of them have fled their countries because their lives were directly in danger, like so many from Afghanistan whose work was related to the occupying forces and got  targeted by the Taliban when these forces left. Others are the only male in their family able to find a way to provide for them. The best way I can describe the situation is this: Imagine there is a huge crisis in this country, everything collapses, there is no transport, no money can be taken out of the banks, there is little food, not enough for everyone. Your family is all here, everyone wants to be safe but as there is not enough money or food something needs to be done. The only option is to go to another country but it is very dangerous. Someone needs to try first and hope to be able to find a way to send money back for food or to help other members of the family to follow safely. Who is the best person to go? The grandmother, the grandfather, the wife, the children? Logic would dictate the strongest male will be the one to take the risk as he will have the most chances to survive. I would say, ths is one of main reasons we have lone men coming from countries like Afghanistan, Sudan, Syria, etc. 

 Lastly, I would add that from the conversations I have had with many people, what they mostly hope for is a possibility of rebuilding their lives, the opportunity to work, the ability to be self-reliant and provide for their families and their children. I have no answers as to how this could be achieved, this is for the citizens and politicians of all our countries to work out in open and honest conversations together. What is clear in the refugee camps in Greece, is that people are still coming and they will continue to come. No amount of ill treatment on this end is going to make someone stay in a country where their lives are endangered by war or famine.



The sunrise in Lesvos, a symbol of hope

Every time I go to Lesvos, I feel I understand a little more about what it means to be human. I am clearly shown those human qualities that many of us have forgotten while we're submerged in our rich nation comforts, qualities such as survival, courage, resilience, solidarity, perseverance, and the inextinguishable and unexplainable little flame of hope that can live inside the heart when there is nothing out there actually giving us hope.

I pray that we will have even a fraction of these qualities if we are ever in extreme situations like the ones all they people I have met in Lesvos have been through. I also pray that all our hearts will fill with compassion for all those who are suffering so close to us and that we will be moved to do what we can to help our human brothers and sisters. We live in a world which is on the brink of nuclear war, and where natural disasters are increasing in frequency and potency. It is very possible that if not us, our children and grandchildren will be in need of compassion and refuge. Let's plant the seeds that we would like them to harvest tomorrow.


I have deep gratitude to everyone who helped me come again and to everyone at Earth Medicine for their incredible work. Also, I want to give special thanks to Helen Kenny from Balance Healthcare for donating the needles that I used during this trip. Without everyone’s help, this work would not be possible.

  

With gratitude and love,

Sandra

If you would like to support Earth Medicine's work please click here

Monday, 5 December 2022

My fourth visit to Lesvos to give acupuncture to refugees

I have just come back from a two week visit to Lesvos, where I was giving acupuncture to refugees living in the island hosted by the wonderful Earth Medicine project.

I arrived in the capital Mytilene early on Sunday 13th of November after travelling all night and had the whole day to rest and prepare for the week to come. I was given an update on the changes that had happened since my last visit in July this year. The most important change was that Earth Medicine obtained permission to work from within the camp so I was to spend my two weeks working from their container located inside the refugee camp.

Our days started early, we would usually get to the Earth Medicine house in Mytilene at 8am, have a quick breakfast and from there we would go together to the camp. When I say “we” I mean Sabine, a homeopath from Germany, Sohrab -Earth Medicine’s worker who, amongst other things, drives, translates from the different Afghan languages into English, fixes what needs fixing and buys fresh bread for breakfast-, sometimes Fabiola -Earth Medicine’s founder and director-, and me. Behind the scenes, we had Malvina who works at the office and gets all the administrative things sorted for all of us; and Ali who was cooking food that he would lovingly serve for us when we came back from the camp.

EM's container inside Lesvos refugee camp
Photo by Thomas Rajten
The Earth Medicine container in the camp is beautifully decorated and has been divided into three separate sections. I had use of two of these and the other one served as reception/consultation space for homeopathy. Although I had visited the camp several times in my previous trips, working from there proved to be a very different experience. In contrast with working in the office, where people were brought in the van in groups and we would have 4 or 5 people to treat every hour, here the more limited space meant fewer treatments. However, as 95% of those who came for treatment were newly arrived in the camp, they often required a lot more time and effort from us. We had a constant flow of people who had made appointments for acupuncture since before my arrival, and others who just turned up to ask for help. The main challenge we had was the lack of interpreters. We lacked someone to help us with Somali language, and sometimes also a female interpreter to help us with the Afghani women. Instead, we had to be resourceful and use the universal language of signs and gestures. This meant we were limited in our ability to help but still the treatments we gave, and the human care, resulted in more relaxed bodies and smiley faces. 

Days in the camp went very quickly. During my first week, I gave between 8 and 10 treatments per day, and on the second between 11 and 13 per day. Most of the people I treated were new arrivals, and I saw as many men as women with ages ranging between 5 years and 67. The most common issues were severe back pain and knee pain from over use and exhaustion after very long and dangerous journeys, anxiety and insomnia, abdominal pain, poor appetite and digestion, and severe weakness. Amongst the women, menstrual irregularities were common ranging from very scant irregular periods to extremely painful periods and excessive menstrual bleeding. Most of these symptoms were exacerbated by the conditions in the camp at this time of year. Those staying in tents (usually the most recent arrivals) were freezing cold all the time which increased the severity of their pain. In addition, the heavy rains that we had while I was there easily flooded the camp and meant that going to the toilet or to get food would result in being soaked and cold for the rest of the day.

 

Scalp acupuncture
Acupuncture for knee painScalp acupuncture
Ear acupunctureAcupuncture for pain




I used scalp and/or ear acupuncture on most people to help with pain, mobility and to calm the nervous system, body acupuncture to address pain and issues with bodily functions, different types of moxibustion for pain and to strengthen the body, cupping on those with severe tension, and massage whenever needed to relax muscles and soothe a person. We also had the heat lamps kindly donated by the organisations Acupuncture Sans Frontiers and Le Mains du Coeur Pour le Cambodge, they have proven a hit with the cold weather and we used them on practically everyone who came for treatment this time. Also thanks to these two organisations, other acupuncturists from Europe have been able to come and work with Earth Medicine this year.  As a result, we have managed to get some continuity in treatments and acupuncture has become a well known treatment amongst the refugees. 

There are two things that, in my view, are quite unique in the work we can do at Earth Medicine: one of them is that we get to treat people every single day which gives us the opportunity to check progress and change strategies if needed to achieve the best results. The other one is the multi-disciplinary approach, getting to work alongside practitioners of other disciplines and finding out how we can combine efforts for the greatest benefit to those we are treating.

 

Acupuncture
Combining acupuncture and physical therapy
Photo by Thomas Rajten

Lesvos abundant veg
From what I have observed, appetite and digestive function amongst refugees is often poor and this leads to other issues including lack of strength and poor general health in the long run. For this reason, I give a lot of importance to enhancing digestion at the same time as addressing their main symptoms. I tended to use a combination of points called the Wheel of life on most people. This combination consists of specific points around the abdomen or on the lower back, which aim to strengthen and activate the function of the digestive system as a whole, increasing appetite and improving the ability to process food and eliminate waste products. The food currently offered in the camp, although most welcome by everyone, is not the most nutritious and not at all like the food the people from Afghanistan, Somalia, or Syria would normally eat. It is all packed in plastic and lacking in freshness and in vegetables. For this reason, many people end up with constipation and acid reflux, which adds to their existing issues. Lesvos is blessed with a gentle climate and with fertile land that produces all sorts of fresh vegetables throughout the year, which are very cheap in the market. It would be ideal if a community kitchen could be set up, managed by the camp authority, where refugees themselves could cook meals which would be much more nutritious and a lot cheaper and environmentally friendly than they are in the current set up. This would also help prevent a lot of health issues. Given the continuing conflicts and natural disasters occurring in many countries,  and the fact that small boats are still arriving in Lesvos with people looking for refuge, perhaps a more sustainable, longer-term set up will be necessary.

I went back to visit the burial ground where the bodies of refugees have been laid to rest by the local authorities. The last time I was there, the grass was overgrown shoulder-high, and it was not possible to see clearly many of the graves. This time, the grass had been cut and the site cleared and I could see clearly the hundreds of graves ( I estimated at least 200). They were mostly marked by wooden sticks with a number, some with white headstones which sometimes had the names and dates of passing of the refugees written in fading letters, and only 3 or 4 graves are done in what I imagine is the proper way, I was told because the family of the deceased was around and could afford to do this. I could also see an area that had been marked and separated for 16 graves, most probably destined for the 16 refugees who drowned in the waters around the island while trying to get to safety, over a month ago. Visiting this place to pay my respects has become an important part of my visits to Lesvos. Nobody knows how many lives have been lost since what is called "the refugee crisis" started, and it’s possible that somewhere, their loved ones are still waiting to hear news from them. It would be even more heart-breaking than it already is, if we left them sink into oblivion.  

Three graves, one of them a child's

Space separated for 16 new graves

 A mother and child


When I asked after all the people I had met before, I was told not many were still in Lesvos. The majority of them had been granted asylum and moved on – mostly to Germany, and some others had been relocated to other camps in mainland Greece. I did manage to say good bye to one family I met earlier this year. The father has an amputated leg and their journey from Afghanistan had been excruciatingly difficult. The mother and the daughters were getting all their things ready to travel to Germany after being granted asylum when I stopped by the container which served them as home for the last 6 months. I felt so happy for them, and for all those I didn’t get to say good bye to. May they all get to feel safe, and have beautiful and prosperous futures. 

Every time I have been to Lesvos, despite all the horrific stories, the pain I see in people's bodies and souls, and the less than ideal conditions they have to live in; I somehow come back full of hope, with my heart expanded with compassion and love for all my fellow human beings. This is partly because I see so much resilience, strength, hope and faith in people there that I think to myself, if they can display those amazing qualities under their circumstances, how could I not? On top of that, it's not like there is only sadness.  Within the difficulties, there are always beautiful moments of laughter, friendship, connection and true sisterhood and brotherhood between us all. May there be a world one day, in which we will all be able to enjoy moments like these with each other.

A joyful moment
Original photo by Thomas Rajten


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You can also read about my first, second, and third trips to Lesvos.