The Use of Acupuncture and Scalp Acupuncture in a Humanitarian Setting- A Case Study

Scalp acupuncture is a system of acupuncture developed in the 20^th Century which – in the case of the Chinese scalp acupuncture illustrated here- integrates traditional acupuncture needling techniques with Western medical knowledge of the functions of the different areas of the cerebral cortex. This system is widely used in China alongside conventional Western treatment for neurological conditions causing motor and sensory dysfunction. In neurology wards in integrative health hospitals in China, patients can be seen performing physiotherapy exercises with needles inserted into the scalp. Many studies show the efficacy of scalp acupuncture in the treatment of mobility issues from diverse causes. (i) (ii) (iii)   

Jiao Scalp acupuncture treatment areas

Acupuncture has been used for a few decades in humanitarian settings and there are several projects initiated by organisations based in the US, UK, and Europe that offer treatments in different areas of the world affected by poverty, war, and natural disasters. It is common to see protocols such as the NADA protocol in these settings. A protocol consists of a fixed ear or body acupuncture point prescription which is repeatedly given to every person without modification, usually in group sessions. This requires a minimum of verbal exchange which can prove a difficulty due to language barriers as well as being suitable for limited levels of time and space and to maximise the amount of people that can be offered treatment at the same time. There is no record of scalp acupuncture being used in this context.

Earth Medicine is an organisation which differs from others that offer humanitarian acupuncture primarily because it is based in the same location as the people they are serving. Currently, this is the only organisation allowed by the Greek government to offer rehabilitation therapies inside the Mavrovouni refugee camp in the island of Lesvos. This organisation has been operating on the island since 2018, four years after the beginning of the so-called “refugee crisis”, when it became obvious that apart from the basic needs of food, water, clothing, and shelter, there were also issues with mobility and long-term injuries amongst the population of the refugee camps. The organisation was born to meet these needs and over the years has been offering physiotherapy, massage, and acupuncture focussing on individual physical needs including rehabilitation.

Because the model of this organisation does not consist of offering treatments temporarily but permanently, it is possible to bring long-term assistance to asylum seekers who stay on the island for several months/years. This article presents a case study of a person treated by Earth Medicine, within a multidisciplinary context and where the use of scalp acupuncture in combination with body acupuncture was crucial. 

CASE STUDY

The patient, who will be referred to as Mr A, male asylum seeker from Somalia in his early 20s, who arrived on the island of Lesvos at the beginning of 2021. After his arrival, he was diagnosed with Pulmonary Tuberculosis (TB) and started treatment for this condition in the Autumn, with an NGO providing medical support. A few weeks later, he was additionally diagnosed with pleural puncture and a month later, he developed Peripheral Neuropathy (PN). At this point, his TB treatment was temporarily stopped. Mr A was admitted to hospital three times in 2021 for the conditions mentioned above. He also had a history of gastritis.

At the time of his initial contact with Earth Medicine, his medication was: Ethambutol 500g, Pyrazinamide 500mg, and Rifinah 300mg and Omeprazole 20mg. 

Mr A’s initial visit to the Earth Medicine’s office was in February 2022. This is a summary of his symptoms at the initial consultation:

Loss of appetite, inability to eat, abdominal pain, severe weight loss: Mr A didn’t feel hungry and if he did eat, he had acid reflux and severe epigastric pain. He also experienced nausea on a daily basis. As a result of this, he had lost a lot of weight and was extremely thin (See Photo 1)

                                     

Photo 1- Mr A in 2021 Hospitalised with lung puncture and showing signs of emaciation

 

Peripheral Neuropathy and loss of mobility of the lower limbs: he presented with total loss of sensation in the lower limbs, burning pain in the legs, inability to stand up and inability to lift or move both feet. At this time, Mr A was spending most of his time lying on his bed as he was too weak to move or get up. He was unable to transfer to a wheelchair or to a chair without a lot of help. Every time he put any weight on his feet, he experienced severe burning pain on the soles of the feet.

Breathing issues: Mr A had scarring on his left lung as a result of the TB (See Photo 2) and experienced tightness in the chest with difficulty breathing. His breathing was agitated when indoors as he felt there was not enough air. He felt calmer outdoors, where he still experienced shortness of breath.

 

Photo 2: An Xray of Mr A’s chest showing lung scarring

 

Constipation: He only passed stools twice per week. Stools were hard, dry, and painful to pass.

Fatigue: Along with physical weakness, Mr A experienced constant physical and mental fatigue.

Mr A Had emotional stress due to his situation which was exacerbated by his having received two asylum rejections. He experienced insomnia as a result of this.

As he had been unable to eat very much for several months, and lack of nourishment was deemed to be exacerbating his extreme weakness and muscle atrophy, the initial stage of his rehabilitation was focussed solely on strengthening his ability to eat and digest with the aim to help him gain the strength necessary for his physical recovery.

INITIAL STAGE OF TREATMENT

At the initial stage of Mr A’s treatment, a diet based on the principles of Chinese medicine was followed. For the first two weeks, he had a simple soup made with bone broth and a few vegetables prepared daily for him at Earth Medicine’s kitchen.  As he had not eaten a proper meal for months, he initially experienced epigastric pain, discomfort, and fullness after eating a small amount of soup. On the third day, the pain started to diminish and it gradually subsided completely over the next days. After two weeks of this diet, Mr A reported having more energy.

As his ability to eat increased, other foods were gradually introduced including rice, a variety of cooked vegetables, and small portions of different types of meat. Everything was very well cooked. As his digestion stabilised, he had more appetite and the nausea subsided, his strength increased and he started to put on weight. At this time, the physical rehabilitation sessions were started.

PHYSICAL REHABILITATION BEGINS

The initial physical therapy aimed to gradually recondition Mr A’s lower limbs and spine. When he started his physical therapy, Mr A was wheel-chair bound, not able to stand without aid and could not lift his feet off the ground. He received daily physiotherapy sessions that integrated games and graded exercises which he performed with aid.

He then started to practise standing from the wheelchair holding on to the parallel physio bars, with a helper holding him up followed by sitting back on the chair. This simple movement was very difficult for him at the beginning because he had severe pain on his feet and ankles on standing and because his legs were not strong enough to hold his weight. With exercises and nutrition, the pain became less severe and his muscles started to feel stronger. After about three weeks, when standing became easier and he was able to stand by himself, a physiotherapist and a helper started to work on aiding him to move along the length of the parallel bars, one moving each foot forward and the other bringing the chair behind him in case he needed to sit down. The lifting of his body, standing and sliding the feet forward were very difficult at the beginning and made the feet and ankle pain return. As he persevered with this work, within two months he was able to move along the length of the bars four times with one helper.  After a lot of practice, he was able to move along the bars by himself, pushing himself from the arms and sliding each foot forward.

At this point, Mr A was able to start using a rollator walker. He was still unable to lift the feet off the ground or move his ankle joints.

 

ACUPUNCTURE ADDED TO REHABILITATION

Mr A received some acupuncture treatments at the beginning of June 2022.

He had six body acupuncture treatments with a practitioner from France. During these sessions, Mr A started to feel some sensation coming back to the toes.

He had no acupuncture treatments for a few weeks and then re-started at the beginning of July, 2022, when I came to the camp for three weeks. We started daily treatments of scalp and body acupuncture. It was stressed that physiotherapy would need to be done after the acupuncture and that the scalp needles- which are threaded under the scalp and therefore do not fall out- would be kept during the physiotherapy sessions. At this time, Mr A was still unable to lift his feet off the ground, the numbness of the toes had returned and he had no feeling from the knees down, he had severe insomnia and he was passing stools every 2 to 3 days. These symptoms were treated with scalp and body acupuncture. The scalp acupuncture lines used were from the Jiao and Lin systems of SA: Du 20, Foot sensory and motor lines, upper parts of Sensory and Motor lines to treat the lower limbs, Anxiety lines (See Photo 3). The body acupuncture was aimed to strengthen his system and help the work of the scalp acupuncture on the lower limbs. Treatments included points on the abdomen to encourage digestion and on the legs to promote circulation and muscle function and reduce pain.

Each day, the physiotherapist from Portugal reported big improvements in his lower limb movement and strength during Mr A’s sessions with the scalp needles. By the fourth treatment, given on July 7^th, Mr A was able to lift his feet off the ground and move the feet from the ankles. After the fifth treatment, he was able to move his toes and managed to give some steps by himself without aid or support. There was a break for the weekend, after which Mr A reported that he had slept very well for three nights and that on the Sunday he had been able to walk around his container without any aid and without experiencing breathing difficulties or shortness of breath.

Photo 3: Mr A having scalp and body acupuncture in July 2022

 

By the 9^th and last treatment of scalp and body acupuncture, Mr A was able to run after a basketball, walked around the city for an appointment and climbed the stairs without help for his acupuncture treatment. Initially his treatments had been given on the courtyard due to his difficulty climbing stairs, then they moved to the ground floor of Earth Medicine’s office as he was able to climb the few steps to get in and for his last treatment, he insisted on being treated on the first floor, which required him to climb up the entrance stairs and then two flights of stairs inside the building. His constipation was not much improved but his sleep was steadily better. He was experiencing pain in his ankles but this was due to excessive exercise. He was so ecstatic about being able to walk that he had been playing basketball in the refugee camp and walking around excessively without much rest.

Mr A had no treatments during August 2022. The next time Mr A had acupuncture and physiotherapy treatments at the beginning of September 2022, his ability to walk was still there and his breathing was normal but he was still experiencing ankle pain which was occasionally severe and stopped him from running, a sport he had started to practice, he was passing stools every other day, had insomnia related to stress and felt tired.

He had eight sessions of body acupuncture with another practitioner from the UK. His pain subsided and he was able to run again, he could sleep better and had more energy.

 

OUTCOME

This is a video compilation of the process of Mr A’s rehabilitation. During July 2022, at the beginning of our treatments, he had poor balance and leg weakness. It can be seen there was rapid change and improvement in mobility during this month as he was having a combination of scalp and body acupuncture plus physiotherapy. These improvements in mobility were sustained  https://www.youtube.com/watch?v=YpbUrDBOroY.

Mr A’s physical rehabilitation ended in October 2022 when he was transferred to another camp in mainland Greece. He was fully able to walk when he left the island, as seen in the video. He eventually was granted asylum and lives in safety with no mobility issues and no breathing difficulties which means he is able to be a productive member of the community he lives in.

This case illustrates how a multidisciplinary approach can produce outstanding results even in severe cases seen in humanitarian settings and how scalp acupuncture can be an effective addition to treatment for mobility issues in this setting. It must be emphasised, that without Mr A’s hard work, perseverance, and faith in the future, none of the treatments provided would have achieved these remarkable effects.

The practitioners involved in the treatment of Mr A were volunteer practitioners fully qualified in their fields of Physiotherapy, Acupuncture and Chinese Medicine. Given the severity of the conditions that can be seen in the refugee camp, the organisation only accepts practitioners with a minimum of 5 years of experience in their field.

I was involved as Acupuncturist and Chinese Medicine practitioner throughout the treatments offered to Mr A with input consisting on the dietary advice based in Chinese medicine theory that was followed and the scalp and body acupuncture treatments during July 2022.

I feel privileged to be able to give treatments with this amazing organisation, if you would like to help Earth Medicine continue their important work, you can donate here.

With gratitude and hope for humanity,

Sandra Arbelaez

 

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REFERENCES

(i) Wang, Shen, Wang, Fu et al. Scalp Acupuncture for Acute Ischemic Stroke: A Meta-Analysis of Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine (2012) https://doi.org/10.1155/2012/480950

(ii) Lan-ya LI, Zhen-huan LIU, Qiao-ling XIE, Meta-Analysis on scalp acupuncture based therapy in treating children cerebral palsy. World Journal of Acupuncture - Moxibustion, Volume 24, Issue 3, 49-53 (2014). https://doi.org/10.1016/S1003-5257(15)60012-5

 (iii) Lee, HS., Park, HL., Lee, SJ. et al. Scalp acupuncture for Parkinson’s disease: A systematic review of randomized controlled trials. Chin. J. Integr. Med. 19, 297–306 (2013). https://doi.org/10.1007/s11655-013-1431-9

 

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. 

 

 

 

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

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