PanAfrican Acupuncture Project (PAAP)

The PanAfrican Acupuncture Project (PAAP) was founded in 2001 in response to the sudden press coverage of the growing AIDS epidemic in Africa. With the knowledge of just how dire the situation was, I was immediately motivated to travel to Africa to treat using acupuncture, which experience had demonstrated to be very beneficial to HIV+ individuals. However, quickly it became very evident that one individual would never be able to do enough. To empower the African people themselves, to provide them with this simple tool—acupuncture, would enable those who were suffering to receive treatment.

And so, PAAP was created, embracing the belief that the most effective way we can help to relieve the suffering of patients with HIV/AIDS, malaria, and TB is to empower community members themselves. This approach, backed by research and over a decade of clinical experience, has led the Project to commit to the training of local community-health providers so that they can provide simple, yet highly effective acupuncture treatments to reduce symptoms and increase the quality of life for those living with HIV infection, malaria, and TB. Through the use of a detailed, easily understood acupuncture training manual and guided by the expertise of specially trained, licensed acupuncturists, Trainees learn how to implement treatment protocols specifically formulated to address the symptoms and signs associated with HIV/AIDS, TB, and malaria. In addition, trainees learn acupuncture protocols that can be used to reduce the stress experienced by other health-care providers and the family members of those with HIV, TB, and malaria.

Thus far, the Project has conducted five Training Sequences in Uganda, each composed of three week-long trainings, and has trained 120 healthcare workers there, including midwives, physiotherapists, a traditional healer, nurses, nurse midwives, and medical doctors. These 120 newly trained practitioners in one year provide approximately 78,000 treatments, demonstrating the viability and validity of PAAP and its teaching methods, and thereby providing a proven track record to support expansion into other countries.

The PanAfrican Acupuncture Project is based upon the following assumptions:

1. PAAP is a training program, i.e., it does not provide direct treatment. By training local healthcare providers, PAAP empowers communities to help themselves, insuring that access to treatment is greatly increased.
2. Acupuncture works alongside conventional treatment modalities, never supplanting them. So, in addition to aiding in reducing pain and suffering, improving quality of life, and helping to increase a sense of hope, the treatments reduce any side effects from the pharmaceuticals, such as the ARVs and anti-malarials. Thus, acupuncture improves compliance to medical regimens.
3. Acupuncture treatments can act as a gateway to other conventional treatments, in that the acupuncture can provide immediate results that reinforce, when necessary, continued visits to hospitals and clinics.
4. Because acupuncture, when provided by those trained by PAAP, is free, the treatments are often accessible to those in areas frequently underserved or forgotten. In this case, though not a substitute for ARVs, antibiotics, and/or anti-malarials, acupuncture can provide symptom relief to those who would otherwise continue to suffer without any treatment.

In December, 2006, PAAP began its Fifth Training Sequence in Ibanda, Uganda, training 34 nurses, midwives, and nurse midwives. The group of Trainers consisted of six volunteer acupuncturists who converged from all across the United States.

The group of Trainees was divided into two, one to work at the Ibanda Hospital and the other at the Ruhoko Health Centre, each group taught and supervised by three Trainers. The first day focused on teaching the Trainees how to navigate through the PAAP Training Manual and thereby learn how to locate the acupuncture points employed in each treatment protocol. Early in the day, the Trainees were taught how to safely and painlessly insert an acupuncture needle. (Although all the Trainees were health-care practitioners, the importance of clean-needle technique and Universal Precautions were stressed daily.) Over the course of the week, additional skills, such as gwa sha, cupping, and moxabustion, were also taught.

Although no one among the Trainees had any prior exposure to acupuncture and Chinese medicine, they learned quickly and readily embraced this new treatment modality.

After the first day, most of the remaining time was spent learning by treating patients. During the training, 348 patients, ranging from 6 to 104 years old, received treatments. Of these, there were approximately three times as many women as men. Forty-eight were known to be HIV positive, while 233 had never been tested. (This fact is particularly distressing, as it is known that, because of a change in sex practices and an increase in sexual interchanges, the prevalence of HIV infection is increasing in this area of Uganda.) Five were suffering from TB and 25 had tested positive for malaria.

Almost all of the patients in Ibanda who came to be treated complained of pain in various forms, such as headache, epigastric pain, backache, and neck pain. It was not uncommon for a patient, both young and old, to complain of chest pain. And, many individuals suffered from extreme splenomegaly, often due to inappropriately or untreated malaria.

Similar to our observations at other trainings, patients frequently experienced immediate and significant relief from their symptoms. After only one treatment, a 65-year-old woman who had come in with knee pain first gingerly stepped off the treatment table, slowly started walking on her "new knees," and then suddenly jumped up and down and danced around the clinic. An elderly man arrived for treatment unable to read due to poor vision. After one treatment, he held up a book without glasses and read from the book. An elderly woman demonstrated how, because her arm was rigid, she was unable to use her arm. With treatment, she excitedly showed how, for the first time in a long time, she was able to touch her nose. A 10-year old boy had difficulty walking due to pain on both sides of his ankles. He walked away with ease, pain free. Towards the end of the week, a man presented with severe neuropathy. He could barely bend his fingers and had limited use of his legs. After treatment, he was able to make a fist and bend his leg so his heel touched his buttock.

Because the Trainees provided so many successful treatments, at both the hospital and the health centre, the number of individuals lining up for acupuncture increased each day. People traveled for miles to receive treatment and patiently waited until it was their turn. At the end of the training, when still there remained many people waiting to be treated; Trainers and Trainees participated in what has become known as “Mass Acupuncture.” Patients sit in chairs and the edges of the treatment tables and receive simple treatments, often including the NADA auricular protocol and a few points to address their main complaints. Although the treatments are quite simple, even these often lead to a reduction in symptoms.

At the end of the training, PAAP is able to provide all of the Trainees with enough acupuncture needles, cups, and moxa poles to be able to begin to provide treatments in their hospitals and health centres. Between trainings, Trainees are able to communicate and receive support through email and cell phone text messaging. In addition, PAAP’s local Ugandan coordinator serves to ensure that all the Trainees are able to maintain an adequate supply of needles.

In April, another group of six licensed acupuncturists returned to Ibanda to provide the first of two enrichment trainings. During this time the Trainees received further support and were also introduced to the process of making simple differential diagnoses. During this training, the Trainees provided over 800 treatments. PAAP hopes to return to Ibanda the end of July to continue in their education.

The PAAP trainings serve to empower those we train. The Trainees frequently mention how gratifying it is to see their patients change so quickly and so dramatically. This, they say, is not usually what occurs when they dole out “tablets.” With the acupuncture, the patients often return repeatedly and enthusiastically, wanting additional problems treated and often bringing other friends and family members so they too can be treated. With medicines, the Trainees often speak of noncompliance. And so, the acupuncture can serve as a gateway to a more holistic and full approach to treating their ailments.

PAAP is planning on continuing to expand within Uganda and to develop programs in other African countries, such as Malawi (December 2007), Kenya, Ethiopia, and Zimbabwe. PAAP has also been invited to a community in Nepal, where trainings are planned to begin this July.

The PanAfrican Acupuncture Project is always looking for acupuncturists to join as Trainers, and it continues to rely on individuals for their generous financial support and donations of supplies. To donate or for more information, please visit the web site (www.panafricanacupuncture.org) or email Richard Mandell, founder and director, at RMandell@panafricanacupuncture.org.