A volunteer experience of going to Chaparda, Gujarat with World Medicine by Alison Gould (December 2014)

Volunteering was always an intention of mine; India always a love; and in time the opportunity to unite these passions arose and I grasped it enthusiastically!

This project has now been running for 5 years, 3 years with just one practitioner and is now gradually expanding. So far it had been an annual event but World Medicine identified a need to make it more frequent and add to the sustainability, ensuring local continuity and less dependence on a specialist team flying in. So in 2014 the group were mandated not only to offer body and ear treatments but also to train some of the hospital staff in a 5 point auricular protocol for pain relief, using the special expertise of Rachel Peckham.

Quite an ambitious programme for two weeks but with the experience and language skills of Malti Shah on the ground and our own clinical expertise we were not unduly phased!

All six of us volunteers team had been well briefed and prepared by the 'home' team for World Medicine on what to expect and had packed our bags with care and attention to the small things that would enhance our experience, like a torch and coffee! We also carried a vast number of tools of the trade, needles of course and also moxa, cups and massage oils.

We met at Heathrow on a chilly December morning, mostly a bit tired from getting our practices tied up for our absences but exhilarated and full of expectation. Four of the group were keen returnees and there were two of us 'newbies ', innocent but not naive, all of us knowing we could make a difference to the people in this fairly remote rural area of Gujarat, prepared to work hard and return weary but satisfied.

Of course we arrived in Chaparda rather discombobulated after a journey of flights and road travel but the simple beauty of the place and our enthusiastic welcome dissipated this, at least for a while! Throughout the visit we were really well looked after; accommodation was quiet and clean (allowing of course for Indian standards) and the food was always delicious for an Indian foodie like myself. Malti ensures we are ' safe' and hygiene is thorough in the kitchen and this certainly paid off with no ills of a digestive nature incurred! Of course this is a blessing as the work is indeed quite tough.

Every morning we walk down to the hospital and are met by serried ranks of motorbikes and clusters of shoes discarded haphazardly at  the hospital's wide marble entrance. We climb the stairs and there find 2 magic carpets full of people sitting quietly and cross legged, one carpet for men and one for women. A barrier of chairs blocks the corridor to our clinic rooms and a narrow entry is manned to stem the flow onwards. Beyond this there are more carpets and chairs and we are met by expectant faces, eyes reflecting curiosity, hope and anxiety and following our every move. It is getting cold now, in mid December, and each person is swathed in saris or shawls and each clutches the piece of paper that is their entry ticket to our various presences.

Three clinics are running, the largest is that for ear acupuncture which takes 20 people at a time, all sitting on chairs around the room for the hour it takes to insert the needles and for them to sit and relax. The other two are for body acupuncture, one men's one women's with between 4 and six beds in each,  and usually manned by two practitioners , a translator and possibly a helper.

The work is intense and continuous with constant stream of patients attending for a possible 6 sessions over the 12 days in a multibed situation. So, how is it to work in this way?

It is multi faceted, exhilarating demanding and rewarding and tiring. The information that has gone out to the villages has emphasised the value of acupuncture for pain and so the vast majority of patients present with musculoskeletal problems. This tends to simplify the nature of diagnosis and is a great opportunity to utilise and hone palpatory and nonverbal skills. This is essential as although there was often a translator present this was not universally the case. The App for “learn Gujarati “ helped a little, and certainly our attempts at speaking brought a good rapport and much amusement. Unfortunately the App does not include the phrases for ’turn over now’ or ‘how much has it improved!’ Next trip we’ll get those off pat!

Body work skills such as massage, tui na and cupping were well used alongside needles and we managed to see 12-20 patients per day each! It does go in a bit of a blur each day and there is not much energy left over in the evening for much other than recovery. There is at least a day off during the trip however and last year we visited a wild life park nearby and rested!

And the rewards are there! We all learned from the patients and the experience of working alongside each other. The results we achieved were good, despite the difficulty of capturing this meaningfully on paper! Most people benefited with reduced pain, thus being able to come off painkillers and to work again or squat or sit comfortably all of which are so important to rural farmers and their wives. I recall one lady with terrible hand and wrist pain from milking the buffalo who was able to continue this vital task after our visit. In addition the ear clinic has continued in the hospital and serves the community in this way, a truly remarkable gift to the area.

Next trip there will be more auricular teaching done, extending the skills to more staff to allow for the inevitable staff changes over time. I will definitely be up for another spell working with such a different, relatively deprived and unusual rural community, alongside skilled and interesting colleagues. What does it take? Stamina, a sense of humour, willingness to be part of a team, commitment and an open mind, probably a rest plan afterwards, oh and yes some fund raising along the way!