The Mae On Project in northern Thailand was officially launched in April 2004 with three main objectives:
- To develop a pilot program to train medical staff in acupuncture as adjunctive treatment for HIV/AIDS patients at Mae On Hospital in northern Thailand.
- To create a free clinic at Mae On Hospital to provide acupuncture for people living with HIV and AIDS.
- To undertake an evaluative pilot study using quantitative and qualitative data that would assess the efficacy of acupuncture on quality of life, the symptoms of chronic HIV infection and the side effects of anti-retroviral therapies.
Mae On Project
2004 to 2005
Once the clinic opened in August 2004, thirty-two people living with HIV/AIDS (PLHIV) in various stages of HIV-infection regularly attended weekly acupuncture treatments in a group out-patient setting.
To assess the efficacy of the acupuncture treatment, a non-randomized, single-arm study was carried out over a 6-month period, for which twenty-seven HIV-positive participants with stable medication use and no significant morbidities were enrolled. The study began in August 2004.
Overall, the findings of the study suggested that acupuncture may be beneficial to people living with HIV/AIDS in this rural region, improving physical symptoms and quality of life. The project demonstrated the feasibility of establishing and maintaining a hospital-based acupuncture clinic for people living with HIV/AIDS in a rural area. This low-cost intervention program was established in less than 12 months and utilized local nursing expertise. The project confirmed that acupuncture was acceptable to this population, with many participants requesting that similar clinics be started in other districts to accommodate those HIV patients who were unable to travel to the Mae On Hospital.
The director of Mae On Hospital and the head nurse of the HIV/AIDS program expressed great satisfaction with the acupuncture program, requesting training for more nurses. Thus far, five nurses have received basic training in the Projectss of traditional Chinese medicine and acupuncture. The acupuncture clinic continues to run on a weekly basis at the Mae On Hospital. The results of the first phase of the Mae On Project were published in the Autumn 2006 issue of HIV Nursing (please see Presentations & Publications Page for details).
“Although our project makes a small impact on worldwide numbers, it has made a very tangible difference in small communities of HIV patients and their families,” according to Dr. Louie.
The following are quotes made by participants in the project:
“Acupuncture is very good because it helps to reduce or get rid of any symptoms we may have without having to depend on medicines. I’m already taking anti-retroviral therapy. If I had to take pain killers for back pain or medications for numbness, I feel I’m putting more chemicals in my body and I worry that all these drugs combined together could have a bad effect on the body. Acupuncture is a way to treat myself without having to take extra medications and it’s also effective at the same time.”
“Prior to having acupuncture I was aware of the symptoms and this would cause me some stress. But now that these symptoms have eased, almost gone, I don’t think about this anymore and consequently feel emotionally and spiritually better. And I can also look to the future with greater hope because I don’t have to worry about these symptoms anymore.”
“Acupuncture increases my hopes and aspirations and gives me encouragement, strengthens me. I have something to lean on. If I don’t come here, I feel like I’ve left something out of my life….”
“Since acupuncture, I don’t think about more getting sick, because I feel ‘normal’. But if I get sick, I feel confident that acupuncture can help.”
The nurses who trained in acupuncture and treated patients living with HIV/AIDS also had strongly positive comments about the project. And this is one of them:
“I feel honoured to have been able to participate in the (acupuncture) program. It’s provided an opportunity for me to help many people. A program like this can’t be found anywhere else in Thailand.”
Our assessment tools and our own personal experiences have shown that acupuncture has important benefits for this resource-poor area.
- In our studies, acupuncture was well-tolerated and safe, with no adverse complications reported. If used correctly, this treatment modality has few side effects and no biochemical interactions with allopathic medications such as antiretroviral therapies.
- Following the studies, calculations showed that acupuncture was inexpensive and also very cost-effective. The average cost of a weekly acupuncture treatment for one participant was approximately $1.55 CA. This translates to $6 CA per month per patient which we feel is amazingly efficient!
- In addition, there are several secondary gains from acupuncture. Many of the participants commented that they experienced improved appetite, better sleep, less stress, and more energy, even though they were not treated directly for these conditions. Traditional Chinese medicine and acupuncture balance the whole body and often lead to dramatic upturns in patients’ physical, mental and spiritual lives.
Mae On Project
2006 to 2007
A second research study was completed in March 2007 by the Laura Louie Hope Projects. Its purpose was to investigate the benefits of acupuncture for people living with HIV, as identified by the respondents (patients). This study built upon our initial research, but employed a more robust design with pre- (phase1) and post-acupuncture (phase 2) data collection using quantitative and qualitative methods.
An abstract summarizing this research was accepted for poster presentation at the XVII International AIDS Conference in Mexico City in August 2008 (Please see Presentations & Publications Page for details).
Significant improvements were reported by participants in most dimensions rated on the quality of life (QoL) scale, including: general health, energy, appetite, ability to work, sleep and mental stress levels.
Interviews of participants involved in the Mae On Project identified four common themes:
1. BENEFITS OF TREATMENT: A majority of participants reported decreased severity of many of their HIV/AIDS related symptoms.
“Since having acupuncture I’ve had a 90% improvement in my condition. I can do my work, and yesterday I spent the whole day standing and potting plants and digging in the nursery. I can sleep more comfortably and fall asleep and sleep through the night.”
2. SOCIAL NETWORKING: Many respondents reported benefits from attending the clinic and socializing with other HIV positive persons. They commented that they would miss the opportunity of meeting with other PLHIV at the clinic once the program ended.
“When I come to the clinic, I have a chance to meet other people; not just people having acupuncture; they are also infected so they know the problems that people with HIV have to face, and I can sit and talk with them openly and honestly.”
3. BECOMING ADVOCATES: Participants described how they became ‘ambassadors’ for acupuncture; telling family and friends about its value and in some cases convincing them to attend the clinic as soon as possible.
“I talked with family and friends about taking part in the programme: they supported my participation and asked if there was another programme for non-infected people who could also have acupuncture for problems they had.”
4. WANTING TO CONTINUE TREATMENT: A universal desire to continue acupuncture was reported in interviews with all the program participants.
“I would like the acupuncture clinic at Mae On Hospital to continue - it helps others, and it does bring results.”
The findings from this second evaluation confirm those of the initial study: a cascade effect from acupuncture was reported on participants’ quality of life. Respondents perceived a decrease in the severity of physical symptoms, which in turn favorably impacted their work and home life on physical, emotional and spiritual levels. Many respondents reported increased financial security because of their improved ability to work. A common perception related this sense of security to acupuncture treatments.
In addition, this evaluation supports the thesis that the clinic serves as a social hub by bringing together large numbers of people living with HIV for a treatment modality set firmly within a holistic and person-centered paradigm. HIV stigma is a serious and ongoing challenge and it compounds the psychological impact of having a chronic disease We were encouraged that the positive impact of taking part in the clinic program was reported by so many respondents (around 90%), suggesting that the social benefit of attending for acupuncture may be as important – from the patient’s perspective – as the acupuncture itself.
The Laura Louie Hope Projects was also encouraged by the willingness of many respondents to share with others the benefits of acupuncture, suggesting that the positive nature of the experience was such that they wished others to gain the benefits they clearly perceived for themselves.
Mae On Project
April 2008 to present
A long-term review of the effects of acupuncture on people living with HIV/AIDS in this community in Thailand is now underway. Interviews will be conducted with several patients who have had acupuncture treatments at the clinic over the last four years. These interviews will be administered by a local Thai translator. Dr. Louie hopes to determine the impact of acupuncture on the physical, mental, emotional and spiritual aspects of the patients’ lives at home and at work. The projected target date for completion of this research is December 31, 2008.