Originalia | Original articlesThe Use of the NADA Protocol for PTSD in KenyaDie Anwendung des NADA-Protokolls bei post-traumatischem Stresssyndrom (PTSD) in Kenia
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Contextual background – a need for treatment
Our initial project addressing PTSD trained local persons to provide NADA treatments to Kenyan refuges in Uganda. Beth and I had met on an international acupuncture project in East Africa, and in December of 2007 I had returned to the continent to train Kenyan healthcare workers in basic acupuncture protocols. The atmosphere in Kenya at that time was charged with anticipation of the upcoming presidential elections, which were held one week after my departure. The results of the elections were
Project Development
Because of on-going security dangers in Kenya itself, we decided to focus our efforts on the thousands of refugees pouring over the border into Uganda. We immediately contacted friends and colleagues in that country for news and suggestions of how to proceed. We were put in touch with a Franciscan nun who ran a school in the border town of Tororo, who in turn connected us with a local man who was volunteering with an organization providing support to a refugee camp set up by the United Nations
First encounters
In our attempt to identify suitable trainees from among the thousands of camp residents, we appealed to community leaders. The camp was divided into 6 blocks, so we called a meeting of the male and female heads of each of these. We offered a basic description of acupuncture, a more specific description of the NADA protocol we were proposing to teach, how we would like to select trainees, and asked for questions. After a lengthy polite and smiling silence, our facilitator suggested we give the
Selecting trainees and training site
We had originally decided to train 10 people in the technique but increased our training group to 20 people when several times this number presented themselves for training. We used as our selection criteria:
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Previous experience in patient care (healthcare workers, social workers, counselors)
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Availability to attend the full training session
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Willingness to provide free treatments to the community after the training
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Ability to speak and read English
As most of the buildings within the camp were in
Five or three needles?
Although the standard NADA protocol uses 5 needles, there is a trend in relief work of using only 3 needles per ear, or a total of 6 needles per treatment. This is based on NADA founder Dr. Michael O. Smith's experience of treatment delivery overseas, and subsequent advice to others treating in similar settings [2]. There is a clear advantage in using fewer needles, as the needle supply will treat around 40 % more patients, but is this method as efficacious for the patient?
In previous projects
Amending the NADA protocol for children
The refugee community included hundreds of children and they, also, came in for treatment. Children could choose whether to receive needles, or the acupressure-style application of ear beads on the points. Many parents described an increase in fear and anxiety in their children since their lives had been disrupted by violence, with experience of nightmares and a significant rise in bed-wetting. For these families living in tents with no electricity or running water, this last symptom was
Follow-up site visit
When we returned to the community in December 2008 six months after the initial training, these NADA practitioners had delivered over 18,000 treatments. In an hours-long welcoming ceremony we were regaled with songs, dances, and several plays put on by different community groups, usually depicting lives changed, stresses relieved and general improvements to people's well-being with the application of the NADA protocol. Our trainees were the last group to perform, and their play was about a man
Conclusion
From these experiences, Beth and I recognize that the NADA protocol can have a profound effect on communities experiencing hardship and transition. Elements we found to be important to the success of such trainings include sponsorship by an international agency, contacts among local service-providing organizations, inclusion of community members in decision-making, follow-up communication with all collaborators and participants, and complete flexibility around clearly defined goals.