Alternative and Complementary Health Practices
Section Newsletter
Fall 2004

Message from Duchy Trachtenberg

Chair – Alternative and Complementary Health Practices

What is the role of alternative and complementary health practices (ACHP) in the health and well-being of the public? Although long an integral part of global health systems, the relationship between public health and ACHP has not often been a congenial or collegial one. Yet the question of the most appropriate role of ACHP in the public health equation remains the most important one to be asked by public health professionals in our time.

We are on the threshold of a paradigm shift – an era that promises innovative and exciting changes in ACHP. In essence, it’s a movement, gaining rapid momentum en route to public acceptance, consciousness and practice. The impetus for this movement is progressively nurtured by groups like the ACHP SPIG. Our SPIG attracts the collective wisdom of its members and opens a myriad of doors to new and challenging avenues.

The ACHP SPIG needs to increase the depth of our efforts by expanding our membership, continuing our research and educating the public we serve. Make a point to attend our SPIG’s program this year at the Annual Meeting. Attend our SPIG Business Meeting and Social Event on Monday, Nov. 8. Help staff our booth at the Exhibit Hall. Volunteer to serve on SPIG committees and submit articles for our SPIG newsletter. Communicate your interests, concerns and suggestions to SPIG leadership. And most importantly, encourage your colleagues and friends to become active members of the ACHP SPIG.

See you in Washington, D.C. on Nov. 7-10!

CAM Data Available for Secondary Analysis

Sociometrics Corporation has recently constructed the Complementary and Alternative Medicine Data Archive (CAMDA) -- an archive of datasets that will facilitate access to and statistical analysis of scientifically sound CAM datasets.

Although CAM therapies have grown in popularity, there are key questions yet to be answered as to whether CAM therapies are safe and whether they work for the diseases or medical conditions for which they are used. CAMDA will help answer these questions by facilitating secondary analysis of available data. It will also promote evidence-based research in complementary and alternative medicine and enhance knowledge about complementary and alternative medicine.

The archive contains machine-readable data and documentation from exemplary studies of CAM therapies and CAM use. The datasets included in CAMDA are based on state-of-the-art research studies conducted in the United States and in foreign countries and published in leading medical journals (such as the Journal of the American Medical Association, New England Journal of Medicine, British Medical Journal and Pediatrics) during the last 10-15 years. The archive includes data from nationally representative surveys as well as from clinical trials. Datasets were selected by a panel of nationally recognized CAM expert scientists, who evaluated studies according to objective selection criteria, broadly defined as: scientific, methodological, and technical quality, substantive utility, and coverage under the National Center for Complementary and Alternative Medicine’s five modalities.

The datasets included in CAMDA cover a diverse set of practices and topics such as the use of:

  • medical, complementary, and self-care strategies for pain;
  • complementary and alternative therapies along with conventional medical therapies;
  • acupuncture for treatment of HIV-related pain;
  • acupuncture for treatment of cocaine addiction;
  • moxibustion for correction of breech presentation of fetus;
  • bone-setting for relief of prolonged back pain; and
  • multivitamin supplementation for prevention of birth defects.
The survey and clinical trial data in CAMDA can be used to address a variety of research questions, including the following:
  • What types of CAM therapies do people use?
  • What types of CAM therapies are effective?
  • What conditions are CAM therapies able to treat?
  • What side effects of CAM therapies are encountered?
  • How much do people pay for CAM therapies?
  • For what groups of people are CAM therapies most/least effective?
For each dataset in the archive, Sociometrics has produced a standard set of products, including a raw data file, SPSS and SAS syntax files, SPSS data dictionary and frequencies files, an SPSS portable file and an SAS transport file, a User’s Guide, and a study protocol or codebook (when provided by the original investigator). Standardized data and documentation products facilitate the use of secondary data across datasets.

Accessible and easy to use, CAMDA will serve a wide user constituency (health researchers, social scientists, educators, students, and policy-makers) and will facilitate the advancement of CAM science through the secondary analysis of scientifically sound CAM datasets.

The CAMDA will be available free to investigators at institutions that subscribe (e.g., via their library) to the Social Science Electronic Data Archive, distributed by Thompson-Gale. The entire CAMDA collection or single datasets can also be purchased directly from Sociometrics via their Web site, www.socio.com
. Questions about CAMDA can be directed to Tom Wells at twells@socio.com.

Looking Beyond the Medical Profession for Medical Relief

A person’s capacity to recover from illness is based on several factors that sometimes extend beyond the medical skills of the attending doctors and the pharmaceutical developments of the drug companies. Many scientists are beginning to believe that the sphere of wellness and health must also include the emotional domain, the physical domain and the spiritual domain, which is highly effective, but often neglected by hard-core scientists. All of these dimensions act in concert to eventually determine a person’s health temperament and their typical response characteristics. As a result, doctors and other medical personnel are urged to consider these dimensions to be important standards when calculating a person’s capacity to recover from illness.

There are many in the scientific arena who support the belief that spirituality is important in helping patients cope with illness because it is the only form of instructive interaction that effectively addresses the uncertainty of life and the unpredictability of the future. Engaging people in spiritual pursuits also proposes routines and strategies to help them cope with the pains and uncertainty of life. Uncertainty and unpredictability serve to contribute to depression and stress, which together decrease a person’s capacity or willingness to combat illness.

The mental struggle over the uncertainty and unpredictability of the outcome of a patient’s illness is instrumental in sometimes limiting a patient’s desire to get well. Spirituality is believed to be the only type of involvement that enables a person to develop the tenacity to struggle and eventually overcome crisis situations and medical complications, simply through the use of an internal support system that serves to engender hope and deliverance.

The interest in adopting a spiritual approach for recovering from illness emanates from the belief that the lives of human beings originate from an act of heavenly conception. As a result, many people believe that divine intervention creates reduced anxiety, less depression, and eliminates the thought of suicide, and that incorporating the patient’s spiritual belief system and spiritual needs as a part of the treatment management plan in clinical practice could yield enormous health benefits and may enhance a patient’s ability to recover from illnesses.

Health care professionals can openly demonstrate to patients their commitment to a comprehensive approach to healing -- that is, a healing approach that incorporates spiritual and wellness strategies. They can do this by emphasizing the emotional, physical, and spiritual domains of health as an integral part of a disease management intervention program. Recent polls have shown that an overwhelming majority of Americans believe in God and Heaven and miracles. There is no harm done, and there have certainly been tremendous benefits noted by the use of faith, prayer, and divine intervention as vehicles to a longer, healthier life, with improved quality, internal fortitude and overall satisfaction with life, accompanied by a willingness to face all struggles with the utmost optimism. Religious commitment and spirituality seem to correlate positively with a variety of beneficial health outcomes because many people believe that the universe is froth with meaning and significance, and their own life is a major part of that meaning and significance.

Contact information:
clifton.addison@jsums.edu , brenda.w.campbell@jsums.edu , mwhite127@hotmail.com

Acupuncture Experience In Rural Guatemala

At the diocesan training center in Poptun, 100 miles southeast of the Tikal ruins in Peten, Guatemala, seven dozen Q’eqchi Maya men, women and children, wait for acupuncture treatments at a free clinic. Their complaints are broad: A 3-year-old with a year-old ganglion cyst; a teenager with a chronic ear infection who is unable to hear nor, consequently, speak; an elderly artist recovering from massive head injuries who no longer remembers how to paint; and a 22-year-old suffering from delayed menstruation.

By 10 p.m. that evening, all the patients were treated, and most claimed improvement for their conditions. The practitioners? Q’eqchi Maya community health workers. They were trained in basic acupuncture by North American volunteer acupuncturists through the Guatemala Acupuncture and Medical Aid Project (GUAMAP). Based in Tucson, Ariz., GUAMAP has since 1995 maintained a presence in the Peten, training over 100 health workers in Traditional Chinese Medicine. To achieve its goals, a GUAMAP volunteer composed a basic acupuncture manual oriented to health conditions arising from rural agricultural areas. GUAMAP supplies donated needles, moxa, bio-medicine, and meridian charts translated into Spanish. The work is done with assistance from an NGO called ASECSA (Association of Community Health Services).

The project extended basic health care to indigenous and poor working families of formerly exiled and internally displaced communities, now scattered throughout this agricultural and rural department of Guatemala. Some rely on their “comadronas” (traditional midwives) and the wisdom of Mayan priests. Community health workers possess considerable knowledge of medicinal plants used in their health promotion work. “Puncture medicine,” practiced by the Yucatec Maya, provides a cultural view for why many Mayan patients welcome acupuncture, knowing from word of mouth that “the needle people” alleviate and help cure a variety of acute and chronic conditions. Health promoters recently spoke of B’anok Rik’in Ak’uux in their Q’eqchi language, calling acupuncture “curing with needles” .

GUAMAP, a health NGO committed to accompaniment and assistance to populations with very limited access to health care, trained in its first community in 1995. Since then, the form of assistance changed over time; from longer periods of stays in community clinics to shorter periods for more intense training, from equipping and financing an acupuncture room in a newly constructed clinic, to delivery of prenatal vitamins to anemic expectant mothers, moving from the neighboring department of Alta Vera Paz to five municipalities in Peten covering 32 percent of national territory. Potable water is still lacking in many communities in 2004, but a few communities now have telephone service. Difficult living conditions, manual labor, and constant local migration are the tremendous daily burdens most face while still shielding themselves from their own trauma of having survived a war that stole loved ones.

Without exposure to these living conditions, acupuncturists are less able to understand and therefore teach appropriate treatments for medical conditions tied to the often overwhelming physical environment. Howler Monkeys and Boa Constrictors are more common in the Peten than doctors visiting rural isolated communities from the capital city, where 70 percent of all trained medical personnel remain. GUAMAP grew from a training organization to one that formally monitors and follows up in community clinics where community health promoters practice acupuncture.

A reporting system was constructed over a three-year period. It introduced patient reporting forms and protocols on needle use and disposal. By 2001, GUAMAP regularly supplied needles on a quarterly basis to two communities in exchange for patient record keeping. By 2004, it distributed 4,200 needles to five communities quarterly. While needles cost less than 3 cents each, and a patient typically uses from 5-10 per treatment, exchanging used needles for patient progress notes facilitated access to patient treatment records. This mechanism ensures good sound acupuncture practice, and improvement in practitioner knowledge. GUAMAP acupuncturists trained 117 community health promoters by 2004; 97 men, and 12 women.

By 2003, study of patient outcomes became a focus for GUAMAP to facilitate curriculum reform and to reach a broader public health audience regarding the preliminary positive health outcomes we have documented. The region’s patient population is diverse. We have trained ladinos, and eight ethnic populations of Maya: Achi, Ixil, Kaqchiquel, Pokomchi, Mam, Mopan, Q’eqchi, and Quiche. Early frequency counts indicate 55 percent of patients treated were men and 45 percent women. To date, GUAMAP has a database of some 1,200 cases, roughly 60 percent with documented diagnosis and treatments, while 40 percent list just diagnosis.

The most prevalent medical conditions reported for the period 2001-2004 were: 1) Gastritis, 2) Back pain, 3) Arthritis, 4) stomach ache, 5) Diarrhea, 6) Shoulder pain, 7) Malaria, 8) Headache, 9) Flu, 10) Fright / Susto. We estimate the general population of the communities at over 4,635 people. While about 32 perecnt of diagnosis were for muscular-skeletal conditions, other treatments were for intestinal conditions and other communicable conditions, typical in the tropics.
In the second phase of this study, we hope to look closer at improved health status, cost savings over alternative treatments (including bio-medicine), and issues governing improved access to curative treatments.

Contact information
blakegentry2003@yahoo.com ; jorgemisael@hotmail.com ; jorgemibarra@netscape.net ; guamap@theriver.com

Design of Walking Environments for Spiritual Renewal

Editor's Note: The following was presented by Jody Rosenblatt Naderi, MLA, RLA, at the June 2004 Fifth International Conference on Walking in the 21st Century in Copenhagen, Denmark. For more information, visit www.citiesforpeople.dk.

Abstract
While existing development pedestrian standards affect environmental design at the city, neighborhood and site scale, it is clear that the fundamental evidence for those standards did not traditionally address all forms of walking needs. This paper presents a new lens with which to regard those standards such that the human need for spiritual renewal comes into focus as an integral part of the urban fabric. Whether transportation engineering or urban design, we question whether the impact of traditional design standards even acknowledge the importance of the street as a health facility regarding spiritual health and renewal.

This inquiry into walking environments includes a sequence of empirical field studies conducted on several walking sites in Texas. The first research team included a group of professional practitioners in planning and landscape architecture as well as a rabbi, a priest and a medical doctor. In addition the research was organized to include an educational and training component, in this instance, students of landscape architecture, urban planning and computer science.

The preliminary findings indicate that there are environmental design variables that contribute positively to the experience of walking in environments for spiritual renewal. While still ongoing, this experimental way of studying pedestrian design raises interesting questions. To encourage this type of walking, we need to examine the human need for spiritual renewal in terms of physical constructs of the street environment and revise existing planning, design practices and guidelines accordingly. Healthy communities could become more of a reality at the site specific scale based on consideration of environmental variables that encourage walking for health and spiritual renewal.

Quality of Life and Physical Complaints in Elderly Patients with Myasthenia Gravis Using Complementary and Alternative Medicine

Editor's Note: Following is the introduction of a study to be presented at the APHA Annual Meeting in Washington, D.C. At press time, the presentation was scheduled for Tuesday, Nov. 9, at 5:15 p.m. See final program for room.

Introduction
Myasthenia gravis (MG) is an autoimmune neuromuscular disorder, with annual incidences of 0.25-2 patients per 100.000 [1]. MG frequently presents with fatiguable weakness of voluntary muscles [2]. Without any therapy, 20-30% of the patients die within ten years. Progress in medical therapy has increased life expectancy in MG patients towards a normal lifespan, without definitively curing the disease. Thus, health professionals are nowadays confronted with a group of elderly MG patients, which was unknown few years ago. Due to the lack of definite cure, patients with MG seek complementary and alternative medicine (CAM) to ease their daily life [3, 4]. Different kinds of CAM do exist, but little is known about the use of CAM in elderly patients with MG [5]. Therefore the study tried to analyze in a sample of elderly German MG patients the differences between MG patients using CAM and MG patients not using CAM.

Relaxation Response Improves Well-Being

Editor's Note: The quantitative results of the following will be presented at the APHA Annual Meeting in November. The study title is "A relaxation response randomized trial on chronic heart failure patients" by Chang BH, Hendricks A, Yue Zhao, James A Rothendler, LoCastro JS, Slawsky M, A. The findings were first published in the journal Preventive Cardiology.

A randomized clinical trial by researchers at the Boston University School of Public Health and the VA New England Health Care System, Bedford Division, found that a relaxation response intervention can improve the well-being of elderly veterans with congestive heart failure (CHF). The relaxation response is a learned state in which individuals evoke a bodily calm resulting in a set of physiological changes that are opposite to stress responses. Although relaxation response techniques have been used in the U.S. health care system for more than 20 years, this is the first study to use a randomized controlled clinical trial to evaluate the efficacy of the relaxation response on congestive heart failure patients.

In the clinical trial, conducted from 2000 to 2003 at VA hospitals in the Boston area, 95 patients (mean age of 69) were randomized to one of three study groups: relaxation response intervention, cardiac education or usual care. Patients in the intervention group attended a weekly relaxation response training group for 15 weeks and were to practice the techniques at home twice a day. The techniques included breathing awareness; mental repetition of a word, sound, phrase, or prayer; mindfulness meditation; guided body scan; progressive muscle relaxation; guided countdown; autogenic; and guided imagery. Patients were also taught a short version of relaxation exercises (minis) involving focused breathing techniques. Patients in the cardiac education group also attended 15 weekly groups to learn various topics in cardiac health. This active control group served to control for possible effects associated with group meetings and patients’ expectations for improvement. The usual care group received usual medical treatments and did not attend any group session.

A special feature of this trial was the inclusion of a qualitative study. Fifty-seven participants were interviewed by phone about their experience and changes as a result of the study participation. Half of the 20 relaxation response group reported physical improvements and 13 reported emotional improvements that went beyond disease management and led to life-style changes and improved relationships with family and friends; the education group and the usual care group reported no similar improvements.

While we were not surprised to observe non-statistically significant intervention effects on physical quality of life and health care utilization, largely due to the short term intervention and the medical conditions of CHF patients, the findings of the intervention effect on spiritual and emotional quality of life nevertheless have important implications for the care of CHF patients. Advanced heart failure has been termed “heart cancer” because of its incurable condition associated with an inexorable decline in functional status. Despite advances in pharmacological therapies, patient morbidity and mortality remain high, and CHF patients experience serious decline in their quality of life. A non-pharmaceutical intervention such as the relaxation response that can improve quality of life of these patients, particularly in the spiritual and emotional domains is valuable. Integrating the relaxation response training into cardiac health care is likely to be beneficial to CHF patients.

Complemetary and Alternative Health Practices in the Global Village

Report from the 15th International AIDS Conference

The conference theme “Access for All” resonated in a variety of ways with over 15,000 delegates. Held in July in Bangkok, Thailand, this year’s gathering actively promoted access to medications and treatment, access to education and information, and access to resources for scientists, clinicians, community leaders and advocates. Sponsors of the conference, which is held every other year, included the International AIDS Society and the Thailand Ministry of Public Health in cooperation with the U.S. Centers for Disease Control and Prevention, the Bill and Melinda Gates Foundation, the United Nations AIDS Bureau, and the Rockefeller Foundation.

Conference tracks included presentations on: basic science; clinical research, treatment and care; epidemiology and prevention; social and economic issues, and program and policy administration. Over 10,000 abstracts were submitted for consideration and were peer-reviewed by experts throughout the world. Special guests and speakers at the conference included U.N. Secretary General Kofi Annan, Nelson Mandela and activist/actor Richard Gere.

Although previous conferences focused on scientific research and medical findings, emphasis has shifted to creating exchange and discussion on issues related to social, public health and community-related responses to the pandemic. A greater commitment to bridging gaps in collaboration and cooperation is evolving, as was evidenced in the broader range and increased visibility of complementary and integrative health care speakers and presentations. The importance of creating strategic alliances is becoming more appreciated as the worldwide epidemic continues to advance.

Seeing saffron-robed Buddhist monks and nuns, traditional healers from Africa clad in multi-hued garments of Kente cloth, and dedicated activists from around the world provided powerful images about the interconnectedness and energetic exchange that all of us share. The perspectives and wide varieties of view-points represented a spectrum of experience and backgrounds, a situation that those of us involved in Asian medicine can appreciate as we comprehend the ever-changing dynamic between yin and yang.

Exhibition booths included an area where conference-goers could drink tea and speak with monks (called Monk Chat), quiet areas for receiving Thai massage, and healing services for body and soul provided by African healers.

This year’s programming included numerous presentations on the roles of traditional healing and other alternative and complementary health practices in working with people living with HIV/AIDS. One of the most exciting and innovative symposia of the conference brought together traditional healers, physicians, and researchers, all who were from Asia or Africa. An audience of a few hundred people was treated to a spirited panel discussion which was the first of its kind ever featured in the conference venue.

The symposium was based on a conference held in Nairobi, Kenya in 2003 entitled “Journey of Connections – workshops on traditional medicine and HIV/AIDS.” Yahaya Sekagya, chair of the symposium, is from Uganda and is affiliated with Prometra, an international organization dedicated to the preservation and restoration of traditional medicine. Facilitator of the symposium, Mary Ann Burris, represented the Trust for Indigenous Culture and Health, based in Kenya.

A powerful message of the symposium echoed the sentiment of the previous gathering in Kenya:
    “We all walk to the future in the footsteps of our ancestors. We believe our ancient ways have many things to offer us today as we work together to make the world a healthier place for all who live here. All of us live in communities affected by HIV and AIDS. All of us live in a world affected by HIV and AIDS. As traditional healers we are often the most trusted and accessible health care providers in our communities. We care for HIV-positive people and their families. They come to us for understanding, medicines, and healing. We invite the scientific community to work with us, to respectfully research our healing approaches so that they can be understood and shared more widely. We commit ourselves to assuring that this wisdom is passed on and does not die or become neglected. We welcome others to help us in this work. We call upon the international HIV/AIDS community to realize that appropriate treatment and care for HIV and AIDS should include traditional healing therapies. We commit ourselves to supporting one another and working together.” 1
The sentiment of cooperation was illustrated eloquently in this statement by Erick Gbodossou:
    “Five centuries ago, the native Americans lost their land, and their people had to hide their knowledge underground. Five centuries ago, Africa was devastated because of slavery, and their knowledge was destroyed. Five centuries ago, all indigenous civilization around the world was destroyed…their cultures, religions, spirituality. Today, five centuries later, it is time for a renaissance, time for indigenous science to play its role, time for ancient civilization to be reborn and to be promoted. The time is now to give hope to a future generation. Today, healers work with physicians, with anthropologists, with pharmacists, advocates, journalists… All speak about making a bridge between the two sciences. The time is now. It is our responsibility to build this bridge. Together we can find a solution to the landmine of HIV/AIDS and begin this renaissance process with unity and dignity.” 2
A record number of posters and presentations on alternative and complementary health practices were included in the conference’s six-day programming; almost 100 abstracts were selected for presentation and publishing in conference-related venues. Topics included acupuncture, herbs, vitamins and nutrition, massage, traditional healing, meditation and exercise including yoga. Information on accessing the content of these and other abstracts can be obtained via the conference Web site: www.aids2004.com.

Numerous poster presentations on acupuncture and Chinese herbs were integrated into the conference proceedings, and included reports on managing neuropathic pain related to HIV/AIDS 3, using Chinese traditional medicine in caring for people coinfected with HIV and Hepatitis C 4, assessing health outcomes for individuals who use acupuncture 5, integrating acupuncture into public health programming 6, and training health care providers to use acupuncture in Uganda 7.

Although the AIDS epidemic is nowhere near being resolved, the conference provided hope and support for healing. The role of traditional medicine is becoming more widely appreciated and taken more seriously. Our experience with complementary and integrative health modalities, grounded in energetic exchange with the life force, provides us with the possibility of contributing to the process of transforming this global crisis into an opportunity for planetary healing.

References

  1. Journey of Connectedness: Workshop in Traditional Medicine and HIV/AIDS. 13th International Conference on AIDS and Sexually Transmitted Diseases in Africa, Nairobi Kenya 9/21/03 Nairobi, Kenya. Published by Prometra, Trust for Indigenous Culture and Health, and Twazeeza Communications.
  2. bid.
  3. Acupuncture in a group setting reduces the pain and neuropathic symptoms associated with HIV infection. Hand GA, Phillipa KD, Skelton WD. Abstract MoPeB3245. 15th International Conference on AIDS.
  4. Complementary Chinese traditional medicine care for HIV/HCV coinfection. Wilson CJ, Cohen MR. Abstract TuPeD5062. 15th International Conference on AIDS.
  5. Health outcomes associated with the use of acupuncturists among HIV positive complementary medicine users. Calabrese C, Polissar N, Koprowicz K, Kim J, Fitzpatrick A, Aickin M, Standish L. Abstract ThPeB7279. 15th International Conference on AIDS.
  6. Providing acupuncture in a public health setting. Sommers EA, Haines B, Porter KE. Abstract ThPeB7236. 15th International Conference on AIDS.
  7. PanAfrican Acupuncture Project: an innovative training program for empowering Ugandan health providers. Mandell RS, Sommers EA. Abstract ThPeB7240. 15th International Conference on AIDS.

Update from The Kang Wen Clinic

The Kang Wen Clinic is pleased to announce our renewed commitment to the CAM community and individuals who are experiencing lifelong challenging illnesses. Kang Wen is now independently operated after five years of partnership with the former Northwest institute of Acupuncture and Oriental Medicine. The year 2004 brings our 15-year anniversary with our services still in high demand, demonstrating how offering CAM clinical services are vital to the wellness of the community.

Our mission is to provide affordable health care to individuals with lifelong challenging illnesses utilizing acupuncture and oriental medicine and other complementary and alternative medicine (CAM) therapies. Kang Wen, or "defeat the epidemic," is a pioneer in CAM as one the first clinics to provide CAM services specifically to the HIV/AIDS community. Since its incorporation in 1989, Kang Wen has helped hundreds of clients achieve longer and more comfortable lives and now serves individuals experiencing all lifelong challenging illnesses. We are located in the Seattle-Metro, First Hill neighborhood that allows convenient access to several conventional and world-renown medical facilities such as University of Washington-Harborview, Swedish, and Virginia Mason Medical Centers.

All of Kang Wen’s practitioners are professionally licensed in Traditional Chinese Medicine (TCM) and trained at accredited institutions. Our services include acupuncture, nutritional and herbal supplements, moxibustion and lifestyle counseling. Kang Wen only prescribes and recommends herbal and nutritional supplements that are pharmaceutical grade and adhere to Good Manufacturing Practices standards. We offer two shifts per week and can accommodate up to 12 clients per shift. Kang Wen operates on a sliding fee schedule with our minimum co-payment of $5 set for individuals at or below the 200 percent Federal Poverty level. The majority of our clients are those with limited incomes so our operations are integral for public health.

During this exciting period, we are seeking individuals or organizations who are eager to help our mission through formal or informal collaborations. Some potential areas we are pursuing are increasing our research activities and the implementation of an advisory panel comprised of CAM and public health experts.

Kang Wen operations are subsidized on the donations of participants, volunteers, agency grants and the generous contributions of caring individuals. Kang Wen is a registered 501(c)(3) non-profit organization. Please contact us at
info@kangwenclinic.org or (206) 322-6945 if you have any questions or would like further information.