“In a world governed by scientific facts, figures, statistics and academic theories it’s so refreshing to find a book about people and their experiences. This is a very human journey to find out what works best for the people who have put their trust in homeopathy. The Triad Method was birthed through necessity and intuition alongside real clients and in real situations. This book is not just of interest to homeopaths and homeopathic students but would be of great interest to all those who have an interest in developing health projects and community based programmes.” Ellen Kramer, MCPH, MARH, Director of the College of Practical Homeopathy

Th e

Tr iad M eth o d

Treating complex cases from grassroots to clinic

Hilary Fairclough

“In 2002, Hilary Fairclough, a homeopath and a former nurse, set up the Maun Homeopathy Project in a remote part of northern Botswana, where over 35% of the population were HIV+. Undaunted, Hilary and her colleagues – notably part and full time local people who have gone on to graduate as professional homeopaths - have since treated over three thousand people with HIV and AIDS, many of whom were also carrying the suppressant effect of conventional treatment. These are quite amazing achievements.There is an entire section devoted to an independent study of the Maun Project clinics carried out by Lancaster University in 2013 and for readers who want to hear directly from the people who have been treated, there are some stunning personal accounts. Overall, this is one of the most powerful, clearly-written and humane accounts of the benefits of the homeopathic Triad Method I have read.” Janice Micallef, MCH, RSHom, co-founder of the Guild of Homeopathy

“Hilary Fairclough brilliantly constructs a Triad Method of homeopathic prescribing with sensitivity and intelligence, which will no doubt inspire the open-minded practitioner to explore and develop his or her own homeopathic instincts and understanding. And the stories of her homeopathic experiences in the Botswana town of Maun will give hope and confidence to many.” Jonathan Stallick, RSHom, author of AIDS: the Homeopathic Challenge “This story of introducing complementary homeopathy to help in the face of widespread chronic illnesses such as AIDS and HIV in Botswana is inspirational and compelling. It tells of tentative first steps in advocating homoeopathy where it was virtually unknown; its initial tribulations and eventual acceptance; the establishment of clinical work in the bush and more. Being a pragmatic homeopath, Hilary Fairclough has developed a style of prescribing that recognises that homeopathy must mould itself to patients and their stories with all the layers of complexity that sickness, poverty, malnutrition and family tragedy might heap on them. Hilary Fairclough’s integrity and compassion and, above all, her absolute conviction that homeopathy can be of service to all, shine through the text.” Colin Griffith, MCH, RSHom, author of The New Materia Medica

The

Triad Method Treating complex cases from grassroots to clinic

Hilary Fairclough 2015

Copyright Hilary Fairclough © 2015 Hilary Fairclough asserts her right to be identified as the author of this work in accordance with Sections 77 and 78 of the Copyright, Designs and Patents Act, United Kingdom. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the publishers.

For Philippa with love, and in memory of Henri Llewelyn-Davies, 1954–2011

ISBN 9781-874581-3

Printed by Berforts Information Press Ltd, Stevenage, UK Text and artwork © Winter Press, 2015 Cover design by Paul Smith Published by Winter Press in 2015

Winter Press 16 Stambourne Way West Wickham, Kent BR4 9NF e: [email protected]

r0

and Mpho Mahopolo, 1957–2011

Contents Acknowledgements ix Introduction 1

About the Author Hilary Fairclough, BA (Hons), RN and RSHom, was a nurse and nurse lecturer for ten years specialising in community and palliative care before she trained in homeopathy at the London College of Classical Homeopathy, qualifying in 1995. She is co-founder and Director of the Maun Homeopathy Project and for this work she received the Society of Homeopath’s Outstanding Achievement Award in 2010. She lives in Brighton, practices homeopathy in London, Brighton and Penzance, and lectures on the Triad Method and the setting up of the Maun Homeopathy Project.

Part 1 The Maun Experience: Origins of the Triad Method

7

Part 2 The Triad Method of Prescribing

43

1  The Triad Method: developing a homeopathic approach

45

2  The Triad Method and healing

62

3  The Triad Method and miasms

79

4  The Triad Method: principles and structure

92

5  The Triad Method: how to use it

109

6  The Triad Method: flexibility of application

124

Part 3 Evaluation of the Maun Clinics

141

Introduction 142 Summary of findings

144

Four cases Case example 1

180

Case example 2

186

Case example 3

190

Case example 4

197

Notes 202 Summary 209 Bibliography 210

Acknowledgements The importance of giving acknowledgments is one of the many things I have learnt in Botswana. I am going to try to emulate this tradition and acknowledge all the people who have contributed to the emergence of this book and without whom it would not have been written. My partner, Philippa Brewster, has been with me all the way through, from establishing the Maun Homeopathy Project to the day to day writing of this book. Ben Gadd has been an insightful and treasured supervisor. My thanks to Kate Nicholls for originally suggesting the idea of setting up clinics in Botswana, and to Susan Curtis and Colin Winter for encouraging the idea of the book and for making it a reality. Also thanks to Cecile Rault and Paul Smith for their contributions to the book design, and to my friends and sister, Alison, for believing that I could do it. The book would not have been written without my experience of the clinics in Maun, Botswana. Wasanapi Kapii, Lebo Sarwanyane and Irene Mohiemang have been steadfast in their commitment to me and the homeopathy clinics over the years. Lebo’s mum, Stella Sarwanyane, has been there from the beginning when she started the clinics with me. Past and present key partners who have put their trust in me and the clinics include Mr Mokgadi from the Maun Counselling Centre; Mary Hastag from the safari industry; Chibuya Dabuta, Mpho Mahopolo and Peggie x

The Triad Method

Ramaphane from Women Against Rape; Lilian Costa, Tracy Buzwani and Charlie Ellis from Bana Ba Letsatsi; Dorcas Sekao from Sehitwa; Reverend Anna Nguvauva and the staff of the Lutheran Church; and Dr Yared Abere Robele and Dr Mungisi, Directors of Health in Maun. Dr Mazhani, former Director of Health Services, and Dr Othwolo, Assistant Director of Health Services have both given me generous support and advice over the years. I also want to thank Allison Brown, Hilary Crous, Ruth Stewart, Marty MacFarlane, Lizette and Delon van Zyl, Christiane Stolhofer and Monica Morrison for being active in their support of me, the homeopathy clinics and the volunteers. Forty homeopaths have travelled to Botswana to volunteer in the clinics and each has contributed significantly to this book through their use of the Triad Method. In particular I would like to mention Lesley Murphy, Vanessa Rainbow and Noam Bar (tutors of the trainees); Carol Butterfield, Cath Donovan, Margaret Ecclestone, Susanne Hartley, Julia Hunn, Tim Lloyd, Penny Rowe, Jeri Russell, Cherry Smith, Sue Townsend and Julia Wilson (regular volunteers, teachers and mentors for our trainees). In the UK I would like to thank the Maun Homeopathy Project Trustees, Kevan Forde, Anita Wicks and Susan Marmot, for their ongoing guidance and faith in me; Peter Molyneux for his good counsel; Sherry White for skilfully managing the volunteer supervision programme; Sheila Reynolds and Theresa and Ian Martin for their generous support; as well as the people who have donated over the years to make the clinics possible. Thanks to Misha and Mani Norland and Ellen Kramer who have been generous in their provision xi

Acknowledgements

of training programmes, to Amanda Bingley for suggesting and carrying out the service evaluation, and to all of my clients in the UK who have trusted me with their homeopathic care. Finally I want to acknowledge our clients in Maun, over 3,000 of whom have put their faith in me and the other volunteers and told us their stories of suffering. It is their experience of the Triad Method prescribing approach that forms the roots of this book.

xii

Introduction This book is about a journey of discovery from grassroots to clinic, which has concerned the development of the Triad Method, a homeopathic prescribing strategy for people living with complex disease. Initially the Triad Method developed as an approach for treating people with HIV and AIDS in Maun, a small town in northern Botswana. Later in the journey its use expanded outwards as it became clear that the Triad Method could be used when treating anyone with a complex disease living anywhere in the world. Through reading this book I hope you find the Triad Method has relevance for you in your homeopathic practice too, wherever you are based. The Triad Method offers a way to prescribe for complex cases. All of us who are in homeopathic practice or studying homeopathy can be faced with cases which are so multi-faceted that it can be difficult to know how to proceed. These complex cases may have deep pathology complicated by the use of conventional medication, multiple stresses and maintaining causes of ill health. If you find the Triad Method resonates with you, it may prove to be a useful option when analysing such a case and deciding on a treatment strategy. The Triad Method is an approach to prescribing rooted in my experiences and those of other Maun Homeopathy Project volunteers. Together we have treated over three thousand people living with HIV and AIDS in and around Maun, since 2002. xiii

1

The Triad Method The Maun Homeopathy Project (a UK registered charity) has been the umbrella organisation for the clinics in Botswana. Through UK based fundraising it has provided free homeopathic treatment for people living with HIV and AIDS and/or traumatised by rape in Maun and the surrounding areas over the last ten years. As joint founder and Director of the Maun Homeopathy Project, it has been my privilege to be involved in all aspects of the charity from day to day management and regular practising in Maun, to the recruitment of international volunteer homeopaths and the training of local people to be homeopaths. It has been a richly rewarding experience for me on many levels, perhaps the most important of which has been the team aspect of the work based on the heart-centred qualities of partnership and trust. I have drawn directly on the texture of my experience in Botswana and the trust placed in me as a stranger to provide a homeopathic service in a place which stimulates and challenges all the senses. This has helped me to write this book and share some of the many lessons learned and insights gained. Moving from the grassroots to the clinic has been part of the journey. In Botswana we started at the grassroots level, often taking cases in remote villages, sitting under the shade of a Mophane tree. As we became more established we opened our own clinic in Maun and now our graduates are starting up their own private practices alongside the free clinics still funded by the Maun Homeopathy Project. The volunteers and I have also moved from the grassroots in Botswana to clinics in our own countries, applying the experience gained of daily treating people with HIV and AIDS in Maun to enhance our own homeopathic practices at home. The use of the Triad Method as an approach when treating people with organic and complex diseases has been 2

Introduction central to this, and it is this experience that I hope this book conveys. When thinking about what needed to go into the book, I realised it was important to start with the story of the setting up of the Maun Homeopathy Project and its clinics: how it all began. This was because these clinics have formed the rich soil in which the Triad Method took root. In coming to understand the context and manifestations of our clients’ suffering in Maun, I found a way to respond homeopathically to help them in their healing. The story of the Maun Homeopathy Project clinics, the roots of the Triad Method, makes up Part 1 of the book. Part 2 explains what the Triad Method actually involves – its theoretical underpinnings, development, structure, flexibility and applications. Part 3 summarises an independent evaluation of the Maun Homeopathy Project clinics carried out by Lancaster University in 2013. Selected aspects of the full evaluation give a voice to the people in Maun and express their views of the homeopathy they have received. It is perhaps not accidental that the book has ended up being composed of three parts. Like the structure of the Triad Method itself, the book has three separate yet linked sections, each with a different focus. My intention in writing the book is that everyone interested in the Triad Method and the experience of the Maun Homeopathy clinics may glean something rich from it. The Triad Method grew from my experience in Maun but also from my experience of treating people homeopathically over the last twenty years in Botswana and in the UK. In both countries I have become especially interested in the context of healing when treating clients. The Triad Method is a layers approach devised to enhance a client’s healing on different levels, especially if she or he has a complex 3

The Triad Method organic disease. But it is my belief that for healing to occur, any therapeutic method is best applied in the context of certain key case-taking components. For example, the practitioner needs to have a healing intention and be able to listen, keep confidentiality and perceive a central disturbance or disturbances in the client’s mental, emotional and/or physical health. Healing can occur alongside other interventions too. As in Botswana, the Triad Method can be a complementary approach. I started out as a classically trained homeopath and the Triad Method has a classical approach as one of its core components. The beauty of classical homeopathy is that it aims to reach the deepest level of disturbance, and my intention is that this focus is preserved in the Triad Method. However, the Triad Method acknowledges that there can be other levels of disturbance, especially in cases of complex disease, which may need to be addressed simultaneously to enhance the deepest healing. So the Triad Method advocates the use of three remedies to address three different layers rather than just one for each prescription. I mention this now because I hope that the book will be of interest to homeopaths from different traditions. In a similar way to how I have recruited volunteer homeopaths from across the range of prescribing styles and philosophies, I hope the book will appeal to many members of our diverse homeopathic community. I have included UK case examples as well as ones from our clinics in Maun throughout the book to illustrate the Triad Method’s applicability and versatility. The case examples are mostly ‘snap shots’ to demonstrate various aspects of the Triad Method. However, for those of you who would like to see how the Triad Method can be used in one case over several consultations, there are also four cases at the 4

Introduction end of the book. All cases have either received permission for inclusion from the client or details have been changed to protect confidentiality. For ease of reading I have chosen to use common names for remedies rather than their abbreviations or full Latin names. The overall intention of the book is for it to be useful for the contemporary prescriber facing the day to day challenge of treating clients with entrenched chronic conditions and /or complex health circumstances such as medical suppression and ongoing trauma or stress. The Triad Method is a tried and tested approach, rooted in a Botswanan experience and branching out in its universal applicability. If it appeals to you and proves useful in your practice, I will feel the book has achieved what I hoped for it.  

Hilary Fairclough Brighton 2015

5

The Triad Method

The Maun Experience

Part 1

The Maun Experience: Origins of the Triad Method

6

7

The Triad Method

The elephant visits: how it began My first visit to Botswana was in 2000. My partner, Philippa, and I stayed on a lion research camp, a temporary collection of tents pitched in the bush on the edge of the Moremi Game Reserve about 50 miles outside a town called Maun. During our first night we were woken by a noise just outside the tent; we looked out and an elephant was standing there looking at us. I was terrified: the elephant was huge and the tent small and fragile. Will she walk over us? Will we be trampled to death? But I was also filled with wonder: the elephant was there and we were here and we were looking at each other. The next night the elephant came to our tent again and the night after that. We told our hosts, Peter and Kate, but they didn’t know why the elephant was coming, it’s unusual behaviour. They put us in a different tent, the elephant came to that one too. I was getting to love our early morning encounters and the fear had gone. We learnt that wild animals see tents as solid objects, so they won’t walk into or over them. I eventually trusted that I was safe. After we left for home in the UK we found out that the elephant had stopped coming. I took the elephant coming as a sign that a connection had been made with Botswana, the spirit of the country. In 2000 I’d been working as a full-time homeopath for 5 years in a busy private practice based in London. In August that year Philippa, who works in publishing, came home and told me she’d been asked to go and edit a book in the Okavango Delta. My first response was to ask: “Where’s that?” My second response on checking the atlas was to say “If you’re going there, I’m coming too.” A month later we were on a flight to Botswana via South Africa. Flying to Maun from Johannesburg, I looked out of the airplane window to see miles and miles of bush, the huge 8

The Maun Experience expanse of unpopulated wilderness that is Botswana. Coming from the UK it was hard to believe that there could be such a vast empty space in the world, even harder to imagine what Maun would be like, a small town in the middle of nowhere. Suddenly we were descending and I saw a spread of low level housing – thatched huts known as ‘rondavels’ and the more modern equivalents, breeze block huts with corrugated iron roofs. The terrain was sandy with many trees intersected by a long tarmac road. I found out later that this road had, in 2000, been in existence for only 5 years. Previously there had been a 500km rough gravel track connecting Maun to the nearest town, Francistown, and Gaborone the capital another 500km away. Until its very recent history Maun was an isolated settlement, cut off not only from the wider world but also from the rest of Botswana. We were met at Maun Airport and driven into the bush to the lion research camp run by Pieter Kat and Kate Nicholls. Kate’s teenage children were writing a book about their experiences of growing up in the bush, 1 and Philippa was their editor. Each day, as Philippa and the children worked, I accompanied Peter as he drove around the bush to track the lions being studied and observe them from the safety of the vehicle. To me every African wild animal imaginable was there – not only lions but also elephants, zebras, giraffes, impala, buffalo, red lechwe, hippopotamus, crocodile, kudu, and a multitude of noisy and brilliantly coloured birds. Kate, like Pieter, is a scientist, and she also used homeopathy for the children. I talked about homeopathy and she talked about Botswana. I learnt that it was a peaceful, democratic country ravaged by AIDS. People were dying in their thousands, there was shame and stigma and I was 9

The Triad Method told that people were being left to die alone in tents around the edge of the local town, Maun. Kate said: “You need to start a homeopathy clinic here; people need help.” It was an idea, a seed which took root in my consciousness and slowly grew into a plan over the next two years. I thought it was an idea with exciting potential (who wouldn’t?) but could I do it? The challenge felt huge like the elephant and I felt small and fragile like I was still in the tent. I needed to find courage.

Under the shade of a Mophane tree: introducing homeopathy Two years after our first visit, we did it. Philippa and I got on a plane back to Maun. This time I had a case of homeopathic remedies with me and the names of people and organisations in Maun who were working with people infected by HIV. Kate met us and introduced us to them. One of the first people we met was Stella who was HIV+, very thin and seemingly fragile but, as I found out, not only did she have a huge heart but she was determined and resilient. She was running the first HIV Support Group in Maun at a community organisation called the Maun Counselling Centre. I told her about homeopathy and she immediately wanted me to start a clinic for her Support Group members. She said: “People are sick, they need help.” But first I had to talk to the elders, staff and clients. So a meeting was called and attendees sat on benches outside the Centre and I stood in the shade of a Mophane tree and talked through an interpreter2 about homeopathy and what it might offer the community. I was nervous as everyone involved in the Centre had turned out to hear what I had to say – about 50 people – but I didn’t talk for long because I noticed that no-one in the audience seemed to be listening. Their gazes were directed elsewhere and many expressions seemed 10

The Maun Experience disinterested. So I stopped and instead asked for questions. I was amazed by the first question – someone stood up and asked: “So, this homeopathy. Is it an art or a science?” This question went straight to the heart of the matter, and had been one of my own preoccupations in seven years of homeopathic practice. Standing under the Mophane tree faced with a large group of people who had never heard of homeopathy, I tried to answer the question. I said that homeopathy was both, a science and an art. I realised then that I should never underestimate the members of an audience in Botswana or their potential interest, understanding and discernment. I have experienced this over and over again, that just because someone doesn’t seem to be listening or interested, it doesn’t mean that they are not taking it all in, thinking about it and forming astute questions to ask. What could be more astute than to ask whether homeopathy is an art or a science? That day I was to be surprised again by people’s quick grasp of the issues in offering a homeopathy service. The next question asked was: “Are you being sponsored by a pharmaceutical company?” I learnt then that in Botswana issues are seen clearly, that the heart of the matter is addressed, that a lot of what is unnecessary falls away. As with the elephant, I had made a connection with people, as they had with me, and I knew I could work there.

Visiting Lesego: partnership and trust In 2002 we were introduced to another local organisation in Maun, Women Against Rape (WAR), which campaigns against sexual violence and supports (through counselling services and legal advice) girls, boys, women and men who have been sexually assaulted. One day I was asked by WAR to visit Lesego at her home as she needed our help: she was 11

The Triad Method HIV+ and unable to walk. It was a blisteringly hot day when Mpho, a WAR counsellor, drove me to Lesego’s compound to treat her at her home. In Botswana a compound is made up of a collection of huts inhabited by different members of an extended family. Lesego’s compound consisted of a couple of rondavels and a breeze block hut. There was no electricity or running water. We found Lesego propped up against the wall of her hut sitting on a blanket. Her home situation was so poor that there was only a couple of broken chairs for us to sit on. The consultation was challenging for me on many levels – I couldn’t help but be affected by the heat, but also by Lesego and her family’s poverty and the desperation of the situation. But with the support of Mpho as interpreter and colleague, I was able to sit, observe, ask questions and listen. Lesego’s main problem was severe pain in her legs. Through Mpho’s interpreting I found out that she could only walk very short distances. She had swelling and numbness of her legs too; frequent diarrhoea for the last year; painful sores in her mouth; and she was weak and thin.3 She sat completely downcast during the consultation. She didn’t smile or look at me and seemed disinterested in answering my questions. In fact she showed no emotion at all. After the consultation Mpho gave me some background information. Previously Lesego had been living with her husband but he’d verbally abused her and brought other girlfriends home, then he’d beaten her up and thrown her out. Since then she had been staying with her mother and feeling depressed. I prescribed remedies and arranged to make a follow-up visit in a month’s time. But I didn’t have to wait that long. Ten days later, I was doing a clinic at the WAR office when she walked in wearing high heeled shoes! She appeared completely different: she was smiling and 12

The Maun Experience open, and the changes in her were such that Mpho didn’t at first recognize her. Lesego said she was feeling much stronger, the diarrhoea had stopped and she no longer had any pains, numbness or swelling in her legs. She was getting on with her life. It had started: I was doing home visits for very sick clients and running small clinics at partner agencies such as Women Against Rape and the Maun Counselling Centre. Trust was growing: I was working closely with Batswana4 like Stella and Mpho, and they and their colleagues witnessed the homeopathic approach, the results of treatment and they liked what they saw. I gave talks and started to treat staff so that they could experience the homeopathy directly themselves and choose whether to recommend it to their clients. I reasoned that this was also a way to support the staff themselves who were often HIV+ and the only breadwinner in large extended families with few other wage earning adults. Deaths through AIDS had hit the working age group the hardest and so for many people there was a living reality of multiple bereavements, orphaned children and unsupported older people. The fabric of society in Botswana was being torn apart by the devastation of AIDS, and in 2002 Maun had one of the highest rates of HIV in the world, over 35%.5 People’s suffering was overwhelming, everyone was affected, and I was feeling small with my case of remedies. I was back in the tent and there was the elephant looking at me. Could I meet the challenge? I went back to basics and did what all homeopaths do: I sat and listened, and provided a non-judgemental consultation space for the people who queued for treatment or who, like Lesego, I visited at home. The approach seemed to work, the remedies seemed to work, in fact I couldn’t believe the ease of homeopathy here and the startling 13

The Triad Method results. I was often shocked by how ill people were when they consulted me. For people living with HIV and AIDS, vomiting and diarrhoea, racking coughs, terrible headaches and fevers, emaciation and weakness were then common. I had to learn fast and as I did so, I started to gain confidence. I wasn’t alone: Stella, Mpho and I were building strong working relationships that would last, and principles of partnership, respect and trust were becoming embedded in my approach as they would in the Maun Homeopathy Project itself. I was also developing links with the ex-patriot community in Maun. In particular I started to build a close working relationship with Allison Brown, a pioneering independent nurse who advised on medical emergencies and, like Stella and Mpho, immediately saw the value of homeopathy for everyone in the community. The foundations of the Maun Homeopathy Project were being laid, although I had no idea then that it might grow and develop in the way that it has. Over the next two years I went backwards and forwards between Botswana and the UK. I didn’t know how to fund my work in Maun and I worried about giving homeopathic treatment to people and then leaving them with gaps when there was no homeopathy, about raising expectations then dashing them. I was aware that there had been a pattern of Westerners going to Africa or other developing continents, having a ‘big idea’ then not following through, leaving disappointment and neglect in their wake. I didn’t want to repeat this pattern, so when I said to people in Maun “I’m leaving but I’m coming back,” I made sure I did come back like the elephant that visited our tent, went away but returned every morning. It felt essential to build trust in

14

The Maun Experience this way, to establish a strong relationship between me and our partners in Maun. In this I was mindful of the history of colonial relations between the UK and Botswana. The country had been scarred by a repressive British administration: in 1885 Botswana became a British Protectorate in return for protection from invasion by the Boers in South Africa, and did not gain independence until 1966. If the integrity of the Project could be held with mindfulness of the larger context, it could perhaps grow with a consciously healing presence on many levels. Like the minimum dose, the project was tiny in the scheme of things, but the ripples of healing started to resonate outwards in the same way.

The river arrives: the pilot project is funded In 2004 we managed to secure some funding from a branch of the Bill and Melinda Gates Fund in Botswana aimed at facilitating the setting up of community projects to support people living with HIV and AIDS. This small grant enabled us to conduct a three month Pilot Project of the homeopathy clinics in Maun. To do this I was staying in a cottage on the bank of the Thamalakane River bed. I’d become used to the river’s absence – where previously a wide river had flowed past the cottage and through Maun, there was now a stretch of sandy land overgrown with Stramonium6 plants, scrub and trees. It was explained to me that there had been a fourteen year drought, and everyone had been waiting for rain, suffering from the heat and lack of water. Now, this year, the rains in Angola had been good, feeding the Okavango Delta and so the river had once again started to flow towards Maun. The excitement in town was palpable; informal weekend parties had sprung up to celebrate the river’s progress at the 15

The Triad Method point where the water had reached. Everyone was talking about it. I was following the advance of the river myself and one morning I got up, went out to check, and yes, it had arrived. It had flowed quietly past the cottage during the night and now I could see the water’s edge seeping forward further down the river bed. As the river filled and widened, lilies and reeds started to grow, birds swooped to fish, and cows and goats drank thirstily. The Thamalakane River was back and it was beautiful. I took heart from its arrival. I saw it as a possible turning point for Maun and the well-being of the community there. Water is crucial for life, and Botswana often lacks it. Its rarity and value is clear by the name given to the currency in Botswana – ‘Pula’ which means rain. I couldn’t help but feel that establishing the homeopathy clinics at that time boded well. We were synchronised with nature – the river had come and our clinics were starting to take root. One of the clinics we set up as part of the Pilot Project was in partnership with an organisation called the Coping Centre for People Living with AIDS (COCEPWA). The centre was brick built with murals on the outside walls including a huge red ribbon, the universal symbol of HIV and AIDS awareness. Inside, the rooms were half finished and the electricity supply sporadic, but the atmosphere was lively and positive. Many people living with HIV and AIDS came for support and there was often singing, lively discussions, sewing and cooking. We had given a presentation about homeopathy to the staff and centre users, and the weekly clinic was attracting a lot of clients. One day a young man, Pabalelo, ran into the consulting room. He shook my hand, said “Dumela Mma”7 and asked: “There are no injections here are there? I’m frightened of them.” He was clearly agitated, had sweaty hands and a stammer. He said: “I have 16

The Maun Experience big dreams, but oh my heart… I have stress when I think about the project I’m setting up, it’s a youth counselling centre. It’s my idea, I think about it but I’m worried. I’d like to be a father but I’m worried about that too because I’m HIV+. My girlfriend tells me she’s pregnant but I don’t trust her.” Pabalelo tells me about his physical symptoms: he has swollen and painful glands in his neck, severe headaches in his temples, and his legs are painful too. He has difficulty sleeping as he’s thinking so much about his future. He is a pastor, his faith is very important to him, but he says: “God can’t see me or help me. I get worried and I pray. I’m quiet, I keep things inside, worries. I get sad from my stress and I cry. My heart beats very fast when I worry.” Pabalelo was open about his anxieties and emotional turmoil, and maybe this is why I remember him so clearly. I prescribed8 and Pabalelo came to see us for two more follow-up consultations after which his swollen glands and pains resolved, and in himself he was a lot calmer. He said “I’m feeling good in myself and I have no problems now. I’m not sad any more, or worried about having a baby. I just want to establish my project.” One night soon after this, Ben Gadd and I were sitting on the cottage verandah in Maun, having supper and talking about our day. Ben was one of the first Maun Homeopathy Project volunteers to travel to Maun to work with me in the clinics. Over the previous weeks he’d been watching me prescribe for clients living with HIV and AIDS. Suddenly, this particular evening, he said, “I think you have a prescribing method.” I was taken aback by this observation and protested that I was just doing what I usually do, but he insisted. We argued a bit and in the end he suggested he interview me to record my thoughts about how I was 17

The Triad Method

The Triad Method of Prescribing

prescribing for people living with HIV and AIDS. So the next day we sat down and Ben asked me questions. I was surprised to find that I did seem to have a method of prescribing in Maun, or at least an approach, and I could articulate its structure and rationale. Over the previous two years of practising I had been prescribing for people living with HIV and AIDS, a life-threatening illness. In this I was trying to match the art with the science. I had caught up quickly with the science as best as I could by reading such writers as Jonathan Stallick and Francisco Eizayaga. I had gone back to Hahnemann and rediscovered James Compton Burnett. I had read the philosophy, experimented in my prescribing, followed my intuition and done my best. I was seeing different totalities which seemed to be expressing different layers, and to address these I was prescribing three remedies at a time. The Triad Method was emerging as a useful approach in treating people living with the ruinous physical, emotional and spiritual effects of HIV and AIDS. Using a triad of remedies in prescribing had resonances for me as a homeopath. I saw strength in the structure provided by the number three. For example, homeopathic prescriptions are based on a minimum of three symptoms known as the ‘three-legged stool’, and there is a healing triad present in the consultation itself, composed of the patient, the homeopath and the remedy or remedies prescribed. The number three has many universal resonances too. For example, it is set in our genetic code: DNA has a triple helix structure and many cultures and religions consider the number three to be holy or divine. The triad has permeated the structure of the Maun Homeopathy Project. Further down the line in the work of the Project we took on three local trainees who are now forming the basis for the future of homeopathy in Botswana. But at this point in 18

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Part 2

The Triad Method of Prescribing

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The Triad Method

Introduction Part 1 explored the context for the development of the Triad Method of prescribing, how it grew from the ground up out of my experience in treating people with HIV and AIDS. Part 2 will describe the Triad Method itself, its rationale, structure and applications, both in Maun for people living with HIV and AIDS, and in other parts of the world when treating people with organic and complex diseases. Through describing my prescribing experience and using case examples from both Maun and the UK, I hope to demonstrate the usefulness of the Triad Method in different contexts.

The Triad Method of Prescribing

1  The Triad Method: developing  a homeopathic approach “The qualities required in the effective homeopathic treatment of HIV/AIDS are flexibility, practicality and creativity. The ability to think laterally is a distinct advantage.” Jonathan Stallick26

In Maun I traced a picture of HIV and AIDS by addressing cultural differences in case-taking to get to the heart of each individual case, and by listening to many individual stories of suffering. Through this I gained an understanding of HIV and AIDS as a chronic miasmatic disease rather than as an acute epidemic disease. This in turn led me to develop the Triad Method as a layers model to address the different totalities evident in each case. As Stallick suggests above, the Triad Method grew as a way to treat people with HIV and AIDS that was flexible enough to meet the health needs of each client; practical for homeopaths to use and clients to take; and creative in its structure and form by using a new way to address the layers. It also involved thinking laterally and following my intuition.

Tracing the picture of the disease in Maun “This individualising examination of a case of disease…demands of the physician nothing but freedom from prejudice and sound senses, attention in observing and fidelity in tracing the picture of the disease.” 

Samuel Hahnemann, The Organon, Aphorism 83

I knew my clients in Maun must be suffering emotionally because the rate of HIV and AIDS was very high. Everyone either feared dying, felt shame or had suffered loss through 44

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The Triad Method bereavement. But initially during consultations at the clinics I was struck by how many clients talked openly about their personal physical symptoms but were very reticent when asked about their emotional well-being. It wasn’t always easy to get to the mental and emotional heart of the case, and I wondered how I could best trace the picture of the disease or identify the disposition of the client. Clients were either unused to expressing difficult emotions or they found it inappropriate to tell me about them. I remember one woman coming for a consultation. She talked openly about her recurrent vaginal discharges but it was only in a subsequent follow-up consultation that she confided she was regularly beaten up by her partner who was also having sex with other women. She had come to the clinic for help with an acute and distressing physical symptom and questions about her emotional life and well-being may have seemed to her beside the point. In some ways this experience is not too different from my practice in the UK where new clients can be surprised to be asked about their emotional state if, for example, they have come for treatment for help with a physical problem. It can take a while for any client to get used to the holistic homeopathic approach, and it doesn’t always suit everyone. But in Maun most clients weren’t opening up, and I was aware that there were other factors to be considered. I was a white outsider who was possibly asking questions in a culturally insensitive or inappropriate way, thus inhibiting the free flow of information. So I turned to my local partners, staff working at the Maun Counselling Centre and Women Against Rape, for help. They suggested I give talks to their colleagues and clients to explain what homeopathy was, which I did, as described in Part 1. When interpreting in the clinics, partner agency staff also explained to each 46

The Triad Method of Prescribing client individually the nature of the homeopathic consultation and what information I needed to know about them to make the best prescription possible. I realised that I also had to learn about cultural differences and find a way to formulate questions so that clients would know what I meant. I found that asking a general question like ‘How are you feeling in yourself?’ which I have used in my UK practice, didn’t work at all in Maun. Instead of opening up I’d get puzzled expressions and silence. However, if I asked clients directly about their stress, family life, relationships or dreams, I found I succeeded more readily in getting to the heart of what was going on for each client, even if clients often laughed at my questions about dreams! I also began to learn that when clients did open up and talk about their emotional suffering, their responses were direct and to the point. Often clients simply said: “I have a pain in my heart and I feel sad,” or “I’m worried, what will happen to my children if I die?” These direct and clear expressions of individual suffering have continued to be both moving on a personal level, and helpful in tracing the picture of each individual disease. I was later surprised that clients responded to questions about themselves as much as they did. This was when I was told that in Botswana, culturally it is considered rude to ask people direct questions about themselves. Maybe my questions were tolerated as I was an outsider, allowances were being made for any cultural insensitivity on my part. Like with all good homeopathic practice, having a non-judgemental approach has been crucial in Maun in developing trust. Stigma and shame surrounding HIV and AIDS were especially widespread in Maun in 2002-4 so it was particularly important that people felt welcomed in our clinics, comfortable enough in the homeopathic 47

The Triad Method consultation to talk about the issues close to their hearts, and confident that the information would go no further. I believe we have succeeded in this, as demonstrated by the Lancaster University Evaluation.27 One client said through the words of an interpreter: “She came here expecting that she would get help here and the good part is that when she arrives here she find loving people who welcomed her; the people who don’t judge other people … just visit Mowana Clinic, they don’t judge you…” Another client said: “Yeah, they didn’t judge you; they didn’t isolate me; they didn’t condemn me, you see what I’m saying, and every time I wanted they were there for me.” Our clients started to realise that our clinics were a place they could come to for help with ‘stress’ as well as physical symptoms. ‘Stress’ is a term broadly used by clients in Maun to describe any emotional distress in response to a traumatic event or associated with personal and social challenges at work or in their home life. As I developed a feel for cultural differences, found more appropriate ways to elicit information in the homeopathic consultation and provided a confidential space to listen attentively to each client’s story in a non-judgemental way, clients started to open up and talk about their suffering. I remember one woman in particular who was HIV+. Her name was Bontle, and she was brought to the clinic by relatives as she could hardly walk. She described pains and numbness in her legs as well as various other physical symptoms, but she was reticent in telling us about any emotional effects of her disability. At her first follow-up consultation she seemed a lot brighter. She told us that the leg pains were better, and she also admitted that she was surprised to find that her feelings of anger had resolved too. She said: “I felt angry that I couldn’t walk. I wanted to work and felt my life was 48

The Triad Method of Prescribing no good without it.” As treatment progressed, the numbness as well as the pains in her legs resolved and she was not only able to walk, but to find work too. She attended the Clinic once more, this time not because of any relapse in her physical symptoms, but because she had lost her job and, at the same time, her partner abandoned her. Then she talked openly about her feelings of anger and betrayal, trusting that the remedies would help with her emotional distress as they had before. Non judgemental listening and observing in case taking was having a big effect. Like with Bontle, more and more people were coming back for follow-up consultations and saying immediately, “My stress is better” or, “What is now stressing me is…” Our clients’ appreciation of this approach came though in the Lancaster University Evaluation. For example, one said: “Myself, I should say a little about homeopathy. They helped me a lot and the thing that I like about it is that the way they [are] treating you. They are treating even emotionally and that is what I like about homeopathy. It is not like at the clinic where the nurse will say, ‘how is your eye, how is...’ but yourself? The way you are questioning, some people they become open; even myself I became open and I was really treated, even my soul was treated. That is why I like homeopathy. They treat the whole being of a person not only flesh. Thank you homeopath.” The case-taking style encouraging the opening up for clients mentally and emotionally has become a core approach in the The Maun Homeopathy Project clinics in Maun. The information gathered on this level has provided an important foundation for the Triad Method by allowing deeper and broader totalities, often based on the previously hidden mental and emotional symptomatology, to be perceived and prescribed for.

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The Triad Method

healing

2  The Triad Method and healing As HIV+ clients in Maun started to attend our clinics for follow-up consultations I witnessed many positive changes in their health and well-being and I started to consider the concepts of healing, cure and palliation, and the intention behind each prescription when using the Triad Method. What were we trying to achieve and what was realistic to expect when treating people with HIV and AIDS?

Cure or healing “The physician’s high and only mission is to restore the sick to health, to cure, as it is termed.” “The highest ideal of cure is rapid, gentle and permanent restoration of health, or removal and annihilation of the disease in its whole extent, in the shortest, most reliable and most harmless way, on easily comprehensible principles.” Samuel Hahnemann, The Organon, Aphorisms 1 & 2

I interpret these aphorisms to be Hahnemann saying that cure is an ideal, not something to be expected in all cases. Cure can be defined as the removal of the disease itself and palliation as the means to lessen or reduce pain or sickness when cure is no longer possible.43 In contrast, the notion of healing is not a linear endeavour with a beginning, middle and end. Rather it is a lifelong journey, incorporating an ebb and flow of suffering on both the physical and mental spheres but also allowing for the resolution of conflicts and the gaining of insights. In the Triad Method I wanted to develop an approach that did not promise or even aim for cure, nor settle for palliation. Instead the approach was 62

designed to facilitate the deepest healing possible for every individual. Whatever our state of health, symptoms can disappear over time, perhaps for ever, with or without treatment. But can we ever consider ourselves cured? Disease is constantly present, manifesting in one form or another and to different degrees in our lives depending on our susceptibility, miasmatic influences and the exciting and maintaining causes of ill health we encounter at different times. Using a model of healing, we can perceive distressing symptoms of disease as telling us something. They may be giving us notice to stop and rest, or to address unconscious or unacknowledged conflicts in our lives. In this way we can learn from our disease through the message and meaning it may present to us,44 as well as attempting to find healing in the medicine we choose to address it. Through a therapeutic relationship with a health practitioner we may experience healing on many levels, often in life-changing ways. For example, physical symptoms may resolve or reduce in intensity and a sense of well-being and peace be achieved, but cure itself will be elusive. Instead, by seeing healing as a life-long dynamic process, there is the potential to learn and grow as physical, emotional and spiritual beings through our suffering, rather than solely aiming to fix a particular troublesome illness.

Functional and organic disease The distinction between functional and organic (pathological) disease manifestations, both of which produce physical symptoms in the body, is useful when considering the aims of our treatment and choosing a prescribing approach. Functional disease affects the healthy functioning of an organ without any change in structure or anatomy.45 63

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miasms

Rather, it creates a temporary transformation of cell function causing irritation, inflammation and/or dysfunction. Organic disease affects the healthy functioning of an organ, but this is due to changes in the structure and anatomy of the affected body organ caused by the disease process. To aim for cure of a particular set of symptoms is more realistic when clients present with functional health disturbances, as these conditions are less deep-seated and therefore more easily reversible. When clients present with organic diseases such as HIV and AIDS it is important to be realistic and think in terms of healing rather than cure. Then there can be an openness to what may be achieved on different levels, rather than aiming for the removal of the disease itself. Wherever we are working, when treating clients with apparently functional symptoms such as Irritable Bowel Syndrome (IBS), headaches or tiredness, care needs to be taken here to make sure that there is no underlying pathology. For example does the IBS have diverticulitis or ulcerative colitis as its cause? Are the headaches due to a brain tumour or meningitis? Or is the tiredness due to an auto-immune condition? Where medical tests are reliable they can provide information to clarify whereabouts on the functional to pathological disease continuum the client has a health disturbance. If clients have had medical tests and investigations which all show ‘nothing abnormal discovered’, we can be confident that the disturbance is on the functional level. These cases will most likely be easier to treat. On the other hand if the tests show up pathological changes, the case is more difficult and is likely to take longer to treat. In this situation we will probably be prescribing alongside conventional medication taken by the client.

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3  The Triad Method and miasms Whilst practising in Maun I became acutely aware of the presence of miasms in the cases of individual HIV+ clients there. I also noticed them in aspects of the day to day life in the community. For example, in 2004-2005, Maun was known as the passion killings ‘capital’ of Botswana.53 In a passion killing, a jealous young man kills his girlfriend then himself, a clear expression of the syphilitic miasm. Miasms are a useful homeopathic framework for understanding the root causes of disease, and can exist on both micro (individual) and macro (community) levels.54 How I have perceived their manifestations in Maun has contributed to the development of the Triad Method. This chapter will explore the idea of miasmatic themes and manifestations underlying the emergence of HIV and AIDS. This approach acknowledges the particular susceptibility of the community in Maun to HIV and AIDS as a multi-miasmatic disease. It will also explore the notion that miasms can have positive aspects and suggest how these manifest in Maun alongside the better known negative manifestations.

Positive miasms In the Triad Method I have taken into account the complexity of the miasmatic aspects of disease and the challenges this complexity presents for individual healing and perhaps the healing of the wider community too. The suggestion that miasms have positive aspects on both the macro and micro levels of life has also informed the way I have understood the impact of HIV and AIDS in Maun. The Triad Method, which addresses the miasmatic aspects to each case, can then be seen to aid the individual in healing the challenge she or he is facing on this level rather than 79

The Triad Method viewing her or him as a passive victim of a very destructive disease.55 It is a subtle yet important distinction. When I reflect on the manifestation of the miasms in Maun I see the Maun Homeopathy Project as a potential healing microcosm in itself. I go back to the idea of a bridge across which we have met our Batswana partners and clients, and shared the opportunity to learn from each others’ negative and positive miasmatic inheritances. This will be described below along with the main miasmatic manifestations seen on different levels in Maun, both as individual symptomatology and how they manifest in the wider community. It is important to note that miasmatic manifestations are not exclusive to Maun or Botswana, but rather exist in different combinations in different communities and countries worldwide. What follows is a description of the particular miasmatic susceptibilities in Maun, which I have observed through my practice and experience there. These have informed the decision to address the miasmatic aspects apparent in each case of HIV and AIDS in the Triad Method.

Dormant, active and exposed miasms I see miasms as the predisposition toward chronic disease underlying the acute manifestation of illness, which are transmissible from generation to generation or which are acquired. Miasms can be dormant, active or exposed.56 The dormant miasm is when the Vital Force is able to keep the miasmatic influence suppressed so that although a strong miasmatic influence can be seen in the family history, few symptoms of that miasm are expressed by the patient. For example there may be a strong family history of heart disease and suicide indicating the syphilitic miasm, but the client shows neither tendency. The active miasm on the 80

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other hand is when symptoms of the miasm are expressed, for example, warts, catarrh, anxieties and wandering joint pains in a sycotic symptom picture. These symptoms can be seen as miasmatic themes of the case. Thirdly, a miasm is exposed if it not only produces symptoms of an active miasm, but also presents a symptom picture of the nosode of that miasm. For example, we may encounter a totality of the Tuberculinum picture in a client if there are such symptoms as dissatisfaction, temper outbursts, fear of dogs, irritability on waking, desire for smoked foods, grinding of teeth and a dry cough, worse at night.

Miasms, HIV and Maun In Maun I have seen the key miasms to be both active and exposed in the HIV cases taken there. The Triad Method addresses the main miasms particularly prevalent in Maun, expressed both in these HIV cases and in the Maun community as a whole. These miasms are the psoric, syphilitic, sycotic, tubercular and cancer miasms. Other miasms which are less central but sometimes observed are the leprosy, malarial and herpes miasms. The AIDS miasm has a particular role. This and the main miasms observed in Maun will be explored below.

Psoric miasm The psoric miasm is about taking care of our basic needs in life. The negative aspects of the psoric miasm are known to be struggle, inhibition, insufficiency and inertia,57 and all these we have witnessed in Maun. For example, our clients often report that their lives are about struggle, especially on the financial level. Poverty is widespread and we are often told how hard it is to find work to earn enough money to survive beyond the level of subsistence. Many of our

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4  The Triad Method: principles and structure When I began to develop a treatment method in Maun, I encountered various and overwhelming effects of HIV and AIDS in the cases I took. Clients often presented with lifethreatening physical symptoms of the disease itself as well as high levels of emotional trauma and stress. As discussed in the previous chapter, I also identified strong miasmatic aspects in each case as well as (later) medical suppression. Following my observations, I identified three common and separate layers to address the key aspects of the manifestations of HIV and AIDS in each individual case, which I considered as requiring three separate prescriptions. These formed the basis of the Triad Method. The Triad Method acknowledges and builds on other methods that have been developed in homeopathic prescribing for serious pathology, especially the layers approaches of Eizayaga and Stallick.

Acute / lesional layer The acute or lesional layer of disease most often consists of the client’s presenting complaint and it may be due to disease, trauma or stress. When starting to use the Triad Method in Maun I named this layer the ‘acute’ layer, as the acute manifestations of HIV and AIDS were pronounced and life-threatening. I included this layer to address the severity of the acute manifestations of the disease. Later, as HIV and AIDS became more chronic in its disease manifestations and I started to use the Triad Method for all cases of organic disease, I expanded this layer label to include the term ‘lesional’. According to Eizayaga,73 the patient develops lesional pathology due to structural and microchemical changes in the cell. The pathological process 92

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creates symptoms localised in organs or systems which can either be reversible or irreversible. In the Triad Method the acute / lesional layer not only incorporates the pathological changes in a particular organ due to the disease such as HIV, but also acute illnesses, acute exacerbations of a chronic disease and/or mental and emotional manifestations. The particular acute / lesional layer chosen to prescribe for is the most intense aspect of the case, the most distressing to the client and/or life-threatening set of symptoms. It may be an acute cough, vomiting and diarrhoea, a severe headache or a set of emotional symptoms from shock or trauma, such as an acute suicidal or homicidal state. The acute / lesional layer may also include iatrogenic disease. To select the correct remedy for this layer, the Boenninghausen CLAMS schema is often used. This schema categorises the symptom totality according to the concomitants, location, aetiology, modalities and sensations, and these are used to guide the selection of the remedy for this layer. Mercy came to see us at the clinic in 2010. She is HIV+ but she has not been prescribed ARVs as her CD4 count has been consistently over 200. However, she doesn’t feel well. She says: “I have flu.” She describes feeling hot and sweaty, especially at night. Her sleep is disturbed by a dry cough which wakes her. She also has a burning and throbbing headache in her occiput, which is better for drinking warm water. Since having flu, her lower abdomen has felt cold and her eyes have been red and itchy in the mornings. This set of symptoms is an expression of the acute layer. CLAMS was used as a guide to identifying this acute total 93

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ity, with the evident concomitants, location, modalities and sensations. In this case, aetiology was not a significant factor. The repertorisation highlighted Sulphur as the indicated remedy for this layer which was prescribed alongside the other remedies of the Triad which addressed the fundamental and miasmatic layers (see below). The acute / lesional prescription should only address the disease manifestation itself. The mental and emotional symptoms present are only used to individualise the acute prescription if they appeared or were exacerbated right from the beginning of the disease. In other words, they cannot be the patient’s chronic symptoms that preceded the disease. This comes from Aphorism 6 of The Organon, with its emphasis on treating only the deviations from the patient’s former healthy state. The sole exception to this is if the acute / lesional layer chosen is on the mental / emotional level itself. It is interesting to note that this lesional layer is the only layer that allopathic medicine can treat – there are no allopathic options for treating the other layers,74 the fundamental and miasmatic layers described below.

Fundamental layer As described in Part 2 chapter 1, my case-taking approach in Maun has included gaining trust from clients living with HIV and AIDS so that they will feel comfortable opening up about their mental and emotional states. As this happened, they began to tell me the stories of their lives and suffering. This information has provided the foundation of the fundamental layer of the Triad Method. The fundamental layer incorporates a totality of symptoms, which includes these functional symptoms on the mental and emotional level with disturbances of an affective and volitional type, such as anxieties and fears. It further includes symptoms 94

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5  The Triad Method: how to use it The Triad Method is straightforward to use. In this chapter I will describe its practical aspects including the prescription format, indications for prescribing, use of potency, assessing follow-up consultations and what to do in cases of medical suppression.

The Triad Method prescription format When using the Triad Method in Maun, three remedies are given, each once a week for 4 weeks as demonstrated by Tshepo’s case. Tshepo is aged 48, HIV+, on ARVs and is working at a safari camp. She came to our outreach clinic there one Saturday in 2010. She presented with pains in her knees and feet. Her knees are aching and feel better if she is walking, worse if she is sitting. Her feet are burning and she has pain between her shoulder blades, like there is a load on her shoulders, worse for bending forward. She has vulval itching and cysts, which come and go. She also complains of a yellow, offensive discharge from her left ear. She says she is stressed about her salary which is not enough to support her family or realise her plans. She has four children and no partner. She doesn’t like to be living and working away from home but she feels she has no choice, she had to take this job to support her family. She works in the laundry and likes making things clean. She says she doesn’t have many friends, rather she likes to be at home by herself or go to church. Right at the end of the consultation she says: “I don’t like how 109

The Triad Method I look, my tummy is too big.” She has warts on the back of her hands and neck. Tshepo is prescribed Rhus-tox 200c for the acute layer, to cover the back and joint pains. Thuja 30c is prescribed for the fundamental layer to cover the totality of being reserved; delusion she is ugly; too strong responsibility; warts; vaginal cysts; and the ear discharge. Carcinosin 1M is prescribed for the miasmatic layer, also indicated by the cysts and strong responsibility, her like of cleaning, and the suppression by the ARVs. The remedies are given as follows: Acute / Lesional Layer Rhus-tox 200c, 1 tablet every Saturday for 4 weeks Fundamental LayerThuja 30c, 1 tablet every Monday for 4 weeks Miasmatic LayerCarcinosin 1M, 1 tablet every Thursday for 4 weeks84 As with Tshepo, clients then wait a week and come back for a follow up consultation if needed. This approach means that patients get the benefit of all three remedies within a week. My observation is that the pace of cure is faster using this method as there is much less watching and waiting. The Triad Method is practical to administer: at the end of the consultation, a prescription of three remedies is given with the client’s name, the remedy name and potency, and the day of the week for it to be taken written clearly on each remedy bag. There is no need to watch and wait or be in touch with clients between consultations as each layer is addressed with each prescription. This method means that the client is getting a remedy about every two days, and in my experience the Vital Force likes this stimulus interval. 110

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Clients like it too! In Maun I have found that the repetition and alternation of tablets is user-friendly. When the course is finished, the client knows to come back for a follow-up if necessary. This is also true of my clients in the UK who seem to appreciate taking a course of remedies during the 4-6 weeks between consultations. An unintended outcome of prescribing in this way is that clients are less likely to contact me between appointments as they are finishing their course of treatment. Of course, remedies are not given for the sake of my peace and quiet! For the majority of my clients in the UK, as in Maun, the Vital Force seems to welcome repeated and alternating prescriptions, and without this there may be a relapse of complaints.

Indications for prescribing The aim is always to treat each layer with the most similar remedy, as defined by the widest meaningful totality of characteristic symptoms. There is no routine prescribing in the Triad Method. The prescription for each layer is considered and decided upon on an individual basis. For each layer I believe that the totality of characteristic symptoms is the most important aspect of selecting the remedy. The remedy is always individualised according to the most characteristic symptoms. For example in cases of rape, I might prescribe Aconite or Arnica based on the shock and trauma; Staphysagria, Cocculus or some other remedy depending on the response; and Carcinosin or Syphilinum because they are the indicated miasm in the particular case. Nothing is routine and everything is individualised. When in Maun, all volunteers decide on the Triad prescription for each client according to repertorisations, knowledge of materia medica and miasmatic guidelines. There is some leeway for prescriptions based on individual 111

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approaches, but the structure of the triad means there is no random or inconsistent homeopathy. In Maun, because clients don’t expect to see the same homeopath each time they come for a consultation, case notes are designed so that remedy indications are clearly written for reference by the next homeopath when she or he leads the follow-up consultation. The feedback I have had from volunteers is that practising in Maun is liberating on many levels. They are working in a close team, sometimes taking cases together, sharing knowledge and experience with each other and with our trainees and partners. In Maun there may be pressure to prescribe on the spot, but there is no pressure to find just one remedy to cover all aspects of the case. We prescribe three similars which are found to be clear and easily identified based on the characteristic symptoms for all three layers. It is an experience of freed up homeopathy.

Aspects of this freed up style of homeopathy can be incorporated into our practices wherever we are working. We may not be practising in a team, but we can use the Triad Method in cases of complex pathology in particular, when we see three different totalities and a single remedy does not cover all aspects of the case. An example of this is when treating cases of hormonal disease made complicated by medical suppression. “The Triad Method seems to work extremely well for anyone with a complicated chronic disease who is also taking conventional medicine. Besides using this method in Botswana I am finding it very useful for women whose hormonal function has been disturbed through strong suppressive contraception.” Sue Townsend, volunteer homeopath

Maureen’s case from my UK practice is an illustration of Sue’s observation.

“When I first started using the Triad Method in Botswana I felt it broadening my mind and freeing me up as a practitioner. The structure of the method encourages the homeopath to think on three levels while with the patient, which helps with sharpening your focus on what is the matter. I found my case-taking becoming more efficient and I was able to think more quickly, which is important in a busy clinic, where you haven’t got the option of studying a case and sending remedies in the post. Liberated from the necessity of finding the one right remedy, I was able to prescribe in a way that stimulated the patient’s Vital Force widely and coherently. The Triad Method makes the practitioner look closely at remedy relationships, in order to find a healing team for each patient. I’ve continued to use this method when back in England. It’s still a Classical approach, but more suited to the modern patient.”  112

Maureen aged 36 consulted me for endometriosis which she’s had since a teenager. On meeting her I noticed that she was tall with an imposing manner. She told me she had a large ovarian cyst and had been prescribed the contraceptive Pill on and off for the endometriosis to some effect. However, recently she had been experiencing severe period pain and continuous slight bleeding. When she got a period she suffered agonising bearing down pains which were causing her to vomit. The pain was extending from her waist downwards and her legs would become numb. She was also getting back ache which she told me she relieved by applying

Lesley Murphy, volunteer homeopath

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Evaluation of the Maun Clinics

these cases, three layers are identified and prescribed for separately and concurrently as has been described. Part 2 has explored the theoretical underpinnings and applications of the Triad Method including the miasmatic components, its structure and form, and how it is best used. Concepts of cure, palliation and healing have been addressed to make clear that the intent behind the method is one of healing. Cure is not claimed for this method, rather it is an approach that addresses some of the challenges of our modern day practices. For me what is perhaps most significant is that the Triad Method is a tried and tested approach, used by all forty volunteer homeopaths when treating several thousand HIV+ clients in Maun. It has a clear structure and ease of use for homeopaths from different backgrounds, and it can be readily used wherever we are practising, especially for any complex cases with pathology and medical suppression.

Part 3

Evaluation of the Maun Clinics

Part 3 consists of a selected summary of the Lancaster University Evaluation. This expresses the views of individual clients and partner agencies in Maun about the homeopathy they have received over the last ten years. It is their voices that speak of the impact of the homeopathy service, delivered using the Triad Method, on their health and lives.

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Evaluation of the Maun Clinics

Introduction In 2012, I wanted to find out what the Maun community thought of the homeopathy service we had been providing over the previous 10 years. During this time, clients and partner agencies had been giving us regular feedback, but we considered it important that an independent assessment be made. As described in Part 1, a team from Lancaster University, Division of Health Research, including two external researchers was commissioned by the Maun Homeopathy Project (MHP) to conduct an independent qualitative service evaluation of the running and practice of the MHP clinics in Maun, including the outreach services. The evaluation was carried out between June and December 2013, with ethical approval given by Lancaster University Research Ethics Committee (UREC) UK, and the Ministry for Health, Botswana. The evaluation did not attempt to prove efficacy of the homeopathy treatment itself. Rather, the focus was to assess the perceived effectiveness and experience of the service as a community health intervention. It was to give a voice to our clients, partners and team.

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What follows is a condensed summary of the Lancaster University Evaluation. I have summarised some of the material and reproduced key sections to highlight the voices of our clients and partners. A full copy of the Evaluation is available to view on the Maun Homeopathy Project’s website.90 The evaluation design used a qualitative narrative approach which invited peoples’ stories of their experiences of the service. This approach allowed an in-depth exploration of peoples’ reflections and thoughts about their experiences. In total 27 one-to-one interviews were conducted, mostly of clients but also of volunteer and local trainee homeopaths. A focus group was also conducted with 9 representatives of partner agencies including the safari camps. Lancaster University analysed the interviews to identify key themes relating to the participants’ experiences. Although the focus was primarily on client interviews, some rich reflections came from the focus group.

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Evaluation of the Maun Clinics

Summary of findings 1 How did people hear about the Maun clinics? People reported hearing about the MHP clinic in a number of ways. The majority of the clinic participants (9 out of 17) had heard about the clinic by ‘word of mouth’, as a personal recommendation from someone who had direct or indirect experience of the clinic. Sometimes this was from talking with friends, with work colleagues or via their local village community. Of the remainder, 3 out of 17 had heard about it because they attended the Lutheran Church, where the Mowana Clinic has been based for a number of years. Only 2 out of 17 of the clinic participants were directly referred via local counselling Non-Governmental Organisations (NGOs) and 2 out of 17 had heard of the clinic via other healthcare providers as being a useful adjunct to managing their health. One participant had heard via a local support group.

There were several aspects to this welcoming attitude that people talked about, including a feeling that staff were attentive, they listened with care and were supportive. The person was given time to explain and discuss the details of their mental and physical state, the effect on their personal and working lives, and of the other healthcare services available to them: “… when you come to the clinic, you’ll be given love, warmth and welcome and they take their time.” “They welcome people … at Mowana Clinic they listen, they give you time to consult so that they can assist you… a good welcome, and then time for consultation.” “Here in our Clinic she will explain to them that they take their time for consultation. They won’t even cut you off, they will let you talk and talk and talk until you tell them that that’s all, unlike the government hospitals. When you get there they don’t

2 The first appointment: welcome and care

have time for you to explain or to tell them how you are feeling.”

Over half the participants recounted stories of ‘welcome’ and this emphasised their experience of care and support that emerged from the interviews with clinic participants. As this man observed:

However, the time taken for consultations was felt by one participant to be rather long, as they explained via the interpreter:

“There is love at Mowana Clinic and they welcome people nicely

“They don’t have any problem coming here to the clinic except

at Mowana Clinic.”

that, because of the long consultations, as people we always complain about the time which is being taken in consultation.

Another participant described the consistent help and warmth of the clinic consultation:

But otherwise there is nothing else because you be asked about the past problems or the pains that… ‘How are you feeling today?’ ‘How about those pains that you experienced for the past

“There is a lot of help at Mowana Clinic during consultation, and

treatments?’ or whatever, but otherwise there’s nothing that can

she feels like as if they always bring the same people, of that good

be a complaint to them.”

love and good warmth and welcome.” 144

(via interpreter) 145

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Evaluation of the Maun Clinics

Participants from both the clinic and the focus group observed that the welcoming and non-discriminating approach helps to create equality in the care: “The customer service, the very good customer service, the welcoming, the love and the warmth that she received here, she

“It’s not easy to stand in front of the people and tell them about HIV AIDS, I tell you…”

In the light of such stigma, people felt that a profoundly important experience of the clinic was the non-judgemental attitude of staff:

valued most because they don’t judge people and they don’t even look at the way the people are and their status, they don’t look

“Yeah, they didn’t judge you; they didn’t isolate me; they didn’t

at that, ‘This one is more sick, this one is like this and that and

condemn me, you see what I’m saying, and every time I wanted

that’, they just take people equally.” 

they were there for me.”

(via interpreter)

People discussed other aspects of their first visit to the clinic, in particular commenting on and appreciating the complete confidentiality practised by all the staff and practitioners. Participants reported that before they attended the clinic they had feared whether confidentiality would be maintained, and were very relieved when they found they could completely trust the practitioners and clinic staff. There were two aspects to this anxiety. From the perspective of clinic participants this reflected the cultural attitudes to what was considered confidential. As participants observed, confidentiality in Botswana was more lax than the very strict confidentiality practised in the MHP service, reflecting different cultural mores. People, including those in the focus group from other NGOs and other organisations, also described their experience of using other services, which tended to follow the more lax cultural ‘norm’.

2i Overcoming stigma: non-judgement Participants reported that in their personal and working lives they had often experienced great stigma if they admitted to having a diagnosis of HIV+:

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The fact that the MHP staff and practitioners are experienced as not discriminating in any way is thus considered by the participants as a vital aspect of the service: “She came here expecting that she would get help here and the good part is that when she arrives here she find loving people who welcomed her; the people who don’t judge other people … just visit Mowana Clinic they don’t judge you...” 

(via interpreter)

“She said at Mowana Clinic there is no discrimination.” 

(via interpreter)

“They’re very good in welcoming people; they do respect people; they don‘t discriminate people...” 

(via interpreter)

These are notable observations given the social and cultural background of perceived stigma for the client diagnosed as HIV+. Stigma in relation to a diagnosis of HIV/AIDS is a deep and persistent issue in many communities around the world. This was borne out in the stories of many of this group of clinic participants, who confirmed that the stigma

147

The Triad Method need it, because otherwise everyone works in different ways and yeah I think it’s good to give bit of a structure. … it gives you the base anyway.”

Priorities in the service that participants emphasise, and we have discussed in the report, are to keep the service managed and running in ways that continue to maintain and develop: The quality of warmth, welcome and care reported by clinic and other participants A high standard of clinic practice Collegial working relations with other organisations in the community

Evaluation of the Maun Clinics The service as a whole appears to benefit from, and offers a positive contribution towards, other local NGOs in health and social care. By following these approaches of high quality practice and care towards those attending the clinics, as well as to clinic staff and other local health and social care organisations, we suggest that the MHP can continue to provide an effective, sensitive and compassionate community healthcare intervention.

There are two or three points about the service that emerge as particularly important to maintain from the perspective of people attending the clinics: A respect for all individuals who seek support regardless of condition or lifestyle A clear and strong commitment to non-discrimination and non-judgement Confidentiality at all times From the perspective of staff (clinic and volunteer practitioners) there are some important benefits that are gained from continuing to maintain and develop: Clear induction and instruction Clarity and consistency in working practice including the maintenance, regular review and development of efficient practice audit and outcome measures Strong mentorship and support in the clinic team Continuing resilient championing and leadership of the service 148

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The Triad Method

Four cases

Four cases

Here are four full cases chosen to demonstrate the use of the Triad Method over several consultations. Each is a case of one or more pathologies complicated by various medical treatments and maintaining causes of ill health. I have selected two cases from my own UK practice and two cases from Botswana with the kind permission of Irene Mohiemang and Wasanapi Kapii, two of the Maun Homeopathy Project graduates. All client names and key personal details have been changed to protect confidentiality.

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Case example 1 First consultation Mary, aged 55, first came for a consultation in 2011. She walked into the consulting room with obvious difficulty, using a walking stick. Her presenting complaint was severe pain from osteoarthritis which had developed gradually over the previous 5 years. She described the pain as aching in all her main joints and particularly bad in her knees, ankles and feet. The anti-inflammatory painkillers she was taking weren’t making much difference. She told me that the pain is better during damp weather and when she lies down at night, but then she gets restless legs which prevent her from getting to sleep. She is also experiencing weakness in her legs. She enjoys knitting but recently she has started to get cramps and numbness in her fingers. She said: “I can’t go on with the pain any longer, it’s destroying my life. I’ve had a traumatic 5 years due to the death of one of my sons in a car accident, and a couple of close friends died too. I became depressed and was prescribed antidepressants. Everything seemed black and I couldn’t see the point of living. I left my job at the same time because I felt I couldn’t do it well enough due to the pain in my joints. It affected my energy levels and concentration. This depressed me as I love working with people. I achieved a lot in my career and had been promoted to management level in the technology company I was working for. Then I had to give it all up. Now I try to get involved with the community as much as possible. It’s important to help others even if I struggle to do so, but I still often get depressed.” Other health issues include an under-active thyroid for which she’s taking Thyroxine, and high blood pressure for which she is also on medication. Sometimes she gets 180

Four cases palpitations and a feeling of heaviness in the chest area. Her appetite is good but she has a strong aversion to meat. She craves oranges and spicy foods. She is married and has elderly parents who need her support. Even though she is in constant pain, she visits them several times a week and is responsible for sorting out any problems that crop up with their carers. Both parents have severe osteoarthritis too. There is also a history of cancer in her family.

Analysis This is a case of organic disease, in particular the advanced nature of her osteoarthritis, which is causing constant pain, distress and suffering. I chose the Triad Method to cover the three separate layers in the case and to give as much healing support as possible alongside the conventional medicine she is taking.

Prescription Acute / Lesional Layer Zinc 30c, 1 tablet weekly for 4 weeks. Using the CLAMS schema, Zinc is indicated by the ailments from grief (aetiology); aching pains (sensation) in her joints < knees, ankles and feet (location); restlessness of the legs at night and cramps and numbness in the fingers (concomitants); and weakness of the legs. There are no strong modalities. Rhus-tox is also indicated and is perhaps the more obvious choice of remedy. However, I chose Zinc because of its appearance in the repertorisation, the strong restlessness of the legs, and because it felt right intuitively. Fundamental LayerAurum1M, 1 tablet weekly for 4 weeks. Aurum is indicated by the grief and black depression 181

The Triad Method with despair; the strong sense of responsibility for others; ambition and the importance of work; the hypertension, palpitations and oppressive sensation in her chest; and the affinity with the joints. Miasmatic LayerMedorrhinum 200c, 1 tablet weekly for 4 weeks. The sycotic miasm is uppermost due to the rheumatic affinity with the Strange, Rare or Peculiar symptom that her joint pains are better in damp weather, and her craving for oranges, both keynotes of Medorrhinum.

First follow up two months later Mary walked into the consulting room without her stick, sat down and said: “I feel very different. I felt some nausea at first and since then I’ve had loose stools, especially first thing in the morning, but the pain in my joints has got better. The cramps in my fingers have gone and generally I have more ease of movement. I’m also a lot brighter in myself and have more energy. A few weeks ago I got a bad cold and now I can’t get rid of the cough, but it’s not bothering me too much. My legs are still restless in the evenings and at night, but not as bad and I’m sleeping better. I’m coping better with my parents, but they’re very demanding of my time and I can get low when I think about them. What’s their future going to be like? Will they continue to have enough support to be able to stay living in their own home? I feel responsible for them and worry we won’t be able to support them financially to do this.”

Prescription Acute / Lesional layer Zinc 30c, 1 tablet weekly for 4 weeks. This is a repeat of the first prescription because the 182

Four cases uppermost acute / lesional layer is still her joints. Despite the improvement I considered that this is the aspect of her health that still needs most support. The early morning diarrhoea and cough are not distressing enough to warrant a change of focus in prescribing for this layer. Fundamental LayerAurum 1M, 1 tablet weekly for 4 weeks. This is repeated as there has been a good response and there is no change in the symptoms of this layer. She is a lot brighter in herself but can still feel low, especially about her parents and her strong sense of responsibility persists. Miasmatic LayerTuberculinum 200c, 1 tablet weekly for 4 weeks. The tubercular miasm is now uppermost. This is indicated by the bothersome cough and the early morning diarrhoea.

Follow up two months later “I’ve been fine but a couple of weeks ago I fell downstairs and injured my back. I fell because I slipped on the carpet, it was stupid of me. My joint pains have gradually got worse since the fall and I’m now very achy again, especially when I start to walk. However, I’m still not as bad as when I first saw you. Since the fall I have back pain which is really bad when I stand up from sitting, and the cramps in my hands have got worse since the fall too. I put up with the pain. I’ve been on holiday and there were a lot of steps but I didn’t complain or say anything to my husband. I coped, although it was painful to get up and down the steps. The doctor started me on some new painkillers; they’re helping a bit but they give me stomach ache. The restless legs are a lot better and I’m still feeling bright in myself.

CONTINUES...

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Notes

Notes 1. A Mcneice, M Mcneice & T Mcneice, The Lion Children, Orion Press, 2002. 2. In Botswana English is the official language and most people speak it well, but some people with little education have a rudimentary understanding of it. 3. Lesego’s leg symptoms were probably due to peripheral neuropathy, a condition common in HIV and AIDS. Frequent diarrhoea, mouth sores, emaciation and weakness are also common symptoms of HIV and AIDS. Ref: Kumar & Clark’s Clinical Medicine, 8th ed, Elsevier, 2012. 4. Batswana is a term that means more than one person from Botswana. Motswana means one person from Botswana. 5. UNAIDS Fact Sheet 2004, Ref: www.unaids.org/publications 6. It seemed significant to me that Stramonium was a common plant in Maun, a town where the community of people living with HIV and AIDS was feeling forsaken and alone in the desert. 7. In Botswana the common greeting, Dumela Mma, means hello when addressing a woman. The greeting Dumela Rra is used when addressing a man. 8. Remedies prescribed for Pabalelo included Silica and Stramonium. 9. P Molyneux, Maun Homeopathy Project Service Evaluation, 2004. 10. Julia Wilson, volunteer homeopath. 11. Tribal chiefs have traditionally been highly respected in Botswana and have had power to make many decisions affecting their communities. However, they have also been regarded as an equal to their people and the main institution crucial in guaranteeing this has been the Kgotla because it gives people the opportunity to advise or criticise the chief. In essence Kgotlas have allowed for an open dialogue between citizens and their government. Ref: Beaulier, S. A, “Explaining Botswana’s Success: The Critical Role of Post-Colonial Policy”, Working Paper 41, George Mason University, 2004. 12. ARV (Anti-RetroViral) medication is sometimes known as ART (Anti-Retroviral Therapy), but commonly referred to as ARV medication or ARVs in Maun, so those will be the terms used in this book. 13. HAART (Highly Active Anti-Retroviral Therapy) Programme was introduced in Botswana in 2002 as a public-private partnership between the Government of Botswana, the Bill & Melinda Gates Foundation and The Merck Foundation. Ref: www.achap.org/overview

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1. CD4 count is a common HIV test performed by a simple blood test. CD4 cells are a type of lymphocyte (white blood cell), an important part of the immune system. The lower the count, the greater damage HIV has done. The normal range is 500-1,600 cells/μL. Anyone who has less than 200 CD4 cells/μL, is considered to have AIDS. Ref: www.aidsinfonet.org/fact_sheets/view/124 In Maun an individual was prescribed ARV medication if the CD4 count fell below 200 cells/μL. In accordance with the 2010 recommendations of the World Health Organisation, Botswana expanded eligibility criteria to all adults with CD4 counts ≤ 350 cells/μL in 2012. Ref: www.hiv.gov.bw/ content/2012-botswana-national-hiv-aids-treatment-guidelines 2. Boipuso was prescribed China, Pulsatilla and Carcinosin. 3. The term ‘epidemic’ is commonly used to refer to a disease that reaches unexpectedly high levels, affecting a large number of people in a relatively short time. Ref: Barnett and Whiteside, AIDS in the 21st Century: disease and globalisation, Palgrave MacMillan, 2002. In a definition such as this, no reference is made to whether the disease is acute or chronic. In homeopathy an epidemic is considered to be “an acute disease which spreads rapidly from place to place affecting large numbers of persons.” Ref: Yasgur’s Homeopathic Dictionary, 4th ed, Van Hoy Publishers, 2007. This distinction is significant and will be discussed in Part 2. 4. Descartes described the separation of mind and body as distinct aspects of a human being. Mind and body belonged to two parallel but fundamentally different realms, each of which could be studied without reference to the other. The body was governed by mechanical laws, but the mind – or soul – was free and immortal. ‘Cartesian Duality’, as it is termed, became a dominant way of interpreting the world in the West. Ref: Descartes, R, Discourse on Method, 4th ed, Hackett Classics, 2011. 5. Botho is one of Botswana’s five national principles (the others being Democracy, Development, Self Reliance and Unity). Botswana’s Vision 2016 states: Botho defines a process for earning respect by first giving it, and to gain empowerment by empowering others. It encourages people to applaud rather than resent those who succeed. It disapproves of anti-social, disgraceful, inhuman and criminal behaviour, and encourages social justice for all. Ref: www.vision2016.co.bw 6. Gaie, J B R & Mmolai, S K, The Concept of Botho and HIV/AIDS in Botswana, Zapf Chancery Presss, 2007. 7. Tarnas describes a ‘desacralisation of the world’ which involves humanity’s separation from an original state of oneness with nature and an encompassing spiritual dimension of being. Ref: Tarnas, R, Cosmos and Psyche, Penguin, 2007.

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The Triad Method

Summary

Summary LAYER

Characteristics

Remedy Selection

Acute/Lesional

Acute or lesional symptom picture

Can use CLAMS to select remedy 1 tablet weekly in chronic cases e.g. Mondays Only prescribe on mental/ emotional symptoms if their 1 tablet every 3 days in cases onset coincided with the acute/ with intense symptoms e.g. lesional symptom picture day 1, 4, 7 & 10

Can be physical acute, emotional acute, or aspect of physical pathology (lesion) Is usually presenting complaint, most stuck or intense symptom and/or what’s bothering the client the most Fundamental

Broadest totality Covers mental/emotional symptoms and health susceptibilities other than the acute/lesional layer

Prescription format

1 tablet daily in acute situations e.g. mornings Select remedy to cover the broadest totality according to repertorisation and/or materia medica knowledge

Similar to Kent’s constitutional approach

1 tablet weekly in chronic cases e.g. Wednesdays 1 tablet every 3 days in cases with intense symptoms e.g. day 2, 5, 8 & 11 1 tablet daily in acute situations e.g. afternoons

Miasmatic

Uppermost miasmatic manifestation Miasm may be active, exposed and/or dormant

Select nosode to match uppermost miasm

1 tablet weekly in chronic cases e.g. Fridays

Nosode may appear in your repertorisation

1 tablet every 3 days in cases with intense symptoms e.g. day 3, 6, 9 & 12

Miasm may appear as themes in the case and/or in the family history Notes

Three layers can be readily identified in complex cases of organic disease Sometimes three layers can be identified in functional or mental/emotional cases

Select each remedy according to its presenting unique and distinct totality There may be some overlap of layers eg fundamental layer remedy may include some symptoms of acute layer Remedies chosen are often complementary but don’t necessarily need to be

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1 tablet daily in acute situations e.g. evenings Always prescribe for 3 layers Prescribe 4 tablets in total for each layer whichever frequency is chosen Choose frequency according to the intensity of the presenting symptoms Always alternate each remedy for each layer

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th

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www.avert.org/aids-botswana.htm www.homeopathyplanet.com

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