A group of Brazilian doctors specializing in traditional Chinese medicine (TCM) have come to Beijing to learn the finer points of acupuncture, cultivate their understanding of Chinese herbology and improve their medical massage techniques.

Projecto Vamos A China (PVC) bringing 60 Brazilian doctors to China to study TCM is an 11-day crash course borne out of a rising demand for TCM in Latin America's largest and most populous country.

"People in Brazil are less and less satisfied with the results of Western medicine and are seeking alternatives," said Dr Paulo Lacava, a psychometrics specialist who enrolled in the program to get better acquainted with the culture that developed TCM.

The World Federation of Chinese Medicine Societies (WFCMS) has enlisted a who's-who of TCM cosmetology gurus from China's top hospitals and universities to teach the Brazilian doctors how to alleviate acne, remove wrinkles and fight flat wart. While the curriculum concentrates on cosmetology, it also tackles more than skin-deep diseases, such as endocrinal disorders, depression and addiction, showcasing the depth of treatments TCM can offer.

"It's an exchange of experience," said Dr Antonia Santana, who uses acupuncture to treat recovering burn victims in Sao Paulo's state hospital. "Sometimes what they teach me, I already know. Other times, what they teach me provides the answers to my failures."

This is the second such group of Brazilian doctors to come to China, and in response to the ever-increasing popularity of TCM services in Brazil, Projecto Vamos A China now bring two to three groups annually.

The proliferation of TCM in Brazil offers an affordable alternative for the country's impoverished population who often cannot afford expensive Western medicine, said PVC's Director Paulo Vieira.

While Chinese medicine has an 80-year history with Brazil, the national government officially only recognized TCM certification in 1986.

"This kind of legislation is part of the government's strategy to provide Brazilians with an alternative to Western medicine," Vieira said.

In this spirit, Brazil's Ministry of Health will recognize the WFCMS certification conferred upon those doctors enrolled in Projecto Vamos A China, pending passing of final exams.

Today, Brazil's mainstream medical community is still testing the waters on TCM and a unanimous verdict is still being awaited.

"TCM is new in Brazil, and many doctors are curious but a little uncertain; they want to confirm its value," Vieira said.

Santana, for one, believes wholeheartedly in the value of Chinese medicine. The TCM practitioner says the program has granted him a deeper understanding of the nuances inherent to acupuncture. Most importantly, he has observed how the manipulation of the speed, depth and rotation of the needle produce particular results in patients' recovery.

Vieira says that in addition to providing TCM instruction, the program also aims to resolve a longstanding debate within Brazil's TCM community about the need for orthodoxy in traditional Chinese medical practice. The nub of contention exists in the advocacy TCM techniques against the backdrop of Western medicine.

Diagnosis is central to the debate, Vieira said, highlighting both sides of the argument. Brazil's orthodox Chinese medicine traditionalists will diagnose patients by analyzing their pulses and examining their faces, tongues and hands. Less orthodox TCM practitioners will instead draw blood samples, a uniquely Western diagnosis method, before using TCM to treat their patients according to these diagnoses, Vieira explained.

While Santana practices "100 percent Chinese medicine," he still believes TCM works best in tandem with Western medicine.

"When you are a doctor of Western medicine, you already have some tools in your toolbox, but Chinese medicine offers you new tools. When you combine these tools, you can develop a better prognosis for treatment," he said.

Calling TCM "alternative therapy" doesn't sit well with Santana, who favors calling it "alternatives in therapy." The burn patients he treats have already received Western medical care up to the point that they enter the recovery ward where he uses acupuncture to ensure a steady course of recovery. He said that compared to the amount of Western medical treatment his patients undergo before he cares for them, his TCM-based role in their care seems small comparable to "only a fingernail on the whole body." 

However, Santana believes it's a question of quality versus quantity. He smiled as he recalls the words of a Brazilian plastic surgeon to who he had explained his "fingernail" metaphor: "Without the fingernail, there is no protection for the finger."

While Santana doesn't apply Western medical techniques in his practice, Western medicine still creates boundaries the acupuncturist doesn't cross.

"The Chinese don't use acupuncture for burn victims; they use herbs. However, in Brazil, I can't use herbs, because in the context of Western medicine, generally speaking, it's still difficult to prove the scientific value of these herbs," he says.

Proving Chinese herbology's usefulness in the eyes of Western medicine will take time, he says, but as the number of Brazilian TCM practitioners increases, the nation's medical community is edging closer to a verdict.

(China Daily September 18, 2006)