In Brazil, there is not yet legislation recognizing or regulating the practice of chiropractic. Most interestingly, the Sao Paulo Physical Therapy Society filed litigation for a court order preventing the UAM from opening a chiropractic program on the grounds that chiropractic fell within the scope of practice of physical therapy in Brazil. UAM, with supporting evidence from the ABQ and the WFC, was successful in having the case dismissed. This provides a valuable precedent in Brazil - and for other countries should physical therapists ever take similar action - to affirm that chiropractic is a separate and distinct profession.
Brazil is a shining example of the potential for rapid growth of the chiropractic profession in many countries if the profession works together. In the late 1980s, there were only two chiropractors in Brazil. A number of chiropractors from around the world formed a strong and united association and worked closely with the WFC to get Palmer scholarships for Brazilian students, who, after graduating, returned to Brazil. They also worked with Brazilian universities and North American chiropractic schools to form partnerships for chiropractic education in Brazil.
In 1988, the first program commenced at Feevale Central University, Novo Hamburgo, in association with Palmer College. The initial two-year program for health science graduates will graduate 22 chiropractors next month; at the same time, a five-year program with 60 first-year students commences. Now there is a second program at UAM with 33 students, giving Brazil 93 first-year chiropractic students. Other universities have already approached the ABQ for further programs.
In the U.S., there has traditionally been some competition and conflict between chiropractic colleges. It is noteworthy that there is no such conflict between the Feevale and UAM chiropractic schools. Leaders from Feevale assisted UAM in the development of its program. Brazil, geographically, is a huge country (pop. 165 million), and it is the view of Feevale, UAM and the ABQ that the development of several chiropractic campuses in various parts of the country will only assist in the development and legal recognition of the profession. Contact: Eduardo Bracher,DC,MD, ABQ Secretary, Sao Paulo: tel/fax: 55-11-813-9686; e-mail:
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Finland - This year the World Congress on Medical Law, held every two years, is in Helsinki, August 6-10, 2000. The WFC, which coordinated the presentation of papers on chiropractic in 1996 (South Africa) and 1998 (Hungary) has had three papers accepted for oral presentation at the Helsinki meeting:
- "The Regulation of Chiropractic Practice in Europe" - by David Chapman-Smith, WFC Secretary General.
- "Special Issues for Chiropractic in a Country Where Practice is Regulated by Law" (Finland) - by Raine Makela, DC, president, Suomen Kiropraktikkoliittot (the Finnish chiropractic association).
- "Special Issues for Chiropractic in a Country Where Practice is not Regulated by Law" (France) - by Benoit Rouy, DC, of the Association Francaise de Chiropratique.
The Congress will provide good opportunities for meetings with Finnish leaders in government and health care, and influential figures from WHO and the international medical-legal community. As a separate matter, two speakers from Finland have accepted invitations to present lectures and workshops at the WFC's 6th Biennial Congress in Paris, May 2001 - Jouko Salminen,MD, will give a lecture and workshop on "Low-back Pain: Prevalence and Risk Factors in Children and Adolescents"; Fraser Bliss,DC, will provide workshops and a seminar on "The Soft-Tissue Subluxation: Trigger Points and Muscle Release Tecnhiques."
Iran - In a development that has great importance for Iran and the Middle East, the Iranian government has formally validated and recognized the academic qualifications of the 10 members of the Iranian Doctors of Chiropractic Association (IDCA), all educated at accredited chiropractic college abroad. This is the first step in the legislation of chirpractic in Iran. The next step is formal recornition of the ISCA. Presently there are thought to be as many as a thousand Iranian chiropractors in North America, a significant number of whom want to return to Iran as the social and legal climate for the practice of chiropractic improves.
Lebanon - The fight is on in Lebanon for recognition of chiropractic as a primary care profession. Following four years of extensive negotiations by the Lebanese Chiropractors' Association (LCA), in late January, the Lebanese cabinet (or Ministerial Parliament) approved legislation. This was skillfully led by Dr. Khodr Hijazi, LCA president, and Dr. Issam Ayache, both of Beirut. They represented seven chiropractors in Lebanon, and up to another 30 who wish to return when the law is settled. It was then discovered, however, that this included a last-minute amendment requiring medical referral. This is, of course, unacceptable to the LCA. The LCA has asked the WFC for support, which has been given on the basis that any requirement of medical referral is against the public interest and that there should either be primary care - which is how Lebanon's chiropractors practice at present - or no law.
Saudi Arabia - Dr. Mario Shameli, president of the Chiropractic Association of Saudi Arabia, reports that there are currently six chiropractors in the country, including the first Saudi national to gain a chiropractic license, Abdul Rahman Al-Hashem,DC. Dr. Shameli, who formerly provided chiropractic services at the King Faisal Hospital, now practices in a clinic in a health center owned by the Saudi Royal Family, the clinic perviously run by Dr. Garrett Moscos, who has returned to the US. Contact: Dr. Mario Shameli: Telephone: (966) 462-6614/464-4370. Fax: (966)462-8983.
Sweden - How many patients seeking chiropractic care for musculoskeletal pain receive secondary health benefits? Congratulations are due to the members of the Legitimerade Kiropraktorers Riksorganisation (LKR - Swedish Chiropractic Association) who, under the leadership of Charlotte Leboeuf-Yde,DC,PhD, from Denmark, has provided the first solid data answering this question. The national survey of 1.504 patients of 87 members of the LKR found:
- About 1 in 4 (23%) of the adult patients consulting chiropractors for musculoskeletal conditions experienced positive nonmusculoskeletal benefits after chiropractic adjustment/manipulation.
- Positive reactions were most commonly grouped under the respiratory system (26%), the digestive system (25%), the heart circulation (14%) and eyes/vision (14%)
- There was an interesting link or correlation between the number of patients reporting a positive nonmusculoskeletal benefit, and the number of spinal areas treated. Of those patients treated in one spinal area, 15% had a nonmusculoskeletal benefit in two spinal areas, 22%; in three spinal areas, 32%; and in four spinal areas, 35%.
Reference:
Leboeuf-Yde C, Hennius R et al. Chiropractic in Sweden: A short Description of Patients and Treatment, J Manipulative Physiol Ther 1995; 18:379-397.
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