In presenting the publication of a dossier on homeopathy in this issue of Interface: Comunicação, Saúde, Educação, I would firstly like to put on the record that this is something new: it is the first time that a Brazilian journal that does not specialize in homeopathy has published a set of articles on this topic. Secondly, I would like to highlight the opportuneness of publishing it at this rather delicate moment when, on the one hand, a great expansion of the institutional presence of this other type of care is taking place, on the other hand, it is perceived at the same time that an enormous lack of knowledge of homeopathy remains among healthcare professionals.
Homeopathy was recognized as a medical specialty by the Federal Council of Medicine in 1980, and as a pharmaceutical specialty by the Federal Council of Pharmacy in 1992. Today, it is a care option for users of the Brazilian Public Health System (SUS) in 158 municipalities. Since 2006, backing for implementing homeopathy has come from the Ministry of Health's public policies. However, as shown by the articles that make up this dossier, it has very limited presence in courses within the field of healthcare. Moreover, the level of disinformation among healthcare professionals themselves is high. This lack of knowledge diminishes the possibilities for partnerships among these professionals and reduces the potential for using this resource.
By reading the articles that follow, interested readers are given an opportunity to come into contact with the specific topics covered, and also, through the bibliographic references, with some of the research on homeopathy that has been produced over the last few years. Given the profile of this journal and the topics that these articles deal with, a stimulating prospect of provoking reflection, dialogue and debate with other professionals within the complex field of health sciences, education and professional training in healthcare is created.
The articles "Teaching of homeopathy and practices within SUS" and "Homeopathic medical practice and integrated care" present reflections on some topics that appear very frequently in health science papers, such as full coverage and humanization of care. These are discussed based on experiences with homeopathic attendance within the scope of SUS.
The first of these articles uses interviews to evaluate the perceptions of homeopathy among healthcare professionals and users at a SUS unit in a higher education institute. It also evaluates the changes in practices and conduct among medical students after they started a specialization course on homeopathy, and the perceptions among teachers, preceptors and the academic board of the Jundiaí School of Medicine regarding homeopathy and the course. Among its results, the description of the transformations that the training process fostered among the students deserves highlighting, since this reaffirms observations from other studies. The students began to value the need to retrieve the whole picture of the patient, placing the individual at the center of attention and strengthening the relationship with the patient.
The second article analyzes the homeopathic medical practice developed at a healthcare unit in Rio Grande do Sul, by means of consulting documents, making direct observations and holding interviews with professionals, users and the manager of the unit. The reference categories were the welcome, ties and care given, which were taken as dimensions of the completeness of the approach. The results reveal the difficulties encountered in integrative practices and non-hegemonic medicine, for them to become organized within the public system. The article concludes by suggesting that "although homeopathy has a medical rationale that is coherent and strengthens the principles of SUS, it needs to be recognized, given value and made available as a therapeutic option for the whole population, thereby contributing towards promoting an integral approach in healthcare".
A third article, "Teaching of homeopathy at undergraduate level within pharmacy", analyzes the process of defining the curriculum and regulating the teaching of homeopathy in the light of the different forces acting on the field of pharmacy: the legislation of the Federal Council of Pharmacy and ANVISA (National Agency for Sanitary Surveillance); the new curricular guidelines; the oscillations in the work market; the political actions of students and professionals; and the demands from professional associations such as the Brazilian Association of Homeopathic Pharmacists. The article presents data that indicate that homeopathic pharmaceutical attendance within SUS has not kept up with the expansion in homeopathic medical care, since only 30% of the homeopathy services within the SUS network provide homeopathic medications. The article also reflects on the need for homeopathy to be included within the training of generalist pharmacists, in order to meet the model of the present curricular guidelines, which will tend to diminish the demand for postgraduate courses on homeopathy.
In conclusion, it can be stated that these articles will certainly serve to bring the field of homeopathy much closer, since readers will be taken through its most important areas: the training of homeopathic specialists (physicians and pharmacists); the characterization of homeopathic practices according to homeopathists themselves, other healthcare professionals and users; the interface between homeopathy and other sectors of the field of healthcare, like SUS, higher education institutes and regulatory bodies; and professional certification.
Enjoy reading them!
Sandra Abrahão Chaim Salles
Instituto de Cultura e Escola Homeopática;
departamento de Medicina Preventiva,
Faculdade de Medicina, Universidade de São Paulo.