Sweet Home Floripa, Florianópolis, Brazil

Dreaming about living in Brazil usually includes fantasies about tropical rain forests, surfing on perfect waves, or dancing the samba with thousands of happy revelers.  In other words, Brazil means good health!  However, ensuring that you remain healthy in Brazil requires planning and forethought.  A good health care plan is fundamental for all expatriates.  Sweet Home Floripa would like to spotlight the international health-care services and insurance provided by the UK firm, Aviva. 

Aviva offers a comprehensive international health care plan called International Solutions.  This service is
for those who will be living overseas for more than six months out of the year.  (They also have a separate
traveler’s insurance.)  International Solutions helps pay for treatments, therapies, hospital accommodation and meals, nursing care, drugs and dressings.  However, the plan is flexible, so you can also choose to include extra benefits on your policy.

Aviva’s service allows you to receive private medical treatment in private, Brazilian hospitals.  It includes specialist fees, diagnostic, tests, hospital charges, and even psychiatric treatment–all at private clinics, hospitals, and out-patient facilities.  While public health care is available in Brazil, long wait times are common in clinics.

Aviva also has a 24-hour telephone service where qualified medical personnel will be on hand to give you advice, travel information and guidance on dealing with symptoms, or directions to find further care. Aviva also provides a 24-hour multilingual telephone service that allows you to consult with staff in your own language.  This is especially important during that early period in Brazil if you haven’t yet fully mastered Portuguese.

Best of all, if you sign up for coverage in Brazil, your policy will cover you for the rest of the world, too, with the exceptions of the US and the Caribbean.  They have a separate policy that covers those countries.

Find out more about Aviva’s global health insurance by downloading the International Solutions brochure for International Solutions.

Finally, notice that in addition to their overseas health services, Aviva also provides home insurance that protects your home while you dancing the samba in Rio or sailing down the Amazon.

I rubbed my aching neck.  I had wrenched it while doing Jiu-Jitsu and all the muscles connected to my upper spine had clenched up, hard as rocks.   I could barely move my head. If I looked down, pain flashed through my whole back.

But would acupuncture really be able to help?  It all seemed like mumbo jumbo to me. I shook my head, then gripped my neck in pain.  Ow!  Another episode flashed through my mind:  I remembered sitting in a run-down little clinic in Ecuador while a technician took blood from my vein.  As I sat alone in the rusting metal chair I saw my arm turn dark then black.  The tech had missed the vein and I was bleeding into the muscle.  He didn’t come back for a long time and it took me months to heal up again.

By the time I reached the entrance to the Centro de Ser toward the Lagoa side of Canto de Lagoa my heart was pounding.  I imagined someone sticking needles into my eyes.  Piercing my spine.  Rupturing my brain pan and poking a hole into my brain.  But I was not going to be deterred by fear.  I needed help and I was willing to risk anything to get it. 

A friend had recommended the services of William Bening, M.Sci  L.Ac., an American living in Florianópolis, who is trained in Trigger Point Therapy, acupressure, and also (gulp!) acupuncture.  The word “puncture. . . puncture” kept repeating in my head as I got out of the car. 

William has a shock of surfer- blonde hair and the tanned skin of a guy who likes the waves.  A native of San Diego, William was trained at  Traditional Chinese Medicine University in his home town.  After four years of study William was licensed to administer acupuncture treatment.  He specializes in the treatment of pain–both emotional and physical–especially sports and work injuries.  He is is also trained in nutrition, massage, and Chinese herbology–though he does not pactice herbology in Brazil as of yet.  William explained that Chinese medicine is at least three thousand years old and capable of treatments beyond the reach of modern, Western medicine.   William explained that “Trigger Point Therapy” is like a “golden key” that unlocks quick solutions to all kinds of pain problems.

As I listened to him and grasped his broad understanding of the human body and its intricate workings, I felt more and more relaxed. Until, that is, it was time to hop up on the table. Suddenly my heart began racing and the words “You put the lime in the coconut . . . “ started running in my brain again. 

As soon as I was on the table William grabbed my foot and starting twisting and turning.  I was relieved.  This was the sort of thing I was used to.  In Jiu-Jitsu there’s always someone trying to twist your joint out of place.  William threw the foot down and grabbed the other and began twisting. 

Pop! said the joint. 

William explained that through constant use our joints gradually slip out of place.  His job is to pop them back into place—realign them.  He did the same for my hands.  Then he asked me to turn onto my stomach.  He stepped away and produced a large, metal rod, rounded at the end and with various extensions sticking out.  At the end of the extensions were iron balls.  William explained that this instrument was called a thera-cane.

William began to push on various places on my back and ask me if the pain radiated outward toward other parts of the body.  If I said yes, then he would apply direct pressure to the spot and hold it there for ten to twenty seconds.  William, it turns out, is a pretty strong guy.  But the more he pushed on these areas with his device, the more I felt them relax.

William moved quickly from spot to spot, working on me. 

“Feel this?” he asked, poking the muscle at the base of my neck. “This muscle is full of little bumps.  That means that it’s contracted and doesn’t know how to relax. That’s what I’m going to do now.  Just remind it to unclench.”  He pushed down hard on the muscle, when he released the pressure blood flowed in and I could feel that everything was returning to normal. 

When he had finished with my back he began to press points along the nape of my neck.  I felt a muscle at the base of my skull pop.  Then pop again. 

“Perfect,” he said.  “That’s exactly what you want.”

When he released his grip I felt the muscle go all loose and soft.  What bliss!  I gave myself over to William’s therapy, understanding that he knew exactly what to do in order to make my twisted neck relex again.   

When he was finished with the pressure points William said, “Okay, now it’s time for the acupuncture.”  I felt a slight twinge of fear, but now I was too relaxed to really be afraid.   

I noticed a slight prick as the first needle went in, but really it was nothing like a hypodermic needle.  William explained that the acupuncture needle is just a tiny fraction of the width of a hypodermic.  I felt the needles going in, but it wasn’t painful at all.   

“Now,” he said after he’d lodged the last needle in the top of my skull, “just lie there and relax.  Many people fall asleep.  Others go into a dream state.  This acupuncture pattern is a simple tonic.  When you come out of it you will feel calm and energized.  I’ll be right back.”

My mind went lax and colors and images drifted before me.  I thought of the lake, still as mirror beneath drifting clouds.  Of the long legs of the blue crane I’d seen wading there that morning.

“Okay, that was just a brief session,” William said, startling me out of my reverie.  “You were only under for like twenty-five minutes.   Usually it’s more like forty-five.”

“Twenty-five minutes?” I asked.  “It felt more like five.”

William smiled.  I stood up and looked around.  I felt calm and centered.  I turned my head this way and that, up and down.  It was as loose and flexible as I could ever remember.

William Bening, M.Sci  L.Ac, is trained in Trigger Point Therapy, acupressure, and  acupuncture. You can contact him via email at Noland3000@gmail.com  or via mobile at (48) 8818-4348.  He attends clients at Centro do Ser, on Canto da Lagoa about a 100 meters south of  Nave Mae, Rua Laurindo do Januario da Silveira 1408, Florianópolis, SC, Brazil.  Tel. 55(48) 3233-5097. 

Dr. Rolf, a tall man with piercing blue eyes and sandy hair, is a familiar figure around Florianópolis.  Of English and Dutch descent Dr. Rolf speaks English, Spanish, and German as well as Portuguese.  He told me that 20% of his patients are foreign and so he is an obvious choice for those moving to the island or for tourists just visiting for a brief time.  Dr. Rolf trained as a doctor in Porto Alegre and also studied medicine in Germany.

I asked Dr. Rolf about what health issues visitors face in Florianópolis that they don’t usually encounter at home.  “For the most part the environment in Florianópolis is a healthy one,” Dr. Rolf told me, “There is no malaria, no cholera, no rabies, for instance.  Still there are a few tamer ailments that visitors should know about and be able to identify.”

Here are Dr. Rolf’s top five health risks on the island:

Mycosis–or ringworm, as it is commonly known–thrives on the island, especially during the warm, humid months of summer.  Unfortunately, just like all of us, mycosis loves the warm beach.  So before you stretch out on that beautiful white sand, spread out a kanga or a beach towel and help avoid inviting ringworm to make a home in your skin.  While mycosis is not particularly dangerous it is itchy, pesky and ugly to look at.  Remember that mycosis is especially fond of children—or perhaps children are especially fond of playing in the sand and so are particularly vulnerable to ringworm.  So if you see round itchy red splotches on you or your child’s body, treat it immediately to avoid a larger invasion.  You can pick up an anti-fungal medicine like Cetoconazol 2% at the pharmacy.  Be sure to spread it on three times a day to stop this pest in its tracks.

Many visitors think that the mycosis is an allergic reaction and treat it incorrectly.  If you have persistent red splotches on your skin you may want to check with a qualified health professional.

Borrachudos. During the hot, summer months borrachudos, or gnats, come out in the twilight hours to feed on juicy humans.  Known to residents of the hotter regions of the United States as no-see-ems, these pesky insects can leave a patch of nasty bites, especially if you go out walking on the dunes at night.  Even worse, some people are allergic to the bites and the result is a nasty red welt.  The solution?  “Prevention,” said Dr. Rolf, “Using insect repellent is a must to preserve your health on the island.”  (My personal favorite is OFF!) Citronela is another solution and the local pharmacies sell a spray called Citronim by Welleda.  If you find OFF! too strong you may want to try Citronela.  Some local pharmacies sell a citronella based repelant called Citronim by Welleda.  Off! Kids also works for sensitive skin or constitutions.

Bicho-de-pé. A problem familiar to year-round residents of the island, but not to visitors, is bicho-de-pé—or translated literally, foot animal or pest.  Bicho-de-pé appears as a round, black circle that resembles a fish eye, usually on the bottom of the foot.  This circle has alarmed more than a few visitors to the island who, not recognizing the bicho-de-pé, thought it was some sort of malignant growth.  In fact, bicho-de-pé is a female sand flea that burrows into the bottom of your foot in order to nest and have it’s sand flea babies.  The black circle is the pregnant flea.  Treatment is simple—you must dig the flea out of your skin.   Dr. Rolf suggested that a trip to the local posto de saude would solve the problem quickly.

Tetanus. Though bicho-de-pé is not anything to worry about, it does sometimes lead to a much more dangerous condition—tetanus.  Caused by the bacteria Clostridium tetani, tetanus strikes victims with painful muscle spasms, including lock jaw and can, if not treated properly, cause death.  “Tetanus is a serious illness,” Dr. Rolf said. “All visitors to Florianópolis should get a tetanus vaccine before leaving home.”

Hepatitis. “All three types of Hepatitis are present in Florianópolis,” Dr. Rolf said,  “and it is important to protect yourself accordingly.”

Hepatitis A is associated with contaminated water. To avoid Hepatitis A drink bottled water and watch where you swim.

“While the waters on the Atlantic side of Florianópolis are pristine,” said Dr. Rolf, “effluents do flow into the bays on the western side of the island.  Florianópolis is growing quickly and its water sanitation system has not yet caught up to the rapid rise in population.”  Because of this, some of the lakes on the island may be less than ideal for swimming as they can harbor hepatitis A as well as other parasites.  While the waters of Lagoa de Conceicao bordering Avenida Rendeiras and the dunes are safe and clean, swimming in the southern lobe of Lagoa de Conceicao is not a good idea.  Some people have recently begun to avoid swimming Lagoinha Pequena, in Campeche, as well because of health concerns.  If you are unsure whether the water is safe  look for signs posted by the city.  The signs identify the water as “proprio” (appropriate) or “improprio” (inappropriate) for swimming.

Hepatitis B is sexually transmitted. Remember folks—use that camisinha (condom.)  Each year the Brazilian government distributes hundreds of millions of free condoms.  There’s a reason for that!

Hepatitis C is passed through blood. First thought to be sexually transmitted, Hepatitis C is now known to be associated with blood-to-blood contact.  Some 300 million people worldwide carry this disease, many without even knowing they have been infected.  The main cause of infection, scientists now know, is recreational, intravenous drug use, specifically the sharing of dirty needles.  A large percentage of injection drug users in the US are infected.  Unsafe sex practices that cause cuts, scrapes, lesions and therefore allow for blood-to-blood contact have also been implicated.  Symptoms include liver scaring, cirrhosis, and liver scarring.  Hepatitis C can be deadly.

Dengué. Dr. Rolf told me that Dengué fever—or bone-break fever, as it is sometimes known—is NOT endemic to Florianópolis, but people who travel here from more northerly places in Brazil do sometimes bring it to the island with them.  Dengué is transmitted by mosquitos so you should take proper precautions if you are traveling further north than Sao Paulo.  Wear that repellant!  While your first dose of dengué won’t kill you, it will cause you considerable pain for two weeks.  The second time you get the illness, it can be deadly.

In all, however, there are few very serious health risks in Florianópolis and with a little education, a little prevention, and a little common sense you should have a very healthy time here on the island. But should you need medical attention Dr. Rolf will be there to help you.

If you don’t speak ANY Portuguese, but need to contact Dr. Rolf urgently call the clinic and say “Por favor, preciso falar com Dr. Rolf de urgencia.” If that doesn’t work just say “Dr. ROLF, help me!!!!”

Dr. Rolf Hillman can be found at Clinica Prontomed in Lagoa, Rua Orlando Carioni, 64—that’s the street running beside the HSBC automatic teller and across from the gas station at the center of town.  For an appointment, call 55 (48) 3232-1704 or 55 (48) 3232-0470.