Women bear the burden of Zika

“IN BRAZIL, women are being blamed for the Zika epidemic,” Dr. Melinda Amorim, a Brazilian doctor on the frontlines of the battle against the disease, pointed out. The rapid spread of Zika through developing nations in Latin America and its imminent arrival in the developed world have set off alarm bells, provoking curiosity and real concern.

Mosquito-borne, by the same mosquito that is responsible for the spread of dengue and chikungunya, Zika has been around for at least 100 years in Africa and Asia, said an expert with the World Health Organization. But it has drawn the world’s attention mainly because this once-harmless disease has somehow mutated into an ailment that threatens the most helpless of human beings—unborn babies.

At one of three sessions on Zika at the Women Deliver Conference held last week in Copenhagen, WHO authorities said that Zika was a relatively benign disease that resulted in nothing more serious than a brief rash. But it emerged as an epidemic in Polynesia in 2013, and last year spread rapidly through Brazil and the rest of South America. This was where the first cases of Zika-caused microcephaly, with infants born with abnormally small skulls as a result of damaged brain structures, emerged.

“We are almost sure the virus somehow mutated when it reached the Americas,” said a WHO expert. And once there, it “spread incredibly rapidly” through 44 countries and it is seen to be arriving soon in the Eastern seaboard of the United States. Brazil, though, remains at the epicenter of this growing epidemic.

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EPIDEMIOLOGISTS and researchers in other fields still don’t understand fully how a virus that once produced mild nonlife-threatening effects mutated into an organism that “targets the neural tissue (of a fetus) at whatever stage of pregnancy.”

Dr. Nathalie Broutet of WHO has gone so far as to describe Zika in Brazil and elsewhere as a “public health emergency.”

Some 3.4 million cases of Zika have been reported in Latin America, said Amorim, with 1.5 million reported in Brazil. While over 7,000 pregnant women reported symptoms of Zika, a total of 1,326 cases of microcephaly and Guillain-Barré syndrome, a nerve and muscle weakening ailment, have been found.

Amorim describes Zika—as well as dengue—as a “disease of poverty.” It emerges, she said, in environments of poor housing, inadequate water supply—that force families to store water in containers that foster mosquito breeding—and faulty sanitation.

Which is why, she says, more than addressing the immediate health needs of Zika-affected babies and their mothers and families, what may be needed to fully address the problem of Zika is “a review of the development model,” and the resulting structure of widespread poverty.

And to top it off, she pointed out, the Zika crisis emerged at a time of “a serious political crisis” that has seen the ouster of Brazil’s president on corruption charges amid the fervid preparations for Brazil’s hosting of the Summer Olympics.

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WOMEN, and especially pregnant mothers, are on the receiving end of much of the criticism and complaints in the face of the Zika epidemic, says Amorim.

“They are living in panic and terror,” the doctor described the women she has treated. When called back to the clinic for an ultrasound scan and other tests, the mothers, she says, visibly quake at the prospect of a diagnosis of Zika.

And yet, even as public opinion and even government hold it against the women for getting pregnant and putting their babies at risk, in Brazil there is still “a lack of an effective contraception policy.” Says Amorim: “It is a surreal situation in Brazil.” While abortion remains illegal in the country, cutting off this alternative for poverty-stricken pregnant women who receive a diagnosis of Zika, neither is there an adequate supply of contraceptives or services for them.

Much of the burden of coping with the threat of Zika is directed at women, Amorim pointed out. Among the measures that health authorities have counseled women to adopt are to wear long-sleeved dark clothing to avoid mosquito bites (“at a time when Brazil is undergoing an extraordinarily warm summer”), stay at home as much as possible, and avoid getting pregnant.

Compounding the difficulties of the mothers, adds Amorim, is the inadequate infrastructure to cope with the needs of babies born with microcephaly. “Mothers have a hard time accessing the rehabilitation services their affected children need, not even the free transportation to clinics that the state had promised.”

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AT the end of the second Zika session, there was a film showing featuring five mothers whose babies were born with microcephaly. One mother, a schoolteacher who lost her job in the wake of government cost-cutting, declared that she was determined to fight “for every right that my daughter deserves.” And even as she was born with physical and mental disabilities, the little girl, she said, “is the center and joy of our lives.”

Most moving of all was the story of one of the first mothers whose baby was diagnosed with Zika in Brazil. Told that her son might live only briefly after his birth, she told the filmmakers that she had agreed to let the doctors “get whatever they need from him to study this sickness so that other babies will be safe.”

Even as she mourns her infant son, she keeps him alive with regular visits to a closet where she has hung the clothes she bought for him, caressing each item of clothing as if they were the baby she had lost to Zika.