The Silent Unknown
Zika has been called the next Ebola. It’s a threatening disease that’s quickly approaching the United States and for which we currently have no vaccine. But unlike Ebola, Zika is often hidden, secretly wreaking havoc. Most of those infected with Zika will experience only mild symptoms, eighty per cent will show no symptoms at all. But in some cases Zika has been linked to Guillain-Barré syndrome (a paralysis) and, among pregnant women, it can lead to microcephaly in infants, a severe birth defect causing underdeveloped brains.
There is currently a Zika outbreak around Latin America, the Caribbean and in some places in the United States (the Center for Disease Control recently announced 234 pregnant American women have Zika). But as the outbreak began experts were most concerned with the place least equipped to deal with it: Haiti.
Zika is a disease that affects poor women most aversely. And Haiti, the poorest nation in the Americas, is right in the middle of the zone affected by Zika.
And like Zika itself, the disease has been a worryingly silent affair. While doctors predicted that Haiti would be among the worst hit, not a single baby has been born with microcephaly despite the fact that pregnant women have contracted Zika (although a Haitian woman gave birth to a baby with microcephaly in Florida last week). Only a dozen cases of Guillain-Barré syndrome have been recorded. In fact, the number of recorded cases of Zika has fallen from about 300 a week at the peak in February to about 30 now.
However, this should not be taken as an indication that Haiti is in the clear. Experts warn that infections are on the rise in the Caribbean in general and that the lack of reported information on Zika may reflect the lack of health care facilities available in remote areas rather than a lack of Zika. This lack of information and the general silence around Zika thus far is disquieting and experts are worried for the coming months as more pregnancies will come to term.
So what is it like for a woman in Haiti who is trying to avoid the Zika virus?
If you are a woman living in a rural area, you likely work outside meaning you’re at higher risk of infection because the mosquito that carries Zika only bites during the day. Even if you remain well covered in the heat and manage to find insect repellent, which can be difficult to find or too expensive, you might contract Zika through your husband or partner. Infected men can sexually transmit Zika. And because, for the majority of people, no symptoms will be visible, it’s possible your partner might not even know that he is carrying the virus at the time of transmission.
If you are a pregnant woman who contracts the disease, there is a chance that your child will be born with microcephaly which causes underdevelopment of infants’ brains. But with few health care centers nearby, you will likely not be able to locate a doctor who could diagnose the infant before he or she is born. And, even if you do manage to locate a doctor who can diagnose you, because abortion is illegal, your only options are a dangerous illegal abortion or carrying the pregnancy to term.
LIVING IN A DISPLACEMENT CAMP
If you live in one of the 36 displacement camps around Haiti, you are like the 62,000 other people who have been forced from permanent homes since the earthquake in 2010. While you probably have electricity, unlike your rural counterparts (50% vs. 15%), the standard of living is quite low. With so much sitting water nearby, mosquitos have the perfect place to breed.
In the displacement camp, as in most houses nation-wide, screens on windows are uncommon, meaning you can do little to prevent mosquitos from entering your home. In fact, only 19% of households have at least one insecticide-treated mosquito net so it is unlikely that you can protect yourself this way.
While the World Health Organization recommends delaying pregnancy for the time being, it is likely (due to the fact that only 35% of Haitians are using contraception, which drops to 14.8% among the poorest women) that you are not currently using contraception. Because the health system is weak, it can be hard to gain access to the kind of modern contraception you need to delay pregnancy.
Slightly wealthier than your counterparts, you might be working in an office and be able to avoid contracting Zika. You tend to have greater access to contraception so you can delay pregnancy until after the Zika outbreak dies down.
While international and national health services are struggling to find a solution to the Zika outbreak, there is little women can do to protect themselves. Many are vulnerable due to the weak health systems and deep-seated infrastructure issues. In the long term, while protections against mosquitos and the search for a vaccine are essential, these root causes will need to be addressed.