Our Grantees on the Zika Virus

Last week, the Zika virus made news headlines around the world.

This week, the virus is already hitting too close to home because two of our grantees, Midwives for Haiti and Asociación Corazón del Agua in Guatemala, are located in hot zones where Zika is spreading.

The Zika virus is caused by mosquito bites from a specific breed of mosquitoes found in parts of Latin America and the Caribbean. So far, only one case (a baby born in Hawaii) has been tied to the U.S. Only 1 in 5 people infected with Zika become sick but those who do experience fever, chills, rash, conjunctivitis (red eyes) and joint pain that lasts for several days to a week. While Zika is primarily transmitted through mosquito bites, it can also be transmitted from mother to baby during pregnancy or birth. Public health officials don’t know yet how often or when during pregnancy Zika is transmitted.

The virus has grown as a public health concern since last spring when an outbreak in Brazil was linked with skyrocketing rates of babies born with microcephaly (an incurable, rare condition where a baby’s head is abnormally small) and brain damage. On average, about 150 cases of microcephaly are reported in Brazil each year. In 2015, more than 3500 cases were reported between March and December among mothers who’d contracted Zika.

While further studies are needed to conclude that Zika definitely caused these birth defects, the Centers for Disease Control thinks the virus is so potentially dangerous, they’ve issued a travel advisory for pregnant women to avoid these 14 countries and territories: Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela, and the Commonwealth of Puerto Rico. The CDC answers questions about Zika and it’s impact on pregnancy on their website.

Heidi Flagg, MD, an Ob-Gyn in New York City says, “This virus appears to be a cause for concern. I don’t recall a travel warning for pregnant patients similar to this. We’re advising our pregnant patients to avoid travel to the countries on the CDC’s list. If travel is unavoidable, we recommend taking preventative measures such as protective clothing, netting and insect repellant. If you’ve traveled recently and have symptoms, inform your healthcare provider. They can offer testing through a CDC lab. Pregnant patients who test positive will be offered more frequent ultrasounds to track their baby’s development. Anyone trying to conceive should also consider avoiding travel. Brain development begins early in pregnancy. Exposure could mean delaying conception for weeks to months.”

What’s it like for healthcare providers in areas where Zika is a threat? We asked Nadene Brunk, CNM, Director and Founder of Midwives for Haiti and Stephen Eads, MD, Midwives for Haiti’s Medical Director about their concerns about Zika.

Brunk says, “We’ve been worried about this for months. We’ve already put out a bulletin telling our volunteers they shouldn’t come to Haiti if they’re pregnant or thinking about becoming pregnant. We’re providing our staff with as much education as possible because clearly, prevention is key. The big question is, ‘How can we protect our patients?” We’re asking lots of questions right now like, ‘Is anyone doing a bed net program to prevent pregnant women from being bitten? Should we pass out DEET to pregnant patients and staff? Should we measure and track all babies’ head circumferences? There’s so much we still need to know.”

Dr Eads isn’t sure recommending bed nets and DEET repellent is enough to prevent Zika’s spread in Haiti. He says, “Bed nets have been handed out by various groups before to reduce mosquito-related viruses, but when you look at people’s homes, most aren’t using nets. They either wore out or were traded for food or something they need more. And nets only prevent bites at night. You still need insect repellant, which most can’t purchase.”

Brunk says that as limited as treatment options are in developed countries, they’re even more limited in Haiti. “You can test for Zika in the U.S., but we can’t here in Haiti yet and if a pregnant woman contracts the disease, there’s nothing we can do to help her baby if he has birth defects.”

Eads adds, “Zika’s impact on a baby doesn’t go away. I’m worried we’re going to see an epidemic of microcephaly and lots of kids who are nonfunctional and have no one to care for them. Prevention and education is all we have right now. We have to get people to realize we’re dealing with a virus that can affect their unborn babies’ brains. Many Haitian people think if they get sick, it’s either bad luck or there’s a curse on them. That belief is really widespread. It’s similar to what Paul Farmer described on the evolution of beliefs about HIV. Everybody thought you got HIV because somebody put a curse on you. Eventually, people came to understand that HIV was a virus, but they still believed you got the virus because somebody put a curse on you. In the next few weeks, we’ll learn more about what we, the government and public health officials can do to prevent transmission. For now, all we can do is provide education.”

Keep an eye on our blog to learn more about how you can help Midwives for Haiti face Zika and how you can help support mothers all over the world.

Topics: Maternal Health 101s