‘Completely failing women’: Why the Zika epidemic is really a women’s rights crisis

‘Completely failing women’: Why the Zika epidemic is really a women’s rights crisis, de Alia Dharssi.
Publicado originalmente por National Post, em 20 de maio de 2016.

Doctor Melania Amorim works at the heart of the Zika epidemic, delivering babies in Campina Grande in northeastern Brazil. Of the 59 babies affected by Zika that have been born at the public hospital where she is an obstetrician, one was stillborn and eight died within 48 hours. Most of those that survived are extremely disabled with deformed arms, atrophied brains or other abnormalities.

“I chose to be an obstetrician because I wanted to be involved with life. Suddenly, you are involved with malformations, where the result is death,” said Amorim, looking sadly into the distance as she spoke on the sidelines of Women Deliver, the world’s largest women’s rights conference, in Copenhagen, Denmark, on Thursday. “… But if it’s necessary, I have to be (there). I have to be with the mothers.”

Even as the Zika crisis has been deemed safe enough for the 2016 Rio Olympics and Brazil has been commended for responding to it swiftly, Amorim and other medical experts contend that the Brazilian government, as well as the world, is not paying enough attention to the connection between Zika, women’s rights and family planning. In doing so, it may be missing a root cause of the virus’ spread and its destructive consequences.

“Instead of talking about how to save women and how to protect women and how to advance women’s rights, we’re obsessed with killing mosquitos,” said Suzanne Ehlers, president and chief executive officer of Population Action International, which promotes access to contraception and reproductive health-care for women worldwide, at a Women Deliver panel on the issue.

“We need leadership in acknowledging that girls need information about sexuality and they need access to contraceptive services,” said Venkatraman Chandra-Mouli, who works on adolescent sexual and reproductive health at the World Health Organization, at another Women Deliver event.
Zika has been reported in 60 countries and WHO expects to see up to four million cases in Latin America in 2016. There were between 500,000 and 1.5 million cases in Brazil alone in 2015. The virus, which can cause deformations in newborns if contracted by their mother during pregnancy, has been linked to more than 1,300 confirmed cases of microcephaly, thousands more suspected ones and thousands of cases of other types of brain damage.

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For Amorim, the Brazilian government’s focus on killing the breed of mosquitos that carries the virus, as well as the Brazilian government’s recommendations that pregnant women wear long, dark clothing, use insect repellant and watch their homes, is too narrow to save the majority of babies that develop microcephaly.

That’s because more than three-quarters are born to the poor, according to a survey conducted by the Brazilian government. Many of the pregnant women that Amorim sees live in shanty towns that lack basic sanitation and a regular clean water supply, but have open sewers. These settlements are a breeding ground for mosquitos likely to carry Zika.

At the same time, the women are often too poor to buy repellant or new long-sleeved clothing to protect themselves — if they get the memo saying they should do so. In the midst of Brazil’s national political crises, there’s been no effort to make sure that key messages about Zika get to the poorest, said Debora Diniz, a law professor at the University of Brasilia who has made a documentary on Zika.

Repellant also hasn’t been made available to those who can’t afford it, she notes.

Meanwhile, recommendations from Brazil and other Latin American governments that urge women to avoid becoming pregnant for up to two years fundamentally misunderstand social dynamics, according to some working on women’s issues in the region.

“We’re talking about my ability to decide if, when, where, how to engage in sexual intercourse,” said Lucia Berro Pizzarossa, who researches sexual and reproductive rights in Latin America as a part of her doctoral research at the University of Groningen. She noted there are high rates of sexual violence against women in Latin America, while 23 million of those who are in intimate relationships and want contraception cannot access it. According to the United Nations Population Fund, the situation is so dire that if the demand for contraception were met, the region would see a decline in unsafe abortions by 64 per cent.

There are a lot of funerals, a lot of funerals of little babies
The Zika crisis has been accompanied by calls to liberalize abortion laws in Brazil, where terminating a pregnancy is illegal except in cases of rape, when the mother’s life is at risk or if the child wouldn’t survive. But some politicians are looking to stiffen them and, with the impeachment proceedings of Brazil’s first female president, Dilma Rousseff, things are looking down for women. Brazil’s new leader, Michel Temer, picked an all-male cabinet and eliminated the ministry of women, racial equality and human rights.

Diniz is working on taking a case to Brazil’s supreme court to demand access to abortion for women whose pregnancies are tainted by Zika and raise other human rights concerns related to the virus. The demands she is making, along with others at a bioethics institute she co-founded, include that the government meet regulations that say health care is guaranteed to all Brazilians and should be within 50 kilometres of their home. Diniz met one pregnant woman who was affected by Zika and had to drive five hours for medical attention.

“Zika is a virus, but the underlying situation that is completely failing women is this public health and human rights crisis,” Pizzarossa said.

Poor health-care systems, as well as the failure to include family planning in public health care, disproportionately affects women and girls, said Ehlers, adding that things stand to worsen the more Zika spreads to developing countries with poor health care.

“The world community should have learned the lessons at the time of Ebola — that when you have weak primary health-care systems, what doesn’t have to be a crisis quickly turns into a crisis,” she said.

As political leaders grapple with Zika, prioritizing mosquito eradication over the rights of women and access to healthcare, babies will continue to die in the arms of Amorim and the mothers she works with.