Public Statement on Zika Virus in Puerto Rico

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Carole McGranahan recently posted (in Savage Minds: Notes and Queries in Anthropology) a call to action was written by Adriana Garriga-López, Ph.D. (Kalamazoo College) and Shir Lerman, M.A., M.P.H., PhD Candidate (University of Connecticut) et al; the authors are members of the Society for Medical Anthropology’s Zika Interest Group. See excerpts below:

We write out of our shared concern over the current Zika virus epidemic in Puerto Rico and the Caribbean in the hopes of making useful interventions. Because of Zika’s adverse effect on fetal development and potential link to Guillain-Barré syndrome, the virus poses serious concerns for public health. [. . .]

Since the virus can be sexually transmitted, reproductive health services offering multiple forms of contraception (i.e., including, but not limited to condoms), prenatal diagnostics, pediatric care, and abortion services are necessary. Despite the Pope Francis’ more liberal views, locally the Catholic Church has condemned the Centers for Disease Control and Prevention (CDC)’s recommendation that people use condoms during sexual intercourse to prevent Zika transmission. This has clear implications for Catholics who may be put at risk of infection by not using proper treatment. Access to and informed use of birth control, as well as reproductive and natal care should be strengthened for Puerto Ricans. People’s right to such access should be supported, and coercive public policy, as well as stigmatizing discourses avoided.

[. . .] We wish to highlight the absolute necessity of updating the water distribution and treatment system in Puerto Rico, especially under the prospect of the imposition of a control board like the one imposed on Flint, Michigan. In that context, we insist on the protection of the local aquifers and watersheds as central to the control of Zika virus and its epidemiology on the island. We call for a response to Zika in Puerto Rico that accounts for the structural inequalities in health care that exist on the island and moves towards remediating the viral exposure now present.

By the same token, we wish to express concern over the possibility of the presence of high levels of toxic chemicals, including insecticides and experimental agents released by private companies such as Monsanto and Dupont, among others present on the island. We express concern over whatever products are being routinely used in the ecosystem, with which Zika or Aedes aegypti may be interacting and we call for accountability to the residents of Puerto Rico. Further, we call for the full disclosure of any transgenic organisms employed in control efforts.

News reports mention that the CDC is studying the possibility that some Aedes agyptaemosquitos have demonstrated tolerance for insecticides, and we call for public disclosure of any information about the usefulness of various insecticidal agents in use, under consideration for use, or having been shown to effectively prevent mosquito bites, especially for safe use by pregnant women (“Puerto Rico Braces for Wave of Mosquito-Borne Zika Virus,” by Danica Coto, AP). Excessive reliance on spraying insecticides as a mosquito control measure may do more harm than good by encouraging viral resistance.

Furthermore, we as a group of experts on the region call on the US federal government and the CDC to do more than just conduct experiments and issue recommendations with regards to Zika virus in Puerto Rico. The United States has responsibilities to Puerto Rico beyond using the island as a live laboratory. Zika in Puerto Rico is more than just a threat to US public health on the continent. Puerto Rican lives matter. Public health authorities must actively assist the population, and support Zika prevention efforts in Puerto Rico. Immediate actions include: provide and install window screens in homes and businesses, assist in water systems management, and distribute vector surveillance and control strategies (http://www.cdc.gov/chikungunya/resources/vector-control.html). In particular, public health authorities can assist with disposing of any waste that might collect water in order to minimize mosquito populations. The CDC has a Dengue station headquarters in San Juan, PR and should use that station as a base to conduct Zika prevention and mosquito mitigation campaigns. [. . .] Finally, care and support must be provided to pregnant women and their families who have or will experience Zika infection. [. . .]

It is imperative that the Medicaid cap be removed for the island and resources mobilized immediately to fight this public health emergency, particularly in terms of prenatal and reproductive health care. Prevention of transmission, expanded medical care, reproductive rights, and long term sustainability of the water infrastructure should be the priorities, beyond the tourist and hotel areas. We call for assistance to local initiatives and support for already existing community structures, and affirm Puerto Rico’s right to defend the health of its population.

[Many thanks to Maritza Stanchich for sharing this news item with us.]

For full article with links and resources, see http://savageminds.org/2016/03/15/public-statement-on-zika-virus-in-puerto-rico

Photo from http://www.huffingtonpost.ca/2016/01/15/mosquito-borne-virus-now-in-mexico-other-sun-spots-may-pose-pregnancy-risk-study_n_8987916.html

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