Health

The Zika Virus’ Unlikely Silver Lining

CREDIT: AP Photo/Felipe Dana

Solange Ferreira bathes her son Jose Wesley in a bucket at their house in Poco Fundo, Pernambuco state, Brazil on Dec. 23, 2015. Ferreira says her son enjoys being in the water, she places him in the bucket several times a day to calm him.

Could a mosquito-borne illness that threatens to spread across the Americas actually push countries to change their restrictive approaches to women’s health care?

International reproductive rights experts hope so. After health officials in several countries affected by the Zika virus suggested women avoid pregnancy in order to avoid having children with the severe birth defects the illness is believed to cause, human rights groups are countering with their own asks. They see the focus the virus has brought to unwanted and unhealthy pregnancies as a way to galvanize around reforming some of the harshest abortion laws in the world.

“Women need to know that their governments aren’t prepared to stop the spread of the virus, but that’s not a complete solution,” Amanda Klasing of Human Rights Watch’s women division told ThinkProgess.

In a region where more than half of all pregnancies in the region are unplanned, she said, governments need to make contraception — and even abortion — accessible to women in order to prevent the most harmful impact of the untreatable virus.

Four of the six countries in the world that ban abortion in all instances have either already been affected by the Zika virus, or are in its current path. Officials with the World Health Organization have warned that the virus is expected to expand its reach across the entire Western hemisphere, with four million cases projected to arise before the close of 2016.

While a few harrowing cases of women denied their reproductive rights — including an 11-year old girl who became pregnant after she was raped by her stepfather in Paraguay last year — have led to widespread demonstrations in some countries, the Zika virus poses a particularly widespread risk to maternal and fetal health.

That’s why some rights’ activists see an opportunity in the alarming illness that made its way from Western Africa to South America in 2014.

For Latin America’s vibrant pro-choice movement, there are some sights for hope, especially since socially conservative Brazil made reforms to its otherwise stringent abortion laws by the health risks posed by anecephaly, a rare condition that fatally damages skull and brain formation in fetuses. Although nearly 80 percent of Brazilians polled in 2014 were against legalizing abortion, they may make an exception in cases of the Zika virus, which can cause fetuses to develop microcephaly, or an underdeveloped brain.

With a threat as widespread as the one posed by the Zika virus, Klasing and other human and reproductive rights’ advocates are hoping for a widespread shift in policy in a region where abortion is no-go issue for many politicians.

“I think it is a unique moment to talk about women’s reproductive health in the context of this very scary public health crises,” Klasing said. “It really demonstrates the heartbreaking impact of restrictions on abortion services for women and girls when you have this potential of birth defects.”

The virus might help shift the discussion from a matter to one of social values mired in religious beliefs into a matter of public health — and the risks Zika poses to the future of Latin America.

“I do think that it’s going to create more of a space for a conversation around reproductive rights, maybe with a little bit less of the stigma and shame that has been associated with those discussions in the past,” Klasing added.

Reproductive health and rights groups have already started to initiate some of those discussions. ThinkProgress reached out to three experts from around Latin America to talk about how an alarming illness could spark change in the region’s entrenched policies against abortion.

Colombia: “Cracks in the system”

In Colombia, a 12-year-old indigenous girl who is suspected to have been infected with the Zika virus became pregnant after she was raped. The case has been widely highlighted by the Colombian media, not least because the girl lives in a remote part of Antioquia, which has been fraught with paramilitary violence for years.

Kerly Ariza, 17-years-old and 20-weeks-pregnant, holds her belly after she was diagnosed with clinical symptoms of the Zika virus at a hospital near her home in Ibague, Colombia on Jan. 26, 2016.

Kerly Ariza, 17-years-old and 20-weeks-pregnant, holds her belly after she was diagnosed with clinical symptoms of the Zika virus at a hospital near her home in Ibague, Colombia on Jan. 26, 2016.

CREDIT: AP Photo/Fernando Vergara

All told, at least 500 pregnant women have reported Zika infections in Colombia — the second-highest number of cases after Brazil. And although Colombia the only one of the four countries that have so far called for women to delay pregnancy that does allow abortion in cases of fetal anomaly, few women there have access to abortions performed by medical professionals.

A staggering 99 percent of all abortions in Colombia are clandestine since so many doctors refuse to perform abortions. That’s despite a 2006 ruling that made abortions legal if pregnancy posed a risk to the woman’s health, would result in a severe birth defects, or if it’s the result of rape or incest.

Mónica Roa of the advocacy organization Women’s Link Worldwide said that’s because access to information and reproductive health care is severely limited across the country.

“There’s a lack of info from side of local governments,” she told ThinkProgress in a phone interview. “Colombia’s minister of health has a lot of clarity around it, he’s been outspoken publicly about sexual health, but it isn’t being talked about in local, smaller, sometimes poorer governments.”

That means that the Zika virus might be a particular menace to those who are already the most marginalized, poor, rural, and perhaps even indigenous women like the 12-year-old girl from Antioquia.

“I heard someone today call Zika ‘the mosquito of the poor,’” Roa said, referring to how the virus might be a particular menace to the country’s lowest income people. “[The virus] is exposing cracks in the system in terms of unfulfilled reproductive rights policy and inequalities regarding gender.”

There is still virulent opposition to abortion rights from many across the country. After the country’s Attorney General announced last year that he would allow abortion on demand during the first 12 weeks of pregnancy, people in the country took the streets in protest.

If nothing is done to increase access to contraception and abortion, Roa warned, “We’ll be turning a public health concern into something much, much bigger.”

Peru: “Avoiding a public discussion”

Sixty percent of Peru is a jungle. It’s a humid, dense jungle brimming with patches of standing water — and an ideal environment for mosquito breeding. Although no cases of the Zika virus have been reported so far in Peru, it seems only a matter of time before the disease hops the border from one of the four neighboring countries where it’s been found.

Nearly a quarter of the country’s population lives in the rural jungle — and many have yet to be informed fast-spreading virus. Reproductive rights activist in the country say that since the Zika virus will mostly affect poor women living in these rural areas, the conservative government is ignoring the needs of women who are or may become pregnant.

“Many of the women we work with live in areas where there are serious problems with accessing clean water, where dengue fever is already endemic, and where there are are few health services,” said Susana Chavez, director of the Center for the Promotion of Sexual and Reproductive Rights in Peru. “These women already have very limited resources and will have to face the consequences of this virus alone.”

Abortion is legal in Peru, but only when a pregnancy could risk the mother’s life — and even so, many doctors refuse to do the procedure. While contraceptives are available in the country, they are difficult to find once you leave urban areas. Coupled with the social stigma around using them — rooted in the Catholic beliefs of the country — and a history of pharmacies selling fake birth control, the chances of women using effective contraceptives are low.

Getting the government to back abortion rights has been an uphill battle. In 2014, Peruvian women’s rights groups joined forces to present Congress with a bill — signed by 60,000 supporters — that would that would allow rape victims and women with fetal deformities, like microcephaly, to get an abortion. After much debate, Peru’s Congress voted against it, sticking to the belief that a human life begins at conception — a familiar argument seen in U.S. courts — and the bill was ultimately shelved. Some members of Congress have said they’d like to bring the discussion back in 2016. But with a presidential election on the horizon, reproductive rights advocates are dubious that their controversial bill will get far.

“Unfortunately, ultra-conservative politicians inside Congress hold serious power and are avoiding any kind of public discussion with people who have favorable opinions about abortion,” Chavez said. “It was Congress that originally closed this debate, which will make it is very difficult to reopen.”

El Salvador: “Telling of our reality”

El Salvador was one of the first countries to recommend women hold off from getting pregnant while the Zika virus spreads. However, El Salvador has one of the most restrictive and penalizing abortion bans in the world, and contraception is only available in cities, if that. Women are essentially being told to stop having sex.

“It’s generated a lot of confusion. Women don’t know what to do about it. It’s creating a lot of fear,” said Paula Avila Guillen, an advocacy advisor for the Center for Reproductive Rights focusing specifically on Latin America. “The government is putting all responsibility on the women.”

A woman covers her mouth while city workers fumigate insecticide to help combat the Aedes Aegypti mosquitoes that transmit the Zika virus, at the San Judas Community in San Salvador, El Salvador, Tuesday, Jan. 26, 2016.

A woman covers her mouth while city workers fumigate insecticide to help combat the Aedes Aegypti mosquitoes that transmit the Zika virus, at the San Judas Community in San Salvador, El Salvador, Tuesday, Jan. 26, 2016.

CREDIT: AP Photo/Salvador Melendez

Government authorities have yet to tell men to change any of their sexual practices, especially when it comes to their role in a pregnancy.

“It’s very telling of our reality,” Avila-Guillen said. “Unfortunately in Latin America, everything related to women’s sexuality is only a woman’s responsibility. There is no responsibility of the man. No responsibility of the government.”

Only when a woman breaks the law to avoid giving birth to a baby with serious deformities will the government step in. Women can spend decades in prison if they’re convicted of attempting to end their pregnancies, even when a pregnancy put a woman’s life at risk or ended naturally through an unintentional miscarriage. Many civil rights and reproductive health organizations across the globe — including the Human Rights Watch — have called for the country to abolish the “outdated” and “absurd” law.

Avila Guillen, who has spent nearly 20 years fighting for abortion decriminalization in El Salvador, said that if the government doesn’t change its harsh laws, the Zika virus will only increase the number of incarcerated women and illegal, unsafe abortions. Her hope is that the international attention on the virus will shine a light on El Salvador’s hypocritical laws.

“Crises like these can be an opportunity to create change and get organized,” she said.