Combating Zika virus in Haiti

Combating Zika virus in Haiti

A midwife distributes insecticide to pregnant women who come in for prenatal appointments at the hospital in Boucan-Carr©.

This story appears in the Summer 2016 issue of Brigham and Women’s magazine.

To explain the dangers of Zika, a virus raging through South and Central America and the Caribbean, Joia Mukherjee, MD, MPH, puts it plainly: “It’s the first mosquito-borne infection known to cause birth defects.”

As associate professor of medicine in the Division of Global Health Equity at Brigham and Women’s Hospital (BWH) and chief medical officer for Partners In Health (PIH), Mukherjee and her colleagues are on the front lines of Zika prevention and care in Haiti, the poorest country in the Western Hemisphere and an epicenter for BWH and PIH’s collaborative global health efforts for nearly 30 years.

Although believed to be largely asymptomatic in adults, some Zika infections trigger Guillain-Barré syndrome, a severe and potentially life threatening autoimmune disorder that attacks the nervous system and requires careful medical attention. In addition, if pregnant women are infected, the Zika virus attacks the nervous system of the fetus, causing underdevelopment of the brain and neurologic damage.

“We see 32,000 expectant moms a year in Haiti,” Mukherjee says. “The potential impact is frightening. As awful as Ebola is, it is treatable. Malaria is preventable and treatable. Zika is a totally different beast because the infection is most often silent but the effects on the developing fetus may be profound.”

Zika-carrying mosquitoes typically bite during the day and can survive in much less standing water than malaria-carrying mosquitoes, which are more active at night.

“People who work the land or sell in open-air market stalls are sitting ducks—yet they have to be outside for many hours because their families depend on these wages,” Mukherjee says.

Adding to the threat, scientists recently discovered the Zika virus can be sexually transmitted. With Haiti’s inadequate medical infrastructure, the virus has the potential to become an epidemic if unaddressed.

Working with the Haitian Ministry of Health, Zanmi Lasante, the Haitian community, and other partners, BWH and PIH developed a six-point plan to combat Zika in Haiti to:

1.      Educate the community about the virus and its risks

2.      Care for mothers and babies before, during, and after pregnancy

3.      Provide prevention supplies such as insecticides, bed nets, and other bite prevention methods

4.      Care for those with complications from Zika

5.      Protect health workers at all clinics from contracting Zika

6.      Participate in research to learn how to beat the virus

“Zika tests are largely unavailable in Haiti,” says Louise Ivers, MD, MPH, DTM&H, associate physician in the Division of Global Health Equity at BWH and senior health and policy advisor at PIH. “Haiti sorely needs the fruits of modern medicine. All moms and babies deserve the highest levels of care, not just for Zika but for every aspect of health.”