Venezuelans Are Almost Defenseless in the Face of Zika

The mosquito-borne virus appears to be spreading rapidly through Venezuela where chronic shortages of medication, repellent, and contraception, are making people particularly vulnerable to its potential risks.
February 19, 2016, 8:35pm
Photo by Alicia Hernández

Nancy Pino should never have died of Guillain-Barré syndrome.

When the 66-year-old Venezuelan first sought medical help after her legs began to feel numb in early January there was still plenty of time to save her. Even as the symptoms began spreading to her hands, and then the rest of her body, doctors said she would almost certainly have recovered with the right medication.

The problem was that neither the clinic, nor the subsequent hospitals she went to, had the 45 daily doses she was told she needed. Her family went on a desperate search, even traveling to the city of Barquisimeto 225 miles from their home in Caracas, but they could only find enough for 15 doses.

Related: Basic Medications and Breast Implants in Short Supply in Deepening Venezuela Crisis

And with every passing day Pino's condition worsened.

"She could not say a word during her last days," said Carlos González, a childhood friend who was close to the family throughout. "But we thought she understood us because she would make gestures with her eyes."

Eventually Pino fell into a coma. She died on January 26, fifteen days after she first went to see a doctor.

Guillain-Barré syndrome, often referred to as GBS, is an autoimmune disorder that attacks the nerves of its victims and causes creeping paralysis. Most patients eventually make a full recovery if they receive adequate treatment, usually injections of immunoglobulin that neutralize the unbalanced actions of the patient's own immune system.

Suddenly, this very rare illness which tends to be triggered by a viral or bacterial infection, has become of major concern throughout Latin America.

This is because doctors are noticing cases they suspect are linked to the Zika virus epidemic currently spreading through the continent via the Aedes aegypti mosquito, which also carries Dengue Fever and Chikungunya.

Those infected with Zika are often asymptomatic or suffer from only mild fever and discomfort.

Related: Venezuelans at Risk as Country's Ailing Healthcare System Deteriorates

The reason why the virus has been declared a global health threat by the World Health Organization, is the existence of evidence linking it to a hike in the number of babies born with abnormally small heads in Brazil. There is now also rising concern about a potential link with GBS that, unlike microcephaly, is already being noted in other countries beyond the epidemic's epicenter in Brazil.

Venezuelans face a particularly worrying situation in the face of Zika, that appears to be spreading through the country very quickly.

This is partly because of the limited amount of information provided to the public by the authorities about the virus, as well as the widespread distrust with which official data is usually seen. The country's economic crisis also ensures there are hardly any tests available to help determine the scale of the epidemic and the intensity of the risks. Chronic shortages of medication, insect repellent, and contraception, are also turning worry into terror for many.

So far the data provided by Venezuelan officials on the Zika epidemic has been scant, sometimes contradictory, and always vague.

President Nicolás Maduro said earlier this month that there were 5,221 cases of possible Zika infections in Venezuela, of which 319 were confirmed. He mentioned 68 "complications" but gave no details about what these were.

Independent experts believe the number of infections is much higher. The Venezuelan Society of Public Health, a well-regarded medical NGO, estimates that the number of infections may be approaching half a million.

So far the local authorities have reported eight deaths associated with Guillain-Barré this year, though local media has reported up to 22. In 2012, the autoimmune disorder reportedly killed 32 people in Venezuela.

Related: Latin America Responds to the Zika Virus With Soldiers, Repellent, and Pregnancy Warnings

Venezuelan doctors, meanwhile, say they are noticing the increase in their clinics.

"Before, we would only have one or two reported cases [of GBS] for each 100,000 patients," Zolia Moros, from the Venezuelan Institute for Scientific Research, told VICE News. "Now we are getting one out of every 1,000 patients infected with Zika."

At the same time, although Venezuela has not reported any increase in microcephalic births, Doctor Ana Teresa Serrao, a gynecologist obstetrician in the Caracas Metropolitan Clinic, believes she is seeing an increase of prenatal problems that might be related to the virus.

Sarrao said that she had noticed a sudden spike in women miscarrying during the third month of their pregnancies soon after saying they had symptoms of Zika.

"It might be for the same reason why some more advanced pregnancies develop microcephaly," she said. "The body defends itself with antibodies and the fetus suffers the consequences."

The doctor said her clinic did not have the resources to buy the tests required to see if her hunch is correct.

If doctors like Serrao are confused and concerned, pregnant women in Caracas are even more so.

One day Kristy Sánchez's body began to itch, her eyes turned red, and her hands and feet became swollen. She had just entered her 26th week of pregnancy.

When the symptoms worsened Sánchez went to the doctor who treated her with anti-allergic medication that did not help. Now, she said, she has "no doubt" that she had Zika and is very frightened that her baby has been affected.

"My gynecologist advised me to stay calm, because there's nothing we can do if something happened to the fetus," the expectant mother said. "I knew nothing about Zika and its symptoms. I thought it was Dengue, so I let it pass."

Officials in several Latin American countries have advised women to postpone getting pregnant until the Zika epidemic is brought under control.

Even the Pope Francis answered a question this week on Zika during his flight back to the Vatican after visiting Mexico that suggested the Catholic church does not have a problem with contraception in this case.

Related: The Zika Virus Is Spreading Through the Americas Very Quickly

"To avoid pregnancy is not an absolute evil. In some cases, like this one… it is clear," he told reporters on his plane. "I would call on doctors to do everything they can to find a vaccine that can protect people against the mosquitos that spread this illness."

Venezuelan government has not said anything about these issues, or even launched any kind of information campaign on the potential risks and what to do about them. And, some note, birth control and family planning is not an easy thing to achieve in Venezuela anyway because of the chronic shortages that limit access to contraceptive pills and condoms.

But probably the most obvious way that Venezuela's economic crisis is impacting the way people are dealing with Zika in their everyday lives is the near impossibility of finding chemical repellent.

Sánchez said she is injecting herself with vitamin B12 and using an old repellent her mother happened to have kept from the days "when you could still buy it."

Yirley, who is five months pregnant, is relying on a natural option made from citronella.

"It's effective and it's better than nothing," she said. "It's been a while since I last bought traditional repellent."

Juan and Griselda said they burn egg cartons to keep the insects away.

"We also do aromatic smoke, but they still bite us," the couple said in the doorstep of their zinc and brick home in the poor barrio of Brisas de Petare in eastern Caracas. The neighborhood does not have running water, so residents depend on tanker trucks that visit the area once every week to fill buckets and barrels that then turn into potential breeding grounds for the mosquitos.

The government has sent out fumigation teams in some areas, such as in Brisas de Petare, but what is so terrifying for many in Venezuela and throughout the region is how much infection, and its potential consequences, still comes down to luck.

Rafael Rodríguez, who lives in the coastal state of Vargas, knows that his 25-year-old daughter Marian is still alive because of luck.

He said the first sign that something was wrong was when she stopped peeing for 24 hours. After that her hands began going numb.

The family took her to seven different clinics and hospitals, but none had infectologists that could treat her until she was finally admitted at a clinic in eastern Caracas where the doctors told him she had Guillain-Barré syndrome following on from an asymptomatic case of Zika.

"I will thank the doctor for the rest of my life, because she acted well and quickly," Rodríguez said. "But had this happened after, she would not have been able to receive treatment, because the clinic only had enough to treat 15 patients when my daughter was admitted."

Marian is still in a wheelchair, but is expected to make a full recovery.

Related: Here's What You Should Know About the Zika Virus

Follow Alicia Hernandez on Twitter @por_puesto

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