The Heart of the Zika outbreak

How Recife, Brazil's hardest-hit city, is coping with the virus

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Brazil, crippled by political turmoil and its most severe recession in 80 years, has also become the epicenter of the Zika outbreak — even as it prepares to host this summer's Olympic Games in Rio de Janeiro.

The hardest-hit city in Brazil is Recife, in the impoverished northern state of Pernambuco. A humid climate, crowded slums and abundant mosquitos have facilitated Zika's spread.

Recife has more than a third of Brazil's Zika-related microcephaly cases, a birth defect that causes babies to be born with undersized heads and often severe neurological damage.

Nation in turmoil

Why the Zika outbreak couldn’t have come at a worse time for Brazil.

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A mother’s journey

Carla Severina de Silva became her family's sole provider soon after her daughter was diagnosed with microcephaly.

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While the Zika threat might be declining in other parts of Brazil, expectant parents in Recife fear the devastating consequences of the virus.

The Zika outbreak has come at a difficult time for Brazil.

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Adriana Scavuzzi,

Gynecologist and women's health coordinator at IMIP Hospital

Voice of Adriana Scavuzzi,

Gynecologist and women's health coordinator at IMIP Hospital

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Brazil is facing its worst recession since the 1930s. At least 1.5 million people have lost their jobs since January.

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President Dilma Rousseff was suspended from office in May and faces an impeachment trial in Brazil’s senate.

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Alexandra Phelan,

Global health and human rights law consultant, researching international and governmental responses to infectious diseases

Voice of Alexandra Phelan,

Global health and human rights law consultant, researching international and governmental responses to infectious diseases

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Workers fumigate the Guabiraba neighborhood of Recife.

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In neighboring Colombia, the number of Zika cases have been carefully counted and a coordinated response implemented.

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But in Brazil, health officials have relied mostly on estimates, making it difficult to properly assess the extent of the outbreak.

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The government has deployed 220,000 soldiers to go home to home to hand out leaflets and spread awareness about how to prevent Zika infections.

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“These are diseases of poverty. … This will take a huge government response. And whether Brazil has been doing that is not particularly clear.”

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The number of new Zika cases in Brazil appears to be dropping. But that may be more indicative of the seasonal change in weather rather than an actual end to the outbreak.

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Southern Brazil is entering a cooler and drier season, but Zika is likely to stay endemic in the region.

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Voice of Carla Severina de Silva

“It was not a planned pregnancy, but it wasn’t an accident because it was meant to be.”

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Carla experienced all the symptoms of Zika during her second month of pregnancy.

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Carla Severina de Silva’s daughter, Eloise, was diagnosed with microcephaly, a rare condition, shortly after birth.

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Her husband left her not long after, making her the sole provider for her three young children.

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She can no longer work full time because she spends most of her days caring for Eloise.

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Eloise sleeps most of the morning. If she sleeps well at night, she’ll wake up early around 5 a.m. to 7 a.m.

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Carla takes care of her usual household chores when Eloise sleeps.

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“She’s quite agitated and complicated, but I’m getting used to it.”

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Each Thursday, Carla takes Eloise to a clinic at the Altino Ventura Foundation (FAV).

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The round-trip journey takes three hours.

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Eloise receives anti-seizure medication every few hours. Like many babies with microcephaly, she suffers from epilepsy and requires extensive medical attention because of her brain damage.

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“Considering everything, it’s very difficult. It’s very difficult. Suffocating. There are times when I just feel like screaming out loud like crazy.”

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According to the World Health Organization, the burden of caring for babies with microcephaly largely falls on young and poor mothers, like Carla.

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These women often have to give up work or have difficulty finding the time and transportation to access support from health and social services.

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Clinics like FAV provide essential services, such as physiotherapy and eye exams, for these children without any charge.

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Carla fears that Eloise will depend on her for everything for the rest of her life.

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She hopes that her daughter will one day have independence and normalcy.

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“She [my daughter] will get married and have children, and the glory of God will shine upon her.”

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Recife’s multitude of rivers, small islands and bridges is why it is called the “Brazilian Venice.”

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The homes of Recife's poorest residents often lack plumbing, so they store water in jugs and containers, where mosquitoes can breed.

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Voice of Fabiana Amanda Oliveira Lima

“We live here because we need to, right? Because if we didn’t have to, we wouldn’t live here. The garbage is too much.”

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Earlier this year, Fabiana and her son came down with chikungunya and dengue fever.

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The same type of mosquito that carries those viruses also carries the Zika virus.

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“The community that we live in suffers too much. … What I want the government to do is to move us out of here, but for us not to go out alone, but with every living thing here. With this whole community.”

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A walk through Fabiana's neighborhood

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Fabiana’s neighbor, Jessica Talia Cruz Menezes, is eight months pregnant and says she hasn’t had Zika.

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Research has shown that 80 percent of people infected with the virus never show symptoms.

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Jessica is excited to have her first child and has all of his future clothes prepared.

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Her family helps pay for the mosquito repellent that she uses three times a day.

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Eight months into her pregnancy, Jessica still is at risk for Zika. She is nervous and unsure of what the future holds.

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Getting through the Summer Olympic Games in August without a new Zika scare will be Brazil’s short-term challenge.

But the country still has to investigate thousands of cases of neurological damage for a possible link to Zika.

The financial and emotional cost of caring for so many children with disabilities will be staggering. It’s one that Brazilian families and the country’s health system will probably bear for years to come.

Reporting, video and photo Whitney Leaming and Matt McClain

Design and development Shelly Tan

Video graphics Julio Negron

With Wendy Galietta and Nick Kirkpatrick

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Additional credits

Additional Editing Reem Akkad, David Bruns, Susan Levine, Dom Phillips and Nick Miroff.

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