A prevalent epidemic of the Zika virus in 2015, caused an outbreak in parts of North and South America, and several islands in the pacific. Zika is an infectious disease that is mainly spread by the bite of an infected mosquito, from the Aedes species. The zika virus can also be spread through sexual transmission and can be passed from a pregnant woman to her fetus, which can result in certain birth defects (Center for Disease Control, 2018).
In October of 2015, in the city of Pernambuco, Brazil, doctors began to see an increase in the number of infants born with microcephaly. The executive secretary of health surveillance for the city of Pernambuco reported 600 new cases before the end of November, when typically, physicians would only see about a dozen cases a year (Human Rights Watch, 2018). Pernambuco, one of the poorest cities in the country, is located in the northeastern region of Brazil near the coast line. Within that city is a small town known as Olinda. This area of the region experiences humid, tropical climates especially during the rainy season. This type of climate is known to contribute to the rapid spread of the zika virus. With higher, rising temperatures, the mosquitos are able to reproduce faster, leading to the rapid spread of the virus. This area also has poor sanitation and access to water, leaving some residents with access to water from only one tap. Just as everywhere else in the world, race and gender are social factors that cause specific socioeconomic groups to be more vulnerable to these living conditions. Individuals who are less wealthy in the country, are less likely to have a constant source to clean water. The change in climate as a result of rainfall patterns, affect the availability of drinking water, exposing this community to vector-borne diseases. The lack of access to water and sanitation can not only result in the spread of Zika, but many other viruses. More than one third of Brazil’s population does not have access to a continuous water supply (Human Rights Watch, 2018). These residents typically store water in containers or other unsafe ways that attract mosquitos. In 2015, there was an estimated amount of 497,593 to 1,482,701 cases of the Zika virus in Brazil. From that amount, 34,579 to 81,303 cases of Zika were reported from the city of Pernambuco alone (Magalhaes et al, 2017). In Brazil, the federal and state government have the responsibility of developing policies for sanitation purposes (Human Rights Watch, 2018). However, government investments in water and sanitation foundation are poor. Most of the outbreaks in Pernambuco are thought to have resulted from not only the climate, but the poor access to a constant water source.
The outbreak in the community of Pernambuco was one of the highest in country. Olinda, where the program will take place, is a small town within the state of Pernambuco, where residents also experience poor sanitation and lack of consistent water. The program that will be implemented will focus on providing ways for accessible, clean water to the residents of the community. The program will also focus on the prevention of transmitting the virus and attracting these mosquitos. The program will include healthcare workers and volunteers from the U.S. and the community. This way, these local workers will be able to relate to the members of the community, allowing the community residents to be more accepting. The program will occur six months prior to the dry and rainfall season, which is usually from April and peaks in early August. The target population will involve residents of the Olinda community, with a focus on pregnant women, children and young women of reproductive years living in the rural area. The program will take place at a local clinic where the health care workers and volunteers from the community and U.S. will work together. The zika prevention program, will offer free urine and blood tests to the target population that will test for zika. Once these individuals get tested, they will be given a brochure that will focus on promoting the prevention of mosquito bites. These brochures will include awareness about the prevention of the virus, including the sexual transmission, followed by the risks and consequences of the virus. We will encourage the residents to take personal protective measures such as wearing clothing that cover up as much of the body as possible, especially if they are around rivers or some body of water. There will also be condoms passed out at each of these events. The program will also encourage residents to use physical barriers such as window screens, and keeping doors closed. At the clinic, insect repellents, and mosquito nets will also be provided. Through the program, we will also introduce The Safe Water System to this community. The Safe Water System is an inexpensive water quality intervention that it used to improve unsanitary water. The Safe Water System increases the use of safe water by including a household water treatment, and providing safe storage for water in homes and other facilities (CDC, 2014). There will also be clean and concealed storage containers for water storing provided to these individuals at the clinic. The final part of the Zika prevention program consists of the two water wells that will be located on each side of the community, making it accessible for those who do not have transportation. These water wells will be sealed and will only be accessible to the residents who participate in the program.
The Zika virus prevention program will occur for three months each year for a total of three years. The residents will still have access to the well after the program is complete for that year. Each year the health workers and volunteers of the program will be tasked to record the number of zika cases from hospitals in the Olinda to observe the outcome of the program each year. The local health workers and volunteers from the Olinda community program will manage the program and report back with any improvements that could be made, and which areas are most beneficial to the community. Although the Zika virus outbreak has since regressed, a reemergence of the outbreak could result in even more cases of the disease, causing an increased number of effects. Since there is no vaccination for Zika, if not prevented the disease could lead to an increased risk of neurological complications, such as neuropathy, myelitis, or Gullian-Barre syndrome (World Health Organization, 2018). By implementing this Zika prevention program, we hope to influence the health behavior of the individuals in this community, and see a reduced amount of Zika cases within the Olinda community.
