In this Jan. 29, 2016 photo, Carmen Cruz, 31, waits to have her prenatal exam at the National Hospital for Women in San Salvador, El Salvador. Latin American governments are preparing as Zika, mosquito-borne illness, spreads through the continent. In the Central American nation authorities have urged women to put off pregnancy for two years, (AP Photo/Salvador Melendez) Photo: AP
An emergency meeting was held at the World Health Organisation on Monday this week to address the growing epidemic of the Zika virus in the Americas. The WHO met to discuss whether or not the spread of the virus should be declared a global health crisis, with some experts suggesting it might pose a bigger threat than the Ebola epidemic that killed approximately 11,000 people over a period of time in 2014 and 2015.
The Zika virus is transmitted by the Aedes mosquito, the same mosquito which passes on dengue fever and chikungunya. While it may not bear the same risk of fatality as Ebola, of the estimated 3-4 million people infected in Latin America there have been thousands of cases of microcephaly in babies born to infected mothers (a congenital side effect hypothesised to be linked to the virus).
In Brazil alone, over 4000 babies are thought to have been affected and the prognosis is bleak - infants born with microcephaly have a diminished life expectancy, a high likelihood of neurological impairments and a possibility for delayed motor functions. Complicating matters even further is the fact approximately 80 per cent of people infected by the virus present with none of the common symptoms, which include fever, rash, joint pain and conjunctivitis. There's no vaccine currently, and even if one were developed it would pose an ethical minefield to test it on pregnant women.
Dr Vanessa Van Der Linden Mota, the neuro-pediatrician who first recognised the microcephaly crisis in Brazil, examines a two-month-old baby last week in Recife, Brazil. Photo: Getty Images
The lack of an effective vaccine for the Zika virus (which was first identified in Africa in 1947, but has never presented such a widespread risk until now) isn't just unfortunate. It also illustrates how easily the human race could be wiped out by a humble mosquito and how powerless we might be to stop it. As Laurie Garrett writes for the website Foreign Policy, "Aggressive urban mosquito programs would help reduce human infections, but the virus would keep coming back year after year, popping out of its remote hiding places. And in the end, the only hope for eliminating human disease would rest with the invention of an effective vaccine and mass, routine vaccination of hundreds of millions of people across the Western Hemisphere. Could it happen?"
In the interim, some governments are embarking on unusual measures to curb the spread of the virus from mother to child and the proposals are troubling to say the least. The El Salvadorian Deputy Health Minister last week urged women in the country to "avoid getting pregnant between this year and next." Essentially, with limited resources available to them to curb the virus' spread, El Salvador is planning for a complete halt in reproduction and fertility until at least 2018.
To some, this may seem like a crude but necessary step. Dystopian, certainly, but if the purpose is to prevent microcephaly in babies then perhaps it makes sense. Right? Unfortunately, a health policy directing women to abstain from pregnancy is almost impossible in a country like El Salvador, where birth control is not only hugely expensive and hard to find but abortions are so heavily criminalised that even women who've suffered miscarriages and stillbirths can imprisoned for up to 50 years. As Joshua A. Kritsch writes on Vocativ, "The irony, which seems lost on El Salvador, is that the same government that denies women control over their reproductive health is now asking those same women to control their reproductive health until 2018."
All this points to a problematic question for El Salvador: given their heavy handed, patriarchal punishment of women who do exert some autonomy over their reproductive choices, will they now have the distinction of becoming the first country to incarcerate women for both starting AND ending pregnancies? And if not - if they actually accept as they have a moral obligation to that abortion may be a suitable response to these unplanned pregnancies - will they then also acknowledge that the almost 130 women prosecuted for "abortion crimes" between 2000 and 2011 are not criminals as claimed by the state but women making sensible decisions about their bodies against a climate of extreme religious conservatism? Women like Guadelupe Vasquez, who was raped by a neighbour of the home in which she worked as a maid and who was prosecuted after the baby was stillborn? In that case, her rapist went free and she served seven years in jail.
El Salvador's response to the potential of airborne viruses to be passed from mother to fetus has only further demonstrated that effective public health policy everywhere must include comprehensive access to a range of reproductive control measures, including safe abortion. And it also demonstrates how vital sex education is for both men and women - because while the government of El Salvador may be urging women to hold off on pregnancy for the next 24 months, there's been no communication made to men that this might require some assistance from them also. Does it really seem likely that a country with rates of sexual violence as high as El Salvador's would respond swiftly and positively to a decree that, in the absence of providing free and comprehensive forms of birth control, essentially translates to No Sex Please, We're El Salvadorian?
Either way, this is potentially a watershed moment for a country under the grips of conservative Catholic rule. Whether they like it or not, change is coming to El Salvador.