Brazil: Zika, Chika, Coup d’Etat

Screen Shot 2016-08-16 at 2.00.43 PM

Photo by Public Domain.

By Nancy Scheper-Hughes

We are in the last week of the Brazil Olympic games. Cal athletes are well represented, and on Berkeley’s campus we are celebrating Cal student Ryan Murphy’s second gold medal in Rio de Janeiro.

Yet, as we cheer on one of our own and take part in the pageantry, we read about the mugging of another Olympic medalist, Ryan Lochte, who along with three other Team U.S. swimmers was attacked coming home from a party Sunday morning.   In addition, police and vigilante violence (often in tandem and in collaboration) runs rampant in Rio and there are real dangers for those infected in the Zika-Chikungunya epidemic.

In such an iconic setting as Rio de Janeiro, a wondrous city with almost mythical standing in the imagination, it seems things have gotten really real.

The Wondrous City

Though initially untouched by U.S. Olympic Committee and Brazilian officials, the mugging incident with Lochte and his teammates was later investigated and confirmed.

During the 3 a.m. incident, questionably counterfeit police officers demanded that the four men get out of a taxi and get down on the ground. Lochte refused, and had a gun cocked at his head. Wallets were taken, passports and IDs returned. The athletes were allowed to return to their bubble, the safe and gated Olympic village.

It was the latest of several street attacks during the Games including the mugging of an Australian Paralympian, Liesl Tesch, and the bungled mugging of the chief of security for the Games.

Rio’s mayor, Eduardo Paes, apologized several times for these incidents. He noted that they are to be expected in a ‘third world country,’ — a term that had been abandoned during the past decade as Brazil’s fortunes and economy soared. Paes lamented, “This is not the best moment to be in the eyes of the world.”

Recently, my colleague, Frederic Vandenberghe, a professor at UERJ, the state university of Rio de Janeiro, sent me a message to pass along to anyone I knew traveling to the Games:

“Welcome to Brazil! We are happy you are here and hope you will enjoy the Olympic Games™©®. We wish we could have received you under better circumstances. As you might know, we had a coup d’État over here. It’s not a classic military coup, as in the ‘60s, but the result is the same. Democracy in Brazil is under siege and you will see Brazil’s military forces everywhere. They are there to guarantee your security, but also to repress an opposition to the illegitimate government…. I hope you will quickly notice that Brazil is a racially diverse country. The majority of the population is black. Our ‘new’ government, however, is all white, all male, and all corrupt… The new government is defending the interests of the banks, privatizing the economy, repressing minorities, exterminating indigenous populations and otherwise doing everything it can to abolish the rights won by the majority of the population… Enjoy your stay!”

Then there is the issue of the Zika-Chikungunya epidemic that arrived in Brazil in February 2015 — just in time for the collapse of Brazil’s national health care system, the Sistema Unico de Saude.

The U.S. Centers for Disease Control and the UN World Health Organization disagreed on the threat of the epidemic for athletes and tourists visiting Rio de Janeiro. The former strongly suggested caution, while the later — embracing medical global diplomacy — urged the show to go on.

Moreover, Dr. Margaret Chan, chief of the WHO, said that she planned on going to the Olympics herself, though she warned the athletes and tourists to take measures to avoid mosquitoes.  “You don’t want to bring to a standstill the world’s movement of people,” Chan said. “This is all about risk assessment and management.”

Immediately after, 240 health professionals from 40 countries signed an open letter to the WHO chief expressing their deep concern about the real threat of Zika to the global visitors and thus to the world.

Zika and Chika

Healthy, pregnant women infected with Zika may have minor symptoms: a rash and a low-grade fever for a few days. But the virus can be lethal to an embryo or fetus, producing serious neurological disabilities, most visible, microcephaly. Neuroscientists do not know what later neurological problems could emerge, according to Berkeley epidemiologist, Lee Riley.

The dangers of Zika have been well publicized. Lesser known, however, is Zika’s evil stepsister, Chikungunya. Referred to in rural Northeast Brazil as ‘Chika,’ it is transmitted by the same mosquito. Chika can be lethal to older people with heart conditions.

Scheper-hughes Chika Virus

Photo by Nancy Scheper-Hughes.

Endemic in parts of Africa, the Swahili term for Chikungunya means “the sickness of crooked walkers” as Chika produces severe arthritic symptoms, pain and swelling of fingers, toes and joints.

Both Zika and Chika are not easily distinguished by confirmatory blood and urine clinical tests. Chika is a transient and mild problem for the young, but can be fatal for elderly persons with preexisting heart disease.

In March 2016, I received an urgent e-mail from my companheiro in the field, Patricio Silva of Timbauba:

“Dear Nancy, I just returned from Timbaúba. I was called home because my father got very sick with Chikungunya, a serious disease related to the Zika virus. Today 30 percent of the population of Timbauba is sick with Zika or Chika. It is a terrible time for us. We want you to come immediately…”

A letter from the secretary of Health of the municipality followed asking me to help the 120 stranded community health agents of Timbauba who were the ‘face’ of medicine in the municipality of 55,000 people.

Scheper-hughes father in bed.png

Photo by Patricio Silva.

The situation was grim: Dedicated, yet underpaid and under-trained, ‘barefoot’ community health workers managed the epidemic in the absence of any resident public health SUS doctors. The only exception was a single Cuban doctor working in a small peripheral rural villa.

These first responders to the Zika-Chika epidemic worked without basic medical equipment, local hospital beds or laboratories to confirm suspected cases. As a result, literally thousands of suspected cases of Zika and Chika in Pernambuco went unconfirmed. The municipality was so hard hit in the weeks following Brazilian carnival that shops and restaurants closed, the streets were empty, and there were no soccer games. The players said their joints hurt too much.

A Mother’s Legacy

Scheper-hughes clinic.png

Photo by Michael Hughes.

The dozens of teenage pregnant girls I interviewed at the local health posts in the poorest communities were ready to admit that they had been sick with Chika, but in denial about whether they had possibly been infected with Zika.  Confirmatory test kits were as scarce in the capital city as mosquito repellant. The shelves at local pharmacies were bare.

The only solution for the infected and pregnant patients of Timbauba was to outsource them all –- the pregnant, the infected and the dying — to public hospitals and clinics elsewhere.

Recife, the capital city, roughly 60 miles away, was the first option. For those pregnant women who had been confirmed infected with Zika and with signs of fetal microcephaly, Oswaldo Cruz Hospital in Recife offered the best care. But with only one public ambulance to transport women in labor and the sick, private cars, taxis and motorized bicycles were making do.

Scheper-hughes agents timbauba

Health workers. Photo by Michael Hughes.

Some pregnant women gave birth in taxicabs. Other patients, not pregnant but infected, had to wait for hours. Sometimes they waited overnight to see a doctor or to be interned in public hospitals that had no vacant beds.

Dr.Humberto Graça, who took down a death squad in Timbauba a decade ago, works today as a promotor for Ministério Publico in Recife. He was outraged about the destruction of the public medical system in Brazil. He told us:

“Today we are facing the fact that the level of medicine we thought we had attained has been dismantled.… Going to the hospital we now see the same depressing scenes of people waiting in queues, people sleeping in the hospital corridors, or put on improvised beds. And people are coming to us for help. We are asked to decide who lives, who dies, because there is only one bed or no beds at all and we [Ministerio Publico] have to decide who will get that bed. So one of our afflictions as prosecutors, judges, and public defenders is to decide how to respond to all the people who come to us for a judicial order to obtain a needed hospital bed. But there are no vacancies. So, I have to ask myself if it is the right for a judge or a public defender to decide who will live and who will die as a consequence? When hospital doctors receive a judicial order to intern a very sick person, they are put into a terrible fix: either they disobey a judicial order (and face prosecution) or they accept it and vacate a bed being used by another mortally sick person… That is the reality of public hospitals and SUS today.”

Scheper-hughes mother

Photo by Michael Hughes.

As for the young women in Timbauba who were suspected of infection with the virus today, their legacy has been compromised. Previously believed to be the first generation that could trust in their future children’s health and well-being thanks to programs that Lula and Dilma put into place (zero hunger, the bolsa familia), they are stalwart about facing the possible threat of giving birth to an infant with special neurological needs.

They said plainly that they would not consider abortion, even if it were made legal in cases such as theirs. They will instead, they said, hold on to their infants and defend their sweet ‘angel babies,’ their anjelinhos, no matter what.

They had adamantly reversed the meaning of a folkloric term that their mothers and grandmothers once used to suggest that a sick or puny infant might, after all, be better off in heaven than on earth.

Update from Nancy Scheper-Hughes on the Ryan Lochte Case: August 19, 2016:

The true and full story of what happened early Sunday morning is still to be told. But the video shows evidence of four U.S. Olympic swimmers on a rampage and behaving like vandals. What ever happened to sportsmanship and global diplomacy? In covering up their disgraceful behavior by fabricating a kidnapping by men dressed as police –who happened to be security guards at a gas station—  the athletes violated the Olympic code of ethics:  respect for human dignity; maintaining harmonious relations with host authorities; and rejecting all forms of harassment, physical abuse and violence. They should be removed from the team and the ringleader, Ryan Lochte (despite his weak apology) should be stripped of his Rio gold medals.  What a sad moment for Brazil and the US.  

Nancy Scheper-Hughes headshotNancy Scheper-Hughes is the Chancellor’s Professor of Medical Anthropology at UC Berkeley and Chair of the doctoral program in critical medical anthropology. Her research and writings focus on the violence of everyday life examined on the ground from a radical existential and critically engaged perspective.


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3 Responses to Brazil: Zika, Chika, Coup d’Etat

  1. Rishat says:

    У меня врождённый и приобретённый иммунитет к инфекционным заболеваниям . Заражаюсь как обычный человек, но болею 2-­4 дня или совсем не болею.возраст 38 лет пол мужской
    Предлагаю сделать лекарство от инфекционных заболеваний из моей крови. Мусульманин. В СВЯЩЕННОМ КОРАНЕ не сказано что нельзя делать вакцину из крови мусульманина в чрезвычайных ситуациях. Всевышний Аллах разрешит сделать вакцину из моей крови. По рекомендации американских врачей сделал общий анализ крови, но пошёл далше. 21 октября сделал укол вакцины от гриппа, 22 октября сделал общий анализ крови. Лейкоцитов 7,8 при норме 9,0 нормальное состояние5.2. Мусульманин. 3 раза в день принимаю тахарат в холодной водопроводной воде, а 2 раза в ледяной воде из колонки, а это микро закаливание. Врождённый иммунитет: болею не сахарным диабетом, диабетом другого типа. Много пью воды Статья скачена в интернете. Эти препараты относятся к числу гомологичных, так как изготовляются из венозной крови доноров, абортной и плацентарной крови. Наиболее широко используется так называемый нормальный иммуноглобулин, который применяют для профилактики вирусного гепатита А, кори и ряда других заболеваний. Специфические иммуноглобулины направленного действия (противостолбнячный, противооспенный, противогриппозный, против клещевого энцефалита, противостафилококковый) Настоящее изобретение относится к иммунологии и биотехнологии. Предложен способ массового производства Fc-фрагмента иммуноглобулина, свободного от начального метионинового остатка, Могут быть люди, предварительно привитых соответствующими вакцинными препаратами. При этом технология производства нормального и специфических иммуноглобулинов идентична.В отличии мне не нужно предварительно прививаться. + 79046762574. Мне охота чтобы из моей крови создали лекарство только против вируса МЕРС 3 года не могу создать лекарство, против вируса ЗИК по сообщениям всемирной организации здравоохранения только через год создадут лекарство, против нового вируса гриппа оно совсем не изучено. С Зам.Глав. врача договорились что поднимим эту тему если вспыхнет эпидемия .После того как нашёл статью в интернете о массовом производстве иммуноглобулина врач поменял свою точку зрения. Понимаю что нужно дополнительные исследования моего иммунитета ,но 33 поликлиника города Альметьевска отказалась из за нехватки ресурсов и отсутствии ингредиентов для производства иммуноглобулинов

  2. Rishat says:

    : I innate and acquired immunity to infectious diseases . Become infected like a normal person, but 2-4 days sick or not sick.age 38 years sex male Offered to make a cure for infectious diseases of my blood. Muslim. In the HOLY QURAN does not say that it is impossible to make a vaccine from the blood of a Muslim in an emergency. Almighty Allah is allowed to make a vaccine from my blood. On the recommendation of the American doctors did a General blood test, but went on. 21 Oct injected flu vaccines, October 22, did a General blood test. Leukocyte 7,8 at the rate of 9.0 normal состояние5.2. Muslim. 3 times a day, take it in cold tap water and 2 times in the icy water from the column, and this micro hardening. Innate immunity: not sick with diabetes mellitus other type. Drink a lot of water Article downloaded on the Internet. These drugs are homologous, as made from the venous blood donors, abortion and placental blood. The most widely used of the so-called normal immunoglobulin, which is used for prevention of viral hepatitis A, measles and several other diseases. Specific immunoglobulins directed action (tetanus, smallpox, influenza, against tick-borne encephalitis, staphylococcal) the Present invention relates to immunology and biotechnology. The proposed method for the mass production of Fc-fragment of immunoglobulin, initial methioninamide free from residue, Can be pre-inoculated respective vaccine preparations. The technology of production of normal and specific immunoglobulins are identical.In contrast, I do not need to be vaccinated. + 79046762574. I want to out of my blood has created a cure against the virus MERS 3 years can not create a cure against the virus, ZEKE, according to reports from the world health organization only after a year will create a drug against the new virus of a flu it is not studied. With Zam.Chapters. the doctor agreed that raising this topic if the epidemic breaks out .After finding an article on the Internet about the mass production of immunoglobulin, the doctor changed his point of view. Understand that you need more research my immune system ,but 33 clinic of the city of Almetyevsk refused because of lack of resources and lack of ingredients for the production of immuno globulins. The Olympic games can neostats for zika virus. I ask You to test the virus on to Zeke for me.Almetyevsk doctors refused to examine my immune system

  3. Pingback: Brazil: Zika, Chika, coup d’état • The Berkeley Blog

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