Doctors Fear Silent Zika Epidemic In Haiti, Which Is Ill-Equipped To Treat Babies With Microcephaly : Goats and Soda There are signs that the virus is spreading. And the health system is ill-equipped to detect or care for babies born with microcephaly.

Why The Low Zika Numbers In Haiti Might Be Wrong

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Haiti officially says it's had just a handful of confirmed cases of Zika. Doctors suspect there are many, many more. They're seeing an increase in babies born with microcephaly. As NPR's Jason Beaubien reports, Haiti's not well equipped to deal with the emerging virus or with a potential surge in disabled children.

JASON BEAUBIEN, BYLINE: If the Zika virus was looking for an ideal place to flourish, Haiti would certainly be a top candidate. I'm standing here in downtown Port au Prince next to a large, open drainage canal that's half full of water and half full of garbage. There's old tires in there. There's plastic bottles. There's a pig rooting around. This is the type of place that the Aedes aegypti mosquito which carries Zika loves to flourish in. And there are spots like this all across Port au Prince.

Yet Haiti has only identified 22 pregnant women suspected of having Zika while the neighboring Dominican Republic has identified nearly a thousand.

JEAN LUC PONCELET: There's no reason I think to believe that the mosquito will behave differently here than in the Dominican Republic.

BEAUBIEN: Dr. Jean Luc Poncelet is the World Health Organization's representative in Haiti. Poncelet says part of the problem in Haiti right now is that the country doesn't have the resources to test extensively for Zika. Haiti's also in the midst of a political crisis that's left it without an elected government since February, and it's got numerous other health issues on its plate, including a cholera outbreak that sickened 25,000 people this year alone.

PONCELET: Zika is definitely a problem. Fortunately it is a problem that is affecting a bit less than other disease in the country.

BEAUBIEN: But to what degree Zika is affecting Haiti is unknown. A doctors strike that stretched from March to August shut down much of the public health care system and has made the country's Zika statistics highly unreliable. In the middle of August, Haiti was officially reporting 20 suspected Zika cases per week while nearby Puerto Rico was tallying nearly 2,000.


LOUISE IVERS: Oh, oh, sorry.

BEAUBIEN: At the Mirebalais Hospital in Haiti's Central Plateau, Dr. Louise Ivers and Dr. Roman Jean-Louis are following three children born in July with microcephaly. Microcephaly can be Zika-related birth defect which causes a smaller-than-normal skull and an underdeveloped brain. Dr. Ivers with Partners in Health, a non-profit that runs the hospital, is checking the reflexes of a baby named Chinashama.

IVERS: So this baby has much more muscle tone than the other babies. She's moving around more. She's kind of fighting me. And the other baby was really not doing that much.

BEAUBIEN: But the girl's legs cross unnaturally at the shins. One foot doesn't respond when Ivers runs her finger over the sole, and the baby's mother says the child cries almost all the time. Dr. Roman says they'd expect to see one or two cases of microcephaly at this hospital per year.

ROMAN JEAN-LOUIS: (Foreign language spoken).

BEAUBIEN: But he says it's highly unusual to get a cluster of three babies with microcephaly as they did in July. Life is already tough in the poorest country in the Western hemisphere. Sixty percent of the population here lives on less than $2 per day, and there are very few services available for children with physical or neurological disabilities.

One of them is the Kay St. Germain rehabilitation center in the Tabarre section of Port au Prince. Outside the gate, a mother holds a child with twisted limbs and a floppy neck. Inside, Annette Johansson is preparing for the start of the fall semester.

ANNETTE JOHANSSON: And then we have a resource room and then speech and language therapy room. But at the moment, we don't have any trained speech and language therapists here.

BEAUBIEN: The center provides physical therapy and basic education to children with cerebral palsy, Down syndrome, autism and other neurological disorders. Much of the center's work, she says, is training parents on how to care for a disabled child.

JOHANSSON: Because they need to be able to address them, change them, feed them in a safe manner. We don't have the equipment here that you have in America or Europe. We can't give them feeding tubes. So it's really important that they know how to handle their kids and position them the best way possible.

BEAUBIEN: Most of the parents, she says, bring their kids to the center in the beat up pickup truck taxis known as tap taps.

JOHANSSON: I don't know if you have seen the tap taps, how full they are. And then you're going to try to get the disabled child into this as well and lifting them onto it.

BEAUBIEN: Just up the dusty dirt road from Kay St. Germain Case is a children's hospital run by the same Catholic organization as the rehab center. The administrator of the hospital, Jacqueline Gautier, says disability is the leading reason kids are abandoned in Haiti.

JACQUELINE GAUTIER: Actually we have a room full of 10 children. We have like that, and all hospitals have a small unit with abandoned children.

BEAUBIEN: The abandoned, disabled kids, she says, will most likely stay at her hospital for the rest of their lives. Jason Beaubien, NPR News.

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