A Zika Tale in a Favela

http://www.nytimes.com/2017/03/11/health/zika-virus-favela-360-video.html

Version 0 of 1.

RECIFE, Brazil — At night, rats often scurry on top of the thin gray mattress where Maria de Fátima dos Santos and Paulo Rogério Cavalcanti de Araújo sleep with their two small children in a one-room house with a floor of dirt and concrete, and a green plastic basin for a toilet.

In this achingly poor section of the Brazilian city of Recife, where a water channel has become an acrid open sewer, and clusters of men stand around smoking marijuana while young girls sniff glue from soda bottles, the couple is struggling to raise a baby with disabilities caused by the Zika virus.

Their daughter, Eduarda Vitória, now 17 months old, has a range of problems stemming from brain damage caused by Zika, which her mother contracted when she was bitten by an infected mosquito while pregnant.

When Eduarda was born, her parents had never heard of Zika, and they said doctors at the hospital did not understand it. But they knew something was wrong. In the hospital nursery, Mr. de Araújo said, “I kept looking at her big body and very small head.”

The small head, a condition called microcephaly, was the most obvious sign of Zika damage. But Eduarda also suffers from seizures, muscle problems, impaired vision, and problems eating. She cries unless she is held, usually calmed only when her father kisses her belly or her mother plays religious songs on her cellphone and sings along.

Poverty makes it hard for the family to manage Eduarda’s needs. Both parents are unemployed and receive a monthly government check of 880 reais (less than $300).

Ms. dos Santos, 21, was abused by a stepmother, ran away to live on the streets at age 8, and became a crack user and prostitute until Mr. de Araújo, 48, met her. She has a stab wound on her left arm from a fight with a client over drugs and has struggled to stay clean since her first child, two-year-old Vitória Maria, was born.

Eduarda, whose eyes cross, waited months for a clinic to have an available pair of glasses. She is supposed to wear braces on her legs and arms, but the leg braces she was given are too loose and the arm braces too tight, her mother says.

Her parents protect Eduarda’s seizure medicine from rodents by keeping it in a plastic bag tied to a pipe. Sometimes, their own food is ravaged by giant rats that climb onto the stove the instant Ms. dos Santos turns to help the baby, and grab sausage right out of the pan.

Eduarda has balked at eating much besides formula, and the government quit providing free formula when she turned 1 year old.

“Donations are over, we are not getting anything,” Ms. dos Santos said.

The parents, who stow Eduarda’s birth certificate and medical records under the mattress of the family’s worn bed, don’t take her to as many physical therapy sessions as some other Zika families. Getting to a session is a two-and-a-half-hour walk, or a 30-minute walk if they pay to take a bus the rest of the way.

In their one-room house, inside a cabinet door, Ms. dos Santos has taped a strip of paper from a piece of candy. A question printed on the paper reads, “Do que você precisa para ser feliz?” (What do you need to be happy?)

“A better life for my daughters,” is Ms. dos Santos answer. “A better future, a future I never had.”