http://orcid.org/0000-0002-7756-9225
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ABSTRACT
Implementing effective health interventions in recent epidemics has been difficult due to the potentially global nature of their spread and sociocultural dynamics, raising questions concerning how to develop culturally-appropriate preventive measures, and how these health threats are understood locally. In Belize, health policy makers have only been marginally effective in managing infections and mosquito vectors, and Zika has been declared endemic in certain regions, particularly on the island of Caye Caulker. Based on ethnographic research conducted primarily in 2017, we examine how perspectives of Zika-related health consequences are shaped, and how state interventions to manage Zika are understood. We argue that despite its declared endemic status, Zika is not perceived as a true health concern for community members due to numerous neoliberal structural challenges. Moreover, the state’s restrictive form of reproductive governance which limits family planning services is forcing individuals to weigh conflicting conceptions of health consequences. This also contributes to an ambiguous healthcare environment for health practitioners, giving them an unclear picture of the scope of Zika as a public health concern. We also consider how critical medical anthropology and feminist analytical approaches are useful in exploring these questions and contributing to understandings of the health impacts of Zika.
Acknowledgements
We would like to express deep gratitude toward the Caye Caulker community and research participants who agreed to take part in this study.
Disclosure statement
No potential conflict of interest was reported by the authors.
ORCID
Deven Gray http://orcid.org/0000-0002-7756-9225
Notes
1 The Gini coefficient—the deviation of the income distribution—for Belize is 53 on a scale from 0 to 100, where 0 indicates absolute equality and 100 represents absolute inequality. For example, the Gini index for countries with greater equality like Norway or Sweden is around 25, while for countries with greater inequality, such as South Africa, is around 63. Belize’s Gini coefficient is on the higher end of this spectrum. See: http://hdr.undp.org/en/content/income-gini-coefficient
2 See: World Economic Forum Report 2012: http://www3.weforum.org/docs/WEF_GenderGap_Report_2012.pdf
3 Until 1973 this territory was considered ‘British Honduras.’ Belize gained its full independence in 1981.
4 Interview with Anna (2017).
5 Interview with Mateo and Camila (2017).
6 Interview with Anna (2017), continued.
7 This finding is consistent with public health research which shows that in Latin American countries where abortion is restricted, women typically obtain (often from local pharmacists) and use mifepristone and misoprostol as a way to self-induce a termination (Lara, Abuabara, Grossman, & Diaz-Olavarrieta, Citation2006).
8 Interview with Dr. Garcia (2017).
9 The focus on women in the epidemiological surveillance for Zika in Belize differs from recommendations by the Center for Disease Control (CDC) in the US. CDC’s recommendations are directed at both women and men living in Zika-infected areas, including men with pregnant partners, men who are planning pregnancy with their partners and men who are not concerned about pregnancy, including precautions for travel, and sexual activity. Florida state guidelines also target men based on the data showing that even asymptomatic men’s semen can remain infected for several months. See: https://www.cdc.gov/zika/men/index.html; https://www.cdc.gov/zika/intheus/florida-update.html.
10 Interview with Chloe (2017).
11 Interview with Marko (2017).
12 Interview with Rena (2017).
13 Interview with Dr. Alvarez (2017).
14 Interview with Dr. Garcia (2017).
15 Interview with Isabell (2017).
16 Interview with Dr. Garcia (2017).