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“The Mosquito Brings the Sickness”: Local Knowledge, Stigma, and Barriers to Zika Prevention in Rural Guatemala

  • Michaela E. Howells
  • Michelle M. Pieters
Chapter
Part of the Global Maternal and Child Health book series (GMCH)

Abstract

The emergence of Zika virus and the resulting occurrence of intrauterine infections has been responsible for increased numbers of spontaneous abortions and significant neurological deficits in newborns—termed the congenital Zika syndrome. Globally, South and Central America are experiencing the highest rates of Zika infection and associated neonate microcephaly, creating a critical need for knowledge regarding barriers to effective Zika prevention. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have issued recommendations to block the future spread of the disease through mosquitoes and sexual transmission. Although well intentioned, these recommendations fail to account for some of the significant barriers to preventing the spread of Zika in areas with weaker public health programs, such as rural and impoverished areas of South and Central America. In particular, these are areas where indigenous people and mestizos are concentrated. In this chapter, we address some of the economic and cultural barriers that rural populations face in accessing preventative health care against Zika. We combined data from a two-month ethnographic study with 40 semi-structured interviews in a mestizo farming community in Escuintla, Guatemala. Although 87.5% of participants were able to identify Zika virus transmission risk through mosquitoes and associated preventative measures, only 5% reported sexual transmission as a risk, and none of the participants listed condom use as a way to prevent transmission. Our research illustrates that, although this population was able to articulate the need for preventing mosquito bites, their actual ability to prevent these bites is limited. We discuss the role of taboos and stigmatization surrounding sexual practices and critical preventative measures that can influence individual decision-making and place people at higher risk of contracting Zika infection. Taken together, challenges in complying with public health recommendations may disproportionately affect less affluent mestizo communities, leading to an increased burden of risk.

Keywords

Indigenous women Maternal health Community participation Pregnancy Central America Prenatal care Guatemala Mestizo Arbovirus Congenital Zika syndrome Zika virus Arthropod-borne infection Stigmatization Sexual practices Prevention Sexual transmission Prevention Condom use Health education Mosquito Family planning 

Notes

Acknowledgments

We would like to extend our sincere thanks to the participants of the Escuintla farm communities who shared their lives with us. We would also like to extend our thanks to Richard Bender, Carolyn Robinson, Christopher Dana Lynn, Samantha Fernando, Holly Wood, Katherine Woolard, Mallory Walker, Santiago Ortiz, David A. Schwartz, and Uli Howells-Loudon for feedback on drafts. Additionally, we would like to acknowledge Katherine Pieters, Nicole De Nes, Jacobo Pieters, Ruth Escobar, Barbara Arroyo, and Amadeo Garcia for their support throughout the field work. Funding was provided by University of North Carolina Wilmington’s Center for the Support of Undergraduate Research and Fellowships (CSURF) and the Summer Undergraduate Research and Creativity Awards (SURCA).

This study was approved by the University of North Carolina Wilmington Internal Review Board (protocol number 16-0340).

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of AnthropologyUniversity of North Carolina WilmingtonWilmingtonUSA

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