It was following this pronouncement that the Director-General of WHO, Dr Margaret Chan, convened an emergency meeting with health experts. The outcome was the declaration that a health threat existed, associated with ensuing cluster cases of Microcephaly; a neurological condition in which an infant’s head is significantly smaller than what is common in children, as a result of the brain developing abnormally in the womb. This among other neurological disorders, though not yet scientifically verified, validated the link that a causal relationship between Zika infection during pregnancy and microcephaly exists.

As explained by Dr Debo Awosika-Olumo, an Adjunct Professor of Public Health in infectious disease epidemiology, the association between the introduction of disease and migration has long been recognized. Dr Olumo accounts that the WHO first identified the Zika virus in 1974 in Uganda in rhesus monkeys through a monitoring network of sylvatic yellow fever. Furthermore, in 1952, the virus was identified in humans in Uganda and Tanzania. He reveals that the transmission is primarily through the bite of an infected Aedes species mosquito, “These mosquitoes typically lay eggs in and near standing water in things like buckets, bowls, animal dishes, flowerpots and vases. They are aggressive daytime biters, prefer to bite people, and live indoors and outdoors near people.” Olumo goes on to explain that prior to 2015, the Zika virus outbreaks have occurred in areas of Africa,

SouthEast Asia, and the Pacific Islands and it was not until May 2015 that the Pan American Health OrganiSation, PAHO, issued an alert regarding the first confirmed Zika virus infections in Brazil. According to him, since 2015, besides Brazil and Cape Verde, there are more than 13 countries in the Americas that have reported sporadic Zika virus infections, added with recent cases in North America and Australia. He attests that the outbreaks occurring in many countries are indicative of the rapid geographic expansion of the virus, agreeing with WHO’s position that the Zika virus will continue to spread. In his assessment, Dr Chikwe Ihekweazu, another Infectious disease epidemiologist, asserts that “Every new virus comes with a lot of uncertainty, and a lot of diagnostic challenges. Even in pregnant women, where the highest risk is, as far as we know, for any congenital defect, dangers are during that first month of pregnancy, and most women in their first month of pregnancy do not know that they are pregnant. This is when the most damage is done to the foetus.” On its part, the CDC points out that though rare, a mother already infected with Zika virus near the time of delivery can pass on the virus to her newborn around the time of birth. It has also been shown that there is a possibility of the virus transmission during pregnancy from mother to foetus. However, reports on how dangerous this infection remains uncertain and while investigations are unfolding, the CDC had issued a travel alert, recommending special precautions for pregnant women and women trying to become pregnant with the options of postponing travel to the areas where the virus transmission is ongoing. In Nigeria, The Minister of Health, Professor Isaac Adewole also warned pregnant Nigerian women against traveling over the recent outbreak and the suspected link to Microcephaly.

Resolute Birth Tourists

These epidemics notwithstanding, birth tourism booms, an aspect that contributes to the 1 to 3 billion naira the Medical Tourism Association’s Research revealed the country loses annually. As it implies, Birth tourists are women who travel out for the singular purpose of giving birth. Some circles crudely refer to some of these kids as ‘anchor babies’ because of their access to citizenship of other ‘greener’ countries under the jus soli. Indications by the centre for immigration studies in Washington estimates that as many as 36,000 birth tourists go to the United States every year and further identifies that Nigerians represent a strong number of guests from Sub-Saharan Africa. The figures are not unlikely as statistics disclose that 23 percent of Nigeria’s population has access to a combined buying power in excess of US28 billion dollars, mostly made up of professional and middle-class Nigerians whose desire to seek privileges such as better health care services or simply dual citizenship options for their child/children is on the rise.   Though not a new phenomenon among Nigerians, the trend has given rise to better planning and even consultancies which guide women on costs and procedures. For Wunmi Ewebiyi, hers is a testimonial on one-child-birth service website where she narrates her delight with the support received and reveals expenditures of up to US 8,000 dollars for Caesarean Section birth. While, Naomi Anyanwu explains to LEADERSHIP Weekend that, “I’ve had two children in America. I spent roughly about US15,000 thousand dollars for my son and less than US10,000 thousand dollars when I had my daughter two years later.”

For recently-wed, Mrs Chinonyerem Chimundiya, she expresses to LEADERSHIP Weekend that having struggled with the Nigerian system, she and her husband hope to offer a better opportunity for their children. “It seems Nigeria has always been on rocky ground. Being able to have steady employment means that we can afford to have our baby in America. It is unfortunate that now I have to contend with this Zika virus, but I have planned and saved for this. When I got married, my husband and I discussed this option of having our child overseas and we both agreed to guaranteeing our kids the option of a stable educational system, plus exposing them to unique climes, and even Snow!” At this time in the United states, though citing of the risk of transmitting the virus through blood donations as “extremely” low, groups like the American Red Cross have requested that blood donors who have travelled to Zika viral outbreak areas wait at least 28 days before donating in the United States. Similarly, the Pan American Health Organization whilst investigating a case of the virus being transmitted sexually, has said more evidence was needed to confirm sexual contact as a means of Zika transmission after a report in Texas. However, despite the ongoing International effort to investigate and understand how the virus evolves, to protect vulnerable groups like pregnant women, there are those who remain steadfast.

For the 29-year-old consultant, who alongside her husband, earn a combined monthly income of a little over 900,000 thousand naira and being six months pregnant, she is set with her plans to travel to the United States, irrespective of ongoing events. “I watch the news, and it is a risk that I will take because I want the best opportunity for my child, and if we can provide that by going overseas, then why not?” she asks. It is a question that an increasing number of middle-income families seem to ponder, and possibly accounts for the growing number of Nigerian women who travel to countries like the United States of America to give birth. Dr Chris Agboghoroma, Consultant Obstetrician & Gynaecologist at the National Hospital Abuja insists that although, the WHO recently declared Zika a Public Health Emergency of International Concern, it stated that there was no justification for restrictions on travel or trade to prevent the spread of Zika, encouraging instead personal measures to avoid mosquito bites as essential. “Information on Zika virus is still evolving. For now, the main mode of transmission is mosquito bites and the main concern is infected pregnant women resulting in congenital malformation – microcephaly and neurological complications in the babies. “Though the world is a global village because of ease of transportation, the vector for this infection- mosquito is not common in USA. While the risk of infection of the most vulnerable group – pregnant women is low in places were mosquito bites are unlikely including USA, same cannot be said of places including South America and Caribbean with mosquitoes.”

Reinforcing this, Dr Ihekweazu urges that every woman that is planning to travel, that is of child bearing age must consider fully whether she needs to go to regions like South America at the Moment. “Women must take the normal precautions against getting bitten buy mosquitoes, but over and above what you would normally do; if you were using mosquitoes repellent sporadically, you would have to then use it all the time. They must inform themselves and educate themselves on the risks so that they can take informed decisions.” Nigeria Public Health Defence System Needs Revamping Following the WHO pronouncement, the National Centre for Disease Control took measures to enact a plan to mitigate an outbreak by issuing infograhics through social media alerting the public on measures to prevent mosquitoes from breeding. However, experts believe the centre is barely functionally. According to Dr Ihekweazu, “We had a fire brigade approach to the Ebola outbreak and to some extent we were successful. We are doing the same thing with Lassa fever and we haven’t succeeded. The truth is most of the work around infectious diseases, doesn’t happen like that, it is very diligent, long term, requires surveillance, testing, research , all of which is completed in specialized institutions. In the United States it is called the CDC, in the United Kingdom it is called Public Health England, in South Africa it is called the National centre for communicable diseases. So, we need to put this capacity together, of experts who will look into this problem, on a proactive basis and develop their capacity, which is how organized society respond to diseases.”

The expert suggests that Nigeria make the most of this opportunity to improvethe nations Malaria Elimination Programme that he says is basically dependent on preventing mosquito bites. “There have been big campaigns around bed nets in Nigeria, and this is an opportunity to scale up and get into the public consciousness the need to prevent malaria and several other diseases. It is an opportunity to reemphasize that very important public health message to prevent getting bitten by mosquitoes by using bed nets, by removing stagnant water around our homes and ultimately , with proper planning, bio-technics like indoor residual strain that the government can think about introducing. “The Public must know that the mosquito is clever, and there are no easy solutions to this, so we must do the bit we can, diligently, with the hope that our government will invest in the resources that will do the rest.”

Source: Leadership Online