The 2016 Summer Olympics in Rio de Janeiro will shine a spotlight on Brazil next month, putting on display both the country’s beauty and its public health issues — as well as the way the country copes with them.
Zika may be at the forefront of U.S. health news stories featuring the games, including risks to athletes and tourists alike. But for the people who live in Brazil, Zika is not the only public health risk they face. Waste and water quality, once the topic of serious concern and reports in the U.S., remains a critical issue for Brazilians, said Joseph Eisenberg, PhD, MPH, professor and chair of epidemiology at the University of Michigan School of Public Health, an expert on infectious disease epidemiology with a background in microbial risk assessment work focused on water quality.
Rio de Janeiro, a coastal city, has minimally treated wastewater flowing into its open waters, which means the population is continually exposed to sewage. A Pan American Health Organization report showed that in 2008, 92.8 percent of Brazil’s urban population had access to drinking water of adequate quality, but only 31.5 percent of the rural population had the same.
And in more than half of municipalities, solid waste is disposed of in irregular open-air dumps, which can lead to contaminated runoff.
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“We’re talking about not just the ocean, but the lakes, and the different ways in which people are living near or accessing those waters, be they recreationally or, in more rural areas, using for bathing and washing and cleaning clothes,” Eisenberg told The Nation’s Health. “More time has been spent on making sure drinking water is treated, but in a place like Rio, where there’s a large population right on the ocean, (exposure) is probably pretty significant.”
The water quality, particularly standing water, serves as the perfect host for mosquito breeding grounds. So are indoor and outdoor containers holding water, which can collect in garbage, roof gutters, flower pots and tires, said Daniel Epstein, MA, communications officer at PAHO.
The Aedes aegypti mosquito that is the main transmitter of Zika is also a carrier for dengue and chikungunya — diseases with riskier symptoms for the general population and, in the case of dengue, death.
“Zika has this obvious, very concerning piece of the disease that can happen when pregnant women are infected,” Eisenberg said of Zika’s link to microcephaly, a condition in which babies are born with abnormally small heads and brains that may not have properly developed. “But there are three viruses that one needs to be worried about. (Public health needs to be) controlling the mosquito vector for all three.”
Epstein noted that the Aedes aegypti mosquito is also a carrier of yellow fever — a potentially deadly and incurable illness that can be prevented easily with a vaccine.
Reproductive health access is also an issue in Brazil. Abortion is illegal in the country except in cases of rape or a threat to the woman’s life. Advocates and the United Nations have called on Brazil to improve access to abortion.
In a Feb. 8 news release from the Harvard T.H. Chan School of Public Health, Alicia Yamin, JD, MPH, a lecturer on law and global health, called the rise of Zika “as much about the poverty and powerlessness faced by women in Latin America” as an issue of health.
Poverty is a major issue of public health in Brazil, particularly in Rio de Janeiro’s favelas, the high-density, low-income communities throughout the city. More than 11.4 million people live in the favelas, which, once marked by violence, are in the center of Olympic activities.
Eisenberg said that historically, public health workers both Brazilian and international had difficulty reaching favela residents and working within the communities.
“I think things are slowly changing and that there’s getting to be more access,” he said.
Advocates in Brazil and the United States can continue to work toward educating the public about the country’s health issues, as well as its successes.
“Once the Olympics are gone, once it fades from the media, this is the opportunity to try and push for some of these more infrastructural changes,” Eisenberg said. “It’s becoming an emerging economy, but the (disparity) is wide.”
For more statistics on health in Brazil, visit www.who.int/countries/bra.
- Copyright The Nation’s Health, American Public Health Association
