It is eight in the morning and the health center of Casas Nuevas opens its doors to pregnant women that have their monthly appointments today.

On this occasion, trained staff from the Ministry of Health take the opportunity to speak to the pregnant women about how to protect themselves from mosquitos that transmit the Zika virus. When they are asked how much they know about Zika, the first to speak is Zenobia, who responds:

“What we know from the talks we have already been given is that Zika is transmitted by female mosquitos that can also cause dengue and chikungunya. This mosquito usually bites during the day, mainly in the early morning and late afternoon, and can live both outside and inside our homes.”

Tania Rojas, three months pregnant, also tells us that she was taught that some cases of Zika are asymptomatic. “The Ministry of Health staff told us that only 1 in every 4 people who contract the Zika virus develop symptoms, and it is very dangerous because if you are pregnant and don’t realize you have Zika, your baby can be born with microcephaly.”

As the women describe the effects of Zika, others explain how it can be prevented. Juana Idalia Urbina, who is three months pregnant, states “we should be careful with any sexual activities during pregnancy because if our partner was infected, the virus can be transmitted to the mother, and baby.” 

Both the pregnant women and the general population of Casas Nuevas are aware that the community is very vulnerable to outbreaks. In previous years there have been cases of leptospirosis, hemorrhagic dengue, cholera, and chikungunya that have caused many deaths.

The town’s environment is conducive to a possible outbreak of Zika, as there are many breeding grounds for the Aedes Aegypit mosquito. Thus, since 2015 the Ministry of Health has been conducting awareness campaigns and cleanups to eliminate the mosquito breeding grounds in an effort to curb potential cases of Zika in this small town.

Dr. José Palacios, who is responsible for the Health Center in Casas Nuevas, makes reference to the Ministry of Health recommendation that people keep water containers completely covered so that mosquitos can’t reproduce. People are instructed to bring inside all containers from the courtyards that may contain water, to get rid of utensils that they don’t use and that could serve as hatcheries, and in the case of pregnant women to wear long clothing and always sleep with mosquito nets. 

“We keep our homes clean, eliminate breeding grounds, keep dry areas where mosquitos can concentrate, and wash barrels and sinks,” Daris Vanesa Marenco, a teen who is two months pregnant, tells us.

Casas Nuevas is located approximately 190 kilometers outside of Managua. It is a small town belonging to the municipality of El Jícaral in the department of León, where there are 300 families (692 people), with 91 children under the age of 5.

For a long time, mosquitos have been a part of daily life for the families of Casas Nuevas, where there is a small artificial lake that supplies irrigation for the extensive rice crops that characterize the community.

“The mosquito is everywhere here in Casas Nuevas, and always has been since I was a girl. But now that I am pregnant, I am scared that my baby will be born with microcephaly or some malformation. Because of this I am taking all precautions to not get bitten so that my baby is born healthy,” says Daris Vanesa Marenco.

Because of the irregular water supply in Casas Nuevas (2 hours per day), the majority of families collect water from the pond or artificial lake for domestic use, creating an environment ripe for mosquito reproduction.

“Often I have to go wash clothes in the lake and there are many mosquitos. Before I became pregnant I didn’t think much about them, but now that I know what can happen to my baby, I wear long shirts and pants to avoid being bitten,” says Zenobia.

Though Casas Nuevas has not reported any positive cases of Zika, the authorities at the Ministry of Health keep a close watch on this town because of the factors that make an outbreak possible. The Ministry of Health is supporting family and community health teams to promote awareness, cleanup activities, and lectures, among other things. These volunteer teams are made up of community members, including teachers, other leaders, young people, and children.

In light of the government-issued health alert, Save the Children’s response in Nicaragua is aimed at strengthening the institutional capacity of the Ministry of Health in the neighborhoods where their health programs are in place.  Save the Children is supporting the Ministry with fuel used for spraying pumps, mobilization of community health workers, and organization of health days. Save the Children will also support the delivery of mosquito nets to delivery centers and travel expenses of community health teams working to prevent transmission of the virus.

With support from the Ministry of Health, Save the Children is prioritizing action in 6 municipalities in León and 6 in Matagalpa. Save the Children has plans to develop an awareness campaign and distribute information about the Zika virus through communications materials including posters, brochures, and flyers so that the population can take the necessary preventive measures and eliminate mosquito hatcheries.

“Pregnant women know a lot about the virus and are taking the necessary measures to avoid contracting Zika,” says Aura Celina Rojas, a member of Save the Children’s health program in Nicaragua