Uncovering a bombshell about Zika in Puerto Rico Date: 01/28/19
By Beth Murphy
In early 2016, I set out to make a series of films focused on the impact of climate change on women and children as part of our multimedia GroundTruth Project series “Living Proof: The Human Impacts of Climate Change.” For this story, reporting from our film work evolved to include a PBS NewsHour report, three podcasts (Reveal by The Center For Investigative Reporting & two WGBH/PRX/GroundTruth) and a short film.
What became clear during research is that the link between climate change and infectious disease is having serious consequences on maternal and infant health. There are a number of examples globally, but with the Zika crisis exploding in Puerto Rico at that time, I decided to focus my attention there.
The book “Climate Change and Public Health” by Barry S. Levy and Jonathan Patz achieved near-Bible status as we set out to understand whether changes in the environment could contribute to Zika spread and risk. At the time, Zika was known only to be spread by mosquitoes – sexual transmission had yet to be discovered.
We did an interview with Levy about the role of warming temperatures on various stages of a mosquito life cycle that in some cases can increase disease transmission rates by mosquito vectors. This grounded us in the latest global research which we wanted to follow with local expertise. Exactly what changes were scientists on the ground in Puerto Rico seeing?
While there hadn’t been any studies that looked directly at the link between Zika and climate change, our questions inspired climate scientists on the island to not only speak publicly for the first time about how climate/mosquito connections they were seeing with other diseases like dengue and chikungunya that could inform about Zika, but also to begin Zika/climate research.
Unlike dengue and chikungunya, Zika can cause devastating birth defects. Microcephaly cases were the most obvious, but given the way the Zika virus attacks babies’ brains, there was increasing evidence that even babies born looking healthy might suffer from longer-term developmental problems – cognitive, eyesight and hearing issues.
While we doggedly pursued the climate change angle, this aspect of the story (which was included in writing and two of the three podcasts) became overshadowed over two years as the reporting became more investigative in nature.
More on the investigation in a moment.
My goal is to tell strong, intimate, character-driven stories that allow for understanding large, complex human rights, social and political issues with the storytelling rooted in finding solutions to those issues. In moments and places of chaos and suffering, I’m always looking for the person who’s bringing order and alleviating that suffering.
For this story, that person was Carmen Zorrilla, M.D., a high-risk obstetrician-gynecologist who has dedicated her life to women’s health. She was on the frontlines of a similar crisis – HIV/AIDS – in the mid-1980s and everything she learned during that crisis, she used to respond to this one. I met Zorrilla through Mildred Rivera, a terrific long-time San Juan health journalist, who joined our team as a Film Fellow.
Zorrilla helped us understand how Zika was being tracked and researched on the island and allowed us intimate access to her work at University Hospital, which was seeing the largest number of Zika cases and where she launched a Zika in Pregnancy study. In addition to caring for pregnant women, Zorrilla was working with her colleagues to research Zika in the womb and follow babies who had been exposed. She was passionate about her work and driven by a moral obligation to find the truth and protect women and children. When she presented the groundbreaking research she and her colleagues were doing at international conferences, we were there filming.
Each doctor we met opened new doors – to other doctors (pediatricians, ophthalmologists, radiologists, neurologists) working on unique aspects of Zika research and to patients they believed might be willing to talk with us.
It helped that they could see we had made a long-term commitment to reporting this story, that we were willing to track down every lead, and that we wanted to get it right.
Their desire to open those doors increased over time as it became clear that the government was not telling the truth about Zika.
While doctors and scientists were in the throes of grappling with this global health crisis, official statistics about Zika (how many cases, how many cases of pregnant women, how many birth defects, etc.) were the domain of the Puerto Rico Health Department which had made it mandatory to test all pregnant women on the island for the virus. The statistics they published regularly were the only official Zika numbers coming from the island. The first red flag came when the Centers for Disease Control and Prevention lost confidence in those numbers and quietly stopped publishing them on their own website. Multiple interviews over the two years with the CDC were essential to our story and provided the basis for best understanding the untruths coming from Puerto Rico health officials.
After Hurricane Maria hit in September 2017, the statistics ended altogether. So, too, according to the Health Department, had Zika. The hurricane had essentially washed away the problem. But we learned through our network of Zika doctors and scientists that Zika testing had stopped. There were no statistics to report because the government had stopped testing.
Answering the question “Why?” became the heart of our story. This is when we were reminded that, as journalists, there is no substitute for showing up. Again. And again.
Showing up gave us our first – and only – interview with a Puerto Rico health official. After being rebuffed for so long, the undersecretary of health acquiesced after we followed her to a press conference about school lunches. Many of her statements contradicted all our other interviews.
Most important, the investment of time we had made on the ground and the relationships we had built over the two years allowed us exclusive access to a new post-hurricane Zika study started by Zorrilla in collaboration with the CDC.
The bombshell: Zika rates in the pregnant women being tested are nearly as high as they were at the height of the epidemic.
Beth Murphy is director of films for the GroundTruth Project and founder of Principle Pictures. She is director/producer/EP for more than 20 documentaries including six features. With films, news reports, podcasts, and photography, Murphy focuses her work on stories of social justice and women’s rights – often in conflict and post-conflict settings. Her work has premiered at top tier film festivals (Tribeca Film Festival, HotDocs) and won numerous awards at festivals globally. Her work has also appeared with PBS Frontline, PBS NewsHour and POV, The New York Times Op-Docs, ABC News, Reveal/CIR, TIME, Washington Post, PRI The World (among many others).