How Puerto Rico’s history makes it hard to fight Zika today

Tanjim Hossain is an NSF Graduate Research Fellow at the University of Miami’s Abess Center for Ecosystem Science and Policy

Courtesy of Tanjim HosseinCo-qui… co-qui… co-qui,” whistle the namesake frogs in a cacophony that fills the humid night air here in La Isla del Encanto. I’ve just stepped off the deplaning ladder in Aguadilla, Puerto Rico. I’m here for a few days to investigate local attitudes toward Zika and delve into the connections between the science, perception, and policy-making here in this hotbed of transmission.

Puerto Rico has nearly 8,000 confirmed cases of locally acquired Zika. Many more are likely to have been infected, since 80 percent of the people who get Zika show no symptoms. Given how much travel there is between the island and the continental U.S., it’s reasonable to assume some of the 157 travel-related cases in Miami-Dade County originated in Puerto Rico.

But despite the outbreak, Puerto Ricans in the capital have fought the use of the insecticide Naled. I wanted to understand why.

Puerto Rico’s problems began long before Zika arrived on its coconut and almond tree-bejeweled shores. Tens of billions of dollars of public debt are strangling  the economy, prompting a historic exodus of the population — who are U.S. citizens — to the mainland U.S. Roughly half the remaining population sits below the poverty line and congressional help is stalled. The New York Times called Puerto Rico a “failed state” within our own borders. The territory has struggled to respond to Zika for all these reasons and more.

Puerto Rico’s history of militaristic colonialism has left islanders distrustful of outside involvement. From Columbus’ second voyage in 1493 until the Treaty of Paris in 1898, marauding waves of French, Spanish, and English soldiers ransacked towns and slaughtered the Taino natives. To this day, Puerto Ricans suffer health effects such as increased cancer rates from abandoned American naval bombing ranges and their associated unexploded ordinance and depleted uranium munitions.

This history, and the distrust it has created, is definitely a key component of Puerto Ricans’ push for self-determination. I’ve come here now, during the Zika outbreak, to investigate whether this is also at least to blame for the resistance to the insecticide Naled. Street protests in San Juan against it prompted Governor Padilla to reject a shipment of the insecticide Naled for Zika control, currently one of the most effective tools available.

“Zika? My cuñada had it. She’s OK now, though,” says Karelys as she hands me the keys to my rental car. She’s vaguely aware of the protests in San Juan and doesn’t think it was the right idea to spurn the offered aid. She mentions the history of Dengue and Chikungunya in Puerto Rico — other mosquito-borne diseases vectored in part by Aedes aegypti mosquitoes — and that she wishes the mosquito problems would just go away.

I wake the next morning to find a female mosquito on my arm, biting me. I quickly smack her, too late, and smear both her body and my own blood across my skin. Climbing out of bed, I realize the fan has loosened one side of the mosquito net, leaving an opening to the buffet inside: me. Slightly annoyed, I prepare myself for the day and talk to Luis, a laborer building an outdoor shower at the hilltop Airbnb where I’m staying.

“It’s bad,” he tells me, referring to Zika. “We should spray everything we can — I don’t want to get Zika.”

“How important is Zika to you?” I ask, “Is there anything else you think we should be doing?”

“Everything,” he replies.

My next interviewee surprises me. Carolina lives on a small farm with her family, where they raise hens. They also sell $3 parking spots for daily access to the snorkeling beach below the small cliff their house rests on.  

“Those damn Sanjuaneros don’t have anything better to do. Here we are in the open, exposed to all kinds of insects, including mosquitoes and the diseases they spread. Meanwhile, they sit in their air-conditioned offices and houses in the city and make life harder for us,” she said.

She not only sees Zika as a threat, but deeply resents the protesters for preventing her family’s access to what the government — in this case the Environmental Protection Agency — has deemed a safe solution for mosquito control.

The next day, over breakfast at a small stand in front of the local supermarket the next morning, Kelvin, the lone employee, says if this had been handled better, there might not be such an outcry.

“What they should have done is talk to the people beforehand,” he replies.  

I spend my last day in Puerto Rico snorkeling the Tortuga Reef adjacent to the nearshore island, Icacos. The captain on the sailing catamaran which has brought me there tells me, “I wish we could use Naled. I wish we could use everything.”

She sees it all from the perspective of a small business owner. While a decent chunk of her revenue comes from locals looking for a fun weekend adventure, enough of it comes from foreign tourists. And too much of that has dried up over fears of Zika.

On my last evening in San Juan, I sit on limestone steps at the edge of a plaza. Throngs of people stream past me. Young and old, everyone is here for the four Pokéstops. Cars on the adjoining street are filled with occupants waving giant flags and shouting, “Monica!” as they pass by, celebrating the first Puerto Rican to win gold at the Olympics. El gran combo blasts from a rooftop from one end of the plaza, while Cosculluela thumps from another. Here, the opinion on Naled is different.

“It’s a toxin.”

“I heard it’s poisonous.”

“We don’t want any of that stuff here.”

As I board my flight back to Miami, I piece together what I’ve learned:

  1. Most people, especially those from rural parts of the country, see Zika as a serious problem. They are the most likely to support Naled and any other interventions to combat the disease and mosquito vectors.
  2. The people in my limited sample size seem to suggest that living in San Juan > more resources and higher social standing e.g. luxury of taking certain positions based on a perceived lessened threat from Zika > more anti-colonial perspectives > more likely to oppose Naled.
  3. On a deeper level, people aren’t hardline partisans as much as back stateside. There might be some flexibility given the right approach.
  4. The right approach is probably to increase budgets and public health capacities for expanded education and outreach activities. These things should be targeted to enhance public understanding and basic scientific literacy of mosquitoes and relevant control methods.

What’s going on in Puerto Rico is deeply connected to Miami. The outcry against Naled here is understandable. Miami-Dade County’s mosquito control has long been deprived of the resources and funding it needs to comprehensively embrace an integrated approach to public outreach and education. We need to see policy changes from the governor’s office down to help put us at the forefront of mosquito disease prevention.

As a mosquito researcher, I’m often asked about whatever the next Zika may be.

“It’s coming.”

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