Sustainable drainage to address Zika in favelas, Brazil: community perspectives

The 2015 Zika virus outbreak in Brazil established that neonate microcephaly was related to maternal infection by the virus during pregnancy, the highest densities of which occurred in the north-east and south-east of Brazil, the country’s most populated areas. These areas were typically associated with informal settlements or favelas, which lacked effective water management, sanitation and drainage; all of these provided suitable breeding environments for the Aedes aegypti mosquito, the Zika virus vector. This paper reports on a novel study of community perceptions around the potential for sustainable drainage systems to provide a means of reducing areas for the mosquito to breed and hence reduce Zika infections in favelas. Interviews were carried out with key external stakeholders working with favelas and members of the favela community. Poor management of water supply, drainage and solid waste were clearly emphasised by participants, illustrating gaps in current research connecting these areas. Participants proposed that only a holistic approach could address sanitation issues, hence the distribution of Zika-carrying mosquitos, subsequent infections and microcephaly. An approach was therefore needed taking account of the environment as a whole, increasing public awareness of sanitation and environmental health, improving sanitation infrastructure and providing adequate systems for solid waste management.