It started with spots. A rash on the stomach, then a mild fever, headache and aching joints. It passed in a few days. In the Brazilian city of Recife, these are familiar enough symptoms.
A year ago, 15-year-old Ruana would have assumed she had a mild version of dengue fever. The heavily pregnant teen certainly wouldn’t have been sitting in a hospital corridor anxiously awaiting an ultrasound.
The paint is peeling, and the walls are lined with those soft-focus photos of idealised mothers and babies by Anne Geddes. Ruana’s here to find out if her baby is likely to be born with birth defects as a result of her brief sickness.
She’s been infected with a mosquito-borne virus, Zika – the four-letter word that now haunts the women of Recife, as well as millions of others across Latin America.
It’s believed to be behind a massive spike in the number of babies born with microcephaly, a condition where their heads are abnormally small, and their brains are underdeveloped.
“We just got scared because we don't know what's going to happen from now on,” Ruana tells me. “We don't know if the baby will be born sick or not. I'm just waiting to see what happens.”
Pregnancy and childbirth are often fraught with anxiety – mothers-to-be are warned off smoking and drinking alcohol, eating certain foods, gardening without gloves and even having a hot bath.
But what do you do if you live in the tropics, surrounded by mosquitoes, and you’re told to avoid getting bitten – for nine months?
If you’re not wealthy enough to enjoy air conditioning, it’s simply not practical to cover up for that long in the oppressive humidity. If you live in a favela, you probably can’t even afford repellent.
How fearful would you be if you knew that because of an insect bite, your child could suffer from seizures, intellectual disability, hyperactivity, impaired motor skills, even blindness and deafness?
I’ve travelled to Recife, the capital of the north-eastern Brazilian state of Pernambuco, because I want to know what it was like to live – and love – with questions like this hanging over your head.
“When you have a baby you hope that the baby is normal,” paediatric neurologist Dr Vanessa van der Linden tells me. “We idealise the ‘perfect baby’ and it’s difficult when you see that it’s not this.”
Much about the Zika epidemic, and its relationship to microcephaly, remains mysterious.
Jacqueline, who’s also waiting for an ultrasound, points out that that some women never show signs of Zika during pregnancy, but still have a baby with microcephaly.
“Yesterday on TV they talked about one mother, pregnant with twins, and the ultrasound showed that everything was perfect. When the babies were born, the girl was born with microcephaly and the boy was perfect,” she tells me.
“But she had no symptoms for the whole pregnancy. Her pregnancy was all normal.”
In fact 80 per cent of people infected with Zika will never show any symptoms, so most pregnant women will never even know they’re infected. Some will be in for a nasty shock.
When I ask 16-year-old Leticia what she thought when she was told her baby’s microcephaly was ultimately caused by a mosquito bite, her mother, Lourdes, butts in:
“We actually doubt it, because this mosquito exists for many years. And now, after all that time, the mosquito is ‘waking up’? We don’t understand it.”
Lourdes points out that their neighbour also had symptoms of Zika during pregnancy, but her child was born healthy in November. One month later Lourdes’ grandson was born with microcephaly.
Unfortunately, Leticia can’t breast feed her son.
“I don’t have any breast milk. I think it’s because I kept thinking about him… because the doctor said he was going to have microcephaly,” she says.
So you may not even know you have Zika. And if you do have it, you won’t know if your baby will have microcephaly. And if your baby is born with microcephaly, you may not know what this will mean for years to come.
It’s a time bomb set for slow release.
The many unanswered questions fuel more fear, along with conjecture and conspiracy theories. Some blame vaccines for the microcephaly. Another theory blames a chemical larvicide added to the municipal water supply. Both theories are easy to debunk, but persist nonetheless.
Obstetrician and gynaecologist Dr Adrianna Scavuzzi actually wishes these theories were true, because if, for example, a vaccine was to blame:
"It would be even easier to fix because we know - stop using this vaccine. But if this problem is directly related to mosquito bites, we have to change the sanitary condition of people. We have to change peoples’ lives. It will take a decade to happen. That's why I'm so worried about this problem.”
Dr Vanessa van der Linden, the paediatric neurologist who first identified the spike in babies being born with microcephaly, knows that the scope of this crisis is yet to unfold.
“It’s not like an infectious disease, like you have a problem for a time and then everything goes away,” she tells me.
“The consequence will be for the future of these children, these mothers, and this country. Because now they are children but soon they will grow and we have adults with severe neurological problems. We need to follow these babies for the rest of their lives.”
The Brazilian health ministry has promised to provide the 7,500 extra health professionals who will be required to care for the children into the future. But in the middle of a crippling recession, the government can’t even pay for the health workers it already employs.
In the meantime, mothers lavish their babies with all the love, hope and prayers they can muster.
And those who want to have a child? Would-be parents pray for a vaccine, and the authorities advise them not to get pregnant. As one woman asked me:
“Because of a mosquito, will I have to postpone a dream?”
See the full story, Love in the Time of Zika, at the top of the page.