Almost exactly two years ago, South America was swept up in a public health crisis that affected hundreds of thousands of women. In Brazil, more than 2,600 children were born with microcephaly – an abnormally small head – and other health complications resulting from the viral infection Zika. Brazilians became accustomed to the unfamiliar name of the disease, which spread fast through the northeast of the country and across borders to Colombia and Venezuela. But even as the disease became an international concern, it quickly became clear that it was a much bigger problem for some than for others.
As someone who works on climate change adaptation, I was particularly struck by the climatic and systemic elements of the epidemic.
In the northeast of Brazil, the area most affected by Zika, droughts are not uncommon and are intensifying with climate change. Substandard or absent water and sanitation services are common in Brazilian cities. In 13 of the 27 state capitals, less than half the population has access to municipal sewage collection services. Thirty-four million people do not have access to treated and clean water in their homes. Many households, particularly among the poor, store water themselves to deal with shortages. In 2015, abnormally high temperatures in the northeast combined with the amount of stored water and poor urban infrastructure provided fertile breeding ground for the mosquito that carries Zika, Aedis aegypti. Thus poor, under-served, urban households faced the brunt of the epidemic.
The most devastating impact, however, was reserved for yet a smaller subset of the population. As a middle-class, white woman living in São Paulo, I felt far removed from the crisis. Despite the incessant national and international media coverage and messages from my friends abroad, I was not concerned with my exposure. Many other Brazilian women faced a different experience.
Six percent of Brazil’s population – almost 12 million people – live in informal settlements known as favelas. Among this population of slum dwellers, roughly half, or 6 million people, are women. Zika spreads not only through Aedis aegypti but through unprotected sex. Most adults with the disease show no symptoms but it can spread to an unborn child and have life-altering effects.
Access to family planning and reproductive health information is limited in Brazil, especially in the favelas. Half of all pregnancies are unplanned, 20 percent of all pregnancies are in teenagers, and abortions are illegal. Throughout the Zika crisis, even as the dangers to poor women and their children became clearer, these basic risk vectors remained unchanged. Abortions were not granted to infected women and reproductive health information and resources remained scarce. The initial government response advised women only to withhold sex and delay pregnancy. The onus to prevent Zika was placed solely on the shoulders of those most affected.
The gender disparity of the crisis was emphasized by University of Brasilia law professor Debora Diniz. “Lost in the panic about Zika is an important fact: The epidemic mirrors the social inequality of Brazilian society,” she wrote in a New York Times editorial. “It is concentrated among young, poor, black and brown women, a vast majority of them living in the country’s least-developed regions.”
Ask the Other Question
A recent and excellent report by Human Rights Watch, “Neglected and Unprotected,” analyzes the long-term impacts of the Zika epidemic on poor, urban women, with far-reaching implications that go beyond climate change and gender inequality. It makes technical recommendations that address public health emergency responses; access to health information; education and awareness raising; child support; people’s rights to water security and sanitation; sexual and reproductive health care; decriminalization of abortion; climate change adaptation policy; and urban development policy.
Seeing the complex ways the crisis affected some and not others, I developed a sense of urgency that the epidemic had afforded us an opportunity to better understand how climate change might affect cities from a systemic and intersectional approach. How can cities ensure their most vulnerable citizens are protected from and prepared for climate change? More importantly, how can cities account for the varying impacts on diverse groups of people, identities and individuals?
The term “intersectionality” was coined by critical race theorist Kimberlé Crenshaw and is defined as “the interaction between gender, race and other categories of difference in individuals’ lives, social practices, institutional arrangements, and cultural ideologies and the outcomes of these intersections in terms of power.” In disasters risk management research, for example, intersectionality helped develop the understanding that although vulnerability to extreme weather events is gendered, it is “also shaped by ability, family type, cultural/racial group and class.”
Adopting intersectional approaches can help reveal otherwise hidden information about groups of people or individuals that are useful for climate change adaptation planning and extreme weather events. The American law professor and activist Mari J. Matsuda employs a method called “ask the other question” that could be used by urban adaptation planners too. “When I see something that looks racist, I ask, ‘Where is the patriarchy in this?,’” she says. “When I see something that looks sexist, I ask, ‘Where is the heterosexism in this?’ When I see something that looks homophobic, I ask, ‘Where is the class interests in this?”
The end of Zika doesn’t begin with the eradication of a mosquito: it requires urban planning through an intersectional lens.
With a better grasp of the realities that poor, black and brown young women face, urban planners could have identified the need to reduce risks of mosquito proliferation and developed long-term support structures for families affected by the disease.
Zika teaches us that solutions to climate change-related problems in cities will come through better governance, planning, and efforts to increase participation and social inclusion. City managers and planners need to internalize and promote awareness of intersecting structures to identify needs and vulnerabilities that aren’t immediately obvious and develop plans accordingly. As cities build capacity to plan for and manage climate change impacts, these processes should be accountable to different life experiences, resources, and levels of agency and power – or they risk missing those most likely to be affected.