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Geopolitics

As Zika Spreads, Desperately Seeking Brazilian Doctors

Doctor examining brain scans of a Zika-infected patient, in Recife, Brazil
Doctor examining brain scans of a Zika-infected patient, in Recife, Brazil
Marcelo Toledo

SÃO PAULO — As dengue and the fear of the Zika virus continue to spread, local authorities across Brazil are desperately looking for doctors as they set up field hospitals to treat patients infected by the Aedes aegypti mosquito, which transmits both diseases.

In cities of the states of São Paulo, Minas Gerais, Mato Grosso do Sul and Paraná, some prefectures are offering up to 1,200 reais ($310) per working day, in a bid to attract enough doctors to meet the high number of patients presenting dengue symptoms. Cities where the epidemic is present or where a state of emergency has been declared are facing the most difficulties to find doctors.

With 927 new patients in the first 15 days of January alone, Ribeirão Preto, in the state of São Paulo, plans to spend 15.8 million reais ($4 million) to employ temporary doctors, nurses, technicians and receptionists to help contain the outbreaks. "We've set up a more flexible contract," explains Darlene Mestriner, vice-secretary of the Health Ministry. "And we're paying 1,200 reais ($310) for a 12-hour shift."

Field hospitals have meanwhile been created in Campo Grande (in Mato Grosso do Sul) and in Paranaguá (in the state of Paraná), where Carnival celebrations have been postponed until July. "We're having huge difficulties finding doctors," says Osvaldo Capetta, a government spokesman in the state of Paranaguá. Volunteers are offered a salary of 3,100 reais ($800) for 20 hours a week.

The city of Uba, in southeastern Brazil, is also in a state of emergency with more than 1,000 cases of dengue, and at least one case of a pregnant woman suffering from Zika. Doctors willing to work there can earn 700 reais ($180) for a day shift, and 780 reais ($200) for a night shift.

President Dilma Rousseff has asked for the whole of Brazilian society to engage in fighting against the mosquito responsible for the outbreak of dengue and Zika — a global emergency for the World Health Organization. The number of confirmed cases in Brazil at the start of the week stood at 404, with 3,670 still being analyzed.

If the installation of field hospitals and the recruiting of doctors alleviates the situation for patients suffering from dengue, it's far from being a lasting solution, experts say. Only better trained health professionals and measures against the mosquito can both improve the patients' conditions and reduce the transmission of the fever and Zika.

For infection specialist Juvencio Furtado, professor at the Faculty of Medicine of the Federal University of ABC, the measures may help unclog the health care system, but won't change the course of the outbreak. "We need to fight efficiently against the transmitter. This should have been done a long time ago already, with simple measures such as the regular collection and treatment of garbage in the streets," Furtado says.

Nearly 30% of Brazilian municipalities have no regular trash collection, no wastewater treatment or potable water. All of these factors combined contribute to the Aedes aegypti's proliferation, not to mention the continuous use of larvicides and insecticides that have enabled the mosquitoes to develop an immunity to these products.

For Artur Timerman, president of the Brazilian Society of Dengue and Arbovirus, the measures taken so far are merely intended to show that something's being done, as criticism over the lack of coordination between local, state and federal authorities grows. "The situation is chaotic," he says.

Worse, he believes that too many of Brazil's doctors aren't prepared to deal with the outbreaks and aren't being adequately trained. "We've had more than 800 deaths due to dengue last year," Timerman says. "Each one of them is proof of a lack of health care."

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Geopolitics

How A Drone Strike Inside Iran Exposes The Regime's Vulnerability — On All Fronts

It is still not clear what was the exact target of an attack by three armed drones Saturday night on an arms factory in central Iran. But it comes as Tehran authorities appear increasingly vulnerable to both its foreign and domestic enemies, with more attacks increasingly likely.

Screenshot of one of the Saturday drone attacks arms factory in Isfahan, central Iran

One of the Saturday drone attacks arms factory in Isfahan, central Iran

Screenshot
Pierre Haski

-Analysis-

PARIS — It's the kind of incident that momentarily reveals the shadow wars that are part of the Middle East. No one has claimed responsibility for the attack by three armed drones Saturday night on an arms factory complex north of Isfahan in central Iran.

But the explosion was so strong that it set off a small earthquake. Iranian authorities have played down the damage, as we might expect, and claim to have shot down the drones.

Nevertheless, three armed drones reaching the center of Iran, buzzing right up to weapons factories, is anything but ordinary in light of recent events. Iran is at the crossroads of several crises: from the war in Ukraine where it's been supplying drones to Russia to its nuclear development arriving at the moment of truth; from regional wars of influence to the anti-government uprising of Iranian youth.

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That leaves us spoiled for choice when it comes to possible interpretations of this act of war against Iran, which likely is a precursor to plenty of others to follow.

Iranian authorities, in their comments, blame the United States and Israel for the aggression. These are the two usual suspects for Tehran, and it is not surprising that they are at the top of the list.

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