The forgotten mothers and babies of Zika

Updated 1:52 PM ET, Thu November 2, 2017

(CNN)Barely more than children themselves when they give birth, many of the forgotten mothers of Zika-striken babies in the Brazilian state of Alagoas are shiny-new teenagers, just learning to navigate their developing bodies.

Traversing the challenges of motherhood at that age is tricky at best; attempting to navigate them with a baby who carries the mark of the mosquito is almost unthinkable.
Rakely Santos da Silva was only 15 when she gave birth to her "special" child. She told women's rights activist Debora Diniz, who was traveling across Alagoas interviewing mothers of babies affected by Zika, that she had no idea her daughter, Mirela, had congenital Zika syndrome when she was born.
"Special" has a religious meaning for mothers like Rakely, says Diniz, because only "special" mothers can take care of special babies. "You are the one that God knows is strong enough to take care of a baby with a strong dependency."
Rakely's doctors never mentioned the possibility, even though there were obvious issues with Mirela's eyes and muscle tone, because her baby didn't have the typical "small head" of microcephaly, a rare nervous system disorder in which the brain and head fail to develop properly.
Yet many babies can have Zika's hallmark symptoms of eye damage, brain calcification and joint and muscle stiffness without a small head at birth.
Children born with congenital Zika syndrome could have swallowing and feeding difficulties as well as hearing and vision loss. They are also at high risk for seizures or severe developmental delays in moving, speaking, playing and learning.
"She should have been invited to a second visit to the hospital to see if the baby was fine and given access to early intervention to improve her baby's chances at a more normal life," said Diniz, a Brazilian native and law professor at the University of Brasília. "But that didn't happen."
Instead, Diniz said, Rakely's case was discarded, and she and her daughter were added to the list of women and babies considered lucky to escape the ravages of the Zika epidemic.
As a result, Mirela received none of the checkups, medications and developmental resources to which she was entitled.
Mayara Santos de Oliveira and her son, Alejandro Carlos Oliveira da Conceição, live near the coast in Maragogi, Alagoas, not far from all-inclusive tropical resorts.
Mayara Santos de Oliveira was 16 when she gave birth in Maragogi, Alagoas, to her "special" baby, a boy named Alejandro. If she had a fever, a rash or muscle aches during her pregnancy, Mayara didn't recognize them as typical symptoms of Zika.
"These women have been living with tropical diseases for a long time," Diniz said. "They told me, 'I felt some pain in my body but nothing different from everyday life.' Dengue, chikungunya, malaria, it's just another experience of the body."
Maria José Santos de Araújo and her daughter Melissa Vitória                                                                               live in Japaratinga, Alagoas, close to the ocean.
Maria José Santos de Araújo had her first baby at 16 and her third, Melissa Vitória, when she was 20. Melissa Vitória was born with microcephaly, the abnormally small head and brain that is the hallmark of Zika's devastating effect on a developing fetus.
Maria -- who likes to be called Neguinha, a common term of endearment in Portuguese that roughly translates to "sweetie girl" -- told Diniz she had no idea she was carrying a "mosquito baby" until the midwife announced the news with horror at the birth.
In a memory Neguinha described to Diniz tearfully as the "greatest offense," the midwife asked, "Are you going to take her home, or are you going to leave her here?"
Cryslane was 21 when she gave birth to Hiago in Santana do Ipanema, but she told Diniz she still wasn't prepared for the stress of caring for a Zika-affected child.

A Zika mystery

These girls, and others like them, are raising their Zika-stricken newborns in Alagoas, a tiny state in Brazil's poverty-stricken northeast nestled between Pernambuco and Bahia, the epicenter of the 2015-16 Zika epidemic.
Though most states in the northeast of Brazil show startling numbers of Zika-related pregnancies and births, the official numbers in Alagoas are low. That stru