An­na-Lisa Paul

As doc­tors re­main fo­cused on pro­vid­ing the best treat­ment and care for preg­nant pa­tients who have con­tract­ed the Zi­ka virus, no thought has been spared as to the im­pact it is hav­ing on those in charge.

In a rare but can­did and soul-bar­ing in­ter­view, one of this coun­try's fore­most pub­lic health au­thor­i­ties on ob­stet­rics and gy­nae­col­o­gy, Dr Karen So­han, has pro­vid­ed an in­sight in­to the psy­cho­log­i­cal and emo­tion­al ef­fect the virus has wrought among those charged with the re­spon­si­bil­i­ty of en­sur­ing the best treat­ment op­tions are avail­able to af­fect­ed moth­ers and their un­born ba­bies.

Ded­i­cat­ing the sim­ply ti­tled piece, The Psy­cho­log­i­cal Im­pact of Zi­ka, to the women she has been serv­ing since March 31 when she was placed in charge of the Min­istry of Health's an­te­na­tal screen­ing pro­gramme at the Mt Hope Women's Hos­pi­tal, So­han shared an­oth­er tid­bit of ex­clu­sive in­for­ma­tion as she con­firmed that the num­ber of ba­bies in which ab­nor­mal­i­ties be­lieved to be caused as a re­sult of the zi­ka virus now ex­ceeds 20.

She said, "For the preg­nant women of this coun­try, this has been a stress­ful pe­ri­od."

Point­ing to the over­whelm­ing ev­i­dence that links the zi­ka virus to ab­nor­mal­i­ties in the un­born ba­by, So­han said, "De­spite this, there were many cou­ples who chose to con­tin­ue their preg­nan­cies. Their mo­ti­va­tion was the over­whelm­ing de­sire for a ba­by."

So­han, the Med­ical Chief of Staff of the Mount Hope Women's Hos­pi­tal, said the 373 women who re­ceived a to­tal of 773 as­sess­ments were a se­lect group–and apart from them hav­ing ev­i­dence of the Zi­ka in­fec­tion, "They all want­ed their ba­bies."

She re­counts, "Un­like the ma­jor­i­ty of ul­tra­sounds per­formed at oth­er times which were ex­pect­ed to be nor­mal and there­fore re­as­sur­ing, in the case of my zi­ka pa­tients, there was al­ways the fear that some­thing would be wrong with the ba­by. The at­mos­phere was one of hope but there was al­ways the threat that some­thing sin­is­ter was lurk­ing."

Re­veal­ing that some pa­tients had con­tract­ed the virus around the time of con­cep­tion, while oth­ers were about to de­liv­er, she said, "We shared in­for­ma­tion as every­one kept up-to-date with the evolv­ing con­di­tion. It was a unique re­la­tion­ship for al­though I have been a doc­tor for 24 years, the doc­tor-pa­tient in­ter­ac­tion with this group was dif­fer­ent."

Con­trolled, well-in­formed and con­fi­dent was how So­han de­scribed her ear­ly in­tro­duc­tion to the virus as she ac­knowl­edged that zi­ka was a new pathol­o­gy and that it would be a learn­ing process.

"All seemed to be go­ing well un­til Sep­tem­ber 5, when the 44th pa­tient was be­ing ex­am­ined. No mat­ter how I tried, I could not get the head mea­sure­ments to cor­re­spond to the num­ber of weeks preg­nant. The head was mea­sur­ing small.

"Fur­ther, as de­scribed in the in­ter­na­tion­al lit­er­a­ture there was in­creased flu­id around the brain and cal­ci­fi­ca­tion of the cere­bral cor­tex.

"An over­whelm­ing sense of pan­ic con­sumed me as I bat­tled with the thoughts fly­ing through my head. The 18 years of prac­tis­ing ob­stet­ric ul­tra­sound at the high­est stan­dards al­lowed me to slip in­to au­topi­lot and com­plete the ex­am­i­na­tion.

"For the first time in my ca­reer, I was re­lieved that my back was to the pa­tient and her hus­band. By now my cheeks and ears were flushed and my mouth was dry. In my head, I re­hearsed how I was go­ing to break the news to this cou­ple. No words can de­scribe the next few min­utes as I looked in­to their eyes and in­formed them that their most-wished-for ba­by was in­deed af­fect­ed by the zi­ka virus.

"The room was filled with such gloom and de­spair, the mag­ni­tude of which I had nev­er ex­pe­ri­enced. Sad­ly, this sce­nario would play out sev­er­al more times," she tear­ful­ly re­lat­ed.

Ad­mit­ting the sci­en­tist in her was ini­tial­ly fas­ci­nat­ed, So­han went on, "For the first time in his­to­ry, a virus car­ried by a mos­qui­to could harm the un­born ba­by and se­lec­tive­ly af­fect the brain com­pared to oth­er or­gans.

"Fur­ther, it on­ly af­fect­ed cer­tain ar­eas of the brain, es­pe­cial­ly those con­cerned with high­er learn­ing. And now, I could iden­ti­fy those changes on ul­tra­sound. These were no longer im­ages on the In­ter­net or in jour­nal ar­ti­cles but in re­al time that I could de­tect."

En­ter­ing in­to a deep-seat­ed con­flict which she says is still on­go­ing, So­han ex­plained, "As I bat­tled with my emo­tions, so did my preg­nant women. They, too, were ex­pe­ri­enc­ing mixed emo­tions: fear, frus­tra­tion and anger. Be­ing with them be­came ther­a­peu­tic as their ex­pres­sions of grat­i­tude for my work pro­vid­ed an un­be­liev­able strength.

" My heart was bro­ken in­to a mil­lion pieces for the women whose ba­bies were af­fect­ed. Their sor­row was over­whelm­ing."

Paus­ing for a mo­ment, So­han qui­et­ly said, "With­out a doubt, zi­ka has hum­bled me. I have seen the beau­ty and ug­li­ness of mankind, for dur­ing cri­sis sit­u­a­tions there are those who give of them­selves and oth­ers who use the calami­ty to pro­mote them­selves."

Thank­ing her rock of sup­port in the form of her hus­band Ster­ling and their chil­dren, San­jeev, Sari­ka and San­jili, So­han al­so cred­it­ed her sis­ters Michelle and Lindy for their un­stint­ing sup­port which she says sus­tains her both at home and in work, and house of­fi­cer Dr Cathy Ann Cyrus, who has been a pil­lar of strength for her dur­ing the last sev­en and a half months.