In Little Haiti, Liberty City, and a number of other neighborhoods in Miami, canvassers are now walking door to door to spread the word about the risks of Zika, one household at a time — hoping to reach 25, 000 people the next six weeks. In some neighborhoods, these workers aren't sponsored by federal or state health agencies, but by Planned Parenthood.
Lillian Tamayo, the CEO of Planned Parenthood of South, East and North Florida, told NPR that Miami-Dade County has the state's largest population of people without health coverage, which leaves these residents particularly vulnerable to Zika. "More than one-third of Florida does not have an OB-GYN," she said. "It also is among the worst states in the country for women's health and women's well-being. And it has staggering infection rates for sexually transmitted diseases. And now we have Zika."
Jean Baptiste is one of the Miami residents Tamayo is eager to reach. Baptiste lives in an apartment above a convenience store in the neighborhood of Little Haiti with her father and several other people. When one of Planned Parenthood's canvassers, Lenroy Watt, showed up at her door recently, Baptiste told him she hadn't heard anything about Zika.
"You're not aware of it?" Watt asked Baptiste, a bit surprised. "All right, not a problem," he continued. "So it's a good thing we're here today then, to make you aware."
Watt talked to Baptiste about the virus and the illness, and left information in Creole, including phone numbers for mosquito control, and for the county's health offices where free Zika tests are available for pregnant women.
In the weeks since local Zika transmission was confirmed in the nearby neighborhood of Wynwood, the mosquito control agency has conducted intensive spraying there. Health workers have also gone door-to-door in Wynwood, testing residents for the virus. But in Little Haiti, just blocks away, people have received very little information about Zika, resident Harry Noel told NPR.
"Nobody ever show up to educate the neighborhood, those people, how to get rid of mosquitoes, what to do," he said. "Nobody! It's for the first time I've seen somebody coming and ... address that problem."
Family planning is a key part of the Planned Parenthood message. The organization is also distributing Zika prevention kits, including condoms and mosquito repellent, to pregnant women at its health centers.
Dr.Christopher Estes, the group's chief medical officer, said Planned Parenthood decided it could best augment the state and federal response by doing outreach in areas where government health workers haven't been active — neighborhoods surrounding the zones of local Zika transmission.
"This is a natural extension of the work we do with reproductive health care and sexually-transmitted infections," Estes said. "It just made sense. And this is a time of a public health crisis. When you have something like this going on, it's, 'All hands on deck.' "
Although Planned Parenthood is working to coordinate with the state, relations are still strained. In recent years, the group's dealings with Florida officials, including Gov. Rick Scott, have been contentious. A federal judge recently struck down a Florida law signed by Scott that would have cut a half million dollars annually for preventive health care from Planned Parenthood. The family planning group is also one of many healthcare providers that have been critical of Florida's governor for blocking an Obamacare-authorized expansion of Medicaid in the state.
State officials declined comment to NPR on the Planned Parenthood canvassing operation. The effort to cut federal funding for the organization has also gotten tied up in Washington with the fight against Zika. Congress became deadlocked over a White House request for $1.9 billion in emergency Zika funding after House Republicans added several riders to the bill — including provisions to defund Planned Parenthood.
At a news conference this week in Miami, Democratic Congresswoman Frederica Wilson called on congressional leaders to stop targeting Planned Parenthood and to get serious about Zika.
"Call us back to Washington, D.C.," she said. "The House and Senate should reconvene and pass a clean bill to fight Zika."
In South Florida, Planned Parenthood expects to knock on some 25-thousand doors in medically underserved areas through September. That's the most recent estimate of when Zika cases are likely to peak in Florida.