From shrieks in bucket to laughs, Brazil Zika baby improves

In this May 2, 2018 photo, Solange Ferreira sits close by as a therapist works with her son Jose Wesley Campos, who was born with the Zika-caused microcephaly birth defect, at the Disabled Child Assistance Association, in Recife, Brazil. Ferreira remains optimistic despite frequent frustrations with the treatments and exhaustion from taking care of a child with so many needs. (AP Photo/Eraldo Peres)
In this May 4, 2018 photo, Solange Ferreira and her son Jose Wesley Campos, who was born with the Zika-caused microcephaly birth defect, wait for his therapy session at the Disabled Child Assistance Association, in Recife, Brazil. Ferreira say she has considerable help compared to many parents in the same situation: Bonito's mayor has a driver take the boy and his mother to appointments in Recife, the state capital that is three hours away, and to his early education day care center. (AP Photo/Eraldo Peres)
In this May 8, 2018 photo, Jose Wesley Campos, who was born with the Zika-caused microcephaly birth defect, sits with fellow students at an early education daycare in Bonito, Brazil. Jose can move his arms and grab a pencil, but he can't crawl or stand and can only sit up, propped up, for short periods. (AP Photo/Eraldo Peres)
In this May 8, 2018 photo, a fellow student gently strokes Jose Wesley Campos, who was born with the Zika-caused microcephaly birth defect, at an early education daycare center in Bonito, Brazil. Jose, who will be 3 in September, attends the daycare two days a week. (AP Photo/Eraldo Peres)
FILE - In this Dec. 23, 2015 file photo, Solange Ferreira bathes her son Jose Wesley Campos, who was born with the Zika-caused microcephaly birth defect, in a bucket at their house in Poco Fundo, Brazil. Images of Jose in the bucket and being soothed by various family members, captured by Associated Press photographer Felipe Dana in 2015 and 2016, helped make Jose an international face of the Zika virus that became a world health crisis. (AP Photo/Felipe Dana, File)
In this May 4, 2018 photo, Jose Wesley Campos, who was born with the Zika-caused microcephaly birth defect, smiles while waiting for his therapy session at the Disabled Child Assistance Association, in Recife, Brazil. A stark contrast from a few years ago, when Jose would shriek uncontrollably. Desperate, his mother would calm him by putting him in a bucket of water. Now his mother says, "Sometimes, it is as if he swallowed a clown.". (AP Photo/Eraldo Peres)
In this May 4, 2018 photo, Jose Wesley Campos, who was born with the Zika-caused microcephaly birth defect, waits for his therapy session at the Disabled Child Assistance Association, in Recife, Brazil. Despite the progress, the developmental challenges for Jose are gargantuan. He recently had hip surgery, which doctors have found necessary for many children with microcephaly as they become toddlers. (AP Photo/Eraldo Peres)

BONITO, Brazil — It's well before dawn, but Jose Wesley Campos giggles nonstop as his mother plays with his thick glasses while preparing to take the toddler to a doctor's appointment three hours away.

"Sometimes, it is as if he swallowed a clown," said his mother, Solange Ferreira.

That is a happy contrast from the child's first months, when Jose, who was born with an abnormally small head amid an outbreak of the Zika virus in northeast Brazil, would shriek uncontrollably. Desperate, Ferreira would calm the boy by putting him in a bucket of water.

Images of Jose in the bucket and being soothed by family members, captured by Associated Press photographer Felipe Dana in 2015 and 2016, helped make the boy an international face of the Zika virus that became a world health crisis.

Today Jose, who will be 3 in September, attends an early education daycare two days a week in Bonito, a city in the hardscrabble state of Pernambuco, one of Brazil's poorest which was hit hard by Zika.

Jose has shown modest improvement. He can keep his head up thanks to therapy that has strengthened his neck and torso. He gets a lot of stimulation from his three older brothers, who play with him and help with exercises at home. His eyes no longer wander aimlessly, but instead focus on whatever is in front of him.

He also can utter three words that are a mix of truncated Portuguese sounds: "goo," ''gui" and "ma" for oatmeal, dad and mom, respectively.

"Our life is very busy, but the evolution has been great," said Ferreira, whose face has deep wrinkles from the blazing Pernambuco sun.

Ferreira, who says her son has taught her so much about love, also has considerable help compared to many parents in the same situation: Bonito's mayor has a driver take the boy and his mother to appointments in Recife, the state capital that is three hours away, and to school. She also remains optimistic despite frequent frustrations with the treatments and exhaustion from taking care of child with so many needs.

The day she and Jose traveled in the wee hours of the morning for an appointment, upon arrival she was told the doctor they came to see had gone on vacation.

A few days later, they returned to the same hospital for what Ferreira hoped would be the start of water therapy. However, the boy was only examined. She was told to return in a few weeks to begin therapy.

"Sometimes things don't work out, but we persist," said Ferreira, 42.

Despite the progress, the developmental challenges for Jose are gargantuan.

He recently had hip surgery, which doctors have found necessary for many children with microcephaly as they become toddlers. That has made him irritated, as therapy can be painful.

He is fed with a tube through the nose, and a water thickener is added to liquids to keep him hydrated. He can move his arms and grab a pencil, but he can't crawl or stand and can only sit up, propped up, for short periods.

Those problems make learning in school very difficult despite doting teachers and being in an inclusive environment with other children.

"His interactions are severely affected," said Dr. Irene Beltrao, one of the doctors who treats Jose at Recife's AACD hospital, which specializes in treating people with disabilities. "He has a high degree of microcephaly."

None of that phases Ferreira, who remembers when doctors told her the boy had little chance of surviving. Indeed, between 7 and 10 percent of children born with microcephaly in the states of Pernambuco and Paraiba, two states particularly hard hit, have died.

With a lot of affection from his family, attention in school and the help of doctors and therapists, Jose is thriving in his own ways. He is also touching people along the way.

"Microcephaly is not a monster, it doesn't come from another planet," said Ferreira, adding that the toddler "will only develop if we love him a lot."

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