Luana Vieira, who is two years old, and was born with microcephaly, reacts to stimulus during an evaluation session with a physiotherapist at the Altino Ventura rehabilitation center in Recife, Brazil, August 6, 2018. Luana’s mother Rosana Vieira Alves has three daughters. “It’s hard to manage the girls. Some of them are jealous, but Luana needs more care. In time, they’ll understand.” Rosana does not have any family support and is overwhelmed by the cost of housing and Luana’s medicines. She counts it a victory that she has managed to get a wheelchair for Luana, and worries about the four surgeries her daughter needs to correct problems with her eyes, her gut and the position of her hips and feet. The demands have taken Rosana to some dark places, and she confesses that she has considered suicide. But she still dreams of a better future, and hopes to get a degree in accounting or civil engineering. REUTERS/Ueslei Marcelino