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Three years ago, an outbreak of the Zika virus in Brazil's impoverished northeast led to thousands of babies being born with a birth defect called microcephaly. The virus is spread by mosquito, and scientists determined that it could lead to congenital defects in fetuses of mothers who were infected during pregnancy.

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In 2017, there were fewer than 18,000 Zika cases and fewer than 300 children born with microcephaly. So far this year, Brazil has seen about 2,200 cases of Zika and 20 cases of microcephaly and other developmental abnormalities. Then, thanks to scientists call "herd immunity" in hard-hit areas and public awareness campaigns, the number of cases of Zika and microcephaly plummeted.

Seeing the children in school helps provide a window into the challenges children with microcephaly may face as they grow, but the institutions receiving them are often ill-equipped meet their needs.

Yara da Costa says her daughter came down with pneumonia on a Monday evening. She was then transferred to a hospital in Campina Grande, one of the state's largest cities. She took the baby to a local hospital in Lagoa Seca, a small poor city in the middle of .

In this May 3, 2018 photo, mothers with their children, who were born with the Zika-caused microcephaly birth defect, sit in a waiting room at the Getulio Vargas Hospital, in Recife, Brazil. Three years ago, an outbreak of the Zika virus in Brazil's impoverished northeast led to thousands of babies being born with microcephaly. (AP Photo/Eraldo Peres) Now toddlers, some are trying out school while others, afflicted with myriad health problems, are fighting to survive.