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Gender and Social Inclusion

Ebola: Nondiscriminatory Virus, Uneven Burden

The Ebola virus is unique in many ways — but not all. A series of facts about the current outbreak reflects a trend that the Women’s Refugee Commission consistently finds in its research and highlights in its advocacy: When crises happen, women and girls of all ages are uniquely vulnerable and disproportionately impacted. 

Fact: The Ebola virus, which is transmitted to people from wild animals and infects humans through human-to-human transmission, is an equal opportunist. The virus, for which no drug or vaccine has been proven effective, demonstrates no preference for male or female, young or old.

Fact: The Ebola virus does not discriminate. Once infected, the outcome is near certain. Since epidemiologists first documented the virus in 1976, Ebola outbreaks have a case fatality rate of 50 to 90 percent. Say it aloud, slowly: of every 10 people infected, up to nine do not survive.

Fact: Despite the virus’s nondiscriminatory characteristics, the burden of disease is uneven.

Official statements by government representatives and recent analyses by UN agencies affirm that women account for up to 60% of the dead in Liberia, Guinea and Sierra Leone, where the outbreak is currently concentrated. An estimated 75% of infected persons are women.

How does a nondiscriminatory virus result in such an uneven burden as it spreads across West Africa?

Gender roles and norms disproportionately expose females to the virus. In an interview with the Washington Post, Julia Duncan-Cassell, Liberia’s minister for gender and development, noted that “Women are the caregivers — if a kid is sick, they say, ‘Go to your mom' … most of the time when there is a death in the family, it’s the woman who prepares the funeral, usually an aunt or older female relative.” Duncan-Cassell also noted that female youth and young women engage in cross-border trade, accessing weekly markets in Guinea and Sierra Leone.

Even pregnancy is a risk factor. According to the World Health Organization (WHO), two of the three largest outbreaks of Ebola involved transmission of the virus in maternity clinics. The cruel irony is that pregnant women are at high risk because of increased contact with health services and workers.

But it’s about more than just women’s roles within households. In West Africa, women are the traditional birth attendants. They are also the nurses and support staff in hospitals. In a recent telephone interview with international media, the first lady of Sierra Leone, Sia Nyama Koroma, stressed that, “women [in her country] constitute a large section of the health workers and are on the frontlines of this crisis.”

Gender norms in these Ebola-affected countries disadvantage women as compared to men. Different social expectations for men and women in the region largely restrict women’s abilities to acquire the skills, resources and networks that help others to navigate crisis.  For example, consider that every country currently affected by the Ebola outbreak is among the bottom quintile for female adult literacy rates globally. According to UNESCO, the female adult literacy rates (in order from highest to lowest) are: Nigeria (44.4%), Sierra Leone (33.6%), Liberia (27.0%) and Guinea (12.2%).

So when a majority of women cannot read, what are the implications for the delivery of health messages that could prevent the spread of the virus? Given these low rates of female literacy and widespread misinformation about the veracity and implications of Ebola, it is critical not to rely solely on written words to disseminate information. This consideration is merely one of several gender-based differences that responders must address as they design and implement a comprehensive response to the outbreak.

Gender norms and roles contribute to shaping the patterns of disease — but women have the potential to be tremendous assets to the emergency response. The WHO has recognized, for example, that women are conduits of information in their communities, and the organization has thus enlisted women as leaders in campaigns to raise awareness about the disease and how to prevent infection. Understanding the role gender plays in an Ebola epidemic, however, extends beyond capitalizing on pre-existing roles that women assume in their families, communities and societies. The WHO and other actors must continue modifying their communication and intervention strategies in ways that compensate for women’s comparative disadvantages.

As a humanitarian crisis, the Ebola virus and its devastating impact are outliers on many levels. This crisis is a biological outbreak, a unique threat as compared to an armed conflict or natural disaster. Its devastation has the potential to exponentially spread beyond a clearly defined geographical area, a chilling thought that summons deep-seated fears.

But in at least one critical respect, it’s not an outlier: being a woman, particularly a young women, is a vast disadvantage, yet holds the potential to be a powerful asset. The humanitarian community should respond accordingly.


Update: As of 20 August 2014, the UN World Health Organization reports that the total number of registered Ebola cases is 2,473. Of these registered cases in Guinea, Liberia, Sierra Leone and Nigeria, WHO reports that the virus has killed 1,350 people.

This blog originally appeared on Trust.org

Gender and Social Inclusion