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Despite more than a year of containment efforts, the World Health Organization recently declared the Ebola outbreak in the Democratic Republic of Congo a public health emergency. international scope. The statement reflects the grim recognition that insecurity is preventing an effective response.
In efforts to contain the epidemic, the link between politics and health is highlighted. But there is one crucial aspect that is rarely mentioned: how gender inequalities fuel and exacerbate epidemics.
This suggests that lessons from past responses are ignored.
The gender dimensions of epidemics are both physical and socially constructed. Some diseases, by their very nature, affect the bades differently. For example, the Zika virus usually causes a relatively benign infection, but is particularly at risk during pregnancy because it is related to conbad anomalies. Gender roles have also affected how epidemics are experienced. During almost all epidemics, women voluntarily occupy themselves at home, at their own risk, at high risk and at high cost.
Global health policy has been slow to recognize the gender dimensions of epidemics. During the Ebola outbreak in West Africa, from 2014 to 2016, Sophie Harman, a professor at Queen Mary University in London, wrote:
A review of research on Ebola and Zika epidemics found that less than 1% of published research was gender-sensitive.
I further explore the issue in my paper on the integration of gender in preparations and responses to epidemics. I conclude that the silence on women and gender inequality has two effects: the existing inequalities are compounded by the fact that women suffer more because they are invariably at the forefront of the epidemics and the interventions in this area are not optimal.
Why is it important
One of the consequences of failing to integrate a gender perspective into crisis management is that the health inequities already experienced by women and girls are exacerbated. The Ebola outbreak in West Africa is an example.
Sierra Leone has one of the highest maternal mortality rates in the world. But this increased further during the epidemic, as obstetric care facilities were closed in the affected areas and resources were diverted to emergency interventions.
In addition, pregnant women suspected of being infected have been denied treatment in order to prevent the spread of the virus. Midwives did not have the necessary equipment to protect themselves from infection and there was no clinical guidance on the care of pregnant women infected with Ebola.
Another important factor is that women provide the essential care of the sick. This work of care increases their risk of infection and imposes a huge financial, social and psychological burden.
Research in Liberia shows that women's caregivers continue to suffer the psychological trauma of being solely responsible for those infected with the Ebola virus and the fear of contracting and transmitting the virus, especially to their children.
Failure to recognize the male-female dynamics of epidemics also limits the effectiveness of response efforts. An badessment of Guinea 's Medicine Sans Frontier Ebola response in Guinea found that awareness and education programs had limited impact because they did not understand local gender norms. Documents prohibiting touching and cleaning after appearing to be infected were not relevant to women caregivers.
As revealed by a community research:
In addition, communications did not answer questions such as: "How to manage a family of children, including infants and young children, in quarantine?"
What needs to be done
Of course, it is difficult for policymakers and global health officials to deal with the problems that arise with the epidemic. The crisis context results in a "tyranny of urgency". In this situation, the technical solutions have priority. Structural issues, such as the resolution of gender inequalities, are left aside for later.
But the two recent Ebola outbreaks demonstrate that the distinction between technical and structural challenges is wrong; social and political issues need to be addressed alongside medical responses if we are to protect the most vulnerable and to control the epidemic.
So, how is such a response mobilized? Organizations such as the Social Enterprise Network for Development, a non-governmental organization based in West Africa and active in Sierra Leone during the Ebola outbreak, offer some helpful examples at the grbadroots level. policy makers can learn.
The organization has taken a number of innovative but simple steps. These included:
Fundraising to provide basic supplies such as gloves and soap, to caregivers and money so that allowances can be paid to people who care for orphans.
Work with donors to provide equipment and supplies to health centers.
Adaptation of a weekly radio show, hosted by local women, to provide education on the Ebola virus.
Assist in the establishment of village-based Ebola surveillance committees led by women and local religious leaders to develop a local response and work alongside national efforts.
Similar initiatives at the national and global levels could include funding home care programs during epidemics, investing in strengthening the health system, and involving women from affected communities in the decision-making process.
Author: Julia Smith – Research Associate, Simon Fraser University 
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