A Clear Insight of Gender in Ebola and COVID-19 Outbreaks: The Susceptibility Normalized

Patients in an Ebola treatment center in Butembo in the Democratic Republic of Congo. Photo by Baz Ratner / Reuters.
By: Joselyne Nzisabira, MBBS/MGHD Class of 2025
This essay was awarded first place in UGHE’s student essay writing competition on “Gender Equity Issues during Pandemics.”

“We are in this together”, is a popular phrase used by leaders and news reporters during the COVID-19 lockdown, and one that is rarely conceptualized. In the past few years, the world has faced a socio-economic and political crisis as a result of the outbreak of pandemics; the Ebola virus which first affected West Africa, and the current on-going Coronavirus also known as COVID-19. Many questions have been raised about the explosion of these diseases and how they affected and are still affecting the global society. Gender is among the most heavily affected areas of the global society. However, the world has failed to realize the vulnerability of women within such outbreaks despite the awareness of gender issues. Recognizing the vulnerability of women in pandemics should be a basis for formulating policies that address the gender imbalances embodied in the different socio-cultural and economic systems of countries. This essay evaluates the vulnerability and probability of women being infected by the Ebola and COVID-19 viruses, and the lessons the world should learn from their experience. The discussion draws examples from a global perspective, with a focus on the Democratic Republic of Congo (D.R.C), United States of America (U.S.A), Rwanda, West, and Central Africa.

Women’s primary role in some societies has been marked as a risk factor in the spread of the Ebola outbreak (UN, 2014). This deadly virus that was named “a care-givers disease” in 2015 by Dr. Paul Farmer, Chief Strategist and Co-founder of Partners In Health, was reported to be a zoonosis that has spread through West and Central Africa and killed more than 25,000 people (BBC, 2016). The spread of the disease was associated with the ways people lived and their contextual circumstances. In D.R.C, as in most African countries, the primary health care providers both at home and in hospitals are women (Menéndez et al., 2015).  In fact, because of historically-reported mistrust in some leaders (Richardson et al., 2019), most sick people first consulted mothers within their communities for treatment before going to hospitals to seek more formal treatment and care. This has put many women at risk of being infected because they lacked the necessary “stuff, staff, space and system”, which are the materials, skilled personnel, and well-organized health system needed to fight against Ebola (Farmer, 2015). However, a clearer solution should be taken to relieve women from the risk they face as primary caregivers. The complex socio-cultural rules that normalized women staying home giving them a primary duty of caregiving while men worked as heads of families left some African people blinded and inconsiderate. Wouldn’t it have been easy to fight against the spread of the pandemic if the negative gendered paradigms had been solved before?

Later in 2020 (Onyango, 2020), the vulnerability of women to these infections was said to be associated with sexual agency and domestic violence. After gender factors came to researchers’ attention, findings showed that the Ebola virus survived in male semen for some months, which put women at risk of getting infected during sexual intercourse (Davies & Bennett, 2016). In fact, women’s power is limited when it comes to sexual reproductive rights in most African cultures. This posed risks for more women to be infected by their survived husbands because there were risks that in some cases, there might be limited consent for sexual activity. The number of women infected by the virus kept increasing, more so than the infection rate for men. In West Africa, there were 8,703 cases of women and 8,333 cases of men by November 4, 2015 (Davies & Bennett, 2016).  An increase in the number of cases in women could have also been associated with domestic violence. Notwithstanding the effects of domestic violence, society keeps normalizing this socially constructed violence which poses more risks to more women now and in the future. The question that should be asked is how much longer will women put up with being taken advantage of?

Women’s rights activists hold printed half-face pictures showing victims of domestic violence during a protest in Bucharest on March 4, 2020 – Photo by DANIEL MIHAILESCU

Despite the worsening of the Ebola virus with unrecognized gender effects, the world hasn’t learned its lesson yet. Most of the mistakes made as a result of the proven gender inequities during the Ebola outbreak are still playing out in the COVID-19 situation. In Rwanda, though the government has tried to make strides in reducing existing income imbalance (GOVRW, 2019), income inequality between men and women has left women struggling since most of them do less paying and casual jobs. This quantifies the global percentage of 76.2% of the unpaid work being done by women (Twahirwa, 2020). However, we should be considerate of the  Staying at home is a good strategy and major recommendation in COVID-19 prevention but vulnerability occurs when the only way of survival comes from jobs that necessitate working out of the home. In fact, in the USA, research showed that the rate of unemployment during the COVID-19  had an increase of 0.9 in women and 0.7 in men (Henriques, 2020). This shows the existing imbalances of how jobs typically prescribed for women are sometimes considered less valuable than those occupied by men. Therefore, society should be sensitive to the fact that women’s limitations due to socially constructed roles especially in Africa plays a role in hampering their employment. 

Rwanda’s journey to battle gender-imbalance is continuously moving forward. The existing gender imbalances manifested in job provision and accessibility should be put into consideration to build strong health systems. Men in Western Europe were found to be more prone to the physical ramifications of dying from COVID-19 due to their weak immune system as a result of their lifestyles such as high alcohol and cigarette consumption compared to women. However, there is a lack of clear evidence to back up the difference in proneness based on gender (Henriques, 2020). Nonetheless, women tend to suffer the social and economic consequences of quarantine more as a result of limited access to a fixed income (Henriques, 2020. Paying no heed to these facts poses more risks to women mainly during pandemics. A lesson the world should learn is that neither men nor women should be victims of their gender when fighting against health issues.

Reported cases of domestic violence have increased in Rwanda during the COVID-19 outbreak (Iliza, 2020). The “stay at home” policy has put spouses with violent partners at risk of being either sexually, physically, or mentally assaulted. Andrews Kananga, a Rwandan lawyer, and executive director at Legal Aid Rwanda has confirmed the receipt of more cases during the quarantine. These cases were mainly from teen mothers obliged to live with husbands who impregnated them and couples whose divorce cases had not yet been resolved before the COVID-19 outbreak (Iliza, 2020). Domestic violence doesn’t discriminate, a victim can either be male or female. However, a large percentage of reported cases, mainly sexual violence, were perpetrated against women  (Iliza, 2020). This shows how unresolved sociocultural issues can expose and exacerbate inequalities during a pandemic.

Given all the challenges women faced as a result of gender roles, what should be done? The global society should recognize the key role that women play, not as a way of repressing their roles but as a basis for formulating policies against the sociocultural violence embodied in these roles. There needs to be a reflection on these gender roles as we fight against the pandemic. Equity and gender-centered institutions should raise awareness based on the data available on gender inequities. Normalization manifested in these imbalances makes the battle harder. Fighting against Ebola would have been easier in West and Central Africa if structural violence resulting from culturally gendered roles had been resolved. By reflecting on this, policymakers need to see that despite ongoing conversations and actions to try to level the imbalances, gender imbalances still exist and not only hamper efforts to fight against pandemics but also countries’ developments. 

Additionally, we need to shift our conversations from ‘how far the pandemics have spread’ to ‘why the pandemics have spread’. Taking a closer look at why the Ebola and COVID-19 pandemics have spread, there was a big contribution of the structural violence that was already taking place before the outbreaks.  A good way to go is to think big and solve the issues before they cause more problems.

The gender-related vulnerability will never end unless there is a friendly ecosystem across every sector, professional, contextual environment, and at national, regional, and community level for women. Women have been among the high prone groups in the Ebola outbreak because of the socio-cultural responsibilities they have in African society. The world needs to learn from the Ebola outbreak lessons to prevent vulnerability in the current COVID-19 pandemic. During these hard times of quarantine, governments should not only put into consideration the general poor population but also consider teen and single mothers without a reliable source of income who are struggling. There is a need for specificity because we cannot ignore that the more we generalize, the more vulnerability increases. It is this specificity that will enable health providers to look at particular reasons why women are disadvantaged. In addition, institutions in charge need to continue to fight against structural violence embodied in socio-cultural organizations manifested in job provisions, and other areas. Ebola and COVID-19 pandemics have exposed the existing economic and sociocultural gendered imbalances. It is time to create new policies, and for each and every one of us to commit to our own personal gender equity agenda, to eradicate these issues before they affect future endeavors.



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