INTERNATIONAL: Ebola Isn't Unique: Women Are Significantly More Likely to Die in Disasters

Monday, August 25, 2014
The Huffington Post
PeaceWomen Consolidated Themes: 
General Women, Peace and Security
Human Rights

"Two excellent stories, one by Buzzfeed's Jina Moore and another by Lauren Wolfe at Foreign Policy, recently brought to light the fact that women make up 75 percent of the current Ebola epidemic's victims in Liberia. Earlier in the week, the Washington Post reported that in other affected states women have comprised 55 to 60 percent of the dead.

"If a man is sick, the woman can easily bathe him but the man cannot do so," says Marpue Spear, the executive director of the Women's NGO Secretariat of Liberia (WONGOSOL), quoted by Wolfe. "Traditionally, women will take care of the men as compared to them taking care of the women."

Both Wolfe and Moore point out that gender roles affect transmission and mortality rates and that not enough is being done to acknowledge this fact in the development of solutions. The principles at work here are fundamentally true in disasters around the world. As global warming increases the incidence of disasters, this will only become more apparent. Which does not in any way, shape or form suggest that it will be paid attention to by people with the power.

The truth is that while epidemics affect genders differently, what is happening right now gender-wise in countries affected by Ebola is the norm in disasters across the globe. As senior gender adviser at the International Union for Conservation of Nature Rose Mwebza puts it, "whereas disasters do not discriminate against people, humans most certainly do." And what systemic global gender discrimination results in is reduced vulnerability for men. To wit: Women and children are 14 times more likely to die men in a disaster.

Here is where I say that this is not an argument for increasing men's suffering, which is a ridiculous suggestion in any case. It's an argument for understanding the role that gender plays in problems and their effective solutions.

Factors that contribute to higher risks for women are gender role expectations, gendered poverty and the impact of boy preference on education, nutrition and resource allocation -- before, during and after events. "The Gendered Nature of Natural Disasters," which seems in need of no clarification, describes the very significant impact of gender roles and male preference on survival. It also significantly impact everything else.

We know that wealth distribution, global health, state security, and international peace are intimately bound with the status of women. That fact is only made clearly in times of crisis. The very same aspects of culture and economics that create the massive potential promise of The Girl Effect are those that powerfully put them at risk. In many countries, including ours, women are most responsible for care work, have lower status, restricted mobility, are not well-represented in policy and reconstruction processes. They are poorer as a class and frequently face social and cultural prohibitions that inhibit their ability to respond effectively in crises. In many counties, overt boy preferences mean girls and women are less well fed and do the majority of hard labor, which makes them physically weaker in times of epidemic or climate related disaster. Already marginalized people, stigmatized by sex work, rape, sexuality, disability or illness, face greater obstacles in getting care and help. Poor sanitation, already in some parts of the world and a major inhibitor to gender equality, gets worse -- affecting the health, safety and dignity of girls and women in ways that are experienced by most men, even during "normal" times. Imbalances in mortality and the shattering of social systems makes usually exacerbate existing gender inequities.

The 2013 report "In Double Jeopardy: Adolescent Girls and Disasters," by the aid organization Plan International, provides granular analysis of why girls and women are not only at much higher risk for dying, but at risk for significant violence after natural disaster. While the circumstances of girls and women vary greatly across the globe, based on baseline gender equity in their homes and countries, family and socioeconomic organization, what they have in common, the report explains, is their invisibility.

The 2004 Indian Ocean tsunami killed four times as many women as men. Experts believe that men, who had more mobility and were not in homes caring for children or the elderly, could flee more easily than women. Many were, according to reports, less likely to be able to climb trees or swim. The dearth of women after the disaster meant men faced domestic lives they were ill-equipped for and sought younger women, whose education might be sacrificed as a result, as wives.

In the wake of Hurricane Katrina, one of the worst natural disasters in U.S. history, men and women died in equal numbers. However, single, low-income, African-American mothers were the most adversely affected. Poorer, less mobile and ill-equipped to seek help or escape flooding, women -- responsible for caring for the elderly and for children -- were unable to respond to crisis in equal measure. Already living in environments where health care was a challenge, particularly women's reproductive health care, they, faced harsher, more dangerous and long-term physical and health risks.

In the Philippines, after last year's record-breaking typhoon, 1,000 women were giving birth a day with almost no medical care as a result of their disastrous typhoon having destroyed virtually every care facility. Medical teams who went to the area were not necessarily prepared or equipped to deal with critical obstetrics and gynecology issues. When disaster strikes the "special" needs of women's bodies, which in reality are not special to more than half of the planet, are still largely treated as peripheral to care. This includes the fact that we are physically and culturally vulnerable to rape and that rape survivors need health care. The U.N. estimates that as a result, in the immediate wake of the massive storm, 65,000 Filipino girls and women were at significantly heightened risk for what were already high rates of rape and sexual assault.

In addition, social ideas about gender, purity and honor -- so crucial to patriarchal organization -- has a very dangerous influence on who can get medical attention. For women it can be shameful to ask for help from unrelated men. Aid workers in Pakistan reported that girls and women made up 85 percent of those displaced. Many simply could not risk getting help from foreigners, especially if they were men. After wars and natural disasters, young adolescent girls are particularly vulnerable to sexual predators. Just when they need help the most, they are, because of their gender, unable to seek it out.

A primary reason cited by Syrian refugees for fleeing their country is fear of sexual violence. Media and governments both minimize what these realities mean in planning courses of action. As communities attempt to achieve a sense of normalcy in refugee camps by sending children to school after disaster and displacement, girls continue to pay a gendered price. Boys are often sent back to school first, either because educating girls is seen as unnecessary, or because they are needed to provide labor and childcare, or because the threat of rape and assault are considered too high. This is happening in Syrian refugee camps. Instead of going to school, many Syrian girls are being forced into early marriage -- where they face sexual and domestic violence and a high likelihood of pregnancy and maternity-related illness and death.

After the 2010 Haiti earthquake, girls and women faced heightened health and security problems that were similar. Even before the earthquake, Haiti had one of the highest rates of violence against women in the world, with an estimated 70 percent of Haitian girls and women thought to have experienced gender-based violence. In post-earthquake camps, girls and women, and probably more boys than we know, were simply grabbed from their homes, taken from the streets, and raped (with UN peacekeepers numbered among the rapists). As in other post-disaster scenarios, in the wake of the earthquake, food distribution was often used as a way to demand "favors" in what is sometimes called survival sex, but is in rape.

Failing to make gender analysis a part of problem-solving is killing children and women and increasing their vulnerability. In countries where only men can claim property rights or inheritance, or where women are less educated and skilled, or where governments recognize only men as heads of households the distribution of food, bedding, medicine and more is almost always imbalanced. As a Global Fund for Women report explained:

"Government compensation for loss often completely excludes women in societies where only males are recognized as heads of household. So women whose husbands had died couldn't claim the money. In Thailand, the government paid twice as much to families for the funeral expenses of men than for those of women."
The attitudes and negligence that create the post-disaster and health care scenarios outlined can be seen in our own domestic and foreign policy. It's how we end up with State Department officials who think of "women's issues" as peripheral in places like Afghanistan and Syria and say things such as "There's no way we can be successful if we maintain every special interest and pet project."

Governance is important, and until we have gender parity, it will continue to create seriously flawed outcomes and half-baked solutions, particularly in times of need.

Look at the humanitarian crisis on the US border. Is that crisis enough yet? The Regional Bureau for Latin America and the Caribbean, a department of the United Nations, called pandemic violence against women and children the "invisible face" of the disaster. People sending their children to cross alone or crossing themselves, well aware of the reality of border rapists, purchase birth control prior to crossing. Sixty percent are estimated to be victims of assault. In March, a mother and her teenage daughter were raped and almost killed... by a border agent.

"The fact that law enforcement and judicial systems are most often dominated by men who are disinclined to pursue sexual violence or trafficking cases, and may in fact be implicated in such violence themselves, further exacerbates the crisis," wrote Mónica Ramírez and Anne K. Ream in an analysis.

Gender matters. In the case of Ebola, deeply understanding the role that its construction plays in transmission and mortality could have immediate effects. Yet, as Wolfe writes:

"When women are the primary victims of an epidemic, few are willing to recognize that this is the case, ask why, and build responses accordingly. Indeed, experts say that too little is being done to put even the small amount that is known about gender differences and infectious diseases into practice -- to determine in advance of outbreaks, for instance, how understanding gender roles might help in the development of a containment or prevention strategy."
Persistently, paternalistically, believing that men alone will find solutions to problems largely defined by their own experiences, and that everyone will benefit by benevolent extension, is the meta-disaster that unites these events.

The Global Fund for Women's "Caught in the Storm: The Impact of Natural Disasters on Women" makes several good policy guidelines and recommendation, some of which I'm including here. Governments and relief agencies, taking the role that gender plays in problems seriously in order to develop lasting solutions, should be:

- Recognizing the care needs of human beings with female bodies
- Increasing security measures so that women can use toilets, get water, work, go to school.
- Including women in strategizing when assessing the scope of problems and designing responses.
- Ensuring equal distribution of care, facilities, aid and other resources
- Raising the overall status of girls and women so that they are well-fed, educated and can work
- Investing in programs that challenge social attitudes leading to boy preferences and gross imbalances in care work.

Much of what I've described is understood, can be anticipated and avoided. That the information is not used effectively, and this level of suffering is perpetuated, is a violation of the rights of children and women. Before, during and after disasters."