The United Nations has been almost the sole international body to ring any alarm bells about the disproportionate effect of the Ebola disease outbreak on women and children, where it has found that up to 75 percent of reported cases are women and approximately 2.5 million children under 5 years old live in Ebola-affected areas. The disease is centered in Guinea, Liberia and Sierra Leone, with very low numbers of isolated cases located in Nigeria and Senegal, all in West Africa.
Humanitarian workers attribute the disproportionately high numbers of women affected to their traditional role as caregivers, noting that they are more likely to care for sick family members — cooking and serving food, cleaning the sick and washing their clothes — putting them at heightened risk for infection.
Women are also more likely to work as nurses, midwives, cleaners and cross-border traders — all careers that the UN has identified as being particularly risky for Ebola transmission. The three countries affected the most all share borders, though some have been closed.
Moreover, women in hospitals and health clinics in the region rarely get the same support and protection that doctors — most of whom are men — receive, making this disease another discriminatory lob against women.
“This was not targeted at [women], but it came as a result of the roles they were playing,” Josephine Odera, the UN Women regional director in West and Central Africa, said in an email. “Those kind of care roles for women in families and communities have put them at higher risk of exposure and many of them have found themselves dying.”
The UN estimates that 2.5 million children under 5 years old live in areas affected by Ebola. Besides the risk of contracting the disease, children face the painful burden of losing parents and other relatives who might tend to them. The outbreak has also led to school closures across the affected countries and has severely disrupted health services, leaving many children without schooling and routine care, including vaccinations. The disruptions in health care systems — which are already heavily taxed with too many patients and too few beds — have also limited access to maternal and newborn care and created tremendous stigma and barriers for pregnant women, who need to go to clinics but can become untouchables in society if they are seen visiting these centers.
Liberia’s minister for gender and development, Julia Duncan-Cassell, said that women make up nearly 75 percent of those infected with Ebola in that country alone. The World Health Organization has found that approximately 57 percent of the 2,407 suspected, probable and confirmed Ebola cases in Liberia were identified in the last 21 days, making it the current epicenter of the deadly disease. The disease first broke out this year in rural Guinea. (A different strain of the disease has been reported in the Democratic Republic of the Congo.)
“Transmission requires close contact with bodily fluids of an infected person, as can occur during health care procedures, home care or traditional burial practices, which involve the close contact of family members and friends with bodies,” Gregory Hartl, a media officer for the World Health Organization, wrote in an email. “In Guinea, around 60 percent of cases has been . . . with women who are the principle caregivers, disproportionately affected.”
“Many families hide infected loved ones on their homes,” Hartl added. “As Ebola has no cure, some believe [they] will be more comfortable dying at home.”
In a report by Martha Anker for the World Health Organization in 2011, about taking into account gender in infectious disease programs, she wrote that in almost all societies, “women are responsible for the care of family members when they fall ill.” And that their “close contact with sick family members exposes them to pathogens that are spread from person to person,” creating an important transmission pathway for new pathogens.
Overall, the World Health Organization’s most recent count for the disease has found more than 5,500 people infected and about 2,630 people dead, primarily in Guinea, Sierra Leone and Liberia — conceding that these numbers are surely underestimates.
The United States Centers for Disease Control and Prevention said this week in a telephone conference call that Guinea “hangs in the balance” — has more or less control over the epidemic — but that the rural forest region, where the disease began, is still seriously problematic.
Yet just a few organizations working on the Ebola response refer directly to the toll the disease is exacting on women. At an emergency session led by the US this month at the UN Security Council on the peace and security threat of Ebola, 45 countries spoke, but just a handful — Australia, Britain and Liberia, among them — mentioned the disproportionate effects on women, with some of these countries citing 70 percent of the cases falling on women.
The council passed a resolution encouraging nations to increase support to the countries that are affected and for those countries to pay special attention to the needs of women when crafting response mechanisms. Nevertheless, the red flag for women in the document was so small it would be easy to read past it: “Expressing concern [resolution’s italics] about the particular impact of the Ebola outbreak on women.”
Caroline Kiarie, a grant-making officer at Urgent Action Fund, Africa, said that “it is imperative that women’s rights and gender perspectives . . . be urgently integrated into national and international policies.” She emphasized that such a multidisciplinary response was the only way to fully combat the spread of the disease and its harmful economic outcomes.
Dulcie Leimbach contributed reporting to this article.