Gender & Dev students Isabelle Tickel, Madhurima Sanyal & Rebeca Moreno Sandoval tell us how women are unduly affected by health pandemics and ask for more gender awareness in the Covid19 response
The recent spread of COVID-19 has resulted in an unprecedented implementation of emergency response strategies around the world. The lockdown of entire cities, social-distancing measures, quarantines and border closures have become the new norm. These restrictions have changed daily life for us all, but they do not impact us equally. We are already seeing that responses to the pandemic are having differentiated impacts, and magnifying existing social inequalities. Class, race, disabilities and gender all shape our everyday experiences of life under lockdown. In this blog we focus on the latter, with the aim of gendering our understanding of health pandemics and identifying a number of key areas of concern for women.
Lessons learned from previous health pandemics have demonstrated the importance of sex-disaggregated data and gender-awareness in emergency responses. Yet, thus far, little attention is being paid by national governments to the gendered impact of COVID-19, with responses to the virus compounding existing areas of gender inequality in many contexts. We identify the following as areas in which responses to COVID-19 are disproportionately impacting women: sexual reproductive health services (SRHR), domestic violence, the care economy, and informal work. We argue that the rights of women cannot, and should not, be compromised by emergency responses to pandemics, since they are inalienable and indivisible according to human rights law and SDGs (Sustainable Development Goals). We further argue the importance of gendered analyses of the impacts of COVID-19 in order to better understand and redress the many ways in which women are being disproportionately and harmfully affected.
Access to sexual and reproductive health services
Emergency responses to health pandemics often result in the de-prioritisation of sexual and reproductive health services, with resources being diverted elsewhere, and women and girls denied their rights to vital healthcare services.
As responses to the COVID-19 outbreak are put in place across the world, delays in supply chains and the suspension of sexual and reproductive health services are resulting in shortages of contraceptives, restrictions on access to abortion and the interruption of outreach services. INGO Marie Stopes International has predicted that as many as 9.5 million women are at risk of losing access to family planning services as a direct result of the pandemic. At the same time, women are being denied the right to make life-changing choices about their own bodies. The US state of Texas, for example, suspended almost all access to abortion services in March, deeming them ‘non-essential’ healthcare procedures.
With the majority of condom production suspended due to social-distancing measures in much of Asia and delays in every stage of supply chains, Karex Bhd, the world’s largest supplier of condoms, has warned of the likelihood of a global condom shortage. Meanwhile, DKT International, a not-for-profit organisation providing family planning to much of the global south, has raised serious concerns that many countries could soon be facing total stock outs of contraceptive implants as a result of supply chain delays. Responses to COVID-19 are therefore resulting in an increased unmet need for contraception for women across the globe. The impacts on the health and well-being of women are likely to be long-lasting, with an increase in unplanned pregnancies, unsafe abortions and infections of sexually transmitted diseases expected.
Meanwhile, outreach services for those most impacted by HIV - including sex workers, adolescent girls and young women, and LGBTQI+ people – are being suspended, raising serious challenges for the prevention and treatment of the virus among high-risk populations.
Sexual and reproductive health services are essential to the empowerment, health and wellbeing of women. Yet, we are seeing the rights of women and girls to access these vital services compromised across the world. Beyond the immediate danger posed, we are deeply concerned that restrictions to services such as abortion could prove lasting, as conservative regimes across the world capitalise on the opportunity to politicise and de-prioritise women’s access to SRHR.
Increasing domestic violence
The social-distancing and quarantine measures that have been enforced by governments across the world to prevent the spread of COVID-19 have confined us to our homes for extended periods of time, with political discourses focussing on the message that this will “keep us safe” from the virus. These discourses overlook the reality that home is not a safe space for everyone. For many women and girls, lockdown measures are exacerbating domestic violence with the home, isolating them from support networks and services and restricting their movement. Stress, financial pressure and alcohol consumption, linked to lockdown measures, all increase levels of domestic violence, including sexual, physical, verbal and psychological abuse.
Statistics published by an anti-domestic violence NGO in the Chinese province of Hubei, the heartland of the initial outbreak of the COVID-19, show that reports of domestic violence doubled during the quarantine period, with 90% of the causes of violence related to the virus. In both the UK and Argentina, reports of domestic violence increased by 25% in the first two weeks under nationwide lockdowns. In Cyprus and Singapore helplines have registered an increase in calls of 30% and 33% respectively. In Mexico, emergency calls have increased 60% during the quarantine and women’s shelters are receiving double the number of admissions.
Yet, even these figures only reflect the number of cases where women were able to reach out to emergency services. Afraid of being overheard by abusive partners or family members, many women are likely to feel unable to report incidents of domestic violence. In Italy, activists have noted that there has been a sharp rise in text messages and emails to helplines and a steady decline of calls. A member of Eva Cooperativa, a group of anti-domestic violence activists, based in Italy, has said it expects to see an overwhelming rise in domestic abuse reports once lockdown measures are relaxed.
Public health emergencies affect women and men disproportionately and during this critical time when women and girls need emergency and protection services more than ever, resources are being diverted elsewhere, domestic violence charities underfunded, and outreach services for victims suspended. As cases of domestic violence under lockdown increase all over the world, women’s organisations are calling on national governments to act urgently. Financial support must be provided to vital services targeted at domestic violence victims and alternative forms of accommodation offered to women who are not safe at home, in reflection of the dramatic increase in violence. National governments must act to uphold the right of every woman to a life free from violence.
The gendered care economy
Another gendered impact of responses to COVID-19 identified within the home is upon unpaid care work. An existing persistent gender imbalance in unpaid care work within the household means that women typically do three times more ‘reproductive work’ (such as cooking, cleaning and childcare) than men. The COVID-19 pandemic is exacerbating this already unequal distribution of unpaid care activities, as the burden of childcare responsibilities linked to closures of schools and childcare facilities fall on women. Many women are thus facing the double-burden of childcare and working from home, causing stress and fatigue.
As a result of gendered norms, caregivers working as front-line health-care workers are predominantly women, as within the home. Globally, women make up around 70% of the health workforce and social sector. According to the World Health Organisation (WHO), nurses, nurse aides, aged-care workers, teachers, child care workers, and cleaners, are all at higher risk of exposure to COVID-19. These professions are also more likely to experience long working hours, psychological distress, occupational burnout, stigma, and even physical and psychological violence during the pandemic. A lack of personal protective equipment (PPE) is further compounding these risks. International organisations, including UN Women, have therefore raised concerns that women working as frontline and key workers are more exposed to, as well as impacted by, COVID-19. Feminists such as Caroline Criado Perez have emphasised the need for the collection of sex-disaggregated data to better understand the relationship between gender, care work, and exposure to COVID-19.
Restricting informal economic activities
Social-distancing and quarantine measures have different economic impacts depending on the country and social context. For most countries in the global south, these measures are almost impossible to execute, with most of their labour forces employed in the informal sector, with jobs that cannot be done from home. The International Labour Organization (ILO) estimates the informal economy constitutes around 72% of economic activity in Sub- Saharan Africa, 71% in Asia, 51% in Latin America and 47% in the MENA region. While Informal work is a broad category, women are predominantly associated with part-time and informal economic activities. Women who are at the intersection of class, caste and race are the most disproportionately impacted by restrictions on economic activities.
Domestic workers and sex workers, for example, are facing destitution in many parts of the world due to their reliance on daily waged work. Such is the case of domestic workers in Mexico, (around 2.2 million women), many of whom are being dismissed without compensation. In Asia, national lockdowns have restricted the mobility of female foreign domestic workers, many of whom travel in southeast Asia between the Philippines, Indonesia, Hong Kong, and Singapore. Meanwhile, in the UK, campaigners have warned of the hardship facing street sex workers, many of whom face homelessness in the wake of social-distancing measures. In India, too, a total nationwide ban on leaving the home is leaving daily waged and migrant workers at risk of starvation.
The financial challenges brought by lockdowns across the world are far-reaching and widespread. However, it is women, making up the majority of the poor and informal workers worldwide, that are facing the greatest threat to their well-being and survival. Often responsible for providing for dependent children and family members too, informal female workers have already reported being forced to accept dangerous working conditions that compromise their security in order to survive restrictions to economic activities posed by COIVID-19.
As we have aimed to demonstrate in this blog, health pandemics are far from gender neutral. Women are both disproportionately exposed to, and impacted by, COVID-19. Gender equality matters in the response to COVID-19 as the historic side-lining of women as the ‘other’ all too often results in women’s needs and services going unaddressed and being de-prioritised in times of emergency. Gender-blind responses to COVID-19 are affecting the lives of women across the world as we write. Women are being exposed to increased violence, denied their rights to vital services, and bearing the increased unpaid care responsibilities and economic hardship.
We therefore add our voices to those of other feminists and international agencies across the globe calling for greater gender-awareness in national responses to COVID-19. Women’s voices must be included in the design of pandemic responses in order to ensure that their needs are recognised and met. Where this does not happen, the de-prioritisation of SRHR and restriction of women’s rights to vital services such as abortion could prove long-lasting, and even irreversible in contexts where such issues are already heavily contested
As development scholars and practitioners with the aim of achieving a more socially just world, we must continue to interrogate the effects of the COVID-19 pandemic, which will endure long beyond the peak of the virus, through gender lenses. Sex-disaggregated data may be a starting point. Beyond this, research into the ways in which COVID-19 has exacerbated existing gender inequalities will be necessary to fully comprehend the many gendered impacts of this pandemic. Class and race disaggregated analyses are also needed to develop a clearer picture of the way in which different sites of inequality intersect with one another to shape our experiences of health pandemics. Lessons must be learned from our collective experiences of COVID-19 to ensure that future responses to health pandemics are more inclusive and intersectional in their approach. We must work towards gender justice, even in times of global crises.