T he current Ebola outbreak in West Africa may ultimately infect as many as 20,000 people and a disproportionate number of those cases will be women, experts say.

On Aug. 14, the Washington Post reported Women account for 55 to 60 percent of victims who have died from Ebola in the current epidemic in Liberia, Guinea and Sierra Leone, according UNICEF.

That same month, the Liberian government announced that 75 percent of the country’s Ebola deaths have been of women.

Experts who have been watching outbreaks of infectious diseases, especially Ebola for many years are not at all surprised at the disproportionate Ebola death rates between men and women.

A 2007 World Health Organization (WHO) document states: “Differences in exposure between males and females have been shown to be important factors in transmission of [Ebola],” therefore, it is important to understand the gender roles and responsibilities that affect exposure in the local area.”

Women are Caregivers

When looking at exposure to the virus, one looks at who is most exposed. “Women are the caregivers if a kid is sick, they say, ‘Go to your mom,'” Sia Nyama Koroma, first lady of Sierra Leone, told The Washington Post. “Most of the time when there is a death in the family, it’s the woman who prepares the funeral, usually an aunt or older female relative.” She added that women constitute a large section of the health workers and are on the frontlines of this crisis.

Women are also most likely to be nurses and the ones taking care of cleaning and laundry in the public health sector.

Reluctant to Seek Medical Care

A key reason this outbreak and others that continue to hit West Africa is because men and women are reluctant to seek medical care. Historically, they have developed strained relationships with healthcare workers and their traditions say that the ill be taken of at home,

It shouldn’t take so many deaths – more than 3 000 at the time of this writing – to realise how attention to gender dynamics might help save lives and how equipping women with and education and instilling in them the importance of using protective measures at home.

Affected by Border Closures

But aid agencies say women are also the most affected by border closures and travel restrictions, as they carry out most of the commercial cross-border trade.

In Liberia, for example, women carry out an estimated 70 percent of cross-border trade.

The closure of borders is doing more harm to the countries affected as women contribute to the informal sector more than men.

Infectious Diseases Target One Gender More

Another 2007 WHO report, “Gender, Health and Malaria” highlights the fact that gender differences may be seen in other infectious diseases, not just Ebola.

Data shows that many infectious diseases affect one gender more than another. Sometimes it is men, as with dengue fever. Sometimes it’s women generally, as with E. coli, HIV/AIDS (more than half the people living with the virus are female), and Ebola in some previous outbreaks

Yet even when women are the primary victims of an epidemic like this Ebola outbreak, few are willing to recognize that this is the case, ask why, and build responses accordingly.

Not only that, but there is too little research being done to understand how infectious diseases affect the sexes differently on a biological level.

It would also mean tackling systemic problems, such as women’s unequal access to adequate health care or the finances they might require for treatment. In short, it would mean challenging fundamental and dangerous

Looking at who dies in an outbreak “shows you who has power and who doesn’t,” says Columbia University epidemiology professor Wafaa El-Sadr. “In a way, it holds a mirror to society. And it shows societies how they treat each other.”

Gender Disparities in Healthcare

According to Lauren Wolfe in Foreign Policy: “Consider nurses. They are primarily female worldwide, and they are frequently at the forefront of dealing with infectious diseases. Yet very often, they are too low on the social – and gender – totem pole for their needs to be heard clearly. “Research has shown that poor nurse-physician relationships are that common in hospital settings, pose a potential threat to patient safety – including the risk of infections and have a negative impact on nurse satisfaction and retention,” the 2011 WHO report stated. Moreover, after the 2003 SARS outbreak, Canadian studies found, according to the WHO, that a “lack of power and influence of nurses was linked to infection control deficiencies.”

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