Women in Guinea will suffer most from Ebola because they are not listened to, aid workers warn

As the Ebola virus rears its head once more in the West African republic of Guinea, aid workers have raised concerns that women will be left to suffer the harshest impacts wrought by the upheaval of an epidemic.

Greater exposure to infection, higher death rates, a rise in sexual abuse and gender-based violence and unequal access to vaccinations are but a few of the dangers facing women which have not been addressed in the government's response to the latest outbreak.

In Guinea, women typically bear the brunt of responsibility in their homes and communities. Along with being primary caregivers, providing support for friends and neighbours, they are responsible for feeding their families.

Teenage girls are forced to drop out of school to help in communities jarred by the disruption wrought by epidemics and the control measures put in place to tackle them.

Women too make up the bulk of the healthcare workforce tackling the virus on the front line and working with infected patients.

However, their fears and complaints go unheard by those who shape the measures imposed during epidemics.

Kassie McIlvaine, who is Regional Programme Quality Deputy Director with CARE, a charity leading research into the gendered impacts of epidemics in the region, says it is imperative that women are brought into the conversation over virus control measures and their impact to inform the response of governments and aid organisations.

"Who you listen to is who you will learn from," Ms McIlvaine toldThe Independent. "Women are left out of the analysis and solutions to these problems when they are the ones who know more."

"When you look at the earlier crises, Covid is a good example, women were the first impacted by embargoes on movement as they were the ones who needed to go out and get food."

A spokesperson for CARE said if the current crisis develops, “there will be an economic impact, which will hit women particularly hard, by limiting their access to food and income”.

While consulting local men no doubt improves the understanding of what measures are required, only getting half the story has before had immediate, deadly, effects on the half who are ignored.

Research from CARE found that found adult women constituted 56 per cent of deaths in last year's Ebola outbreak in Democratic Republic of Congo (where another outbreak is now ongoing), while adult men accounted for just 11 per cent.

Sexual abuse and exploitation of young women rose during that outbreak too. And women, along with children, had more difficulty accessing the vaccine, not least due to a now-reversed policy from the World Health Organisation barring pregnant and lactating women from getting a jab.

At the height of West Africa's deadliest Ebola outbreak, lasting from 2013-16, Clara Menendez, a specialist in community health from the Barcelona Centre for International Health Research, found pregnant women in particular were found to be at high risk due to inadequate maternal healthcare in Guinea and neighbouring countries.

Pregnant women with Ebola ranked low among the priorities of healthcare facilities dealing with the outbreak and saw high rates of miscarriage, Ms Menendez wrote in The Lancet medical journal at the time.

When Covid took hold in West Africa last year and travel networks were closed down, women were left asking how they would feed their families.

“I have a lot of anxiety about the future and how I will feed my family," N’cho Akaffou Raymonde from neighbouring Cote D'Ivoire, who is married with three children said at the time.

"All of us don’t know how to feed our families. We want to help our communities, but as we have nothing all we can do is pass messages and raise awareness."

Soon after virus control measures were put in place, Ms McIlvaine said women across West Africa were selling their possessions to buy food for their families.

The impacts can keep a hold over women for a lifetime. During West Africa's massive Ebola outbreak of 2013-16, many children and teenagers had to drop out of school to meet the needs of their families and communities.

After the epidemic cleared, Ms McIlvaine said, the boys went back but the girls, many of whom had been married and or been impregnated, never returned.

Men alone have failed to provide the solutions to these problems. Ms McIlvaine, with CARE, seeks to hear more from women, particularly those who are confined to rural communities who either have not been approached before or who have chosen not to come forward.

Rapid Gender Analysis, which assesses the different impacts for men and women, is being undertaken after the decalaration of Guinea's latest Ebola outbreak.

Ground workers from CARE conduct this research alongside locals, often young people, and get into communities to establish what could be done to better assist them during such crises.

The results of the analysis will be shared with the government and local authorities. Ms McIlvaney said it is as yet a case of not knowing what they do not know with regards to the research.

“What we do know, is that we would know more if women were involved,” she said.