With limited health sector capacities, COVID-19 will be fought in Bangladesh’s homes where women play an outsized role.
Less than a month since the World Health Organization (WHO) declared a COVID-19 pandemic on March 11th, the global burden of infections has reached 1.3 million and the official death toll nearly 75,000. The number of COVID-19 positive cases and deaths has started to climb in Bangladesh as testing finally expands to hundreds of people. Within Bangladesh, stress levels are high as anxiety rises about the vulnerability of our near and dear ones and the possibility of future economic fallout from a severe global lockdown.
Yet for health systems like Bangladesh’s, there are no high-tech solutions. Our primary line of defense against this global pandemic is to stay home to limit the spread of the disease and to self-isolate if showing symptoms. Globally, most countries of the world have declared national lockdowns with varying degrees of enforcement and success. In Bangladesh reports coming from even remote rural areas suggest that law enforcement has been mobilised extensively to restrict people’s movement and prevent large gatherings. Mosques have restricted the number of people praying together to five at a time. The virus’ primary strength is the speed with which it can spread, and so restricting social interaction to limit contagion is our weapon of choice against it.
The recommendations are to stay home, wash your hands, do not touch your face and wear a mask and shelter in place if sick. The cities of Bangladesh have emptied out as there are few prospects for earning in cities under lockdown. The day after lockdown millions left for their rural homes. There has been some confusion regarding how the formal workforce is affected. It is widely reported that garment workers, mostly women, who are the main formal sector workers adversely affected by cancelled orders and lockdown orders, have been caught in a confused medley of policies. Their predicament is visible and deserves proactive action.
In all of this confusion, the very forces on whom we will have to rely to combat this scourge, have remained invisible and absent from official and policy discourse. The women and girls who are confined to their homes, or to their role as domestic helpers in other people’s homes, are conspicuously absent in policy discourse. Yet, the more that we learn about this virus and how to cope with it given the realities about our health sector capabilities, the more we realise that it is the home which is the locus of action and intervention, and where women and girls are central to our response to the pandemic.
In Bangladesh, as in the rest of the world, women are the primary caregivers of the young, infirm and the elderly. A recent comparative study on children’s nutrition shows that women spend the majority of their time in domestic work and more so than other low and middle income countries. My own work showed that married and unmarried girls spend considerably more time on domestic work, caregiving work in particular, than boys. As the disease strikes this burden of care is likely to increase disproportionately for women and girls.
In addition to the care responsibilities, the directives about cleanliness and hygiene are also likely to intensify the workloads of women and girls who are the ones implementing instructions on wiping down high touch surfaces, washing clothes, maintaining general hygiene as well as the creative management of dwindling resources to put food on the table as provisions dry up.
Gender disparity in care responsibility may not be something that can be addressed easily in the short run. However, there are associated concerns with regard to stress levels and potential fallout in terms of domestic violence that do need urgent attention. A recent report from UN Women warns of the possibility of increased violence against those who are at the frontlines of care particularly, as household members cope with the stress of illness and potential loss of lives and livelihoods.
As far as we can tell, behavioral change campaigns ignore the role of girls and women and their frontline status in the war against this virus. It is unclear how these messages are received in homes all around the world. A message from UN Women highlights the vulnerability of women and girls as potentially having to bear the brunt of stress in terms of increased domestic violence. However, there is also a need to recognise their key role in the implementation of the barrage of directives about cleanliness which are propagated through the airways, through broadcast channels and nationwide text messaging.
The role of primary caregivers at home is central to current strategies of combating contagion and containing spread. WHO emphasises testing to be able to isolate those who are infected. That puts women and girls on the frontlines. There is evidence that severity of illness is linked to viral load which is why healthcare workers have been infected in high numbers. As primary caregivers in the home, women and girls are therefore at higher risk too, and so they should be the focus of Covid-19 testing as well. In communities and households, girls and women recognise that being on the front line of care makes them both vulnerable to Covid-19 but also well positioned to help stop the spread. It is high time we recognise this essential reality and engage women and girls in meaningful ways to respond to the Covid-19 pandemic.
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* The article was originally written for Netra News*
Photo 2: Zakir Hossain Chowdhury/Alamy Stock Photo
Taken from Netra News: April 2nd 2020, Dhaka, Bangladesh — A mother with her child waits for rickshaw during countrywide lockdown as a preventive measure against the Covid-19.