Over the last decade much has been written about camouflaged sexism. Reams of research and analysis has highlighted how our world is designed for ‘the average man’. This is particularly true in the field of medicine. Medical research, drug regulation, product design orientates to men. The default that informs decisions is men, men’s lives and practices and male bodies. This can have dangerous and even fatal consequences for women.
Health care workers are predominantly women. They have been infected at alarming rates. In a review of available studies globally totalling 152888 infections of health care workers, women represented 71.6 per cent of cases, 38.6 per cent of cases were nurses. Perhaps because of this certain narratives have emerged. Health care workers are described as ‘heroes’. And whilst this has given rise to expressions of gratitude, systematic concerns about payment and protection of health care workers have been marked across the course of our COVID19 response. There are many of these that remain unresolved more than one year into the pandemic.
From the first days of the pandemic, the assumptions underlying the approach to keeping ‘people’ safe have prioritised men and men’s interests and placed many women at risk. Measures to encourage social distancing means for some women, more time at home with abusive partners. Cutting contacts, means fewer social interactions and leads to less accountability for male perpetrators of domestic violence and fewer opportunities for family to intervene to support women. Evidence based on 29 studies from different cities, states, and several countries around the world, is strong. Incidents of domestic violence increased in response to stay-at-home and lockdown orders.
Equally, issues related to women’s reproductive health have been repeatedly marginalised as a concern. Pregnant women are at particular risk during any public health emergency. Not only are pregnant women more vulnerable to domestic violence, they face increased susceptibility to complications from some respiratory infections. This knowledge was widely available because of the SARS and MERS crises. But it is only now we are at last advising Irish women of this. And there is no sign of any support for pregnant women who, by virtue of their economic circumstances, must work. How are we helping those in precarious employment to minimise their work contacts? Why have we not prioritised pregnant women for vaccination?
Antenatal care has been the source of serious concern over the course of the pandemic. It has taken concerted efforts on the part of women for their concerns to even be heard. Action took even longer. In the post-natal period women continue to be advised of the need to social distance. Those who bring home new babies and are attempting to establish breast feeding, or recover from labour and delivery are not permitted visitors to their homes. Mothers, sisters and female friends, the backbone of women’s support during the difficult post-natal period are all disallowed. Whilst this is arguably relevant to reducing viral transmission, this decision, which has separated new mothers from their wider support networks, is likely to have profound short and long-term mental and physical health implications for mothers and babies.
School closures are another decision have had radical impact on women’s lives. Whilst we have all felt their effects, the impact of school closure have been much greater for women than men. Population Surveys illustrate that women, particularly mothers, have been disproportionately affected. Mothers are more likely than fathers to have exited the labour force and become unemployed. Among heterosexual married couples working from home, research shows that mothers have scaled back their work hours to a far greater extent than fathers.
Women are users of health services, they are agents of change in health, make critical contributions as parents, front-line responders, health promoters, influencers, researchers and scientists. But women have been placed outside of the room as decisions and responses to the pandemic have been decided.
I wonder could we chose to follow the science here? We know from decades of research that stability and security, community trust and financial accountability, innovative and ethical decision-making, and a reduction in bias can all be countered with gender diversity. A lack of diversity in decision making and failure to leverage women’s expertise and talent in decision making invariably limits the effectiveness of any response. Follow the science: greater gender representation brings faster and better quality decisions.
Our male cabinet COVID subcommittee has set the cause of gender equality back a decade or maybe more. My fear is that these effects will have negative consequences for women’s personal health and circumstances for the short and long term. My hope is that there will be a political reckoning that questions male power and privilege for once and for all.
Orla Muldoon is professor of psychology at University of Limerick