Gender, COVID-19 and the health workforce

By Lynda Keeru

COVID-19 has caused havoc around the world in the lives of many, but especially for one half of the population – women. Global health security depends on women. Unfortunately, global health is delivered by women but led by men. In the webinar, ‘Gender, COVID, and Health Workforce’, experts from the Gender and COVID-19 Working Group, the Gender Equity Hub and Women in Global Health, focused on COVID-19, gender inequalities and health care providers.

The pandemic has impacted woman in the health workforce – including mental stress, constant torment caused by the risk of infecting their family, fear of financial hardship, managing childcare and home-schooling during lockdown, long hours and the burden of domestic work, powerlessness within health systems, high risk of infection among many others.

The COVID-19 pandemic shone a harsh light on inequality and is due in large part to the ways power and privilege play out in the health workforce worldwide.

The United States, Canada, the Netherlands and Rwanda

In the United States, women hold more than 75% of the healthcare jobs. Pavitra Kotini in her presentation underscored that as of April 2020, 73% of healthcare professionals who tested positive for COVID-19 were women. As of July 2020, 53% of confirmed cases were among health care personnel of color, including 26% who were black, 12% who were Hispanic and 9% who were Asian. According to the CDC, 790 deaths have occurred among health care personnel as of November 9, 2020. WHO Global Strategy on Human Resources for Health: Workforce 2030 estimates a global shortfall of almost 18 million health workers by 2030.

Julia Smith made a presentation on a study on the experiences of women healthcare workers during COVID-19 in British Columbia. In Canada, COVID-19 infection among healthcare workers is almost double the global average. Over 80% the health workforce in Canada identify as women and they do two-three times more unpaid work than men. A focus group conducted with women physicians revealed that the pandemic has brought about negative feelings like anxiety, insomnia, sadness, fatigue, stress, suffering and chaos. Julia also highlighted that midwives have experienced a lack of support and this is pushing them to the brink as demand of their services are soaring causing them a lot of burnout and fatigue and this is no different for the nurses.

Saskia Dujis shed light on the plight of freelance eldercare workers’ experiences during the pandemic in the Netherlands. They are pushed toward the margins of the labor market because of the precarious working conditions that they encounter while on the job by constantly being exposed to the virus. They also have to work risky shifts with a high risk of infection and without adequate protection from care organizations, policy makers and the government. They sadly have no access to nationally distributed Personal Protective Equipment for care workers nor are they protected by social protection measures for freelancers. The findings of the study revealed that the pandemic has uncovered the health workforce’s dependency on invisible, devalued and informal care work of women and exhausted the reproductive work of women. Regrettably, care workers shifted from public domain to the market and were consequently excluded from political efforts to support and protect care workers/freelancers. Lobbying needs to be done to include freelancers in political and public efforts to protect eldercare workers.

Saskia shared some women healthcare workers’ experiences on how they were stretched to the limits:

“We’re care providers, but we are also mothers, we are someone’s daughter, we are an aunt or someone’s cousin or niece. You do this work from your heart, but there is also no safety. If you stay home, you feel guilty because there are shortages of staff. But if you go to work, I might infect my son. My thoughts are just going both sides all the time.” 32-year-old, Antilean Dutch, mother of son with asthma

Chantal Umuhoza, a feminist activist on sexual reproductive justice from Rwanda, relayed the experiences of female members of the health workforce during the pandemic. Women in Rwanda make up the majority of the healthcare industry, particularly at low levels. During the lockdown, these women who work in an industry that is essential, continued to work and in fact, for longer hours with no extra financial support. With the public transport system not operational, their transport costs increased and many female care workers carried more burden of caring for their families with no extra financial support. As is the case in many other countries, Rwanda has experienced a gendered impact of the pandemic with unpaid domestic care work increased for health workers with schools closing and more people constantly at home as expressed by this woman, “I am a single mother of two. During the lockdown, schools were closed so they had to be at home. I didn’t have anyone else to take care of them and could not afford paying someone. I had to leave them at home by themselves because I had to work.”

Margaret Walton-Roberts and Lena Gahwi from the Balsillie School of international Affairs discussed the transnationalization and the crisis of care occurring in many OECD nations.  Using the case of Ontario in Canada they focused on impact of COVID-19 in long term care facilities, including the type and skill mix of labor, and the degree to which immigrant workers are over-represented in this sector. They considered the issue as a matter of social justice and ethics and provided a particular emphasis on the the gendered and racialized devaluing of migrant labour that emerges as so essential to the sector.

What should be done?

These gendered impacts are due to pre-existing structural and systematic inequalities. The response to COVID-19 should be gender sensitive. This will call for things like equal pay for female health care workers, increased investment in their capacity, investment in public infrastructures and programs to address unpaid care work. Social protection programs need to be strengthened and to ensure a dignified life of healthcare workers through accessing basic needs like housing and other living costs.

Notes

Panellists: Roopa Dhatt (Co-chair of the Gender Equity Hub hosted by Women in Global Health and WHO); Julia Smith (Simon Fraser University, Canada and the Gender and COVID-19 Project); Saskia Duijs (Amsterdam UMC, VU University Medical Centre); Chantal Umuhoza (Executive Director at SPECTRA Young Feminists Activism in Rwanda); Margaret Walton-Roberts (Balsillie School of International Affairs); and Pavitra Kotini-Shah (University of Illinois).

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