Categorising the Gendered Harms to Caregivers During Humanitarian Emergencies: An Analysis of Law and Practice During Ebola Crises
| Author | Sharifah Sekalala |
| Published date | 01 December 2021 |
| Date | 01 December 2021 |
| DOI | http://doi.org/10.1177/0964663920974433 |
| Subject Matter | Articles |
Article
Categorising the Gendered
Harms to Caregivers During
Humanitarian Emergencies:
An Analysis of Law and
Practice During Ebola Crises
Sharifah Sekalala
University of Warwick, UK
Abstract
Recent global health emergencies have highlighted the critical role of health care
workers in stemming the spread of pandemics. Healthcare workers provide an essential
service to local communities impacted by epidemics such as Ebola. Global health scholars
suggest that carers may suffer harm while performing this essential work. Building on
feminist theories of ‘harm’ and ‘social reproduction’, this article uses as case studies the
early 21st century Ebola epidemics that broke out in West Africa and the DRC to ask
how do women carers in humanitarian crises experience harm? The article illustrates the
hierarchical and gendered nature of harm, and how those at the bottom of social
hierarchies face intersectional harms stemming from their race, class and economic
status. The article highlights an urgent need to rethink how law at both the domestic and
international levels has contributed to the reproduction of inequalities faced by these
carers.
Keywords
COVID-19, Ebola, front-line workers, gender, human rights, humanitarian crisis, inter-
national law, private law, social reproduction
Corresponding author:
Sharifah Sekalala, University of Warwick, Coventry, CV4 7AL, UK.
Email: sharifah.sekalala@warwick.ac.uk
Social & Legal Studies
ªThe Author(s) 2020
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DOI: 10.1177/0964663920974433
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2021, Vol. 30(6) 825–847
Introduction
Emergency situations caused by the outbreak of infectious diseases often leave devel-
oping states without the capacity to respond effectively to these crises, forcing them to
seek medical humanitarian assistance from the international community (Gostin and
Friedman, 2015; Harman and Wenham, 2018). For instance, some of the world’s worst
recent infectious disease outbreaks, such as Cholera and MERS in Yemen (2019), Ebola
in West Africa (2014–2016) and the ongoing epidemic in DRC (2018–2020) and Lasa
Fever in Sierra Leone, Guinea, Nigeria and Liberia (2016–2019) occurred in recently
war-ravaged states, and/or during existing humanitarian crises triggered by armed con-
flict (Gostin et al., 2019). Many of these crises occur in states with weak health systems
characterised by poor infrastructure, inadequate medical facilities, a scarcity of health
professionals, and inadequate access to essential treatment and diagnostics (Anderson
and Beresford, 2016; Kieny and Dovlo, 2015; Piot et al., 2014).
International bodies such as the World Health Organization (WHO) and the United
Nations (UN) increasingly highlight the impact of violence on health workers during
humanitarian health crises (WHA Assembly, 65/20 2012; UN Doc S/2013/689 Resolu-
tion 2286). This article argues that, in framing international discussions on the relation-
ship between the risk of violence faced by frontline health workers in the field, and the
scarcity of professionally trained health workers, the international community fails to
recognise that caring during complex emergencies must often be provided by non-
professionals. The patriarchal culture of many of these societies means that care work
is gendered, and it falls on women to provide care work, and so it is women who most
often perform this labour. I specifically investigate how caring is organised during
humanitarian health crises by asking: how does caring during crises reproduce gendered
and other hierarchies of power among different categories of women care workers?
Using as case studies the Ebola crises of West Africa (2014–2016) and the ongoing
crisis in the DRC, this article contributes to the body of scholarship on the gendered
nature of caring during global health crises (Davies and Bennett, 2016; Harman, 2016;
Menendez et al., 2015). The role of carers in emergencies remains an underexamined
area of research, and further analytic attention would provide a useful lens to examine
how paid and unpaid social reproductive work generates different forms of harm during
health crises. This article contributes to both law and political science by illustrating the
uneven legal coverage of care work during national health emergencies, and how law –
specifically human rights law and private domestic law – can provide understanding of
how gender inequalities may be reproduced during humanitarian health emergencies.
Some of the lessons that we can take from this resonate powerfully with concerns over
how caring is organised in the current COVID-19 crisis. Again, we see that, even in the
most developed countries, caring is stratified along race and class. Many carers, such as
cleaners, nursery workers and care workers, who are largely women, primarily with low
economic status and from black Asian and other ethnic minority backgrounds, have
struggled to gain access to Personal Protective Equipment to keep them safe. Many
cleaners and healthcare workers are no longer paid directly by states, as this labour has
shifted to private, extractive industries. As such, they enjoy weaker employment rights,
are not unionised, and often cannot demand health and safety measures that many other
826 Social & Legal Studies 30(6)
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