AN OVERLOOKED DISASTER: The Trampling of Female Rights During National Disasters

By Christopher Dove & Meghana Kunkala

In four villages of the Aceh Besar district of Indonesia, only 189 of 676 survivors were female. In four separate villages in the North Aceh district, out of 366 deaths, 284 were females. In Kuala Cangkoy, 80 percent of deaths were female, while in Cuddalore, India, 391 females died compared to 146 males. In Pachaankuppam, only females died¹. Death tolls from the tsunami of 2004 have only begun to shed light on the gender bias that has plagued the international community in its effort of natural disaster relief. Often, areas that suffer most from gender-based oppression in normal times are the same locations the medical community comes into contact with during natural disasters. It is imperative that we, and the medical community at large, examine how the social and economic perspectives of gender inform the experience of both natural disasters and natural disaster relief efforts.

While the notion of gender is being challenged and redefined by groups confined by it, there are still large groups of people that identify themselves as female, which often includes traditional social roles. The line between whether females are more discriminated after a natural disaster and whether the discrimination is just the result of conditions during normal times is unclear. However it is clear that we have failed to take gender into consideration when creating disaster relief plans and when negotiating health care aid and resources. In the aftermath of natural disasters, rehabilitation and reconstruction often yield females vulnerable and their suggestions disregarded. Prejudice, both subtle and overt, is inflamed when disasters create shortages of food, shelter, utilities, and healthcare.

Healthcare and disaster relief are primarily distributed through the remnants of biased institutional structures that have been one of the main causes of the unequal treatment toward females. For example, religious law that was abandoned during the disaster comes into play again in the face of disaster relief. In Indonesia, most aid is given only to males². If a female is the head of household, her household receives no aid unless a male is willing to claim to be the head. The Indonesian government refuses to acknowledge females as heads of household, effectively shutting those females out of resources³. Both domestic and international agencies, perhaps inadvertently, often sacrifice female rights in the name of cultural respect and efficiency⁴. However the recent run of natural disasters and heightened media awareness has increased scrutiny on this classic trap. Treating females as second-class citizenry during natural disasters has led to increases in sexual and physical violence, limited access to food, doctors, and even sanitary supplies - effectively making them second-class citizens⁵.

Health risks increase after a natural disaster because social norms become more difficult, if not impossible, to follow. In Bangladesh, for example, menstruation is not mentioned in public. During the floods of 1998, the WHO described, "adolescent girls [with] perineal rashes and urinary tract infections because they were not able to wash out menstrual rags properly in private, often had no place to hang the rags to dry, or access to clean water." Moreover, sex becomes the only way to get access to necessities such as food, shelter, clean water, medications and sanitary supplies. Sex sometimes gets used as the new currency between those with resources and the displaced.

If resource disparities are not enough to coerce females into sex, it is simply forced upon them. There are a disproportionate number of females in rescue shelters and refugee camps, making them more vulnerable to sexual abuse. Kavita Ramdas of the Global Fund reports that females in disaster-affected areas become uniquely susceptible to sexual abuse for a variety of reasons. Men, migrating to find work after a disaster, often find emotionally and physically vulnerable females. Domestic abuse cases also increase in camps and temporary shelters due to increased alcohol consumption. Male unemployment fuels the abuse as well. Local law enforcement in the camps views domestic abuse to be within the private sphere and rarely interfere.

To add further insult to injury, rape and domestic violence crisis centers become one of the first places to shut down during a natural disaster, so those that get raped have nowhere to turn to. The Louisiana Foundation Against Sexual Assault explained that many rapes were not even reported in the days after Hurricane Katrina because local rape counseling centers had been closed.

Female health care after a natural disaster is often appallingly poor, since other forms of emergency care seem to take precedence during the many phases of reconstruction. However, such shortsightedness leads to both immediate and long term health problems for females. For example, pregnancies are habitually prioritized beneath other health emergencies leading to spiraling infant and maternal mortality rates. Gynecologists are few and far between in many disaster stricken areas, forcing pregnant females to give birth without medical supervision. Also, the needs of lactating females who have lost their babies are ignored. Bhoopathy, a lactating mother whose 8-month-old baby was lost in the tsunami, is now suffering from milk-clotted breasts and other physical pains. She could not get treatment at the camp at Poriayar in the Nagai district of India during the tsunami.

Female unemployment in many areas becomes disproportionately higher after a disaster. Because females in these regions of world are still heavily involved in an informal economy or the agricultural sector, they are the most heavily impacted. According to the Pan American Health Organization, many females are trapped in a gendered division of labor and are forced into substandard employment with less security than males. This increasing economic vulnerability not only distances females from the medical care they need but also increases the psychological trauma. Such psychological trauma occurs in both the long and short-term and stems from threats to security and the loss of loved ones. Ignoring this trauma on a wide scale threatens the stability of already shaken families. Psychological issues that are not ordinarily considered until after reconstruction must be prioritized due to the "implications for the central cultural role that females play in caring for all members of the family."

Despite females and males contributing equally to initial relief efforts, females get left behind in the reconstruction phase. Ramdas maintains that females are systematically underrepresented or left out during the process of reconstruction. This pattern seems to hold true in all countries. When females are excluded from planning stages, their needs are not adequately met. They are rarely in charge of camp governance, have little say on the allocation of supplies, and are excluded from the negotiations with aid organizations that provide the resources. Females are frequently disadvantaged when they receive food because males are seen as having greater physical strength. Heightened inequality finds a stable niche after a disaster.

The effects of the gender bias observed in natural disasters and the relief effort following are influenced by two main reasons: the interplay of distribution methods with local cultures and tainted disaster relief research.

The medical community, when providing health aid through international organizations and other non-profit organizations, uses the power structures that rise in the time of natural disasters for the sake of efficiency. Most of the time females are nowhere to be found in this power structure. Females were not allowed to help in relief efforts in places where it might not be considered safe for them to work. The main point being that the choice of what is safe was made for them.

Patriarchal power structures are reinforced by the international health community's ignorance of the oppression of females. Data collection for disaster relief must be critically examined so that gender disparities are not overlooked. Gender has only been integrated into disaster research, if at all, as a demographic variable or a personality trait. Also, gender is usually used in conjunction with class status. Looking only to the intersection of gender and class and not gender independently can easily lead to the false conclusion that females are vulnerable because they are poor. This blame shift allows the international community to blame gender biases entirely on class biases and does not lead to realistic solutions.

Current treatment of gender by international organizations only examines the effect of gender on females but does not deal with how it favors males. The male gender, in disaster relief, gets the luxury of being able to define themselves compared to females. If females are weak, then males are not weak. This opportunity to define by exclusion is what taints gender further. It also allows males to take power over language, garnering them their place in certain power structures.

It is easy for many of us to condemn the oppression of females in a single region while disregarding the patriarchal mindset that still exists in the international community - where it is more difficult to accept. We have to start taking steps towards mitigating vulnerability of females during natural disasters. Due to the overwhelming catastrophic damage natural disasters have on all people, it may become easy for the health community to forget about maintaining female rights. However, giving time towards equal rights will ultimately save more lives. This ethical dilemma between rights and life creates a false dichotomy. Ameliorating gender inequality is less of a dilemma than we would be lead to initially believe. When the equal treatment of females is taken into consideration during disaster medical relief, it allows for better care of the population as a whole. In post-tsunami Sri Lanka, for example, a lack of female input into the reconstruction process led to homes that were built without kitchen facilities. The input of females during a disaster is not something that should just be pursued on a moral or charitable level: females' concerns yield practical benefits.

The only way that we can start reaping the benefits of equal rights is if we start integrating females into all parts of the disaster relief mission via female human right groups or through rare but existing female leaders in communities. This is the only way that the international community can get beyond the way that it treats gender now and treat it as the complex social relation that it is. Equal rights, in the national and international realms, is an ongoing battle. However, equal rights should be a top priority in healthcare. If not, we walk the dangerous line of handpicking who we wish to have better lives. Obviously, the international medical community cannot redraw patriarchal structures or force female aid workers into "unsafe" areas. However we can start incorporating the females that want to be included and more importantly simply change the way that we think of females in natural disaster efforts. Treating females as vulnerable and weak is what makes them vulnerable and weak. Natural disasters with all of their tragedy provide a unique opportunity to start overturning that mindset.

References:

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