Study commissioned by Finn Church Aid Leena Kotilainen, February 2015
Executive Summary
This study examines the gendered impacts of the Ebola virus disease (EVD) in Liberia in the largest outbreak of EVD ever recorded. The findings are based on an extensive two-week desk study and one-week participatory field study conducted in January 2015 in the cities of Monrovia and Buchanan in Liberia.
Gender and sex are addressed in the report in relation to other possible discrimination categories such as social class, geographical region and age. It is emphasised that different forms of discrimination have a tendency to reinforce one another hence causing systematic inequalities and overlapping vulnerabilities. For instance, a young, illiterate and poor woman residing in a shanty town in Liberia was in many ways discriminated even before EVD entered the country (e.g. due to her age, sex, gender, social class, and region), and has therefore been very vulnerable to the short- and long-term impacts of EVD. These include, among other things, reduced health-care possibilities; increased maternal mortality; economic downturn that has hit especially harshly urban petty traders; prolonged closure of the education sector; societal stigmas from EVD and decreased social cohesion in families and communities. It is argued in the study that EVD is an additional vulnerability that has reinforced already existing societal inequalities in Liberia.
The recommendations on how to respond to these multifaceted challenges are separated into three categories. Firstly, general recommendations for addressing overlapping vulnerabilities in fragile contexts are detailed. In this task it is of high importance to include a gender element to all stages of the programme cycle. Among other things, this will allow specifying the interaction between gender-based discrimination and other possible vulnerabilities in the relevant project surrounding. It is also argued that when planning and implementing gender-sensitive programmes, a close relationship with community leaders should be established. These well-respected individuals can in many ways enhance not only the work in the communities themselves but also the sustainability of the project at hand.
The second category of recommendations argues that for addressing possible future EVD epidemics in Liberia and beyond, lessons from the current epidemic should be drafted and made readily available in each involved organisation. It is unfortunate that the current crisis has shown, once again, how short organisational memories can be. The information on how to plan gender-sensitive responses to infectious diseases is for example widely available, yet even WHO failed to follow its own recommendations on the matter at the beginning of the epidemic. A very crucial component of the lessons learnt from the current crisis is that communities need to be deeply involved in all the stages of the programme cycle. Previous examples show that traditional strategies can be found and utilised e.g. for halting infectious diseases in certain communities.
The final set of recommendations concentrates on the aftermath of EVD epidemic in Liberia and argues that the already established community relations should be maintained and utilised in all kind of project work in the future. Since societal stigma of EVD victims and their families is deep and social cohesion in the country was in many ways damaged in the crisis, programmes that aim to enhance mental wellbeing and community cohesion are crucial for successful recovery. In addition, highly-affected groups such as urban petty traders, prostitutes and bushmeat hunters should be supported by providing education on alternative income-generating activities. Finally, and maybe most importantly, restarting and reinforcing the education and healthcare sectors of Liberia are crucial elements of successful post-EVD recovery.