by KAILEE JORDAN
As a humanitarian, I’ve worked in health emergencies around the world. Alongside many amazing colleagues, I’ve responded to Ebola epidemics, malnutrition outbreaks, and set up programs for victims of conflict and violence. I work with communities to try and understand their needs, and adapt our responses to their concerns. I’m used to working in times of stress, intensity, and danger. For the first time since I’ve started this work however, I’m scared of what I’m seeing and what we are collectively living through.
It is incredibly destabilizing to witness the impact that COVID-19 is having on communities close to my heart. I watch as my loved ones go through the experience of preparing for and witnessing potential devastation and disease, and experience emotions that I associate with my work in Ebola areas or in active conflict. Many of you are going through reflections and processes that are similar to life as an aid worker. So, from one aid worker to the rest, here are some observations that are important to keep in mind as we enter into this next phase of the pandemic.
Gendered dimensions of a crisis
A large part of my work involves advocating that gendered concerns, such as violence against women, are addressed in humanitarian responses. Most recently in the Democratic Republic of Congo, I saw first-hand how, because of the ongoing Ebola epidemic, women were no longer able to access clinics for sexual and reproductive health services. This meant that sexual violence survivors couldn’t access post-rape care and women were not able to access contraception. In the West African Ebola epidemic, we also saw many of the same issues, with gendered consequences ranging from an increase in teenage pregnancy, a rise in unsafe abortions, and higher maternal mortality.
Gendered impacts exist in any crisis, and COVID-19 will be no different. In fact, we can already see the effects it is having on women’s rights. One of the first, and most deadly impacts is the rise of domestic violence. Here in Canada, stories from front-line responders point to a significant increase in domestic abuse calls. Women’s rights organizations from across Europe are already warning that lockdowns are leading to increases in violence, and are calling for more resources to help address these challenges. Chinese women’s rights organizations have noted a steep rise in domestic violence rates since they started their lockdown. In many crises, increased stress and financial pressures exacerbate existing tensions and lead to increased inter-partner violence. Such is also the case with COVID-19. For many women, the added element of lockdowns means that they have nowhere to escape. At a time when violence is increasing, services are struggling to keep up, as many shelters, hotlines, and support roles have been closed or decreased due to COVID-19.
Sexual and reproductive health services will also be impacted. If hospitals become overwhelmed -as we are seeing in Italy, Spain, and the US – how will women safely deliver, if there are no resources for C-sections, maternal complications, or even just regular deliveries? If healthcare systems become overburdened, how will women access contraception? Access to safe abortion is also critical in times like these. As one of the leading causes of maternal mortality worldwide, there is ample evidence to show that a lack of health resources does not stop abortions, they just push women into using unsafe and dangerous methods. During my most recent assignment in Cameroon, I saw women die from unsafe abortions, alone and unable to access medical care, because of the collapse of their healthcare system due to conflict. Whether from conflict, a pandemic, or anything else – when healthcare systems collapse, women’s health suffer. Sexual and reproductive health services are essential and should continue to be provided. If not, the secondary effects on women’s health could be catastrophic and have a much higher morbidity and mortality rate than of just the virus itself.
Finally, it is also important to acknowledge the gendered dimensions of health leadership and caring responsibilities. Globally, women shoulder the majority of the care burden, either as at-home-carers or as healthcare professionals, where women make up 70% of the global workforce. With COVID-19, women play critical care roles that are needed for sick family members and communities at large. This also means – as we move into isolation and lockdowns, with many families working from home – that women will bear the responsibility for increased childcare, emotional labour, and unpaid care work. Finally, we need to acknowledge the many public leadership roles women are playing in this crisis. For example, in Canada, the majority of senior public health officers that are leading the emergency response are women. This leadership is something that needs to be recognized, and applauded.
‘Whose voice counts’ and the political dynamics of global health expertise
Whose voice counts is an inherently political question that needs to be examined in any health emergency. Who are we listening to for our information? Who do we view as an expert? Much has already been said about the need to have information from credible sources, and how damaging misinformation and rumours can be. Above and beyond this, however, we are missing some critical voices in the fight against COVID-19– those from the communities who have already lived through epidemics, many in the Global South, who have lessons that we should be learning from.
In particular, I’m thinking about the health experts and communities who have experienced various Ebola epidemics, such as the West African epidemic that claimed over 11,000 lives in 2014, or the ongoing Ebola epidemic being battled in the Democratic Republic of Congo. There are many examples of local problem-solving during Ebola that demonstrate the ingenuity needed to fight an epidemic. For example, when young children were getting sick, and their families were unable to enter treatment units with them, women who had already survived the virus (and as such were immune to reinfection) took up child-care responsibilities. When official healthcare systems started to collapse, villages set up their own community care and isolation centers, and started community nursing programs. Large efforts were also made to invest in mental health support to families of victims, as well as survivors themselves, to address the stigma and isolation that many survivors of the virus were facing.
These examples are lessons that we can adapt and apply to the situation ongoing today. Why, in a health crisis of this scale, are we not turning to the experts, the health workers, the Global South communities that have this knowledge? Although there have been some articles detailing what we can learn from these experiences, by and large, these voices are missing from mainstream reporting around COVID-19, leaving a gap in our expertise. There is a desperate need for shared learning, and the quicker we can listen to the voices of those who have already been there, the quicker we can also find creative solutions for the Covid-19 response.
Necessity of self-care
Whenever I deploy for a humanitarian assignment, self-care and looking after my emotional health is one of the most important things that I’ve learned that I can do. This isn’t selfish, this is necessary for me to be able to do my work. You cannot take care of others if you do not first take care of yourself.
The importance of looking after our own mental health cannot be overstated during COVID-19. Many people are already feeling overwhelmed with various emotions, whether that be anxiety around an uncertain future, stress over financial tensions, or grief about loved ones that may be ill. At a moment like this, self-care is critical. I’m not just talking about bath bombs or scented candles, but a wider version of self-care, that emphasizes connection and collectivity. As defined in another Gender at Work blog, self-care is looking after the physical, emotional, spiritual and mental wellbeing, not only of ourselves but of our family, friends, colleagues, and community. One of the only ways that we are going be able to get through the pandemic with resilience, is making sure that we prioritize self-care for ourselves, and for our loved ones. This will be even more important for those on the front-line. We cannot ask others to respond to a health crisis of this magnitude, without caring for both their physical and emotional needs.
One of the other lessons that I’ve learned during my time in the field is that we all react differently to risk, threats and stress. Loneliness, grief, sadness, anxiety, anger – these are all normal reactions to what we are facing. We need to give ourselves permission to feel whatever we are feeling, there is no roadmap on how to respond correctly. However, there are things we can do to counter these emotions, and care for ourselves. Whenever I’m deployed, making sure to do yoga, meditation and regularly talking to a therapist is what works for me. For others I’ve worked with, knitting, journaling, or going for a run works better. Finding ways of establishing collectively with others is important, such as keeping up social connections with family and friends, even if you are apart physically. Figure out what works for you, and set the intention to keep doing this. It sounds simple, but it does help – physical distancing, but with social solidarity!
In these uncertain times, self-care isn’t a luxury, it is a necessity. Our overall well-being needs to be seen as an inherent part of the response. We need to be able to not only survive the daily stress, anxiety, and grief that COVID-19 has brought into our lives, but also to make sure that when this ends – and it will end- that we enter into the ‘after’ stage with resilience. I’ve witnessed communities around the world face what seemed like insurmountable challenges, and still be able to hold onto the hope and courage needed to start their lives over again. For us to do that, to not only survive COVID-19 and the upheaval it has brought to our society, but to get through it with resilience and a will to face whatever comes next, we need to make sure that love, support, and compassion are at the center of our response. If we can do that, then we can, and we will, get through this.
Kailee Jordan is a Canadian humanitarian worker and independent consultant, based between Vancouver and East Africa. She has spent the last six years working in various humanitarian emergencies in places such as DRC, Haiti, and Somalia. Most recently, she was part of the Ebola epidemic response in DRC, as well as part of a team responding to armed conflict in Cameroon. She has a particular focus on gender in conflict, and has managed multiple sexual violence response projects in different emergencies.
The cover image was taken at Nyiragongo, DRC.