The irony of excluding women’s voices when it all goes wrong is that it is exactly in these extreme contexts that old prejudices are least justified, because women are already disproportionately affected by conflict, pandemic and natural disaster. The data on the impact of conflict (mortality, morbidity, forcible displacement) on women is extremely limited and sex-disaggregated data is even rarer. But the data we do have suggests that women are disproportionately affected by armed conflict.1 In modern warfare it is civilians, rather than combatants, who are most likely to be killed.2 And while men and women suffer from the same trauma, forcible displacement, injury and death, women also suffer from female-specific injustices.
Domestic violence against women increases when conflict breaks out. In fact, it is more prevalent than conflict-related sexual violence.3 To put this in context, an estimated 60,000 women were raped in the three-month Bosnian conflict and up to 250,000 in the hundred-day Rwandan genocide. UN agencies estimate that more than 60,000 women were raped during the civil war in Sierra Leone (1991-2002); more than 40,000 in Liberia (1989-2003); and at least 200,000 in the Democratic Republic of the Congo since 1998.4 Because of data gaps (apart from anything else, there is often no one for women to report to), the real figures in all these conflicts are likely to have been much higher.
In the breakdown of social order that follows war, women are also more severely affected than men. Levels of rape and domestic violence remain extremely high in so-called post-conflict settings, ‘as demobilized fighters primed to use force confront transformed gender roles at home or the frustrations of unemployment’.5 Before the 1994 genocide in Rwanda, the average age for marriage for a girl was between twenty and twenty-five years; in the refugee camps during and after the genocide, the average age for marriage was fifteen years.6
Women are also more likely than men to die from the indirect effects of war. More than half of the world’s maternal deaths occur in conflict-affected and fragile states, and the ten worst-performing countries on maternal mortality are all either conflict or post-conflict countries. Here, maternal mortality is on average 2.5 times higher, and this is partly because post conflict and disaster relief efforts too often forget to account for women’s specific healthcare needs.
For over twenty years, the Inter-agency Working Group on Reproductive Health in Crises has called for women in war zones or disaster areas to be provided with birth kits, contraception, obstetrics care and counselling. But, reports the New York Times, ‘over the past two decades, that help has been delivered sporadically, if at all’.7 One report found that pregnant women are left without obstetrical care, ‘and may miscarry or deliver under extremely unsanitary conditions.’
This can also be an issue in post-disaster zones: following the Philippines’ 2013 typhoon in which 4 million people were left homeless, an estimated 1,000 women were giving birth every day, with almost 150 of them expected to experience life-threatening conditions.8 Birthing facilities and equipment had been destroyed by the typhoon, and women were dying.9 But when the United Nations Population Fund asked donor nations for funds to pay for hygiene kits, staff at temporary maternity wards and counselling for rape victims, the response was ‘lukewarm’, with only 10% of the amount needed being raised.10
Post-conflict and post-disaster zones are also particularly vulnerable to the spread of infectious diseases – and women die in greater numbers than men when pandemics hit.11 Take Sierra Leone, the country at the heart of the 2014 Ebola outbreak, and which has the highest maternal mortality rate in the world: 1,360 mothers die per every 100,00 live births (for comparison, the OECD average is fourteen per 100,00012), and one in seventeen mothers have a lifetime risk of death associated to childbirth.13 The government has recently released data revealing that at least 240 pregnant women die every month in Sierra Leone.14
Throw Ebola into the mix and women suddenly had two types of death to fear: from childbirth and from Ebola. In fact it was worse than that, because pregnant women were at increased risk of contracting Ebola due to their high levels of contact with health services and workers:15 the Washington Post reported that two of the three largest outbreaks of Ebola ‘involved transmission of the virus in maternity settings’.16 The fact that Ebola decimated healthcare workers (themselves mainly women) made the feminised risk even higher: the Lancet estimated that in the three countries affected by the virus, an extra 4,022 women would die every year as a result of the shortage.17
The reluctance to factor gender into relief efforts is partly due to the still-persistent attitude that since infectious diseases affect both men and women, it’s best to focus on control and treatment ‘and to leave it to others to address social problems that may exist in society, such as gender inequalities after an outbreak has ended’.18 Academics are also at fault here: a recent analysis of 29 million papers in over 15,000 peer-reviewed titles published around the time of the Zika and Ebola epidemics found that less than 1% explored the gendered impact of the outbreaks.19 But, explains a WHO report, the belief that gender doesn’t matter is a dangerous position which can hinder preventative and containment efforts, as well as leaving important insights into how diseases spread undetected.20
Failing to account for gender during the 2009 H1N1 (swine flu virus) outbreaks meant that ‘government officials tended to deal with men because they were thought to be the owners of farms, despite the fact that women often did the majority of work with animals on backyard farms’.21 During the 2014 Ebola outbreak in Sierra Leone, ‘initial quarantine plans ensured that women received food supplies, but did not account for water or fuel’. In Sierra Leone and other developing countries, fetching fuel and water is the job of women (and of course fuel and water are necessities of life), so until the plans were adjusted, ‘women continued to leave their houses to fetch firewood, which drove a risk of spreading infection’.22
Women’s care-taking responsibilities also have more deadly consequences for women in pandemics. Women do the majority of care for the sick at home. They also make up the majority of ‘traditional birth attendants, nurses and the cleaners and laundry workers in hospitals, where there is risk of exposure’, particularly given these kinds of workers ‘do not get the same support and protection as doctors, who are predominantly men’.23 Women are also those who prepare a body for a funeral, and traditional funeral rites lead many to be infected.24 In Liberia, during the 2014 Ebola epidemic, women were estimated to make up 75% of those who died from the disease;25 in Sierra Leone, the ‘epicentre’ of the outbreak, UNICEF estimated that up to 60% of those who died were women.26
A 2016 paper27 also found that in the recent Ebola and Zika epidemics international health advice did not ‘take into account women’s limited capacity to protect themselves from infection’.28 In both cases, advice issued was based on the (inaccurate) premise that women have the economic, social or regulatory power ‘to exercise the autonomy contained in international advice’. The result was that already-existing gender inequalities were ‘further compounded’ by international health advice.
We need to address the gender data gap when it comes to post-disaster relief with some urgency, because there is little doubt that climate change is making our world more dangerous. According to the World Meteorological Organisation, it’s nearly five times more dangerous than it was forty years ago: between 2000 and 2010 there were 3,496 natural disasters from floods, storms, droughts and heat waves, compared to 743 natural disasters in the 1970s.29 And beyond analyses that suggest climate change can be a factor in the outbreak of conflict30 and pandemic,31 climate change itself is causing deaths. A 2017 report in the journal Lancet Planetary Health predicted that weather-related disasters will cause 152,000 deaths a year in Europe between 2071 and 2100.32 This compares to 3,000 deaths a year between 1981 and 2010.33 And, as we will see, women tend to dominate the figures of those who die in natural disasters as well.
We didn’t have firm data on the sex disparity in natural-disaster mortality until 2007, when the first systematic, quantitative analysis was published.34 This examination of the data from 141 countries between 1981 to 2002 revealed that women are considerably more likely to die than men in natural disasters, and that the greater the number of people killed relative to population size, the greater the sex disparity in life expectancy. Significantly, the higher the socio-economic status of women in a country, the lower the sex gap in deaths.
It’s not the disaster that kills them, explains Maureen Fordham. It’s gender – and a society that fails to account for how it restricts women’s lives. Indian men have been found to be more likely to survive earthquakes that hit at night ‘because they would sleep outside and on rooftops during warm nights, a behavior impossible for most women’.35 In Sri Lanka, swimming and tree climbing are ‘predominantly’ taught to men and boys; as a result, when the December 2004 tsunami hit (which killed up to four times as many women as men36) they were better able to survive the floodwaters.37 There is also a social prejudice against women learning to swim in Bangladesh, ‘drastically’ reducing their chances of surviving flooding,38 and this socially created vulnerability is compounded by women not being allowed to leave their home without a male relative.39 As a result, when cyclones hit, women lose precious evacuation time waiting for a male relative to come and take them to a safe place.
They also lose time waiting for a man to come and tell them there’s a cyclone coming in the first place. Cyclone warnings are broadcast in public spaces like the market, or in the mosque, explains Fordham. But women don’t go to these public spaces. ‘They’re at home. So they’re totally reliant on a male coming back to tell them they need to evacuate.’ Many women simply never get the message.
A male-biased warning system is far from the only part of Bangladesh’s cyclone infrastructure that has been built without reference to women’s needs. Cyclone shelters have been built ‘by men for men’, says Fordham, and as a result they are often far from safe spaces for women. Things are slowly changing, but there is a ‘huge legacy’ of old-style cyclone shelters, which are basically just ‘a very large concrete box’. Traditionally the shelter is just one big mixed-sex space. There are usually no separate latrines for men and women: ‘just a bucket in the corner and you might have 1,000 people in these places sheltering’.
Beyond the obvious problem of a single bucket for 1,000 people, the lack of sex segregation essentially locks women out of the shelters. ‘It’s embedded in Bangladeshi culture that women cannot mix with men and boys outside of their family males,’ explains Fordham, for fear of bringing shame on the family. Any woman mixing with those males ‘is just fair game for any kind of sexual harassment and worse. So the women won’t go to the shelters.’ The result is that women die at much higher rates (following the 1991 cyclone and flood the death rate was almost five times as high for women as for men40) simply for want of sex-segregated provision.
On the subject of the violence women face in disaster contexts, we know that violence against women increases in the ‘chaos and social breakdown that accompany natural disaster’ – but, in part because of that self-same chaos and social breakdown, we don’t know by exactly how much. During Hurricane Katrina local rape crisis centres had to close, meaning that in the days that followed no one was counting or confirming the number of women who had been raped.41 Domestic-violence shelters also had to close, with the same result. Meanwhile, as in Bangladesh, women were experiencing sexual violence in gender-neutral storm shelters. Thousands of people who had been unable to evacuate New Orleans before Katrina hit were temporarily housed in Louisiana’s Superdome. It didn’t take long for lurid stories of violence, of rapes and beatings, to start circulating. There were reports of women being battered by their partners.42
‘You could hear people screaming and hollering for people to help them, “Please don’t do this to me, please somebody help me”’, one woman recalled in an interview with IWPR.43 ‘They said things didn’t happen at the Superdome. They happened. They happened. People were getting raped. You could hear people, women, screaming. Because there’s no lights, so it’s dark, you know.’ She added, ‘I guess they was just grabbing people, doing whatever they wanted to do.’ Precise data on what happened to whom in Hurricane Katrina has never been collated.
For women who try to escape from war and disaster, the gender-neutral nightmare often continues in the refugee camps of the world. ‘We have learned from so many mistakes in the past that women are at a greater risk for sexual assault and violence if they don’t have separate bathrooms,’ says Gauri van Gulik, Amnesty International’s deputy director for Europe and Central Asia.44 In fact international guidelines state that toilets in refugee camps should be sex-segregated, marked and lockable.45 But these requirements are often not enforced.
A 2017 study by Muslim Women’s charity Global One found that 98% of female refugees in Lebanon did not have access to separate latrines.46 Research by the Women’s Refugee Commission has found that women and girls in accommodation centres in Germany and Sweden are vulnerable to rape, assault and other violence because of a failure to provide separate latrines, shower facilities or sleeping quarters. Mixed living and sleeping quarters can mean women develop skin rashes from having to keep their hijab on for weeks.
Female refugees regularly47 complain that the remote location48 of many toilets is worsened by a lack of adequate lighting both on the routes to the latrines and in the facilities themselves. Large areas of the infamous Idomeni camp in Greece were described as ‘pitch-black’ at night. And although two studies have found that installing solar lighting or handing out individual solar lights to women in camps has had a dramatic impact on their sense of safety, it’s a solution that has not been widely adopted.49
So most women find their own solutions. A year after the 2004 tsunami women and girls in Indian displacement camps were still walking in pairs to and from the community toilet and bathing facilities to ward off harassment from men.50 A group of Yezidi women who ended up in Nea Kavala camp in northern Greece after fleeing sexual slavery under ISIS formed protection circles so they could accompany each other to the toilet. Others (69% in one 2016 study51), including pregnant women who need frequent toilet trips, simply don’t go at night. Some women in reception centres in Germany have resorted to not eating and drinking, a solution also reported by female refugees in Idomeni, at the time Greece’s largest informal refugee camp.52 According to a 2018 Guardian report, some women have taken to wearing adult nappies.53
Some of the failure to protect women from male violence in European camps can be put down to the speed with which authorities in, for example, Germany and Sweden (who to their credit have taken far more refugees than most), have had to respond to the crisis.54 But this is not the whole story, because women in detention centres around the world experience the same problems with male guards. Women at a US immigration facility in 2005 reported that guards used a camera phone to take pictures of them while they were sleeping, as well as when they came out of the showers and bathrooms.55 In 2008, a seventeen-year-old Somali refugee detained at a Kenyan police station was raped by two policemen when she left her cell to use the toilet.56 Yarl’s Wood Detention centre in the UK has been dogged for years by multiple cases of sexual abuse and assault.57
Given the steady stream of abuse reports from around the world, perhaps it’s time to recognise that the assumption that male staff can work in female facilities as they do in male facilities is another example of where gender neutrality turns into gender discrimination. Perhaps sex-segregation needs to extend beyond sanitation facilities, and perhaps no male staff should be in positions of power over vulnerable women. Perhaps. But if this is going to happen, authorities would first have to countenance the idea that male officials might be exploiting the women they are meant to be variously helping, guarding or processing. And, currently, authorities are not countenancing this.
In an email to humanitarian news agency IRIN a spokesperson for the Regional Office of Refugee Affairs in Berlin (LAF) wrote that ‘After countless conversations with shelter managers, I can assure you that there is no unusual occurrence [of sexualised violence] reported from emergency or community shelters.’58 Despite multiple accounts of sexual harassment and abuse they were, they said, ‘confident there is no significant problem’. Similarly, news website BuzzFeed reports that in Europe the possibility that male border guards might trade sex for entry is all but denied.59 And yet a 2017 Guardian report revealed that ‘Sexual violence and abuse was widespread and systematic at crossings and checkpoints. A third of the women and children interviewed said their assailants wore uniforms or appeared to be associated with the military.’60
The LAF substantiated their claim of ‘no significant problem’ by pointing to the ‘very low numbers of police reports’, with only ten cases of ‘crimes against the sexual freedom of a person’ involving women living in refuge shelters registered by Berlin police in the whole of 2016.61 But are police statistics a reliable measure of the problem, or is this yet another gender data gap? When BuzzFeed reporters contacted the national police of the major European transit countries (Greece, Macedonia, Serbia, Croatia and Hungary) for any information they had about gender-based violence, many simply did not respond to ‘repeated requests for information’. The Hungarian national police did reply, but only to say that ‘it does not collect information related to asylum-seekers, including reports of rape or attempted sexual assault’. The Croatians said they ‘could not disaggregate crime reports by victim category’, although in any case they ‘had no reports of asylum-seekers experiencing gender-based violence’. This may of course be true, although not because it’s not happening. Several women’s organisations who work with refugees point out that although many of the women they work with have been groped and harassed at shelters, a mixture of cultural and language barriers mean that a ‘very, very high number of sexually motivated attacks go unreported’.62
The data gap when it comes to sexual abuse is compounded in crisis settings by powerful men who blur the lines between aid and sexual assault, exploiting their position by forcing women to have sex with them in order to receive their food rations.63 The data gaps here are endemic, but the evidence we do have suggests that this is a common scenario in post-disaster environments,64 and one which has recently hit headlines worldwide, as first Oxfam and then various other international aid agencies were rocked by allegations of sexual abuse by their workers, and subsequent cover-ups.65
The irony of ignoring the potential for male violence when it comes to designing systems for female refugees is that male violence is often the reason women are refugees in the first place.66 We tend to think of people being displaced because of war and disaster: this is usually why men flee. But this perception is another example of male-default thinking: while women do seek refuge on this basis, female homelessness is more usually driven by the violence women face from men. Women flee from ‘corrective’ rape (where men rape a lesbian to ‘turn her straight’), from institutionalised rape (as happened in Bosnia), from forced marriage, child marriage and domestic violence. Male violence is often why women flee their homes in low-income countries, and it’s why women flee their homes in the affluent West.
Homelessness has historically been seen as a male phenomenon, but there is reason to doubt the official data on this issue. Joanne Bretherton, research fellow at the University of York’s Centre for Housing Policy, explains that women are actually ‘far more likely to experience homelessness than men’,67 while in Australia the ‘archetypal homeless person’ is now ‘a young women aged 25-34, often with a child, and, increasingly, escaping violence’.68 But this ‘serious social problem’69 has been grossly underestimated – and it’s a gender data gap that is in many ways a product of how researchers define and measure homelessness.70 According to the Canadian Centre for Policy Alternatives (CCPA) ‘much of the research on homelessness [. . .] lacks a comprehensive gender-based analysis’.71
Homelessness is usually measured by counting those who use homeless services, but this approach only works if men and women are equally likely to use these services, and they aren’t. Women made homeless as a result of domestic violence are often likely to seek refuge in domestic-violence shelters rather than homeless shelters. In the UK this means that they will not be counted as homeless.72 They are also likely to live in precarious arrangements with other people, ‘without their own front door, privacy and their own living space, and without access to any housing of their own to which they have a legal right’.73 Sometimes, as witnessed by the recent rise in ‘sex for rent’ agreements across the UK, they will, like women in refugee camps, be sexually exploited.74
According to Canadian research, women fall into these precarious arrangements because they don’t feel safe in the official emergency accommodation, especially when it’s mixed sex.75 And these safety issues are not a product of women’s imaginations: the CCPA calls the levels of violence experienced by women in shelters ‘staggering’. Supposedly ‘gender-neutral’ services that are ‘presumed to be equally accessible for men and women’, concludes the CCPA, ‘actually put women at significant risk’.
Female homelessness is therefore not simply a result of violence: it is a lead predictor of a woman experiencing violence.76 Women in the US are choosing to live rough rather than access shelters they perceive as dangerous.77 Katharine Sacks-Jones, director of women-at-risk charity Agenda, explains that in the UK homelessness services are ‘often set up with men in mind’, and that they ‘can be frightening places for vulnerable women who’ve experienced abuse and violence’.78
Gender-sensitive provision is not just about safety, however, it’s also about health. In the UK, homeless shelters can (and do) request free condoms from the NHS,79 but they cannot request free menstrual products. As a result, shelters can only provide menstrual products for free if they happen to have spare funds (unlikely) or if they receive a donation. In 2015, a campaign group called The Homeless Period petitioned the UK government to fund the provision of menstrual products as they do condoms.80 Despite questions being raised in Parliament, government funding has not been forthcoming, although in March 2017 the campaign group announced a partnership with Bodyform to donate 200,000 packs of sanitary products by 2020.81 Campaigners in America have been more successful: in 2016 New York City became the first US city to provide free tampons and pads in public schools, homeless shelters and correctional facilities.82
Female refugees have also not been spared the impact of the chronic global failure to account for the fact that women menstruate. Funding for this essential resource is often not forthcoming,83 and the result is that women and girls can go for years without access to menstrual products.84 Even where hygiene kits are distributed, they have traditionally been ‘designed for household-level distribution with no adjustment for the number of menstruating females in each household’.85 Distribution is also too often designed without regard for the cultural taboo around menstruation: expecting women to feel able to request menstrual products from male workers or in front of male family members;86 and not providing culturally sensitive products or disposal methods.87
These gaps in provision affect women’s health and freedom. Reduced to resorting to unhygienic substitutes (‘old rags, pieces of moss, pieces of mattress88), one study found that over 50% of women had ‘suffered from urinary-tract infections which were often left untreated’.89 And ‘because of the stigma surrounding menstruation and the risk of leakages’, women are restricted in their movements, unable to ‘access food, get services, information, interact with other people’.
Closing the gender data gap will not magically fix all the problems faced by women, whether or not they are displaced. That would require a wholesale restructuring of society and an end to male violence. But getting to grips with the reality that gender-neutral does not automatically mean gender-equal would be an important start. And the existence of sex-disaggregated data would certainly make it much harder to keep insisting, in the face of all the evidence to the contrary, that women’s needs can safely be ignored in pursuit of a greater good.