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In the midst of one of the most severe Ebola outbreaks in recent history, women, particularly those who are pregnant, are facing unprecedented challenges in eastern Congo. As communities grapple with the spread of the Bundibugyo strain—a variant with no approved treatment or vaccine—numerous women find themselves torn between caring for sick family members and protecting their own health. The situation highlights the gendered dynamics of health crises and the critical need for targeted interventions to safeguard vulnerable populations.
The Harrowing Choices of Caregivers
Aline Kasiwa, a 28-year-old woman from Bunia, is emblematic of the struggles many women in the region are enduring. With no other family to rely on, she has taken on the sole responsibility of caring for her ill mother, risking exposure to the deadly virus with each passing day. “She is the only family I have left. I cannot abandon her,” Kasiwa explains, underscoring the emotional and physical toll of her caregiving role. The fear of taking her mother to a hospital, where infection rates among patients and even medical staff have surged, adds another layer of anxiety to her already precarious situation.
Women in eastern Congo are frequently the primary caregivers, a fact that health professionals warn significantly heightens their risk of contracting Ebola. Dr. Furaha Elisabeth, director of a local gynaecology and obstetrics clinic, emphasises that caregiving responsibilities typically fall to women, who are often left without adequate protective measures. “It’s the woman who gives them a bath, it’s the woman who feeds them,” she states, highlighting the intimate nature of care that makes hygiene practices challenging to maintain.
The Current Outbreak: A Deadly Pattern
The current outbreak has seen the confirmation of 363 cases and 62 deaths, with neighbouring Uganda also reporting infections. Unfortunately, the true extent of the crisis remains uncertain, as the Bundibugyo strain was initially overlooked during testing, delaying crucial public health responses. Historical data from previous outbreaks indicates a troubling trend: women have consistently been disproportionately affected. For instance, during the first recorded outbreak in the 1970s, women comprised 56% of fatalities, and during the 2018-2020 outbreak, they accounted for approximately two-thirds of reported cases.
Sofia Calltorp, UN Women’s chief of humanitarian action, predicts that similar patterns will emerge in the current outbreak. “Ebola transmission follows social realities,” she notes, pointing to factors such as caregiving, domestic labour, and burial practices that often place women in harm’s way.
Insufficient Protective Measures for Health Workers
Despite the pressing need for personal protective equipment (PPE), local clinics continue to report severe shortages. Julienne Lusenge, president of Women’s Solidarity for Inclusive Peace and Development, highlights that the Karibuni wa Maman clinic has not received any PPE since the outbreak began, leaving healthcare workers dangerously exposed. “During previous outbreaks, many women died because they were the ones nursing sick family members,” she warns, illustrating the dire consequences of inadequate resources.
As the outbreak continues to unfold, aid organisations like Doctors Without Borders have expressed concern that the virus is spreading faster than the response can manage. “Nobody knows the true scale and severity of this outbreak,” warns Dr. Alan Gonzalez, underscoring the complexities of the situation exacerbated by inadequate infrastructure and ongoing conflict in the region.
The Consequences for Maternal Health
The epidemic’s impact on pregnant women is particularly concerning. Anny Ekyambo, a 32-year-old woman who is five months pregnant, shares her fears about seeking medical care amidst the outbreak. “When you see the way people die—even the nurses who treat us are dying—how can you not be afraid?” Her experience resonates with many in her community who fear attending clinics for routine check-ups, thereby risking their health and that of their babies.
Lusenge warns that this aversion to healthcare facilities may lead to a rise in maternal and neonatal mortality. “We risk seeing a rise in prenatal and postnatal mortality, for both mothers and children,” she states, emphasising the critical need for safe access to care during this health crisis.
Why it Matters
The situation in eastern Congo serves as a poignant reminder of the gendered dimensions of health crises and the urgent need for tailored public health responses. Women, as primary caregivers, bear the brunt of the Ebola outbreak’s devastating effects, often prioritising familial responsibilities over their own safety. Addressing these disparities through targeted interventions—such as increased access to protective equipment, public health education, and support for maternal health services—will be essential in mitigating the impact of this outbreak and safeguarding the health of women and children in vulnerable communities.
