8. FACTS ABOUT EBOLA

  

FACTS ABOUT EBOLA VIRUS

• Ebola virus disease (EVD), formerly known as Ebola hemorrhagic fever, is a rare but severe, often fatal illness in humans.

• The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.

 • The average EVD case fatality rate is around 50%. Case fatality rates have varied from 25% to 90% in past outbreaks.

 • Community engagement is key to successfully controlling outbreaks.

• Good outbreak control relies on applying a package of interventions, namely case management, infection prevention and control practices, surveillance and contact tracing, a good laboratory service, safe and dignified burials and social mobilization.

 • Vaccines to protect against Ebola are under development and have been used to help control the spread of Ebola outbreaks in Guinea and in the Democratic Republic of the Congo (DRC).

 • Early supportive care with rehydration, symptomatic treatment improves survival. There is no licensed treatment proven to neutralize the virus but a range of blood, immunological and drug therapies are under development.

 Findings

The principal research findings have been organized thematically, helping to shed light on the most salient issue areas and identifying key levers for supporting greater gender equality in Ebola prevention and response strategies.

 • Division of domestic labor:

  One of the spaces in which gender norms, attitudes and expectations are the most apparent is within the household. There are often large gender-driven disparities in how domestic chores are divided between men and women, as well as between boys and girls. Indeed, these socio-cultural determinants and drivers can often mean that women and girls are more predisposed to infection.

• Mobility analysis:

  Gender-driven differences in the division of labour are reflected in mobility patterns of different segments of the population. Day-to-day tasks including fetching water, cultivating fields and going to the market mean that many women are more likely to have wider ‘environmental ranges thereby exposing them to many more people in public settings within their communities per day, including those that may be unknowingly infected with Ebola.

 • Changes in health-seeking behaviors:

 Men and women, boys and girls all reported changes in health-seeking behaviors since the start of the crisis. Many research respondents explained that fear of contracting Ebola – in addition to the possibility of quarantine - kept them from seeking medical attention for other health needs. The sexual and reproductive health of women and girls have been particularly impacted.

 • Unequal access to vaccinations:

 Vaccinations have played a significant role in the current outbreak, not least because it is the first time an effective vaccine has been developed and deployed as part of an overarching Ebola response strategy. However, conditions to receive vaccinal protection have been historically unfavorable to women and children.

 Increased exposure to economic or sexual exploitation and abuse:

 

 Ebola has brought with it specific employment opportunities, and the gendered dimensions of the disease show up in the economic sphere too. While some women have successfully secured employment, some respondents have pointed to the existence of exploitative practices when it comes to hiring and retention for such openings. The influx of Ebola responders and associated cash flow may also inadvertently have created conditions which favorite economic or sexual exploitation and abuse. The visibility and rise of such incidents are likely correlated with parallel increases in community resistance against Ebola response efforts.

 A gender gap in communication:

  Ebola-related key messaging and content were perceived as being heavy or confusing. This gender gap is likely correlated with existing gender inequalities in terms of access to education during childhood years and later adult literacy levels. Not only are women sometimes disadvantaged when it comes to accessibility and comprehension of key messages, they are also frequently hampered in their ability to respect recommendations precisely because of their gender.

 Gender bias in research and resourcing:

  The scientific underpinnings behind EVD-related policy and practice are subject to gender biases in both research and resourcing – with differential consequences

on women, men, girls and boys. One key example pertains to transmission trends, particularly those that disproportionately impact women and young children. Specifically, the continued presence of the virus in seminal and maternal fluids (semen and breastmilk) amongst male and female Ebola survivors has been identified but little is known about exactly how long the virus can persist after a patient has ‘recovered. ‘Similarly, a parallel de-prioritization was evident in research on the safe use of anti-Ebola vaccines on pregnant and lactating women, as well as, children.

• Socio-behavioral and biological vulnerabilities of children:

 In addition to adult women, children have been disproportionately affected by EVD. Children are at higher risk of infection to Ebola because it is transmitted through direct contact. They are subject to greater physical contact with caregivers, and generally have relatively poorer hand-washing practices.vi While such behavioral factors partly explain the susceptibility of children to Ebola, it is also important to understand the biologically-related factors.

Timely identification of cases amongst children may be hampered by the fact that many early symptoms (fever and fatigue, for example) resemble those of other commonly-found disease in sub-Saharan Africa, including malaria

 Key Recommendations

1. Improve the consistency and visibility of data disaggregation

2. Women are key stakeholders and their role should be front and centre

3. Integrate conflict-sensitive and gender transformative approaches

4. Promote prevention while reinforcing reporting and referral mechanisms for abuse survivors

5. Tailor and target EVD-related communication efforts

6. Redress gender bias in scientific research

7. Encourage and embed child-friendly innovations

8. Bolster community resilience through key entry points such as schools

9. More spotlight on inclusive practices and programming