How gender disparity is affecting Pakistan’s fight against Covid-19
Bed number 281 and 282 in the High Dependency Unit (HDU) have been occupied by two middle-aged women for the last 18 days. Both patients were shifted from the isolation unit at the same time. This prolonged illness, being hooked up to numerous machines and an inability to breathe without assistance, has made them quite irritable – yet their children are at their beck and call every day without any complaints. Two different women who were otherwise healthy, two different families, affected by the same virus. Both their children ask the same question everyday: when can we take our mother home? A question which we don’t have an answer for.
There have been very few victories during this pandemic – but the provision of Coronavirus vaccinations has brought an element of hope. However, vaccine hesitancy, especially amongst women, is hindering our aim to win the battle against this deadly virus.
While gender disparity impacting vaccine uptake is a global concern, Pakistan in particular and South Asia in general are at a greater risk. India is facing similar problems according to multiple studies.
According to the World Economic Forum (WEF), Pakistan ranks 153 out of 156 countries in the Global Gender Gap Index Report 2020. Reflective of our deep-rooted patriarchal values and structural inequality in the region, this gender gap sticks out like a sore thumb in our vaccination drive as well.
Among other factors which contribute to this gap, the lack of concern for women’s wellbeing is a significant contributor. Typically, the health of men is prioritised over that of women in our society since men are perceived as the breadwinners of the household. As a result, Covid-19 vaccinations are not considered a priority for women. Moreover, traditionally, women are not the primary decision-makers in the family. Hence, their decision to get vaccinated is heavily reliant on the male members of the family.
Digital illiteracy and lack of access to technology also act as barriers for many women. According to the United Nations Children’s Fund (UNICEF), women’s access to information regarding Covid-19 is often restricted to receiving news from their male family members. Additionally, this barrier prevents them from registering for the vaccine themselves.
Misinformation regarding the vaccine impacting women’s fertility is another important factor contributing to the gender divide. While numerous studies have deemed the vaccine safe with no side effects on fertility, fake news and forwarded messages on WhatsApp continue to cause damage daily.
Furthermore, conservative social norms restrict the majority of women to domestic environments, which is why most government-imposed restrictions such as access to outdoor facilities do not present much of a threat. The two harshest restrictions by the government for unvaccinated individuals, namely the closure of SIM cards and the withholding of salaries for those who remain unvaccinated, fail to serve as an incentive for many. According to the International Labour Organisation (ILO), there are 8.5 million domestic workers in Pakistan, the majority of whom are women and children. Since salary restrictions do not impact this informal sector, there is no urgency to get vaccinated. As for the SIM cards deterrence, most women use SIM cards issued on the CNIC of their male family members. Moreover, a significant chunk of Pakistan’s female population does not have access to valid legal identity documentation such as a CNIC or a passport, which in turn hinders the equitable vaccine uptake.
Despite all these obstacles, even if women register for the vaccine, mobility issues restrict their ability to access the vaccine. A lack of cheap, accessible and safe public transport options and a reliance on a male family member to take them to the vaccination centre complicates the vaccination process.
Both of the women in the HDU were hospitalised with us for more than a month, but only one survived and was discharged with home oxygen support. Every day, we hear news entailing statistics about the number of lives lost to Covid-19. To others, these are merely numbers, but we get to see the real-life stories and people behind these numbers. The faces that represent those stats. The weeping families holding onto every strand of hope, the patients fighting for any chance they have at life – it is an emotionally draining experience.
Effective and efficient vaccination is our only shot against this pandemic, and that is only possible if the government visualises the Covid-19 vaccination effort through a gender lens. According to Dr Princess Nuthemba, the Assistant Director-General for Family, Women, Children and Adolescents at the World Health Organisation (WHO),
“If we don’t put gender equality at the forefront of the Covid-19 response, we will all lose.”
We have a large network of female health workers who can provide awareness and dispel the many false rumours regarding vaccines which continue to make the rounds. This is imperative since the public health system of Pakistan is very fragile, with a ratio of one doctor to 963 people and one hospital bed to 1,608 people. Everyone needs to be vaccinated for us to have a fighting chance against this virus because no one is safe unless all of us are safe.