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Second wave: Disruption in health services 'exacerbated' gender inequalities

By Ritika Gupta, Anshula Mehta, Ishika Chaudhary, Sakshi Sharda, Arjun Kumar*

The second wave of Covid-19 pandemic has exacerbated inequalities to a great extent affecting every sector of life deeply. To understand its effect on women, the Gender Impact Studies Center (GISC), Impact and Policy Research Institute (IMPRI), New Delhi, organized a panel discussion on Gendered Impact of the Catastrophic Second Wave of COVID-19 Pandemic: Way Forward towards Combating the Third Wave in India.
Prof Vibhuti Patel, eminent economist and feminist, formerly at the Tata Institute of Social Science Research (TISS), Mumbai, initiated the discussion, stating that it is important to discuss the gender implications of the pandemic as the situation went worse in the second wave. Covid orphans and Covid widows are the new terms added to our vocabulary due to the devastating impact of the Covid-19.
She pointed to naked profiteering by private enterprises amidst the pandemic, which is pathetic. Stating that we need to promote universal health care and 6% of our GDP should be devoted to the public health sector, she insisted, the government needs to give attention to one crore girls who are at the verge of dropping-out of schools; food and nutrition safety; job safety for unemployment; recognition, reduction and redistribution of care work; application of labour standards; health insurance to Asha and anganwadi workers; and global minimum tax of 15% for corporate profits as talked about during G7 summit 2021.
Gender responsive public policy for inter-sectional marginalities based on caste, class, religion, gender and ethnicity is the need of the hour, Prof Patel said, adding, gender based violence has taken varied forms in the form of sexual violence, online harassments, domestic abuse, forced child marriages etc. Mata corona temples have been set up in villages as people believe that by worshipping corona, they can get rid of it. Labour codes affecting women need to be discussed promptly.
Renu Khanna, trustee, Sahaj, Vadodara, and, member, Feminist Policy Collective, focused on public health response of the pandemic. She presented a case study of maternal health, which suggested that there are social determinants affecting maternal health. Effective response is required to “build back better”. Food and livelihood security are crucial.
Providing data, she said, the proportion of households eating less before the second wave lockdown was 60%, compared to 77% during the lockdown which followed. Nearly 66% migrants and informal workers ate less than two meals a day and less nutritious food even in September-October 2020. Relief measures helped but patchy Debt trap increased due to depletion of physical and financial resources.
According to a UN Women report, in 2021, 118 women for every 100 men aged 25 to 34 were living in extreme poverty. This would reach to 130 women by 2030. According to a World Bank report, in India more than 12 million people would be pushed to poverty because of the pandemic. There is reduced nutrition for lactating and pregnant women, and increased workload, care work and violence against women.
She quoted a Centre for Disease Control study to say that there is 70% increased the risk of death among pregnant women during Covid. Lancet’s global health report has also revealed that maternal deaths and still births have risen by 33% because of disruption in health services.
During the second wave, more women got get infected -- 38.5% of total cases as compared to 34% in July 2020 in Telangana, she said. Women are generally admitted late, especially those from rural areas. Denial of services is a huge issue. There are heart tormenting stories of pregnant women. Doctors are reporting dilemmas as doing a C section on a Covid positive pregnant women. Digital divide is further aggravated the situation as women in rural areas find it hard to register on CoWin App.
Poonam Kathuria, director, Society for Women’s Action and Training Initiatives (SWATI), Ahmedabad, highlighting gender based violence, said, there have been higher cases of unwanted pregnancies. Women are losing jobs more than men due to additional family responsibilities. In rural areas, land is mainly registered in the name of males, but due to the death of male in the family because of Coronavirus, women are facing problems related to inheritance.
Seema Kulkarni, founding member, Society for Promoting Participative Ecosystem Management (SOPPECOM), Pune, said that the bargaining power of Dalit women was particularly found to be very low during the second wave. This apart, there is a sharp rise of Covid widows in rural areas. In fact, public systems failed women.
She added, subsistence agriculture is in critical state. There are no opportunities for livestock and forest workers. To access PDS, documents are needed to access food. Therefore, food security is critical. Access to loans via micro finance institutions is leading to mounting debt crisis. Women are subjected to sexual harassment on not paying loans. Widows and orphans need our attention. Structural inequalities need to be looked into deeply. Community support also needs to be strengthened. Ecologically sound agriculture needs to be promoted.
Dr Swati Rane, CEO, Seva Shakti Healthcare Consultancy, and core committee member, Jan Swasthya Abhiyan, Mumbai, asserted that every person who gives care professionally is a healthcare worker. Females are the primary care workers. Violence against female health care workers is only tip of the iceberg. Gender leadership gaps are driven by stereotypes, discrimination, power imbalance and privilege. In India, women form 50% of healthcare workforce. Nearly 88% women are nurses and midwives.
Women are almost 70% of health workforce but it is estimated that they hold only 25% of senior roles, she said. Sanitation workers, large number of whom are women, remain most ignored. States haven’t come with uniform policies for these workers, many of whom are women. Nurses, estimated to be around 50% of all health workers, are significantly under-represented in national health leadership. Nearly 76% nurses are overworked, according to the study conducted jointly with Saathi. In the first wave, there were 62 deaths in eight months, and in the second wave, there were 62 deaths in three months.
She continued, across Maharashtra, at least 570 Asha workers were infected with Covid-19. Asha workers are underpaid and overworked. They are subjected to physical abuse or violence during house to house surveys. There is no proper job role for them, as their duties include prenatal and postnatal care, immunization drives for children, population-based screening for disease-based surveillance among others.
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*Researchers team at Impact and Policy Research Institute (IMPRI), New Delhi

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