- Sarfraz S. No Time for Hot Air: the Climate and Health Intersection is Gendered. Health Policy Watch. 22/12/2023
Dr. Shabnum Sarfraz's analysis underlines how women, constituting a significant part of the health workforce, are at the centre of the climate change-human health-gender equality triad connection, facing unique challenges during climate emergencies and pandemics. The article emphasises the need for a more equitable involvement of women in decision-making processes and a deeper understanding of how the climate crisis differentially impacts genders.
In early December, Dr Shabnum Sarfraz was one of nearly 100,000 delegates attending the 28th United Nations Climate Change Conference (COP 28), the largest climate conference ever organised. She wrote an article about it in Health Policy Watch, and its highlights are summarised in this blog post.
As a health professional and advocate for gender equity in health, she welcomed the adoption of the COP28 UAE Declaration on climate and health, the first international declaration on climate and health, which took place during the COP28.
Climate change was recognised as a direct threat to human health at a time when humanitarian disasters caused by fires, floods, heat waves and hurricanes have become increasingly frequent. According to the World Health Organisation (WHO), 3.6 billion people live in areas that are highly susceptible to climate change, representing almost half of the world's population. Forecasts indicate that between 2030 and 2050, climate change could cause around 250,000 deaths per year, resulting from malnutrition, malaria, diarrhoea and stress.
Women and girls, as part of vulnerable populations, are particularly affected by the dual climate-health crisis. They represent 20 million people out of the 26 million already displaced by climate change. Due to poverty, unfavourable social and cultural norms and other factors, they are often the last to access vital health services, a true gender injustice.
The close link between climate, health and gender is reinforced considering that the vast majority of those facing the impacts of climate disasters within health services are, surprisingly, women. They make up 70% of the health workforce and even 90% of frontline health workers during emergency situations, such as natural disasters or the COVID-19 pandemic. They are the ones who bear the brunt of major emergencies, keeping health systems operational and saving lives.
The praiseworthy dedication of women health workers is, however, accompanied by unsafe working conditions. Many of them lack the minimum personal protective equipment, as documented by the Women in Global Health research carried out during the COVID-19 pandemic. Some doctors and nurses found themselves forced to make gowns using rubbish bags or to reuse PPE due to insufficient supplies. Furthermore, when PPE is supplied, it often does not fit women because it is designed to fit a male body, ignoring the variety of body shapes.
To complicate the picture, according to Dr Shabnum Sarfraz, one must add that female health workers regularly suffer abuse, sexual violence and harassment from male colleagues, patients and community members. During the COVID-19 pandemic, female frontline workers were even falsely accused of spreading the infection and violently attacked by anti-vaxers.
A possible solution to this situation could come from a more equal involvement of women in health care decision-making processes. Indeed, despite constituting the vast majority of the health workforce, women occupy only 25% of leadership positions. In January 2020, only five women were invited to join the 21-member WHO emergency committee.
A 2020 survey conducted by Women in Global Health found that 85% of the 115 COVID-19 national task forces had a majority of male members. This inequality is not only unfair, it comes at a cost, as shown by the new report The Great Resignation, which highlights the growing global trend of women in health leaving or considering leaving the profession. The gender crisis in the health sector is an issue that, according to Dr Shabnum Sarfraz, should not be ignored.
When it comes to the humanitarian impacts of the climate crisis, the involvement of women takes centre stage. They are the first responders during climate disasters, both in health, family and community settings. Climate change is amplifying and multiplying health emergencies, making gender equity not only desirable but critical to our resilience. According to Dr Shabnum Sarfraz, we depend on women to maintain security and minimise the human toll of the climate crisis.
Despite the appreciation for the adoption of the COP28 UAE Declaration on climate and health, it is clear that further efforts are needed. The declaration mentions health workers, yet it mentions women and girls only once, when, according to Dr Shabnum Sarfraz, they should be at the centre of our thinking and actions in the relationship between climate and health.
Without a new social contract for women in health, without equity in leadership, and without gender-transformative approaches in our health systems, we risk being unable to meet the unpredictable challenges posed by climate events.