November 12, 2014 • 36 mins
Why is the Ebola virus killing more women than men in West Africa? Cristen and Caroline chart the spread of the Ebola virus and the gender roles that put women more at risk for contracting Ebola virus and other pandemics.
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Episode Transcript
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Speaker 1 (00:03):
Welcome to Stuff Mom Never Told You from how Supports
dot com. Hello, and welcome to the podcast. I'm Kristen
and I'm Caroline, and today we are going to talk
about a bowla because obviously, um, this is a massive
healthcare issue that's going on right now in West Africa
(00:26):
and abroad, and there's also a lot going on in
terms of the intersection of women and a bowla, a
facet of it that might not be focused on as closely.
So we're going to take some time to talk about
what a bola is, how it's spread, why it's spreading
so fast, and also why women are at a particular
risk for contracting a bowla. Right, so let's turn to
(00:49):
the World Health Organization to figure out what evil is exactly. Basically,
it is a severe and often fatal virus that's hard
to distinguish in terms of its symptoms from things like laria, typhoid, fever,
and meningitis, and in terms of its fatality rate. It
is fatal fifty of the time. And once you are
(01:09):
infected with the virus, the time from infection to onset
of symptoms can range anywhere from two to twenty one days,
and you're probably if you've been following these reports, probably
familiar with that twenty one day figure, because that's the
amount of time that a lot of authorities are saying
that people coming back from West Africa should be quarantine.
There's a big debate over that um. But people are
(01:31):
not actually infectious until they develop symptoms. So it's not
like you're carrying it around infecting people if you don't
know you have it. But once you do develop symptoms,
the virus is so contagious that it even can be
detected on your skin. And the kinds of symptoms that
we're talking about usually start with things like fever, muscle pain,
sore throat. We hear a lot about how doctors and
(01:52):
nurses are constantly having to take their temperatures every few
hours because that's usually one of the first indications that
I have contracted a bola. And then the symptoms can
progress to include things like diarrhea, vomiting, impaired kidney or
liver function. And then it can also progress when it
when it starts reaching a fatal point where you begin
(02:15):
bleeding internally. Uh that lowers your blood pressure and eventually
causes organ failure. Yeah, and we don't have anything super
optimistic to report as of press time in terms of treatment,
other than to say they're working on it. Um health
care teams rehydrate patients, they provide I mean therapies and
(02:36):
blood products. Vaccines are being worked on. But it generally
seems like the push for that did not come until
this fall, actually, even though the outbreak started much earlier.
So how does it spread among people? Because there's obviously
in the United States been a lot of panic about
it being so contagious as and we'll talk about this
(03:00):
as there have been a bull of patients on US soil.
And the bottom line is that it's not an airborne virus.
It is contracted through direct contact, usually through broken skin
or mucous membranes with blood secretions, organs or other bodily
fluids of infected people. And you can also contracted through
(03:22):
direct contact with surfaces and materials such as betting and
clothing that have been contaminated with those bodily fluids, and
so you can imagine that Also part of the problem
is the burial and mourning rituals that are common in
parts of West Africa where this outbreak has occurred, in
which people directly handle the body. And so you can
(03:44):
imagine that if in the ways it is contagious through
secretions and blood and other bodily fluids, that if those
still exist on the person after death, and you have
people washing the body and bearing the body improperly, that
it could still infect people around them. Yeah, because in
terms of how long it's infectious, pretty much as long
(04:05):
as blood and bodily fluids remain, including things like semen
and breast milk, it likely also contains the virus. For instance,
men who have recovered from ebola can still transmit the
virus through their semen for up to seven weeks after
recovery from illness, which is crazy. That's crazy. So it's
(04:27):
not just like, oh, you're bleeding and I'm going to
get it. It's like it can also be sexually transmitted,
which makes sense, but it's also terrifying. Um, but so
where did this come from? People originally got it from animals,
and fruit baths are thought to be the natural hosts
of the e bowl of virus, and so then humans
come into contact with fluids like blood, organs or droppings
(04:49):
of these animals, and animals like chimpanzees, gorillas, monkeys, forest
antelopes and porcupines found dead or injured in the rainforest,
and in act, the first Ebola outbreaks occurred in remote
villages in Central Africa near tropical rainforests. In nineteen six,
there were two simultaneous outbreaks, one in Sudan and one
(05:11):
in the Democratic Republic of Congo, and that one was
near the Ebola River, hence the name. Now when it
comes to the current outbreak, um the outbreak in West
Africa has also involved not only rural areas but major
urban areas as well, and it's the largest and most
complex Ebola outbreaks since the virus was first discovered, as
(05:33):
a lot of people are probably aware and it's concentrated
largely in three main countries, Guinea, Sierra Leone, and Liberia,
but there have been cases in Molly, Spain, the US obviously,
and Nigeria and Senegal are also on watch right and
(05:53):
with this outbreak we've seen more cases and deaths than
all other Ebola outbreaks combined. More than four hundred healthcare
workers in West Africa have been infected and two hundred
and thirty three had died as of October eight, so
obviously that number would need updating, so The question then,
is why is it spreading so fast. We've had these
previous outbreaks before, why is this one so particularly aggressive? Um?
(06:17):
The World Health Organization largely attributes it to things such
as lack of education about transmission. I mean, I I
know from seeing news coverage in the United States there's
been so much confusion about how it is transmitted and
the fact that it's not in fact airborne. UM. There's
also been a reluctance to seek treatment. There has been
(06:38):
among some people in West Africa, suspicion that it doesn't
even exist, that it's perhaps a conspiracy. Um. But also
in the most severely affected countries Guinea, Sierra Leone and Liberia.
These three countries have just come out of long periods
of conflict and because of that, their health systems have
already been weakened due to lack of human and infrastructural resources.
(07:02):
So they didn't even have the systems in place to
jump on a case like this, and so now it's
as if we're starting from behind. Obviously, the fact that,
like you said, Caroline, work on a vaccine didn't even
start until the fall, right, Um. Well, and it's another
thing too to look at the World Health World Health
(07:24):
Organizations guidelines about infection control. These are very good guidelines, obviously,
but when you hear them, it makes more sense why
it's spreading so fast among people with limited resources. Because
the things that they recommend include hand hygiene, respiratory hygiene,
and use of personal protective equipment. Okay, that makes sense,
you want to block splashes or contact with infective materials.
(07:47):
But they also talk about things like safe injection practices,
safe burial practices, applying extra infection control measures, wearing face
protection like a face shield or medical mask and goggles,
wearing clean, non sterile, long sleeve gowns and gloves for procedures.
And that's all well and good, and those things would
all be readily available in America and other countries, but
(08:11):
in some of these rural villages that are going through
this health crisis, all of these preventive measures are not
necessarily available well. And also in terms of the number
of trained health care workers you have to treat this population, um,
they're clearly not enough. Obviously, we're getting more UH international
medical workers on the ground building hospitals as fast as
(08:34):
they can, but in terms of just looking at what
West Africa you have one nurse for about every ten
thousand people, and so in such a crisis as this,
it's easy for those kinds of very strict protocols to
sometimes fall by the wayside or something to slip up,
just because of so many people needing care. And the
(08:59):
thing that has sparked a lot of Western focus and
American focus on this outbreak is the fact that it
has obviously been contracted on US soil now, which says
a lot about our priorities in terms of UM, really
only caring about crises like this when they affect us
(09:23):
in our backyards. UM. But we want to walk through
just a brief timeline of how that happened and how
that sort of led up to this more American panic
around Ebola and our response to that. Yeah, this is
coming from US News and World Report. We also took
some details from a Reuter's timeline. UM. But basically, health
(09:44):
authorities think that a guinea and toddler who died in
December is patient zero for the current outbreak, because then
that toddler's family contracted the disease and it's spread from there.
In March, that's when we have Guineas Ministry of Health
announcing the ebola outbreak was suspected cases in Sierra Leone
in Liberia, and by July the World Health Organization was
(10:07):
reporting more than five people dead. And then on July
this was really when uh CNN, for instance, started having
it's almost twenty four hour constant coverage of the bowl outbreak,
because this is when Dr Kent Brantley and fellow AID
worker Nancy right Bowl are diagnosed with a bowla in Liberia.
(10:28):
They're then both flown to Atlanta to be treated at
Emory Hospital. Um. That transport to Emery happens in early August,
and so all of a sudden, the fact that these
two workers are being transported here, oh, then it catches
our attention. Obviously there was awareness that a NI bowla
outbreak was happening, but this was really when more of
(10:51):
day to day focus was being placed on what this
really means for us too. And so by August night,
the World Health Organization reported that when thousand people were
dead in Guinea, Sierra Leone, Liberia, and Nigeria, and just
ten days later they declare the worst ebola outbreak in history. Meanwhile,
(11:12):
though the organization Doctors without Borders had been saying the
same thing for a while. They had called the spread
unprecedented back in April. Yeah, and then if we jumped
forward to September fift this is when Thomas Eric Duncan,
who had previously helped a pregnant Ebola victim, get to
the hospital in Liberia. He leaves Liberia a few days
(11:36):
later for the US and then becomes the first person
to develop a bowl of symptoms in the US. After
he had been sent home from a Dallas hospital with antibiotics,
his health took a turn for the worst. He returns
to the hospital where he's ultimately diagnosed with a bola
and then he dies on October eighth, two thousand fourteen.
And this is also when the a bowl of panic
(11:58):
begins ramping up in the US as well, these questions
of how did this happen? How are you know? People
are flying to the US, what's going on? And also
the fact that this is the first e bowla casualty
on US soil, because we should note that right Bowl
and Brantley had already recovered and been released from Emory, right,
(12:18):
and so Duncan's death creates the spiral. Like Kristen said,
there was definitely a panic going on, but there were
also actually real consequences for other people involved. Um the
nurses who cared for Duncan in the worst of his
disease during his high risk period when he's vomiting and
having diarrhea, Nina Fam and Amber Vincent both contract ebola
(12:39):
and both are treated. Vincent has flown to Atlanta to
go to emery and Nina Fam has flown to a
facility in Maryland. Both recover. They become the fifth and
sixth American abola patients to recover. And so of course
this leads to a lot of news media craziness, lots
of speculation and conjecture over whether we're about to have,
(13:01):
you know, a giant worldwide pandemic. Yeah, and all of
this leads us up to late October UM after Dr
Craig Spencer has flown back home from Guinea to New York. Um,
as was repeated in every single UH media story about him,
he went bowling in Brooklyn and then developed the bowl
(13:21):
of symptoms where he was diagnosed, and so the panic
was reaching a fever pitch here to the point that
on October twenty four, New York Governor Andrew Cuomo and
New Jersey Governor Chris Christie announced a mandatory twenty one
day quarantine in New York and New Jersey for anyone
returning from West African countries. And by this point as well,
UM at airports, the airports that were still open in
(13:44):
West Africa, and obviously UM the airports in the US,
we're already doing mandatory screening of anyone flying back from
impacted areas. UM. And the thing about it is, this
is also when we start hearing too from a lot
of American nurses who are very concerned about how they
(14:05):
will be impacted. UM. This is when we start seeing
more information about this gender angle of a bola. Not
to pit male doctors against female nurses, but it is notable,
for instance, that a lot of the nurses that have
been affected, and a lot of the nurses speaking up
on behalf of nurses saying we need more training, we
need more resources, um, have been women as well, simply
(14:28):
because nurses tend it's an industry more dominated by women. UM.
But that's only that's talking state side. While all this
is going on, while there are still fewer than you know,
a dozen of BOLA cases in the US, as of
early November, the World Health Organization estimated that there were
(14:49):
four thousand, nine hundred fifty one dead in West Africa
from a bola out of thirteen thousand, five hundred sixty
seven documented cases. However, the head of doctor is Without Borders,
which again Caroline you noted that they have sort of
been on top of this even before the World Health
Organization started paying closer attention. The head of the of
(15:09):
Doctors Without Borders said that actually, these numbers are are
probably being vastly under reported. For instance, since Cerra Leone,
entire villages have been wiped out because it's so aggressive,
and he says that the the SMIs could be as
high as twenty people dead due to this, which I
think only goes to show too how much we're still
(15:30):
learning about this, right and goes back to again our
Western biases of only really tracking what's going on in
our own country exactly. And we wanted to give you
this primer on the e bowlavirus to then lead up
to why we're going to focus on women and why
it is that women, especially in West African and also
(15:53):
in American hospitals where a lot of the nurses are women,
why they are at particular risk for contracting this disease
and other similar kinds of pandemics, and we'll talk about
that when we come right back from a quick break. Okay,
(16:15):
So before the break, we presented you with a lot
of information about the current ebola outbreak and the crisis
and where it came from. Um and Kristen had started
delving into the issue of the gender division in terms
of who is being affected the most by ebola, and
we do know that women are being hit harder by
this outbreak. Women account for fifty five to six of
(16:40):
the deceased in the current epidemic in Liberia, Guinea, and
Sierra Leone, and that's coming from UNI SEF And in July,
for instance, health teams in Liberia said of those who
were infected or died from ebola were women, and so
that's established. We understand that these numbers are higher for
women that for men. But why what's going on? Well,
(17:00):
it turns out that men are likelier to be hit first,
largely due to what we were talking about earlier and
how animals are the disease vectors, and as men are
often the hunters, they might come into contact with it
first through hunting infected animals UM, but then women become
(17:20):
disproportionately affected, largely due to gender roles at its most
basic UM. This is something that Liberia's Minister for Gender
and Development, Julia Duncan Castle, has talked about UM. She said,
women are the caregivers. If a kid is sick, they say,
go to your mom. The cross border trade women go
to Guinea and Sierra Leone for weekly markets and they're
(17:44):
also the caregivers. We mentioned earlier the risk of contracting
a bola through burial practices, and those burial practices and
funeral rites are often led by women right and women
are also the traditional birth attendants, nurses and cleaners and
laundry workers in hospitals as well. And it's interesting to
(18:06):
note too that the gender divisions that exist in the
home also extend into the hospital. Uh Sufia to tunis
a spokesperson for the Community Response Group in Sierra Leone
and who was also a leader of the Social Mobilization Committee.
An Ebola was also talking about this issue of how
women are the primary caregivers at home. They take care
(18:26):
of the sick, They cook for the sick and clean
up after them, and she says that this role is
extended to the medical field, where women are most of
the nurses and cleaners, and they don't get the same
support and protection as the doctors, who are primarily men. Well,
and it was also it might have been Tunis who
was saying that if at home, for instance, if the
(18:48):
woman gets sick, other women will come and take care
of her. It's not that the husband will assume the
female duties. Um. And this is the same pattern from
the Origin nine nine outbreak in Sedan, for instance, sixty
of those affected were women, according to you a two
thousand seven report by the World Health Organization. And this
(19:12):
becomes an even bigger health crisis when pregnancy is added
to the equation. And in fact, our major inspiration for
wanting to delve more into this topic in this podcast
is from a New Yorker article about um the particular
risk of being pregnant with abola. Right, it's it sounds
(19:34):
absolutely horrific, and it is scary enough to be pregnant,
but to then experience eubola, it adds so much terror
to the experience. UM. So, basically, when a woman is pregnant,
her body has a special immune response to the fetus
and it knocks it down a few notches to help
protect this growing thing inside of it. But that means
(19:57):
that what's good for the fetus is not as good
for the mother because she can't fight off infection as well.
And so if a woman, if a pregnant woman contracts ebola,
that has a lot of terrible things that can go
along with it. For instance, just one thing is that
the ebola infection can cause spontaneous abortion. And when a
pregnant woman with ebola goes into labor, they end up
(20:19):
bleeding a lot, and her sweat, her blood, and her
amniotic fluid are all highly infectious, which is bad for her,
it's bad for her baby, and it's bad for any
healthcare workers try to take care of her. Right when
you go to West Africa, pregnant women with ebola are
often turned away from the standard of bowl awards at hospitals,
not only due to overcrowding, but because of the higher
(20:43):
infection risk that she poses not only to other patients,
but also to the healthcare workers who often have to
weigh giving her the resources and medicine and treatment or
giving it to someone who is not pregnant likelier to
survive because not only is a pregnant woman likelier to
(21:04):
succumb to a bola, but also likelier to almost take
hospital workers with her. Yeah, but then there's the whole
self perpetuating idea that, you know, maybe if a pregnant
woman were provided with really really good resources and medicine
and medical care, that she could overcome it. But because
(21:28):
people already have this belief that, oh, well, she's pregnant,
she's going to get us all sick, they're less likely
to treat her, which means, of course pregnant women are
more likely to suffer and die. And this story that
we were reading said that overall, only time will tell
as far as rates of pregnant women recovering versus not,
(21:49):
because some health care workers overwhelmed by this current situation
might not even record whether a patient is pregnant or
not well. And we should also notice and we should
also note too that in the very limited studies that
have been done on women pregnant women with a BOWLA,
the mortality rate for um their fetuses, even if they
deliver our carry a child to term and deliver, the
(22:14):
mortality rates are extremely high. There was only one in
one study there was only one case of a woman
delivering um a live baby, and the baby then went
on to die a few days later, just because it's
immune system had already been so compromised. Um. And you
also have to keep in mind too that in the
(22:34):
context of West Africa, this is an area where women
might not be getting a good prenatal care to begin with, because,
like we said earlier, getting sier Leone and Liberia have
all been highly susceptible to a bowl of spreading so
aggressively because it didn't have a lot of strong health
(22:57):
care infrastructure in place to begin with, and that it
sends to maternal healthcare in the region as well. Yeah,
and so basically, um, any any advances that these countries
and their health systems were making and being able to
provide prenatal care, um care for infants, it's all sort
of taken a back seat to the Cibola outbreak because
(23:19):
all of a sudden, any resources that were being put
towards pregnant women and families and infants, everything is being
focused now on Ebola. Every every reward at every hospital
almost is being turned into any bowl award. UM. And so,
like we said, many healthy pregnant women aren't even able
to get to the hospital if they need to deliver.
And UM Dr Emmanuel dark Court, the senior Health director
(23:42):
at the International Rescue Committee, was really lamenting this situation
and said, there are so many ways we as a
global community have failed pregnant women who play such an
important role in society. We all have a responsibility in
a way for their safety, and we have failed in
so many ways. And a bowlah disproportion only affecting women
has broader reaching effects than simply more women dying. UM
(24:07):
Serial leone First Lady Saia Nayama Coromo talked about how
in rural areas where the majority of small holder farmers
are women, food production can be affected. And on top
of that, the border restrictions that are being put in
place to try to slow the spread of a bola
that is then affecting these cross bordered traders, a majority
(24:31):
of whom are women, making it difficult for them to
provide for their families. And if we look at the
idea of disease in general affecting women, UM Julie L.
Gerbert Ing, who's the former director of the CDC, read
a paper called Women and Infectious Diseases where she said
that the social, economic, and psychological effects of disease are
(24:52):
more severe for women. When their partners or fathers die,
women often lose economic rights. She points to a Ugandan
survey that found that one in four widows or reported
losing their property after their partner died, so that ties
in with the whole issue of cross border trade, of
women having a major economic role in the family, and sadly,
as Garbing points out, this is this wholy Bullock crisis
(25:14):
and its effects on women is part of a much
bigger picture of infectious diseases like this tending to hit
women harder. Speaking to Foreign Policy magazine, JOHNS. Hopkins University
professor Soberklin said that we take note of the gender division,
but so few people actually do anything with that information
(25:35):
because doing something would mean consciously evaluating what happens in
an outbreak or any health crisis through a gender lens,
which then would lead to the need for more focused
on these systemic problems. These systemic issues that lead up
to perhaps gender disupport, disproportionate um faced palities that might
(26:01):
include things like women's unequal access to adequate healthcare, or
the finances or the fact that they might not be
first in line for treatment, or that they might be
or that men might be prioritized, I should say, over
them for treatment. So in short, it would, it would.
It requires far more than just say finding a vaccine
(26:22):
or something, you know, one simple step, right. And Klein
also points out what Kristy and I have mentioned on
the podcast a few times, which is that we have
a history, uh in our in our history of medicine
and research and medical research of focusing just on men
and how a disease affects men and how a treatment
affects men, and we really as a as a global
(26:44):
community almost need to take into account a disease is
biological components and the differences in how men and women
respond to a disease. So you're basically saying both sex
differences and gender differences have to be taken account taken
into account when and you look at diseases, and so,
you know, Kristen mentioned, in quoting Klient and Foreign Policy Magazine,
(27:08):
the whole issue of maybe men being prioritized over women
in terms of getting care, and this is kind of
something that Columbia University epidemiology professor Wafa El Sader also
said to foreign policy. He said that looking at who
dies in an outbreak quote shows you who has power
and who doesn't. In a way, it holds a mirror
to society, and it shows societies how they treat each other.
(27:31):
And it extends not only to lay women, but also
to nurses who are primarily female worldwide, but also are
often low on the totem pole. And like I said earlier,
we've been hearing a lot from leaders of nurses unions
and associations in the United States asking for more resources
on the ground here. Um, nor is it just limited
(27:55):
to a bull in the same way as this gender
issue applies to other pandemics as well. Um. There were
some Canadian studies conducted on the two thousand three Stars
outbreak and it found that quote a lack of power
and influence of nurses was linked to infection control deficiencies.
And similarly, a two thousand eleven World Health Organization report said,
(28:19):
quote research has shown that poor nurse physician relationships are
common in hospital settings, pose a potential threat to patients safety,
including the risk of infections, and have a negative impact
on nurse satisfaction and retention. And that quote right there
from the report sounds like a summary of a lot
of what we've been hearing in terms of UM nurses
(28:40):
asking for help right now, right because when you look
back at Nina fam and Amber Vincent, the nurses at
the Dallas hospital where Duncan died, I mean, they did
not receive proper training. They didn't really know what was
going on basically, I mean ebola was something brand new
to western hospitals. UM, having someone suffered from those types
of symtoms, they just weren't prepared for it. UM. But
(29:02):
of course, you know, we've we've talked about how ebola
affects pregnant women, and pregnant women also are so badly
affected in by infectious diseases in general. UM. For instance,
in two thousand nine, during the H one and one
influenza pandemic here in the US, of infected pregnant women died,
(29:23):
whereas the mortality rate for the rest of the population
was just point oh two percent. And several other infectious
diseases like malaria, hepatitis, tuberculosis, and loss of fever have
been reported to be more severe in pregnant women. So
clearly more attention is needed, and not only attention, but
also action um. But one important thing to talk about
(29:46):
two before we close is the fact that, yes, women
are being disproportionately affected, but women also to have a
very strong role in possibly limiting this outbreak and stoping um,
this pandemic because again that actually relates back to gender
(30:06):
roles and divisions. UM. There was an article about this
in the Washington Post recently talking about how women in
West Africa play a major role as the conduits of
information in their communities um, and they are often being
enlisted as leaders in public health campaigns to spread awareness
(30:27):
about the disease in terms of you know, if someone
is sick in your home and caring for them and
and laundering dirty linen's and how they deal with the
burial practice, all those kinds of things. It's the women
who are being relied on as the gatekeepers of that
crucial information. Right. So it's interesting to see how that
(30:48):
reliance on traditional gender roles and roles in society maybe
affects women more leads to more women contracting the disease,
but it can also provide a solution, and people haven't
always grasped that. Again, this is coming from Foreign Policy
Magazine where they talk about how in one previous Ebola outbreak.
One anecdotal reports said that men were dominating informational meetings
(31:12):
on the disease, despite the fact that women were already
known to be the primary caregivers, and during one of
the Avian flu outbreaks, government officials were dealing with men
because they thought that, hey, these men have to be
the owners of the farms, right, despite the fact that
women were the ones doing the majority of the work
with animals in their backyard farms. Yeah. I think that
(31:34):
Julie Gerberding, who is the former director of the CDC,
really summed it up most effectively. Beyond Ebola, um, she said,
you have to attack quote, the root causes of these
disparities social economic and educational inequalities that fuel the spread
of diseases and perpetuate poverty throughout the world. And this
(31:56):
kind of focus can be applied to so many things,
even and you know, like she said, even beyond healthcare
crises like this. Um. So hopefully some of these tragic
but crucial lessons can be taken from the Sabola crisis.
I mean, it is a big question mark though, because
(32:16):
everyone is in such understandably emergency mode. It's like these are.
We almost barely have time to even talk about it,
so at this point only time will tell which is
which is scary, absolutely, but there are. It is heartening
to know that there are a lot of people though,
(32:37):
on the ground who are paying attention to this, and
hopefully for listeners who aren't in West Africa who might
not have direct contact with people affected by the virus
or people who are working to fight the virus, hopefully
this can add more of a deeper understanding to the
(32:58):
news coverage that we do see about it. And if
you do have a connection though, to what we really
want to hear from you about this issue. Mom Stuff
at how stuffworks dot Com is where you can email us.
You can also tweet us at Mom's Stuff podcast or
messages on Facebook, and we've got a couple of messages
to share with you right now. So I've got a
(33:22):
message here from Sarah about our episode on the Golden Girls,
and she writes, I first watched Golden Girls a few
years ago when I was doing part time caretaking work
for a woman with early onset Alzheimer's. I would go
to her house to make breakfast and lunch in the morning,
then come back in the evening to make dinner. We
did cross words together and went on walks, but as
her illness progressed, she really just wanted to watch TV.
(33:45):
The only thing that could really get her talking and
interacting with people was The Golden Girls. I would sneakily
get their remote and put the show on, and before
too long, she would be telling me all about the
various adventures she'd had as a teacher, as well as
some of the raunchy stories about her first and second husbands.
Over the course of my time with her, we watched
pretty much every episode of the show. I think Blanche
(34:08):
and Dorothy triggered some memories and helped her hold on
for just a little longer. Plus, when she got to
the point where she couldn't recall my name anymore, she
started calling me Sophia because she felt like I was
as sassy as a cell Getty's character. Unfortunately, her decline
was rapid. She had to be moved into a living
facility before too long, but she watched Golden Girls all
the way to the end. Beyond that, the Girls totally
(34:31):
changed how I planned my golden years. When I am
a certain age, I fully intend to become a Blanche
Sophia hybrid wearing slinky robes and la garie while dishing
out some serious sass. I'm not far off in that
lifestyle now, although usually I'm in stretchy pants dishing out sass.
I just need to get my robe game up and
I'm set. Thank you for a brilliant episode on a
wonderful show that it's been a huge part of changing
(34:54):
how my generation thinks about getting old. I adore the
show and will probably re listen to the episode with
a big slice of cheesecake in front of me, So
thank you, Sarah. Okay, I have a note here from
Maryanne about our Women of a Certain Age episode. Um.
She says, I get the I roll at the idea
of biology making it so women want sex more when
(35:15):
they reach a certain age. Would have thought that at
your age as well, But as I have hit the
over forty mark, I have to say biology is a thing,
and yeah, if there wasn't birth control, I would definitely
be more likely to have a baby now than I
was twenty years ago. More importantly, though, I felt you
missed one aspect of more mature women's sexuality and how
it is treated. Young women are more insecure and less experienced,
(35:37):
and therefore their sexuality is able to be controlled by men. Historically,
fathers passed them to husbands who kept them pregnant and
at home. Their sexuality is non threatening and enticing. But
as women mature they become more comfortable in their own skin,
They're less likely to become pregnant and are therefore able
to control their own sexuality. This is threatening. I believe
that in order to tamp down the possibility of these
(35:59):
more mature ladies getting out of hand, society has placed
to strong value on youth and shamed older women for
their sexual desires. On another note, I also wanted to
write a thank you for your episode on black women's
hair allowing that episode to go along with the right decision.
You always do a great job of handling diversity issues
with great sensitivity and fairness, so thank you, Marianne. We
appreciate the letter, and thanks to everybody who's written into us.
(36:21):
Mom Stuff and How Stuff Works. Dot com is our
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(36:42):
stuff Works dot com
Welcome to Stuff Mom Never Told You from how Supports
dot com. Hello, and welcome to the podcast. I'm Kristen
and I'm Caroline, and today we are going to talk
about a bowla because obviously, um, this is a massive
healthcare issue that's going on right now in West Africa
(00:26):
and abroad, and there's also a lot going on in
terms of the intersection of women and a bowla, a
facet of it that might not be focused on as closely.
So we're going to take some time to talk about
what a bola is, how it's spread, why it's spreading
so fast, and also why women are at a particular
risk for contracting a bowla. Right, so let's turn to
(00:49):
the World Health Organization to figure out what evil is exactly. Basically,
it is a severe and often fatal virus that's hard
to distinguish in terms of its symptoms from things like laria, typhoid, fever,
and meningitis, and in terms of its fatality rate. It
is fatal fifty of the time. And once you are
(01:09):
infected with the virus, the time from infection to onset
of symptoms can range anywhere from two to twenty one days,
and you're probably if you've been following these reports, probably
familiar with that twenty one day figure, because that's the
amount of time that a lot of authorities are saying
that people coming back from West Africa should be quarantine.
There's a big debate over that um. But people are
(01:31):
not actually infectious until they develop symptoms. So it's not
like you're carrying it around infecting people if you don't
know you have it. But once you do develop symptoms,
the virus is so contagious that it even can be
detected on your skin. And the kinds of symptoms that
we're talking about usually start with things like fever, muscle pain,
sore throat. We hear a lot about how doctors and
(01:52):
nurses are constantly having to take their temperatures every few
hours because that's usually one of the first indications that
I have contracted a bola. And then the symptoms can
progress to include things like diarrhea, vomiting, impaired kidney or
liver function. And then it can also progress when it
when it starts reaching a fatal point where you begin
(02:15):
bleeding internally. Uh that lowers your blood pressure and eventually
causes organ failure. Yeah, and we don't have anything super
optimistic to report as of press time in terms of treatment,
other than to say they're working on it. Um health
care teams rehydrate patients, they provide I mean therapies and
(02:36):
blood products. Vaccines are being worked on. But it generally
seems like the push for that did not come until
this fall, actually, even though the outbreak started much earlier.
So how does it spread among people? Because there's obviously
in the United States been a lot of panic about
it being so contagious as and we'll talk about this
(03:00):
as there have been a bull of patients on US soil.
And the bottom line is that it's not an airborne virus.
It is contracted through direct contact, usually through broken skin
or mucous membranes with blood secretions, organs or other bodily
fluids of infected people. And you can also contracted through
(03:22):
direct contact with surfaces and materials such as betting and
clothing that have been contaminated with those bodily fluids, and
so you can imagine that Also part of the problem
is the burial and mourning rituals that are common in
parts of West Africa where this outbreak has occurred, in
which people directly handle the body. And so you can
(03:44):
imagine that if in the ways it is contagious through
secretions and blood and other bodily fluids, that if those
still exist on the person after death, and you have
people washing the body and bearing the body improperly, that
it could still infect people around them. Yeah, because in
terms of how long it's infectious, pretty much as long
(04:05):
as blood and bodily fluids remain, including things like semen
and breast milk, it likely also contains the virus. For instance,
men who have recovered from ebola can still transmit the
virus through their semen for up to seven weeks after
recovery from illness, which is crazy. That's crazy. So it's
(04:27):
not just like, oh, you're bleeding and I'm going to
get it. It's like it can also be sexually transmitted,
which makes sense, but it's also terrifying. Um, but so
where did this come from? People originally got it from animals,
and fruit baths are thought to be the natural hosts
of the e bowl of virus, and so then humans
come into contact with fluids like blood, organs or droppings
(04:49):
of these animals, and animals like chimpanzees, gorillas, monkeys, forest
antelopes and porcupines found dead or injured in the rainforest,
and in act, the first Ebola outbreaks occurred in remote
villages in Central Africa near tropical rainforests. In nineteen six,
there were two simultaneous outbreaks, one in Sudan and one
(05:11):
in the Democratic Republic of Congo, and that one was
near the Ebola River, hence the name. Now when it
comes to the current outbreak, um the outbreak in West
Africa has also involved not only rural areas but major
urban areas as well, and it's the largest and most
complex Ebola outbreaks since the virus was first discovered, as
(05:33):
a lot of people are probably aware and it's concentrated
largely in three main countries, Guinea, Sierra Leone, and Liberia,
but there have been cases in Molly, Spain, the US obviously,
and Nigeria and Senegal are also on watch right and
(05:53):
with this outbreak we've seen more cases and deaths than
all other Ebola outbreaks combined. More than four hundred healthcare
workers in West Africa have been infected and two hundred
and thirty three had died as of October eight, so
obviously that number would need updating, so The question then,
is why is it spreading so fast. We've had these
previous outbreaks before, why is this one so particularly aggressive? Um?
(06:17):
The World Health Organization largely attributes it to things such
as lack of education about transmission. I mean, I I
know from seeing news coverage in the United States there's
been so much confusion about how it is transmitted and
the fact that it's not in fact airborne. UM. There's
also been a reluctance to seek treatment. There has been
(06:38):
among some people in West Africa, suspicion that it doesn't
even exist, that it's perhaps a conspiracy. Um. But also
in the most severely affected countries Guinea, Sierra Leone and Liberia.
These three countries have just come out of long periods
of conflict and because of that, their health systems have
already been weakened due to lack of human and infrastructural resources.
(07:02):
So they didn't even have the systems in place to
jump on a case like this, and so now it's
as if we're starting from behind. Obviously, the fact that,
like you said, Caroline, work on a vaccine didn't even
start until the fall, right, Um. Well, and it's another
thing too to look at the World Health World Health
(07:24):
Organizations guidelines about infection control. These are very good guidelines, obviously,
but when you hear them, it makes more sense why
it's spreading so fast among people with limited resources. Because
the things that they recommend include hand hygiene, respiratory hygiene,
and use of personal protective equipment. Okay, that makes sense,
you want to block splashes or contact with infective materials.
(07:47):
But they also talk about things like safe injection practices,
safe burial practices, applying extra infection control measures, wearing face
protection like a face shield or medical mask and goggles,
wearing clean, non sterile, long sleeve gowns and gloves for procedures.
And that's all well and good, and those things would
all be readily available in America and other countries, but
(08:11):
in some of these rural villages that are going through
this health crisis, all of these preventive measures are not
necessarily available well. And also in terms of the number
of trained health care workers you have to treat this population, um,
they're clearly not enough. Obviously, we're getting more UH international
medical workers on the ground building hospitals as fast as
(08:34):
they can, but in terms of just looking at what
West Africa you have one nurse for about every ten
thousand people, and so in such a crisis as this,
it's easy for those kinds of very strict protocols to
sometimes fall by the wayside or something to slip up,
just because of so many people needing care. And the
(08:59):
thing that has sparked a lot of Western focus and
American focus on this outbreak is the fact that it
has obviously been contracted on US soil now, which says
a lot about our priorities in terms of UM, really
only caring about crises like this when they affect us
(09:23):
in our backyards. UM. But we want to walk through
just a brief timeline of how that happened and how
that sort of led up to this more American panic
around Ebola and our response to that. Yeah, this is
coming from US News and World Report. We also took
some details from a Reuter's timeline. UM. But basically, health
(09:44):
authorities think that a guinea and toddler who died in
December is patient zero for the current outbreak, because then
that toddler's family contracted the disease and it's spread from there.
In March, that's when we have Guineas Ministry of Health
announcing the ebola outbreak was suspected cases in Sierra Leone
in Liberia, and by July the World Health Organization was
(10:07):
reporting more than five people dead. And then on July
this was really when uh CNN, for instance, started having
it's almost twenty four hour constant coverage of the bowl outbreak,
because this is when Dr Kent Brantley and fellow AID
worker Nancy right Bowl are diagnosed with a bowla in Liberia.
(10:28):
They're then both flown to Atlanta to be treated at
Emory Hospital. Um. That transport to Emery happens in early August,
and so all of a sudden, the fact that these
two workers are being transported here, oh, then it catches
our attention. Obviously there was awareness that a NI bowla
outbreak was happening, but this was really when more of
(10:51):
day to day focus was being placed on what this
really means for us too. And so by August night,
the World Health Organization reported that when thousand people were
dead in Guinea, Sierra Leone, Liberia, and Nigeria, and just
ten days later they declare the worst ebola outbreak in history. Meanwhile,
(11:12):
though the organization Doctors without Borders had been saying the
same thing for a while. They had called the spread
unprecedented back in April. Yeah, and then if we jumped
forward to September fift this is when Thomas Eric Duncan,
who had previously helped a pregnant Ebola victim, get to
the hospital in Liberia. He leaves Liberia a few days
(11:36):
later for the US and then becomes the first person
to develop a bowl of symptoms in the US. After
he had been sent home from a Dallas hospital with antibiotics,
his health took a turn for the worst. He returns
to the hospital where he's ultimately diagnosed with a bola
and then he dies on October eighth, two thousand fourteen.
And this is also when the a bowl of panic
(11:58):
begins ramping up in the US as well, these questions
of how did this happen? How are you know? People
are flying to the US, what's going on? And also
the fact that this is the first e bowla casualty
on US soil, because we should note that right Bowl
and Brantley had already recovered and been released from Emory, right,
(12:18):
and so Duncan's death creates the spiral. Like Kristen said,
there was definitely a panic going on, but there were
also actually real consequences for other people involved. Um the
nurses who cared for Duncan in the worst of his
disease during his high risk period when he's vomiting and
having diarrhea, Nina Fam and Amber Vincent both contract ebola
(12:39):
and both are treated. Vincent has flown to Atlanta to
go to emery and Nina Fam has flown to a
facility in Maryland. Both recover. They become the fifth and
sixth American abola patients to recover. And so of course
this leads to a lot of news media craziness, lots
of speculation and conjecture over whether we're about to have,
(13:01):
you know, a giant worldwide pandemic. Yeah, and all of
this leads us up to late October UM after Dr
Craig Spencer has flown back home from Guinea to New York. Um,
as was repeated in every single UH media story about him,
he went bowling in Brooklyn and then developed the bowl
(13:21):
of symptoms where he was diagnosed, and so the panic
was reaching a fever pitch here to the point that
on October twenty four, New York Governor Andrew Cuomo and
New Jersey Governor Chris Christie announced a mandatory twenty one
day quarantine in New York and New Jersey for anyone
returning from West African countries. And by this point as well,
UM at airports, the airports that were still open in
(13:44):
West Africa, and obviously UM the airports in the US,
we're already doing mandatory screening of anyone flying back from
impacted areas. UM. And the thing about it is, this
is also when we start hearing too from a lot
of American nurses who are very concerned about how they
(14:05):
will be impacted. UM. This is when we start seeing
more information about this gender angle of a bola. Not
to pit male doctors against female nurses, but it is notable,
for instance, that a lot of the nurses that have
been affected, and a lot of the nurses speaking up
on behalf of nurses saying we need more training, we
need more resources, um, have been women as well, simply
(14:28):
because nurses tend it's an industry more dominated by women. UM.
But that's only that's talking state side. While all this
is going on, while there are still fewer than you know,
a dozen of BOLA cases in the US, as of
early November, the World Health Organization estimated that there were
(14:49):
four thousand, nine hundred fifty one dead in West Africa
from a bola out of thirteen thousand, five hundred sixty
seven documented cases. However, the head of doctor is Without Borders,
which again Caroline you noted that they have sort of
been on top of this even before the World Health
Organization started paying closer attention. The head of the of
(15:09):
Doctors Without Borders said that actually, these numbers are are
probably being vastly under reported. For instance, since Cerra Leone,
entire villages have been wiped out because it's so aggressive,
and he says that the the SMIs could be as
high as twenty people dead due to this, which I
think only goes to show too how much we're still
(15:30):
learning about this, right and goes back to again our
Western biases of only really tracking what's going on in
our own country exactly. And we wanted to give you
this primer on the e bowlavirus to then lead up
to why we're going to focus on women and why
it is that women, especially in West African and also
(15:53):
in American hospitals where a lot of the nurses are women,
why they are at particular risk for contracting this disease
and other similar kinds of pandemics, and we'll talk about
that when we come right back from a quick break. Okay,
(16:15):
So before the break, we presented you with a lot
of information about the current ebola outbreak and the crisis
and where it came from. Um and Kristen had started
delving into the issue of the gender division in terms
of who is being affected the most by ebola, and
we do know that women are being hit harder by
this outbreak. Women account for fifty five to six of
(16:40):
the deceased in the current epidemic in Liberia, Guinea, and
Sierra Leone, and that's coming from UNI SEF And in July,
for instance, health teams in Liberia said of those who
were infected or died from ebola were women, and so
that's established. We understand that these numbers are higher for
women that for men. But why what's going on? Well,
(17:00):
it turns out that men are likelier to be hit first,
largely due to what we were talking about earlier and
how animals are the disease vectors, and as men are
often the hunters, they might come into contact with it
first through hunting infected animals UM, but then women become
(17:20):
disproportionately affected, largely due to gender roles at its most
basic UM. This is something that Liberia's Minister for Gender
and Development, Julia Duncan Castle, has talked about UM. She said,
women are the caregivers. If a kid is sick, they say,
go to your mom. The cross border trade women go
to Guinea and Sierra Leone for weekly markets and they're
(17:44):
also the caregivers. We mentioned earlier the risk of contracting
a bola through burial practices, and those burial practices and
funeral rites are often led by women right and women
are also the traditional birth attendants, nurses and cleaners and
laundry workers in hospitals as well. And it's interesting to
(18:06):
note too that the gender divisions that exist in the
home also extend into the hospital. Uh Sufia to tunis
a spokesperson for the Community Response Group in Sierra Leone
and who was also a leader of the Social Mobilization Committee.
An Ebola was also talking about this issue of how
women are the primary caregivers at home. They take care
(18:26):
of the sick, They cook for the sick and clean
up after them, and she says that this role is
extended to the medical field, where women are most of
the nurses and cleaners, and they don't get the same
support and protection as the doctors, who are primarily men. Well,
and it was also it might have been Tunis who
was saying that if at home, for instance, if the
(18:48):
woman gets sick, other women will come and take care
of her. It's not that the husband will assume the
female duties. Um. And this is the same pattern from
the Origin nine nine outbreak in Sedan, for instance, sixty
of those affected were women, according to you a two
thousand seven report by the World Health Organization. And this
(19:12):
becomes an even bigger health crisis when pregnancy is added
to the equation. And in fact, our major inspiration for
wanting to delve more into this topic in this podcast
is from a New Yorker article about um the particular
risk of being pregnant with abola. Right, it's it sounds
(19:34):
absolutely horrific, and it is scary enough to be pregnant,
but to then experience eubola, it adds so much terror
to the experience. UM. So, basically, when a woman is pregnant,
her body has a special immune response to the fetus
and it knocks it down a few notches to help
protect this growing thing inside of it. But that means
(19:57):
that what's good for the fetus is not as good
for the mother because she can't fight off infection as well.
And so if a woman, if a pregnant woman contracts ebola,
that has a lot of terrible things that can go
along with it. For instance, just one thing is that
the ebola infection can cause spontaneous abortion. And when a
pregnant woman with ebola goes into labor, they end up
(20:19):
bleeding a lot, and her sweat, her blood, and her
amniotic fluid are all highly infectious, which is bad for her,
it's bad for her baby, and it's bad for any
healthcare workers try to take care of her. Right when
you go to West Africa, pregnant women with ebola are
often turned away from the standard of bowl awards at hospitals,
not only due to overcrowding, but because of the higher
(20:43):
infection risk that she poses not only to other patients,
but also to the healthcare workers who often have to
weigh giving her the resources and medicine and treatment or
giving it to someone who is not pregnant likelier to
survive because not only is a pregnant woman likelier to
(21:04):
succumb to a bola, but also likelier to almost take
hospital workers with her. Yeah, but then there's the whole
self perpetuating idea that, you know, maybe if a pregnant
woman were provided with really really good resources and medicine
and medical care, that she could overcome it. But because
(21:28):
people already have this belief that, oh, well, she's pregnant,
she's going to get us all sick, they're less likely
to treat her, which means, of course pregnant women are
more likely to suffer and die. And this story that
we were reading said that overall, only time will tell
as far as rates of pregnant women recovering versus not,
(21:49):
because some health care workers overwhelmed by this current situation
might not even record whether a patient is pregnant or
not well. And we should also notice and we should
also note too that in the very limited studies that
have been done on women pregnant women with a BOWLA,
the mortality rate for um their fetuses, even if they
deliver our carry a child to term and deliver, the
(22:14):
mortality rates are extremely high. There was only one in
one study there was only one case of a woman
delivering um a live baby, and the baby then went
on to die a few days later, just because it's
immune system had already been so compromised. Um. And you
also have to keep in mind too that in the
(22:34):
context of West Africa, this is an area where women
might not be getting a good prenatal care to begin with, because,
like we said earlier, getting sier Leone and Liberia have
all been highly susceptible to a bowl of spreading so
aggressively because it didn't have a lot of strong health
(22:57):
care infrastructure in place to begin with, and that it
sends to maternal healthcare in the region as well. Yeah,
and so basically, um, any any advances that these countries
and their health systems were making and being able to
provide prenatal care, um care for infants, it's all sort
of taken a back seat to the Cibola outbreak because
(23:19):
all of a sudden, any resources that were being put
towards pregnant women and families and infants, everything is being
focused now on Ebola. Every every reward at every hospital
almost is being turned into any bowl award. UM. And so,
like we said, many healthy pregnant women aren't even able
to get to the hospital if they need to deliver.
And UM Dr Emmanuel dark Court, the senior Health director
(23:42):
at the International Rescue Committee, was really lamenting this situation
and said, there are so many ways we as a
global community have failed pregnant women who play such an
important role in society. We all have a responsibility in
a way for their safety, and we have failed in
so many ways. And a bowlah disproportion only affecting women
has broader reaching effects than simply more women dying. UM
(24:07):
Serial leone First Lady Saia Nayama Coromo talked about how
in rural areas where the majority of small holder farmers
are women, food production can be affected. And on top
of that, the border restrictions that are being put in
place to try to slow the spread of a bola
that is then affecting these cross bordered traders, a majority
(24:31):
of whom are women, making it difficult for them to
provide for their families. And if we look at the
idea of disease in general affecting women, UM Julie L.
Gerbert Ing, who's the former director of the CDC, read
a paper called Women and Infectious Diseases where she said
that the social, economic, and psychological effects of disease are
(24:52):
more severe for women. When their partners or fathers die,
women often lose economic rights. She points to a Ugandan
survey that found that one in four widows or reported
losing their property after their partner died, so that ties
in with the whole issue of cross border trade, of
women having a major economic role in the family, and sadly,
as Garbing points out, this is this wholy Bullock crisis
(25:14):
and its effects on women is part of a much
bigger picture of infectious diseases like this tending to hit
women harder. Speaking to Foreign Policy magazine, JOHNS. Hopkins University
professor Soberklin said that we take note of the gender division,
but so few people actually do anything with that information
(25:35):
because doing something would mean consciously evaluating what happens in
an outbreak or any health crisis through a gender lens,
which then would lead to the need for more focused
on these systemic problems. These systemic issues that lead up
to perhaps gender disupport, disproportionate um faced palities that might
(26:01):
include things like women's unequal access to adequate healthcare, or
the finances or the fact that they might not be
first in line for treatment, or that they might be
or that men might be prioritized, I should say, over
them for treatment. So in short, it would, it would.
It requires far more than just say finding a vaccine
(26:22):
or something, you know, one simple step, right. And Klein
also points out what Kristy and I have mentioned on
the podcast a few times, which is that we have
a history, uh in our in our history of medicine
and research and medical research of focusing just on men
and how a disease affects men and how a treatment
affects men, and we really as a as a global
(26:44):
community almost need to take into account a disease is
biological components and the differences in how men and women
respond to a disease. So you're basically saying both sex
differences and gender differences have to be taken account taken
into account when and you look at diseases, and so,
you know, Kristen mentioned, in quoting Klient and Foreign Policy Magazine,
(27:08):
the whole issue of maybe men being prioritized over women
in terms of getting care, and this is kind of
something that Columbia University epidemiology professor Wafa El Sader also
said to foreign policy. He said that looking at who
dies in an outbreak quote shows you who has power
and who doesn't. In a way, it holds a mirror
to society, and it shows societies how they treat each other.
(27:31):
And it extends not only to lay women, but also
to nurses who are primarily female worldwide, but also are
often low on the totem pole. And like I said earlier,
we've been hearing a lot from leaders of nurses unions
and associations in the United States asking for more resources
on the ground here. Um, nor is it just limited
(27:55):
to a bull in the same way as this gender
issue applies to other pandemics as well. Um. There were
some Canadian studies conducted on the two thousand three Stars
outbreak and it found that quote a lack of power
and influence of nurses was linked to infection control deficiencies.
And similarly, a two thousand eleven World Health Organization report said,
(28:19):
quote research has shown that poor nurse physician relationships are
common in hospital settings, pose a potential threat to patients safety,
including the risk of infections, and have a negative impact
on nurse satisfaction and retention. And that quote right there
from the report sounds like a summary of a lot
of what we've been hearing in terms of UM nurses
(28:40):
asking for help right now, right because when you look
back at Nina fam and Amber Vincent, the nurses at
the Dallas hospital where Duncan died, I mean, they did
not receive proper training. They didn't really know what was
going on basically, I mean ebola was something brand new
to western hospitals. UM, having someone suffered from those types
of symtoms, they just weren't prepared for it. UM. But
(29:02):
of course, you know, we've we've talked about how ebola
affects pregnant women, and pregnant women also are so badly
affected in by infectious diseases in general. UM. For instance,
in two thousand nine, during the H one and one
influenza pandemic here in the US, of infected pregnant women died,
(29:23):
whereas the mortality rate for the rest of the population
was just point oh two percent. And several other infectious
diseases like malaria, hepatitis, tuberculosis, and loss of fever have
been reported to be more severe in pregnant women. So
clearly more attention is needed, and not only attention, but
also action um. But one important thing to talk about
(29:46):
two before we close is the fact that, yes, women
are being disproportionately affected, but women also to have a
very strong role in possibly limiting this outbreak and stoping um,
this pandemic because again that actually relates back to gender
(30:06):
roles and divisions. UM. There was an article about this
in the Washington Post recently talking about how women in
West Africa play a major role as the conduits of
information in their communities um, and they are often being
enlisted as leaders in public health campaigns to spread awareness
(30:27):
about the disease in terms of you know, if someone
is sick in your home and caring for them and
and laundering dirty linen's and how they deal with the
burial practice, all those kinds of things. It's the women
who are being relied on as the gatekeepers of that
crucial information. Right. So it's interesting to see how that
(30:48):
reliance on traditional gender roles and roles in society maybe
affects women more leads to more women contracting the disease,
but it can also provide a solution, and people haven't
always grasped that. Again, this is coming from Foreign Policy
Magazine where they talk about how in one previous Ebola outbreak.
One anecdotal reports said that men were dominating informational meetings
(31:12):
on the disease, despite the fact that women were already
known to be the primary caregivers, and during one of
the Avian flu outbreaks, government officials were dealing with men
because they thought that, hey, these men have to be
the owners of the farms, right, despite the fact that
women were the ones doing the majority of the work
with animals in their backyard farms. Yeah. I think that
(31:34):
Julie Gerberding, who is the former director of the CDC,
really summed it up most effectively. Beyond Ebola, um, she said,
you have to attack quote, the root causes of these
disparities social economic and educational inequalities that fuel the spread
of diseases and perpetuate poverty throughout the world. And this
(31:56):
kind of focus can be applied to so many things,
even and you know, like she said, even beyond healthcare
crises like this. Um. So hopefully some of these tragic
but crucial lessons can be taken from the Sabola crisis.
I mean, it is a big question mark though, because
(32:16):
everyone is in such understandably emergency mode. It's like these are.
We almost barely have time to even talk about it,
so at this point only time will tell which is
which is scary, absolutely, but there are. It is heartening
to know that there are a lot of people though,
(32:37):
on the ground who are paying attention to this, and
hopefully for listeners who aren't in West Africa who might
not have direct contact with people affected by the virus
or people who are working to fight the virus, hopefully
this can add more of a deeper understanding to the
(32:58):
news coverage that we do see about it. And if
you do have a connection though, to what we really
want to hear from you about this issue. Mom Stuff
at how stuffworks dot Com is where you can email us.
You can also tweet us at Mom's Stuff podcast or
messages on Facebook, and we've got a couple of messages
to share with you right now. So I've got a
(33:22):
message here from Sarah about our episode on the Golden Girls,
and she writes, I first watched Golden Girls a few
years ago when I was doing part time caretaking work
for a woman with early onset Alzheimer's. I would go
to her house to make breakfast and lunch in the morning,
then come back in the evening to make dinner. We
did cross words together and went on walks, but as
her illness progressed, she really just wanted to watch TV.
(33:45):
The only thing that could really get her talking and
interacting with people was The Golden Girls. I would sneakily
get their remote and put the show on, and before
too long, she would be telling me all about the
various adventures she'd had as a teacher, as well as
some of the raunchy stories about her first and second husbands.
Over the course of my time with her, we watched
pretty much every episode of the show. I think Blanche
(34:08):
and Dorothy triggered some memories and helped her hold on
for just a little longer. Plus, when she got to
the point where she couldn't recall my name anymore, she
started calling me Sophia because she felt like I was
as sassy as a cell Getty's character. Unfortunately, her decline
was rapid. She had to be moved into a living
facility before too long, but she watched Golden Girls all
the way to the end. Beyond that, the Girls totally
(34:31):
changed how I planned my golden years. When I am
a certain age, I fully intend to become a Blanche
Sophia hybrid wearing slinky robes and la garie while dishing
out some serious sass. I'm not far off in that
lifestyle now, although usually I'm in stretchy pants dishing out sass.
I just need to get my robe game up and
I'm set. Thank you for a brilliant episode on a
wonderful show that it's been a huge part of changing
(34:54):
how my generation thinks about getting old. I adore the
show and will probably re listen to the episode with
a big slice of cheesecake in front of me, So
thank you, Sarah. Okay, I have a note here from
Maryanne about our Women of a Certain Age episode. Um.
She says, I get the I roll at the idea
of biology making it so women want sex more when
(35:15):
they reach a certain age. Would have thought that at
your age as well, But as I have hit the
over forty mark, I have to say biology is a thing,
and yeah, if there wasn't birth control, I would definitely
be more likely to have a baby now than I
was twenty years ago. More importantly, though, I felt you
missed one aspect of more mature women's sexuality and how
it is treated. Young women are more insecure and less experienced,
(35:37):
and therefore their sexuality is able to be controlled by men. Historically,
fathers passed them to husbands who kept them pregnant and
at home. Their sexuality is non threatening and enticing. But
as women mature they become more comfortable in their own skin,
They're less likely to become pregnant and are therefore able
to control their own sexuality. This is threatening. I believe
that in order to tamp down the possibility of these
(35:59):
more mature ladies getting out of hand, society has placed
to strong value on youth and shamed older women for
their sexual desires. On another note, I also wanted to
write a thank you for your episode on black women's
hair allowing that episode to go along with the right decision.
You always do a great job of handling diversity issues
with great sensitivity and fairness, so thank you, Marianne. We
appreciate the letter, and thanks to everybody who's written into us.
(36:21):
Mom Stuff and How Stuff Works. Dot com is our
email address and for links to all of our social
media as well as all of our blogs, videos and podcasts,
including this one. With all of our sources so you
can follow along with us, you can head on over
to stuff Mom Never told you dot com For more
on this and thousands of other topics. Is it How
(36:42):
stuff Works dot com
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