One of the many socioeconomic ramifications of the COVID-19 pandemic has been its differentiated gendered impact. Preliminary research has shown that social and biological determinants make men more likely to die from the virus. However, at the same time, women might be at greater risk of contracting the virus due to the gendered ways in which our societies function. Figures from the World Health Organization estimate that women represent around 70% of the health workforce globally and, specifically, an average of 80% of the nurse workforce in all regions. Nurses are among the healthcare workers that have the most direct contact with sick patients, thereby increasing their risk vis-à-vis infectious diseases.
Those gender imbalances in the health workforce can be dissected in several ways. First, there are the pay gaps that show females earning an average of 28% less than their male counterparts, due largely to working hours and occupations. Secondly, there is the gendered dimension of care. In ordinary circumstances, women are predominantly caregivers for their families. In cases such as the COVID-19 pandemic or the 2014 Ebola outbreaks, when healthcare systems are unable to absorb the demand of patients, women are more likely to step up to care for sick family members with the entailed risk of becoming infected themselves.
A third element that intersects with these gender imbalances is migration. In the United States, the COVID-19 pandemic has had a disproportionate and devastating impact on medical staff of Filipino origins. A report from the country’s largest nurse union published in September 2020 showed that 31.5% of registered nurses who died of COVID were of Filipino origins, whereas Filipino nurses only make 4% of the registered nurses nationally. This trend adds up to the overwhelming toll of the virus on nurses of colour. From the 213 registered nurses that died due to COVID-19 or complications arising from the virus, 58.2% of casualties were nurses of colour, despite only 24.1% of registered nurses being people of colour.
A closer look at these figures reveals a telling intersection of gender, migration, race, and care. The migration of Filipino healthcare practitioners, especially nurses, to the US has grown exponentially since the 1960s. The increase may be due to American agencies launching English-language nurse training in the Philippines and setting up programmes that facilitated the requirements for these individuals to migrate to the US. Through these programmes, the agencies had the aim of filling the shortage of nursing staff in American hospitals with Filipino–mostly women–nurses.
When the pandemic hit, Filipino and Filipino-American nurses were on the frontlines caring for sick patients, risking their lives, and often sacrificing them in what many, including National Nurses United, deemed preventable deaths. Lack of adequate protective equipment has been a constant factor putting healthcare workers at risk since the onset of the pandemic, but in the case of these nurses, other factors have also played a major role. The nurses are overexposed to the virus, as they are more likely to work in settings where patient contact is closer, such as ICUs, emergency rooms, and long-term nursing facilities.
Besides being on the frontlines of the pandemic, immigrant nurses find themselves at the centre of intersecting gender and care dynamics, as they are often the main breadwinners, sending remittances to relatives in several countries. The pandemic has exacerbated the existing socioeconomic disparities of migrant workers worldwide. Across the globe, migrants make up large sectors of the informal economy, and especially women workers have faced a disproportionate impact. The combination of gender, labour, and migratory dynamics has resulted in women being severely impacted by deep-rooted socioeconomic patterns of unpaid care work, juggling between familial and professional responsibilities, and persistent gender pay gaps and exploitation. Paradoxically, the pandemic-related restrictions and changes to work worldwide have highlighted some of these disparities.
This Women’s History Month provides an opportunity to reflect on these aspects of gender inequalities and how to move forward. Kanlungan might be a good place to start: its name means “shelter” or “refuge” in Tagalog, and it is a site that pays tribute to those health workers of Filipino origins who lost their lives while caring for others.
Amalia Ordóñez Vahí was previously a Fulbright scholar at New York University, where she graduated with an MA in International Relations. She spent most of 2020 interning at the Open Society Foundations' Justice Initiative working on cases related to COVID-19, human rights, and detention. She has also interned in refugee representation at Human Rights First, and holds an MA in Conference Interpreting from the University of Manchester. She is currently a cultural diplomacy fellow in New York, while she pursues an MA in Human Rights.