COVID and Gender in the Middle East

As the coronavirus ravages the globe, its aftermaths have brought gender inequalities to the forefront of many conversations. Countries in the Middle East and North Africa have been slow to prepare for, adapt to, and mitigate the COVID-19 health crisis and its impacts on governance, economics, security, and rights. Women’s physical well-being, social safety nets, and economic participation have been disproportionately affected, and with widespread shutdowns and capricious social welfare programs, women are exiting the workplace and the classroom, carrying the caregiving burden.

With feminist foregrounding, Rita Stephan's collection COVID and Gender in the Middle East gathers an impressive group of local scholars, activists, and policy experts. The book examines a range of national and localized responses to gender-specific issues around COVID’s health impact and the economic fallout and resulting social vulnerabilities, including the magnified marginalization of Syrian refugees; the inequitable treatment of migrant workers in Bahrain; and the inadequate implementation of gender-based violence legislation in Morocco. An essential global resource, this book is the first to provide empirical evidence of COVID’s gendered effects.

• Language: English
• Publisher: University of Texas Press
• Release date: Feb 21, 2023
• ISBN: 9781477326541

Book preview

COVID and Gender in the Middle East

EDITED BY RITA STEPHAN

University of Texas Press

Austin

Copyright © 2023 by the University of Texas Press

All rights reserved

First edition, 2023

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Library of Congress Cataloging-in-Publication Data

Names: Stephan, Rita, editor. | AbiRafeh, Lina, 1974– writer of foreword.

Title: COVID and gender in the Middle East / edited by Rita Stephan ; with a foreword by Lina AbiRafeh.

Description: First edition. | Austin : University of Texas Press, 2023. | Includes index.

Identifiers: LCCN 2022008890

ISBN 978-1-4773-2652-7 (hardback)

ISBN 978-1-4773-2653-4 (PDF)

ISBN 978-1-4773-2654-1 (ePub)

Subjects: LCSH: COVID-19 Pandemic, 2020—Social aspects—Middle East. | COVID-19 Pandemic, 2020—Social aspects—Africa, North. | Women—Middle East—Social conditions. | Women—Africa, North—Social conditions. | Women—Health and hygiene—Middle East. | Women—Health and hygiene—Africa, North. | COVID-19 Pandemic, 2020—Economic aspects—Middle East. | COVID-19 Pandemic, 2020—Economic aspects—Africa, North. | Women—Middle East—Economic conditions. | Women—Africa, North—Economic conditions.

Classification: LCC RA644.C67 C458 2022 | DDC 362.1962/41400956—dc23/eng/20220225

LC record available at https://lccn.loc.gov/2022008890

doi:10.7560/326527

To the more than 6 million lives lost due to the coronavirus, politics, and inequalities

To the half billion who experienced the fear of being infected with the virus

To scientific inquiry, not only to find the medical cure but also to alleviate social and economic hardships

To all women, especially Arab women, who matter

Contents

Foreword: The Response to COVID—and to Everything—Is Female

LINA ABIRAFEH

Acknowledgments

Abbreviations

Introduction: Why Is COVID Female?

RITA STEPHAN

PART I. Care and Care Work Spheres

Chapter 1. COVID-19, Women, and Healthcare

VALENTINE M. MOGHADAM

Chapter 2. COVID-19: A Threat to Lebanese Women’s Precarious Condition

JENNIFER SKULTE-OUAISS AND JANA G. MOURAD

Chapter 3. The Impact of COVID-19 on Women’s Prosperity in the Gulf Countries: Survey Evidence from Bahrain

OMAR AL-UBAYDLI, DEEMA ALMOAYYED, AND GHADA ABDULLA

Chapter 4. When Inequalities Interconnect: Women Scholars’ Productivity amid the COVID-19 Pandemic in the Middle East and North Africa

NERMIN ALLAM, GAIL J. BUTTORFF, AND MARWA SHALABY

PART II. Social Vulnerabilities

Chapter 5. The LGBTIQ+ Community’s COVID Dilemma in Lebanon

LINA ABOU-HABIB AND AMINA ALI

Chapter 6. The Gendered Impact of the Pandemic on Syrian Refugee Women in Jordan

OROUB EL-ABED AND NUSEIBAH SHABAITAH

Chapter 7. Violence against Moroccan Women during and after Lockdown

RHIZLAINE BENACHIR AND SOFIA RAÏS

Chapter 8. Gender Dynamics and Distance Education: Toward a Situational-Interactionist Model of the COVID-19 Contingency Effect on Female University Students in Morocco

ILHAM SADOQI

PART III. A Gender Lens on COVID Impact in the Middle East and North Africa

Chapter 9. COVID’s Three-Order Impacts on Women’s Lives: A Typology

RITA STEPHAN

Chapter 10. Women’s Rights and Roles during the COVID-19 Pandemic

SALMA AL-SHAMI, MICHAEL ROBBINS, AND Zach BAMPTON

Chapter 11. Unmasking Masculinity during COVID in the Middle East and North Africa

MERISSA KHURMA, YOUSSEF CHOUHOUD, AND RITA STEPHAN

PART IV. Feminist Responses

Chapter 12. COVID-19 and Feminism in the Middle East: Challenges, Initiatives, and Dilemmas

NADJE AL-ALI

Chapter 13. The Power of Bipartisan Mobilization: The Success of Tunisia’s Feminist Movement during the Coronavirus Pandemic

MARO YOUSSEF AND SARAH YERKES

Chapter 14. Harmony of Feminine and Masculine Leadership during the COVID-19 Pandemic in Jordan

MAYYADA ABU JABER

Chapter 15. The Feminist Position: Corona Crisis Management and Its Impact on Palestinian Women

REHAM ABU AL-ASAL, NABILA ESPANIOLY, SAMAH SALAIMA, NAHIDA SHEHADEH, SHAHIRA SHALABI, AND HANA AMOURY

Contributors

Index

FOREWORD

The Response to COVID—and to Everything—Is Female

LINA ABIRAFEH

It was impossible to predict how our world would change in March 2020. What began as temporary measures to assess an unusual situation swiftly turned into a global response to an unprecedented pandemic.

Everyone continues to be affected by this collective crisis. However, we know from global evidence that the virus and its aftermath affect women and girls more severely. And women and girls who are already marginalized—the elderly, refugees and those who are displaced, those with disabilities, those without insurance, those with compromised immunity, LGBTIQ+ populations—face even greater challenges.

I have spent my career as a humanitarian aid worker in insecure environments, supporting women to mitigate risks and access the safety and support that they desire and deserve. Everywhere I have worked—from Afghanistan to Mali to Haiti—women and girls suffer more. It does not matter whether this is due to a conflict, a natural disaster, or an epidemic.

In the Arab region, where I spent many years, women were vulnerable before the crisis. And even as the pandemic abates around the world, the crisis for Arab women and girls is just beginning. The Arab region is plagued by a range of socioeconomic instabilities and protracted humanitarian crises, with more than 79 million people in need of humanitarian assistance (UNICEF 2022). The pandemic is simply the latest in a series of challenges facing the region. The Arab region also suffers the world’s worst social indicators, with wide gender gaps across health, education, politics, and the economy (UN ESCWA 2019). All these are exacerbated by instability, crises, and the current pandemic.

Nearly 23 million Arab women are not connected to the internet and do not have access to a mobile phone (GSM Association 2021). Coupled with alarming literacy rates—approximately 66 percent for women (World Bank 2021)—this means that women are disproportionately unable to access accurate information about the virus to help them prepare, respond, and survive.

Intimate partner violence is the most common form of violence against women worldwide. Seeking shelter and safety from an abusive partner, difficult even in normal contexts, was practically impossible with restrictions during the pandemic.

From the immediate onset, as the lockdown took effect, reports of domestic abuse rose rapidly, limiting women’s rights to live free from fear and violence and to decide about their bodies and lives. The Arab region was not immune to these risks. Even in so-called normal times, the region deals inadequately with intimate partner violence. It is shrouded in shame and blame, women are silenced and ostracized, services are scant, and legislation fails to protect women or prevent cases.

This crisis, combined with the continued conflicts and insecurities plaguing the region, has had a detrimental impact on women’s lives. For too many women in the region, home is not safe—although it should be. Stay at home is a message that is both dangerous and naïve. Lockdown measures have increased the severity of preexisting cases and created new cases. And we know that cases on record are far fewer than cases in reality.

The pandemic has increased women’s risk of harm and decreased their access to healthcare, education, and economic opportunity. When children are forced to stay out of school, it is often the girls who never return. These girls are married younger and become mothers sooner. Global statistics have documented the increase in girl-child marriage and in harmful practices such as female genital mutilation as a result of the pandemic.

When women are forced out of the workplace, they often never go back. They are the first to be dismissed and the last to be readmitted. The pandemic is expected to result in a loss of 1.7 million jobs in the Arab region, approximately 700,000 of which are held by women (UN Women and ESCWA 2020).

Arab women were already an underutilized economic force, too often relegated to the informal sector and traditionally feminized work. They have fewer protections and face greater risks in these areas. This will only increase as we transition from the pandemic into productive lives.

Women are the world’s caregivers and risk increased exposure to infection in both their personal and professional capacities. Arab women make up the majority of the region’s healthcare practitioners and family caretakers, performing unpaid labor and exposing themselves to infection to care for a sick child, an elderly family member, or a needy member of the community. Women in the Arab region perform nearly five times as much unpaid care work as men (Ferrant, Pesando and Nowacka 2014). In every emergency I have worked, women are the ones who know who is in need, what they need, and how to get it to them. They are the world’s social safety net.

And the Arab region still clings to its patriarchal views on women, their rights, their roles, and their responsibilities—both inside and outside the home. This creates an artificial juxtaposition between what is valued and what is not. Perhaps this pandemic is an opportunity to lay this trope to rest.

Viewing our post-pandemic world through a feminist lens means reframing the way we merge all aspects of our lives to reflect our meaningful, multidimensional realities. This pandemic has forced us to integrate our personal and professional lives in unprecedented ways. But there is a silver lining here. We can build a more honest—and equitable!—life where we respect women’s lives, recognize their leadership, and transform our ecosystems to cultivate stronger societies that can withstand future shocks.

Those shocks will inevitably come. Will women once again be denied leadership roles? If so, it will be to the region’s peril. The pandemic teaches us a lesson: ample evidence shows that countries with low cases, low deaths, and strong responses have female leaders. Are any of them Arab countries? Alas, no.

If we want to build stronger countries and more robust economies and prevent future crises, we need a feminist response. Women are not an afterthought. And feminism is not an import. It is everywhere in the Arab region. There’s ample evidence for this, too.

One thing is clear: Arab women cannot continue to be sidelined. Doing so risks their rights, equality, autonomy, and the well-being of the entire region. Their voices are strong. And they are screaming loudly. Who is listening?

The authors of this book demand that we all listen. This book speaks to these challenges—the impact of being both Arab and female in the context of this pandemic. It is a critical contribution to the conversations we have all been having since March 2020: What will our lives look like now? What does this mean for the Arab region? And what does this mean for Arab women?

Fueled by the voices of feminist experts—both academics and activists—this book is not just a candid examination of a historic moment. It is a crucial playbook for any future crisis. The bottom line is this: when women lead, we will weather any storm—even this one.

References

Ferrant, Gaëlle, Luca Maria Pesando, and Keiko Nowacka. 2014. Unpaid Care Work: The Missing Link in the Analysis of Gender Gaps in Labour Outcomes. OECD Development Centre. https://www.oecd.org/dev/development-gender/Unpaid_care_work.pdf. GSM Association. 2021. Connected Women: The Mobile Gender Gap Report 2021. https://www.gsma.com/r/wp-content/uploads/2021/06/The-Mobile-Gender-Gap-Report-2021.pdf.

UN ESCWA (United Nations Economic and Social Commission for Western Asia). 2019. Rethinking Inequality in Arab Countries. https://archive.unescwa.org/sites/www.unescwa.org/files/uploads/rethinking-inequality-arab-countries-summary-english.pdf.

UNICEF. 2022. Humanitarian Action for Children: Middle East and North Africa Region. https://www.unicef.org/media/113966/file/2022-HAC-MENA.pdf.

UN Women and ESCWA (Economic and Social Commission for Western Asia). 2020. The Impact of COVID-19 on Gender Equality in the Arab Region. https://arabstates.unwomen.org/sites/default/files/Field%20Office%20Arab%20States/Attachments/Publications/2020/04/Impact%20of%20COVID%20on%20gender%20equality%20-%20Policy%20Brief.pdf.

World Bank. 2021. Literacy, Adult Female (% of Females Ages 15 and Above)—Arab World. "https://data.worldbank.org/indicatorSE.ADT.LITR.FE.ZS?+name_desc=false&locations=1A&locations+=1A&year_high_desc=false.

Acknowledgments

This pandemic has magnified every existing inequality in our society—like systemic racism, gender inequality, and poverty.

MELINDA GATES

The COVID-19 pandemic has magnified why partial solutions do not work. More importantly, it has magnified global inequalities, whereby the rich got to live and the poor died serving the rich. While we are all in this storm together, some are holding on to a raft, some sheltering in a large boat, and some safe on shore.

This volume would not have been possible without the valued contributions of the authors, who are pioneers in delivering the voices of Arab women, not as victims, but more importantly as caregivers, providers, and heroes.

I am also grateful to my dear friend Jim Burr, senior editor at University of Texas Press, and his staff. His encouragement and support are unmatched. Meeting over the years in the book booth at the Middle East Studies Association Conference, we shared our love for books, Texas, and UT-Austin.

I want to thank Guita Hourani and her team for assisting with the translation. I also would like to thank the legendary May Rihani for her guidance and Maya Charrad and Maro Youssef for chatting about ideas with me.

Finally, I am grateful to my partner, husband, and supporter, Camille; my precious children, Rony and Karla; and my mother, Adele, who have been by my side, lifting me up, helping me out.

Abbreviations

INTRODUCTION

Why Is COVID Female?

RITA STEPHAN

Why is France Says COVID-19 Is Definitely Female (Ledsom 2020) newsworthy? Does it matter if the term COVID is female? Linguistically, nouns and subjects vary in how they are gendered in most languages. L’Académie Française, the Office Québécois de la Langue Française (Quebec Board of the French Language), and the Royal Spanish Academy recommend treating COVID as feminine because the original English word—coronavirus disease—is translated to la maladie du coronavirus, which is feminine (Ledsom 2020). English linguists posit that complex concepts like COVID and government contribute to a bigger argument about linguistic purism and the practice of gendering in language (Tavarez 2020). Adverse events are typically masculine in Arabic and omnipotent events are feminine, so COVID-19 is masculine as a virus and feminine as a pandemic (Jaeha). One can argue that global responses did not measure up to the complexity of the pandemic regardless of the naming convention. However, COVID-19 has had a disastrous impact on families, economies, and communities—especially women.

COVID and Gender in the Middle East highlights the gendered economic and social impact of the pandemic. Providing a comprehensive account of women as crucial members of society, it does not portray women as passive recipients of governmental assistance or silent victims of the pandemic. Instead, it centers women’s roles in mitigating the first-order (health), second-order (economic), and third-order (social) impacts of the pandemic on women in their social milieus. This volume offers an Arab feminist perspectives on national and localized responses to COVID gender-specific issues such as care responsibilities, gender-based violence (GBV), girls’ education, and displacement vulnerabilities.

Why Are Women at the Heart of Care and Response?

The World Health Organization (WHO) proclaimed that this pandemic is attacking societies at their core. The United Nations Department of Economic and Social Affairs (UN DESA) assesses that the COVID-19 outbreak affects all segments of the population and is particularly detrimental to members of those social groups in the most vulnerable situations, continues to affect populations, including people living in poverty situations, older persons, persons with disabilities, youth, and indigenous peoples (UN DESA 2020). UN DESA warns that policies must be implemented to address the social crisis created by the pandemic, including an increase in inequality, exclusion, discrimination, and unemployment. It calls for urgency in creating comprehensive, universal social protection systems, best described by the UN secretary-general during the launch of a COVID-19 Global Humanitarian Response Plan on March 23, 2020:

We must come to the aid of the ultra-vulnerable—millions upon millions of people who are least able to protect themselves. This is a matter of basic human solidarity. It is also crucial for combating the virus. This is the moment to step up for the vulnerable. (UN DESA 2020)

Official responses have considered women as a special category analyzed separately. They have compartmentalized the pandemic’s gender effects in discussions by women or about women. UN Women (2020a) suggests that the impacts of crises are never gender-neutral, and COVID-19 is no exception. Citing From Insights to Action: Gender Equality in the Wake of COVID-19, it claims that the pandemic will push 96 million people into extreme poverty by 2021, 47 million of whom are women and girls. This will bring the total number of women and girls living on USD 1.90 or less, to 435 million (UN Women 2020a).

UN Women (2020b) also claims that globally the COVID-19 pandemic is not just a health issue. It is a profound shock to our societies and economies, and women are at the heart of care and response efforts underway. This statement requires a pause to unpack. What does it mean that COVID is not just a health issue? The social shock is real and must be addressed just as seriously as the economic shock. Women are not peripheral to the pandemic. They are not just passive victims. Most countries ignore this UN call for gender equity and inclusion. However, women are not silent about this double victimization by the pandemic and the exclusion. Their contributions, perspectives, and knowledge must be considered when designing care and response strategies. This volume is yet another place that allows women to claim their space in the solution and impose themselves on or work outside the system.

These studies deliver a strong message for decision-makers to take serious measures in the recovery efforts to invest in women and ensure the equal inclusion of their contributions. Further, they stress the need to protect women in informal/insecure labor markets and promote remote modalities for income generation (UN 2020, 5). In a nutshell, they see now as the perfect time to bridge the gender divide and overcome gender inequalities.

A few scholarly accounts have been emerging with a focus on the global footprint of the coronavirus. They highlight how the pandemic affected vulnerable populations’ access to social services, family dynamics, and psychological and career ramifications. Notably, Bristol University Press released several volumes addressing these topics, including Bringel and Pleyers (2022), Eccleston-Turner and Wenham (2021), and Greene (2020). Likewise, Routledge published important volumes including Bismark et al. (2022), Gammel and Wang (2022), and Ryan and Nanda (2022). Collections focused on pandemic vulnerabilities in ethnic and non-Western contexts or feminist perspectives include Castellanos and Sachs (2021), Gouws and Ezeobi (2021), Green and O’Reilly (2021), and Grugel and Barlow (2022). While the Middle East and North Africa (MENA) remain newsworthy, local voices are almost always absent. This book is the first volume that elevates this critical region to contribute to the global discourse on the pandemic and its mitigation strategies.

Several Western-based intergovernmental agencies, think tanks, and higher-education institutions were quick to deliver reports on COVID’s political and economic consequences in MENA. A study by the Project on Middle East Political Science (POMEPS 2020) identifies important themes in evaluating state responses, including variations in state capacity; the securitization of the pandemic response and the potential for increased repression; the profound challenge to war-torn areas, conflict zones, and refugee concentrations; and the prominence in international relations of soft power, battles over narrative, and non-military interdependencies. POMEPS’s second report ensures the inclusion of pieces by a number of authors featured in this volume, who address gender as a cross-cutting analytical category. UN Women, the United Nations Development Programme (UNDP), and the Organisation for Economic Co-operation and Development (OECD) conducted numerous analyses of COVID-19’s impact on women and girls, especially increasing GBV, education, and economic burdens. Yet these two bodies of literature do not recognize how women and their organizations have responded to the pandemic or analyze women’s roles within their communities, families, or workplaces.

Organization of the Book

COVID and Gender in the Middle East expresses local voices that discuss the pandemic’s first-, second-, and third-order impacts. It provides empirical evidence of the gendered effects in MENA in four areas: care and care work spheres, social vulnerabilities, a gender lens on COVID, and feminist responses.

Part I is about care and care work: the one thing that women have to do whether they are capable of doing it or not—care in the home; frontline care; care for children, the ill, and the dying; care in the absence of healthcare (migrant women). With feminist foregrounding, the chapters in this section focus on paid and unpaid care work, traversing women’s care responsibilities between home and the workplace. Moghadam’s COVID-19, Women, and Healthcare describes how the care burdens of women in the health profession have increased. She discusses the deteriorating conditions in medical work, including low wages, overwork due to the high volume of patients, staffing shortages, and inadequate equipment. She stresses the need to embark on new social and gender contracts to improve the health and well-being of women and their families rather than spending on militarization. Likewise, Skulte-Ouaiss and Mourad, in COVID-19: A Threat to Lebanese Women’s Precarious Condition, describe the paradox faced by Lebanese women who are highly educated yet held hostage to multilayered patriarchal systems. They analyze how the unprecedented economic meltdown was a compounding factor in negatively affecting women’s lives.

Moving to a different sphere of care work, Al-Ubaydli, Almoayyed, and Abdulla examine the wide-ranging socioeconomic effects of COVID-19 in The Impact of COVID-19 on Women’s Prosperity in the Gulf Countries: Survey Evidence from Bahrain. They study how female nationals have outperformed their male counterparts while migrant workers suffered. This chapter explains COVID within the context of the unique Gulf economies, with a special focus on Bahrain. Offering a perspective on the academic profession, Allam, Buttorff, and Shalaby argue that the pandemic furthered the gender gap in academia with the extra pressure from socially imposed norms and a male-dominated patriarchal workplace. When Inequalities Interconnect: Women Scholars’ Productivity amid the COVID-19 Pandemic in the Middle East and North Africa explores the pandemic’s adverse effect on women academics’ productivity, showing the dual lose-lose burden on research and domestic care.

Giving visibility to the neglected third-order impact of COVID, the four chapters in part II address the social vulnerabilities exacerbated by the pandemic. The LGBTIQ+ Community’s COVID Dilemma in Lebanon by Abou-Habib and Ali unveils the LGBTIQ+ community’s extreme vulnerabilities and deprivation of social protection due to the compacted impact of COVID, the Lebanese economic fallout, and the Beirut Port blast. Focusing on refugees in Jordan, The Gendered Impact of the Pandemic on Syrian Refugee Women in Jordan by El-Abed and Shabaitah explains the pandemic’s magnified effects on the economic, social, legal, temporal, and spatial transitions in the experience of Syrian refugees. Refugee women are forced into early marriages, dropping out of school and assuming new responsibilities as breadwinners. Addressing gender-based violence, Benachir and Raïs in Violence against Moroccan Women during and after Lockdown analyze how, despite their best intentions, Moroccan authorities neglected to address domestic violence during the pandemic. Sadoqi examines the fluctuating connections between distance education and gender discourse in Gender Dynamics and Distance Education: Toward a Situational-Interactionist Model of the COVID-19 Contingency Effect on Female University Students in Morocco. By adopting a situational approach, she argues that COVID-19 has eclipsed gender discourse in state strategies to mitigate its impact on women by focusing on socioeconomic stability rather than human and women’s well-being.

Gendered effects are rarely considered in a region where patriarchal structures are strong and war and conflict are prevalent. Part III offers a gendered lens to view the overall impact of the pandemic. Stephan’s COVID’s Three-Order Impacts on Women’s Health: A Typology classifies countries into rentier, fragile, and failed states based on their political efficacy and prosperity. She discusses how states responded differently to the pandemic’s health aspects but failed to recognize its gendered social and economic problems. In Women’s Rights and Roles during the COVID-19 Pandemic, Al-Shami, Robbins, and Bampton find that attitudinal changes are happening in the private sphere to acknowledge women’s equal role in critical decisions within the household. However, women face structural barriers to reentry into the workforce and disproportionately bear the brunt of the pandemic’s effect on both monetized and nonmonetized economies. Offering a unique and innovative perspective, Khurma, Chouhoud, and Stephan in Unmasking Masculinity during COVID in the Middle East and North Africa measure masculinity quantitatively, adopting indices developed for respondents in the United States. They find that MENA men are twice as likely to score high on the masculinity index as women and twice as likely as women to express anti-mask attitudes and exercise risky behaviors.

Part IV engages feminist initiatives and dilemmas. Its point of departure is the exclusion of women and gender from COVID policy responses. In COVID-19 and Feminism in the Middle East: Challenges, Initiatives, and Dilemmas, Al-Ali addresses the gendered implications of COVID-19 in MENA, focusing on how the preexisting intersectional inequalities have led to increased risks and vulnerabilities. In The Power of Bipartisan Mobilization: The Success of Tunisia’s Feminist Movement during the Coronavirus Pandemic, Youssef and Yerkes argue that the Tunisian government handled some concerns about violence during the pandemic because feminist coalitions, formed before the pandemic, succeeded in elevating the fight against GBV to public policy levels. Abu Jaber’s Harmony of Feminine and Masculine Leadership during the COVID-19 Pandemic in Jordan considers both government and civil society’s socioeconomic and psychosocial support for women during the pandemic. She grounds her findings in an integral and holistic feminine approach to crisis management and feminist leadership. Similar accounts carry the voices of Palestinian feminists in Israel. The Feminist Position: Corona Crisis Management and Its Impact on Palestinian Women by Abu Al-Asal et al. discusses the failure of the state and local authorities to respond adequately to the pandemic due to the political exclusion of Palestinians and the limited economic resources allocated to their towns.

In the following pages we strive to assert that COVID is indeed female, and so must its solutions be.

Note

The views expressed in this introduction are those of the author and do not represent the views of, and should not be attributed to, the US Department of State or the United States Agency for International Development (USAID).

References

Bismark, Marie, Karen Willis, Sophie Lewis, and Natasha Smallwood. 2022. Experiences of Health Workers in the COVID-19 Pandemic: In Their Own Words. New York: Routledge.

Bringel, Breno, and Geoffrey Pleyers, eds. 2022. Social Movements and Politics in a Global Pandemic. Bristol, UK: Bristol University Press.

Castellanos, Paige, and Carolyn E. Sachs. 2021. Gender, Food and COVID-19: Global Stories of Harm and Hope. New York: Routledge.

Eccleston-Turner, Mark, and Clare Wenham. 2021. Decla ring a Public Health Emergency of International Concern. Bristol, UK: Bristol University Press.

Gammel, Irene, and Jason Wang, eds. 2022. Creative Resilience and COVID-19: Figuring the Everyday in a Pandemic. New York: Routledge.

Gouws, Amanda, and Olivai Ezeobi. 2021. COVID Diaries: Women’s Experience of the Pandemic. Stellenbosch, South Africa: Stellenbosch University.

Green, Fiona, and Andrea O’Reilly. 2021. Mothers, Mothering, and COVID-19: Dispatches from the Pandemic. Toronto, Canada: Demeter Press.

Greene, Alan. 2020. Emergency Powers in a Time of Pandemic. Bristol, UK: Bristol University Press.

Grugel, Jean, and Matt Barlow. 2022. The Gendered Face of COVID-19: The Development, Gender and Health Nexus in the Global South. Bristol, UK: Bristol University Press.

Hans, Asha, Kalpana Kannabiran, Manoranjan Mohanty, and Pushpendra Mehta. 2021. Migration, Workers, and Fundamental Freedoms: Pandemic Vulnerabilities and States of Exception in India. New York: Routledge.

Ledsom, Alex. 2020. France Says COVID-19 Is Definitely Female. Forbes (May 16). https://www.forbes.com/sites/alexledsom/2020/05/16/france-says-covid-19-is-definitely-female/?sh=2fced7dc7c9c.

POMEPS (Project on Middle East Political Science). 2020. The COVID-19 Pandemic in the Middle East and North Africa (April). https://pomeps.org/wp-content/uploads/2020/04/POMEPS_Studies_39_Web.pdf.

. 2022. COVID-19 in the MENA: Two Years On (June). https://pomeps.org/wp-content/uploads/2022/06/POMEPS_Studies_47.pdf.

Ryan, J. Michael, and Serena Nanda. 2022. COVID-19: Social Inequalities and Human Possibilities. New York: Routledge.

Tavarez, Nicole. 2020.The Language of COVID-19: Masculine or Feminine? (July 2). https://www.altalang.com/beyond-words/languages-gendering-covid-19.

UN (United Nations). 2020. Policy Brief: The Impact of COVID-19 on the Arab Region: An Opportunity to Build Back Better (July). https://unsdg.un.org/sites/default/files/2020-07/sg_policy_brief_covid-19_and_arab_states_english_version_july_2020.pdf.

. n.d. The 17 Goals. https://sdgs.un.org/goals.

UN DESA (Department of Social and Economic Affairs). 2020. Everyone Included: Social Impact of COVID-19. https://www.un.org/development/desa/dspd/everyone-included-covid-19.html.

UN Women. 2020a. COVID-19 and Its Economic Toll on Women: The Story behind the Numbers (September 16). https://www.unwomen.org/en/news/stories/2020/9/feature-covid-19-economic-impacts-on-women.

. 2020b. In Focus: Gender Equality Matters in COVID-19 Response (March 23). https://www.unwomen.org/en/news/in-focus/in-focus-gender-equality-in-covid-19-response.

PART I

Care and Care Work Spheres

CHAPTER 1

COVID-19, Women, and Healthcare

VALENTINE M. MOGHADAM

Starting as an outbreak in Wuhan, China, in late 2019, the COVID-19 virus quickly spread globally, becoming a pandemic. Its worldwide diffusion resulted from aspects of contemporary globalization, such as increased international travel, but also from poverty, social exclusion, unequal healthcare, and under-resourced healthcare systems. Like the economic crises that feminist social scientists have studied, disease outbreaks affect women and men differently, and pandemics make existing social and gender inequalities worse.¹ In the case of COVID-19, gendered effects were discussed in terms of job, income, and mobility losses; increased demands on women’s domestic labor and time burdens to homeschool children and care for the sick and elderly; domestic violence spikes as stay-at-home orders expanded; expulsions of refugees or migrants; and vulnerability to the virus in feminized sectors such as healthcare, schooling, the food industry, and other frontline or essential sectors. These impacts extend to the Middle East and North Africa (MENA) region, bearing in mind certain distinctive features:

• Healthcare systems in MENA (Arab countries, Iran, Israel, and Turkey) are functional, and some are of excellent quality, but (a) out-of-pocket expenditures are extremely high in most countries, (b) a quality gap exists between the private and public health systems in some countries, and (c) rural populations are often ill-served, while many do not have health insurance. Most of the middle-income countries have seen two decades of deteriorating public health services.

• The MENA region is known for very high military spending, with several countries spending more on the military than on healthcare. In 2019–2020, according to World Bank data, average healthcare spending in Arab countries as a percentage of Gross Domestic Product (GDP) was 5.08 percent, compared to 5.7 percent on the military. In contrast, the world average for healthcare expenditure was 9.8 percent of GDP and 2.4 percent for the military (World Bank