Women carry the heavy load of COVID-19


COVID-19 has increased pressures on women. Liesl Orr argues that it is mainly women who work in low paid service and health jobs, and so at work they are vulnerable to contracting COVID, and more likely to fall into increased poverty.  This means that taking up gender issues is central to managing the pandemic.

The impact of COVID-19 on women workers, women’s daily lives, and gender relations between men and women has been significant.  This is because of the gender division of labour. Women are responsible for care work; they are the most numerous in insecure, precarious employment; they suffer from weak and inaccessible health and social services; and they have been victims of increased gender-based violence.

COVID-19 further burdens women

Women are largely responsible for caring and holding people and communities together – at home, in schools, in health care, and in care for the elderly.  In most countries women do most care work without pay.  When employers, including government, pay for care work, the pay is less than in male-dominated jobs. Also it is mainly black working class women who do the care work. 

This burden of care on women increased with the coming of the COVID-19 pandemic.  Yet, governments’ responses are often gender-blind. They have not taken into account the impact of the health crisis on women, nor have they developed policies to help to address this, with few exceptions.

Nancy Fraser identified the crisis of care under current neo-liberal capitalism.  She refers to this crisis as one where the economy relies on women’s reproductive labour, or in other words relies on women to do care work and domestic housework including cleaning, cooking, child and old age care.  This pushes society and families to breaking point.

In times of crisis the unpaid reproductive labour of women and girls is stretched to capacity. This affects all aspects of their lives, including access to employment and education. 

The International Labour Organisation (ILO) warns that the COVID-19 crisis has “exposed devastating gaps in social protection in developing economies, and recovery will only be sustained and future crises prevented if they can transform their ad hoc crisis response measures into comprehensive social protection.”  It is vulnerable people and groups who are mostly affected by weak social protection systems, including women who are primary caregivers, as well as workers in insecure and informal employment.

Criado-Perez author of Invisible Women, writes that, Women’s care-taking responsibilities have more deadly consequences for women in pandemics.  Women do the majority of care for the sick at home.  They are also make up the majority of nurses, cleaners and laundry workers in hospitals, where there is a risk of exposure because these workers do not get the same kind of protection as doctors, who are predominantly men.”

Essential workers are mainly women

Women make up over 70% of health and social service workers world-wide.  Due to the pandemic, health workers face a double burden of longer and more demanding shifts together with greater demands for care at home.  The ILO describes health workers as “exhausted, worried and emotionally drained.”  Some workers have been infected with COVID-19, and some have died as a result.  Also health workers are not able to pay their last respects to their co-workers because of COVID-19 restrictions.

Even more disturbing is that employers could have prevented some deaths.  Some health workers lost their lives because of exposure to the virus due to poor protection and the lack of personal protective equipment (PPE).  South Africa has also been rocked by scandals of over-priced PPE and corruption in procurement by private sector and government representatives. This has resulted in shortages of PPE.

Worldwide the majority of retail workers are black working class women. Retail workers in South Africa had to stop work around PPE, especially getting access to face masks in the early days of the coronavirus.  They also stopped work when managers failed to inform them of infections, and failed to follow proper procedures.  In some cases, workers faced disciplinary action and victimisation from companies for the companies’ failures. 

Trade unions had tense struggles with companies to pay workers in quarantine at home.  Unions argue that workers cannot go without pay when they have to stay at home because of possible COVID infection.  Without pay workers will be tempted to go to work in order to earn wages even if they are infected.  South African Commercial Catering & Allied Workers Union (SACCAWU) shop stewards argue that functioning company health and safety committees can best manage the pandemic because they listen to workers.  The health and safety committees can work with shop stewards to keep workers informed of procedures and cases of infections.  One shop steward also stated that women managers were more caring and compassionate in their treatment of workers who were infected.

Health unions have raised serious concerns about shortages in PPE.  Many companies did not cater for staff members such as cleaners and porters.  The National Education Health and Allied Workers Union (NEHAWU) reported that health workers at Charlotte Maxeke Johannesburg Academic Hospital had to use refuse bags to protect themselves at the height of the first COVID-19 wave. 

Some companies victimised union members for raising questions on PPE shortages, the absence of daily screenings of healthcare workers, and managers’ refusal to allow workers to self-isolate if they suspected exposure to the virus.  

The Minister of Health, Zweli Mkhize, stated that health workers should not risk their lives, “It should be clear to all that the primary protection of health workers is a matter on which we will all agree with no exception. Our approach must therefore be to support the simple ethos: no PPE no work.”

Many women health workers have lost their lives due to exposure to COVID-19 and lack of personal protective equipment (ENCA)

According to Health-e News, there are four ways to lessen stress and anxiety for doctors and health workers, and indeed all essential workers. These are improving access to PPE, increasing the availability of rapid turnaround testing, clear communication about COVID-19 protocol changes, access to self-testing, and personal leave for frontline providers.

PPE that fits women’s bodies

The pandemic has highlighted the long-standing problem that companies give women PPE that does not fit their bodies.  

The Guardian (UK) reported that National Health Service (NHS-UK) professional bodies, experts and trade unions have warned that female healthcare workers’ lives are put at risk because PPE is designed for men.  An intensive care nurse noted that half the female nurses in her unit had poorly fitting masks that did not seal because the PPE is designed to fit male-sized faces.  PPE that doesn’t fit properly, doesn’t protect.  Nurses reported having to use tape to seal masks or pulling them so tight that they had bruises and blisters on their faces.

This issue has been raised by unions in South Africa and globally for many years, but women workers’ concerns are often invisible.  A 2016 survey conducted by the TUC and other organisations found that only 29% of women who responded used PPE designed for women, and 57% said that their PPE hampered their work.   The TUC found that, “most PPE is based on the sizes and characteristics of male populations from certain countries in Europe and the United States”. 

Criado-Perezargues that ill-fitting PPE could prove fatal for women.  She believes the failure to design PPE for women results from gender-blindness in research design.   “The ‘gender data gap’ is the term I use to describe the phenomenon whereby the vast majority of information we have collected globally, and continue to collect, has been collected on men, male bodies and male-typical lifestyle patterns.  This means everything in the world, from the office you work in, to the transport you use to get there, to the medical treatment you receive, to the phone in your hand, to the apps on that phone, have been designed to be used by men.”

Another impact on women’s health is a decline in sexual and reproductive health services due to the pressure that COVID-19 patients are putting on the health system.  According to Doctors Without Borders, the lesson from the Ebola outbreak was that the biggest threat to women and girl’s lives was not the virus itself, but the shutdown of every day health services, as well as the fear of going to health facilities.

Health, retail, and other essential workers are discriminated against when they use public transport and in their communities.  People see them as carriers of the COVID disease and avoid them as a result of intense fear combined with a lack of education and information.   

Economic impact of COVID on Women

The economic impact of COVID-19 on women’s employment has been devastating – almost 2 million (66%) of 3 million jobs were lost by women.  Around 15-20 years of growth in women’s employment was destroyed in weeks.  In February 2020, 46% of women were employed, but by April 2020, only 36% of women were working.  This compares to a decline in employment for men from 59% to 54%.

Women’s working hours also declined significantly. Reduction in hours of work for women was much greater than for men – 35% fewer hours for women compared with a 26% decrease in hours for men. 

The economic impact of COVID-19 was highest for vulnerable workers – in particular African women and men in low wage jobs.  Sectors where women predominate, such as domestic work, hospitality, clothing, retail and informal employment have been hard hit by income and job losses.

During the lockdown employers laid off huge numbers of domestic workers in South Africa who often permanently lost their jobs.  A large number of unemployed domestic workers were unable to access unemployment benefits because employers had not registered them.  Government changed Unemployment Insurance Fund (UIF) regulations to deal with such cases, but domestic workers had difficulty accessing payment due to technological and practical barriers.

COVID-19 has exposed huge gaps in access to paid sick leave and social protection.  The ILO warns that the lack of access to sick leave benefits may force workers to report to work when they are sick or when they should be in self-quarantine.  The ILO also raised concerns about the loss of income during sickness for informal workers in particular, many of whom are women, exposing workers and their families to increased poverty.  This highlights the need for the extension of sickness benefits to workers in the informal economy.

Increase in Gender-Based Violence and Femicide

According to the World Health Organisation (WHO), one in three women has experienced physical or sexual violence in her lifetime.  The WHO sees Gender-based Violence (GBV) as a major public health problem and a violation of human rights.  Gender-based violence and femicide (GBVF) impacts on almost every aspect of life.  Women, girls and LGBTI (Lesbian, Gay, Bisexual, Transgender and Intersex) are mostly affected by GBVF. 

Studies and statistics worldwide show that GBVF increased during the COVID-19 pandemic.  Social and economic stresses made existing ‘toxic masculinity’ (male domination and aggression) and gender inequalities worse. Many countries imposed hard lockdowns where victims of violence were trapped at home with their abusers and unable to access support and social services.

It is critical that government responds with adequate funding for women’s shelters, including for community based organisations dealing with GBVF, as well as state facilities, such as Thuthuzela Care centres (one-stop centres for victims of rape).  South Africans also need to ensure that they continue to rally the state and civil society against GBVF and the fight for gender equity.


A huge impact of COVID-19 is gendered, so responses must be gendered.  South Africans need to ensure that social and health services, employment services, economic relief and collective bargaining, put women’s need at the centre of their interventions.  The society should fight hard against retrenchments and ensure that vulnerable workers are protected against further income losses.

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About the author

Liesl Orr
Senior Researcher at National Labour and Economic Development Institute | + posts

Liesl Orr is a Senior Researcher at the National Labour and Economic Development Institute (NALEDI).

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