Gender Issues and Male Marginalisation

Over the last twenty years Caribbean women have gradually mobilised themselves to the point of changing their role in society and the family. Women are now more consistently outperforming men in the workplace and boys in the school setting. Women are increasingly owning property and choosing to raise children on their own. There exists more camaraderie among women and a number of national women's organisations have been formed to ensure their continuous empowerment.

Men have found it difficult to adjust to this role change. Men find women to be too assertive. Others find it difficult to accept that women have their own resources. Increasingly men have aggressed against their women resulting in domestic abuse and even murder. The increased substance abuse among men along with drop out from school and high unemployment have been the concern from some quarters. Some are suggesting that this has amounted to a phenomenon generally referred to as male marginalisation.

While it is true that there needs to some real strategy geared towards supporting men's adjustment to their new role, women are being made to feel that it is their fault that these changes have happened and that it is their responsibility to fix the situation. While the debate is continuing women are not prepared to give in on the ground already gained.

The Situation

Not too long ago, the country was considered rich in terms of both its material and human resources. That all changed when it became clear that the HIV epidemic had been spreading throughout the population: so much so, that it is now estimated that more than 20% of the adult population is already infected and that this figure is considerably higher in some places and populations.

Infections tend to be concentrated among the better educated and skilled and the impact is already taking its toll on the national economy. Companies are having to spend a far greater proportion of their earnings on health costs and in specific sectors, skilled labour recruitment and training is becoming very scarce.

In the rural areas things are particularly bad as people who are already ill return from the towns to their homes for care and support. Some households are now completely overwhelmed and a new problem is emerging of integrating children whose parents have died. Funerals are becoming a common sight all over the country. Agricultural production is deteriorating as households have less time (and human resources) to devote to necessary tasks and consequently shift their efforts to crops which are less labour intensive (but also less nutritious and profitable) .

There are concerns for the security and stability of the country. Many members of the armed forces are infected. One consequence of the gradually deteriorating transport and communication systems is the presence in many districts of largely unsupervised and unoccupied groups of military personnel.

At the epicentre (Figure 1), of the chain of consequences is the transmission of the virus from person to person, adult to adult and from adult to child. The consequences of this spread radiate outwards over time and continue to spread. Over time, various types of repercussions have become apparent. Their extent and nature are determined by many factors but patterns do emerge.

¬ The first wave of consequences follows directly from the spread of the virus: those who are infected will, in time, start falling ill and dying.

¬ The second wave of consequences arises from two dominant characteristics of the epidemic:

C those who are infected are overwhelmingly at the stage of their lives when they have the maximum number of dependents: children, parents, others living with them and others that they are supporting;

C the virus is clustered in households and so whole groups of dependents will be left with few or no means of support.

¬ The third wave of consequences arises from the other dominant characteristics of the epidemic:

C those who are infected are at their most economically productive and active period of their lives;

C the virus is clustered occupationally and geographically;

C the rigidity of the gender division of labour, skills and responsibilities.

¬ The extent and nature of the fourth wave of consequences is determined by two dominant characteristics:

C the response of communities and nations to those infected, those caring for them and those who survive after their deaths, in particular by whether or not they remain an integral part of their communities, supported and cared for by them;

C the clustering in certain occupations and geographically.

Chart -waves of the epidemic

The personal, psychological, social and economic consequences of the spread of the virus will unfold for decades after the virus has taken hold in a community and will continue to unfold for as long as the virus continues to spread.

Look at the overlapping waves of consequences more closely.

The first wave of impact to emerge is centred on the infected person and her or his family, partners and carers. It includes the trauma of diagnosis, community reactions (acceptance or stigma and discrimination), economic and emotional impact on their households, reaction of health care workers, illness and death.

In developing countries, most women and men are faced with the probability of their being infected when a baby or young child is clinically diagnosed with HIV. The lack of confidentiality which is too frequent in these settings often leads to the mother being singled out for blame. Fear and denial on the part of the father can lead to the woman's rejection and repudiation. The family may be torn apart and the women and her children left destitute and homeless.

As the burden of illness increases, household incomes and provisioning will be directly affected. Those unable to pay rent or repay mortgages may lose their homes. School fees and food requirements may become unaffordable. Furthermore, the use of household savings and assets in the futile search for a cure can seriously impoverish the family.

Often it is not until large numbers of the population are infected and many have progressed to AIDS or associated diseases such as tuberculosis that there is the possibility of a national consensus on the urgency of the matter. It is usually only at this stage that the voices of public health officials, health workers and the infected and their families finally begin to be heard.

As more adults die, the second wave of impact begins to emerge: increasing numbers of children and the elderly left without support and of single headed households. For every adult dead, there could be on average two to three dependants. Thus the magnitude of this phase could be two to three times greater than the mortality rates in the previous phase. Poverty will also be deepening; households disintegrating; children scattered. The most striking feature of this wave is the psychological impact on individuals and communities of so many lives lost, so many parents, siblings, friends, children, colleagues, neighbours dead. In young children this often induces an almost catatonic state, a withdrawal from the world of pain and despair.

One story from the Kagera region in Tanzania is of a young girl sitting day after day at the edge of the yard, rocking on her heels and staring into space. Both her parents are dead, brothers and sisters, aunts and uncles. There is little food but she is not hungry. She rocks, grieving. The grandmother takes time away from her overwhelming burden of care of all her other grandchildren to come and sit quietly beside the young girl. She knows she must gently draw her back into the land of the living or she will slowly die. The little girl has no will to eat, to go to school, to help out in the house.
As the epidemic deepens, grandmothers and grandfathers are increasingly numbered among the infected. Extended family and neighbourhood forms of care will soon become overwhelmed unless they themselves are supported. A recent study in Kigali, where the impact of the epidemic in creating dependent survivors has already become visible, shows that already one in every two households is caring for one or more children other than their own.

The third wave of impact centres around the loss of so many members of the workforce and the impact of the epidemic on household and domestic savings and on foreign exchange earnings. For both men and women the vast majority of those infected are young adults, the active workforce.

The epidemic will cause a reduction in the quantity and quality of labour available to produce output in both the formal and informal sectors and both measured and unmeasured activities. Women's labour, both productive and domestic, is disproportionately unmeasured. The loss of women's labour will threaten the living standards of households and communities as well as national productivity. Patterns of labour supply and demand will change, the determining factor being the clustering of the virus occupationally and geographically.

There will also be a reduction in and changing patterns of use of savings. The quantity of savings available and how this is employed influences the rate of growth of Gross National Product (GNP). Decreasing levels of savings will occur at the same time as the direct and indirect costs associated with the epidemic escalate.

Economies most vulnerable will be those that depend on a single or a limited number of sectors, agriculture alone or mining and agriculture, for example. The sectors most vulnerable will be those which require a critical number of trained personnel for whom replacements are difficult to find, pilots and mining engineers, among many others, or occupations with high infection rates, transport sector workers, construction workers, senior public servants, students, for example.

The transport sector knits together producers and markets, raw materials and finished products, matches migrant labour supply to labour demand, links urban and rural economies, holds families together, enables centralised military and police control. A slowing down in this sector will have extensive economic, social and political repercussions.

In the agricultural sector, farming systems which are labour intensive throughout the agricultural cycle or where labour demand peaks at certain times, as well as those with which is associated a strict gender division of labour, are most vulnerable to shortages in the labour supply. In subsistence farming systems, crop mixes are already changing, swinging away from cash crops and certain food crops to less demanding crops such as manioc. Farming systems based on the availability of wage labour, for example, plantation crops, are also vulnerable. Significant changes in patterns of production will adversely affect household nutrition and income levels as well as urban food supplies and foreign exchange earnings.

With growing numbers of women falling ill and dying, and with women being increasingly occupied with the care of the ill, women will have less time for caring for and socialising their own children and for productive work in the fields, in self-employment or in the paid workforce. This work is often unrecognised and undervalued. Too much of it is missing from systems of national accounting and economic measures such as GNP. It will be difficult to monitor the impact at the macro level of the loosening of these social and economic networks of parenting, providing, coping and caring. However, their absence will be widely felt. This work of women is essential for the economic and social well-being of families, communities and societies.

Increasing morbidity will eventually affect all sectors of the economy: financial institutions, education and health sectors, water and electricity supplies, industry and governance.

The fourth wave of impact is directly linked to the failure of previous interventions. If the spread of the virus is not slowed down as early as possible in the epidemic and if those affected by it are not adequately supported, then the very survival of communities and nations will be in jeopardy. The survival tactics of the bands of destitute children could lead to the terrorisation of populations. Strategic vulnerability will increase with the morbidity rates in the military. Basic services, water, electricity, road maintenance, financial services, will be impaired. Price increases and service decreases will lead to discontent and unrest. National governance could come to a halt. Households, communities and countries will disintegrate.

At this stage, even international interventions to prevent the total disintegration of the nation state may be too late.

These longer term consequences are not totally inexorable. The extent and seriousness of the consequences will depend directly on the timeliness and effectiveness of behaviour change programmes and of policies adopted to respond to the needs of the infected, the ill and the survivors.

The spread of the virus initiates an inevitable chain of consequences which will continue for decades, for generations. The nature of these repercussions is so devastating that despair and fatalism would seem to be the only rational responses. However, this bleakness is held at bay by the extraordinary response that the epidemic evokes. Wherever the virus spreads, individuals and communities respond.