Neglected tropical diseases (NTDs) disproportionately affect the poor; they are diseases of neglected populations, of the poorest and most marginalized. They are also diseases that disproportionately affect women; women bear the largest burden of infection and consequences of disease, and have the fewest resources available to combat them.
Women are particularly affected by NTDs, such as trachoma, due to gendered roles and responsibilities that expose them more consistently to transmission. Women and girls are primarily responsible for caring for children, including sick children, and washing fomites, which exposes them more often to the trachoma causing bacteria Chlamydia trachomatis, for example. Some evidence suggests that women, who often collect water and defecate far from their homes at dawn or dusk, may be more exposed to crepuscular mosquitos, such as the one that transmits dengue and yellow fevers.
And beyond infection, women often have more limited access to health services than men. They are less likely to be taken to health care centers and clinics when they are ill. They have more limited control over financial resources further compromising their purchasing power of medical treatment or preventive measures, as well as adequate nutrition for themselves and their children.
Whilst women bear the largest burden of consequence of the NTDs, they are also the resilient and often unsung combatants that will help to overcome them. NTDs are preventable – but clean water, sanitation, and hygiene are essential. In most communities, women are the primary duty-bearers of water for domestic use, household sanitation and hygiene.
Women’s empowerment has demonstrable effects on sustained access to clean water, sanitation and hygiene in many of the world’s poorest communities. CARE’s work, for example, has shown that involving women in decision making and administration of water supply points increases the sustainability of water supply in the medium and long term. Sufficient and safe access to water helps combat NTDs such as trachoma, schistosomiasis and soil transmitted helminths (STH), and mitigates the devastating impacts of diseases like lymphatic filariasis.
And it is often women who drive demand for household toilets and sanitation improvements in the world’s poorest communities. In India for example, many women are refusing to marry unless their would-be-husbands ensure an adequate household latrine. Similar increases in demand for and access to household sanitation will help reduce the incidence of trachoma, STH, and schistosomiasis, as well as diarrheal and fecally transmitted diseases connected to malnutrition.
Women are also still largely responsible for household hygiene in the poorest communities: ensuring that children’s bodies and hands are washed free from soil and contaminants that contribute to STH and other infections; that clothes and bed sheets that might transmit trachoma bacteria are clean and that children’s faces are washed free from contagion; and that households and compounds remain clean and free from flies and mosquitos that are primary culprits in tropical disease transmission.
Global stakeholders and national governments have set aggressive goals to combat NTDs by 2020. Water, sanitation, and hygiene will be a central element. And on International Women’s Day, this is a poignant reminder that women must be at the helm.
Stephanie Ogden, Senior Water Policy Advisor at CARE
‘Defending Dignity. Fighting Poverty.’