Gender and Vulnerability to Cholera in Sierra Leone: Gender analysis of the 2012 cholera outbreak and an assessment of Oxfam's response

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Cholera strikes indiscriminately of sex, age, and social status. However, these are factors that may contribute to individuals
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  OXFAM RESEARCH REPORT JUNE 2013 www.oxfam.org   GENDER AND VULNERABILITY TO CHOLERA IN SIERRA LEONE Gender analysis of the 2012 cholera outbreak and an assessment of Oxfam‟s response   NOELLE RANCOURT Cholera strikes indiscriminately of sex, age, and social status. However, these are fac- tors that may contribute to individuals’ vulnerability to cholera, by dictating social roles and behaviours. In a society that adheres to strict gender roles, cholera trans-mission routes are more likely to be sex and age-specific. Despite this, the linkages between gender and vulnerability to cholera are not well understood and there is little literature on the topic. This research analyses the roles socially ascribed to boys, girls, men and women in specific environmental, economic and socio-cultural con-texts to highlight groups that may be more vulnerable to cholera in Sierra Leone. Oxfam Research Reports  are written to share research results, to contribute to public de-bate and to invite feedback on development and humanitarian policy and practice. They do not necessarily reflect Oxfam policy positions. The views expressed are those of the author and not necessarily those of Oxfam.  2 CONTENTS NOELLE RANCOURT ............................................................................ 1   Executive summary .............................................................................. 5   1 Introduction ........................................................................................ 7   2 Gendered patterns of the outbreak ................................................ 11   3 Contexts of research ....................................................................... 15   4 Gendered dimensions of cholera vulnerability .............................. 18   5 Assessment of Oxfam’s response and recommendations  ........... 36   Annex 1 Roles and Activities Profile ................................................. 46   Annex 2 Key Informants ..................................................................... 57    3 Acknowledgements The author would like to thank the research team members Saffiatu Q. Kobba, Lawrence Marrah, and Memunatu M. Sesay, for their insights and initiative, and the Oxfam Programme Assistants who enabled a smooth entry into communities, Fatmata Koroma, Aminata Marrah, Dauda Kamara, and in particular Naiomi Dumbyua, who also assisted with data collection in Freetown. The report has benefited from the support and inputs of Oxfam staff, especially Helene Juillard, Emergency Coordinator; Pamela Palma, Programme Manager for Tonkolili District; Beth Megnassan, Public Health Team Leader in Koinadugu District; Helen Tirebuck, Programme Manager for Freetown; Fadimata Inorene, Gender Programme Manager; Sammy Chagali Engoke, Public Health Technical  Advisor; Joachim Peeters, Regional WASH Advisor; and Tess Dico-Young, Global Gender Adviser, Humanitarian. Oxfam also acknowledges the research of Michelle Trombley for UNICEF in „ Strategy for Int egrating a Gendered Response in Haiti‟s Cholera Epidemic‟ . 1  Thanks also to the Ministry of Health and Sanitation, especially Roland Conteh, National Surveillance Officer, for sharing the data that enabled this study. Finally and foremost, to the individuals and communities who shared their experiences and reflections.  4  ACRONYMS BFV CBO Blue Flag Volunteers Community-based organization CLTS Community-led total sanitation CTC Cholera treatment centre DDPC Department for Disease Prevention and Control DHMT District Health Management Team DSO Disease Surveillance Officer D&V Diarrhoea and vomiting MOHS Ministry of Health and Sanitation NGO Non-government organization ORS Oral rehydration salts PHE Public Health Engineer PHP Public health promotion PHU Public health unit WASH Water, sanitation, and health
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