Women Bear the Quiet Burden of Ebola Bundibugyo Disease

Health officials are monitoring outbreaks of Ebola Bundibugyo disease through parts of East and Central Africa. This highly contagious disease will hit some groups harder than others. When health care workers and resources are limited, that burden falls heavily on women.

Part of this is cultural. In many countries around the world, womanhood brings with it a strong expectation to handle all (or most) child and elder caregiving, meal preparation, and homemaking duties. In some places, this extends to time-intensive behaviors (like walking miles to gather the family’s water) that limit their economic opportunities. Women are also often involved in major life events that put them in direct contact with people giving birth, as well as those who are sick or dying. They are also more often health workers.

During times of severe infectious diseases, it can be difficult to break from these cultural norms. So, women become the predominant workforce at ground zero. During the 2014 Ebola outbreak in West Africa, Liberian authorities reported that 75% of deaths were among women and Sierra Leone sources said women represented 59% of the country’s deaths.

The risk women face doesn’t just come at the point of an outbreak. Given social and engrained gender roles, women are often at greatest risk of contracting the disease in the first place. Ebola virus disease is a zoonotic disease—meaning it originates in animals and then jumps from animal to human. Hantavirus is another example of a zoonotic disease. Activities like food preparation and cleaning mean women are at increased risk of disease. Pregnant women who contract Ebola face increased risk of pregnancy loss or hemorrhage.

"From Hurricane Katrina, the 2014 Ebola pandemic, and COVID-19 pandemic we know that women and girls suffer increases in gender-based violence during natural disasters and health emergencies," says Dabney Evans, PhD, associate professor of global health. "These emergencies can exacerbate existing violence and present opportunities for new violence. Unless we deliberately focus efforts at preventing this kind of violence, we can expect more of the same during this Ebola outbreak. However, this outcome is not predetermined. Such violence is preventable—if the political will and resources are there to make prevention possible."

How Ebola Bundibugyo Disease Spreads

Ebola is spread through direct contact with bodily fluids. This includes spit, vomit, blood, feces, sweat, vaginal fluid, breast milk, urine, amniotic fluid, and semen. The risk continues even after death, when the deceased person’s body is prepared for burial. In many cultures, it’s women who are at the bedsides during birth, sickness, and death—all times when bodily fluids are plentiful.

"There is local knowledge and practice in Uganda and other countries where Ebola is endemic that can be leveraged now,” says Evans. “But there is also a need for on the ground basic science education about how viruses are transmitted and how to interrupt transmission."

There is no vaccine for this strain of the virus—which is different from the Zaire ebolavirus (Orthoebolavirus zairense), strain that circulated in West Africa in 2014. The recommended treatment is supportive care, which means replenishing fluids (ideally through an IV), rest, and managing symptoms.

In 2014, health teams saw success preventing disease spread when caring for infected patients through careful use of personal protective equipment. Meticulous PPE use remains an effective strategy for preventing disease when caring for sick people. But, broken supply chains and ongoing conflict is making it difficult to get PPEs to those who need them the most.  

Gender Imbalances Hurt Health During Emergencies and Beyond

The unequal burden women face during Ebola outbreaks reflects a broader global pattern in which caregiving labor—both paid and unpaid—falls disproportionately on women.

This physical and mental load speaks not only to disease risk, but to burnout. It’s something the United States is seeing through its ongoing nursing shortage.

According to estimates, most nurses (77%) worldwide are women. In the United States, eight out of 10 health care workers are women. During the COVID-19 pandemic, women’s economic performance took a global hit as women exited the workforce in droves to care for families and provide schooling at home.

“According to the 2025 Global Gender Gap Report, sex-segregated industries persist, with women concentrated in lower-paid, people-centric sectors like health care, care, and education," says Kathryn Yount, PhD, Asa Griggs Candler Professor of Global Health. 

"Women also allocate more ‘invisible’ time to unpaid domestic and dependent care work. Empowering women economically requires affordable, high-quality options for dependent care that enable all women to advance their educations, skills, and careers. Workplaces also need to support women’s pay equity and career advancement, and research should monitor women’s economic empowerment alongside institutional and system change.”