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Series on Women and Children’s Health in Conflict - Maternal and Reproductive Health in the Gaza Strip: the impact of years of blockade and conflict

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A Palestinian woman holds her baby in one of the UNRWA school shelters in the Gaza Strip during Operation Protective Edge in the summer of 2014, Photo by UNRWA.

This article is part of the Strife Series on Women and Children’s Health in Conflict. Read the Series Introduction at this link.

Over two million Palestinians in the Gaza Strip live in degrading conditions of poverty, food insecurity, and high unemployment. In June 2007, Israel imposed a land, sea, and air blockade on the Gaza Strip, and since 2008, Israeli military forces have mounted several operations against the Strip. Years of blockage compounded by military interventions have led to ruinous consequences on the healthcare system. While reports by health organizations and media outlets focus disproportionately on the numbers of casualties, deaths, and long-term disabilities, much less attention is paid to the conflict’s impact on maternal and reproductive health services.

Since the start of the blockage, the healthcare system in the Gaza Strip has been suffering from a significant shortage of essential services, with maternal and child healthcare services being affected the worst. Mothers and their babies are often discharged early (within 2-3 hours) due to the limited capacity and high demands for healthcare facilities. The quality of maternal services is also compromised due to the high number of deliveries and increasing rates of caesarean section, which further increase the burden on healthcare workers in the field. While the total fertility rate has declined in the occupied Palestinian Territory, it is still one of the highest in the region. At any given time, there are about 45,000 pregnant women in the Gaza Strip.

The large number of pregnancies in Gaza can be attributed to the uneven and relatively poor access to family planning services. Indeed, women in lower socioeconomic brackets who live in remote and disadvantaged regions are less likely to benefit from them. The unmet need for family planning increases the number of unwanted pregnancies, and therefore, increases the risk of unsafe abortions and maternal complications. According to a family health survey in 2010, high unmet needs for family planning was associated with 30% of unwanted pregnancies. In 2019, two out of the five essential family planning methods (male condoms and progesterone-only pills) have been at zero stock level (available for less than a month) at the United Nations Relief and Works Agency (UNRWA) and Ministry of Health (MoH) clinics in the Gaza Strip.

Maternal pharmaceuticals have also been affected by the blockade. For example, iron (a drug used to treat anaemia) and folic acid (a drug used to prevent a certain type of congenital defects) have been severely limited. In 2018, according to the MoH in Gaza, nearly 40% of pregnant women were anaemic. Although several organisations have supported the provision of life-saving maternal health drugs, 70% of essential maternal and child health drugs remain at zero stock in the MoH. In a mapping study done by the United Nations International Children’s Emergency Fund (UNICEF), all assessed primary healthcare (PHC) facilities reported that essential pharmaceuticals and life-saving drugs were either unavailable or had been experiencing interrupted supply for the last six months. These include iron, folic acid, antibiotics, and methyldopa (a drug used to treat high blood pressure during pregnancy).

Year on year, maternal and reproductive health in Gaza becomes increasingly concerning. A 2019 situation report by the World Health Organisation (WHO) showed that maternal deaths increased by 122% between 2017-2018 (from 8.6 to 19.1 per 100,000 live births), and of these, 63% occurred before childbirth. Several factors can be attributed to this increase. One of these is poor PHC. PHC staff have limited training, and according to the UNICEF report, preconception care (care before the pregnancy) guidelines were not available at any of the assessed PHC centres. The same report also showed that all the interviewed pregnant women were not aware of danger signs during pregnancy.

There is no doubt that the decline in healthcare standards is more significant during and following major military operations: women become unable to access maternal and reproductive healthcare services, and medical resources become incredibly scarce. In July 2014, the Gaza Strip experienced a 51-day military operation (Protective Edge) by the Israeli military, one of four major military operations since 2009. Nearly the entire population in Gaza was involved in the conflict and was affected by the concurrent destruction of infrastructure. The impact of Protective Edge on women specifically was huge. The UN-Human Rights Council (UNHRC) reported that 299 women were killed and 3,540 others were injured. The UN Office for the Coordination of Humanitarian Affairs (OCHA) reported that over 40,000 pregnant women were unable to access essential maternal healthcare, and accordingly, the neonatal mortality rate doubled from 7% to 14%.

The inability to access healthcare services can be attributed to two main factors. First, many healthcare facilities were damaged, and the remainder were overwhelmed. During the crisis, only 50% of PHC centres were operating, leading to a significant decline in accessing family planning services. Moreover, 17 hospitals were put out of action, and six maternity wards were closed. The high number of casualties meant some remaining wards (including maternity units) were adapted into surgical wards. Thus, women were subject to low levels of care and were discharged early after delivery, resulting in a massive deterioration of their health.

Secondly, there was a near lack of capacity and preparedness to respond to the needs of internally displaced persons (IDPs). OCHA reported that half a million people (28% of the population) were internally displaced in schools and informal shelters which were not equipped to provide maternal and reproductive health services. Throughout the military operation, women who needed these services were instead referred to outside facilities during a time when transportation was severely restricted and highly dangerous even to ambulances. Furthermore, pregnant and lactating women had reduced access to special dietary support and vitamin supplements. The overcrowded shelters, where multiple families had to stay in the same room, were particularly challenging for women due to the lack of privacy and female hygiene products.

In addition to the effect of the blockade and the repetitive military operations on providing essential healthcare services for women, the Great March of Return (GMR) also had significant impacts. The GMR, which catalysed on March 30th 2018, sought to end the Israeli’s illegal blockade on the Gaza Strip. In doing so, however, it has added extra pressure on the already overwhelmed healthcare system. The massive influx of casualties led to the suspension of elective surgeries and the reallocation of hospital beds to serve the injured patients.

About six months after the start of the GMR, the US Trump administration decided to cut off the American financial assistance to the UNRWA. UNRWA plays a vital role in the Gaza Strip’s health sector, delivering free PHC services through 22 facilities. UNRWA clinics serve about 70% of the Palestinian population in the Gaza Strip, providing them with essential antenatal and postnatal healthcare services. In 2018, 39,709 pregnant women attended PHC facilities at the UNRWA. This reflects the tremendous effect of the withdrawal of US financial support on the quality of maternal and reproductive health services in the Gaza Strip.

Maternal and reproductive health in the Gaza Strip is on the edge of the abyss. There is an urgent and immediate need to ease the blockade and improve maternal healthcare infrastructure, both by opening new facilities and increasing medical staff’s capacity. A holistic emergency plan, which prioritises womens’ needs and rights, is indispensable and should be adopted. Every woman has the right to receive full and high-quality maternal and reproductive health services, even during emergencies. Good womens’ healthcare is critical to maintaining a healthy life for every Palestinian in the Gaza Strip. The Palestinian society will not be safe unless Palestinian women are safe.

Changing the Patriarchal Mindset: Combatting Rape as a Weapon of War in Tigray

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Photo Credit: Rod Waddington, licensed under Creative Commons

The Tigray Region in northern Ethiopia, once the core of the Aksumite Kingdom, is now witnessing a grinding civil war. Of grave international concern is the fact that this crisis has turned into an act of ethnic cleansing, whereby Ethiopian and Eritrean forces are using rape to cleanse the Tigrayan bloodline, and hence gradually eliminate the Tigrayan ethnic group from the region. Therefore, rape is being used, in effect, as a weapon of war. However, despite the scale of these atrocities, society has tools at its disposal to halt them and prevent their reoccurrence in the future. The answer lies, not in mere condemnation, nor in the use of force, but in a deep-rooted social change driven by the empowerment of women and the education of men in gender (in)equality matters. Only in this way, will Ethiopia be able to rise above this patriarchal violence and become a less gendered society.

Currently the Ethiopian and Eritrean soldiers are employing rape as punishment towards those linked to the Tigray People Liberation Front (TPLF), a former political party which dominated Ethiopian politics before Abiy Ahmed became Ethiopia’s Prime Minister in 2018. Since Abiy came to power, hostilities have been constant between his government and the leaders of the TPLF due to the latter not being recognised as an official Ethiopian party and being excluded from the ruling coalition government. Such enmities culminated with the TPLF going to war with the Ethiopian and Eritrean governments in November 2020. This is a conflict, which according to Abiy, has now ceased. However, violence continues to assail the region. The government’s forces keep on not only attacking the Tigray Defence Forces Armed movement (formerly TPLF), but also pursuing the systemic annihilation of the Tigray ethnic group. Civilian attacks have become a constant in the region, with women being the preferred target. Sexual violence against this demographic is rife, despite being prohibited under international humanitarian law and human rights laws, and the practice being condemned by the Ethiopian government itself.

A United States Institute of Peace special report on wartime sexual violence has concluded that a quest for power is the main motive behind sexual violence. The Ethiopian army uses this method to advance its quest to overthrow the Tigray Defence Forces, and exert its regional dominance. Army members have been attacking, beating, and raping civilians in a bid to demonstrate their power. For instance, allegations have surfaced of women coerced into exchanging sex for basic commodities due to their need to provide for their families. Moreover, a UN report confirmed that official soldiers have been forcing individuals to rape their own female family members in exchange for their lives. To make matters worse, most victims are part of those 735,000 internally displaced people (IDPs) who were forced by the outbreak of war to flee their homes. Thus, these purposeful, humiliating acts, are empowering the perpetrators whilst leaving the Tigray populous feeling vulnerable as they have no place where they can live in safety.

Nevertheless, the Ethiopian and Eritrean soldiers are not the sole offenders of such violations; the Tigrayan forces have also been accused, albeit on fewer occasions, of similar sexual crimes. However, irrespective of allegiances, sexual violence is plaguing Tigrayan society and is unlikely to decrease any time soon. A coordinator of a gender-based violence crisis centre in Tigray told CNN reporters that rapes in the area have grown from averaging one a week prior to the outbreak of the conflict to more than 22 daily cases. However, the number of cases is probably even higher, as many go unreported due to most of victims keeping these atrocities to themselves.

Sexual violations are generally treated as a taboo topic, with many victims not reporting them due to fear, shame, or even guilt. As seen with the Tigray War, this sentiment only intensifies in conflict zones, where insecurity is the norm. Such insecurity has prevented countless women from seeking help and reporting their experiences. Many have sought to become less noticeable, using head coverings and long skirts, out of fear of being assaulted. Therefore, Tigrayan women need protection and education to empower them to fight for their freedom and to escape from the victim role which they are being forced into by the Ethiopian and Eritrean soldiers.

However, as stated by the International Committee of the Red Cross in a report on sexual violence in conflict zones, the protection of civilians against sexual crimes in these environments is very complicated. Sexual violations in conflict are not carried out in isolation but are normally accompanied by other unlawful violations, ranging from looting to civilian killings or child recruitment. For instance, in early March 2021, Human Rights Watch and Amnesty International reported how Eritrean soldiers massacred more than one hundred civilians in Tigray, including children, in November 2020. These more visible war crimes overshadow the cruelty of sexual violations, a more silent and difficult crime to detect, but one that still leaves deep wounds in the victims, their families and communities. International Law, International Humanitarian Law, and Human Rights Law all deem acts of sexual violence unlawful, providing societal frameworks and conventions aimed at preventing such actions from occurring, such as the Convention on the Elimination of Discrimination Against Women (CEDAW). Furthermore, powerful institutions that condemn these violations exist, including the International Criminal Court (ICC), yet, sexual violence is still very much present, with the Tigrayan atrocities attesting to this.

A major hurdle to addressing the sexual abuse currently taking place in the Tigray War is the abundance of deliberate misinformation and contradicting reports being released from the conflict zone to mislead external opinions over the conflict. Although numerous recent reports and allegations about the possible atrocities taking place against the Tigrayan population have surfaced, much is still flying under the radar. The invisibility of these massacres has also been fomented by the Ethiopian government, which has imposed severe restrictive access measures for journalists and humanitarian workers, making it challenging to corroborate survivors’ stories. Thus, it is almost impossible to estimate the multitude of offenses that are taking place and who, in reality, is to blame. So, the opaque nature of the experiences of locals, together with the feelings of shame or fear are preventing the reporting of such actions, hindering the possibility of intervention to halt such cruelty.

Even prior to the present civil war, in Ethiopia, sexual and gender violence has been a common social problem for decades, with 35% of married women in 2016 reporting some sort of sexual violence. This number has dramatically increased in the Tigray region since the war broke out, with more than 500 cases officially reported in March 2021 in that region alone (with real numbers likely being much higher). This is occurring despite the Ethiopian government ratifying many women right’s conventions such as the CEDAW, and including women’s rights provisions and policies in its 1995 Constitution. The Ethiopian administration has also endeavoured to treat gender-based violence survivors with the establishment of more shelters and programmes to reintegrate them into society. However, gender inequalities are ingrained in the daily lives of women and girls, leading them to have a greater likelihood of living with violence in their homes compared with men. Combined with a lack of control over their bodies, this ensures they are more prone to violations of their sexual and reproductive rights; hence, why nationwide progress on gender equality is needed.

It is not enough for a country’s leaders to state their position against sexual violence, just like those in Ethiopia have done, whilst their own army is simultaneously executing such appalling actions. Thus, on top of halting hostilities, investigating into the grave violations committed and condemning the perpetrators of such acts, the latter being a process that has now been initiated through international communal pressure and headed conjunctly by the UN’s High Commissioner Office and the Ethiopian Human Rights Commission (EHCR), a more educational and cultural change is needed. As stated by the 48th Session of the Commission of Status of Women (CSW), to achieve that change towards gender equality, men need to engage in conversations around sexual health, gender-sensitive behaviour and toxic masculinity. Also, it is essential to break gender stereotypes, and to instigate a reconstruction of the concept of masculinity to allow for men’s patriarchal and violent mindsets to, with time, decrease. Likewise, women empowerment programmes can provide great value to sexual violence survivors and to the community itself. These can change participants’ beliefs and increase their self-confidence, making women more participative within their own communities. Furthermore, they can also make women more willing to support and educate others on gender violence, sexual assaults, and mistreatment of women. The damaging effects of these acts can include sexually transmitted infections such as HIV, psychological effects like PTSD (between 17% and 65% of women sexually assaulted in adulthood display symptoms of PTSD), self-harm, and relational and social adverse effects, such as loss of trust, isolation or fear of intimacy. Developing a nurturing community can thus assist in overcoming these devastating physical, psychological, emotional, and social consequences of gender violence. Hence, in Ethiopia, this more holistic approach to this challenge, engaging both men and women in the process of change, will not only help to prevent actions of sexual violence from occurring again but will also empower communities and the coming generations to speak out and defend human rights for all, forming and sustaining more equal and inclusive societies.

Unfortunately, changing mindsets and bringing about cultural change takes time. As efforts continue, strong prosecution and condemnation of sexual crimes remain essential to keep offenders in line and prevent future waves of atrocities like those currently taking place in Tigray. Human Rights and International Humanitarian Law must not be breached merely to wield power. Rape and other sexual crimes must not remain as tools of war in Tigray, nor anywhere else. Thus, the Ethiopian Government, its Prime Minister, Abiy Ahmed (a Nobel Peace Prize winner) and the international community must denounce and take action to prevent such cruel tactics from continuing to be used. The Tigrayan population, and especially its women, deserve to feel safe again.

Female Suicide Bombers: An Uncomfortable Truth

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By Anne Preesman

Black Widow ready for action (Daily Star, 2010)

In the early 2000s, Russia engaged in a violent war with its southern republic of Chechnya. During the conflict, the Chechen insurgents increasingly resorted to terrorist attacks, the hostage crisis in a Moscow theatre in 2002 being one of them. The attacks were characterised by female suicide bombers who the press named ‘Black Widows’ because many had lost their husbands during the conflict. These women are not unique; other terrorist groups, such as Al Qaeda, also employ female jihadis as suicide bombers.

There is a broad literature on how conflict is related to gender roles; Enloe, for instance, argues in her work ‘Bananas, Beaches, and Bases’ that militarisation enforces the masculine social order. At the same time, we observe that women take over traditionally ‘male’ roles during war, such as working in military factories. However, society tends to be more uncomfortable with the idea of women being active combatants. Elshtain argues that this is caused by the fact that society tends to view women as ‘life-givers’ instead of ‘life-takers’. According to Cook, this leads to women’s roles in war and terrorist organisations not being accurately recognised.
Although women historically played a more passive role during times of conflict because they were often not conscripted, we should not neglect those who were active in combat. For example, the British Special Operations Executive (SOE) sent women to occupied France to sabotage German operations during the Second World War. Female suicide bombers are, thus, not the first women to act as active combatants during times of conflict. Still, female suicide bombers are unique because of their high commitment; they are willing to sacrifice themselves for the cause. The common view of female suicide bombers is that they are from highly traditional Islamic societies where they have an inferior position. Although this piece will focus on Islamic female suicide bombers, it is essential to note that not all female suicide bombers are connected to Islam. Furthermore, the idea that women in Islamic societies have an inferior position is a Western perspective; instead, the Quran argues against female oppression in various verses.

However, it remains interesting to study if women’s social status pushes them to suicide attacks; therefore, I ask: Does a woman’s place in society push her towards suicide bombing roles?

Although women have been active in combat for centuries, men have actively resisted the idea of using women as a weapon, let alone employing their weaponised bodies as a tactical ‘tool’. It namely conflicts with the idea of women as ‘life-givers’. Using women, however, offers a tactical advantage. Women can pass security checks with greater ease, allowing them to have better access to potential targets. This makes female suicide attacks often more lethal than male attacks. Female attacks also receive more media attention, giving the terrorist group a broader reach. The Chechens were not the only ones trying to benefit from these tactical advantages. One of the first known attacks dates back to 1985 when a teenage girl drove a bomb-laden car into an Israeli defence force in Lebanon. In the modern day, other acts of terrorism committed by women can be found in Sri Lanka, Israel and Palestine, Turkey, Nigeria, and Russia.

In the literature, views on female suicide bombers and their motivations differ enormously. There is the idea that female suicide bombers are ‘failed women’; they are divorcees, infertile, victims of rape, or they lost their husbands, meaning they cannot fulfil their designated societal roles as wives or mothers. This can have two reinforcing consequences. First, these grievances can cause women to commit to the cause and make them willing to participate in suicide attacks. Interestingly, research finds that female empowerment is only a minor motivating factor for women joining a terrorist group, let alone perpetrating a suicide bombing. Second, being more controversial, one could also argue that such ‘failed women’ feel useless in society, making them useful to terrorist groups. These women may feel that the only way to become worthy to society again is by sacrificing themselves. Additionally, because women are hardly ever found in leadership positions, they are ‘replaceable’ to the group and thus suitable suicide bombers. Of course, there are exceptions, such as Samantha Lewthwaite, the White Widow who likely orchestrated the terrorist attack on a university in Kenya. Still, terrorist organisations remain very much a man’s world.

However, it should also be pointed out that not all female suicide terrorists are necessarily ‘failed women’. We also see highly educated, politically engaged, and/or married women committing suicide terrorism acts. Furthermore, female suicide bombers are not only from non-Western states; Western women have committed suicide bombings too, Muriel Degauque being a notorious example.

In short, it would be incorrect to argue that there is one specific ‘type’ of female suicide bomber. At the same time, however, the attacks also affect women’s roles after they have occurred. Female participation does not necessarily lead to emancipation; instead, suicide attacks can reinforce women’s inferior positions. Although some female suicide bombers have been romanticised, like Palestinian Wafa Idris, most of them are perceived as ‘failed women’ after being involved in terrorism. Palestinian terrorism especially, elevates men but shames women. Thus, women who were unsuccessful in perpetrating their suicide attacks are not only forced back into their traditional roles; their positions are even worse than before they joined the fighting. Finally, it should also be noted that not all female suicide bombers are voluntary perpetrators. Boko Haram, for example, is known to coerce women into committing suicide attacks, although it denies these allegations. For these women, suicide bombings are not a process of female liberation but a method of female oppression and a sign of male domination.

The presence of female suicide bombers shows that women are not only passive actors in times of conflict. However, there is no exact ‘type’ of woman that commits such attacks; different female suicide bombers can come from different societal positions. These women do have in common that their attacks do not elevate the positions of women in their societies. Although some women become martyrs, most societies look down on their terrorist acts. If women were to survive their time in a terrorist group, their positions are more likely to deteriorate instead of improve.

 

Anne Preesman is an MA student taking Intelligence and International Security. She is interested in the role of women in terrorist groups and conflict in the Post-Soviet space.

Notorious RBG: Justice Ginsburg and Shattering the Glass Ceiling

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by Isabela Betoret

Ruth Bader Ginsburg in her chambers in at the Supreme Court on July 31, 2014.

Women belong in all places where decisions are being made.
– Ruth Bader Ginsburg

The passing of Justice Ruth Bader Ginsburg, who may be the most well-known US Supreme Court Judge in the world, feels like someone scratching at an already open wound. The underrepresentation of women in sectors from media to academia has been well documented. Leslie and Cimpian go as far as suggesting that women are underrepresented in any sector that is perceived to require raw ability and talent over effort.

Senator Mitch McConnel, in the same statement where he offered condolences to Justice Ginsburg’s family, said that congress would waste no time in approving Trump’s pick to replace her. As Justice Ginsburg was only the second of four women ever appointed to the Supreme Court, followed by Justice Sotomayor and Justice Kagan, the odds are not in favour of the fifth being next. With McConnel in control of the senate, it is possible that a conservative pick could be approved before the election in November and a possible change in leadership, shifting the priorities of the court for generations to come.

And so, the wound reopens a little, we lose a woman in one of the highest positions of power. A role model to millions of female students and law graduates aspiring to the foremost jobs in the legal system, as well as to millions of women who benefited from the closer scrutiny Ginsburg gave to laws that affected them.

The women who occupy spaces in politics and conflict seem to be, largely, well known. Female heads of state are criticised for their every move, and it is far too easy to remember all their names because of the often-outrageous coverage they receive. Female professors, those who survived in a discipline that was for so many years hostile to our existence within it, are memorable. Though they are perceived to be less naturally talented, their brilliance has shone through years of doubt directed at them. Like Justice Ginsburg, they help millions find inspiration and courage by virtue of their work being published.

Though in the years since the women’s liberation movement there has been an influx of women into male-dominated fields, this was not often looked at in a positive light. Two studies one in 2016 and one in 2018 revealed that eighty percent of surveyed female European MPs had experienced acts of psychological violence; from harassment and misogyny to explicit threats of physical harm. Martin Van Creveld wrote that the more women who enter a profession the fewer men would remain due to its decrease in value because of ‘Feminisation’. Though he was referring explicitly to the Military, the roles for women in conflict areas has remained low. Women appear to be attacked for daring to enter the field, and then face constant threats and doubt once inside.

For all the inspiration they provide, women in positions of power in the realm of conflict and politics are rare. Statistics from the United Nations are staggering. Between 1992 and 2018 only thirteen percent of negotiators, three percent of mediators, and four percent of signatories in major peace processes were women; numbers which do not seem to have improved in the last couple of years. Before 2018 under fifty percent of humanitarian responses to conflict took into account gendered data. Studies have shown an increase of misogynistic and sexist speech by world leaders has increased the rate of violence committed against women. In January 2019 only 24.3 percent of parliamentary seats globally were held by women, and 19 women served as Head of State or Government. Only 21.7 per cent of Heads of Higher Institutions were women in 2017. And in the United Kingdom, women in academia were paid, on average, 15.1 per cent less than men in 2019.

With such numbers is it surprising that women like Ruth Bader Ginsburg are so widely admired? Despite the lack-lustre representation, there is now precedent for women in the world of conflict. Ginsburg did for the law what many women did in other fields. Marie Colvin for journalists and war correspondents; Condoleezza Rice, the first female Africa-American Secretary of State; Hillary Clinton, the first female presidential nominee for a major political party. But we must remember that for those doors to be opened the women who first walked through them had to live in conflict.

Ginsburg had to fight against blatant sexism in order to make it to the very top of the legal profession. She was demoted from her job at a social security firm when pregnant with her first child, leading her to conceal her second pregnancy almost to term. She was one of only nine female students at Harvard Law School in a class of five hundred, and every day her place there was questioned because of her gender. She worked on the legal side of the Women’s Liberation Movement, being one of the first to argue gender discrimination cases in the Supreme Court—where she had to teach the justices what that meant. Despite facing cancer five times, she only missed oral arguments twice due to illness. Many other women balance motherhood and the expectations of society with their careers and ambitions.

For the first time in history it became possible to urge before the courts successfully that equal justice under law requires all arms of government to regard women as persons equal in stature to men.
- Ruth Bader Ginsburg

Representation is not enough without inclusion. Tokenism will always fall short, and it will never give the minds of women the credit they deserve. We do not fight to have a woman be placed on a position of power because she is a woman; rather, we argue that she belongs there because of her brain, of her ability, her passion, and these should not be devalued because of her gender.

Self-belief, it would seem, is not an attractive quality in a woman. We are constantly forced into being humble and modest until we stop believing in all the things we are capable of. Women are now represented, if poorly, in conflict resolution and politics. Women have always been a part of the history of war, be it in the home front or on the battlefield—but femininity is often absent, both in men and women, in this field. To survive in the world of conflict we must harden our edges and adopt many of the qualities of the masculine workforce we enter.

According to a study by Krause and Bränfors, those precious few instances where women are sitting at the negotiating table during peace processes tend to end in a more durable peace. The same study found that ‘peace agreements signed by women show a higher number of agreement provisions aimed at political reform and a higher implementation rate of these provisions.’ Through the Coronavirus Pandemic countries led by women were said to have a better response to the crisis. The answer does not necessarily lie in their gender or biology, women are not genetically pre-determined to make more effective leaders. Helen Lewis argues that a shift in leadership style, away from the strongman, the traditional masculine leader in the time of uncertainty (be it male or female) is occurring. A change of perspective is suddenly welcome, and it would appear many new ideas and styles are being brought forth by women—but more importantly, people seem to be listening.

If our field could do with more women, it could also do with the qualities of individual women, not merely having us imitate what has already been done in order to have a seat at the table. Like Ruth Bader Ginsburg we can teach those around us why our perspective is unique, and both men and women can benefit from it. Despite Van Creveld’s objections, a change of perspective may not be so wholly disastrous.

Women like Ruth Bader Ginsburg matter and we feel their loss so acutely because there are few examples for us to look up to. Few encouragements to put pen to paper—or fingers to keyboard—and have the courage to say: this is what I think, and I know it has value; I know it is good, and you will listen to it not because I am a woman, but because what I have to say matters.

Justice Ginsburg once said ‘I think I was born under a very bright star.’ Ginsburg knew what her life meant, and she believed in all she had achieved. Not only was she proud of her legacy, but she also inspired women all over the world to be proud of their own accomplishments. The remedy to the pain, and the only way to close the wounds left behind, is not for one woman to take her place—but for all of us to do so. For every single one of us to take the inspiration she gave and believe in our own potential. As Justice Ginsburg once replied when asked when there would be enough women in the Supreme Court: ‘When there are nine.’

Isabela Betoret is the Outreach Coordinator in charge of the Women In Writing Mentoring Scheme. The Scheme is an opportunity for women undertaking an MA at King’s College London to interact with a network of similar-minded people, build a community, become familiar with the world of academic publishing, and improve confidence in their writing skills. The Scheme exists to be the outstretched hand welcoming you to our community, the rest is up to you. If you would like to know more about Women In Writing or apply to the scheme you can do so here.

The Forgotten Casualties: The Indirect Gendered Consequences of Explosive Violence on Civilian Populations

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by Miles Cameron Hunter

9 July 2019

One of thousands of Syria’s widows; Hanaa’s husband went missing before their son was even born. She now struggles to support him on her own. (Image credit: 2014 UNRWA Photo by Taghrid Mohammad)

Explosive violence is a feature of most contemporary armed conflicts. It comes in many forms: from mortars and airstrikes, to landmines and suicide bombings. Tragically, it is civilians who face the brunt. There is little sign of this trend abating: the casualty monitor run by Action on Armed Violence observed a 165% increase in civilian deaths as a result of explosive violence between 2011 and 2017.

The impact of explosive violence is far-reaching, triggering numerous indirect consequences beyond an initial blast; this affects everything from the provision of effective healthcare, to education and sanitation. However, this piece focuses on a less-discussed impact of explosive violence: the series of indirect gender-related consequences. Patriarchal societal norms and values in many war-torn regions often result in women being immensely disadvantaged. Meanwhile, the traditional impression that men are the chief actors in war is still overstated, frequently leading to the impact on women going unseen. These views persist even as explosive violence in modern war harms a growing number of women and children. Women regularly find themselves widowed in societies that repress their independence, raising families alone in poverty while often enduring limited access to health and after care services. Greater awareness regarding these gender-based issues is overdue.

For men, the consequences are often more self-evident. As a result, they tend to overshadow the subtler, but no less important, impact on women. The raw statistics suggest that men and boys are more likely to be harmed in an explosive incident than women, especially when looking at landmines or explosive remnants of war (ERWs). According to data from 2015, 86% of explosive incidents where the gender was known involved men. A main reason for this is societal norms and traditional gender roles that are often present in affected areas.

In many of the worst hit regions, such as Syria and Zimbabwe, it is commonplace for men to be the chief breadwinners for the family, while afflicted regions also tend to be more economically disadvantaged. As a result, occupations such as farming and scrap salvaging are notably at risk, with labourers (usually men) forced to work dangerous land to provide for their families.

But there are more indirect gendered-consequences. In societies where it is the norm for a man to provide, a maimed father has a knock-on effect on the family. Often, it is children, generally boys, who are pulled out of school to work instead, facing the same dangers from explosive ordnance. Women also suffer the cost.

Despite being more likely to suffer direct consequences of blasts, men are also in a more advantageous position to cope by receiving treatment and/or finding alternate employment. This is largely due to gender-based bias in many affected societies. Dr Sherry Wren, in association with Doctors Without Borders, has expressed concerns that medical treatment in conflict zones, such as those in Sub-Sharan Africa and the Middle East, is far less accessible to women. Data suggests that sixty-nine percent of surgeries between 2008 and 2014 were on men, leading to fears that women are under-represented in hospitals due to their second-class societal status. It is true that for direct violent trauma, such as gunshot wounds and explosive injuries, seventy percent of surgeries were performed on men. This is not surprising. However, the alarming figure is that even for indirect trauma, such as illness and disease, seventy-three percent of surgeries were performed on men. This is a stark inequality.

The key finding of this report is that women endure many long-term, and often overlooked, indirect consequences of explosive violence. In general, there is already an issue with long-term trauma in post-war states being neglected. However, for women this is exacerbated due to a second-class status in the patriarchal societies that make up the majority of modern conflict zones. Injured women are less likely to have access to aftercare services and generally face more stigma and marginalisation than men if disfigured; according to UN research into gender-based perceptions of war survivors. There are also health complications unique to women. For instance, a blast can damage the female placenta, leading to direct or indirect complications in childbirth in future: indeed, this is one of the biggest killers of young women according to the WHO.

Women in Non-Western patriarchal societies also suffer from many indirect socio-economic consequences of explosive violence. Those widowed, or who have a husband incapacitated, face a plethora of struggles. They find themselves in a position where they must be chief breadwinner in cultures that frequently militate against women working, while also retaining the responsibility of raising children.

In Syria and Lebanon, fifty percent of families with a female head face food insecurity and are twice as likely to live in deprived informal settlements. Many women struggle to find work due to gender-based stigma. As a result, they risk being dragged into poverty and/or forced into exploitative means of income such as sex work or seeking early marriage for young girls. All of this can cause intense psychological scarring, which although not as immediately evident as physical injury, can be equally debilitating.

Even when women struggling in the aftermath of explosive violence do find conventional work there are harsh inequalities. In Lebanon, it is reported that women often work longer hours than men for just seventy-seven percent of what their male counterparts earn, while also having demanding maternal duties.

There are many more hardships facing women than those documented in this report. But its findings are demonstrative of clear gender-based issues persisting in civilian populations affected by explosive violence. The notion that men are the primary actors in war still prevails despite the ever-greater toll on women and children. Consequently, the plight of thousands of women affected by explosive incidence often goes unnoticed. As awareness for their predicament grows, traditional assumptions need to evolve along with the changing nature of war.

Miles Hunter graduated from King’s College London with a BA in War Studies and an MA in Terrorism, Security and Society. He is currently a researcher with the charitable NGO Action on Armed Violence.