Caregiving will forever have a new outlook following the ongoing pandemic. From unpaid caregiving to the increased duties of professional caregivers, there has been little or no respite over this past year. And we still keep going, with many cities across the globe seeing no end to this pandemic any time soon.

The COVID-19 pandemic has made evident the numerous cracks in a previously trusted system. Healthcare receivers and givers have spent the past year aching for a lot of things that were once considered basic.

While each of us was tackling a known enemy, COVID-19, there was a lot going on under the radar that highlighted how low the investment into healthcare truly was.

The Immediate Effects of the Global Lockdown

With a shift to the four walls of our homes, we all had to learn how to accommodate our whole lives within their homes. This meant all meals were eaten at home, we worked from home, went to school from home, and took care of illness at home. The world was in a situation that had no manual to follow. Yet, everyone had to find their way. And to find this median took several months of experimentation.

And with time, as the social constructs would have it, a lot of the caretaking responsibilities fell on women’s shoulders. The Organization for Economic Co-operation and Development (OECD) found that approximately 75% of the unpaid domestic work within a household, across the globe, was managed by women and girls.

In a pre-pandemic era, women daily clocked about 4 hours and 37 minutes of unpaid care work, according to the International Labour Organization. Whereas men were observed to put in an estimate of 1 hour and 23 minutes per day. And today we stand at probably double or triple those daily numbers.

Another startling fact observed across Asia was that girls were dropping out of school more frequently than boys. According to a survey of 28,000 girls conducted by Room to Read, 42% of girls reported that their households were bringing in less income, which meant the girls had to support their families financially.

Also, especially in rural parts of the globe, girls were expected to manage the household responsibilities and boys were often sent for education.

Women and the Frontline Fight Against COVID-19

When this pandemic required a global call to action, it was observed that women made up approximately 70% of the frontline workforce. This included unpaid caregiving in addition to being doctors, nurses, care staff, community workers, and social activists — which meant that around the globe, women were at a higher risk of infection.

While these global statistics only highlight the reality at the perceived front lines, in households across the globe, women were tackling the unseen repercussions of the pandemic. They were managing household tasks, taking care of their sick, homeschooling, and balancing a professional life.

Women were also at the front lines when addressing the community impact of COVID-19. It was reported that women were primarily the ones conducting surveys, cooking meals, establishing contact tracing, running charities, and continuing to spread awareness during the pandemic. For households that had individuals that were ill, women would often open their homes to children from other families or look after the elderly who didn’t have caregivers to look after them.

And all of this was done with little or no help at home and on minimum wages when they ventured out for work or as community volunteers. Additionally, when women were out on the front lines, the lack of efficient personal protective equipment (PPE) was also highlighted. As the pandemic progressed with cases increasing, there was little or no change on these fronts.

Assessing the Caregiving Burden

A lot of the COVID-19 studies about women have reflected their roles as the primary caregivers within families.

While global trends pre-pandemic highlighted more women moving into the workforce, it failed to highlight the higher strain women faced as primary caregivers within households. This has exposed the negligible shift in patriarchal constructs around the globe. Many African countries, India, Nepal, and Bangladesh observe higher statistics that reflect women taking over unpaid household tasks primarily due to the stronger patriarchal influences among these societies.

While these statistics are revealing, little is known about the mental health struggles that women as caregivers experience. During the COVID-19 pandemic, women have been burdened with the “third shift,” which involves ensuring optimum emotional well-being of their children, spouses, parents, and community. While the multi-faceted approach women take toward caretaking is popularized and sometimes called “Superwoman Syndrome,” in reality, donning several capes at once has had severe repercussions.

The Unseen Struggles of COVID-19 Caregivers

In November 2020, UN Women reported that while the hours of unpaid labor have increased for both men and women, a sizable portion of this was still managed by women. This report goes on to mention that this is equivalent to hours clocked for a full-time job.

This is why one year later, more women compared to men are resigning from their full-time jobs citing burnout and household responsibilities as causes.

Support for caregivers has also been minimal in terms of their own healthcare needs. If women within a household fell ill, there was often no one to assist them with their health.

The Lancet also highlighted that there were around 7 million unwanted pregnancies during this pandemic. And accessible and safe abortions were not available for many women. Women who resided in rural parts of the globe had limited to no access to healthcare services and products such as menstrual products or contraceptives.

A policy brief by the UN additionally documented the increase in gender-based violence during the pandemic. With women locked within households with their abusers for numerous hours during the day, the chances of violence increased exponentially. The policy brief pointed out closed spaces, financial struggles, substance abuse, and minimal peer support as direct causes for the increase in violence. Women and girls were also likelier targets for violence within households.

A mental health study among caregivers reported an increase in depression, anxiety, and parent-perceived stress. Among caregivers, there was also an increase in suicide ideation, grief, and PTSD that was also documented. There were limitations in drawing out differences in the mental health struggles between male and female caregivers. This was primarily due to the low numbers among males who took up caregiving roles.

The Future of Caregiving

In her article discussing the mental and emotional toll caregiving takes on women, writer and caregiver Kate Washington aptly says, “Sick, chronically ill, and disabled people have a right to the care they need to live. Their lives have unquestionable value. The lives and work of we, who care for them, have value, too.”

The pandemic has made the requirement for alternate and supportive health care practices a must. This includes using technology to build accessible healthcare platforms. A prioritization of mental health is crucial to managing the emotional labor involved with caregiving. Awareness is the key to detecting early signs of emotional fatigue.

Having community aid is also vital in times of crisis. The pandemic has shown that at large, communities were unable to support their ill, elderly, and those in distress. Women and the vulnerable were unable to report the violence they experienced. Having community-based systems in place to address this not only lightens the caretaking burden but also ensures the safety of primary caregivers within households.

The UN policy brief rightly indicated that the unpaid labor women provide is not “infinitely elastic.” This means recognition of the gender disparity in caretaking and child-rearing responsibilities is crucial. This will mobilize more accomodating practices within both households and professional arenas.

As the number of vaccinated people creeps upward and the world inches closer to a post-pandemic era, it is essential to remember that primary caregivers are humans and not machines. Having open lines of communication is one of the first steps to understanding the current plight of caregivers. Additionally, it is vital to note that while primary caregivers are usually women, there are few women among stakeholders who make policies. Representation among policymakers will encourage the incorporation of policies that give caregivers what they need.

Caregiving is an ecosystem, with the caregiver at the center. Without providing the basic requirements within the ecosystem, it is difficult for a caregiver to thrive. Within most households, these caregivers are women. They often shoulder this responsibility without giving these caregiving tasks a second thought. Building an ecosystem that is conducive for them to selflessly provide is the basis of building a thriving caregiving ecosystem.

By Gabrielle Baglino at Oak Street Health