Disasters and access to healthcare in the coastal region of Bangladesh: a gendered analysis

Abstract

This research focuses on the gendered impacts of disasters on health and healthcare access. It aims to explore the gender-specific health impacts of cyclones, and the factors shaping accessibility to healthcare in disasters. It investigates current disaster plans and policies for pre-and post-disaster healthcare provision, and to what extent they account for gender. The study is situated in Barguna, Bangladesh, highly vulnerable to cyclones due to its remote coastal location, poor socio-economic conditions and transport, and insufficient healthcare provision. The qualitative research methodology included interviews with local inhabitants and officials from government and non-government organizations, focus groups discussions, participatory diagramming and observation. The findings reveal that disasters have very significant gendered impacts on health and healthcare access. Women are subject to an inverse care law, where those with more injuries receive less care. Advantages for some groups of women, in employment, educational status, position in the family, income and urban location, make a positive difference to the risks they face, but the research found that their status does not assure healthcare access after disasters. Thus gendered identity creates more homogeneity than difference among women in healthcare access after disasters, strongly influenced by cultural attitudes, behaviours and norms around gender within society. Prevailing disaster management plans consider 'women' without this context of gender relations, which raises serious questions about the successful implementation of disaster plans. The research also highlights the vital contributions of qualitative research in disaster and gender studies, in taking an approach that accessed a highly traditional society and collecting rich data from women on private experiences and perspectives. The thesis recommends consideration of deeply rooted social determinants, and gender-sensitive disaster management plans that focus on local culture, society and economic conditions. In this way, more effective implementation of disaster management plans may establish equality in healthcare access and reduce women’s vulnerability to future cyclones.