Source: International Rescue Committee
The Ebola crisis in West Africa has taken a harsh toll on women and girls in some unexpected ways.

Christiana Conteh is the International Rescue Committee's women's protection and empowerment manager in Sierra Leone, a country dealing not only with Ebola but also with the continuing issue of violence against women. Millicent Juana runs an IRC-supported center for survivors of sexual violence in Kenema, Sierra Leone's second largest city. Called the Rainbo Initiative, it has been providing clinical care, counseling and other support for women and girls since 2002, when the country emerged from a long and brutal civil war.

Photo: Peter Biro/IRC

We asked Christiana and Millicent—who recently had to relocate the Kenema Rainbo center a safe distance away from an Ebola isolation unit—about the many ways Ebola has affected the lives of women and girls in their country and what can be done to help:

Ebola fighters in Lofa County, Liberia
Photo: Peter Biro/IRC

1. Women aren't getting essential treatment because so many medical staff are focused on Ebola—and also because many people are afraid they'll catch the virus if they visit health facilities.
"The qualified doctor who worked at the Rainbo center fled without telling anyone. The doctor who replaced him died of Ebola himself. Since then, the center has not been able to hire another doctor."
- Christiana Conteh

"Everyone was so scared of catching Ebola that clients and relatives stopped coming here. The Ebola mortuary was built behind our center and all of our staff was at risk of contracting this disease as [at the time] we didn't have any protective gear."
- Millicent Juana

Mother and newborn at a health center in Sierra Leone
Photo: Aubrey Wade/IRC

2. Childbirth has become more risky because maternal health clinics have had to close, or pregnant women choose to stay home to give birth.
"Even maternal health services have stopped in many places or women don't feel safe reaching them. We are so worried."
- Christiana Conteh

3. Survivors of sexual assault cannot reach medical treatment and counseling because of the unavailability of health staff and travel restrictions on Ebola-hit towns.
"We are extremely worried for the medical complications for survivors if they cannot access treatment. How soon can we reopen critical centers to help survivors of violence? How will we find qualified doctors willing to come here?"
- Christiana Conteh

4. Survivors of violence are finding it difficult to obtain the doctor's reports needed for police to build a legal case against the perpetrators.
"The lack of available medical services for survivors of violence has also meant that some cases charged to magistrate court are dismissed for want of sufficient evidence because there is no medical report."
- Millicent Juana

A girl collects water in Sierra Leone
Photo: Aubrey Wade/IRC

5. Reports of rape—including of underage girls—are on the rise.
"Not only are sexual violence cases not being prosecuted for lack of medical reports, but because cases are being dismissed, it is understood that there is impunity for this kind of violence. We recently received a report of an Ebola male survivor who raped a girl of 14 years, and he may still be carrying the infection through seminal fluid. "
– Millicent Juana

6. Many more girls are becoming pregnant as a consequence of schools being closed for the duration of the Ebola crisis.
"We fear that many girls will not return to school, and the loss of family members to Ebola and resulting financial pressures mean that girls are the first to be pulled out of school to work and be caretakers for the family."
– Christiana Conteh

Photo: Aubrey Wade/IRC

7. The Ebola crisis has slashed economic opportunities for women and made it difficult for them to afford the things they and their families need.
"Women's economic potentials have dropped drastically. There are not many agricultural activities going on, which has led to high cost of local commodities."
- Christiana Conteh

8. Women and girls who have lost husbands and parents to Ebola have become targets for exploitation.
"Stigma, stress and shame arise from losing their husbands and family members to Ebola. If a woman's husband has died, no one will want to be near her, and certainly not employ her or buy her goods. This is increasing the sexual exploitation and abuse of women and girls. They tend to be highly dependent now as they have no access and control over their own resources."
- Christiana Conteh

9. Reports of violence in the home are increasing — as all forms of violence against women tend to do during times of crisis.
"We are also hearing about domestic violence, including marital rape."
– Christiana Conteh

3 creative solutions

Photo: Aubrey Wade/IRC

"Ebola doesn't just take away your health," Christiana explains. "For women and girls, it takes away our loved loves, our safety, our money, our jobs, our education, access to safe childbirth, and at times, control over our own bodies and futures. While doctors are responding to the disease, we need a response for society's illness that is taking away everything else."

She and Millicent shared these suggestions for how to help:

1. Enable other health professionals to provide care for women and girls
"Doctors are hard to hire these days, so we recommend midwives and female community health workers to fill the gap."
– Millicent Juana

2. Create new economic opportunities for women and girls
"We need to rebuild women and girls' economic status and advocate for educational and financial support for girls in and out of school. It's crucial to continue providing support to women and girls affected by violence."
– Christiana Conteh

3. Mobilize community groups to support survivors and reduce impunity
"We need to focus support on survivors of violence and other emerging issues, and not only on Ebola – there needs to be effective service provision and for men to be accountable for their actions."
– Christiana Conteh