Gender is a factor in the type of role as a worker that women and men would take up. Men tend to be given roles that require a lot of labor such as lifting heavy things as compared to women who are often given lighter work.
I became more aware of this during my interaction with community members in Mwea region in Kenya. For context, the Mwea region is known as the main rice-growing area in Kenya, making rice farming the main economic activity. Rice growing activities can be divided into planting, weeding, and harvesting. Both women and men work in the rice fields, but what is interesting is that each of them is actively involved in different stages. Women tend to be more involved in the planting and weeding while men are mostly involved in the application of fertilizer and harvesting.
The two stages that women are primarily involved in are also those that pose the highest risk of exposure and infection with schistosomiasis. This is mainly because the rice paddies are usually full of water, the perfect environment for the parasite that causes schistosomiasis to live. Women work barefoot in the paddies since footwear of any kind would get stuck in the mud increasing their exposure.
Women between the age of 18-35 typically seek casual labor in rice farms as compared to their male counterparts who seek alternative forms of employment such as being motorcycle riders or even seek casual labor in warehouses within the town center.
I had the pleasure of visiting the rice farms during planting and harvesting. During planting I met a greater number of women than men who were actively working in the rice paddies. While during the harvesting period, I met a greater number of men than women within the rice field presumably because harvesting is more labor intensive.
Men and women play different roles within a household setting. Men are considered the providers, while women are considered the caregivers which entails cooking, cleaning, and taking care of children.
What stood out to me during my field visits was the state of water and sanitation in the area. The rice field had no sanitation facilities and the people I spoke to clearly brought out the fact that they usually tend to urinate and defecate in the fields. This in itself is one of the main ways that schistosomiasis persists and spreads at the farms. Access to clean water was also something that I realized is not readily available in these communities. People usually fetch water from the canals that feed the rice farms and use that water at home for cooking and cleaning since most of them lack piped water in their homes and those that do have piped water do not get a regular supply. This exposes a whole family unit to schistosomiasis whether they had direct contact with the paddy water or not.
Women are seen as caregivers, meaning the duty of taking care of children is on them. One of the questions I asked was at what age they started working within the rice farms, and most of them mentioned they started as early as years old when they would come with their mothers. This exposes children to infection unknowingly, cementing the importance of regular mass drug administration in schools. This I learned usually happens within the area at least once a year.
Schistosomiasis has remained endemic in different parts of Kenya, mainly in the coastal and western regions of the country. Access to clean water, diagnosis and treatment, preventative chemotherapy, and, most of all, community education remain key in reducing the spread and persistence of schistosomiasis within these communities. Lack of knowledge on what schistosomiasis is and how it spreads continues to be a barrier to behavior change and the management of schistosomiasis. There is a saying that goes “when you educate a woman, you educate a whole village.” Empowered women empower their families, and these families empower the whole village. Through community education of women in Mwea and leveraging the roles that have been assigned to them, behavior change can be realized within schistosomiasis endemic areas. I hope through this fellowship I can be able to educate women and hopefully they will pay it forward to other women building a community of women who can bring social change.