Climate change has exacerbated the intensity of climate change-induced disasters (hereafter, Climate Disasters or CD) across the globe (IPCC, 2014). Among them, Water-Related Disasters (WRD) which refers to all disasters from water including flooding, droughts or extreme storms (UN-Water, 2012), accounts for over 90% of CDs. Especially, the Asian and Pacific region is the most vulnerable to WRDs, occupying 90% of the people affected by such disasters and more than 45% of fatalities (Adikari and Yoshitani, 2009). When it comes to human sufferings from disasters, it is now widely accepted that, geographically, the people in tropical countries or, socioeconomically, Low and-Middle Income Countries (LMCs) would suffer the most. More specifically, it is the people in poverty who would face the most detrimental effect of climate change and its induced disasters. Together with the fact that more women are poorer than men (World Bank, 2018), these insights provided a ground for the focus on women in the discourse of climate change with a new perspective. The recent gendered understanding of climate change then puts forward, as it is in this paper, that women are disproportionately vulnerable to climate disasters (Hemmati and Rör, 2007).

The topic of gender dynamics as they relate to CD is an emerging field of study that remains inadequately comprehended globally. So far, the critical analysis of disaster literature has pointed out that “in the disaster context, gender is typically regarded an unimportant component of the many stages leading up to, during, and in the aftermath of the natural disaster” (Militzer, 2008:8). This short discussion paper aims to summarise the existing body of research in terms of women in WRD to highlight the importance of a gender-inclusive approach to changes in the public health sector in response to the growing burden of WRD globally.

To understand the gender dynamics of WRD, this paper takes a Feminist Political Ecology (FPE) perspective as a theoretical framework. The theory of FPE has been widely known after the launching of a book titled “Feminist political ecology: Global issues and local experiences”, written by Rocheleau and her colleagues in 1996. Since then, the theory has been prolific in exploring the relationship between gender and environment, becoming a knowledge resource for policymakers, practitioners as well as researchers (Elmhirst, 2011). FPE frames gender as an axis of power, similar to class or race, which shapes access to and control over natural resources (Sundberg 2017). The theory provides useful tools to examine environmental issues such as the costs of natural disasters, capturing various social formations involved in human-environment interactions (Nightingale, 2006). FPE views the complexity of social dynamics of gender and other social labels when understanding the human-environment interactions (Goldman & Schurman, 2000).

FPE sits in the intersections of analyses on gender and the environment, and in terms of transformative politics at multiple social scales and layers. Therefore, the main concerns have been on the traditional feminist struggles over natural resources. So far it has been understood as a strong analytical frame and a feminist strand for drawing attention on gendered power dynamics in the society with regards to access and control over resources properties (Sato and Alarcón, 2019). By considering the complexities of social-environmental relations when understanding environmental issues, FPE recognizes unequal access, uses, and controls over resources caused by gendered social relations of power. It provides an important foundation for understanding differential opportunities and challenges between women and men in the case of environmental changes (Rocheleau et al., 2013).

However, FPE is yet to fully embrace the ongoing climate change discourse, especially in terms of disaster preparedness, recovery and relief. The gendered power relations in a society undergoing extreme stresses from disasters has been focused only since the late 1990s (Enarson and Morrow, 1998; Fordham, 1999, 2003; Cannon, 2002; Wisner et al., 2004; Neumayer and Plumper, 2007), while the issue has been ever more emphasised by various emergency practitioners and field report (Sultana, 2010). Based on such empirical studies, the FPE is expected to critically analyse this emerging area of research, further understanding the gendered social constructions and its gendered outcome when facing climate disaster which is warned to be more frequent and intense in near future.

When hit by WRD, women’s vulnerabilities and capabilities arise from pre-existing gendered dynamics are put together with drastic external environmental changes, such as displacement. The disaster-induced displacement often exposes people to numerous negative consequences to human health (McLeman and Hunter, 2011; Hunter, 2012; McMichael, 2015). It involves health risk heightening changes as forced displacement, crowded or mass gatherings, poor quality of shelters and water, lack of sanitation and hygiene as well as healthcare facilities (Hammer et al., 2018). It is women who comprise the overwhelming majority of the population displaced by climate change (UNDP, 2016), and are facing greater difficulties in accessing resources, privacy and assistance (GIWPS, 2017) while doing their share of work to reconstruct livelihood.

To clearly delineate such circumstances with a concrete case so far has been difficult due to lack of gender-aggregated data collected in the disaster-hit area. Yet, Satkhira district, the most disaster-prone area in South West coast of Bangladesh, would be the best example, if not only, as a number of local studies have strived to deal with the issue of women in climate change. A recent study of randomly selected women from 142 households in Satkhira district illustrates women in WRD with figures (Hasan and Shovon, 2019). During a disaster, women are confronted with difficulties in arriving at a secured place that are different than men. First, women’s physicality including their long hair (40.84%), apparels (89.43%), physical strength (61.6%) and lack of swimming skills (25.35%) hampered them from escaping fast. Second, their roles in the family to take care of their family members (children 33.8%, waiting for relatives 47.18%) and household assets (92.25%). Third, their gendered structure of the society, such as not being informed of the disaster (83.8%), not taking emergency decisions (86.61%) or not able to go out alone (27.46%).

After a disaster strikes and demolishes houses, survivors are led to shelters and camps. However, many women prefer not to move to cyclone shelters as they deem dangerous for them. The reason for them to stay in their houses or temporary housings for themselves are shown below (Table 1), which is concluded by the author that such temporary shelters does not consider gendered needs.

Fig. 1. 
Barriers for women to maneuver to secured place during disaster (Hasan and Shovon, 2019.)

Fig. 2. 
Discouragements for women to go to cyclone shelters (Hasan and Shovon, 2019.)

Not only does it lack consideration for women, but a lack of infrastructure and facility for housework in many shelters add workload for women. Another study in Satkhira district outlined a triple burden of women in dealing with climate change, saying that they work as 1) a producer, 2) caregiver and 3) breadwinner (Mondal, 2014). From 6 focus group discussions with 10 women each together with 2 In-depth interviews in a village in Satkhira, the study summarises that due to frequent cyclones and recurrent high tide in rivers, houses, markets and homesteads have been destructed while salinity ingression degraded agricultural land. The cultivating land has shrunk from 80% to 15% within two decades. As a result, the ecosystem is changing while women now need to walk long distances to fetch fresh water.

In Satkhira, securing potable water is a major factor for exhaustion when women are already suffering from chronic nutritional deficiency. They are highly affected by different water-borne diseases during a disaster, as well as the prevalence of skin disease (76%) followed by diarrhoea (60%) (Hasan and Shovon, 2019). The risk of water-borne disease for women rises as they are compelled to stay within a certain radius from their homes while tube-wells that many of the disaster-prone areas rely on to fetch water frequently become polluted. Further, while men would take boats to defecate far from their communities, women would have to find communal latrine or find a place near their houses, which further pollutes their living environments. Most significantly, pregnant women with less mobility face further difficulties with slippery floors, which makes them far more vulnerable to secure safe water (Neelormi, 2009). Also, long exposure to saline water has induced severe gynaecologic diseases to many. Further, when infected, many find cost a barrier to visiting medical centres in cities.

The climate disasters present significant and devastating broad of public health concerns that pose tremendous challenges to the communities and their residents. Displaced women are often excluded from early warning systems before the disaster as well as post-disaster recovery efforts, facing greater difficulty than men in accessing assistance (Arnold, 2017). These intertwined vulnerabilities and lack of resilience often push women into poverty trap or permanently displace them from their homes, as well as weaken their health mentally and physically, which extends the adverse effect of disaster. Therefore, in order for the health-related decision-making groups to ensure and provide a successful diagnosis and treatment of the health impacts of WRD, it is necessary to build a gender-inclusive public health response and raise awareness of such needs in reality. The efforts would include, but not limited to the following:

• Gender-inclusive Early Warning System and drills
• Emergency response and swimming education focused on women as disaster preparedness
• Immediate and reliable data collection (gender, age-disaggregated)
• Gender-inclusive design of shelters
• Safety measures for women for domestic and sexual violence

As briefly outlined in this paper as an example of a thought process, the argument put forward for the women in the times of WRD is as follows. First, human vulnerability and capacity to respond are highly gendered (Hunter and David, 2009). The impacts of disaster can largely be correlated to existing social inequalities which act in complex ways to disadvantage women in their society (GFDRR, 2018). Second, while advocating disproportionate impacts on women, the narratives of seeing women as a group of victims have been constructed in the face of WRD, or climate disasters in general. Such narratives frame women as mere passive beneficiaries, obscuring the potential of women (Okali and Naess, 2013). Third, the underrepresentation of women in the decision-making process for disaster responses is the reason behind failing to both reduce vulnerabilities and enhance capacities of women in responding and building resilience towards disaster (Arora-Jonsson, 2011).

Gender-inclusive WRD response methods that suit country- or local-specific contexts have not been thoroughly devised to materialise such goals and plans. While some countries still need to strive for institutionally incorporate gender inclusiveness, the concept rather has long been a buzzword in the international and national political agenda yet remains mere rhetoric to a degree that it is seen too often without meaning. As this paper addressed the need for sector-specific gender-inclusive climate disaster response in the public health context, incorporating the gendered dynamics in every sector and fields is vital to building a truly holistic climate change response. On one side, a feasible and workable plan needs to be built in the face of emerging risks of further climate change consequences, but it also should be compatible with more robust research and study. In this regard, this paper concludes with a plea for future climate change responses of all fields to proactively contemplate on gendered dynamics in each and every corner of their work.