This article contributes to discussions on the gender dimensions of disease outbreaks, and preparedness policies and responses, by providing a multi-level analysis of gender-related gaps, particularly illustrating how the failure to challenge gender assumptions and incorporate gender as a priority at the global level has national and local impacts. The implications of neglecting gender dynamics are illustrated through a case study of the Social Enterprise Network for Development (SEND) Sierra Leone based in Kailahun, during the Ebola outbreak. The article concludes by calling for policy and programming responses to recognise the care work conducted largely by women in situations of disease outbreak, and then find ways to support their work without relying on it.