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Humanitarian

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Emergency appeal for the Tsunami & Earthquake in Indonesia
02 October 2018

Emergency appeal for the earthquake and tsunami in Indonesia

Updated 18 October 2018 We are continuing our response to the earthquake and tsunami of 28 September through our local partner the Indonesia Planned Parenthood Association. The latest death tolls stands at over 2,100 people and sadly, is expected to rise. Our response team remains on the ground and our supplies have started to arrive, such as much needed contraceptives and mobile sexual and reproductive tents. Our response During all emergencies, women and marginalised groups are the most vulnerable. In the coming days, and weeks, we will continue to expand our reach to the 78,994 people still displaced by this double disaster with clinical services such as prenatal care, STI and HIV screenings, contraceptive provision and gender based violence screening. Our team from the Indonesia Planned Parenthood Association has been operating locally since 1957 so is well placed to respond to the needs to the local population and work closely with the Indonesia Government in their response efforts. Our emergency appeal  Our emergency fund will allow us to reach more people with these much needed, and overlooked, services. 100 percent of the donations made to this fund will go directly to our partner the Indonesia Planned Parenthood Association to allow them to continue their services. Please donate now. Donate now Our Member Association, the Indonesia Planned Parenthood Association (IPPA) has an office and clinic in Palu City and is currently sending additional support from other IPPA offices to Palu. As well as undertaking initial assessments of the urgent SRH needs, the team will distribute prepositioned hygiene kits to affected communities. IPPA has also sent their medical doctor from Makassar to the field as part of a joint outreach team with the Indonesian Government health response team.  Satyawanti Mashudi, Executive Director of IPPA, says:  "Indonesia has been rocked by a series of natural disasters lately, but Friday’s earthquake and tsunami double disaster has caused a catastrophic amount of destruction and loss of life. We are grateful that all our local staff have been safely accounted for, and now our attention must go towards the affected communities and their sexual and reproductive health needs. With tens of thousands of people sleeping in temporary shelters, and many more displaced, we know from experience the SRH needs will be high, and urgent."   With a total population of 1.5 million in affected areas, we know that as many as 375,000 of those are women of reproductive age, 300,000 are sexually active men and as many as 27,225 women could be pregnant. It is crucial we can reach these populations during the initial days and weeks after the disaster to provide life-saving SRH care.  Donate now

Delivering supplies to Vanuatu
19 December 2017

Emergency care in the most disaster-prone country in the world

“All I do is sit and cry with my children. I want family planning so bad. I’ve known about it, but I have never managed to get it,” says Esther, 31, sitting in the tiny village on the island of Ambae, in Vanuatu. On her lap is her youngest child, Elijah. Next to her on the mat is her two-year-old child, Stewart. Running around outside her modest house are her four other children - George, 12, James, 10, Steven, 8, and Judith, 6. Esther lives on the Manaro Voui volcano in Vanuatu - where sudden recent seismic activity causes it to belch toxic fumes. Esther’s husband is barely home. Her second youngest, Stewart, has a disability and cannot walk. Her youngest, Elijah, was born one week before the family were forced to evacuate to another island. Entire island evacuated On her own, Esther packed up their home and safely brought her children to the evacuation centre. This was the first time that an entire island population had been evacuated in the Pacific Region. Once the threat level was decreased and the population returned, the Vanuatu Family Health Association, through the International Planned Parenthood Federation, commenced a humanitarian response with mobile health clinics and awareness sessions. The services available through the clinics included pregnancy and delivery support, contraceptives such as condoms, injectables, implants and emergency contraceptives, and screening and management of sexually transmitted infections.   Often the communities were in areas that were impassable by road, so the VHFA response team - which included nurses and midwives - travelled by boat and foot with their medical supplies to reach those closest to the crater. Esther lived in one of those villages, evident by the smoke constantly billowing out of the crater in the near distance. Raising six children alone was already difficult for Esther but her life was made even harder during and after the evacuation. Emergency situations are particularly unsafe for women and children, who are more likely to die during an emergency than men. Transmission rates of sexually transmitted infections - including HIV - increase during an emergency, as does sexual violence and maternal deaths. Esther desperately wanted access to long term contraceptives. The nearest clinic for her is a two-hour way away, almost impossible with six children in tow. When the Vanuatu Family Health Association arrived at her village they were able to counsel her about her contraceptive options, and return the following week to give Esther a five-year contraceptive implant. Increased sexual literacy ‘Mothers do everything in Vanuatu, so having a smaller family makes it easier to move around in emergencies,’ says Julie Aru, a nurse working with VHFA during their humanitarian response. This is particularly important in Vanuatu, which according to the World Risk Index, is the most disaster-prone country in the world. ‘But the biggest issue is isolation. Mothers do not have access to family planning even in stable times,” says Julie. “The second issue is ‘kastom’ - religious and cultural beliefs – which sometimes don’t allow women access to family planning. We are working to change this.” Whilst emergencies create immense challenges, they also provide opportunities for organisations like the Vanuatu Family Health Association to reach remote communities such as Esther’s, to increase sexual literary rates, and to provide women with reproductive choices. By the end of the response, VHFA had reached over 1,600 people across the southern part of Ambae Island with sexual and reproductive health care and information, and 480 dignity kits were distributed on North and East Ambae.

The earthquake destroyed entire villages credits: IPPF/Jon Spaull/2017
25 July 2017

Continuing contraception services and women's health in the wake of disaster, Nepal

Just before midday on Saturday 25 April 2015, a 7.8 magnitude earthquake shook Nepal, causing massive devastation and loss of life. It was the worst natural disaster to strike the country for 80 years – and one the country is still recovering from. Three million people were displaced, 22,000 were injured and 9,000 people lost their lives. According to UNDP, 800,000 homes, were damaged or destroyed. A Nepalese government assessment in 2015 estimated the cost of damage, loss and reconstruction to be $14.6 billion – around three quarters of the country’s entire gross domestic product for 2015 The stories of survivors are harrowing. Twenty-two-year-old Anjana Suwal spent five hours trapped in the rubble of her family’s house. “I was thinking to myself: this is going to be the end of my life: I won’t survive,” she says. “I could hear sounds from outside and I began shouting and shouting, but no one heard me. My throat began to get sore and eventually I couldn’t make any more sounds: I felt so hopeless.” Others speak of their desperate searches to find their children, alongside bittersweet gratitude that the earthquake had occurred on a Saturday rather than an ordinary school day, when the loss of life could have been far higher. The effect on healthcare and family planning was severe. Clinics and hospitals were destroyed and those that survived quickly became overcrowded and had turn away hundreds of injured patients. Millions of people were forced from their homes into tents, often many miles from their usual clinics and family planning centres. Women, girls and orphans were particularly vulnerable: living in tents exposed them to sexual violence, while menstrual hygiene and basic cleanliness in the searing April heat became a struggle. “There was always the fear of getting abused,” says FPAN volunteer Rita Tukanbanjar, who spent 20 days living in a tent after the earthquake. Hitting the ground running When the earthquake struck, FPAN lost no time in taking action. The first job was to do a needs assessment. Then, within 48 hours, FPAN had set up mobile health camps across the country, providing family planning services as well as general health check ups. The team offered essential items like oral rehydration, medicines, food and water. They also distributed contraception and dignity kits, provided women with antenatal checks, and set up blood-testing labs and psycho-social counselling services. Women- and children-friendly spaces provided a haven for the most vulnerable to retreat to in safety. The organisation also organised classes on menstrual hygiene and taught women and girls how to make sanitary pads from scratch. “During that time, girls were facing a lot of problems maintaining their menstrual hygiene,” explains FPAN volunteer Rita Tukanbanjar. “All the shops and services for menstrual hygiene were closed.” FPAN’s classes provided a vital service to women and girls, as well as valuable knowledge for life after the emergency response. Up in the mountains of Rasuwa, close to the border with Tibet, FPAN ran a three-month mobile health camp, providing basic healthcare and family planning services. Equipped for future disasters FPAN, like Nepal, still has visible earthquake damage. “Most of our service delivery points in the Kathmandu Valley are still damaged,” says Sharad Kumar Argal. But amid the tragedy and loss of the earthquake, the impressive and efficient emergency response it galvanised has left FPAN in a much stronger position, should another natural disaster strike Nepal. It also mobilised a huge number of young people to help: many of these volunteers are still working for FPAN, delivering vital sexuality education and community home-based care services.

Fiji family helped by IPPF
05 April 2017

Helping Fijian communities to rebuild after Cyclone Winston

Cyclone Winston that devastated Fiji was the strongest to ever hit the South Pacific. IPPF’s humanitarian response there is part of our SPRINT Initiative, funded by the Australian Government’s Department of Foreign Affairs and Trade. In 2016, the highest grade cyclone to ever hit the South Pacific devastated Fiji, affecting 40% of the population. IPPF was among the first on the ground providing critical life-saving services: sexual and reproductive health provisions, which are often neglected when disaster strikes. In the wake of a crisis, sexual violence often escalates, leaving women and young people vulnerable to STIs and unwanted pregnancy.  It is estimated that approximately 20% of women are pregnant at any given time during an humanitarian crisis, and with the help of our local Member Associations on the ground, we prioritize services to women and young girls, especially those who are pregnant and lactating, as well as new mothers. Xerxes Arcenal was part of the team which traveled to Viti Levu, the remote Fijian villages affected by the cyclone, to deliver much-needed medical attention and supplies. During their travels, he saw all the health facilities down and the schools down. "The young people will have nothing to do. This is a special concern for NGOs, as it is a critical time in the lives of adolescents, and it is not ideal for them to be left idle for a long time." Our local IPPF Member Association, the Reproductive and Family Health Association of Fiji, was instrumental in connecting with the local communities. This was important because cultural restrictions make it hard to discuss issues of sex within Fijian communities, which is a barrier to delivering sexual health issues. Xexes also stresses that sexual and reproductive health should not be considered an optional extra when it comes to any NGO mounting a response to a humanitarian disaster. Girls continue to menstruate, women continue to give birth, couples continue to have sex in the confused and chaotic weeks and months after a natural disaster. There will be cases of sexual violence, particularly when situations are stressful or people are forced to live in makeshift shared shelters. Unprotected sex will result in unplanned pregnancies, and children born in chaotic circumstances may fall behind on their development markers. “If you talk to the government they will say, we don’t need to respond to reproductive health right now, it’s not life threatening. So you initially get resistance from partners, from government, and you have to work around that, constantly engage them in discussion, show them proof of what happens.” At the same time, he identified the main challenge as squaring the gap between expectation and reality: the expectations of funders that a successful humanitarian aid mission should be based on numbers to whom services were delivered to, rather than the reality on the ground, where there might not be mass numbers who need attention, but rather, difficult circumstances that need to be overcome in order to deliver aid. “As it is in every disaster, it will relate to funds. No matter the road conditions, if you have enough resources you will be able to overcome it. The geo-economic situation of Fiji and other countries in the Pacific makes prices, cost of services and commodities very high. Add disaster to that, it will be ten times normal,” say Xerxes. “As it was, we would need our own vehicles [to effeciently deliver aid]. In Rakiraki we would love to serve one of the villages but you need a chopper to be able to reach the area. So these things are very challenging.” For Tarai Nakolinivalu, IPPF's Humanitarian response leader and former midwife, the Cyclone Winston response provided invaluable learning on how best to deal with the aftermath of natural disasters in Fiji. Tarai was part of the IPPF team that was involved in distributing aid to affected communities “Some of the roads were washed away, even bridges, so it was hard to drive,” says Tarai. The team travelled to villages to find sometimes great damage: trees uprooted, houses destroyed, sometimes more than 100 people living together in the community hall. One of the biggest challenges is that Given the strained circumstances, the team sometimes had to forego some Fijian customs, like the traditional kava ceremony which is undertaken by the village to show outsiders they are welcome. “The learning is to always be prepared because we never know. Because of climate change, natural disasters are here to stay now. We can’t be complacent here in Fiji.”   Stories Read more stories about our work in Fiji after the Cyclone Winston

IDP camp in Yemen, served by IPPF
17 May 2017

Humanitarian crises are not temporary, nor are sexual and reproductive health needs

Women and girls are disproportionately affected in humanitarian crises and face multiple sexual and reproductive health challenges in these contexts. IPPF has been providing much needed support to vulnerable communities through our global federation of member associations, who provide contextualised, timely and tailored interventions drawing on local partners' knowledge and expertise. However, recent shifts in the global political landscape are concerning and threaten to undermine IPPF's mission and impact on the ground. We live in a time when crises, whether brought on by human causes or natural disaster, have displaced more people than at any point since the Second World War. The needs of those driven from their homes are not transitory. Refugees now find themselves facing impermanent conditions for an average of 20 years. They must resort to living in temporary shelters or makeshift accommodation, and their refugee status often leaves them ineligible to access public healthcare and education. The UN reports there are more than 125 million people worldwide in need of humanitarian assistance. Of those, a quarter are women and girls between the ages of 15 and 49. And one in five of these women and girls is likely to be pregnant. A woman who has been forced to flee is particularly vulnerable. More than 60% of maternal deaths take place in humanitarian and fragile contexts, according to the UN Population Fund (UNFPA). At least half of these women’s lives could easily be saved. And yet women and girls affected by humanitarian crises face other risks too. A breakdown in civil order following disasters consistently increases the occurrence of sexual violence, exposure to sexually transmitted infections including HIV, and unintended pregnancies. After the 2015 cyclone in the Pacific Island nation of Vanuatu, a counselling centre recorded a 300% spike in gender-based violence referrals. Likewise, a study with Syrian refugee women displaced by conflict found that more than 50% experienced reproductive tract infections, almost a third had experienced gender-based violence, and the majority had not sought medical care. IPPF is at the forefront of delivering life-saving services. Our sexual and reproductive health program in crisis and post-crisis situations (SPRINT), established in 2007 and supported by the Australian Government, has ensured access to essential sexual and reproductive health services for women, men and children in times of crisis. Under the banner of our new IPPF Humanitarian division, the SPRINT initiative is now part of a global movement that seeks to provide all those affected by crises worldwide with dignity, protection and care. As a federation of 142 locally-owned but globally connected member associations, IPPF has a unique model for providing these vital humanitarian services. Our focus on valuing local solutions means our responses are rapid and sustainable. We see it as vital to be on the ground before, during, and after crises. Member associations work to mitigate against sexual and reproductive health (SRH) issues ahead of a crisis to reduce negative impacts, and remain afterward to assist communities to recover and rebuild their lives. When Cyclone Winston struck Fiji in February last year, IPPF’s local member association, the Reproductive and Family Health Association of Fiji (RFHAF), was already preparing to mobilise teams of volunteers and health staff. Initially, sexual and reproductive health was not prioritised at a national level, thus the first challenge was to convince the Government of Fiji and lead agencies of the critical importance of including sexual and reproductive health issues in the response. With support from IPPF and SPRINT personnel, RFHAF successfully advocated with the government to include reproductive health concerns into the post-cyclone needs assessment, and supported the Government in carrying this assessment out. Coordination and collaboration was critical as the damage was across an extensive area on several islands. Working in partnership with the Ministry of Health (MoH), UNFPA, Red Cross Society and local non-government agencies, RFHAF provided SRH care to remote areas identified as being worst hit by the cyclone. Colleagues from SPRINT and RFHAF split into three teams, moving into the field simultaneously to conduct 37 mobile medical missions to reach women and girls, with vulnerable pregnant women and new mothers prioritised. Comprehensive follow up beyond the initial response post-cyclone was a particular challenge for an organisation of just 11 staff. To address this, RFHAF leveraged their existing partnership with the MoH to facilitate training and handover of SRH service provision to district nurses and sub-divisional health centres, once these facilities were again operational. The response in Fiji utilised the Minimum Initial Service Package for Reproductive Health, which IPPF helped to pioneer. Commonly referred to as ‘the MISP’, the package is a series of priority life-saving interventions that IPPF seek to implement as soon as possible following a crisis.

Emergency appeal for the Tsunami & Earthquake in Indonesia
02 October 2018

Emergency appeal for the earthquake and tsunami in Indonesia

Updated 18 October 2018 We are continuing our response to the earthquake and tsunami of 28 September through our local partner the Indonesia Planned Parenthood Association. The latest death tolls stands at over 2,100 people and sadly, is expected to rise. Our response team remains on the ground and our supplies have started to arrive, such as much needed contraceptives and mobile sexual and reproductive tents. Our response During all emergencies, women and marginalised groups are the most vulnerable. In the coming days, and weeks, we will continue to expand our reach to the 78,994 people still displaced by this double disaster with clinical services such as prenatal care, STI and HIV screenings, contraceptive provision and gender based violence screening. Our team from the Indonesia Planned Parenthood Association has been operating locally since 1957 so is well placed to respond to the needs to the local population and work closely with the Indonesia Government in their response efforts. Our emergency appeal  Our emergency fund will allow us to reach more people with these much needed, and overlooked, services. 100 percent of the donations made to this fund will go directly to our partner the Indonesia Planned Parenthood Association to allow them to continue their services. Please donate now. Donate now Our Member Association, the Indonesia Planned Parenthood Association (IPPA) has an office and clinic in Palu City and is currently sending additional support from other IPPA offices to Palu. As well as undertaking initial assessments of the urgent SRH needs, the team will distribute prepositioned hygiene kits to affected communities. IPPA has also sent their medical doctor from Makassar to the field as part of a joint outreach team with the Indonesian Government health response team.  Satyawanti Mashudi, Executive Director of IPPA, says:  "Indonesia has been rocked by a series of natural disasters lately, but Friday’s earthquake and tsunami double disaster has caused a catastrophic amount of destruction and loss of life. We are grateful that all our local staff have been safely accounted for, and now our attention must go towards the affected communities and their sexual and reproductive health needs. With tens of thousands of people sleeping in temporary shelters, and many more displaced, we know from experience the SRH needs will be high, and urgent."   With a total population of 1.5 million in affected areas, we know that as many as 375,000 of those are women of reproductive age, 300,000 are sexually active men and as many as 27,225 women could be pregnant. It is crucial we can reach these populations during the initial days and weeks after the disaster to provide life-saving SRH care.  Donate now

Delivering supplies to Vanuatu
19 December 2017

Emergency care in the most disaster-prone country in the world

“All I do is sit and cry with my children. I want family planning so bad. I’ve known about it, but I have never managed to get it,” says Esther, 31, sitting in the tiny village on the island of Ambae, in Vanuatu. On her lap is her youngest child, Elijah. Next to her on the mat is her two-year-old child, Stewart. Running around outside her modest house are her four other children - George, 12, James, 10, Steven, 8, and Judith, 6. Esther lives on the Manaro Voui volcano in Vanuatu - where sudden recent seismic activity causes it to belch toxic fumes. Esther’s husband is barely home. Her second youngest, Stewart, has a disability and cannot walk. Her youngest, Elijah, was born one week before the family were forced to evacuate to another island. Entire island evacuated On her own, Esther packed up their home and safely brought her children to the evacuation centre. This was the first time that an entire island population had been evacuated in the Pacific Region. Once the threat level was decreased and the population returned, the Vanuatu Family Health Association, through the International Planned Parenthood Federation, commenced a humanitarian response with mobile health clinics and awareness sessions. The services available through the clinics included pregnancy and delivery support, contraceptives such as condoms, injectables, implants and emergency contraceptives, and screening and management of sexually transmitted infections.   Often the communities were in areas that were impassable by road, so the VHFA response team - which included nurses and midwives - travelled by boat and foot with their medical supplies to reach those closest to the crater. Esther lived in one of those villages, evident by the smoke constantly billowing out of the crater in the near distance. Raising six children alone was already difficult for Esther but her life was made even harder during and after the evacuation. Emergency situations are particularly unsafe for women and children, who are more likely to die during an emergency than men. Transmission rates of sexually transmitted infections - including HIV - increase during an emergency, as does sexual violence and maternal deaths. Esther desperately wanted access to long term contraceptives. The nearest clinic for her is a two-hour way away, almost impossible with six children in tow. When the Vanuatu Family Health Association arrived at her village they were able to counsel her about her contraceptive options, and return the following week to give Esther a five-year contraceptive implant. Increased sexual literacy ‘Mothers do everything in Vanuatu, so having a smaller family makes it easier to move around in emergencies,’ says Julie Aru, a nurse working with VHFA during their humanitarian response. This is particularly important in Vanuatu, which according to the World Risk Index, is the most disaster-prone country in the world. ‘But the biggest issue is isolation. Mothers do not have access to family planning even in stable times,” says Julie. “The second issue is ‘kastom’ - religious and cultural beliefs – which sometimes don’t allow women access to family planning. We are working to change this.” Whilst emergencies create immense challenges, they also provide opportunities for organisations like the Vanuatu Family Health Association to reach remote communities such as Esther’s, to increase sexual literary rates, and to provide women with reproductive choices. By the end of the response, VHFA had reached over 1,600 people across the southern part of Ambae Island with sexual and reproductive health care and information, and 480 dignity kits were distributed on North and East Ambae.

The earthquake destroyed entire villages credits: IPPF/Jon Spaull/2017
25 July 2017

Continuing contraception services and women's health in the wake of disaster, Nepal

Just before midday on Saturday 25 April 2015, a 7.8 magnitude earthquake shook Nepal, causing massive devastation and loss of life. It was the worst natural disaster to strike the country for 80 years – and one the country is still recovering from. Three million people were displaced, 22,000 were injured and 9,000 people lost their lives. According to UNDP, 800,000 homes, were damaged or destroyed. A Nepalese government assessment in 2015 estimated the cost of damage, loss and reconstruction to be $14.6 billion – around three quarters of the country’s entire gross domestic product for 2015 The stories of survivors are harrowing. Twenty-two-year-old Anjana Suwal spent five hours trapped in the rubble of her family’s house. “I was thinking to myself: this is going to be the end of my life: I won’t survive,” she says. “I could hear sounds from outside and I began shouting and shouting, but no one heard me. My throat began to get sore and eventually I couldn’t make any more sounds: I felt so hopeless.” Others speak of their desperate searches to find their children, alongside bittersweet gratitude that the earthquake had occurred on a Saturday rather than an ordinary school day, when the loss of life could have been far higher. The effect on healthcare and family planning was severe. Clinics and hospitals were destroyed and those that survived quickly became overcrowded and had turn away hundreds of injured patients. Millions of people were forced from their homes into tents, often many miles from their usual clinics and family planning centres. Women, girls and orphans were particularly vulnerable: living in tents exposed them to sexual violence, while menstrual hygiene and basic cleanliness in the searing April heat became a struggle. “There was always the fear of getting abused,” says FPAN volunteer Rita Tukanbanjar, who spent 20 days living in a tent after the earthquake. Hitting the ground running When the earthquake struck, FPAN lost no time in taking action. The first job was to do a needs assessment. Then, within 48 hours, FPAN had set up mobile health camps across the country, providing family planning services as well as general health check ups. The team offered essential items like oral rehydration, medicines, food and water. They also distributed contraception and dignity kits, provided women with antenatal checks, and set up blood-testing labs and psycho-social counselling services. Women- and children-friendly spaces provided a haven for the most vulnerable to retreat to in safety. The organisation also organised classes on menstrual hygiene and taught women and girls how to make sanitary pads from scratch. “During that time, girls were facing a lot of problems maintaining their menstrual hygiene,” explains FPAN volunteer Rita Tukanbanjar. “All the shops and services for menstrual hygiene were closed.” FPAN’s classes provided a vital service to women and girls, as well as valuable knowledge for life after the emergency response. Up in the mountains of Rasuwa, close to the border with Tibet, FPAN ran a three-month mobile health camp, providing basic healthcare and family planning services. Equipped for future disasters FPAN, like Nepal, still has visible earthquake damage. “Most of our service delivery points in the Kathmandu Valley are still damaged,” says Sharad Kumar Argal. But amid the tragedy and loss of the earthquake, the impressive and efficient emergency response it galvanised has left FPAN in a much stronger position, should another natural disaster strike Nepal. It also mobilised a huge number of young people to help: many of these volunteers are still working for FPAN, delivering vital sexuality education and community home-based care services.

Fiji family helped by IPPF
05 April 2017

Helping Fijian communities to rebuild after Cyclone Winston

Cyclone Winston that devastated Fiji was the strongest to ever hit the South Pacific. IPPF’s humanitarian response there is part of our SPRINT Initiative, funded by the Australian Government’s Department of Foreign Affairs and Trade. In 2016, the highest grade cyclone to ever hit the South Pacific devastated Fiji, affecting 40% of the population. IPPF was among the first on the ground providing critical life-saving services: sexual and reproductive health provisions, which are often neglected when disaster strikes. In the wake of a crisis, sexual violence often escalates, leaving women and young people vulnerable to STIs and unwanted pregnancy.  It is estimated that approximately 20% of women are pregnant at any given time during an humanitarian crisis, and with the help of our local Member Associations on the ground, we prioritize services to women and young girls, especially those who are pregnant and lactating, as well as new mothers. Xerxes Arcenal was part of the team which traveled to Viti Levu, the remote Fijian villages affected by the cyclone, to deliver much-needed medical attention and supplies. During their travels, he saw all the health facilities down and the schools down. "The young people will have nothing to do. This is a special concern for NGOs, as it is a critical time in the lives of adolescents, and it is not ideal for them to be left idle for a long time." Our local IPPF Member Association, the Reproductive and Family Health Association of Fiji, was instrumental in connecting with the local communities. This was important because cultural restrictions make it hard to discuss issues of sex within Fijian communities, which is a barrier to delivering sexual health issues. Xexes also stresses that sexual and reproductive health should not be considered an optional extra when it comes to any NGO mounting a response to a humanitarian disaster. Girls continue to menstruate, women continue to give birth, couples continue to have sex in the confused and chaotic weeks and months after a natural disaster. There will be cases of sexual violence, particularly when situations are stressful or people are forced to live in makeshift shared shelters. Unprotected sex will result in unplanned pregnancies, and children born in chaotic circumstances may fall behind on their development markers. “If you talk to the government they will say, we don’t need to respond to reproductive health right now, it’s not life threatening. So you initially get resistance from partners, from government, and you have to work around that, constantly engage them in discussion, show them proof of what happens.” At the same time, he identified the main challenge as squaring the gap between expectation and reality: the expectations of funders that a successful humanitarian aid mission should be based on numbers to whom services were delivered to, rather than the reality on the ground, where there might not be mass numbers who need attention, but rather, difficult circumstances that need to be overcome in order to deliver aid. “As it is in every disaster, it will relate to funds. No matter the road conditions, if you have enough resources you will be able to overcome it. The geo-economic situation of Fiji and other countries in the Pacific makes prices, cost of services and commodities very high. Add disaster to that, it will be ten times normal,” say Xerxes. “As it was, we would need our own vehicles [to effeciently deliver aid]. In Rakiraki we would love to serve one of the villages but you need a chopper to be able to reach the area. So these things are very challenging.” For Tarai Nakolinivalu, IPPF's Humanitarian response leader and former midwife, the Cyclone Winston response provided invaluable learning on how best to deal with the aftermath of natural disasters in Fiji. Tarai was part of the IPPF team that was involved in distributing aid to affected communities “Some of the roads were washed away, even bridges, so it was hard to drive,” says Tarai. The team travelled to villages to find sometimes great damage: trees uprooted, houses destroyed, sometimes more than 100 people living together in the community hall. One of the biggest challenges is that Given the strained circumstances, the team sometimes had to forego some Fijian customs, like the traditional kava ceremony which is undertaken by the village to show outsiders they are welcome. “The learning is to always be prepared because we never know. Because of climate change, natural disasters are here to stay now. We can’t be complacent here in Fiji.”   Stories Read more stories about our work in Fiji after the Cyclone Winston

IDP camp in Yemen, served by IPPF
17 May 2017

Humanitarian crises are not temporary, nor are sexual and reproductive health needs

Women and girls are disproportionately affected in humanitarian crises and face multiple sexual and reproductive health challenges in these contexts. IPPF has been providing much needed support to vulnerable communities through our global federation of member associations, who provide contextualised, timely and tailored interventions drawing on local partners' knowledge and expertise. However, recent shifts in the global political landscape are concerning and threaten to undermine IPPF's mission and impact on the ground. We live in a time when crises, whether brought on by human causes or natural disaster, have displaced more people than at any point since the Second World War. The needs of those driven from their homes are not transitory. Refugees now find themselves facing impermanent conditions for an average of 20 years. They must resort to living in temporary shelters or makeshift accommodation, and their refugee status often leaves them ineligible to access public healthcare and education. The UN reports there are more than 125 million people worldwide in need of humanitarian assistance. Of those, a quarter are women and girls between the ages of 15 and 49. And one in five of these women and girls is likely to be pregnant. A woman who has been forced to flee is particularly vulnerable. More than 60% of maternal deaths take place in humanitarian and fragile contexts, according to the UN Population Fund (UNFPA). At least half of these women’s lives could easily be saved. And yet women and girls affected by humanitarian crises face other risks too. A breakdown in civil order following disasters consistently increases the occurrence of sexual violence, exposure to sexually transmitted infections including HIV, and unintended pregnancies. After the 2015 cyclone in the Pacific Island nation of Vanuatu, a counselling centre recorded a 300% spike in gender-based violence referrals. Likewise, a study with Syrian refugee women displaced by conflict found that more than 50% experienced reproductive tract infections, almost a third had experienced gender-based violence, and the majority had not sought medical care. IPPF is at the forefront of delivering life-saving services. Our sexual and reproductive health program in crisis and post-crisis situations (SPRINT), established in 2007 and supported by the Australian Government, has ensured access to essential sexual and reproductive health services for women, men and children in times of crisis. Under the banner of our new IPPF Humanitarian division, the SPRINT initiative is now part of a global movement that seeks to provide all those affected by crises worldwide with dignity, protection and care. As a federation of 142 locally-owned but globally connected member associations, IPPF has a unique model for providing these vital humanitarian services. Our focus on valuing local solutions means our responses are rapid and sustainable. We see it as vital to be on the ground before, during, and after crises. Member associations work to mitigate against sexual and reproductive health (SRH) issues ahead of a crisis to reduce negative impacts, and remain afterward to assist communities to recover and rebuild their lives. When Cyclone Winston struck Fiji in February last year, IPPF’s local member association, the Reproductive and Family Health Association of Fiji (RFHAF), was already preparing to mobilise teams of volunteers and health staff. Initially, sexual and reproductive health was not prioritised at a national level, thus the first challenge was to convince the Government of Fiji and lead agencies of the critical importance of including sexual and reproductive health issues in the response. With support from IPPF and SPRINT personnel, RFHAF successfully advocated with the government to include reproductive health concerns into the post-cyclone needs assessment, and supported the Government in carrying this assessment out. Coordination and collaboration was critical as the damage was across an extensive area on several islands. Working in partnership with the Ministry of Health (MoH), UNFPA, Red Cross Society and local non-government agencies, RFHAF provided SRH care to remote areas identified as being worst hit by the cyclone. Colleagues from SPRINT and RFHAF split into three teams, moving into the field simultaneously to conduct 37 mobile medical missions to reach women and girls, with vulnerable pregnant women and new mothers prioritised. Comprehensive follow up beyond the initial response post-cyclone was a particular challenge for an organisation of just 11 staff. To address this, RFHAF leveraged their existing partnership with the MoH to facilitate training and handover of SRH service provision to district nurses and sub-divisional health centres, once these facilities were again operational. The response in Fiji utilised the Minimum Initial Service Package for Reproductive Health, which IPPF helped to pioneer. Commonly referred to as ‘the MISP’, the package is a series of priority life-saving interventions that IPPF seek to implement as soon as possible following a crisis.