With support from the Government of Japan, International Planned Parenthood Federation’s (IPPF) Member Associations in five countries, namely Afghanistan, Palestine, Sudan, Ukraine and Yemen, will provide urgent sexual and reproductive health (SRH) services to communities affected by natural disasters and conflict situations.  These IPPF Member Associations will: Provide sexual and reproductive health (SRH) and maternal and child health services for women and girls and marginalized communities in six remote and flood affected provinces in Afghanistan; Provide urgent sexual and reproductive health services to communities affected by the escalating violence in Palestine; Improve accessibility of services and community sustainability to decrease sexual and reproductive health-related mortality and morbidity of women and girls in three States with high internally-displaced populations in Sudan; Restore health facilities and access to maternal health services in conflict affected areas for populations affected by the destruction of the Kakhovka Dam in Ukraine;  Provide critical sexual, reproductive and maternal health care to internally displaced people and local communities in Yemen. This vital funding from Japan will help with provision of badly needed but currently missing health services, especially for women, so that they can live with dignity and free from unwanted pregnancies, death of themselves and their newborns, and reproductive ill-health. It will allow us to provide essential and quality SRH and maternal and child health services in the communities, prevent and manage the consequences of sexual and gender-based violence, including the clinical management of rape, equip community-based midwives with skills to provide high quality obstetric and neonatal services and strengthen health information systems to collect high quality data to respond to the needs and priorities of women and girls’ health. IPPF Director General, Dr Alvaro Bemejo, said, "I offer heartfelt thanks to the Government of Japan for their  unparalleled generosity to enable IPPF to respond to the needs of women and girls caught up in crises around the world. This generosity will allow IPPF and our local partners to provide a critical lifeline to the growing number of people in desperate need of humanitarian assistance."   By the end of December 2024, IPPF, through our local partners in the five countries, will aim to deliver health services and information to at least 239,000 people in total.   For further information, please contact Yuri Taniguchi, IPPF London Office, at [email protected].   Photo Credits: IPPF/Hannah Maule-ffinch/Sudan

Week after week, heavy Israeli bombardment from air, land, and sea, has continued across most of the Gaza Strip. According to the Ministry of Health, at least 21,320 Palestinians have been killed in Gaza since October 7th, about 70% of whom are women and children. Nearly 2 million people have been displaced from their homes, forced to live in extremely overcrowded and unsanitary shelters. The Ministry of Health says that 50% of pregnant women in the shelters suffer from thirst and malnutrition, and there is a lack of health care and vaccinations for newborns.  The suffering is unimaginable, yet it is all too real.  Many of those bearing witness to the seemingly endless death and misery are frontline healthcare workers - including those delivering sexual and reproductive healthcare. But they, too, are at risk of being killed just for doing their jobs. Israel continues to bombard Gaza’s health facilities and residential areas, despite mounting international pressure for a ceasefire - something IPPF and many other humanitarian organisations have been demanding for months. According to the World Health Organization (WHO) there have been more than 200 Israeli attacks on hospitals and ambulances since Oct. 7, with many medical workers detained during Israeli raids. At least 300 healthcare workers have been reported killed, according to the UN. This is more than the total number of health worker deaths recorded across all countries in conflict last year, and in any single year since 2016.   Staff at IPPF's local member association, the Palestinian Family Planning and Protection Association (PFPPA), are among the heroic healthcare workers in Gaza that continue to provide care as best they can in the ongoing humanitarian catastrophe. We fear for their safety - and that of the 2.3 million civilians in Gaza - every single day. In their own words, PFPPA and other health workers describe what it's like to provide care under bombardment and blockade in Gaza and in the West Bank - offering glimpses of terror, devastation, and even some hope. 

Conflict everywhere is a reproductive health and justice issue. This reality is acutely felt in Palestine, where women have faced barriers and systematic denial to comprehensive sexual and reproductive health and rights since long before Israel’s declaration of war on the Gaza Strip in October. The consequences of this essential health care service denial exhibit gendered patterns disproportionately impacting aspects of women's sexual and reproductive health, such as pregnancy, childbirth, menstruation, contraceptive access and bodily autonomy.   To be a woman in Gaza right now is to have your basic needs – and your life – relegated to the backseat. It’s not a coincidence that the vast majority of the more than 17,000 deaths in Gaza so far are women and children. The systematic denial of sexual and reproductive health and rights in Palestine - and the urgency in integrating these services into broader humanitarian responses in Gaza and the West Bank - is a crucial point of discussion.   Palestinians have long been systematically denied their sexual and reproductive health and rights  Prior to 7 October, around 94,000 Palestinian women lacked access to sexual and reproductive health services, as reported by the United Nations Population Fund (UNFPA). Likewise, the UN had previously stated that restricted movement adversely affects maternity services, influences decisions regarding labor induction and c-sections, and deters postnatal care-seeking due to travel challenges. 

15 November 2023 - With the forced closure of Gaza’s largest hospital, Al Quds, due to the lack of fuel and incessant Israeli bombardment, and the recent storming of al-Shifa Hospital by Israeli forces, midwives are a lifeline for the estimated 180 women who are giving birth each day.  As of 13 November, all but one of the hospitals in Gaza City and northern Gaza are reportedly out of service due to lack of power, medical consumables, oxygen, food and water, compounded by bombardments and fighting in their vicinities, according to OCHA. 26 year old Narmeen Al Shafee is a midwife currently living in Deir al-Balah in central Gaza, who has previously worked with the Palestinian Family Planning and Protection Association (PFPPA) outreach team. She describes the case of a 29-year-old pregnant woman who fled along with her family from Sheikh Radwan to Deir al-Balah to seek refuge in a school shelter near her home. The women was in her ninth month of pregnancy and not long after being displaced from her home she underwent a cesarean section. Midwife Al Shafee said: “After giving birth, and for her own safety, the shelters did not want to accommodate her due to the widespread infectious diseases and [the] high risk of infection since she had a cesarean section. Her husband was calling out in the streets for someone to receive his wife and three children. My parents welcomed them into our home to take care of her. I would change her bandages daily and monitor her and her child. After ten days, I removed the stitches. Thank God, her condition is now stable, and there are no problems.” In a separate case, Al Shafee describes caring for her 23-year-old cousin who was pregnant for the first time and lost her husband early in the war. “Her delivery date was approaching, and she gave birth at Nasser Hospital in Khan Younis [in southern Gaza]. Her child faced complications during birth, and due to the bombings she sought refuge with us. I took care of her and her child until their situation stabilized. Now, I am helping her with breastfeeding, as she is finding it difficult.” Aminah*, another midwife who has also previously worked with the PFPPA outreach team, said: “I’ve been in contact with two pregnant women multiple times, providing weekly consultations. One woman experienced severe cramps, and after offering advice, she was referred to the hospital. She needed lung maturation injections for the fetus, along with rest and nutritional supplements and iron. Another woman, 29 weeks pregnant, suffered dizziness and vomiting and she took Ancozine [an antiemetic] for nausea during the visit. I also found out that she was taking iron and provided her with information on the correct way to take iron tablets in order for her to benefit from them as needed. I am also providing information to women in my area and around me hoping that it will help them if and when needed.” According to data from the UNFPA, there are an estimated 50,000 pregnant women in Gaza, with 15% expected to encounter complications. In many instances women are only admitted to hospital when they are fully dilated, with some forced to deliver their babies in cars, in the streets, and in overcrowded shelters where the risk of infection and the spread of disease is high. There are reports of c-sections bring performed without anesthesia, and there is currently no type of post natal care available in Gaza.  Levels of early labor and miscarriages are expected to increase with the trauma and conditions being faced.  Al Ahli Hospital, in Gaza City, which currently accommodates over 500 patients, is reportedly the sole medical facility able to receive patients, amid increasing shortages and challenges. In Shifa hospital, 32 patients, including three premature babies, have reportedly died since 11 November, following the power cut and amid dire conditions. Without a full and immediate ceasefire, and the unimpeded delivery of humanitarian aid across all parts of Gaza, maternal and neonatal deaths will continue to rise. For media enquiries, or to speak to our staff member in Palestine, please contact [email protected] Click here to donate to IPPF's emergency appeal for Palestine. About PFPPA Established in Jerusalem in 1964, the Palestinian Family Planning and Protection Association (PFPPA) is locally registered as an independent, non-profit and non-governmental association with headquarters in Jerusalem. PFPPA has service delivery points located in the West Bank Areas of Ramallah, Bethlehem, Hebron and Halhoul, in addition to one in the Gaza Strip, which has yet to be relocated after it was destroyed following an Israeli airstrike on 8 October. Furthermore, and in cooperation with local partners, PFPPA is also responsible for 3 safe spaces to provide Gender Based Violence (GBV) related services in the Jerusalem area. About the International Planned Parenthood Federation IPPF, through its 149 Member Associations and collaborative partners, delivers high-quality sexual and reproductive healthcare and helps advance sexual and reproductive rights, especially for marginalized people with diverse needs that are currently unmet. IPPF's Member Associations and partners are locally owned, independent organisations, which means the support and care they provide are informed by local expertise and context. IPPF advocates for a world where people have the information they need to make informed decisions about their sexual and reproductive health and their bodies. We stand up and fight for sexual and reproductive rights and against those who seek to deny people their human right to bodily autonomy and sexual and reproductive freedom. We deliver care rooted in rights, respect, and dignity for all - no matter what. Banner image: Midwife Narmeen Al Shafee provides care to a newborn baby in Deir al-Balah, in central Gaza. 

Nama Abu Khalifa, a social worker with the Palestinian Family Planning and Protection Association (PFPPA) in the occupied West Bank, faces near-impossible challenges in getting to work every day.  "Every morning and evening, I undergo physical inspection by the Israeli occupation forces at the checkpoints,” she said. “Additionally, there are armed settler attacks on the roads, attempts to intimidate passersby, and the placement of iron gates to close the entrances and exits of the village, tightening the grip on its residents. The gates are closed and opened without any prior warning, making it difficult for me to return home."  Abu Khalifa works for the Ramallah branch - one of four PFPPA service delivery points across the West Bank that are still operational, despite tightened security and rising violence in the West Bank amid the ongoing war in the Gaza Strip. PFPPA’s only health center in the Gaza Strip was destroyed after an Israeli air strike hit an adjacent building on 8 October.  While all eyes are rightfully on the dire situation in Gaza, Israeli settler violence and increased movement restrictions in the West Bank mean Palestinians are also facing increasing challenges and risks when it comes to seeking sexual and reproductive health care. Attacks, forced displacement, rampant discrimination and harassment by Israeli forces continue – and have increased in the last month. According to the OCHA, nearly 2,000 Palestinians have been displaced amid settler violence since 2022, with 43% since 7 October, severely limiting Palestinians’ access to essential services. As of 20 November, the total number of Palestinians killed by Israeli forces in the West Bank, including East Jerusalem, is 200, including 52 children.

Today marks one month since Hamas launched its attack on civilians that triggered Israel’s declaration of an unprecedented war in the Gaza Strip, and a subsequent humanitarian catastrophe. Since 7 October, some 1,400 Israeli civilians have been killed, 200 hostages taken, and thousands injured, according to the Israeli authorities. In Gaza, over 10,000 people have been killed, the vast majority of whom are women and children. IPPF echoes international demands for an immediate and full ceasefire to prevent further atrocities. The continued bombing and rockets will make it virtually impossible to distribute any aid to civilians. In addition to the immediate need for fuel, water, food, and medicine for civilians in Gaza, the urgency of sexual and reproductive health care needs must not be overlooked. Alvaro Bermejo, IPPF Director General said: “Our colleagues in Gaza are currently sheltering for their lives, yet still delivering sexual and reproductive healthcare in any way they can amid appalling conditions. For 30 days, bombs have been falling across Gaza, leaving behind devastation and destruction unlike anything we have dealt with before as a Federation. In the absence of a full ceasefire, we are gravely concerned for the lives of our colleagues, civilians, and humanitarians who are desperately trying to deliver aid inside Gaza.” Insufficient supplies, resources and equipment for sexual and reproductive health and rights were already a pressing issue in Gaza, which has been under Israeli occupation and blockade for decades. Since 7 October, thousands of Palestinian mothers and children have been killed, marking a recurring stifling of reproductive justice in the region. Pregnant women are miscarrying due to stress and shock, and the availability of medical facilities to birth safely is now virtually non-existent. Women and girls are reporting a severe lack of menstrual hygiene products and contraceptives, and a rise in cases of sexually transmitted diseases and urinary tract infections with little to no medical treatment available. Without a full and immediate ceasefire, we can expect to see this vicious cycle continue, with thousands more maternal and newborn deaths. On top of this, we will see a rise in unintended pregnancies, the spread of sexually transmitted infections including HIV, and a rise in psychological trauma and conflict-related sexual violence, all of which will have long-term, generational impacts. We echo calls by the UN Inter-Agency Standing Committee to establish a robust aid operation in a safe and peaceful context. Gaza needs a coordinated effort that meets the urgent needs of all its people, including the particular sexual and reproductive healthcare needs of women, girls and vulnerable groups. There are no justifications for war crimes or grave violations of international humanitarian law, regardless of who commits them or against whom they are committed. We reaffirm that all people have the right to access emergency sexual and reproductive healthcare, no matter where, and no matter what. IPPF calls for an immediate ceasefire to end the violence, deaths and suffering of civilians in Israel and Palestine. This ceasefire is an essential precursor towards a path to peace with justice.   For media enquiries, or to speak to our staff member in Palestine, please contact [email protected] Click here to donate to IPPF's appeal for Palestine.   About PFPPA Established in Jerusalem in 1964, the Palestinian Family Planning and Protection Association (PFPPA) is locally registered as an independent, non-profit and non-governmental association with headquarters in Jerusalem. PFPPA has service delivery points located in the West Bank Areas of Ramallah, Bethlehem, Hebron and Halhoul, in addition to one in the Gaza Strip, which has yet to be relocated after it was destroyed following an Israeli airstrike on 8 October. Furthermore, and in cooperation with local partners, PFPPA is also responsible for 3 safe spaces to provide Gender Based Violence (GBV) related services in the Jerusalem area.   About the International Planned Parenthood Federation IPPF, through its 149 Member Associations and collaborative partners, delivers high-quality sexual and reproductive healthcare and helps advance sexual and reproductive rights, especially for marginalized people with diverse needs that are currently unmet. IPPF's Member Associations and partners are locally owned, independent organisations, which means the support and care they provide are informed by local expertise and context. IPPF advocates for a world where people have the information they need to make informed decisions about their sexual and reproductive health and their bodies. We stand up and fight for sexual and reproductive rights and against those who seek to deny people their human right to bodily autonomy and sexual and reproductive freedom. We deliver care rooted in rights, respect, and dignity for all - no matter what.  

Shelter conditions in Gaza for the estimated 1.4 million internally displaced people have become dire, with women and girls reporting a severe lack of menstrual hygiene products, cases of sexually transmitted diseases and urinary tract infections with little to no medical treatment available in the severely overcrowded shelters. Contraception is in very short supply, and according to our local team sheltering and providing services in Gaza, women are sharing contraceptive pills. Women with intrauterine contraceptive devices (IUDs) are experiencing bleeding and infections due to the unhygienic conditions in the camps. There are currently no options for IUD removal in Gaza, posing long term risks to women’s reproductive health, including severe bleeding. On 25 October, the UN said that fuel in Gaza could run out within hours, and that hospitals in the Gaza Strip are taking emergency cases only, which will prevent many women and girls from seeking sexual and reproductive health care. If Israel continues to block humanitarian aid including safe delivery kits from entering Gaza, many of the estimated 50,000 pregnant women[1] in Gaza will have no safe place to give birth, with at least 15% likely to experience complications[2], further compromising already stalled progress in reducing the rates of maternal morbidity and mortality. Wafa Abu-Hasheish, a health worker at PFPPA in Gaza said: “The shelter is suffering from a shortage of water, lack of medical care, and an increase in the incidence of diseases such as influenza, chest infections, skin ulcers, scabies, lice, and diarrheal diseases, and girls and women are reporting menstrual disturbance. There are also cases of sexually transmitted infections and urinary tract infections. Women using contraceptive pills are sharing their supplies with others." The number of internally displaced persons (IDPs) in Gaza is currently estimated at around 1.4 million (more than half the population), with a large part of that population living in overcrowded and under-supplied shelters with food, water, and fuel running out – and basic and life-sustaining services becoming more inaccessible by the hour. The mental and physical health toll on local health workers in Gaza is immense. Abu-Hasheish added: “On a personal level, being the service provider and being present in the shelter has caused me several psychological problems, stress, and fear. I also suffer problems such as neck ache and back muscle tension due to the inability to sleep or sit properly. I have contracted a flu and developed excessive breathing difficulties, but there is a lack of available treatment for displaced people due to the high number of patients and the scarcity of medicines. I had to go home for rest and relaxation, despite the dangers and lack of safety at home. Ammal Awadallah, the Executive Director of the Palestinian Family Planning and Protection Association (PFPPA) said: "If pregnant women are lucky enough to reach a health center or hospital, they are only admitted when they are fully dilated. And they must leave the hospital within three hours after delivery, due to overcrowding in hospital facilities, lack of space and resources. “Women are forced between choosing privacy and a clean space in their own homes, where they still stand, or shelters with dire conditions. It is choosing between the different evils. There is no safe place in Gaza.” For media enquiries, or to speak to our staff member in Palestine, please contact [email protected] Click here to donate to IPPF's appeal for Palestine. About PFPPA Established in Jerusalem in 1964, the Palestinian Family Planning and Protection Association (PFPPA) is locally registered as an independent, non-profit and non-governmental association with headquarters in Jerusalem. PFPPA has service delivery points located in the West Bank Areas of Ramallah, Bethlehem, Hebron and Halhoul, in addition to one in the Gaza Strip, which has yet to be relocated after it was destroyed following an Israeli airstrike on 8 October. Furthermore, and in cooperation with local partners, PFPPA is also responsible for 3 safe spaces to provide Gender Based Violence (GBV) related services in the Jerusalem area. About the International Planned Parenthood Federation IPPF, through its 149 Member Associations and collaborative partners, delivers high-quality sexual and reproductive healthcare and helps advance sexual and reproductive rights, especially for marginalized people with diverse needs that are currently unmet. IPPF's Member Associations and partners are locally owned, independent organisations, which means the support and care they provide are informed by local expertise and context. IPPF advocates for a world where people have the information they need to make informed decisions about their sexual and reproductive health and their bodies. We stand up and fight for sexual and reproductive rights and against those who seek to deny people their human right to bodily autonomy and sexual and reproductive freedom. We deliver care rooted in rights, respect, and dignity for all - no matter what. [1] Source: UNFPA [2] Source: MISP

An estimated 19,000 pregnant women are part of the 1.1 million residents forced to flee from northern Gaza due to Israel’s evacuation order on 13 October, with no safe place to give birth. Women are miscarrying pregnancies due to stress and shock, and the availability of medical facilities to birth safely in Gaza’s already overwhelmed healthcare system is rapidly dwindling. Wafa Abu Hasheish, a healthcare provider with the Palestinian Family Planning and Protection Association (PFPPA), an IPPF Member Association, has been providing medical aid to residents of her neighbourhood in northern Gaza where she has been sheltering since 10 October, three days after Israel declared war on the Gaza Strip. She said: “I have dealt with two suspected cases of miscarriages already, where there was no movement for the foetus and the mother had hypotension, bleeding and back pain. There has been one case where a woman was referred to where I am staying, since they knew I was a health service provider in the neighborhood. The woman was 8 months pregnant and was suffering from severe labor pain and was having a premature birth. We were very fortunate that when she reached me that we were able to refer her to a health center in time to be able to give birth safely." Even if the delivery of limited amounts of aid is allowed into southern Gaza, as was reported on 16 October, it remains unclear exactly how this aid will reach the more than 9,600 injured and the nearly 600,000 internally displaced people in central and southern Gaza[1] who are living in increasingly dire conditions. It has also been reported that the aid will not be distributed into northern Gaza, where 1.1 million residents have been ordered to evacuate ahead of a likely Israeli ground invasion. Ammal Awadallah, Executive Director of PFPPA, said: