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Vanuatu

Articles by Vanuatu

SPRINT
26 April 2022

SPRINT: Sexual and reproductive health in crisis and post-crisis situations

  The SPRINT Initiative provides one of the most important aspects of humanitarian assistance that is often forgotten when disaster and conflicts strike: access to essential life-saving sexual and reproductive health services. We build capacity of humanitarian workers to deliver essential life-saving sexual and reproductive health services in crisis and post-crisis situations through the delivery of the Minimum Initial Service Package (MISP) for reproductive health in emergencies.   Through funding from the Australian Government's Department of Foreign Affairs and Trade (DFAT), our SPRINT Initiative has brought sexual and reproductive health to the humanitarian agenda, increased capacity and responded to a number of humanitarian emergencies. Australia has funded the SPRINT initiative since 2007. Since then, the SPRINT initiative has responded to 105 humanitarian crises and worked with partners in 99 countries. SPRINT has reached over 1,138,175 people, delivering 2,133,141 crucial SRH services, and continues to respond to ongoing emergencies. In each priority country, we work with an IPPF Member Association to coordinate and implement life-saving sexual and reproductive activities. Through these partnerships, SPRINT helps strengthen the enabling environment, improve national capacity and provide lifesaving services during times of crisis. You can read more about IPPF Humanitarian’s Programme here. Australia's location in the Indo-Pacific provides DFAT with a unique perspective on humanitarian action. Australia is committed to helping partner governments manage crisis response themselves. This is done through building the capacity of the national government and civil society to be able to respond to disaster. DFAT also works with experienced international partners to prepare for and respond to disasters, including other donors, United Nations agencies, the International Red Cross and Red Crescent Movement and non-government organisations.          

Nurse Leias Obed attending to a patient
02 June 2020

Cyclone Harold response: A 'hidden agenda'?

Leias Obed is a registered nurse working with the Vanuatu Family Health Association (VFHA). She’s part of the Emergency Medical Team operating out of Pangi in south Pentecost, as part of the Cyclone Harold response, which hit in April 2020. We caught up with her there. Sexual and reproductive health is a "hidden agenda", she said, putting a positive spin on the phrase. Women often have to hide their sexual and reproductive health issues and concerns, for fear of stigmatization, or even coercion and violence. By joining the relief effort as part of larger joint medical teams capable of addressing numerous concerns for both men and women, the VHFA staff are able to use the opportunities presented to contact potential clients discreetly and without putting them at risk. Informal exposure to skilled medical staff and counsellors is often enough to initiate a process that results in better, more manageable living conditions for women and their families. Unaware of their own pregnancy “We came to central Pentecost,” said Leias, “and we came across many issues affecting women and girls, but it's like I mentioned, it's a 'hidden agenda'. One thing that we found out is that many women have large numbers of children and their spacing is too close together. But they don't see it as a problem. It's not a problem for them." “Some women who became pregnant during the disaster weren't even aware of their status, but when they came to see us, we have pregnancy tests, and when we test them, they're positive. They're pregnant, and a lot of them have family planning needs.” “Their communities are a long long way from accessing facilities like [these] clinics. We go there and we help them understand, about implants that last five years. A lot of them didn't really understand. They didn't know, it but their main issue is family planning.” Information and education for all “During a response we're more concentrated on the issues facing women right now but it's clear there's a need for us to come back. We must come back so that people can come to understand: What exactly is family planning? Why is it important to use contraceptive treatments? “They really don't understand well at all about family planning products.” The information and education process needs to reach everyone, though: “It would be good if we came back. We come back and present small workshops to fathers, chiefs and to communities at large. To young girls, to mothers so they can come to understand.” There’s a need to follow through, she says. “Family planning is an individual right. We won't force anyone to take it. But there's a need. The more we stay with them, the more we explain, then they can begin to change their mind-set. Then they can freely choose to take family planning.”

Vanuatu - IPPF/Alana Holmberg
16 August 2018

World Humanitarian Day: The view from Vanuatu

In the ten months since the Monaro Volcano on the tiny island of Ambae, in Vanuatu, became active, every conceivable surface on the island has been covered by a thick layer of ash.  Volcanic ash is acidic, so it severely affects the crops many people rely on for their daily sustenance. The air becomes thick, making breathing labored and difficult. The water becomes contaminated, making it undrinkable.  The first temporary evacuation, back in September last year, relocated residents to a nearby island for one month. Only a few months after they returned the volcanic activity worsened again, and a few weeks ago, the government declared another mandatory evacuation.  Uncertain futures on the island IPPF’s partner on the ground, the Vanuatu Family Health Association, was on Ambae delivering emergency sexual and reproductive healthcare to evacuees during this time. This is their second humanitarian response to the island, having previously responded late last year.  Find out more about sexual health during humanitarian crises Having to relocate both internally and externally, living in evacuation centres, and an uncertain future all impact the sexual and reproductive health needs of a population. On Ambae, many women reported wanting to stop or delay their pregnancies until their futures were more certain.  Other women reported feeling less safe in general due to there being less people on the island.  Our humanitarian response team conducted mobile health clinics on Ambae, providing much-needed contraception and other sexual and reproductive health services.  Humanitarian workers going above & beyond Of the 11,500 original inhabitants of Ambae, thousands of people remained in their coastal homes or evacuation centres, and 4,000 people had registered to be relocated to nearby Maewo Island by the government.  Our team travelled with the evacuees on the ship, even providing impromptu medical care en route. Now they are on their “second home” on Maewo, our teams will continue their outreach to the thousands of new arrivals.  Our humanitarian workers are truly amazing and will do what it takes to provide services to people in need.  On remote Pacific islands, this often means travelling by small plane, boat, vehicle and foot, all the time with the medical supplies. Once the team arrive at a community, they set up mobile health clinics in classrooms or community halls, and deliver education sessions under trees.  This week, in the lead up to World Humanitarian Day on the 19 August, we want to thank our teams on the ground who go above and beyond.  Stories from Ambae’s women IPPF spoke to some of the outgoing residents of Ambae Island to find out about some of the health challenges they were facing as they left their homes.  Rosina, a 29-year-old mum of five, is one of them: "Five children is enough. I have never used family planning, but I know about it. I want to take it but my husband refuses to let me take the pill or the five-year stick. He says if I go on family planning then maybe I will go see other men instead of him. Many men on this island are like that. They need to be educated."  "When my husband and I discuss family planning, he disagrees. He says I know once you are on the pill or take other injectables you won’t think of me as your husband. I tell him, ‘but I am young, and I want to protect me. Then I can care for our kids, look after them properly’. I don’t know how to convince him. It’s really hard." 19-year-old Annie is pregnant with her first child: "We planned for this baby. I always wanted to have a baby. I feel good to have a baby, I’m excited. My husband is excited too." "I know what family planning is. I have heard of the pill and other methods. My grandfather told me that you [the Vanuatu Family Health Association] were here today. I haven’t received any antenatal care yet, but I knew I was pregnant. A nurse checked my baby, and she said the baby is healthy. She gave me some medication for the baby. Seeing the clinic today has saved me time.  The volcano makes me feel bad, it’s scary. I want to leave Ambae... It’s much harder being pregnant now. I want my baby to have a good future." Providing sexual and reproductive healthcare during emergencies is vital – find out why.

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.

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.

IPPF Humanitarian - Australian Aid logos

Supporting women during humanitarian crisis

The Australian Parliamentary Group on Population and Development (APGPD) welcomes the commitment by the Australian Government to continue funding the International Planned Parenthood Federation’s work with women during humanitarian crises. Over 800 women and girls are dying every day from complications in pregnancy and childbirth. Three in five preventable maternal deaths occur in conflict, displacement and natural disasters. When disasters hit we must not forget women still need access to safe birthing spaces, family planning services, and protection against sexual violence. Since commencing in 2007 the IPPF SPRINT (Sexual and Reproductive Health Program in Crisis and Post-Crisis Settings) initiative has supported over 890,000 people through times of disaster including in Fiji, Nepal and Vanuatu. The APGPD is pleased to see the Australian Government continuing to support women in accessing sexual and reproductive health services. While other countries are pulling back and leaving women and children vulnerable it is vital Australia continues to show global leadership focused on gender equality. Access to reproductive health services is a key component of women’s empowerment, with better health outcomes leading to better education and economic outcomes for all. The Australian Parliamentary Group on Population and Development (APGPD) is a cross-party group of parliamentarians who work collaboratively to champion sexual and reproductive health and rights, gender equality and women’s empowerment globally. The APGPD was established in 1995 as part of a global network of parliamentary groups and is a member of the Asian Forum of Parliamentarians on Population and Development.

Vanuatu Family Health Association

As Vanuatu's pioneering sexual and reproductive health and rights (SRHR) organisation, VFHA is a trusted provider of SRHR services and commodities to the nation of 271,000. It works closely with the Ministry of Health (MOH) to provide service delivery from its two main clinics, advocating to political and religious leaders and conducting educational campaigns targeting youth and the broader community.

Fifty-eight per cent of the population is below 24-years-old so the needs for sexual and reproductive health (SRH) services are significant. Vanuatu has a high static fertility and high teenage fertility rates, rising rates of sexually transmitted infections (STIs) and low rates of contraceptive prevalence. About 76 per cent of the population lives in rural areas, making it difficult and expensive to provide quality reproductive health (RH)

The association was also the leading NGO on the provision of SRHR services during the Post Cyclone Winston Response that has devastated the lives of the people of Vanuatu. Lives were touched during the response as they were able to go to the rural and remote areas on the provision of services.

 

Julie, former midwife, now nurse and Project manager for IPPF-SPRINT in Vanuatu

Overcoming barriers to family planning in Vanuatu: Julie's experience at IPPF-SPRINT

Julie was a midwife with the Ministry of Health for 20 years before she joined the Vanuatu Family Health Association (VFHA) as nurse and project manager for IPPF's SPRINT Initiative response in Vanuatu. When Cyclone Pam hit Vanuatu, the SPRINT Initiative and VHFA started providing life-saving services to the Island, Tanna, which was the population worst affected by the typhoon. Many communities there live remotely, in grass huts, with no immediate access to medical care.  Julie was there with the VFHA team. “When I first came here we used the kitchen to operate from. On my second trip, we created a clinic in our youth centre, and used the nearby health post for clinical procedures. Soon we saw more patients pouring in, which created a huge demand for space." Health conditions are very low. Even before the cyclone hit the island, it was reported that the average mother loses two pregnancies each, in her lifetime. Every person in the village knows at least one mother who has died during child birth. Access and knowledge to family planning is overlooked as traditional practices are used first. As Julie explains, advocating about family planning is a challenge in the area, also for language barriers. “Talking about birth-spacing and talking in the regional dialect of Tanna is a problem. Most of us in Vanuatu speak Bislama, but people here in Tanna aren’t well versed with it. However, we try our level best with all possible methods including sign language and demos to impart knowledge about family planning.” Family planning services are just a part of the IPPF-SPRINT Cyclone Pam response, that also included general health check-up, counselling and awareness about Sexual and Gender Based Violence, maternal care and awareness and prevention of HIV and Sexually Transmitted Infections (STI).  

The SPRINT team finally at the mission

A long walk to help: IPPF teams' journey to reach typhoon-affected population in Vanuatu

Cyclone Pam, one of the most intense storms of the South Pacific Ocean, caused widespread devastation in Vanuatu’s southern provinces of Shefa and Tafea in May 2015. The International Planned Parenthood Federation (IPPF) through its humanitarian wing, the SPRINT Initiative, supported the Tropical Cyclone Pam affected population by providing them life-saving sexual and reproductive health (SRH) services through the Vanuatu Family Health Association (VFHA), a Member Association of IPPF. “The IPPF-SPRINT and the VFHA team walked for more than 2 hours to Labasilis Community Village in North Tanna, Vanuatu. It had rained continuously the previous night, hence it was impossible to use the 4-wheel drive transport and the team made the entire trek by foot, carrying all the medical equipment! We passed a few small settlements on the way, and in one village, Dr William, a MOH (Ministry of Health) medical doctor who had volunteered with VFHA for the mission treated a young man with a chest infection and a lady with musculoskeletal pain. “There was no such thing as a clinic or shelter, and the makeshift table was on a piece of zinc on the ground, where the medical bag was opened,” explains Subatra Jayaraj, SPRINT Regional Manager, The International Planned Parenthood Federation-East & South East and Oceania Region. After crossing the peak of 3 hills, the team arrived at the Labasilis Village and set up clinic in a tent that had been provided to the community by UNICEF. At least it provided shelter from the storm outside. “It had rained heavily the previous night. However, we started early to reach Labasilis. We started walking slowly. Maintaining one’s balance in the slippery muddy road was a real challenge, everyone decided to walk bare foot – walking though the bush was also preferred for better grip. I was relieved to learn that Tanna soil does not have insects or snakes- may be due to volcanic sand deposit. Many of us slipped or almost slipped couple of times. Each time one team member slipped it was counted as one point and if one almost slipped, then half a point is scored. Need not to mention, that we all contributed towards quite a good score for the team. The scenery was indeed beautiful, but continuous rain and the slippery road kept us focusing on each step we took forward,” said Aditi Ghosh, Acting Director, IPPF-SPRINT Initiative. Thanks to IPPF-SPRINT and VRHA, we served four communities via three outreach mission in the Tanna Island, providing Sexual and Reproductive (SRH) services, including HIV/STI and Family Planning services, Maternal, Obstetric and Neonatal Health Care.

SPRINT
26 April 2022

SPRINT: Sexual and reproductive health in crisis and post-crisis situations

  The SPRINT Initiative provides one of the most important aspects of humanitarian assistance that is often forgotten when disaster and conflicts strike: access to essential life-saving sexual and reproductive health services. We build capacity of humanitarian workers to deliver essential life-saving sexual and reproductive health services in crisis and post-crisis situations through the delivery of the Minimum Initial Service Package (MISP) for reproductive health in emergencies.   Through funding from the Australian Government's Department of Foreign Affairs and Trade (DFAT), our SPRINT Initiative has brought sexual and reproductive health to the humanitarian agenda, increased capacity and responded to a number of humanitarian emergencies. Australia has funded the SPRINT initiative since 2007. Since then, the SPRINT initiative has responded to 105 humanitarian crises and worked with partners in 99 countries. SPRINT has reached over 1,138,175 people, delivering 2,133,141 crucial SRH services, and continues to respond to ongoing emergencies. In each priority country, we work with an IPPF Member Association to coordinate and implement life-saving sexual and reproductive activities. Through these partnerships, SPRINT helps strengthen the enabling environment, improve national capacity and provide lifesaving services during times of crisis. You can read more about IPPF Humanitarian’s Programme here. Australia's location in the Indo-Pacific provides DFAT with a unique perspective on humanitarian action. Australia is committed to helping partner governments manage crisis response themselves. This is done through building the capacity of the national government and civil society to be able to respond to disaster. DFAT also works with experienced international partners to prepare for and respond to disasters, including other donors, United Nations agencies, the International Red Cross and Red Crescent Movement and non-government organisations.          

Nurse Leias Obed attending to a patient
02 June 2020

Cyclone Harold response: A 'hidden agenda'?

Leias Obed is a registered nurse working with the Vanuatu Family Health Association (VFHA). She’s part of the Emergency Medical Team operating out of Pangi in south Pentecost, as part of the Cyclone Harold response, which hit in April 2020. We caught up with her there. Sexual and reproductive health is a "hidden agenda", she said, putting a positive spin on the phrase. Women often have to hide their sexual and reproductive health issues and concerns, for fear of stigmatization, or even coercion and violence. By joining the relief effort as part of larger joint medical teams capable of addressing numerous concerns for both men and women, the VHFA staff are able to use the opportunities presented to contact potential clients discreetly and without putting them at risk. Informal exposure to skilled medical staff and counsellors is often enough to initiate a process that results in better, more manageable living conditions for women and their families. Unaware of their own pregnancy “We came to central Pentecost,” said Leias, “and we came across many issues affecting women and girls, but it's like I mentioned, it's a 'hidden agenda'. One thing that we found out is that many women have large numbers of children and their spacing is too close together. But they don't see it as a problem. It's not a problem for them." “Some women who became pregnant during the disaster weren't even aware of their status, but when they came to see us, we have pregnancy tests, and when we test them, they're positive. They're pregnant, and a lot of them have family planning needs.” “Their communities are a long long way from accessing facilities like [these] clinics. We go there and we help them understand, about implants that last five years. A lot of them didn't really understand. They didn't know, it but their main issue is family planning.” Information and education for all “During a response we're more concentrated on the issues facing women right now but it's clear there's a need for us to come back. We must come back so that people can come to understand: What exactly is family planning? Why is it important to use contraceptive treatments? “They really don't understand well at all about family planning products.” The information and education process needs to reach everyone, though: “It would be good if we came back. We come back and present small workshops to fathers, chiefs and to communities at large. To young girls, to mothers so they can come to understand.” There’s a need to follow through, she says. “Family planning is an individual right. We won't force anyone to take it. But there's a need. The more we stay with them, the more we explain, then they can begin to change their mind-set. Then they can freely choose to take family planning.”

Vanuatu - IPPF/Alana Holmberg
16 August 2018

World Humanitarian Day: The view from Vanuatu

In the ten months since the Monaro Volcano on the tiny island of Ambae, in Vanuatu, became active, every conceivable surface on the island has been covered by a thick layer of ash.  Volcanic ash is acidic, so it severely affects the crops many people rely on for their daily sustenance. The air becomes thick, making breathing labored and difficult. The water becomes contaminated, making it undrinkable.  The first temporary evacuation, back in September last year, relocated residents to a nearby island for one month. Only a few months after they returned the volcanic activity worsened again, and a few weeks ago, the government declared another mandatory evacuation.  Uncertain futures on the island IPPF’s partner on the ground, the Vanuatu Family Health Association, was on Ambae delivering emergency sexual and reproductive healthcare to evacuees during this time. This is their second humanitarian response to the island, having previously responded late last year.  Find out more about sexual health during humanitarian crises Having to relocate both internally and externally, living in evacuation centres, and an uncertain future all impact the sexual and reproductive health needs of a population. On Ambae, many women reported wanting to stop or delay their pregnancies until their futures were more certain.  Other women reported feeling less safe in general due to there being less people on the island.  Our humanitarian response team conducted mobile health clinics on Ambae, providing much-needed contraception and other sexual and reproductive health services.  Humanitarian workers going above & beyond Of the 11,500 original inhabitants of Ambae, thousands of people remained in their coastal homes or evacuation centres, and 4,000 people had registered to be relocated to nearby Maewo Island by the government.  Our team travelled with the evacuees on the ship, even providing impromptu medical care en route. Now they are on their “second home” on Maewo, our teams will continue their outreach to the thousands of new arrivals.  Our humanitarian workers are truly amazing and will do what it takes to provide services to people in need.  On remote Pacific islands, this often means travelling by small plane, boat, vehicle and foot, all the time with the medical supplies. Once the team arrive at a community, they set up mobile health clinics in classrooms or community halls, and deliver education sessions under trees.  This week, in the lead up to World Humanitarian Day on the 19 August, we want to thank our teams on the ground who go above and beyond.  Stories from Ambae’s women IPPF spoke to some of the outgoing residents of Ambae Island to find out about some of the health challenges they were facing as they left their homes.  Rosina, a 29-year-old mum of five, is one of them: "Five children is enough. I have never used family planning, but I know about it. I want to take it but my husband refuses to let me take the pill or the five-year stick. He says if I go on family planning then maybe I will go see other men instead of him. Many men on this island are like that. They need to be educated."  "When my husband and I discuss family planning, he disagrees. He says I know once you are on the pill or take other injectables you won’t think of me as your husband. I tell him, ‘but I am young, and I want to protect me. Then I can care for our kids, look after them properly’. I don’t know how to convince him. It’s really hard." 19-year-old Annie is pregnant with her first child: "We planned for this baby. I always wanted to have a baby. I feel good to have a baby, I’m excited. My husband is excited too." "I know what family planning is. I have heard of the pill and other methods. My grandfather told me that you [the Vanuatu Family Health Association] were here today. I haven’t received any antenatal care yet, but I knew I was pregnant. A nurse checked my baby, and she said the baby is healthy. She gave me some medication for the baby. Seeing the clinic today has saved me time.  The volcano makes me feel bad, it’s scary. I want to leave Ambae... It’s much harder being pregnant now. I want my baby to have a good future." Providing sexual and reproductive healthcare during emergencies is vital – find out why.

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.

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.

IPPF Humanitarian - Australian Aid logos

Supporting women during humanitarian crisis

The Australian Parliamentary Group on Population and Development (APGPD) welcomes the commitment by the Australian Government to continue funding the International Planned Parenthood Federation’s work with women during humanitarian crises. Over 800 women and girls are dying every day from complications in pregnancy and childbirth. Three in five preventable maternal deaths occur in conflict, displacement and natural disasters. When disasters hit we must not forget women still need access to safe birthing spaces, family planning services, and protection against sexual violence. Since commencing in 2007 the IPPF SPRINT (Sexual and Reproductive Health Program in Crisis and Post-Crisis Settings) initiative has supported over 890,000 people through times of disaster including in Fiji, Nepal and Vanuatu. The APGPD is pleased to see the Australian Government continuing to support women in accessing sexual and reproductive health services. While other countries are pulling back and leaving women and children vulnerable it is vital Australia continues to show global leadership focused on gender equality. Access to reproductive health services is a key component of women’s empowerment, with better health outcomes leading to better education and economic outcomes for all. The Australian Parliamentary Group on Population and Development (APGPD) is a cross-party group of parliamentarians who work collaboratively to champion sexual and reproductive health and rights, gender equality and women’s empowerment globally. The APGPD was established in 1995 as part of a global network of parliamentary groups and is a member of the Asian Forum of Parliamentarians on Population and Development.

Vanuatu Family Health Association

As Vanuatu's pioneering sexual and reproductive health and rights (SRHR) organisation, VFHA is a trusted provider of SRHR services and commodities to the nation of 271,000. It works closely with the Ministry of Health (MOH) to provide service delivery from its two main clinics, advocating to political and religious leaders and conducting educational campaigns targeting youth and the broader community.

Fifty-eight per cent of the population is below 24-years-old so the needs for sexual and reproductive health (SRH) services are significant. Vanuatu has a high static fertility and high teenage fertility rates, rising rates of sexually transmitted infections (STIs) and low rates of contraceptive prevalence. About 76 per cent of the population lives in rural areas, making it difficult and expensive to provide quality reproductive health (RH)

The association was also the leading NGO on the provision of SRHR services during the Post Cyclone Winston Response that has devastated the lives of the people of Vanuatu. Lives were touched during the response as they were able to go to the rural and remote areas on the provision of services.

 

Julie, former midwife, now nurse and Project manager for IPPF-SPRINT in Vanuatu

Overcoming barriers to family planning in Vanuatu: Julie's experience at IPPF-SPRINT

Julie was a midwife with the Ministry of Health for 20 years before she joined the Vanuatu Family Health Association (VFHA) as nurse and project manager for IPPF's SPRINT Initiative response in Vanuatu. When Cyclone Pam hit Vanuatu, the SPRINT Initiative and VHFA started providing life-saving services to the Island, Tanna, which was the population worst affected by the typhoon. Many communities there live remotely, in grass huts, with no immediate access to medical care.  Julie was there with the VFHA team. “When I first came here we used the kitchen to operate from. On my second trip, we created a clinic in our youth centre, and used the nearby health post for clinical procedures. Soon we saw more patients pouring in, which created a huge demand for space." Health conditions are very low. Even before the cyclone hit the island, it was reported that the average mother loses two pregnancies each, in her lifetime. Every person in the village knows at least one mother who has died during child birth. Access and knowledge to family planning is overlooked as traditional practices are used first. As Julie explains, advocating about family planning is a challenge in the area, also for language barriers. “Talking about birth-spacing and talking in the regional dialect of Tanna is a problem. Most of us in Vanuatu speak Bislama, but people here in Tanna aren’t well versed with it. However, we try our level best with all possible methods including sign language and demos to impart knowledge about family planning.” Family planning services are just a part of the IPPF-SPRINT Cyclone Pam response, that also included general health check-up, counselling and awareness about Sexual and Gender Based Violence, maternal care and awareness and prevention of HIV and Sexually Transmitted Infections (STI).  

The SPRINT team finally at the mission

A long walk to help: IPPF teams' journey to reach typhoon-affected population in Vanuatu

Cyclone Pam, one of the most intense storms of the South Pacific Ocean, caused widespread devastation in Vanuatu’s southern provinces of Shefa and Tafea in May 2015. The International Planned Parenthood Federation (IPPF) through its humanitarian wing, the SPRINT Initiative, supported the Tropical Cyclone Pam affected population by providing them life-saving sexual and reproductive health (SRH) services through the Vanuatu Family Health Association (VFHA), a Member Association of IPPF. “The IPPF-SPRINT and the VFHA team walked for more than 2 hours to Labasilis Community Village in North Tanna, Vanuatu. It had rained continuously the previous night, hence it was impossible to use the 4-wheel drive transport and the team made the entire trek by foot, carrying all the medical equipment! We passed a few small settlements on the way, and in one village, Dr William, a MOH (Ministry of Health) medical doctor who had volunteered with VFHA for the mission treated a young man with a chest infection and a lady with musculoskeletal pain. “There was no such thing as a clinic or shelter, and the makeshift table was on a piece of zinc on the ground, where the medical bag was opened,” explains Subatra Jayaraj, SPRINT Regional Manager, The International Planned Parenthood Federation-East & South East and Oceania Region. After crossing the peak of 3 hills, the team arrived at the Labasilis Village and set up clinic in a tent that had been provided to the community by UNICEF. At least it provided shelter from the storm outside. “It had rained heavily the previous night. However, we started early to reach Labasilis. We started walking slowly. Maintaining one’s balance in the slippery muddy road was a real challenge, everyone decided to walk bare foot – walking though the bush was also preferred for better grip. I was relieved to learn that Tanna soil does not have insects or snakes- may be due to volcanic sand deposit. Many of us slipped or almost slipped couple of times. Each time one team member slipped it was counted as one point and if one almost slipped, then half a point is scored. Need not to mention, that we all contributed towards quite a good score for the team. The scenery was indeed beautiful, but continuous rain and the slippery road kept us focusing on each step we took forward,” said Aditi Ghosh, Acting Director, IPPF-SPRINT Initiative. Thanks to IPPF-SPRINT and VRHA, we served four communities via three outreach mission in the Tanna Island, providing Sexual and Reproductive (SRH) services, including HIV/STI and Family Planning services, Maternal, Obstetric and Neonatal Health Care.