It wasn’t the group meetings, the testing services or the health facilities that attracted Manny Norman, it was the offer of a free subway card and a bite to eat. A friend who was also a substance use told him about the workshops in a basement at a nearby community centre. Manny focused on the subway card which would be worth a few dollars if he sold it on. “I just wanted something to eat,” he says. “I hadn’t eaten in probably 20 hours. And the idea of getting more drugs without stealing sounded good to me.” Thirteen years later and he is still attending the Safety Counts meetings run by Planned Parenthood’s Project Street Beat, and credits them with helping him rebuild a life shattered by drug abuse. At the time, he explains he was neglecting his young family, stealing from them to buy crack cocaine and alcohol. His wife would call the police or lock him out of the home on an almost daily basis. “I was on crack and alcohol, the drugs that led me to dereliction, that led me to stealing, being unmanageable, not responsible, without a care in the world,” he says. “(I) didn’t want to work. I just wanted to feed my drug addiction.” Starting a new life But when he walked into the Safety Counts meetings, he says now, he realised he was among people who understood his life. “They met me where I was at,” he says. “They could tell I was under the influence. They could tell I was hurting, that I wasn’t doing the right thing and they made me feel no less than and no different. They gave me hope to come back the next week.” At first, he just went with the flow, focusing on the food and the subway card, not taking much notice of the services on offer. But eventually, he realised there were other people in the room he had come out the other side and rebuilt their lives. “We talked about harm reduction,” he says. “I could identify with the stories other people were telling. Lying, cheating, stealing, borrowing money knowing you wouldn’t pay it back.” Detox and rehab followed. He used the facilities of the projects mobile medical unit to get himself tested for Hepatitis C and HIV and has managed to stay clean, even training as an HIV outreach worker, and has rebuilt his family life. “It’s a happy home now,” he says. “My daughter got her father back, my wife got her husband back. Most of all I got myself back, thank God.” Without Project Street Beat he says his life would have continued its downward spiral. He would most likely be in prison today. Instead, he works as a supervisor for a cleaning company. And when he bumps into one of his friends from the old days he knows what to do. “When I walk down the street and see someone I know – someone I took drugs with or drank with – I let them know exactly where the mobile might be at,” he said. “I have cards in my pocket I give out to people and let them know this is the new way.” Watch Project Street Beat in action

A young man stops by a pile of rubbish at the side of the road. He fiddles with an abandoned umbrella, snapping off one of its broken ribs and slipping it into his backpack. Eric Fairchild spots the signs. The HIV prevention specialist greets the man like an old friend. “We got condoms, leaflets, testing right here,” he says standing in front of Planned Parenthood’s mobile medical unit. The man refuses initially, stepping into a nearby grocery store, before returning a few minutes later with his girlfriend to hear about the services on offer. The umbrella rib, says Mr Fairchild later, was a giveaway. It makes a perfect tool for scraping the residue from a substance pipe. Understanding and overcoming Eric has worked for Planned Parenthood for 12 years, using his experience growing up in the Brooklyn neighbourhood of Brownsville to help spot others who are in need of help. “I was part of the streets,” he says. “I was a substance abuser. Never injected, but I smoked, sniffed... stuff of that nature.” He has been clean for 26 years but explains that his experiences help him connect with other users. “The first thing I do when I have hardcore substance abusers sitting in front of me, I first show them identification,” he says.  “I let them know I understand just how they feel. I’ve been there feeling hopeless, helpless, confused about where to turn.” Some occasions might mean he has to use the training and education he has received as an outreach worker. Other times it is a case of using his 60 years’ experience of life in Brooklyn. “That’s my benefit to the programme,” he says. “I’m street savvy as well as educated in the classroom. I have the best of both worlds.” Eric already had an extensive background in community work before joining the project, prompted by a desire to learn more about HIV prevention following the death of a relative and a friend died from the illness. He is often the first point of contact for clients, handing out pamphlets on the street corner, conducting HIV tests and explaining Project Beat Street– and the facilities available on the mobile unit to wary newcomers. From there he can offer advice and guidance on other services, from home care managers to sources of funding for people with HIV and setting up appointments at clinics. He follows up with phone calls and meetings, often at every step of a client’s progress. “I saw when they came in,” he says. “I saw them come in from a struggling situation, uncomfortable with their lifestyle at the time. Going from being an unproductive member of society to taking better care of themselves and being in a healthier situation that they were before. I am always happy to know I was part of that process.” Watch Project Street Beat in action

Leiti is a Tongan word to describe transgender women, it comes from the English word “lady”. In Tonga the transgender community is organized by the Tonga Leiti Association (TLA), and with the support of Tonga Family Health Association (TFHA). Together they are educating people to help stop the discrimination and stigma surrounding the Leiti community. Leilani, who identifies as a leiti, has been working with the Tonga Leiti Association, supported by Tonga Health Family Association to battle the stigma surrounding the leiti and LGBTI+ community in Tonga. She says "I started to dress like a leiti at a very young age. Being a leiti in a Tongan family is very difficult because being a leiti or having a son who’s a leiti are considered shameful, so for the family (it) is very difficult to accept us. Many leitis run away from their families." Frequently facing abuse Access to health care and sexual and reproductive health service is another difficulty the leiti community face: going to public clinics, they often face abuse and are more likely to be ignored or dismissed by staff. When they are turned away from other clinics, Leilani knows she can always rely on Tonga Health Family Association for help. 'I think Tonga Family Health has done a lot up to now. They always come and do our annual HIV testing and they supply us (with) some condom because we do the condom distribution here in Tonga and if we have a case in our members or anybody come to our office we refer them to Tonga Family Health. They really, really help us a lot. They (are the) only one that can understand us." Tonga Family Health Association and Tonga Leiti Association partnership allows for both organisations to attend training workshops run by one another. A valuable opportunity not only for clinic staff but for volunteers like Leilani. "When the Tonga Family Health run the training they always ask some members from TLA to come and train with them and we do the same with them. When I give a presentation at the TFHA's clinic, I share with people what we do; I ask them for to change their mindset and how they look about us." Overcoming stigma and discrimination  With her training, Leilani visits schools to help educate, inform and overcome the stigma and discrimination surrounding the leiti community. Many young leiti's drop out of school at an early age due to verbal, physical and in some cases sexual abuse.  Slowly, Leilani is seeing a positive change in the schools she visits.  “We go to school because there a lot of discrimination of the leiti's in high school and primary school too. I have been going from school to school for two years. My plan to visit all the schools in Tonga. We mostly go to all-boys schools is because discrimination in school is mostly done by boys. I was very happy last year when I went to a boys school and so how they really appreciate the work and how well they treated the Leiti's in the school." In February, Tonga was hit by tropical cyclone Gita, the worst cyclone to hit the island in over 60 years. Leilani worries that not enough is being done to ensure the needs of the Leiti and LGBTI+ community is being met during and post humanitarian disasters. "We are one of the vulnerable groups, after the cyclone Gita we should be one of the first priority for the government, or the hospital or any donations. Cause our life is very unique and we are easy to harm." Despite the hardships surrounding the leiti community, Leilani is hopeful for the future, "I can see a lot of families that now accept leiti's in their house and they treat them well. I have a feeling the future will be better. Please stop discriminating against us, but love us. We are here to stay, we are not here to chase away."    Watch the Humanitarian teams response to Cyclone Gita

Menstrual regulation, the method of establishing non-pregnancy for a woman at risk of unintended pregnancy, has been a part of Bangladesh’s family planning program since 1979. It is allowed up to 10 –12 weeks after a woman’s last menstrual period. Nursing Supervisor Ms. Lovely Yasmin is one of several staff members providing family planning, menstrual regulation, and post-procedure care services at Upzila Health Complex in Belkuchi, Bangladesh. “Before this training we used to sometimes advise people on such services and provided menstrual regulation (MR) services but after the training I’ve have become and confident and efficient in providing MR services,” she says. “Earlier there could possibly have been mistake but now I can provide MR services efficiently and perfectly. I can now provide MR services in more organized manner.” But while Yasmin, who has worked in family planning for 16 years, says that the recent training has increased her confidence in properly doing MR procedures, the health complex still lacks basic supplies. “There were difficulties due to limited equipment,” she says. “We sometimes have to use personal equipment.” But, she says, the presence of Kit 8 has made life easier. “Prior to this kit, many clients did not complete the full course of medical as advices due to financial issues… during floods there are many hardships including financial difficulty,” she says. “However with this kit, most of the medicines are provided and clients are easily managing on their own.”

Menstrual regulation, the method of establishing non-pregnancy for a woman at risk of unintended pregnancy, has been a part of Bangladesh’s family planning program since 1979. It is allowed up to 10 –12 weeks after a woman’s last menstrual period. When Shana Khatun, a mother of three, became pregnant again she says she began to feel very weak and had issues with massive bleeding.Citing her age and the possibility of further medical complications, Khatun decided to undergo a menstrual regulation procedure. “But if the hospital and services weren’t there then I would have had to have continued with my pregnancy, even when (I do) not want another child” she says. Khatun says that the procedure went well, but that without the presence of medicine found in Kit 8 she would have lacked post-operation medicine. “After the menstrual regulations services I was prescribed a few medicines which I could not buy due to poor financial condition,” she says. “But the hospital gave me a number of medicines that I could take.” And while Khatun had talked with women about various family planning methods, she didn’t feel she could talk with anyone aside from her husband about getting the procedure. “I feared they would treat me poorly (the hospital),” she says. But Kahtun says she found the hospital trustworthy and helpful, even when she was suffering complications such as mass bleeding. “I will be very cautious that I should not get pregnant again however in event if I get pregnant again then I will come to this hospital only,” she says.

Menstrual regulation, the method of establishing non-pregnancy for a woman at risk of unintended pregnancy, has been a part of Bangladesh’s family planning program since 1979. It is allowed up to 10 –12 weeks after a woman’s last menstrual period. Auliya Khatun, a mother of three children, was 40 years old when she found out that she had unintentionally become pregnant again. Khatun says she had heard about family planning services and menstrual regulation services available at the Upzila Health Complex from other women in her small village. She discussed the option of undergoing menstrual regulation with her husband. “My spouse was supportive and he gave me the freedom to come to this decision myself,” Khatun says. “If this service was not available then I would have carried on with the pregnancy. It would have been embarrassing, though,” she explains. “It is embarrassing to have another child at this age.” Khatun, who sometimes assists her husband with work in a local handloom, also cited the financial burden another child would have on her family. “We are facing financial difficulty so it is not possible to have another child.” Khatun says she only experienced mild gastric discomfort after the procedure but felt assured about her recovery due to being able to check-in with doctors at the local health centre. The access to the services and doctors, she says, was a major factor in a smooth and easy recovery. “Since this service was in a government facility I could prevail [through] this and survive,” she says. “It is an important service.”