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Sera Vulavou is the Senior Monitoring and Evaluation Officer with IPPF’s Sub-Regional Office for the Pacific. She was trained as a humanitarian surge roster member in early 2020, to be able to deploy to emergencies to provide technical assistance to Member Associations – here she shares her experience with us. Severe Tropical Cyclone (TC) Yasa was the strongest in the South Pacific since TC Winston in 2016, as well as the fourth most intense TC on record in the basin.  The Reproductive and Family Health Association of Fiji (RFHAF) humanitarian response to TC Yasa has reached some of the most difficult and geographically scattered islands and communities, which included the islands of Moala, Totoya, and Matuku.  Being part of the IPPF humanitarian surge roster team gave me the opportunity to accompany the RFHAF response team during their humanitarian work. This experience was about putting in action what I could only personally describe as being at the right place at the right time. 

In early April 2020, the all too familiar destruction of a Tropical Cyclone (TC) – Harold – hit the Solomon Islands, Vanuatu, Fiji and Tonga. One of the worst affected areas was the Eastern part of Fiji. Through support by Department of Foreign Affairs and Trade (DFAT), our Member Association, Reproductive and Family Health Association of Fiji (RFHAF), was quick to respond ensuring access to essential sexual and reproductive healthcare for Kadavu’s women, girls, and vulnerable groups. Fiji's vulnerable coastline Fiji’s worst affected area was the Eastern part, with TC Harold bringing destructive storm force winds and storm surge. RFHAF focused its humanitarian response on the local Kadavu population. This remote area proves a challenge to reach for the team with supplies. Share on Twitter Share on Facebook Share via WhatsApp Share via Email RFHAF's humanitarian response team tackle rough terrain National travel restrictions - due to the current COVID-19 pandemic - on all inter island transfers has slowed the response in some areas, including Kadavu. The island of Kadavu is one of the least developed areas of Fiji, the main source of income is substance living (Yaqona). Transport around the island is difficult, with very few roads, no public water system or electricity. The humanitarian team from RFHAF travels by boat and then on foot. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Asenaca, client Kadavu, the biggest island in the Eastern division has the greatest population (10,897). 197 evacuation centres were activated in total, initially hosting over 6,240 people. Many are women of reproductive age, with an estimated 150 currently pregnant. Asenaca learns about breast cancer self-checks from RFHAF’s healthcare provider, Karo. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Nasi, RFHAF healthcare provider The medical mobile team deliver a broad range of healthcare including contraception, information and counselling on sexual health, pregnancy, HIV and STI care and testing. RFHAF Team in Kadavu performing general health checks after TC Harold. Nasi administers a HPV shot to a client. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Kate, client Young women and girls are at the heart of RFHAF’s healthcare provision. Kate walks home with her dignity kit after a health check at the mobile clinic. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Karo, RFHAF healthcare worker RFHAF offers sexual and reproductive healthcare as well as counselling, and referrals for follow up care. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Alidi, RFHAF healthcare worker The team ensures young people in the community are not forgotten and provide information and education on relationships and sexual health and rights. Alidi conducting a session with a local group of young people at Gasele, Kadavu.Photos ©IPPF/Rob Rickman/Fiji Share on Twitter Share on Facebook Share via WhatsApp Share via Email

“I saw this challenge when children are having children and they're having a number of children at a very young age,” says 37-year-old Matiisetso Sefako, after emerging from the Lesotho Planned Parenthood Association (LPPA) tent in Mokhethoaneng village, an hour drive from the capital Maseru. “For them to be engaged in family planning, it would really help them.” The mother of two lives just outside the village and says she’s become something of a community activist on the issue of early child marriage and the need for family planning. After she receives services, she lingers for an hour, speaking with young women and teenage girls who are looking over at the LPPA mobile clinic with interest.    She herself was a 19-year-old mother and has been using contraceptives for nearly 20 years. Then, it was harder to come by and she would often have to travel at her own cost. Now, she comes regularly when LPPA makes the monthly visit to her village.  And she’s done quite a lot on this to advise people to try and convince them to come and access such services, she says.  “The only problem I encounter is that the biggest challenge within the village is that there is a high rate of teenage pregnancy. I try to convince them this tent will help.”  This is her fourth visit to the LPPA outreach to receive services herself. Her only wish? “That these services be here every day,” she says, explaining that there is a deeply-felt need in her community and her hope is that she can refer more young women to follow up and receive the same monthly services she benefits from.  

When Raphel Marafan Kori’s husband died in 2001, she was left to fend for herself, in a largely patriarchal society. Now 45-years-old, she keeps busy and earns an income as a peer educator in Tsenekeng village in Lesotho’s Semonkong region.  She goes door to door to counsel her neighbors and residents of the village in family planning options available. She’s been doing it for nine months and visibly brightens when she starts talking about the work. "I introduce myself, after that I explain to the people the services that we provide, the importance of the choices that we can make about contraceptives."  She was appointed by the village chief, Makholu Mahao, to participate in a training provided by LPPA in the capital, Maseru and soon after, dove into her fieldwork. Some people immediately understand and welcome the offerings, she says, while others take some time.  Protection & permission  Now nine months into the work, she says the biggest issue facing her community is “that adolescents still need consent from the parents. And the parents seem to have a problem with that because in a way, [they think] it is allowing them, giving them the freedom to indulge in sex.”  “Another way I can explain [is to] mention  HIV testing here and to remind [parents] it's not only they're getting protection but also for them to help them plan for future."   Going door to door Occasionally she’ll hold community gatherings, but mostly she has these conversations door to door. “I’m working very hard to make sure the children also engage in this for the future. It’s a challenge,” she admits. She herself comes to the mobile outreach post for family planning services, something she says helps break the ice when she is out in the community talking about family planning. She tells them she uses the pill because she is allergic to the injectable option offered here.  “I get to talk to people because I can counsel them on HIV and AIDS daily to make them understand that just because you have HIV it's not the end of the world but you need to take your medication properly and life continues,” she explains proudly, sitting a few meters away from the She Decides tent with a line of women outside. Overall, she says she has benefitted as much from her work as the beneficiaries. “I engage with people. I also learned a lot, it educated me especially on the protection side because even myself before I was not aware of such information but now I've learned and I can give other people this information.” 

“I was 18 when I married. But back then that was old!” 76-year-old Makholu Mahao laughs as she goes on to list her nine children – 4 boys, 5 girls including twins.  “At the time that I was married, if I knew about contraceptives, I wouldn’t have had so many children,” she insists.  Her tone becomes forceful and serious when she shifts to subjects like teenage pregnancy and childhood marriage, both ills that are prevalent in her village in the Semonkong region, known as Tsenekeng Hamojalefa.  The village sits atop a rocky hillside, most easily accessible by horse or donkey, and 114 kilometres from the capital, Maseru. She is the village chief now, a post she took up when her husband, the former chief, died.  And to her, “the big challenges are teenage pregnancy and early marriage. We’re seeing the difficulty in labor, children dying in labor, and young mothers dying in early labor. Those are the main things I need assistance with,” she explains to staff from Lesotho Planned Parenthood Association (LLPA), on a field visit to LPPA’s mobile clinic down the hill from Makholu’s home.  More than family planning “How can we stop this problem,” she asks her visitors.  Underage girls “marry at a young age, they don’t know what marriage is. They bear children and bear children and have problems, like death or infant death,” she reiterates. And it’s not just family planning that benefits the residents of her village. 16 villages ring the hillsides around the mobile outreach post, set up today to offer family planning, counseling, and HIV testing.  Before the arrival of LPPA on a monthly basis, “we were not receiving any other services other than the two clinics,” she explains, describing clinics approximately 40 km from her village. She adds, “We would leave early in the morning to get there at 9 or 10 to get the services. It was very congested so we would leave and get back here without getting any services.” Encouraging young people When it comes to combatting stigma in a patriarchal society, this great grandmother says some couples do go together for services or at least are in agreement about pursuing services. Still, “men cannot go with the women,” she explains. Throughout the day, men and women gather in separate groups outside the LPPA tents to receive consultations separately.  She sends a strong message by giving her OK for underage single women to seek family planning services. “It is acceptable that [minors] can get it [services], single or not,” she says. “At the end of the day, it’s protection for early pregnancy. The elderly – like me – don’t usually agree with that. But the [minors] will go on their own, however they can. I support that.”    

Bolelwa Falten in based in Losotho’s capital, Maseru, and has been working as a HIV counsellor for the better part of a decade, bouncing from different organizations depending on where the funding goes. Before she joined, IPPF nine months ago, 40-year-old Bolelwa worked with PSI Losotho. Now, she runs the “North team” as part of LPPA’s outreach program.  She handles five different outreach posts and today, she is running the HIV testing clinic at one site.  Bolelwa proudly takes us through the full range of tests and counseling services they offer there, taking particular pride in explaining how she follows up patients who test positive. She knows the beneficiaries appreciate the work – it’s something she sees every time she does an outreach day.  “They no longer need transport money, time to get to the clinic. Our being here is actually bringing the service to where they are and where they need it,” she says. But quickly, she follows up, noting that in general, HIV and STI mobile healthcare services have been hit-hard by funding cuts in recent years.

"This is a relief. I'm feeling very happy now that services have been brought,” 34-year-old Makamohelo Tlali, says, smiling outside the Lesotho Planned Parenthood Association (LPPA) tent on the hillside of Hamoshati village in Lesotho. Makamohelo is a relatively new beneficiary of family planning services offered monthly at a post near her village. This is her second visit. She walks over 30 minutes each way but says that’s by far the best option for her.  "I feel happy that services are here, for free. When I accessed them before it would take transport costs to get to the place."  In the past, it would cost her 40 rand for taxis to the closest clinic, plus the additional cost of family planning services.      Makamohelo first heard about these offerings from a peer mobilizer going door to door in her village.  “I met her along the way and discussed the way I can access family planning services. They’re scarce this side. And she told me on a specific date there would be LPPA people offering services." “Now here I am,” she says, laughing.  She takes advantage of the free HIV testing offered here as well and says she is hopeful the family planning will be maintained, mentioning that other NGOs have come and gone over the course of several years. For her and her husband, family planning is openly discussed in the household and important for the health of their current family. They have three children, 2 girls and a boy.  “Three is enough! My husband has no problem with me accessing family planning here,” she explains, adding that her husband relies on piecemeal jobs while she farms to feed the family. 

Cyclone Winston, which devastated Fiji, was the strongest to ever hit the South Pacific. IPPF’s humanitarian response there was carried out with our Member Association, the Reproductive & Family Health Association of Fiji, and is part of our SPRINT Initiative, funded by the Australian Government. Despite its flourishing international tourism industry, Fiji remains a deeply conservative and traditional society, bound by long-held rules on culture and conduct. In particular, any discussion about sex and sexuality is taboo: including talk of sex, condoms, pregnancy and sexually transmitted infections. Given Fiji’s relatively high rate of teen pregnancy (36 in 1000 in the 15-19 age group, according to UNFPA 2016 statistics), it is an issue of growing concern. It falls upon the village headman to provide guidance on how the issue is tackled: and when there is one who is progressive and not afraid to discuss taboo topics, it augers well for the sexual health of the entire community. Sevuama Sevutia is one such leader. The deputy headman of Naiserelegai village is a proud advocate of condom-use, telling the young people of the village that it is vital to wear them to prevent pregnancy. “My experiences, I share with the kids,” says Sevuama. “I tell the children, get to that stage of knowing what the sexual relationship is all about. Please look after yourself and if you have a problem, with the young boys or if someone is giving you the wrong advice, please tell people. It’s my job to tell them, to call their mother, their father.” “Nowadays, as the education level rises, we have to open up. But in the village, in the olden days, when people would see condoms they would say, 'no no, don’t talk about that'. But I am encouraging them to open up.” His children, too, are encouraged to be open. “I tell them, this is a condom,” he says, brandishing an imaginary condom. “Safe sex. If you want to have sex, use a condom. Use the condom! And protect yourself from the other things.” Sevuama, 53, a former marine engineer, spent decades in Suva before returning to his bayside home village of Naiserelegai. He was in the city at the time of the cyclone but managed to get back three or four days later when the roads had re-opened. He found his home damaged but intact and his five children safe, but much of the village destroyed and his wife still in shock. He received a small amount of money from the government to help fix his roof. Earlier this year, he, along with other men in the village, participated in IPPF information sessions on male sexual health and fertility, which he described as very helpful in complementing and reinforcing his existing knowledge. “We had a lot of questions, like mostly for the man, something might have happened to them during a difficult time. All this information helps the communities.” Stories Read more stories about our work in Fiji after the 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. My name is Elenoa Male and I live in the village of Navala. At the time of Cyclone Winston I was seven-months pregnant. It was already very hard trying to keep my other three children safe. I was alone with them because my husband went out hunting before the cyclone hit. Just before the time of the cyclone, my family was living between our traditional bure (thatched house) and a tin-roofed house. When the warnings first came, I decided to move my family from the bureto to the tin-roofed house. I realised that it would be hard to go to school where the evacuation centre was because I was pregnant. I told the kids we were sleeping under the bed. After we had dinner we prayed and we told God that now it is your will and we ask for your protection. So we lay down, and then my husband arrived and asked for the kids. I told him that we are all lying down under the bed. He said we really didn't know how strong the cyclone would be, but I told him to shut up and prepare for it. We all lay under the bed for hours. All I could hear was the strong winds. Once the winds died down, I came out but found our bure house was completely destroyed. I was sad because we need the bure for relaxation because of its coolness. I received a dignity kit from IPPF containing clothes for my children along with toothpaste and brushes, and this helped a lot in the weeks after Cyclone Winston. What I needed the most was for my kids to be fed properly and to wear good clothes. It really helped us a lot.   Stories Read more stories about our work in Fiji after the Cyclone Winston

Cyclone Winston, which devastated Fiji, was the strongest to ever hit the South Pacific. IPPF’s humanitarian response there was carried out with our Member Association, the Reproductive & Family Health Association of Fiji, and is part of our SPRINT Initiative, funded by the Australian Government. My name is Verenaisi Katerina. I have five children and we live in a remote village in the Ba Highlands. At the time the cyclone hit we were all living in a timber house and I was pregnant. I’ve lived in a bure (traditional timber house with a thatched grass roof) all my life, I’m so used to living in a bure, I’m not used to living in a tin-roofed house. We tried to be prepared when the cyclone came. But we had to all rush to the evacuation centre when the roof blew off our house. My whole family was scared, our house was flooded and our crops were all damaged. My daughter was covering her eyes and ears and crying for help. While I started preparing to move to the local school to take shelter, my husband went to get us some food. I was really, really afraid. I was so worried about my kids. I told my husband not to be late and to help me out with the kids going down to the school. In the end, I managed to get my children to the school on my own, and my husband joined us later. While my family took shelter, lots of other homes in Navala were destroyed. We were lucky: most of their possessions were blown away, but some managed to survive, and our home was damaged, but remained standing. When we came back the next day, my husband tried to start repairing the kitchen so that we could move back. We had a small stove that we were using, and we made a small kitchen so at least we could cook. My husband could only get us what was left over from the farm and that’s basically what we were living on. We had to eat a lot of flour products, a lot of rice, because our farm was badly damaged. I received a dignity kit from IPPF and found it extremely helpful, particularly in clothing my children and the baby. Some of it was worn on the very same day we received it. I later took part in a family planning session conducted by IPPF. I learned a lot from the workshop on that day. I told myself, this is it. I’m only going to have five kids. Having to go through that experience of Cyclone Winston, if I had more children, then it might have been more difficult, too late, for me to run up to that school for shelter. I have had a talk with my husband and we have decided that this one is my last. My fifth is my last.   Stories Read more stories about our work in Fiji after the Cyclone Winston