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Latest stories from IPPF

Spotlight

A selection of stories from across the Federation

Humanitarian response team, Fiji.
Story

In pictures: Humanitarian photographers share their experiences of storytelling in the field

IPPF’s localized approach to humanitarian emergencies is led by our Member Associations' response teams and whenever possible, we deploy local photographers.
Healthcare worker
story

| 14 January 2021

“Most NGOs don’t come here because it’s so hard to reach”

Dressed in a sparkling white medical coat, Alinafe runs one of Family Planning Association of Malawi (FPAM) mobile clinics in the village of Chigude. Under the hot midday sun, she patiently answering the questions of staff, volunteers and clients - all while heavily pregnant herself.  Delivering care to remote communities  “Most NGOs don’t come here because it’s so hard to reach,” she says, as women queue up in neat lines in front of two khaki tents to receive anything from a cervical cancer screening to abortion counselling. Without the mobile clinic, local women risk life-threatening health issues as a result of unsafe abortion or illnesses linked to undiagnosed HIV status. According to the Guttmacher Institute, complications from abortion are the cause of 6–18% of maternal deaths in Malawi.    District Manager Alinafe joined the Family Planning Association of Malawi in 2016, when she was just 20 years old, after going to nursing school and getting her degree in public health. She was one of the team involved in the Linkages project, which provided free family planning care to sex workers in Mzuzu until it was discontinued following the 2017 Global Gag Rule.  Seeing the impact of lost funding on care  “This change has reduced our reach,” Alinafe says, explaining that before the Gag Rule they were reaching sex workers in all four traditional authorities in Mzimba North - now they mostly work in just one. She says this means they are “denying people services which are very important” and without reaching people with sexual and reproductive healthcare, increasing the risk of STIs.    The reduction in healthcare has also led to a breakdown in the trust FPAM had worked to build in communities, gaining support from those in respected positions such as chiefs.    “Important people in the communities have been complaining to us, saying why did you do this? You were here, these things were happening and our people were benefiting a lot but now nothing is good at all,” explains Alinafe.    Still, she is determined to serve her community against the odds - running the outreach clinic funded by Global Affairs Canada five times a week, in four traditional authorities, as well as the FPAM Youth Life Centre in Mzuzu.  “On a serious note, unsafe abortions are happening in this area at a very high rate,” says Alinafe at the FPAM clinic in Chigude. “Talking about abortions is a very important thing. Whether we like it or not, on-the-ground these things are really happening, so we can’t ignore them.”

Healthcare worker
story

| 26 May 2022

“Most NGOs don’t come here because it’s so hard to reach”

Dressed in a sparkling white medical coat, Alinafe runs one of Family Planning Association of Malawi (FPAM) mobile clinics in the village of Chigude. Under the hot midday sun, she patiently answering the questions of staff, volunteers and clients - all while heavily pregnant herself.  Delivering care to remote communities  “Most NGOs don’t come here because it’s so hard to reach,” she says, as women queue up in neat lines in front of two khaki tents to receive anything from a cervical cancer screening to abortion counselling. Without the mobile clinic, local women risk life-threatening health issues as a result of unsafe abortion or illnesses linked to undiagnosed HIV status. According to the Guttmacher Institute, complications from abortion are the cause of 6–18% of maternal deaths in Malawi.    District Manager Alinafe joined the Family Planning Association of Malawi in 2016, when she was just 20 years old, after going to nursing school and getting her degree in public health. She was one of the team involved in the Linkages project, which provided free family planning care to sex workers in Mzuzu until it was discontinued following the 2017 Global Gag Rule.  Seeing the impact of lost funding on care  “This change has reduced our reach,” Alinafe says, explaining that before the Gag Rule they were reaching sex workers in all four traditional authorities in Mzimba North - now they mostly work in just one. She says this means they are “denying people services which are very important” and without reaching people with sexual and reproductive healthcare, increasing the risk of STIs.    The reduction in healthcare has also led to a breakdown in the trust FPAM had worked to build in communities, gaining support from those in respected positions such as chiefs.    “Important people in the communities have been complaining to us, saying why did you do this? You were here, these things were happening and our people were benefiting a lot but now nothing is good at all,” explains Alinafe.    Still, she is determined to serve her community against the odds - running the outreach clinic funded by Global Affairs Canada five times a week, in four traditional authorities, as well as the FPAM Youth Life Centre in Mzuzu.  “On a serious note, unsafe abortions are happening in this area at a very high rate,” says Alinafe at the FPAM clinic in Chigude. “Talking about abortions is a very important thing. Whether we like it or not, on-the-ground these things are really happening, so we can’t ignore them.”

woman
story

| 14 January 2021

“I learnt about condoms and even female condoms"

Mary, a 30-year-old sex worker, happily drinks a beer at one of the bars she works at in downtown Lilongwe. Her grin is reflected in the entirely mirrored walls, lit with red and blue neon lights.    Above her, a DJ sat in an elevated booth is playing pumping dancehall while a handful of people around the bar nod and dance along to the music. It’s not even midday yet.    Mary got introduced to the Family Planning Association of Malawi through friends, who invited her to a training session for sex worker ‘peer educators’ on issues related to sexual and reproductive health and rights as part of the Linkages project.    “I learnt about condoms and even female condoms, which I hadn’t heard of before,” remembers Mary.  Life-changing care and support   But the most life-changing care she received was an HIV test, where she learnt that she was positive and began anti-retroviral treatment (ART). “It was hard for me at first, but then I realized I had to start a new life,” says Mary, saying this included being open with her son about her status, who was 15 at the time.    According to UNAIDS 2018 data, 9.2% of adult Malawians are living with HIV. Women and sex workers are disproportionately affected - the same year, 55% of sex workers were estimated to be living with HIV.    Mary says she now feels much healthier and is open with her friends in the sex worker community about her status, also encouraging them to get tested for HIV.  “Linkages brought us all closer together as we became open about these issues with each other,” remembers Mary.  Looking out for other sex workers   As a peer educator, Mary became a go-to person for other sex workers to turn to in cases of sexual assault. “I’ll receive a message from someone who has been assaulted, then call everyone together to discuss the issue, and we’d escort that person to report to police,” says Mary.    During the Linkages project - which was impacted by the Global Gag Rule and abruptly discontinued in 2017 - Mary was given an allowance to travel to different ‘hotspot’ areas. In these bars and lodges, she explains in detail how she would go from room-to-room handing out male and female condoms and showing her peers how to use them.    FPAM healthcare teams would also go directly to the hotspots reaching women with healthcare such as STI testing and abortion counselling. FPAM’s teams know how crucial it is to provide healthcare to their clients ensuring it is non-judgmental and confidential. This is a vital service: Mary says she has had four sex worker friends die as a result of unsafe abortions, and lack of knowledge about post-abortion care.    “Since the project ended, most of us find it difficult to access these services,” says Mary, adding that “New sex workers don’t have the information I have, and without Linkages we’re not able to reach all the hotspot bars in Lilongwe to educate them.”

woman
story

| 26 May 2022

“I learnt about condoms and even female condoms"

Mary, a 30-year-old sex worker, happily drinks a beer at one of the bars she works at in downtown Lilongwe. Her grin is reflected in the entirely mirrored walls, lit with red and blue neon lights.    Above her, a DJ sat in an elevated booth is playing pumping dancehall while a handful of people around the bar nod and dance along to the music. It’s not even midday yet.    Mary got introduced to the Family Planning Association of Malawi through friends, who invited her to a training session for sex worker ‘peer educators’ on issues related to sexual and reproductive health and rights as part of the Linkages project.    “I learnt about condoms and even female condoms, which I hadn’t heard of before,” remembers Mary.  Life-changing care and support   But the most life-changing care she received was an HIV test, where she learnt that she was positive and began anti-retroviral treatment (ART). “It was hard for me at first, but then I realized I had to start a new life,” says Mary, saying this included being open with her son about her status, who was 15 at the time.    According to UNAIDS 2018 data, 9.2% of adult Malawians are living with HIV. Women and sex workers are disproportionately affected - the same year, 55% of sex workers were estimated to be living with HIV.    Mary says she now feels much healthier and is open with her friends in the sex worker community about her status, also encouraging them to get tested for HIV.  “Linkages brought us all closer together as we became open about these issues with each other,” remembers Mary.  Looking out for other sex workers   As a peer educator, Mary became a go-to person for other sex workers to turn to in cases of sexual assault. “I’ll receive a message from someone who has been assaulted, then call everyone together to discuss the issue, and we’d escort that person to report to police,” says Mary.    During the Linkages project - which was impacted by the Global Gag Rule and abruptly discontinued in 2017 - Mary was given an allowance to travel to different ‘hotspot’ areas. In these bars and lodges, she explains in detail how she would go from room-to-room handing out male and female condoms and showing her peers how to use them.    FPAM healthcare teams would also go directly to the hotspots reaching women with healthcare such as STI testing and abortion counselling. FPAM’s teams know how crucial it is to provide healthcare to their clients ensuring it is non-judgmental and confidential. This is a vital service: Mary says she has had four sex worker friends die as a result of unsafe abortions, and lack of knowledge about post-abortion care.    “Since the project ended, most of us find it difficult to access these services,” says Mary, adding that “New sex workers don’t have the information I have, and without Linkages we’re not able to reach all the hotspot bars in Lilongwe to educate them.”

Matilda Meke-Banda
story

| 22 January 2018

"We are non-judgemental; we embark on a mutual learning process."

It used to take Matilda Meke-Banda six hours on her motorbike along dirt roads to reach two remote districts and deliver sexual and reproductive health (SRH) services. In this part of southern Malawi, Machinga, family planning uptake is low, and the fertility rate, at 6.6, is the highest in the country. The Family Planning Association of Malawi, known as FPAM, runs a clinic in the town of Liwonde and it’s from here that Matilda travelled out six times a month. “We have established six watch groups, they are trained to address SRH issues in the community,” she explains. Luc Simon is the chair of one of those groups.  “We teach about Family Planning,” he says. “We encourage parents and young people to go for HIV testing. We address forced early marriages, talk to parents and children to save a lot of young people.” And there are a lot of myths to dispel about family planning. Elizabeth Katunga is head of family planning in the district hospital in Machinga: “Family Planning is not very much accepted by the communities. Many women hide the use of contraceptives,” she says. “Injectables are most popular, easy to hide. We have cases here where husbands upon discovery of an implant take a knife and cut it out. It is not that people want big families per se but it is the misconceptions about contraceptives.” FPAM’s projects are based at the Youth Life clinic in Liwonde. The clinic offers integrated services: Family planning, HIV services, STI screening, cervical cancer screening and general healthcare (such as malaria). This joined-up approach has been effective says FPAM’s executive director Thoko Mbendera: “In government health facilities, you have different days, and long queues always, for family planning, for HIV, for general health, which is a challenge if the clinic is a 20 km walk away.There are privacy issues.” But now, FPAM’s services are being cut because of the Global Gag Rule (GGR), mobile clinics are grounded, and there are fears that much progress will be undone. Some of FPAM’s rural clients explain how the Watch Groups work in their community. “It starts with me as a man,” says group member George Mpemba. “We are examples on how to live with our wives. We are non-judgemental; we embark on a mutual learning process. Our meetings are not hearings, but a normal chat, there is laughing and talking. After the discussion we evaluate together and make an action plan.” Katherine, went to the group for help: “There was violence in my marriage; my husband forced himself on me even if I was tired from working in the field. When I complained there was trouble. He did not provide even the bedding. “He is a fisherman and he makes a lot of cash which he used to buy beer but nothing for us.I overheard a watch group meeting once and I realised there was a solution. They talked to him and made him realise that what he was doing was violence and against the law. It was ignorance.Things are better now, he brings money home, sex is consensual and sometimes he helps with household chores.”

Matilda Meke-Banda
story

| 26 May 2022

"We are non-judgemental; we embark on a mutual learning process."

It used to take Matilda Meke-Banda six hours on her motorbike along dirt roads to reach two remote districts and deliver sexual and reproductive health (SRH) services. In this part of southern Malawi, Machinga, family planning uptake is low, and the fertility rate, at 6.6, is the highest in the country. The Family Planning Association of Malawi, known as FPAM, runs a clinic in the town of Liwonde and it’s from here that Matilda travelled out six times a month. “We have established six watch groups, they are trained to address SRH issues in the community,” she explains. Luc Simon is the chair of one of those groups.  “We teach about Family Planning,” he says. “We encourage parents and young people to go for HIV testing. We address forced early marriages, talk to parents and children to save a lot of young people.” And there are a lot of myths to dispel about family planning. Elizabeth Katunga is head of family planning in the district hospital in Machinga: “Family Planning is not very much accepted by the communities. Many women hide the use of contraceptives,” she says. “Injectables are most popular, easy to hide. We have cases here where husbands upon discovery of an implant take a knife and cut it out. It is not that people want big families per se but it is the misconceptions about contraceptives.” FPAM’s projects are based at the Youth Life clinic in Liwonde. The clinic offers integrated services: Family planning, HIV services, STI screening, cervical cancer screening and general healthcare (such as malaria). This joined-up approach has been effective says FPAM’s executive director Thoko Mbendera: “In government health facilities, you have different days, and long queues always, for family planning, for HIV, for general health, which is a challenge if the clinic is a 20 km walk away.There are privacy issues.” But now, FPAM’s services are being cut because of the Global Gag Rule (GGR), mobile clinics are grounded, and there are fears that much progress will be undone. Some of FPAM’s rural clients explain how the Watch Groups work in their community. “It starts with me as a man,” says group member George Mpemba. “We are examples on how to live with our wives. We are non-judgemental; we embark on a mutual learning process. Our meetings are not hearings, but a normal chat, there is laughing and talking. After the discussion we evaluate together and make an action plan.” Katherine, went to the group for help: “There was violence in my marriage; my husband forced himself on me even if I was tired from working in the field. When I complained there was trouble. He did not provide even the bedding. “He is a fisherman and he makes a lot of cash which he used to buy beer but nothing for us.I overheard a watch group meeting once and I realised there was a solution. They talked to him and made him realise that what he was doing was violence and against the law. It was ignorance.Things are better now, he brings money home, sex is consensual and sometimes he helps with household chores.”

Healthcare worker
story

| 14 January 2021

“Most NGOs don’t come here because it’s so hard to reach”

Dressed in a sparkling white medical coat, Alinafe runs one of Family Planning Association of Malawi (FPAM) mobile clinics in the village of Chigude. Under the hot midday sun, she patiently answering the questions of staff, volunteers and clients - all while heavily pregnant herself.  Delivering care to remote communities  “Most NGOs don’t come here because it’s so hard to reach,” she says, as women queue up in neat lines in front of two khaki tents to receive anything from a cervical cancer screening to abortion counselling. Without the mobile clinic, local women risk life-threatening health issues as a result of unsafe abortion or illnesses linked to undiagnosed HIV status. According to the Guttmacher Institute, complications from abortion are the cause of 6–18% of maternal deaths in Malawi.    District Manager Alinafe joined the Family Planning Association of Malawi in 2016, when she was just 20 years old, after going to nursing school and getting her degree in public health. She was one of the team involved in the Linkages project, which provided free family planning care to sex workers in Mzuzu until it was discontinued following the 2017 Global Gag Rule.  Seeing the impact of lost funding on care  “This change has reduced our reach,” Alinafe says, explaining that before the Gag Rule they were reaching sex workers in all four traditional authorities in Mzimba North - now they mostly work in just one. She says this means they are “denying people services which are very important” and without reaching people with sexual and reproductive healthcare, increasing the risk of STIs.    The reduction in healthcare has also led to a breakdown in the trust FPAM had worked to build in communities, gaining support from those in respected positions such as chiefs.    “Important people in the communities have been complaining to us, saying why did you do this? You were here, these things were happening and our people were benefiting a lot but now nothing is good at all,” explains Alinafe.    Still, she is determined to serve her community against the odds - running the outreach clinic funded by Global Affairs Canada five times a week, in four traditional authorities, as well as the FPAM Youth Life Centre in Mzuzu.  “On a serious note, unsafe abortions are happening in this area at a very high rate,” says Alinafe at the FPAM clinic in Chigude. “Talking about abortions is a very important thing. Whether we like it or not, on-the-ground these things are really happening, so we can’t ignore them.”

Healthcare worker
story

| 26 May 2022

“Most NGOs don’t come here because it’s so hard to reach”

Dressed in a sparkling white medical coat, Alinafe runs one of Family Planning Association of Malawi (FPAM) mobile clinics in the village of Chigude. Under the hot midday sun, she patiently answering the questions of staff, volunteers and clients - all while heavily pregnant herself.  Delivering care to remote communities  “Most NGOs don’t come here because it’s so hard to reach,” she says, as women queue up in neat lines in front of two khaki tents to receive anything from a cervical cancer screening to abortion counselling. Without the mobile clinic, local women risk life-threatening health issues as a result of unsafe abortion or illnesses linked to undiagnosed HIV status. According to the Guttmacher Institute, complications from abortion are the cause of 6–18% of maternal deaths in Malawi.    District Manager Alinafe joined the Family Planning Association of Malawi in 2016, when she was just 20 years old, after going to nursing school and getting her degree in public health. She was one of the team involved in the Linkages project, which provided free family planning care to sex workers in Mzuzu until it was discontinued following the 2017 Global Gag Rule.  Seeing the impact of lost funding on care  “This change has reduced our reach,” Alinafe says, explaining that before the Gag Rule they were reaching sex workers in all four traditional authorities in Mzimba North - now they mostly work in just one. She says this means they are “denying people services which are very important” and without reaching people with sexual and reproductive healthcare, increasing the risk of STIs.    The reduction in healthcare has also led to a breakdown in the trust FPAM had worked to build in communities, gaining support from those in respected positions such as chiefs.    “Important people in the communities have been complaining to us, saying why did you do this? You were here, these things were happening and our people were benefiting a lot but now nothing is good at all,” explains Alinafe.    Still, she is determined to serve her community against the odds - running the outreach clinic funded by Global Affairs Canada five times a week, in four traditional authorities, as well as the FPAM Youth Life Centre in Mzuzu.  “On a serious note, unsafe abortions are happening in this area at a very high rate,” says Alinafe at the FPAM clinic in Chigude. “Talking about abortions is a very important thing. Whether we like it or not, on-the-ground these things are really happening, so we can’t ignore them.”

woman
story

| 14 January 2021

“I learnt about condoms and even female condoms"

Mary, a 30-year-old sex worker, happily drinks a beer at one of the bars she works at in downtown Lilongwe. Her grin is reflected in the entirely mirrored walls, lit with red and blue neon lights.    Above her, a DJ sat in an elevated booth is playing pumping dancehall while a handful of people around the bar nod and dance along to the music. It’s not even midday yet.    Mary got introduced to the Family Planning Association of Malawi through friends, who invited her to a training session for sex worker ‘peer educators’ on issues related to sexual and reproductive health and rights as part of the Linkages project.    “I learnt about condoms and even female condoms, which I hadn’t heard of before,” remembers Mary.  Life-changing care and support   But the most life-changing care she received was an HIV test, where she learnt that she was positive and began anti-retroviral treatment (ART). “It was hard for me at first, but then I realized I had to start a new life,” says Mary, saying this included being open with her son about her status, who was 15 at the time.    According to UNAIDS 2018 data, 9.2% of adult Malawians are living with HIV. Women and sex workers are disproportionately affected - the same year, 55% of sex workers were estimated to be living with HIV.    Mary says she now feels much healthier and is open with her friends in the sex worker community about her status, also encouraging them to get tested for HIV.  “Linkages brought us all closer together as we became open about these issues with each other,” remembers Mary.  Looking out for other sex workers   As a peer educator, Mary became a go-to person for other sex workers to turn to in cases of sexual assault. “I’ll receive a message from someone who has been assaulted, then call everyone together to discuss the issue, and we’d escort that person to report to police,” says Mary.    During the Linkages project - which was impacted by the Global Gag Rule and abruptly discontinued in 2017 - Mary was given an allowance to travel to different ‘hotspot’ areas. In these bars and lodges, she explains in detail how she would go from room-to-room handing out male and female condoms and showing her peers how to use them.    FPAM healthcare teams would also go directly to the hotspots reaching women with healthcare such as STI testing and abortion counselling. FPAM’s teams know how crucial it is to provide healthcare to their clients ensuring it is non-judgmental and confidential. This is a vital service: Mary says she has had four sex worker friends die as a result of unsafe abortions, and lack of knowledge about post-abortion care.    “Since the project ended, most of us find it difficult to access these services,” says Mary, adding that “New sex workers don’t have the information I have, and without Linkages we’re not able to reach all the hotspot bars in Lilongwe to educate them.”

woman
story

| 26 May 2022

“I learnt about condoms and even female condoms"

Mary, a 30-year-old sex worker, happily drinks a beer at one of the bars she works at in downtown Lilongwe. Her grin is reflected in the entirely mirrored walls, lit with red and blue neon lights.    Above her, a DJ sat in an elevated booth is playing pumping dancehall while a handful of people around the bar nod and dance along to the music. It’s not even midday yet.    Mary got introduced to the Family Planning Association of Malawi through friends, who invited her to a training session for sex worker ‘peer educators’ on issues related to sexual and reproductive health and rights as part of the Linkages project.    “I learnt about condoms and even female condoms, which I hadn’t heard of before,” remembers Mary.  Life-changing care and support   But the most life-changing care she received was an HIV test, where she learnt that she was positive and began anti-retroviral treatment (ART). “It was hard for me at first, but then I realized I had to start a new life,” says Mary, saying this included being open with her son about her status, who was 15 at the time.    According to UNAIDS 2018 data, 9.2% of adult Malawians are living with HIV. Women and sex workers are disproportionately affected - the same year, 55% of sex workers were estimated to be living with HIV.    Mary says she now feels much healthier and is open with her friends in the sex worker community about her status, also encouraging them to get tested for HIV.  “Linkages brought us all closer together as we became open about these issues with each other,” remembers Mary.  Looking out for other sex workers   As a peer educator, Mary became a go-to person for other sex workers to turn to in cases of sexual assault. “I’ll receive a message from someone who has been assaulted, then call everyone together to discuss the issue, and we’d escort that person to report to police,” says Mary.    During the Linkages project - which was impacted by the Global Gag Rule and abruptly discontinued in 2017 - Mary was given an allowance to travel to different ‘hotspot’ areas. In these bars and lodges, she explains in detail how she would go from room-to-room handing out male and female condoms and showing her peers how to use them.    FPAM healthcare teams would also go directly to the hotspots reaching women with healthcare such as STI testing and abortion counselling. FPAM’s teams know how crucial it is to provide healthcare to their clients ensuring it is non-judgmental and confidential. This is a vital service: Mary says she has had four sex worker friends die as a result of unsafe abortions, and lack of knowledge about post-abortion care.    “Since the project ended, most of us find it difficult to access these services,” says Mary, adding that “New sex workers don’t have the information I have, and without Linkages we’re not able to reach all the hotspot bars in Lilongwe to educate them.”

Matilda Meke-Banda
story

| 22 January 2018

"We are non-judgemental; we embark on a mutual learning process."

It used to take Matilda Meke-Banda six hours on her motorbike along dirt roads to reach two remote districts and deliver sexual and reproductive health (SRH) services. In this part of southern Malawi, Machinga, family planning uptake is low, and the fertility rate, at 6.6, is the highest in the country. The Family Planning Association of Malawi, known as FPAM, runs a clinic in the town of Liwonde and it’s from here that Matilda travelled out six times a month. “We have established six watch groups, they are trained to address SRH issues in the community,” she explains. Luc Simon is the chair of one of those groups.  “We teach about Family Planning,” he says. “We encourage parents and young people to go for HIV testing. We address forced early marriages, talk to parents and children to save a lot of young people.” And there are a lot of myths to dispel about family planning. Elizabeth Katunga is head of family planning in the district hospital in Machinga: “Family Planning is not very much accepted by the communities. Many women hide the use of contraceptives,” she says. “Injectables are most popular, easy to hide. We have cases here where husbands upon discovery of an implant take a knife and cut it out. It is not that people want big families per se but it is the misconceptions about contraceptives.” FPAM’s projects are based at the Youth Life clinic in Liwonde. The clinic offers integrated services: Family planning, HIV services, STI screening, cervical cancer screening and general healthcare (such as malaria). This joined-up approach has been effective says FPAM’s executive director Thoko Mbendera: “In government health facilities, you have different days, and long queues always, for family planning, for HIV, for general health, which is a challenge if the clinic is a 20 km walk away.There are privacy issues.” But now, FPAM’s services are being cut because of the Global Gag Rule (GGR), mobile clinics are grounded, and there are fears that much progress will be undone. Some of FPAM’s rural clients explain how the Watch Groups work in their community. “It starts with me as a man,” says group member George Mpemba. “We are examples on how to live with our wives. We are non-judgemental; we embark on a mutual learning process. Our meetings are not hearings, but a normal chat, there is laughing and talking. After the discussion we evaluate together and make an action plan.” Katherine, went to the group for help: “There was violence in my marriage; my husband forced himself on me even if I was tired from working in the field. When I complained there was trouble. He did not provide even the bedding. “He is a fisherman and he makes a lot of cash which he used to buy beer but nothing for us.I overheard a watch group meeting once and I realised there was a solution. They talked to him and made him realise that what he was doing was violence and against the law. It was ignorance.Things are better now, he brings money home, sex is consensual and sometimes he helps with household chores.”

Matilda Meke-Banda
story

| 26 May 2022

"We are non-judgemental; we embark on a mutual learning process."

It used to take Matilda Meke-Banda six hours on her motorbike along dirt roads to reach two remote districts and deliver sexual and reproductive health (SRH) services. In this part of southern Malawi, Machinga, family planning uptake is low, and the fertility rate, at 6.6, is the highest in the country. The Family Planning Association of Malawi, known as FPAM, runs a clinic in the town of Liwonde and it’s from here that Matilda travelled out six times a month. “We have established six watch groups, they are trained to address SRH issues in the community,” she explains. Luc Simon is the chair of one of those groups.  “We teach about Family Planning,” he says. “We encourage parents and young people to go for HIV testing. We address forced early marriages, talk to parents and children to save a lot of young people.” And there are a lot of myths to dispel about family planning. Elizabeth Katunga is head of family planning in the district hospital in Machinga: “Family Planning is not very much accepted by the communities. Many women hide the use of contraceptives,” she says. “Injectables are most popular, easy to hide. We have cases here where husbands upon discovery of an implant take a knife and cut it out. It is not that people want big families per se but it is the misconceptions about contraceptives.” FPAM’s projects are based at the Youth Life clinic in Liwonde. The clinic offers integrated services: Family planning, HIV services, STI screening, cervical cancer screening and general healthcare (such as malaria). This joined-up approach has been effective says FPAM’s executive director Thoko Mbendera: “In government health facilities, you have different days, and long queues always, for family planning, for HIV, for general health, which is a challenge if the clinic is a 20 km walk away.There are privacy issues.” But now, FPAM’s services are being cut because of the Global Gag Rule (GGR), mobile clinics are grounded, and there are fears that much progress will be undone. Some of FPAM’s rural clients explain how the Watch Groups work in their community. “It starts with me as a man,” says group member George Mpemba. “We are examples on how to live with our wives. We are non-judgemental; we embark on a mutual learning process. Our meetings are not hearings, but a normal chat, there is laughing and talking. After the discussion we evaluate together and make an action plan.” Katherine, went to the group for help: “There was violence in my marriage; my husband forced himself on me even if I was tired from working in the field. When I complained there was trouble. He did not provide even the bedding. “He is a fisherman and he makes a lot of cash which he used to buy beer but nothing for us.I overheard a watch group meeting once and I realised there was a solution. They talked to him and made him realise that what he was doing was violence and against the law. It was ignorance.Things are better now, he brings money home, sex is consensual and sometimes he helps with household chores.”