Stories

Women around the world have faced multiple barriers to accessing safe abortion care during the COVID-19 pandemic including the de-prioritization of sexual and reproductive healthcare, overwhelmed health systems and restrictions on movement. The COVID-19 crisis has sparked innovation among IPPF Member Associations who responded swiftly by developing new approaches to reach women with safe abortion care including telemedicine and home-based provision of medical abortion. Strong evidence generated from this work supports the continuation and strengthening of these approaches beyond the end of the pandemic. Cameroon Cameroon National Planning Association for Family Welfare (CAMNAFAW) To ensure that quality abortion care can be provided to women during travel restrictions, CAMNAFAW’s service providers travel to partner clinics in underserved areas and to clients’ homes to provide medical and surgical abortion care. This model of taking safe abortion care closer to women will continue even with easing of travel restrictions, as this has been found to be an effective and acceptable approach to increasing access.Photo: IPPF/Xaume Olleros/Cameroon Share on Twitter Share on Facebook Share via WhatsApp Share via Email Guinea Association Guinéenne pour le Bien-Etre Familial (AGBEF) Building on lessons learned during the Ebola crisis in Guinea, AGBEF quickly took measures to prevent infection in its clinics to continue providing sexual and reproductive healthcare, including surgical and medical abortion, in a safe environment. AGBEF donated protective materials to communities, including hand-washing stations, face masks and antibacterial gel, alongside messaging on infection prevention. This community visibility reassures clients they can safely attend AGBEF clinics for abortion and contraceptive care.Photo: AGBEF/Guinea Share on Twitter Share on Facebook Share via WhatsApp Share via Email India Family Planning Association of India (FPA India) FPA India and partners advocated to have sexual and reproductive healthcare, including abortion, recognized as essential by the government, which meant FPA India could continue healthcare delivery during the national lockdown. To reduce in-person clinic visits, FPA India established teleconsultation and counselling for abortion care, and is continuing to provide in-clinic care for both medical and surgical abortion. Photo: IPPF/Alison Joyce/India Share on Twitter Share on Facebook Share via WhatsApp Share via Email Nepal Family Planning Association of Nepal (FPAN) FPAN and partners advocated for interim approval of home provision of medical abortion and telemedicine for abortion counselling during COVID-19. FPAN is now implementing these approaches, ensuring continued access to abortion care in Nepal, where many people live in remote locations with limited mobility, which has been further restricted by COVID-19 lockdowns. Photo: FPAN/Nepal Share on Twitter Share on Facebook Share via WhatsApp Share via Email Pakistan Rahnuma – Family Planning Association of Pakistan (Rahnuma-FPAP) Rahnuma-FPAP and partners successfully advocated for the government to class sexual and reproductive healthcare as ‘essential’, which enabled the team to continue providing post-abortion care during the pandemic. Rahnuma-FPAP expanded its telemedicine and home-based provision for menstrual regulation counselling and post-abortion care. These new approaches have ensured continued access to services for clients unable to reach clinics.Photo: Rahnuma-FPAP/Pakistan Share on Twitter Share on Facebook Share via WhatsApp Share via Email Palestine Palestinian Family Planning and Protection Association (PFPPA) In response to the government-mandated closure of its clinics, PFPPA quickly established a toll-free call centre which provides consultations, counselling, referrals and follow-up, including consultation for abortion care through a harm reduction approach, ensuring that women are provided with accurate information. Due to its success, PFPPA is exploring options for continuing this healthcare delivery model beyond the pandemic, with the aim of keeping it free of charge for users.Photo: SAAF/Samar Hazboun/Palestine Share on Twitter Share on Facebook Share via WhatsApp Share via Email Sudan Sudan Family Planning Association (SFPA) Following a nation-wide shutdown in April, SFPA  established  a call centre to increase access to healthcare, including abortion and contraceptive counselling and referrals.  An unexpected outcome of the new call centre is that it has reached an increased number of young women who regularly call to discuss their reproductive health and rights. SFPA  is working  towards institutionalizing this model for continuation beyond the pandemic.Photo: SFPA/Sudan Share on Twitter Share on Facebook Share via WhatsApp Share via Email Togo Association Togolaise pour le Bien-Etre Familial (ATBEF) ATBEF adapted its mobile application ‘Infos Ado Jeunes’, adding a toll-free teleconsultation service for young clients to use to access abortion consultations and pre- and post-abortion counselling. This app has given young clients ongoing access to care when they face challenges travelling to clinics. It has also eased overall client flow in clinics at a time when social distancing is being implemented.Photo: ATBEF/Togo Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Women and girls in Palestine face a number of difficulties and challenges. The ongoing conflict and lack of sitting government as well as high unemployment, has led to poverty and inequality, while an increasingly conservative society and traditionally patriarchal culture has led to increased gender-inequality and lack of access to sexual and reproductive healthcare. The current abortion law unfairly pushes women to risk their lives and health to attempt to end their unwanted pregnancies in unsafe ways. In this context, the Palestinian Family Planning and Protection Agency (PFPPA) has been working since 1964, to provide sexual and reproductive healthcare and advocate for women’s rights. Having received two grants from Safe Abortion Action Fund (SAAF) since 2014, they have been working on the lack of access to safe abortion in the country with a focus on increasing their provision of abortion-related services and advocating at community and national level for changes to the abortion law. My name is Fatima, I am a midwife and have worked with PFPPA for 18 years in the Halhul clinic in Palestine.   PFPPA has had a great impact on me personally as well as the community as a whole. I experienced violence in my marriage but when I joined the organization I learned the meaning of violence and I realized that I didn’t have to put up with it and could make decisions for myself. This was a turning point in my life. My life changed 180 degrees, thank God, and my husband stopped being violent.  Society & acceptance Since I have worked here, I have seen changes in society’s acceptance of sexual and reproductive health issues and I feel that more people are supporting us. They can be women, religious personalities or young volunteers. One of the proudest moments of my work has been working with a young man who was training to be a peer educator, he was violent, especially with his sister. From the very start of the training, he was against the issues that we were presenting, however, he started to understand our issues. I also met his mother and she thanked me for the change that happened in his life. She came to say that he is now helping in the house - washing dishes and doing other tasks that he would have thought were just for women before.  The challenges that we face are a misunderstanding of religion, negative traditions and customs, as well as the political situation in Palestine with the occupation, the walls, the checkpoints as well as the economic situation. We work on issues that will take many years to witness any change due to the negative traditions and customs.  Harm reduction & abortion care We have recently started implementing a harm reduction approach to abortion care. I remember one woman who was 44 years old and divorced. She came to the clinic and was seven weeks pregnant. Her face was pale and tired...I felt that all the problems were on her shoulders. She was looking for a saviour. We supported her with harm reduction information and afterwards provided information on post-abortion contraception. After one or two months she sent a message thanking me, saying that we had saved her life, I was really happy about that.  There are also cases of women that come here, maybe they took pills or they did something that made them bleed. They don’t tell you what they did but I can detect if I think an abortion happened. If it is an incomplete abortion, we explain how to take the treatment and we follow up with support.  Unsafe methods  Women in our communities use many unsafe methods to try to end pregnancies. They drink special teas or chlorine. They jump off things or ask their children to jump on them. They sometimes put suppositories made from Arabic medicinal herbs into the cervix. Although it is common, deaths are not registered as linked to unsafe abortion but are probably registered as maternal deaths.  When the society says that abortion is haram (forbidden), they don’t take into consideration the issues and these women in need. Imagine if we had safe abortion services at the hospitals, we would not see these issues at all. There are women who would choose abortion for reasons like their age, their health, social issues and psychological issues. There are women themselves who say “I will die if I complete this pregnancy”. I am passionate about the work that I do. I advocate for these issues everywhere I go, on the bus, during weddings and with friends and family, wherever I go. That is why the Safe Abortion Action Fund (SAAF) funded project is so important. I have learned a lot about advocacy and campaigning, how we manage legal advocacy and how to work with decision-makers. We have run events to mark International Safe Abortion Day with groups of women gathered here in the centre and with decision-makers and volunteers. Read more stories from SAAF in Palestine

Women and girls in Palestine face a number of difficulties and challenges. The ongoing conflict and lack of sitting government as well as high unemployment, has led to poverty and inequality, while an increasingly conservative society and traditionally patriarchal culture has led to increased gender-inequality and lack of access to sexual and reproductive healthcare. The current abortion law unfairly pushes women to risk their lives and health to attempt to end their unwanted pregnancies in unsafe ways. In this context, the Palestinian Family Planning and Protection Agency (PFPPA) has been working since 1964, to provide sexual and reproductive healthcare and advocate for women’s rights. Having received two grants from Safe Abortion Action Fund (SAAF) since 2014, they have been working on the lack of access to safe abortion in the country with a focus on increasing their provision of abortion-related services and advocating at community and national level for changes to the abortion law.  My name is Amani and I am 24 years old. I live with my parents in Bethlehem in the West Bank and I work as a midwife in a family hospital in Jerusalem as well as a peer education volunteer with the Palestinian Family Planning and Protection Agency.  Working in schools Part of my role as a volunteer involves going to schools and doing presentations about early-marriage, family planning and gender-based violence. Even though sex outside of marriage is taboo, it does happen. However, it is very hard for unmarried people to access contraception as the culture is so restrictive, especially here in Hebron. When they need contraception, the man usually goes by himself or they look online.  When we go to schools and talk to students about the subject of sexual health, the students want to know more because at home it is a taboo to talk about such things. We get many questions about issues such as masturbation or what causes pregnancy. They just know that it happens when men and women are together, they do not know how it happens. So people may ask a question like: ‘if I touch somebody, if I stand near someone or kiss them will I get pregnant?’ Abortion is still a taboo The students don’t normally ask about abortion as it is such a taboo. I do know that unsafe abortion happens though, for example my grandmother tried to end her pregnancy once. She was forty-five years old and had six children already. She did not know any way of not getting pregnant or safely ending the pregnancy. She told me that she drank liquids and jumped from the stairs, taking a great risk. She really didn’t want to be pregnant again and tried hard to end it but it did not work.  I am very proud that as a peer educator I have expanded my knowledge on many issues, including how to provide harm reduction information to women so that they can reduce risks of unsafe abortion and not do what my grandmother did in case they don’t want to be pregnant.   Once I met with a woman who already had six children, she was tired of having children but her husband wanted to have more so we visited them at home and through conversation, the husband understood the need, so she was able to access an IUD. Here we work a lot with women, we change them, we speak with them, they change their opinions, they become decision-makers and they leave the clinic as different people.  Read more stories from SAAF in Palestine

Women and girls in Palestine face a number of difficulties and challenges. The ongoing conflict and lack of sitting government as well as high unemployment, has led to poverty and inequality, while an increasingly conservative society and traditionally patriarchal culture has led to increased gender-inequality and lack of access to sexual and reproductive healthcare. The current abortion law unfairly pushes women to risk their lives and health to attempt to end their unwanted pregnancies in unsafe ways. In this context, the Palestinian Family Planning and Protection Agency (PFPPA) has been working since 1964, to provide sexual and reproductive healthcare and advocate for women’s rights. Having received two grants from Safe Abortion Action Fund (SAAF) since 2014, they have been working on the lack of access to safe abortion in the country with a focus on increasing their provision of abortion-related services and advocating at community and national level for changes to the abortion law.  My name is Khawla*, I am 42 years old and I am a midwife and university lecturer. I have been married for 10 years and have three children, two boys and a girl. I have multiple health issues and a number of hereditary conditions in my family. I first became involved with PFPPA through my work, having taken many trainings with them about issues such as early marriage, gender-based violence, sexual health and safe abortion. Then last year I accidentally became pregnant myself. My youngest child was just two years old, I had a new job at the time and was suffering with a number of health issues that would make another pregnancy dangerous for me.  Unintended pregnancy When I read that the pregnancy test was positive, it was a very hard time. I started crying – I felt like the world was very black – it was the end of my life. I would kill myself, if I didn’t end this pregnancy. So I came to PFPPA and they treated me as a client. I met with the social worker, midwife and doctor and, since the pregnancy was risk to my life and I was very weak and bleeding when I reached them they were able to prescribe the tablets. These pills are highly regulated and restricted here and not all pharmacists stock them but I was able to access them with the prescription and they worked. PFPPA provided follow up afterwards helping me to find an effective long-acting family planning method. Even though I knew about the different methods, they discussed them all with me to ensure that they would be appropriate for my health.  Even though the law allows abortion in cases of risks to health of the woman, you need to get permission from the religious leaders and they are very hard to convince. I took my case to them and, despite my health issues, they refused despite it being very early in the pregnancy, before the ensoulment and is allowed according to Islam. The public hospital will not perform it unless they receive the permission from the religious leaders and they don’t give it despite what the religious rules say.  Stigma & access From my experience the situation in relation to abortion in Palestine is very hard. There are many women who get pregnant who did not plan it and it’s not the time for the pregnancy. The door is closed to them from the public health system. I have started to campaign on this issue now, I talk to the students in my course about how we can solve this problem. I think the stigma is very difficult. I never thought I would be in this situation, I talked a lot about it before but when you are in the situation, it is totally different.  I really appreciated the help given from the PFPPA team, particularly the psychological support. When I felt bad, they helped me to see that I was doing the right thing and it was my right. Read more stories from SAAF in Palestine *Not her real name

The Safe Abortion Action Fund (SAAF) which is hosted by IPPF was set up in 2006 in order to support grass-roots organisations to increase access to safe abortion. One such organisation which received support under the last round of funding is called Lady Mermaid's Bureau. I am Pretty Lynn, aged 25. I am a sex worker but I went to university. I graduated with a Bachelor's Degree in Tourism in 2013. But now, during the day I’m sleeping and during the night I’m working. That is how my day goes every day. I got into sex work through friends. Okay it is not good but I am earning.  I tried to get a job when I graduated. I have been applying since I graduated in 2013. I’m still applying but I’m not getting anywhere. You know to get jobs in Uganda; you have to know someone there and no one knows me there. To be a sex worker is like a curse. People look at you like, I don’t know, as someone that has no use in society. People look at you in a bad way. They even don’t consider why you are selling. They just see you as the worst thing that can happen in the society. So it is not comfortable, it is really hard but we try and survive. The fact sex working is illegal means you have to hide yourself when you are selling so that police cannot take you. And then you get diseases, men don’t want to pay. When the police come and take us, sometimes they even use us and don’t pay. So it is really hard. They want a free service. Like if they come and take you and pay that would be fair. But they say it is illegal to sell yourself. But they still use you yet they are saying it is illegal. You can’t report the police because there is no evidence.  Abortion and unwanted pregnancies are really common because men don’t want to use condoms and female condoms are really rare and they are expensive. Though at times we get female condoms from Lady Marmaid’s Bureau (LMB) because there are so many of us they can’t keep on giving you them all the time. At times when we get pregnant we use local methods. You can go and use local herbs but it is not safe. One time I used local herbs and I was successful. Then the other time I used Omo washing powder and tea leaves but it was really hard for me. I almost died. I had a friend who died last year from this. But the good thing is that LMB taught us about safe abortion. I have had a safe abortion too. There are some tabs they are called Miso (misoprostol). It costs about fifty thousand shillings (£10 pounds or $20.) It is a lot of money. But if I’m working and I know I’m pregnant, I can say, "this week I’m working for my safe abortion". So if I’m working for twenty thousand, by the end of the week I will have the money. It is expensive compared to Omo at five hundred shillings but that is risky. So if I say I will work this whole week for Miso (misoprostol) it is better. But I'm working and I'm not eating. A project like this one from Lady Mermaid's can help young girls and women. But to take us from sex work, it would really be hard. They would not have enough money to cater for all of us. So what they have to do is to teach us how to protect ourselves, how to defend ourselves. Safe abortion yes. They will just have to sensitise us more about our lives, protection, female condoms and all that. I don't have a boyfriend but maybe when I get money and leave this job I will. But for now, no man would like a woman who sells. No man will bear the wife selling herself. And that will happen only if I get funds, settle somewhere else and become responsible woman. I don’t want this job. I don’t want to be in this business of sex work all the time. I want be married, with my children happily, not selling myself. Stories Read more stories about the amazing success of SAAF in Uganda

The Safe Abortion Action Fund (SAAF) which is hosted by IPPF was set up in 2006 in order to support grass-roots organisations to increase access to safe abortion. One such organisation which received support under the last round of funding is called Volunteers for Development Association Uganda (VODA). Unsafe abortion is a huge problem in Uganda with an estimated 400,000 women having an unsafe abortion per year. The law is confusing and unclear, with abortion permitted only under certain circumstances. Post-abortion care is permitted to treat women who have undergone an unsafe abortion, however lack of awareness of the law and stigma surrounding abortion mean that service providers are not always willing to treat patients who arrive seeking care. The VODA project aims to ensure that young women in Uganda are able to lead healthier lives free from unsafe abortion related deaths or complications through reducing abortion stigma in the community, increasing access to abortion-related services and ensuring the providers are trained to provide quality post-abortion care services. I am Helen. I have been a midwife at this small clinic for seven years and I have worked with VODA for four years. Unsafe abortion continues and some schoolgirls are raped. They then go to local herbalists and some of them tell me that they are given emilandira [roots] which they insert inside themselves to rupture the membranes. Some of them even try to induce an abortion by using Omo [douching with detergent or bleach]. At the end of the day they get complications then they land here, so we help them. Unsafe abortion is very common. In one month you can get more than five cases. It is a big problem. We help them, they need to go back to school, and we counsel them. If it is less than 12 weeks, we handle them from here. If they are more than 12 weeks along we refer them to the hospital. Most referrals from VODA are related to unwanted pregnancies, HIV testing, family planning, and youth friendly services. A few parents come for services for their children who are at school. So we counsel them that contraception, other than condoms, will only prevent pregnancy, but you can still get HIV and STIs, so take care. I am Josephine and I work as a midwife at a rural health centre. I deal with pregnant mothers, postnatal mothers, and there are girls who come with problems like unwanted pregnancy. I used to have a negative attitude towards abortion. But then VODA helped us understand the importance of helping someone with the problem because many people were dying in the villages because of unsafe abortion. According to my religion, helping someone to have an abortion was not allowed. But again when you look into it, it’s not good to leave someone to die. So I decided to change my attitude to help people. Post-abortion care has helped many people because these days we don’t have many people in the villages dying because of unsafe abortion. These days I’m proud of what we are doing because before I didn’t know the importance of helping someone with a problem. But these days, since people no longer die, people no longer get problems and I’m proud and happy because we help so many people.   My name is Jonathan. I am married with three children. I have a Bachelor of Social Work and Social Administration. I have worked with VODA as a project officer since 2008. Due to the training that we have done about abortion many people have changed their attitudes and we have helped people to talk about the issue. Most people were against abortion before but they are now realising that if it’s done safely it is important because otherwise many people die from unsafe abortion. I have talked to religious leaders, I have talked to local leaders; I have talked to people of different categories. At first when you approach them, they have a different perception. The health workers were difficult to work with at first. However they knew people were approaching them with the problems of unsafe abortion. Due to religion, communities can be hard against this issue. But after some time we have seen that they have changed their perception toward the issue of safe and unsafe abortion. And now many of them know that in some instances, abortion is inevitable but it should be done in a safe way.   I’m Stevens and I am nurse. We have some clients who come when they have already attempted an unsafe abortion. You find that it is often inevitable. The only solution you have to help those clients is to provide treatment of incomplete abortion as part of post-abortion care. Because of the VODA project there is a very remarkable change in the community. Now, those people who used to have unsafe abortions locally, know where to go for post-abortion care - unlike in the past. I remember a schoolgirl, she was in a very sorry state because she had tried some local remedies to abort. I attended to her and things went well. She went back to school. I feel so proud because that was a big life rescue. A girl like that could have died but now she is alive and I see her carrying on with her studies, I feel so proud. I praise VODA for that encouragement. This service should be legalised because whether they restrict it or not, there is abortion and it is going on. And if it’s not out in the open, so that our people know where to go for such services, it leads to more deaths. Stories Read more stories about the amazing success of SAAF in Uganda

The Safe Abortion Action Fund (SAAF) which is hosted by IPPF was set up in 2006 in order to support grass-roots organisations to increase access to safe abortion. One such organisation which received support under the last round of funding is called Volunteers for Development Association Uganda (VODA). Margaret's daughter, Gladys, was raped by a relative as a teenager and became pregnant. She did not tell her mother what had happened and not wanting to have a child at such a young age conceived through incest, Gladys tried to terminate the pregnancy herself using local herbs but got an infection and died. "My name is Margaret and I am a widow." "I lost my daughter in 2011. She was called Gladys and she was 16. I didn’t know that she was pregnant. She tried to use local herbs to abort. I only found out about it three days later when she was bleeding very heavily. I tried to take her to the hospital but unfortunately she died on the way." Despite being the cause of many deaths in the region, the stigma surrounding abortion means that most people do not mention the cause of death publically. However at Gladys' funeral one of her school friends spoke out and said that she had died due to unsafe abortion. This prompted VODA to start working on the issue and when the project started they included Margaret in their training on how to prevent unsafe abortion. "The training made me stronger to talk about it. Now, I continue to tell my remaining two girls about the dangers of unsafe abortion, sexually transmitted infections and unwanted pregnancies. VODA has really helped us. I think my girl wouldn’t have died if VODA was active then like it is now." "I have used VODA's information to carry on with my parental work. That information has been helpful because we are noticing change. I keep on reminding them, 'didn’t you see what happened to your friend here?'. So they have really changed especially with the ongoing help of the people from VODA." "Unsafe abortion was rampant in the past. We had tried to speak to the students, as parents, but it seemed that our information was not enough. But now we have another helping hand from VODA, especially with those seminars targeting the girls."   Stories Read more stories about the amazing success of SAAF in Uganda

The Safe Abortion Action Fund (SAAF) which is hosted by IPPF was set up in 2006 in order to support grassroots organisations to increase access to safe abortion. One such organisation which received support under the last round of funding is called Volunteers for Development Association Uganda (VODA). Peer educators in schools provide counselling and advice to other students, who otherwise would have no one to turn to in times of crisis. Today, we have the largest generation of young people ever, each one with their own unique needs. Peer educators are critical in gaining the trust and confidence of hundreds of young girls each term, and together they help each other gain more knowledge about their sexual and reproductive health. Peer educators themselves also gain a great deal from the training and experience and VODA has been successful in empowering many of these young girls to feel confident and be able to talk out in public, something that they were not able to do before. Poverty, gender inequality, lack of knowledge about sex and relationships and lack of access to sanitary protection mean that girls in rural Uganda are at high risk of sexual exploitation and abuse. All of this coupled with very little access to contraception means that Uganda has high rates of unintended pregnancies among young girls. Despite abortion being legal in Uganda in cases of rape and incest, most girls are not aware of the law and resort to unsafe abortion often using local herbs or washing liquid. The peer educators trained by VODA are able to listen to other young people's issues and provide support and information a range of issues including safe abortion as well as how to access contraception. My name is Mabel. I am in my final year of O'Levels and I am a peer counsellor at  a Secondary School in Namuganga. I was selected with two others by VODA and my head teacher, and then trained to be a peer counsellor. We were trained to help our colleagues at school to handle various problems. Girls used to get pregnant and some were dropping out of school. So we counselled many of our colleagues about unwanted pregnancies. We have seen a change because we get free condoms from VODA. We could preach abstinence from sex. For those that could not manage abstinence, we could give them male condoms. Unsafe abortion has been a big problem. Girls were using local herbs and sharp instruments like metallic hangers for abortion. Many would get injured and some would die. I remember last year there was a girl who aborted using those local methods but she died and was buried in Seeta. If VODA wasn't here I think things would be very bad because as students, we did not have access to most of the information that we needed. We would have seen a big number of girls out of school because of unwanted pregnancies or unsafe abortion.  I have benefited a lot. I have acquired information which I have used to keep myself safe in terms of unwanted pregnancies. I don’t think I could ever be lured to perform unsafe abortion because I know the risks. In the past, I wasn't able to speak in public but now I can stand and talk freely.  I’m Sharon and I’m a student counsellor at a Secondary School in Namuganga. I counsel fellow students, young people in communities and even adults. Before I was selected for VODA training I thought it was just an organisation to promote abortion. But then I realised they were addressing a big problem that was happening at our school and our villages. I have learnt that when someone gets pregnant I don’t have to force her to abort and I don’t encourage her to go for unsafe abortion. If we hear that a certain girl has a boyfriend, we approach her and counsel her on issues like unwanted pregnancy. Many young girls have been lured into early sex because they need money, which is why we end up with unwanted pregnancies. In a bid to fulfil those needs, they get boyfriends or other guys who use them for money, impregnate them and then leave. The girls know about contraceptives like the pill and we have given some of them referral cards for them to access the contraceptives from the health centres. But there has been debate against giving young girls contraceptives. There are restrictions that the government puts in place but that does not mean that girls are not getting pregnant. I remember the girls who died after aborting through unsafe abortion methods and I think about the lives that would have been saved if they had knowledge about contraceptives. I’m  Rita and I’m 15-years-old. I was twelve when I was selected to be a VODA counsellor in my primary school. I was lucky because many people wanted to be counsellors but I was chosen. My parents were very happy and they got interested. When I joined this school, I introduced myself to other students because I wanted to continue with my work as a counsellor. I told my colleagues to feel free to share with me their issues. We are lucky here because there are many counsellors.  Girls are having unwanted pregnancies because they are lured by men who give them presents and things such as money for sanitary pads that they cannot get from their parents. Before I joined this school, there were many cases of girls terminating pregnancies with unsafe abortions. It was common to hear of or see someone who had aborted. Many would abort so that they would return to school. When I joined this school last year and we intensified the counselling sessions, many came and shared their problems with us. We have learnt that two girls at school gave birth and have since returned to school but we have not had cases of unsafe abortions here since I joined.  I wasn’t as serious with studies before I became a counsellor but because I want to maintain my status, I have improved in my studies because I don’t want to feel ashamed in front of my fellow students. VODA gave us T-shirts for identification purposes which has made people in the community respect me as well. In terms of preventing unwanted pregnancies in schools, most of what we see here originates from the girls' homes. Many parents don’t provide for the girls’ necessities (like sanitary towels) so that makes them vulnerable to be lured by men. Stories Read more stories about the amazing success of SAAF in Uganda

The Safe Abortion Action Fund (SAAF) which is hosted by IPPF was a fund set up in 2006 in order to support grass-roots organisations to increase access to safe abortion. One such project which received funding is called Volunteers for Development Association Uganda (VODA). My name is Anne*, I am 14-years-old, I am a student at one of the local schools near my (rural) village. I recently went to the health centre for post-abortion care. I was referred there by VODA and I was helped by the mid-wife, her name was Grace.  The VODA community volunteers, they found me at my grandmother's house. They brought me to the health centre. I was on my way to visit my grandmother. A man just caught me. After he finished with me he told me to go back home and never to tell anyone about it. I went back home to my parents, in Luwero District. There is no VODA there. I realised I was pregnant because I found out I had missed my periods. Then I told my mother. My mother said we should try to do something about the pregnancy, but not in our home district, otherwise my father would not longer pay my school fees. I had just finished my Primary Leaving Examinations and I was looking forward to joining secondary. So then I had to go back to my grandmother's house. She said we were going to the hospital but it wasn't like the one where Grace works, where I finally got my post-abortion treatment. She took me to a place where a woman gave me some herbs. Then we went home and the thing came out. I was bleeding. Then the VODA counsellor came to my home and suggested to my grandmother that I should be taken for treatment. I had learnt about how girls can get pregnant but I didn't know anything about safe abortion. In Luwero, where I come from, many girls I hear they use herbs to abort but I had not tried it because I had not had any sex until that man forced me. I am telling my friends about safe abortion and contraceptive services but I also need to be given more information about it because I was not taught about most of what Grace the midwife was telling me. I know that women can take precautions for family planning like pills but my mum told me it's only for married people. I am very thankful to VODA, I maybe could have died if the counsellors from VODA hadn't asked to rush me to the health centre for post-abortion care. *Not her real name Stories Read more stories about the amazing success of SAAF in Uganda

The Safe Abortion Action Fund (SAAF) which is hosted by IPPF was set up in 2006 in order to support grass-roots organisations to increase access to safe abortion. One such organisation which received support under the last round of funding is called Volunteers for Development Association Uganda (VODA). Teachers and community volunteers provide support for young people in schools. They are critical in reshaping the social norms and stigma surrounding teen pregnancies. For many young girls, an unwanted pregnancy can limit their education and significantly restrict their life options. In Uganda, teachers are now helping to provide counselling for girls on contraception and safe abortion. Prior to VODA working with schools to provide teachers with training, the rate of deaths from unsafe abortion was significantly high. This was even the case in primary schools. Now the prevalence of unwanted pregnancies has dropped and girls are more aware of their sexual and reproductive health. I’m Deborah. I’m 27-years-old and I'm a teacher as well as being a community volunteer with VODA Uganda. There is a problem with unsafe abortion and teenage pregnancies in this area. Young girls have been getting pregnant and some of them have been dropping out of school. Some have even died because of unsafe abortions. When VODA came in, they taught us about teenage pregnancies and unsafe abortion. So we came in to teach young people in the villages so that they can be aware of these issues. Many girls secretly use injectable contraceptives after being told to do so by their parents. When these parents realise that their daughters are sexually active, they fear that they could get pregnant before they complete school. They do it secretly because they fear stigma. They do it that way to avoid rumours that may circulate if they know that one’s daughter was taken for family planning while she is still at school. Many people in our community think that a teenager who is on contraceptives is spoilt. When I had just come to this area, incidents of unsafe abortion were high. But when I began working here and the girls came to know about me, I began counselling them about safe sex, contraceptives and condoms. I told them that if you think you cannot have protected sex, then you need to use contraceptives. But we also warned them against sexually transmitted infections. Using contraception has reduced the number of girls engaging in unsafe abortion. There are different local methods used to abort. Some of them would get complications that needed medical attention after trying these methods. Some would also secretly try to go to health centres after the abortion had gone wrongly or they had even nearly died. Now some of those that have unwanted pregnancies do approach me and I counsel them. In the past, if one talked about abortion or unwanted pregnancies, I would harshly judge her saying that she wanted it. But having become a volunteer with VODA I have learned sometimes the pregnancies are due to defilement or rape, so I came to understand that not all those that get pregnant want to have a child.  Sometimes abortion is inevitable. For example, when a girl has been raped by her father, uncle, brothers or close relatives. How would a girl carry that baby? It is very important to educate young people about unsafe abortion, especially when they have reached that stage when they can get pregnant. That will help them to prevent having unwanted pregnancies and also to avoid unsafe abortion. It is important to give young girls contraceptives because some will have premarital sex. So such girls must have contraceptives if they are to avoid getting pregnant. I am Mily and I am 38-years-old. I am a volunteer for VODA Uganda and a teacher at a primary school in Kasawo. I have been teaching here for eight years. Before VODA was here, there were a lot of school dropouts from girls. They were getting unwanted pregnancies whereby they were forced to leave school. There was no one to counsel them. They were using local medicines for unsafe abortion. But when VODA came in they started to advise about unsafe abortion. We are working together with doctors and nurses from various hospitals so girls could get good care.   VODA workers approached us and explained how it could help our children to stay in school. Then we had a workshop and our head teacher selected who would manage this. Before VODA came in unsafe abortion was rampant. Many of the girls were dying. Here at this school we had a girl in P4 - we were not even expecting that girl could be pregnant. Unfortunately, we heard about it when the girl was already dead. She was trying to have an unsafe abortion.  Before VODA came, there was no sexuality education or counselling to do with STIs. That is why our children were dying because they feared to tell their parents. We thought that pregnant girls should leave school without further assistance. But as a volunteer, I thank VODA because now I know that that girls can be helped and they can continue with their studies. I am Frida and I'm 18-years-old. I am a peer counsellor at school and have counselled many girls about unsafe abortion. I came to know about VODA on a careers day at school and by attending training workshops on unsafe abortion. At our school, I’m very well-known as a youth counsellor. I help other girls who are sexually active with unwanted pregnancies. The training I received from VODA has given me self-confidence. Before, I couldn’t stand in public. But now I can stand in the presence of even one thousand people and I can talk. I’m not shy anymore. The problems are that girls can't access services like post-abortion care and family planning, like the pill. Girls are poor. Some services need money yet some girls don’t have money. They are getting pregnant because they have less information about unprotected sex and they are sexually active. To help them there needs to be places where they can find such services. From my training with VODA I now want to be a social worker so that I can work with people. I have realised that I can handle people well. Stories Read more stories about the amazing success of SAAF in Uganda