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Spotlight

A selection of stories from across the Federation

2024 trends
Story

What does the year 2024 hold for us?

As the new year begins, we take a look at the trends and challenges ahead for sexual and reproductive health and rights.
Muna receiving her implant
story

| 15 February 2019

"I’m so happy I now don’t have to worry about contraception for another five years”

In August 2017, weeks of continued and heavy rainfall across Nepal resulted in flash floods and landslides that affected 36 of the 75 districts. Many people lost their homes or were displaced. It was estimated that of those affected, 112,500 were women of reproductive age, including 8,694 pregnant women.  IPPF Humanitarian, through their Member Association, The Family Planning Association of Nepal (FPAN), activated its emergency response system early on. With funding support from the Australian Government, FPAN and IPPF Humanitarian initially mobilised their response in four of the worst affected districts (Sunsari, Saptari, Bardiya, and Dang). Mobile medical camps were established to meet the sexual and reproductive health needs of the affected population, including through the distribution of short and long acting methods of contraception, STI and HIV screening, and GBV referrals. In collaboration with the USAID-SIFPO project, services were then expanded into five more affected districts. IPPF Humanitarian spoke with 21-year old Muna in her home district of Sunsari in Nepal.  “I got married at 16 years old and have two children, a four-year-old girl and two-year-old boy.  In my caste, we get married early, so my parents took me to get an arranged marriage. I was in the 8th class at the time, and returned to school after I got married, but only lasted one year.  My husband works in construction and had to stop working for two weeks when the floods came. When he doesn’t work, he doesn’t get paid, so it’s been very difficult.  A FPAN social worker told me about the mobile medical camp today. I used to be on the three-month injectable but today I changed to the five-year implant in my arm.  When my youngest child was eight months old I found out I was pregnant again. I decided to discontinue that pregnancy, so I took the five small tablets given to me by my neighbourhood doctor. I was two months pregnant at the time.  From this, I had two days bleeding and cramp like pain, and then weakness. I decided to abort that pregnancy because my youngest will still only eight months old, and I didn’t want any more children.  If I had more than two children, it would be very difficult to feed and educate them, and would badly affect my body too. I’m so happy I now don’t have to worry about contraception for another five years.” Want to know more about safe abortion access? Join IPPF'S I Decide movement

Muna receiving her implant
story

| 28 March 2024

"I’m so happy I now don’t have to worry about contraception for another five years”

In August 2017, weeks of continued and heavy rainfall across Nepal resulted in flash floods and landslides that affected 36 of the 75 districts. Many people lost their homes or were displaced. It was estimated that of those affected, 112,500 were women of reproductive age, including 8,694 pregnant women.  IPPF Humanitarian, through their Member Association, The Family Planning Association of Nepal (FPAN), activated its emergency response system early on. With funding support from the Australian Government, FPAN and IPPF Humanitarian initially mobilised their response in four of the worst affected districts (Sunsari, Saptari, Bardiya, and Dang). Mobile medical camps were established to meet the sexual and reproductive health needs of the affected population, including through the distribution of short and long acting methods of contraception, STI and HIV screening, and GBV referrals. In collaboration with the USAID-SIFPO project, services were then expanded into five more affected districts. IPPF Humanitarian spoke with 21-year old Muna in her home district of Sunsari in Nepal.  “I got married at 16 years old and have two children, a four-year-old girl and two-year-old boy.  In my caste, we get married early, so my parents took me to get an arranged marriage. I was in the 8th class at the time, and returned to school after I got married, but only lasted one year.  My husband works in construction and had to stop working for two weeks when the floods came. When he doesn’t work, he doesn’t get paid, so it’s been very difficult.  A FPAN social worker told me about the mobile medical camp today. I used to be on the three-month injectable but today I changed to the five-year implant in my arm.  When my youngest child was eight months old I found out I was pregnant again. I decided to discontinue that pregnancy, so I took the five small tablets given to me by my neighbourhood doctor. I was two months pregnant at the time.  From this, I had two days bleeding and cramp like pain, and then weakness. I decided to abort that pregnancy because my youngest will still only eight months old, and I didn’t want any more children.  If I had more than two children, it would be very difficult to feed and educate them, and would badly affect my body too. I’m so happy I now don’t have to worry about contraception for another five years.” Want to know more about safe abortion access? Join IPPF'S I Decide movement

IPPF volunteer in Nepal for FPAN
story

| 25 July 2017

Female volunteers take the lead to deliver life critical health advice after the earthquake

“After the earthquake, there were so many problems. So many homes were destroyed. People are still living in temporary homes because they’re unable to rebuild their homes.” Pasang Tamang lives in Gatlang, high up in the mountains of northern Nepal, 15 kilometres from the Tibetan border. It is a sublimely beautiful village of traditional three-storied houses and Buddhist shrines resting on the slopes of a mountain and thronged by lush potato fields. The 2000 or so people living here are ethnic Tamang, a people of strong cultural traditions, who live across across Nepal but particularly in the lands bordering Tibet. The earthquake of 25 April had a devastating impact on Gatlang. Most of the traditional houses in the heart of the village were damaged or destroyed, and people were forced to move into small shacks of corrugated iron and plastic, where many still live. “Seven people died and three were injured and then later died,” says Pasang. These numbers might seems small compared to some casualty numbers in Nepal, but in a tightknit village like Gatlang, the impact was felt keenly. Hundreds of people were forced into tents. “People suffered badly from the cold,” Pasang says. “Some people caught pneumonia.” At 2240 metres above sea level, nighttime temperatures in Gatlang can plunge.  Pregnant women fared particularly badly: “They were unable to access nutritious food or find a warm place. They really suffered.” Pasang herself was badly injured. “During the earthquake, I was asleep in the house because I was ill,” she says. “When I felt the earthquake, I ran out of the house and while I was running I got injured, and my mouth was damaged.” Help was at hand . “After the earthquake, there were so many organisations that came to help, including FPAN,” Pasang says. As well as setting up health camps and providing a range of health care, “they provided family planning devices to people who were in need.” Hundreds of families still live in the corrugated iron and plastic sheds that were erected as a replacement for tents. The government has been slow to distribute funds, and the villagers say that any money they have received falls far short of the cost of rebuilding their old stone homes. Pasang’s house stands empty. “We will not be able to return home because the house is cracked and if there was another earthquake, it would be completely destroyed,” she says. Since the earthquake, she has begun working as a volunteer for FPAN. Her role involves travelling around villages in the area, raising awareness about different contraceptive methods and family planning. Volunteers like Pasang perform a crucial function in a region where literacy levels and a strongly patriarchal culture mean that women marry young and have to get consent from their husbands before using contraception. In this remote community, direct contact with a volunteer who can offer advice and guidance orally, and talk to women about their broader health needs, is absolutely vital.

IPPF volunteer in Nepal for FPAN
story

| 28 March 2024

Female volunteers take the lead to deliver life critical health advice after the earthquake

“After the earthquake, there were so many problems. So many homes were destroyed. People are still living in temporary homes because they’re unable to rebuild their homes.” Pasang Tamang lives in Gatlang, high up in the mountains of northern Nepal, 15 kilometres from the Tibetan border. It is a sublimely beautiful village of traditional three-storied houses and Buddhist shrines resting on the slopes of a mountain and thronged by lush potato fields. The 2000 or so people living here are ethnic Tamang, a people of strong cultural traditions, who live across across Nepal but particularly in the lands bordering Tibet. The earthquake of 25 April had a devastating impact on Gatlang. Most of the traditional houses in the heart of the village were damaged or destroyed, and people were forced to move into small shacks of corrugated iron and plastic, where many still live. “Seven people died and three were injured and then later died,” says Pasang. These numbers might seems small compared to some casualty numbers in Nepal, but in a tightknit village like Gatlang, the impact was felt keenly. Hundreds of people were forced into tents. “People suffered badly from the cold,” Pasang says. “Some people caught pneumonia.” At 2240 metres above sea level, nighttime temperatures in Gatlang can plunge.  Pregnant women fared particularly badly: “They were unable to access nutritious food or find a warm place. They really suffered.” Pasang herself was badly injured. “During the earthquake, I was asleep in the house because I was ill,” she says. “When I felt the earthquake, I ran out of the house and while I was running I got injured, and my mouth was damaged.” Help was at hand . “After the earthquake, there were so many organisations that came to help, including FPAN,” Pasang says. As well as setting up health camps and providing a range of health care, “they provided family planning devices to people who were in need.” Hundreds of families still live in the corrugated iron and plastic sheds that were erected as a replacement for tents. The government has been slow to distribute funds, and the villagers say that any money they have received falls far short of the cost of rebuilding their old stone homes. Pasang’s house stands empty. “We will not be able to return home because the house is cracked and if there was another earthquake, it would be completely destroyed,” she says. Since the earthquake, she has begun working as a volunteer for FPAN. Her role involves travelling around villages in the area, raising awareness about different contraceptive methods and family planning. Volunteers like Pasang perform a crucial function in a region where literacy levels and a strongly patriarchal culture mean that women marry young and have to get consent from their husbands before using contraception. In this remote community, direct contact with a volunteer who can offer advice and guidance orally, and talk to women about their broader health needs, is absolutely vital.

Young nepalese female farmer, IPPF, FPAN
story

| 25 July 2017

Reproductive health for Nepalese female farmers after the earthquake

Two years after the earthquake that struck Nepal in April 2015, the village of Gatlang in the country’s mountainous north still lies in partial ruin. The houses here are built from enormous slabs of local stone, carved windows and doors, and roofs of stacked wooden planks. They face east towards the rising sun, their facades bedecked in intricate wooden carvings patterns linked to the ancient Buddhist culture of the Tamang people. Today, most of these houses lie in ruin, emptying the heart of the village of people, with most moving to temporary shacks on Gatlang’s fringes. Kopila Tamang is a 24-year-old farmer and mother to two young boys. Her husband, Nakul, works as a lorry driver and is often away. “When the earthquake struck, I was working in the fields,” she says. “If I had been at home, I would have died.” Kopila’s house – or what remains of it – lies at the centre of old Gatlang, on a street of traditional houses that have either entirely collapsed or are uninhabitable due to cracks and structural damage. Piles of stone and wooden cross beams are strewn in what was once a thriving village street. Like many families here, Kopila and her husband and boys have moved into a small shack built from corrugated iron and plastic. This was meant to be a temporary solution, but two years later, they are still living in it, unable to afford the enormous cost of rebuilding their old home. “It needs lots of money,” she says. “I don’t know when we will have the money to build this home again.” FPAN provided emergency health support to families like Kopila’s in the weeks and months after the earthquake. Mobile health camps offered medicines, health check ups, dignity kits, family planning, antenatal checks and other vital services.  These days, Kopila gets regular advice from Pasang Tamang, the FPAN reproductive health female volunteer in the village. Kopila had suffered after the birth of her last child. “I didn’t menstruate for eight months, and then after that I started using the [contraceptive] injection,” she says. “But there were some side effects: I started menstruating twice a month.” She then went to a mobile health camp run by FPAN and started using the intrauterine coil. “After that, my menstruation went back to normal,” she says. In a village scarred by the earthquake, access to family planning has brought some much needed stability and relief to Kopila and her small family. “FPAN provide different services and knowledge: I have come to know that having more children can bring suffering, because it’s not enough to just feed children, they must be educated too” she says. “A small family is a happy family.”

Young nepalese female farmer, IPPF, FPAN
story

| 28 March 2024

Reproductive health for Nepalese female farmers after the earthquake

Two years after the earthquake that struck Nepal in April 2015, the village of Gatlang in the country’s mountainous north still lies in partial ruin. The houses here are built from enormous slabs of local stone, carved windows and doors, and roofs of stacked wooden planks. They face east towards the rising sun, their facades bedecked in intricate wooden carvings patterns linked to the ancient Buddhist culture of the Tamang people. Today, most of these houses lie in ruin, emptying the heart of the village of people, with most moving to temporary shacks on Gatlang’s fringes. Kopila Tamang is a 24-year-old farmer and mother to two young boys. Her husband, Nakul, works as a lorry driver and is often away. “When the earthquake struck, I was working in the fields,” she says. “If I had been at home, I would have died.” Kopila’s house – or what remains of it – lies at the centre of old Gatlang, on a street of traditional houses that have either entirely collapsed or are uninhabitable due to cracks and structural damage. Piles of stone and wooden cross beams are strewn in what was once a thriving village street. Like many families here, Kopila and her husband and boys have moved into a small shack built from corrugated iron and plastic. This was meant to be a temporary solution, but two years later, they are still living in it, unable to afford the enormous cost of rebuilding their old home. “It needs lots of money,” she says. “I don’t know when we will have the money to build this home again.” FPAN provided emergency health support to families like Kopila’s in the weeks and months after the earthquake. Mobile health camps offered medicines, health check ups, dignity kits, family planning, antenatal checks and other vital services.  These days, Kopila gets regular advice from Pasang Tamang, the FPAN reproductive health female volunteer in the village. Kopila had suffered after the birth of her last child. “I didn’t menstruate for eight months, and then after that I started using the [contraceptive] injection,” she says. “But there were some side effects: I started menstruating twice a month.” She then went to a mobile health camp run by FPAN and started using the intrauterine coil. “After that, my menstruation went back to normal,” she says. In a village scarred by the earthquake, access to family planning has brought some much needed stability and relief to Kopila and her small family. “FPAN provide different services and knowledge: I have come to know that having more children can bring suffering, because it’s not enough to just feed children, they must be educated too” she says. “A small family is a happy family.”

Young nepalese volunteer from IPPF in Nepal, FPAN
story

| 25 July 2017

Thousands of young volunteers join us after the earthquake

The April 2015 earthquake in Nepal brought death and devastation to thousands of people – from which many are still recovering. But there was one positive outcome: after the earthquake, thousands of young people came forward to support those affected as volunteers. For Rita Tukanbanjar, a twenty-two-year-old nurse from Bhaktapur in the Kathmandu Valley, the earthquake was an eye-opening ordeal: it gave her first-hand experience of the different ways that natural disasters can affect people, particularly women and girls. “After the earthquake, FPAN was organising menstrual hygiene classes for affected people, and I took part in these,” she says. The earthquake severely affected people’s access to healthcare, but women and girls were particularly vulnerable: living in tents can make menstrual hygiene difficult, and most aid agencies tend to neglect these needs and forget to factor them into relief efforts. “After the earthquake, lots of people were living in tents, as most of the houses had collapsed,” Rita says. “During that time, the girls, especially, were facing a lot of problems maintaining their menstrual hygiene. All the shops and services for menstrual hygiene were closed.” This makes FPAN’s work even more vital. The organisation stepped into the breach and organised classes on menstrual hygiene and taught women and girls how to make sanitary pads from scratch. This was not only useful during the earthquake, but provided valuable knowledge for women and girls to use in normal life too, Rita says: “From that time on wards, women are still making their own sanitary pads.” In an impoverished country like Nepal, many women and girls can simply not afford to buy sanitary pads and tampons. Nepal is one of the poorest countries in the world with gross domestic product per capita of just $691 in 2014. In this largely patriarchal culture, the needs of women often come low down in a family’s priorities. “This is very important work and very useful,” Rita says. The women and girls also learned about how to protect themselves from sexual violence, which saw a surge in the weeks after the earthquake, with men preying on people living in tents and temporary shacks. Rita and her family lived in a tent for 20 days. “There was always the fear of getting abused,” she says. Eventually they managed to return home to live in the ruins of their house: “one part was undamaged so we covered it with a tent and managed to sleep there, on the ground floor.” Seeing the suffering the earthquake had caused, and the work FPAN and other organisations were doing to alleviate it, cemented Rita’s decision to begin volunteering. “After the earthquake, when things got back to normal, I joined FPAN.” She also completed her nursing degree, which had been interrupted by the disaster. “Since joining FPAN, I have been very busy creating awareness about sexual rights and all kinds of things, and running Friday sexual education classes in schools,” Rita says. “And since I have a nursing background, people often come to me with problems, and I give them suggestions and share my knowledge with them.” She also hopes to become a staff nurse for FPAN. “If that opportunity comes my way, then I would definitely love to do it,” she says.

Young nepalese volunteer from IPPF in Nepal, FPAN
story

| 28 March 2024

Thousands of young volunteers join us after the earthquake

The April 2015 earthquake in Nepal brought death and devastation to thousands of people – from which many are still recovering. But there was one positive outcome: after the earthquake, thousands of young people came forward to support those affected as volunteers. For Rita Tukanbanjar, a twenty-two-year-old nurse from Bhaktapur in the Kathmandu Valley, the earthquake was an eye-opening ordeal: it gave her first-hand experience of the different ways that natural disasters can affect people, particularly women and girls. “After the earthquake, FPAN was organising menstrual hygiene classes for affected people, and I took part in these,” she says. The earthquake severely affected people’s access to healthcare, but women and girls were particularly vulnerable: living in tents can make menstrual hygiene difficult, and most aid agencies tend to neglect these needs and forget to factor them into relief efforts. “After the earthquake, lots of people were living in tents, as most of the houses had collapsed,” Rita says. “During that time, the girls, especially, were facing a lot of problems maintaining their menstrual hygiene. All the shops and services for menstrual hygiene were closed.” This makes FPAN’s work even more vital. The organisation stepped into the breach and organised classes on menstrual hygiene and taught women and girls how to make sanitary pads from scratch. This was not only useful during the earthquake, but provided valuable knowledge for women and girls to use in normal life too, Rita says: “From that time on wards, women are still making their own sanitary pads.” In an impoverished country like Nepal, many women and girls can simply not afford to buy sanitary pads and tampons. Nepal is one of the poorest countries in the world with gross domestic product per capita of just $691 in 2014. In this largely patriarchal culture, the needs of women often come low down in a family’s priorities. “This is very important work and very useful,” Rita says. The women and girls also learned about how to protect themselves from sexual violence, which saw a surge in the weeks after the earthquake, with men preying on people living in tents and temporary shacks. Rita and her family lived in a tent for 20 days. “There was always the fear of getting abused,” she says. Eventually they managed to return home to live in the ruins of their house: “one part was undamaged so we covered it with a tent and managed to sleep there, on the ground floor.” Seeing the suffering the earthquake had caused, and the work FPAN and other organisations were doing to alleviate it, cemented Rita’s decision to begin volunteering. “After the earthquake, when things got back to normal, I joined FPAN.” She also completed her nursing degree, which had been interrupted by the disaster. “Since joining FPAN, I have been very busy creating awareness about sexual rights and all kinds of things, and running Friday sexual education classes in schools,” Rita says. “And since I have a nursing background, people often come to me with problems, and I give them suggestions and share my knowledge with them.” She also hopes to become a staff nurse for FPAN. “If that opportunity comes my way, then I would definitely love to do it,” she says.

Portrait of Binu
story

| 05 July 2017

How cultural traditions affect women’s health

High up in the mountains of central northern Nepal, not far from the Tibetan border, lies the district of Rasuwa. The people here are mainly ethnic Tamang and Sherpa, two indigenous groups with cultural traditions stretching back centuries. But these rich cultural traditions can come hand-in-hand with severe social problems, compounded by entrenched poverty and very low literacy rates. Binu Koraila is a health facility mentor for the Family Planning Association of Nepal (FPAN) in Rasuwa. "Stigma, myths and cultural practices can have a damaging effect on sexual health, family planning and women’s rights", she says. Misconceptions about contraception are widespread. “People think the intrauterine coil will go into the brain or will fall out. They think the contraceptive implant will penetrate into the muscles.” Funeral rites present another problem. “Men who want a vasectomy need permission from their parents,” she explains. “But it’s thought that men who have had vasectomies won’t be able to perform the rituals after their parent’s death: parents think that God won’t accept that, so they don’t allow men to have vasectomies.” The culture here is strongly patriarchal. Among the Tamang, marriage involves boys or men picking out young girls from their communities.Early and forced marriage is widespread among the Tamang. If chosen, the girls have no choice but to get married. “If a boy likes a girl, they can just snatch them and take them to their house,” Binu says. Some girls are as young as 13 years old. “The girls don’t know enough about family planning, so there is a lot of teenage pregnancy.” Early marriage and teenage pregnancy can create all kinds of physical, emotional, social and economic problems for girls and their families. For many, their bodies are not well developed enough for childbirth, and maternal mortality remains a major problem in Nepal, at 258 deaths per 100,000 live births, according to UNFPA data. Their large families also suffer because there is not enough food and money to go around. “Women are the worst affected,” Binu says. Parents and husbands keep strict control of women’s access to contraception. “If they want to use contraception, women tend to need consent from their parents or husbands. “I have seen cases where if a woman gets contraceptive implant services, they get beaten by their father-in-law and husband. One woman asked to have her implant removed because she had been beaten by her husband.” Binu’s role is to deliver sexual health and family planning advice and services to villages across Rasuwa district: “I go to remote places, where people are marginalised and don’t know about family planning.” She also trains government health workers on family planning, and mentors them after they return from training in Kathmandu to Rasuwa. As well as delivering health services, the FPAN team have been working hard to change perceptions. “Recently we had a health camp at Gatland,” she explains. "After two hours of counselling one client requested an IUD. After months there was a rumour in Gatlang that her coil had fallen out. The FPAN volunteer went to the woman’s house and asked if this was true. She said, ‘No, I’m really comfortable with that service.’ After that, the client went door to door and told others how happy she was with it and that they should take it at the next family planning camp. “After four or five months, we went back to the Gatlang camp and at that time another eight women took the IUD.” These numbers might seem small but they are far less so when viewed against the wall of stigma and myth that can obstruct contraception use here, as in so many rural areas of Nepal. The involvement of committed, passionate health mentors and volunteers is vital to show people how important it is to take sexual health and family planning seriously: the benefits are felt not just by women and their families, but by entire communities. Stories Read more stories from Nepal

Portrait of Binu
story

| 28 March 2024

How cultural traditions affect women’s health

High up in the mountains of central northern Nepal, not far from the Tibetan border, lies the district of Rasuwa. The people here are mainly ethnic Tamang and Sherpa, two indigenous groups with cultural traditions stretching back centuries. But these rich cultural traditions can come hand-in-hand with severe social problems, compounded by entrenched poverty and very low literacy rates. Binu Koraila is a health facility mentor for the Family Planning Association of Nepal (FPAN) in Rasuwa. "Stigma, myths and cultural practices can have a damaging effect on sexual health, family planning and women’s rights", she says. Misconceptions about contraception are widespread. “People think the intrauterine coil will go into the brain or will fall out. They think the contraceptive implant will penetrate into the muscles.” Funeral rites present another problem. “Men who want a vasectomy need permission from their parents,” she explains. “But it’s thought that men who have had vasectomies won’t be able to perform the rituals after their parent’s death: parents think that God won’t accept that, so they don’t allow men to have vasectomies.” The culture here is strongly patriarchal. Among the Tamang, marriage involves boys or men picking out young girls from their communities.Early and forced marriage is widespread among the Tamang. If chosen, the girls have no choice but to get married. “If a boy likes a girl, they can just snatch them and take them to their house,” Binu says. Some girls are as young as 13 years old. “The girls don’t know enough about family planning, so there is a lot of teenage pregnancy.” Early marriage and teenage pregnancy can create all kinds of physical, emotional, social and economic problems for girls and their families. For many, their bodies are not well developed enough for childbirth, and maternal mortality remains a major problem in Nepal, at 258 deaths per 100,000 live births, according to UNFPA data. Their large families also suffer because there is not enough food and money to go around. “Women are the worst affected,” Binu says. Parents and husbands keep strict control of women’s access to contraception. “If they want to use contraception, women tend to need consent from their parents or husbands. “I have seen cases where if a woman gets contraceptive implant services, they get beaten by their father-in-law and husband. One woman asked to have her implant removed because she had been beaten by her husband.” Binu’s role is to deliver sexual health and family planning advice and services to villages across Rasuwa district: “I go to remote places, where people are marginalised and don’t know about family planning.” She also trains government health workers on family planning, and mentors them after they return from training in Kathmandu to Rasuwa. As well as delivering health services, the FPAN team have been working hard to change perceptions. “Recently we had a health camp at Gatland,” she explains. "After two hours of counselling one client requested an IUD. After months there was a rumour in Gatlang that her coil had fallen out. The FPAN volunteer went to the woman’s house and asked if this was true. She said, ‘No, I’m really comfortable with that service.’ After that, the client went door to door and told others how happy she was with it and that they should take it at the next family planning camp. “After four or five months, we went back to the Gatlang camp and at that time another eight women took the IUD.” These numbers might seem small but they are far less so when viewed against the wall of stigma and myth that can obstruct contraception use here, as in so many rural areas of Nepal. The involvement of committed, passionate health mentors and volunteers is vital to show people how important it is to take sexual health and family planning seriously: the benefits are felt not just by women and their families, but by entire communities. Stories Read more stories from Nepal

Rita receiving services
story

| 05 July 2017

Battling stigma against sexual and reproductive health and information

“People used to shout at me when I was distributing condoms. ‘You’re not a good girl, you’re not of good character’ they’d say. They called me many bad things.” “But later on, after getting married, whenever I visited those families they came and said: ‘you did a really good job. We realise that now and feel sorry for what we said before.” Rita Chawal is recalling her time as a volunteer for the Family Planning Association of Nepal (FPAN), Nepal’s largest family planning organisation. Her experiences point to the crucial importance of family planning education and support in Nepal, a country still affected by severe maternal and infant mortality rates and poor access to contraception. Poor government services, remote communities, a failing transport network and strict patriarchal structures can make access to family planning and health services a challenge for many people across the country. Services like FPAN’s are vital to reach as many people as possible. Rita is now 32 years old and herself a client of FPAN. She lives with her husband and six-year-old son in Bhaktapur, an ancient temple city, 15 kilometres from the centre of Kathmandu. Before getting married, she spent 10 years working as a family planning youth volunteer for FPAN, running classes on sexual health, safe abortion and contraception. Her time at the organisation set her in good stead for married life: after marrying she approached FPAN right away to get family planning support, antenatal classes, and, later on, contraception. “I had all this knowledge, so I decided to come and take the services,” she says. “I found that the services here were very good.” But Rita is far from the norm. She shudders when she recalls the abuse she received from neighbours and her community when she worked distributing contraception. Stigma still surrounds contraception in many places: for an unmarried young woman like Rita to be distributing condoms was seen as immoral by many, particularly older, people, even in an urban setting like Bhaktapur. Stigma can be even more extreme in rural areas. Across Nepal, rumours about the side effects of different contraceptive devices are also a problem. Attitudes are slowly changing. Rita says people now come to her whenever they have a family planning problem. “I have become a role model for the community,” she says. She herself is now using the contraceptive implant, a decision she arrived at after discussing different options with FPAN volunteers. She has tried different methods. After her son’s birth, she began using the contraceptive injection. “After the injection, I shifted to oral pills for six months, but that didn’t suit me,” she says. “It gave me a headache and made me feel dizzy. So I had a consultation with FPAN and they advised me to use the implant. I use it now and feel really good and safe. It’s been five years now.” This kind of advice and support can transform the lives of entire families in Nepal. Reductions in maternal and infant mortality, sexual health, female empowerment and dignity, and access to safe abortion are just a few of the life-changing benefits that organisations like FPAN can bring. Stories Read more stories from Nepal

Rita receiving services
story

| 28 March 2024

Battling stigma against sexual and reproductive health and information

“People used to shout at me when I was distributing condoms. ‘You’re not a good girl, you’re not of good character’ they’d say. They called me many bad things.” “But later on, after getting married, whenever I visited those families they came and said: ‘you did a really good job. We realise that now and feel sorry for what we said before.” Rita Chawal is recalling her time as a volunteer for the Family Planning Association of Nepal (FPAN), Nepal’s largest family planning organisation. Her experiences point to the crucial importance of family planning education and support in Nepal, a country still affected by severe maternal and infant mortality rates and poor access to contraception. Poor government services, remote communities, a failing transport network and strict patriarchal structures can make access to family planning and health services a challenge for many people across the country. Services like FPAN’s are vital to reach as many people as possible. Rita is now 32 years old and herself a client of FPAN. She lives with her husband and six-year-old son in Bhaktapur, an ancient temple city, 15 kilometres from the centre of Kathmandu. Before getting married, she spent 10 years working as a family planning youth volunteer for FPAN, running classes on sexual health, safe abortion and contraception. Her time at the organisation set her in good stead for married life: after marrying she approached FPAN right away to get family planning support, antenatal classes, and, later on, contraception. “I had all this knowledge, so I decided to come and take the services,” she says. “I found that the services here were very good.” But Rita is far from the norm. She shudders when she recalls the abuse she received from neighbours and her community when she worked distributing contraception. Stigma still surrounds contraception in many places: for an unmarried young woman like Rita to be distributing condoms was seen as immoral by many, particularly older, people, even in an urban setting like Bhaktapur. Stigma can be even more extreme in rural areas. Across Nepal, rumours about the side effects of different contraceptive devices are also a problem. Attitudes are slowly changing. Rita says people now come to her whenever they have a family planning problem. “I have become a role model for the community,” she says. She herself is now using the contraceptive implant, a decision she arrived at after discussing different options with FPAN volunteers. She has tried different methods. After her son’s birth, she began using the contraceptive injection. “After the injection, I shifted to oral pills for six months, but that didn’t suit me,” she says. “It gave me a headache and made me feel dizzy. So I had a consultation with FPAN and they advised me to use the implant. I use it now and feel really good and safe. It’s been five years now.” This kind of advice and support can transform the lives of entire families in Nepal. Reductions in maternal and infant mortality, sexual health, female empowerment and dignity, and access to safe abortion are just a few of the life-changing benefits that organisations like FPAN can bring. Stories Read more stories from Nepal

Muna receiving her implant
story

| 15 February 2019

"I’m so happy I now don’t have to worry about contraception for another five years”

In August 2017, weeks of continued and heavy rainfall across Nepal resulted in flash floods and landslides that affected 36 of the 75 districts. Many people lost their homes or were displaced. It was estimated that of those affected, 112,500 were women of reproductive age, including 8,694 pregnant women.  IPPF Humanitarian, through their Member Association, The Family Planning Association of Nepal (FPAN), activated its emergency response system early on. With funding support from the Australian Government, FPAN and IPPF Humanitarian initially mobilised their response in four of the worst affected districts (Sunsari, Saptari, Bardiya, and Dang). Mobile medical camps were established to meet the sexual and reproductive health needs of the affected population, including through the distribution of short and long acting methods of contraception, STI and HIV screening, and GBV referrals. In collaboration with the USAID-SIFPO project, services were then expanded into five more affected districts. IPPF Humanitarian spoke with 21-year old Muna in her home district of Sunsari in Nepal.  “I got married at 16 years old and have two children, a four-year-old girl and two-year-old boy.  In my caste, we get married early, so my parents took me to get an arranged marriage. I was in the 8th class at the time, and returned to school after I got married, but only lasted one year.  My husband works in construction and had to stop working for two weeks when the floods came. When he doesn’t work, he doesn’t get paid, so it’s been very difficult.  A FPAN social worker told me about the mobile medical camp today. I used to be on the three-month injectable but today I changed to the five-year implant in my arm.  When my youngest child was eight months old I found out I was pregnant again. I decided to discontinue that pregnancy, so I took the five small tablets given to me by my neighbourhood doctor. I was two months pregnant at the time.  From this, I had two days bleeding and cramp like pain, and then weakness. I decided to abort that pregnancy because my youngest will still only eight months old, and I didn’t want any more children.  If I had more than two children, it would be very difficult to feed and educate them, and would badly affect my body too. I’m so happy I now don’t have to worry about contraception for another five years.” Want to know more about safe abortion access? Join IPPF'S I Decide movement

Muna receiving her implant
story

| 28 March 2024

"I’m so happy I now don’t have to worry about contraception for another five years”

In August 2017, weeks of continued and heavy rainfall across Nepal resulted in flash floods and landslides that affected 36 of the 75 districts. Many people lost their homes or were displaced. It was estimated that of those affected, 112,500 were women of reproductive age, including 8,694 pregnant women.  IPPF Humanitarian, through their Member Association, The Family Planning Association of Nepal (FPAN), activated its emergency response system early on. With funding support from the Australian Government, FPAN and IPPF Humanitarian initially mobilised their response in four of the worst affected districts (Sunsari, Saptari, Bardiya, and Dang). Mobile medical camps were established to meet the sexual and reproductive health needs of the affected population, including through the distribution of short and long acting methods of contraception, STI and HIV screening, and GBV referrals. In collaboration with the USAID-SIFPO project, services were then expanded into five more affected districts. IPPF Humanitarian spoke with 21-year old Muna in her home district of Sunsari in Nepal.  “I got married at 16 years old and have two children, a four-year-old girl and two-year-old boy.  In my caste, we get married early, so my parents took me to get an arranged marriage. I was in the 8th class at the time, and returned to school after I got married, but only lasted one year.  My husband works in construction and had to stop working for two weeks when the floods came. When he doesn’t work, he doesn’t get paid, so it’s been very difficult.  A FPAN social worker told me about the mobile medical camp today. I used to be on the three-month injectable but today I changed to the five-year implant in my arm.  When my youngest child was eight months old I found out I was pregnant again. I decided to discontinue that pregnancy, so I took the five small tablets given to me by my neighbourhood doctor. I was two months pregnant at the time.  From this, I had two days bleeding and cramp like pain, and then weakness. I decided to abort that pregnancy because my youngest will still only eight months old, and I didn’t want any more children.  If I had more than two children, it would be very difficult to feed and educate them, and would badly affect my body too. I’m so happy I now don’t have to worry about contraception for another five years.” Want to know more about safe abortion access? Join IPPF'S I Decide movement

IPPF volunteer in Nepal for FPAN
story

| 25 July 2017

Female volunteers take the lead to deliver life critical health advice after the earthquake

“After the earthquake, there were so many problems. So many homes were destroyed. People are still living in temporary homes because they’re unable to rebuild their homes.” Pasang Tamang lives in Gatlang, high up in the mountains of northern Nepal, 15 kilometres from the Tibetan border. It is a sublimely beautiful village of traditional three-storied houses and Buddhist shrines resting on the slopes of a mountain and thronged by lush potato fields. The 2000 or so people living here are ethnic Tamang, a people of strong cultural traditions, who live across across Nepal but particularly in the lands bordering Tibet. The earthquake of 25 April had a devastating impact on Gatlang. Most of the traditional houses in the heart of the village were damaged or destroyed, and people were forced to move into small shacks of corrugated iron and plastic, where many still live. “Seven people died and three were injured and then later died,” says Pasang. These numbers might seems small compared to some casualty numbers in Nepal, but in a tightknit village like Gatlang, the impact was felt keenly. Hundreds of people were forced into tents. “People suffered badly from the cold,” Pasang says. “Some people caught pneumonia.” At 2240 metres above sea level, nighttime temperatures in Gatlang can plunge.  Pregnant women fared particularly badly: “They were unable to access nutritious food or find a warm place. They really suffered.” Pasang herself was badly injured. “During the earthquake, I was asleep in the house because I was ill,” she says. “When I felt the earthquake, I ran out of the house and while I was running I got injured, and my mouth was damaged.” Help was at hand . “After the earthquake, there were so many organisations that came to help, including FPAN,” Pasang says. As well as setting up health camps and providing a range of health care, “they provided family planning devices to people who were in need.” Hundreds of families still live in the corrugated iron and plastic sheds that were erected as a replacement for tents. The government has been slow to distribute funds, and the villagers say that any money they have received falls far short of the cost of rebuilding their old stone homes. Pasang’s house stands empty. “We will not be able to return home because the house is cracked and if there was another earthquake, it would be completely destroyed,” she says. Since the earthquake, she has begun working as a volunteer for FPAN. Her role involves travelling around villages in the area, raising awareness about different contraceptive methods and family planning. Volunteers like Pasang perform a crucial function in a region where literacy levels and a strongly patriarchal culture mean that women marry young and have to get consent from their husbands before using contraception. In this remote community, direct contact with a volunteer who can offer advice and guidance orally, and talk to women about their broader health needs, is absolutely vital.

IPPF volunteer in Nepal for FPAN
story

| 28 March 2024

Female volunteers take the lead to deliver life critical health advice after the earthquake

“After the earthquake, there were so many problems. So many homes were destroyed. People are still living in temporary homes because they’re unable to rebuild their homes.” Pasang Tamang lives in Gatlang, high up in the mountains of northern Nepal, 15 kilometres from the Tibetan border. It is a sublimely beautiful village of traditional three-storied houses and Buddhist shrines resting on the slopes of a mountain and thronged by lush potato fields. The 2000 or so people living here are ethnic Tamang, a people of strong cultural traditions, who live across across Nepal but particularly in the lands bordering Tibet. The earthquake of 25 April had a devastating impact on Gatlang. Most of the traditional houses in the heart of the village were damaged or destroyed, and people were forced to move into small shacks of corrugated iron and plastic, where many still live. “Seven people died and three were injured and then later died,” says Pasang. These numbers might seems small compared to some casualty numbers in Nepal, but in a tightknit village like Gatlang, the impact was felt keenly. Hundreds of people were forced into tents. “People suffered badly from the cold,” Pasang says. “Some people caught pneumonia.” At 2240 metres above sea level, nighttime temperatures in Gatlang can plunge.  Pregnant women fared particularly badly: “They were unable to access nutritious food or find a warm place. They really suffered.” Pasang herself was badly injured. “During the earthquake, I was asleep in the house because I was ill,” she says. “When I felt the earthquake, I ran out of the house and while I was running I got injured, and my mouth was damaged.” Help was at hand . “After the earthquake, there were so many organisations that came to help, including FPAN,” Pasang says. As well as setting up health camps and providing a range of health care, “they provided family planning devices to people who were in need.” Hundreds of families still live in the corrugated iron and plastic sheds that were erected as a replacement for tents. The government has been slow to distribute funds, and the villagers say that any money they have received falls far short of the cost of rebuilding their old stone homes. Pasang’s house stands empty. “We will not be able to return home because the house is cracked and if there was another earthquake, it would be completely destroyed,” she says. Since the earthquake, she has begun working as a volunteer for FPAN. Her role involves travelling around villages in the area, raising awareness about different contraceptive methods and family planning. Volunteers like Pasang perform a crucial function in a region where literacy levels and a strongly patriarchal culture mean that women marry young and have to get consent from their husbands before using contraception. In this remote community, direct contact with a volunteer who can offer advice and guidance orally, and talk to women about their broader health needs, is absolutely vital.

Young nepalese female farmer, IPPF, FPAN
story

| 25 July 2017

Reproductive health for Nepalese female farmers after the earthquake

Two years after the earthquake that struck Nepal in April 2015, the village of Gatlang in the country’s mountainous north still lies in partial ruin. The houses here are built from enormous slabs of local stone, carved windows and doors, and roofs of stacked wooden planks. They face east towards the rising sun, their facades bedecked in intricate wooden carvings patterns linked to the ancient Buddhist culture of the Tamang people. Today, most of these houses lie in ruin, emptying the heart of the village of people, with most moving to temporary shacks on Gatlang’s fringes. Kopila Tamang is a 24-year-old farmer and mother to two young boys. Her husband, Nakul, works as a lorry driver and is often away. “When the earthquake struck, I was working in the fields,” she says. “If I had been at home, I would have died.” Kopila’s house – or what remains of it – lies at the centre of old Gatlang, on a street of traditional houses that have either entirely collapsed or are uninhabitable due to cracks and structural damage. Piles of stone and wooden cross beams are strewn in what was once a thriving village street. Like many families here, Kopila and her husband and boys have moved into a small shack built from corrugated iron and plastic. This was meant to be a temporary solution, but two years later, they are still living in it, unable to afford the enormous cost of rebuilding their old home. “It needs lots of money,” she says. “I don’t know when we will have the money to build this home again.” FPAN provided emergency health support to families like Kopila’s in the weeks and months after the earthquake. Mobile health camps offered medicines, health check ups, dignity kits, family planning, antenatal checks and other vital services.  These days, Kopila gets regular advice from Pasang Tamang, the FPAN reproductive health female volunteer in the village. Kopila had suffered after the birth of her last child. “I didn’t menstruate for eight months, and then after that I started using the [contraceptive] injection,” she says. “But there were some side effects: I started menstruating twice a month.” She then went to a mobile health camp run by FPAN and started using the intrauterine coil. “After that, my menstruation went back to normal,” she says. In a village scarred by the earthquake, access to family planning has brought some much needed stability and relief to Kopila and her small family. “FPAN provide different services and knowledge: I have come to know that having more children can bring suffering, because it’s not enough to just feed children, they must be educated too” she says. “A small family is a happy family.”

Young nepalese female farmer, IPPF, FPAN
story

| 28 March 2024

Reproductive health for Nepalese female farmers after the earthquake

Two years after the earthquake that struck Nepal in April 2015, the village of Gatlang in the country’s mountainous north still lies in partial ruin. The houses here are built from enormous slabs of local stone, carved windows and doors, and roofs of stacked wooden planks. They face east towards the rising sun, their facades bedecked in intricate wooden carvings patterns linked to the ancient Buddhist culture of the Tamang people. Today, most of these houses lie in ruin, emptying the heart of the village of people, with most moving to temporary shacks on Gatlang’s fringes. Kopila Tamang is a 24-year-old farmer and mother to two young boys. Her husband, Nakul, works as a lorry driver and is often away. “When the earthquake struck, I was working in the fields,” she says. “If I had been at home, I would have died.” Kopila’s house – or what remains of it – lies at the centre of old Gatlang, on a street of traditional houses that have either entirely collapsed or are uninhabitable due to cracks and structural damage. Piles of stone and wooden cross beams are strewn in what was once a thriving village street. Like many families here, Kopila and her husband and boys have moved into a small shack built from corrugated iron and plastic. This was meant to be a temporary solution, but two years later, they are still living in it, unable to afford the enormous cost of rebuilding their old home. “It needs lots of money,” she says. “I don’t know when we will have the money to build this home again.” FPAN provided emergency health support to families like Kopila’s in the weeks and months after the earthquake. Mobile health camps offered medicines, health check ups, dignity kits, family planning, antenatal checks and other vital services.  These days, Kopila gets regular advice from Pasang Tamang, the FPAN reproductive health female volunteer in the village. Kopila had suffered after the birth of her last child. “I didn’t menstruate for eight months, and then after that I started using the [contraceptive] injection,” she says. “But there were some side effects: I started menstruating twice a month.” She then went to a mobile health camp run by FPAN and started using the intrauterine coil. “After that, my menstruation went back to normal,” she says. In a village scarred by the earthquake, access to family planning has brought some much needed stability and relief to Kopila and her small family. “FPAN provide different services and knowledge: I have come to know that having more children can bring suffering, because it’s not enough to just feed children, they must be educated too” she says. “A small family is a happy family.”

Young nepalese volunteer from IPPF in Nepal, FPAN
story

| 25 July 2017

Thousands of young volunteers join us after the earthquake

The April 2015 earthquake in Nepal brought death and devastation to thousands of people – from which many are still recovering. But there was one positive outcome: after the earthquake, thousands of young people came forward to support those affected as volunteers. For Rita Tukanbanjar, a twenty-two-year-old nurse from Bhaktapur in the Kathmandu Valley, the earthquake was an eye-opening ordeal: it gave her first-hand experience of the different ways that natural disasters can affect people, particularly women and girls. “After the earthquake, FPAN was organising menstrual hygiene classes for affected people, and I took part in these,” she says. The earthquake severely affected people’s access to healthcare, but women and girls were particularly vulnerable: living in tents can make menstrual hygiene difficult, and most aid agencies tend to neglect these needs and forget to factor them into relief efforts. “After the earthquake, lots of people were living in tents, as most of the houses had collapsed,” Rita says. “During that time, the girls, especially, were facing a lot of problems maintaining their menstrual hygiene. All the shops and services for menstrual hygiene were closed.” This makes FPAN’s work even more vital. The organisation stepped into the breach and organised classes on menstrual hygiene and taught women and girls how to make sanitary pads from scratch. This was not only useful during the earthquake, but provided valuable knowledge for women and girls to use in normal life too, Rita says: “From that time on wards, women are still making their own sanitary pads.” In an impoverished country like Nepal, many women and girls can simply not afford to buy sanitary pads and tampons. Nepal is one of the poorest countries in the world with gross domestic product per capita of just $691 in 2014. In this largely patriarchal culture, the needs of women often come low down in a family’s priorities. “This is very important work and very useful,” Rita says. The women and girls also learned about how to protect themselves from sexual violence, which saw a surge in the weeks after the earthquake, with men preying on people living in tents and temporary shacks. Rita and her family lived in a tent for 20 days. “There was always the fear of getting abused,” she says. Eventually they managed to return home to live in the ruins of their house: “one part was undamaged so we covered it with a tent and managed to sleep there, on the ground floor.” Seeing the suffering the earthquake had caused, and the work FPAN and other organisations were doing to alleviate it, cemented Rita’s decision to begin volunteering. “After the earthquake, when things got back to normal, I joined FPAN.” She also completed her nursing degree, which had been interrupted by the disaster. “Since joining FPAN, I have been very busy creating awareness about sexual rights and all kinds of things, and running Friday sexual education classes in schools,” Rita says. “And since I have a nursing background, people often come to me with problems, and I give them suggestions and share my knowledge with them.” She also hopes to become a staff nurse for FPAN. “If that opportunity comes my way, then I would definitely love to do it,” she says.

Young nepalese volunteer from IPPF in Nepal, FPAN
story

| 28 March 2024

Thousands of young volunteers join us after the earthquake

The April 2015 earthquake in Nepal brought death and devastation to thousands of people – from which many are still recovering. But there was one positive outcome: after the earthquake, thousands of young people came forward to support those affected as volunteers. For Rita Tukanbanjar, a twenty-two-year-old nurse from Bhaktapur in the Kathmandu Valley, the earthquake was an eye-opening ordeal: it gave her first-hand experience of the different ways that natural disasters can affect people, particularly women and girls. “After the earthquake, FPAN was organising menstrual hygiene classes for affected people, and I took part in these,” she says. The earthquake severely affected people’s access to healthcare, but women and girls were particularly vulnerable: living in tents can make menstrual hygiene difficult, and most aid agencies tend to neglect these needs and forget to factor them into relief efforts. “After the earthquake, lots of people were living in tents, as most of the houses had collapsed,” Rita says. “During that time, the girls, especially, were facing a lot of problems maintaining their menstrual hygiene. All the shops and services for menstrual hygiene were closed.” This makes FPAN’s work even more vital. The organisation stepped into the breach and organised classes on menstrual hygiene and taught women and girls how to make sanitary pads from scratch. This was not only useful during the earthquake, but provided valuable knowledge for women and girls to use in normal life too, Rita says: “From that time on wards, women are still making their own sanitary pads.” In an impoverished country like Nepal, many women and girls can simply not afford to buy sanitary pads and tampons. Nepal is one of the poorest countries in the world with gross domestic product per capita of just $691 in 2014. In this largely patriarchal culture, the needs of women often come low down in a family’s priorities. “This is very important work and very useful,” Rita says. The women and girls also learned about how to protect themselves from sexual violence, which saw a surge in the weeks after the earthquake, with men preying on people living in tents and temporary shacks. Rita and her family lived in a tent for 20 days. “There was always the fear of getting abused,” she says. Eventually they managed to return home to live in the ruins of their house: “one part was undamaged so we covered it with a tent and managed to sleep there, on the ground floor.” Seeing the suffering the earthquake had caused, and the work FPAN and other organisations were doing to alleviate it, cemented Rita’s decision to begin volunteering. “After the earthquake, when things got back to normal, I joined FPAN.” She also completed her nursing degree, which had been interrupted by the disaster. “Since joining FPAN, I have been very busy creating awareness about sexual rights and all kinds of things, and running Friday sexual education classes in schools,” Rita says. “And since I have a nursing background, people often come to me with problems, and I give them suggestions and share my knowledge with them.” She also hopes to become a staff nurse for FPAN. “If that opportunity comes my way, then I would definitely love to do it,” she says.

Portrait of Binu
story

| 05 July 2017

How cultural traditions affect women’s health

High up in the mountains of central northern Nepal, not far from the Tibetan border, lies the district of Rasuwa. The people here are mainly ethnic Tamang and Sherpa, two indigenous groups with cultural traditions stretching back centuries. But these rich cultural traditions can come hand-in-hand with severe social problems, compounded by entrenched poverty and very low literacy rates. Binu Koraila is a health facility mentor for the Family Planning Association of Nepal (FPAN) in Rasuwa. "Stigma, myths and cultural practices can have a damaging effect on sexual health, family planning and women’s rights", she says. Misconceptions about contraception are widespread. “People think the intrauterine coil will go into the brain or will fall out. They think the contraceptive implant will penetrate into the muscles.” Funeral rites present another problem. “Men who want a vasectomy need permission from their parents,” she explains. “But it’s thought that men who have had vasectomies won’t be able to perform the rituals after their parent’s death: parents think that God won’t accept that, so they don’t allow men to have vasectomies.” The culture here is strongly patriarchal. Among the Tamang, marriage involves boys or men picking out young girls from their communities.Early and forced marriage is widespread among the Tamang. If chosen, the girls have no choice but to get married. “If a boy likes a girl, they can just snatch them and take them to their house,” Binu says. Some girls are as young as 13 years old. “The girls don’t know enough about family planning, so there is a lot of teenage pregnancy.” Early marriage and teenage pregnancy can create all kinds of physical, emotional, social and economic problems for girls and their families. For many, their bodies are not well developed enough for childbirth, and maternal mortality remains a major problem in Nepal, at 258 deaths per 100,000 live births, according to UNFPA data. Their large families also suffer because there is not enough food and money to go around. “Women are the worst affected,” Binu says. Parents and husbands keep strict control of women’s access to contraception. “If they want to use contraception, women tend to need consent from their parents or husbands. “I have seen cases where if a woman gets contraceptive implant services, they get beaten by their father-in-law and husband. One woman asked to have her implant removed because she had been beaten by her husband.” Binu’s role is to deliver sexual health and family planning advice and services to villages across Rasuwa district: “I go to remote places, where people are marginalised and don’t know about family planning.” She also trains government health workers on family planning, and mentors them after they return from training in Kathmandu to Rasuwa. As well as delivering health services, the FPAN team have been working hard to change perceptions. “Recently we had a health camp at Gatland,” she explains. "After two hours of counselling one client requested an IUD. After months there was a rumour in Gatlang that her coil had fallen out. The FPAN volunteer went to the woman’s house and asked if this was true. She said, ‘No, I’m really comfortable with that service.’ After that, the client went door to door and told others how happy she was with it and that they should take it at the next family planning camp. “After four or five months, we went back to the Gatlang camp and at that time another eight women took the IUD.” These numbers might seem small but they are far less so when viewed against the wall of stigma and myth that can obstruct contraception use here, as in so many rural areas of Nepal. The involvement of committed, passionate health mentors and volunteers is vital to show people how important it is to take sexual health and family planning seriously: the benefits are felt not just by women and their families, but by entire communities. Stories Read more stories from Nepal

Portrait of Binu
story

| 28 March 2024

How cultural traditions affect women’s health

High up in the mountains of central northern Nepal, not far from the Tibetan border, lies the district of Rasuwa. The people here are mainly ethnic Tamang and Sherpa, two indigenous groups with cultural traditions stretching back centuries. But these rich cultural traditions can come hand-in-hand with severe social problems, compounded by entrenched poverty and very low literacy rates. Binu Koraila is a health facility mentor for the Family Planning Association of Nepal (FPAN) in Rasuwa. "Stigma, myths and cultural practices can have a damaging effect on sexual health, family planning and women’s rights", she says. Misconceptions about contraception are widespread. “People think the intrauterine coil will go into the brain or will fall out. They think the contraceptive implant will penetrate into the muscles.” Funeral rites present another problem. “Men who want a vasectomy need permission from their parents,” she explains. “But it’s thought that men who have had vasectomies won’t be able to perform the rituals after their parent’s death: parents think that God won’t accept that, so they don’t allow men to have vasectomies.” The culture here is strongly patriarchal. Among the Tamang, marriage involves boys or men picking out young girls from their communities.Early and forced marriage is widespread among the Tamang. If chosen, the girls have no choice but to get married. “If a boy likes a girl, they can just snatch them and take them to their house,” Binu says. Some girls are as young as 13 years old. “The girls don’t know enough about family planning, so there is a lot of teenage pregnancy.” Early marriage and teenage pregnancy can create all kinds of physical, emotional, social and economic problems for girls and their families. For many, their bodies are not well developed enough for childbirth, and maternal mortality remains a major problem in Nepal, at 258 deaths per 100,000 live births, according to UNFPA data. Their large families also suffer because there is not enough food and money to go around. “Women are the worst affected,” Binu says. Parents and husbands keep strict control of women’s access to contraception. “If they want to use contraception, women tend to need consent from their parents or husbands. “I have seen cases where if a woman gets contraceptive implant services, they get beaten by their father-in-law and husband. One woman asked to have her implant removed because she had been beaten by her husband.” Binu’s role is to deliver sexual health and family planning advice and services to villages across Rasuwa district: “I go to remote places, where people are marginalised and don’t know about family planning.” She also trains government health workers on family planning, and mentors them after they return from training in Kathmandu to Rasuwa. As well as delivering health services, the FPAN team have been working hard to change perceptions. “Recently we had a health camp at Gatland,” she explains. "After two hours of counselling one client requested an IUD. After months there was a rumour in Gatlang that her coil had fallen out. The FPAN volunteer went to the woman’s house and asked if this was true. She said, ‘No, I’m really comfortable with that service.’ After that, the client went door to door and told others how happy she was with it and that they should take it at the next family planning camp. “After four or five months, we went back to the Gatlang camp and at that time another eight women took the IUD.” These numbers might seem small but they are far less so when viewed against the wall of stigma and myth that can obstruct contraception use here, as in so many rural areas of Nepal. The involvement of committed, passionate health mentors and volunteers is vital to show people how important it is to take sexual health and family planning seriously: the benefits are felt not just by women and their families, but by entire communities. Stories Read more stories from Nepal

Rita receiving services
story

| 05 July 2017

Battling stigma against sexual and reproductive health and information

“People used to shout at me when I was distributing condoms. ‘You’re not a good girl, you’re not of good character’ they’d say. They called me many bad things.” “But later on, after getting married, whenever I visited those families they came and said: ‘you did a really good job. We realise that now and feel sorry for what we said before.” Rita Chawal is recalling her time as a volunteer for the Family Planning Association of Nepal (FPAN), Nepal’s largest family planning organisation. Her experiences point to the crucial importance of family planning education and support in Nepal, a country still affected by severe maternal and infant mortality rates and poor access to contraception. Poor government services, remote communities, a failing transport network and strict patriarchal structures can make access to family planning and health services a challenge for many people across the country. Services like FPAN’s are vital to reach as many people as possible. Rita is now 32 years old and herself a client of FPAN. She lives with her husband and six-year-old son in Bhaktapur, an ancient temple city, 15 kilometres from the centre of Kathmandu. Before getting married, she spent 10 years working as a family planning youth volunteer for FPAN, running classes on sexual health, safe abortion and contraception. Her time at the organisation set her in good stead for married life: after marrying she approached FPAN right away to get family planning support, antenatal classes, and, later on, contraception. “I had all this knowledge, so I decided to come and take the services,” she says. “I found that the services here were very good.” But Rita is far from the norm. She shudders when she recalls the abuse she received from neighbours and her community when she worked distributing contraception. Stigma still surrounds contraception in many places: for an unmarried young woman like Rita to be distributing condoms was seen as immoral by many, particularly older, people, even in an urban setting like Bhaktapur. Stigma can be even more extreme in rural areas. Across Nepal, rumours about the side effects of different contraceptive devices are also a problem. Attitudes are slowly changing. Rita says people now come to her whenever they have a family planning problem. “I have become a role model for the community,” she says. She herself is now using the contraceptive implant, a decision she arrived at after discussing different options with FPAN volunteers. She has tried different methods. After her son’s birth, she began using the contraceptive injection. “After the injection, I shifted to oral pills for six months, but that didn’t suit me,” she says. “It gave me a headache and made me feel dizzy. So I had a consultation with FPAN and they advised me to use the implant. I use it now and feel really good and safe. It’s been five years now.” This kind of advice and support can transform the lives of entire families in Nepal. Reductions in maternal and infant mortality, sexual health, female empowerment and dignity, and access to safe abortion are just a few of the life-changing benefits that organisations like FPAN can bring. Stories Read more stories from Nepal

Rita receiving services
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| 28 March 2024

Battling stigma against sexual and reproductive health and information

“People used to shout at me when I was distributing condoms. ‘You’re not a good girl, you’re not of good character’ they’d say. They called me many bad things.” “But later on, after getting married, whenever I visited those families they came and said: ‘you did a really good job. We realise that now and feel sorry for what we said before.” Rita Chawal is recalling her time as a volunteer for the Family Planning Association of Nepal (FPAN), Nepal’s largest family planning organisation. Her experiences point to the crucial importance of family planning education and support in Nepal, a country still affected by severe maternal and infant mortality rates and poor access to contraception. Poor government services, remote communities, a failing transport network and strict patriarchal structures can make access to family planning and health services a challenge for many people across the country. Services like FPAN’s are vital to reach as many people as possible. Rita is now 32 years old and herself a client of FPAN. She lives with her husband and six-year-old son in Bhaktapur, an ancient temple city, 15 kilometres from the centre of Kathmandu. Before getting married, she spent 10 years working as a family planning youth volunteer for FPAN, running classes on sexual health, safe abortion and contraception. Her time at the organisation set her in good stead for married life: after marrying she approached FPAN right away to get family planning support, antenatal classes, and, later on, contraception. “I had all this knowledge, so I decided to come and take the services,” she says. “I found that the services here were very good.” But Rita is far from the norm. She shudders when she recalls the abuse she received from neighbours and her community when she worked distributing contraception. Stigma still surrounds contraception in many places: for an unmarried young woman like Rita to be distributing condoms was seen as immoral by many, particularly older, people, even in an urban setting like Bhaktapur. Stigma can be even more extreme in rural areas. Across Nepal, rumours about the side effects of different contraceptive devices are also a problem. Attitudes are slowly changing. Rita says people now come to her whenever they have a family planning problem. “I have become a role model for the community,” she says. She herself is now using the contraceptive implant, a decision she arrived at after discussing different options with FPAN volunteers. She has tried different methods. After her son’s birth, she began using the contraceptive injection. “After the injection, I shifted to oral pills for six months, but that didn’t suit me,” she says. “It gave me a headache and made me feel dizzy. So I had a consultation with FPAN and they advised me to use the implant. I use it now and feel really good and safe. It’s been five years now.” This kind of advice and support can transform the lives of entire families in Nepal. Reductions in maternal and infant mortality, sexual health, female empowerment and dignity, and access to safe abortion are just a few of the life-changing benefits that organisations like FPAN can bring. Stories Read more stories from Nepal