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Provision of sexual and reproductive healthcare for all, regardless of age, is at the core of Famia Planea Aruba’s (FPA) work. Over the years FPA has developed different information packages specifically aimed at reaching and supporting young people, families, and educators.   The inspiration for delivering comprehensive sexuality education digitally to young people was propelled by the COVID-19 lockdown. Like other frontline healthcare providers, FPA was faced with unforeseen challenges about how to continue reaching their communities. Undeterred, the team embraced the challenge to create, develop, and launch FPA’s first Online Puberty Educational News Program (OPEN).   Responding to clients' needs digitally  “In the last few years, FPA’s in-school Comprehensive Sexuality Education (CSE) program was growing rapidly, and then all of a sudden we hit a wall; our Island was in complete lockdown and all schools were closed. At first, we were very sad, since we were fully booked for the upcoming few months, and would lose the opportunity to reach thousands of young people”, says Evelyn Yarzagaray, FPA’s Executive Director.   Typically, during April and May FPA usually focuses on students between the ages of 11 and 13 and supporting with the transition from elementary school to secondary school. At this age young people are starting to experience changes to their bodies and hormones.   “We were all of a sudden bombarded with parents who started requesting one-on-one counselling sessions for their kids, but due to safety regulations this was not an easy option. That was when we started looking for a way to reach both parent and child in the safety of their own homes. By converting materials used during our in-person CSE program, we developed an educational video that can be viewed by both parent and child”, says Evelyn.  The OPEN platform has been designed with a colourful background, emojis, and animation to appeal to its target audience. Users can access valuable information through the FAQ section, international news, and video content such as an interview with a Family Physician.   “The filming and editing were the longest and most difficult part of the entire process, but once it was launched, we immediately saw that is was completely worth it, reaching over 42,000 people on social media”, Evelyn says.  “I know it's all part of the growing up process”  Jeanira, 37, is a doctor’s assistant and has two young children aged two and 12. She has been a member of FPA for many years, but only recently learned that FPA provides healthcare for all ages and stages of life – particularly young people.   “About a year ago I had begun researching the best way and time to start talking to my daughter about her upcoming body changes, sexuality, and puberty in general”, explains Jeanira.  It was a family member who suggested the FPA video on social media about puberty that was in Jeanira’s native language.   “The video is fun, educational, featured local professionals and related to my daughter’s age. I love the fact that I could introduce the video to her and let her watch it in her own comfort zone. At the end, it did stimulate conversations and questions for a few days after and it truly made it easier for us to talk about some of the topics that can sometimes be a little hard to approach”, says Jeanira.  11-year-old Xiqiën really enjoyed the video: “My favourite part was to be able to recognize some changes that I am going through right now. There are some changes that I would like to skip but I know it’s all part of the growing up process. I’m so thankful that FPA had the idea to make such a fun video for us to learn from. There was some stuff that I already knew, but I also learned some new things. I did ask my mom a lot of questions after the video, mostly because they said that everyone is different, and I really wanted to know how my mom is different from me. I don’t feel quite as worried to talk to my mom about these things anymore, I know that she will try to help.”    

Accessibility to information and contraceptives has always been a priority for Famia Planea Aruba (FPA) – whether through the office, delivery service, or in schools.   For over 15 years FPA has worked in partnership with one of the largest secondary schools on the island. The FPA team visits the school every month to provide guidance, counselling, and contraceptive care to students, and to help ensure they stay in school to complete their education.   “One of my first experiences providing comprehensive sex education with FPA was at the EPB School, during my education as a social worker. Many years later I still very much enjoy this”, says Richenella, FPA’s Finance and Information, Education and Communication (IEC) support staff.  Building trust  FPA’s client is at the heart of its healthcare provision. The FPA team works with students to build trust and ensure they feel safe to talk openly. This helps to provide a sense of consistency for the student, as well as efficiency for the team being familiar with specific students and cases. They are better able to notice if something changes, and if a student needs a referral to a medical doctor or other organization for additional treatment.  “The consultations are always fun; you get a change of scenery by stepping out of the office. Over the years you see so many faces and still somehow you manage to remember most of them. After just a few visits you can start to build a profile of most students; you can start to tell who the class clown is, the Mister Popular, the shy one, the loud one, and the one who just wants to take his time to avoid going back to class”, Richenella laughs.  Working in partnership with the school social worker   FPA places great value on the 14-year relationship they have with Adriana, the social worker at EPB San Nicolas School. Adriana is the person who has the most contact with the students, and the one most student’s turn to when they need help.   “Most of the time you get to have fun with the students, however every now and then you will come across a heartbreaking case. Since Aruba has so many different migrants, very often you will come across one person who is not insured at the moment, who needs products and can’t afford it – and you figure out a way to help”, Adriana says.  For registered youth under 21 years of age, the costs of the healthcare provision are covered by the national health insurance, however, some students fall outside of the system.  “For our second, third and fourth-year students, FPA has been collaborating with us to provide a monthly session where the students receive contraceptives and guidance on school grounds. Since around this age, most of our students are already sexually active, we try to help them stay safe in and out of school.”  “The love, patience, and dedication that FPA has shown our students over the years are outstanding. At the beginning of the COVID-19 crisis we had to stop the consultation hours, but thankfully we are now back at it, bigger and better. Due to the collaboration with FPA we were able to finish out our 2018-2019 school year with no new pregnancies, which was a first for our school. We hope to accomplish this again, now that we can continue our consultations, and keep our kids educated and in school for as long as we can so they can achieve the best possible future”, Adriana says.   

When Famia Planea Aruba (FPA) saw a gap in the market, the team developed an online contraceptive store and bespoke delivery service to better reach their clients. The online store is available in the local Aruban language, Papiamento, and has been designed to provide quick access to various contraceptive methods, with supporting information to help clients make choices based on their needs.   Ghislaine, Head of Information, Education and Communication Support at FPA has been managing the delivery service since it started in August 2018.  “Since the start of the delivery service in 2018, our clients were enthusiastic however, the usage started slow. I believe this was due to the unfamiliarity, and people were still in the transition phase to online services. Moreover, clients believed that the delivery transportation would have been in a car, completely covered in images of condoms, sperm cells and pills, which made them sceptic of using the service due to embarrassment”, says Ghislaine.   The site is accessible to both FPA members and non-members who can shop in privacy for their contraceptives and schedule a delivery. Orders are delivered by FPA staff with clients having the option to pay cash or debit upon delivery. To ensure a clients’ privacy and confidentiality orders are delivered discreetly.  Challenges and opportunities  As with any new service comes challenges as well as opportunities. “Some of the challenges we face are the overload of deliveries on one day.” Even though Aruba is a small island and there are traffic jams only at specific hours in the day. “Sometimes I get stuck in traffic and try to rush myself to deliver the products in the time slot and at times I find myself in places that I barely recognize and discover new locations.”  “The part I enjoy is the communication with the clients. Building a relationship with the client and vice versa provides a smoother transition of service but also provides the comfort and safe feeling for the client.”  Ghislaine says the service often calls for more than the delivery of contraceptive orders, as clients may have questions or need support about their health.  Personal and convenient healthcare  Damara is a data analyst and a member of the Sustainable Development Goals Commission. She started using FPA contraceptive delivery service a year ago.   “It definitely has made my life much easier, especially when I have a busy schedule. With the delivery service I simply order my products through the online store and choose the date and time that is most convenient for me”, she says.  Damara values the personal service and the convenience of paying by card and choosing a preferred delivery time. “I love this service because sometimes I place an order a few days before and the employees at FPA call to confirm the order the day of the delivery, which is great because it is like a personal reminder! The best part is that they also have a portable ATM machine. I get my products, guidance and have it delivered to my location, what more can you ask for?”  FPA’s bespoke healthcare delivery has seen a successful growth since it started, with an increase of 115% during 2019 and 170% in 2020. “There has been an immense increase in the service in 2020 due to the pandemic. We already had the service in place, so we just had to fill in the gaps; for example, providing more hours and dates for clients to make use of the service”, says Ghislaine.  Hilyann, a journalist, is another regular user of the online store. “Shopping on the FPA online store makes me feel very in control and empowered. I hope that more people of all ages take advantage of this service. I hear far too often that people say they don’t have time, nobody has actually, but FPA is there for you. Take control of your sexual and reproductive health, empower yourself, be the boss of your time and your body.”   

In May 2017, flash flooding in Sri Lanka triggered landslides resulting in many people losing their homes, forcing them to seek shelter in camps. IPPF’s member association the Family Planning Association of Sri Lanka (FPASL) assisted those affected and provided health camps with the support of IPPF Humanitarian. Chathurika Jayalath, a youth volunteer for FPASL, took part in the response. Chathurika is a 24-year-old student from Kegalle, a large town about 80 km from Colombo, and she has been working with FPASL for the last three years. She started out as a youth volunteer and recently became a member of the Youth Technical Advisory Committee. During her engagement with FPASL, Chathurika has learned about sexual and reproductive health and rights (SRHR) and gender issues and has organized workshops on similar topics in her own community. In fact, she runs a youth club at her university to inform her peers about SRHR.  Shortly after the floods began, Chathurika received a WhatsApp message from FPASL where they called for youth volunteers to take part in the response.  “I wanted to volunteer during the response,” Chathurika told us. “As a university student I didn’t have money to donate so I figured I could contribute with my strength instead. I volunteered in the health camp. There, I assisted the medical staff with basic things such mobilizing affected people, making sure they queued up when seeking health care and packed medicine.” Ongoing SRHR needs, even in a crisis Chathurika is keen to learn more about humanitarian work. She received training with FPASL on the needs of people in humanitarian settings in which she and other trainees were presented with different case studies. “There was particularly one story that struck me. We were told that when the flash floods came, women fled without anything, they fled with the only pair of clothes they were wearing,” recalls Chathurika. “When they reached the camp, they received donated water and food. Some of them got their period while living in the camp. They did not have any sanitary pads nor additional cloths. Some of them even fled without underwear. This story made me realize that people’s SRHR needs don’t disappear just because there is a crisis.” Youth empowerment is important to Chathurika and she would like to continue this work while learning more about development and humanitarian work. She is a firm believer “that young people can contribute. Through my own experience I have seen that it is possible.”   

Prijani and Chandana were forced to flee their home during the floods of May 2017 in Sri Lanka. They didn’t have time to take any belongings, so ran with their two small children. After the floods, they attended gender based violence training run by Family Planning Association of Sri Lanka, where they learned about child protection needs. “We weren’t informed that the floods were going to come, but when the water reached our knee level we knew we have to move. We just took the kids and left” says Prijani. “I was worried about two things: my kids, as we were staying at a camp in the school, and losing my house. I allowed a workshop run by Family Planning Association of Sri Lanka to be held in my garden as we had the most room. There I learnt a lot about child protection the teacher gave a lot of examples of child protection and what can go wrong. We learned about sexual violence that kids face from older people”. “One day, I saw my son masturbating and I asked him how he knew how to do that, and that’s when he told me about what happened at school. The workshop taught me to look out for these signs” says Chandana, who is planning to report the incident to the school when it re-opens. “I never thought the issue was that bad. Now, we are a lot more attentive to our kids”.   Stories Read more stories from Sri Lanka

Nimal* and her family were asleep when the floods came into their house on the 27 May 2017. She and her husband took their young children to safety upstairs. Since the floods, Nimal and her family attended the clinic set up by The Family Planning Association of Sri Lanka (FPA-SL), and received medical care and gender based violence training. This training to families enables them to openly talk about issues that can help provide a safer environment for themselves and their children. "We were all sleeping in this house when the flood came in the night," Nimal recalls. "When we woke up we were surrounded by four feet of water in the house. Our van and bicycle were damaged. We specifically constructed this house to be flood resistant, but this flood was higher even than that level. We took the children and mattresses upstairs to be safe." "We found out through word of mouth about the The Family Planning Association of Sri Lanka (FPA-SL) clinic. I went two to three days after the flood to the clinic, which was being held out of a temple. My children were treated there as they had a cold from the flooding. I was also treated as I kept fainting." "I attended the training on Gender Based Violence awareness with my husband, and learnt a lot about parenting adolescents, and how to prevent domestic violence between a husband and wife. For example, by avoiding alcohol and to openly discuss our problems. It’s good to have this knowledge before my children reach adolescent age so I am prepared." *names have been changed at the request of the interviewee  Stories Read more stories from Sri Lanka  

Incessant rains across Sri Lanka during May 2017 affected over half a million people in seven districts. Most affected was the Ratnapura district where over 20,000 people faced flash floods, and where 46 deaths were reported. IPPF Humanitarian, in partnership with FPA Sri Lanka, responded to this catastrophe through the distribution of over 700 dignity kits in Ratnapura Dr. Rohan Jayasuriya and midwife Chaturika Lakmale were on the ground during and after the floods providing family planning services and contraception to women affected by the disaster. “When the floods came our clinic was located on higher ground, so it wasn’t damaged. The floods finished on the 31 May 2017, and we reopened one day later on the 1 June 2017. After the floods, we arranged several special clinics just for family planning, and distributed condoms and emergency supplies of the pill to camps in case women missed their regular form of contraception like injectables, implants or IUDs. In Sri Lanka, approximately 67% of couples use family planning, 26% of which prefer IUDs” We offered condoms and emergency supply of the pill. We told women to keep one packet of the pill in their handbag, and one in their home, should they ever have to run quickly in an emergency. One pregnant woman was delivering at this time, so she had to go on a boat to dry land, and then onwards in a vehicle to the hospital. Once we reopened the clinic, two of our own midwives were unable to attend work as the floods had affected them, but I was here. It was so busy.” Stories Read more stories from Sri Lanka

Incessant rains across Sri Lanka during May 2017 affected over half a million people in seven districts. Most affected was the Ratnapura district where over 20,000 people faced flash floods. “When the flood came, my husband was feeding my eldest child and the baby was asleep in the bed. I was outside of the house. My mother was brushing her teeth outside the back of the house. I looked up and saw trees falling near my neighbour’s house up the hill. My neighbours died. I couldn’t take any possessions – I just had to run for my life. My husband took my younger child. They were all screaming. Since then, I have had my children checked here in the Ministry of Health clinic; their weight, height and nutrition. We had two houses on the one block of land, but we will only get compensation for one house. We can’t live in a tent with a baby so are currently renting a house with our own money, but for a while my mother and father slept in this clinic.” Stories Read more stories from Sri Lanka