Stories

Week after week, heavy Israeli bombardment from air, land, and sea, has continued across most of the Gaza Strip. According to the Ministry of Health, at least 21,320 Palestinians have been killed in Gaza since October 7th, about 70% of whom are women and children. Nearly 2 million people have been displaced from their homes, forced to live in extremely overcrowded and unsanitary shelters. The Ministry of Health says that 50% of pregnant women in the shelters suffer from thirst and malnutrition, and there is a lack of health care and vaccinations for newborns.  The suffering is unimaginable, yet it is all too real.  Many of those bearing witness to the seemingly endless death and misery are frontline healthcare workers - including those delivering sexual and reproductive healthcare. But they, too, are at risk of being killed just for doing their jobs. Israel continues to bombard Gaza’s health facilities and residential areas, despite mounting international pressure for a ceasefire - something IPPF and many other humanitarian organisations have been demanding for months. According to the World Health Organization (WHO) there have been more than 200 Israeli attacks on hospitals and ambulances since Oct. 7, with many medical workers detained during Israeli raids. At least 300 healthcare workers have been reported killed, according to the UN. This is more than the total number of health worker deaths recorded across all countries in conflict last year, and in any single year since 2016.   Staff at IPPF's local member association, the Palestinian Family Planning and Protection Association (PFPPA), are among the heroic healthcare workers in Gaza that continue to provide care as best they can in the ongoing humanitarian catastrophe. We fear for their safety - and that of the 2.3 million civilians in Gaza - every single day. In their own words, PFPPA and other health workers describe what it's like to provide care under bombardment and blockade in Gaza and in the West Bank - offering glimpses of terror, devastation, and even some hope. 

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

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

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

At a local bar, we meet nine women from Kirundo. They’re all sex workers who became friends through Association Burundaise pour le Bien-Etre Familial's (ABUBEF) peer educator project. Yvonne is 40 and has known that she’s HIV-positive for 22 years. After her diagnosis she was isolated from her friends and stigmatized both in public and at home, where she was even given separate plates to eat from. “I started to get drunk every day,” she says. “I hoped death would take me in my sleep. I didn’t believe in tomorrow. I was lost and lonely. Until I got to the ABUBEF clinic.” ABUBEF has supported her treatment for the past six years. “I take my pill every day and I am living example of having a good life even with a previous death sentence,” Yvonne explains. “But I see that the awareness of HIV, protection and testing provided by ABUBEF is still very small.” Yvonne became a peer educator, speaking in public about HIV awareness, wearing an ABUBEF T-shirt.  The project spread to the wider region, and volunteers were given travel expenses, materials and training, along with condoms for distribution. But funding cuts mean those expenses are no longer available. Yvonne says she’ll carry on in Kirundo even if she can’t travel more widely like she used to. Her friend, 29-year-old Perusi, shares her experience of ABUBEF as a safe space where her privacy will be respected. It often happens, she says, that her clients rape her, and run away, failing to pay. Since sex work is illegal, she says, and there’s no protection from the authorities, and sex workers like her often feel rejected by society.  But at ABUBEF’s clinics, they are welcomed.

Monica has never told anyone about the attack. She was pregnant at the time, already had two teenage sons, and rape is a taboo subject in her community in Burundi. Knowing that her attacker was HIV-positive, and fearing that her husband would accuse her of provocation - or worse still, leave her - she turned to a place she knew would help.   ABUBEF is the Association Burundaise Pour Le Bien-Etre Familial. Their clinic in Kirundo offered Monica HIV counselling and treatment for the duration of her pregnancy.  Above all, ABUBEF offered privacy.  Neither Monica nor her daughter has tested positive for HIV. “They saved the life of me and my child,” Monica says. “I hope they get an award for their psychological and health support for women.” Three years on from the attack, Monica, now 45, raises her children and tends the family farm where she grows beans, cassava, potatoes and rice. She’s proud of her eldest son who’s due to start university this year. She educates her boys against violence, and spreads the word about ABUBEF. Monica speaks to other women to make sure they know where to seek help if they need it. Her attacker still lives in the neighbourhood, and she worries that he’s transmitting HIV. But the ABUBEF clinic that helped Monica is under threat from funding cuts. The possibility that it could close prompted her to tell her story.    “This is a disaster for our community,” she says. “I know how much the clinic needs support from donors, how much they need new equipment and money for new staff. I want people to know that this facility is one of a kind - and without it many people will be lost.”

On Friday afternoon in Municipal Lycee of Nyakabiga, Burundi,  headmistress Chantal Keza is introducing her students to the medical staff from Association Burundaise pour le Bien-Etre Familial (ABUBEF). Peer educators at the school, trained by ABUBEF,  will perform a short drama based around sexual health and will answer questions about contraception methods from students. One of the actresses is peer educator Ammande Berlyne Dushime. Ammande, who is 17 years old is one of three peer educators at the school. Ammande, together with her friends, perform their short drama on the stage based on a young girls quest for information on contraception. It ends on a positive note, with the girl receiving useful and correct information from a peer educator at her school. A story that could be a very real life scenario at her school. Peer programmes that trained Ammande, are under threat of closure due to the Global Gag rule.   Ammande says, “I am afraid what will happen when there will be no more projects like this one. I am ready to go on with work as peer educator, but if there are not going to be regular visits by the medical stuff from the clinic, then we will have no one to seek information and advice from. I am just a teenager, I know so little. Not only I will lose my support, but also I will not be taken serious by my schoolmates. With such important topic like sexual education and contraception, I am not the authority. I can only show the right way to go. And this road leads to ABUBEF.” She says “As peer educator I am responsible for Saturday morning meetings at the clinic. We sing songs, play games, have fun and learn new things about sex education, contraception, HIV protection and others. Visiting the clinic is then very easy, and no student has to be afraid, that showing up at the clinic that treats HIV positive people, will ruin their reputation. Now they know that we can meet there openly, and undercover of these meetings seek for help, information, professional advice and contraception methods” Peer educator classes are a safe and open place for students to openly talk about their sexual health. The Global Gage Rule will force peer educator programmes like this to close due to lack of funding.   Help us bridge the funding gap   Learn more about the Global Gag Rule

In Palestine sexual violence against women, especially within the family, is common. Women's virginity is linked to the honour of their family, and will face threats of death for dishonouring their family. Mariam needed help to get out of a coerced “relationship”, fearing for her life if her relatives find out. “In the beginning my nephew wanted to kiss me. “I resisted. But then he started touching my body. It became a relationship between lovers. To “preserve” virginity, it was always anal sex.  “I knew it was wrong. But who I should talk to? If my brother found out he would have beaten me - killed me.”  At the Palestinian Family Planning and Protection Association (PFPPA)'s clinics, social workers give awareness sessions on sexual violence in the waiting rooms, hoping to catch the attention of women there for other reasons who are hiding the fact they have been abused. It was this kind of session that proved vital for Mariam. “When my sister was pregnant I went with her to the PFPPA clinic,” she remembers. “The social worker there, Ruba, started speaking about sexual violence. When my sister went in with the doctor, I went to Ruba's office and told her I needed help; I cried.” Mariam kept visiting Ruba, and ended things with her nephew. “What happened to me is not rare. It would have been impossible for me to approach a relative and tell them what was going on; I was too frightened. And nobody would have believed me over a man. “I've found there are other women of my age who've had similar experiences to me but women are frightened to speak about it.  “Before, I despised myself. Now I feel powerful. I leave the house, I meet people. I feel I'm responsible for myself, that I have to protect myself, and that I need to help others if they need me. Everyone's telling me 'you've changed, you're stronger'.” Through its association with religious and community leaders, the PFPPA seeks to persuade the public of the importance of talking openly about sexual health and relationships, and dispel the idea that sexuality education for young people goes against the teachings of Islam.