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Love wins! The fight for marriage equality has seen incredible progress worldwide, with a recent surge in legalizations. Across the world, 36 out of 195 countries have legalized equal marriage: Andorra, Argentina, Australia, Austria, Belgium, Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Denmark, Ecuador, Estonia, Finland, France, Germany, Greece, Iceland, Ireland, Luxembourg, Malta, Mexico, the Netherlands, New Zealand, Norway, Portugal, Slovenia, South Africa, Spain, Sweden, Switzerland, Taiwan, the United Kingdom, the United States of America and Uruguay. In 2023, three new countries legalized same-sex marriage (Andorra, Estonia and Slovenia), and three more solidified legislative progress towards decriminalizing same-sex unions: a Japanese court ruled it is unconstitutional for the nation not to legally recognize same-sex unions. And the Supreme Courts of Nepal and Namibia recognized marriages of same-sex couples registered abroad. So marriage equality marches on! Already in 2024, two more countries have said "I do" to equal rights.   According to the Human Rights Campaign Foundation, even more countries could legalize equal marriage in 2024. In particular, the Czech Republic, India, Japan, Nepal and Philippines show signs of growing support for marriage equality. The fight for marriage equality isn't over, but the momentum is undeniable. IPPF stands with those working to make love win everywhere.

“I saw this challenge when children are having children and they're having a number of children at a very young age,” says 37-year-old Matiisetso Sefako, after emerging from the Lesotho Planned Parenthood Association (LPPA) tent in Mokhethoaneng village, an hour drive from the capital Maseru. “For them to be engaged in family planning, it would really help them.” The mother of two lives just outside the village and says she’s become something of a community activist on the issue of early child marriage and the need for family planning. After she receives services, she lingers for an hour, speaking with young women and teenage girls who are looking over at the LPPA mobile clinic with interest.    She herself was a 19-year-old mother and has been using contraceptives for nearly 20 years. Then, it was harder to come by and she would often have to travel at her own cost. Now, she comes regularly when LPPA makes the monthly visit to her village.  And she’s done quite a lot on this to advise people to try and convince them to come and access such services, she says.  “The only problem I encounter is that the biggest challenge within the village is that there is a high rate of teenage pregnancy. I try to convince them this tent will help.”  This is her fourth visit to the LPPA outreach to receive services herself. Her only wish? “That these services be here every day,” she says, explaining that there is a deeply-felt need in her community and her hope is that she can refer more young women to follow up and receive the same monthly services she benefits from.  

When Raphel Marafan Kori’s husband died in 2001, she was left to fend for herself, in a largely patriarchal society. Now 45-years-old, she keeps busy and earns an income as a peer educator in Tsenekeng village in Lesotho’s Semonkong region.  She goes door to door to counsel her neighbors and residents of the village in family planning options available. She’s been doing it for nine months and visibly brightens when she starts talking about the work. "I introduce myself, after that I explain to the people the services that we provide, the importance of the choices that we can make about contraceptives."  She was appointed by the village chief, Makholu Mahao, to participate in a training provided by LPPA in the capital, Maseru and soon after, dove into her fieldwork. Some people immediately understand and welcome the offerings, she says, while others take some time.  Protection & permission  Now nine months into the work, she says the biggest issue facing her community is “that adolescents still need consent from the parents. And the parents seem to have a problem with that because in a way, [they think] it is allowing them, giving them the freedom to indulge in sex.”  “Another way I can explain [is to] mention  HIV testing here and to remind [parents] it's not only they're getting protection but also for them to help them plan for future."   Going door to door Occasionally she’ll hold community gatherings, but mostly she has these conversations door to door. “I’m working very hard to make sure the children also engage in this for the future. It’s a challenge,” she admits. She herself comes to the mobile outreach post for family planning services, something she says helps break the ice when she is out in the community talking about family planning. She tells them she uses the pill because she is allergic to the injectable option offered here.  “I get to talk to people because I can counsel them on HIV and AIDS daily to make them understand that just because you have HIV it's not the end of the world but you need to take your medication properly and life continues,” she explains proudly, sitting a few meters away from the She Decides tent with a line of women outside. Overall, she says she has benefitted as much from her work as the beneficiaries. “I engage with people. I also learned a lot, it educated me especially on the protection side because even myself before I was not aware of such information but now I've learned and I can give other people this information.” 

“I was 18 when I married. But back then that was old!” 76-year-old Makholu Mahao laughs as she goes on to list her nine children – 4 boys, 5 girls including twins.  “At the time that I was married, if I knew about contraceptives, I wouldn’t have had so many children,” she insists.  Her tone becomes forceful and serious when she shifts to subjects like teenage pregnancy and childhood marriage, both ills that are prevalent in her village in the Semonkong region, known as Tsenekeng Hamojalefa.  The village sits atop a rocky hillside, most easily accessible by horse or donkey, and 114 kilometres from the capital, Maseru. She is the village chief now, a post she took up when her husband, the former chief, died.  And to her, “the big challenges are teenage pregnancy and early marriage. We’re seeing the difficulty in labor, children dying in labor, and young mothers dying in early labor. Those are the main things I need assistance with,” she explains to staff from Lesotho Planned Parenthood Association (LLPA), on a field visit to LPPA’s mobile clinic down the hill from Makholu’s home.  More than family planning “How can we stop this problem,” she asks her visitors.  Underage girls “marry at a young age, they don’t know what marriage is. They bear children and bear children and have problems, like death or infant death,” she reiterates. And it’s not just family planning that benefits the residents of her village. 16 villages ring the hillsides around the mobile outreach post, set up today to offer family planning, counseling, and HIV testing.  Before the arrival of LPPA on a monthly basis, “we were not receiving any other services other than the two clinics,” she explains, describing clinics approximately 40 km from her village. She adds, “We would leave early in the morning to get there at 9 or 10 to get the services. It was very congested so we would leave and get back here without getting any services.” Encouraging young people When it comes to combatting stigma in a patriarchal society, this great grandmother says some couples do go together for services or at least are in agreement about pursuing services. Still, “men cannot go with the women,” she explains. Throughout the day, men and women gather in separate groups outside the LPPA tents to receive consultations separately.  She sends a strong message by giving her OK for underage single women to seek family planning services. “It is acceptable that [minors] can get it [services], single or not,” she says. “At the end of the day, it’s protection for early pregnancy. The elderly – like me – don’t usually agree with that. But the [minors] will go on their own, however they can. I support that.”    

Bolelwa Falten in based in Losotho’s capital, Maseru, and has been working as a HIV counsellor for the better part of a decade, bouncing from different organizations depending on where the funding goes. Before she joined, IPPF nine months ago, 40-year-old Bolelwa worked with PSI Losotho. Now, she runs the “North team” as part of LPPA’s outreach program.  She handles five different outreach posts and today, she is running the HIV testing clinic at one site.  Bolelwa proudly takes us through the full range of tests and counseling services they offer there, taking particular pride in explaining how she follows up patients who test positive. She knows the beneficiaries appreciate the work – it’s something she sees every time she does an outreach day.  “They no longer need transport money, time to get to the clinic. Our being here is actually bringing the service to where they are and where they need it,” she says. But quickly, she follows up, noting that in general, HIV and STI mobile healthcare services have been hit-hard by funding cuts in recent years.

"This is a relief. I'm feeling very happy now that services have been brought,” 34-year-old Makamohelo Tlali, says, smiling outside the Lesotho Planned Parenthood Association (LPPA) tent on the hillside of Hamoshati village in Lesotho. Makamohelo is a relatively new beneficiary of family planning services offered monthly at a post near her village. This is her second visit. She walks over 30 minutes each way but says that’s by far the best option for her.  "I feel happy that services are here, for free. When I accessed them before it would take transport costs to get to the place."  In the past, it would cost her 40 rand for taxis to the closest clinic, plus the additional cost of family planning services.      Makamohelo first heard about these offerings from a peer mobilizer going door to door in her village.  “I met her along the way and discussed the way I can access family planning services. They’re scarce this side. And she told me on a specific date there would be LPPA people offering services." “Now here I am,” she says, laughing.  She takes advantage of the free HIV testing offered here as well and says she is hopeful the family planning will be maintained, mentioning that other NGOs have come and gone over the course of several years. For her and her husband, family planning is openly discussed in the household and important for the health of their current family. They have three children, 2 girls and a boy.  “Three is enough! My husband has no problem with me accessing family planning here,” she explains, adding that her husband relies on piecemeal jobs while she farms to feed the family. 

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

Milan Khadka was just ten years old when he lost both his parents to HIV. “When I lost my parents, I used to feel so alone, like I didn’t have anyone in the world,” he says. “Whenever I saw other children getting love from others, I used to feel that I also might get that kind of love if I hadn’t lost my parents.” Like thousands of Nepali children, Milan’s parents left Nepal for India in search of work. Milan grew up in India until he was ten, when his mother died of AIDS-related causes. The family then returned to Nepal, but just eight months later, his father also died, and Milan was left in the care of his grandmother. “After I lost my parents, I went for VCT [voluntary counselling and testing] to check if I had HIV in my body,” Milan says. “After I was diagnosed as HIV positive, slowly all the people in the area found out about my status and there was so much discrimination. My friends at school didn’t want to sit with me and they humiliated and bullied me,” he says. “At home, I had a separate sleeping area and sleeping materials, separate dishes and a separate comb for my hair. I had to sleep alone.” Things began to improve for Milan when he met a local woman called Lakshmi Kunwar. After discovering she was HIV-positive, Lakshmi had dedicated her life to helping people living with HIV in Palpa, working as a community home-based care mobiliser for the Family Planning Association of Nepal (FPAN) and other organisations. Struck by the plight of this small, orphaned boy, Lakshmi spoke to Milan’s family and teachers, who in turn spoke to his school mates. “After she spoke to my teachers, they started to support me,” Milan says. “And after getting information about HIV, my school friends started to like me and share things with me. And they said: ‘Milan has no one in this world, so we are the ones who must be with him. Who knows that what happened to him might not happen to us?” Lakshmi mentored him through school and college, encouraging him in his schoolwork. “Lakshmi is more than my mother,” he says. “My mother only gave birth to me but Lakshmi has looked after me all this time. Even if my mother was alive today, she might not do all the things for me that Lakshmi has done.” Milan went on to become a grade A student, regularly coming top of his class and leaving school with flying colours. Today, twenty-one-year-old Milan lives a busy and fulfilling life, juggling his college studies, his work as a community home-based care (CHBC) mobiliser for FPAN and a burgeoning music career. When not studying for a Bachelor’s of education at university in Tansen, he works as a CHBC mobiliser for FPAN, visiting villages in the area to raise awareness about how to prevent and treat HIV, and to distribute contraception. He also offers support to children living with HIV, explaining to them how he lost his parents and faced discrimination but now leads a happy and successful life. “There are 40 children in this area living with HIV,” he says. “I talk to them, collect information from them and help them get the support they need. And I tell them: ‘If I had given up at that time, I would not be like this now. So you also shouldn’t give up, and you have to live your life.” Watch Milan's story below:      

“Family Planning Association of Nepal is playing a crucial role in protecting the rights of female sex workers in the whole of Nepal” says Jamuna Sitvla, senior programme officer at Family Planning Association of Nepal (FPAN). There are around 40,000 sex workers in Nepal. Around 1,300 are infected with HIV. FPAN is working to increase awareness among sex workers to practice safe sex and to use condoms to protect from HIV. "One challenge is that when female sex workers carry condoms, if the police find the condoms, they criminalise the women. Some of the sex workers have been organised via different organisations in order to protect their rights. Now the Supreme Court has given an a ruling that policemen have to ensure the sexual rights of female sex workers have to be addressed. This decision includes that women can carry condoms: that is their right. The second decision is that sex workers have the right to organise. Some sex workers are afraid of asking heir clients to wear condoms and this increases their risk of contracting HIV but the more confident sex workers are ensuring that their clients wear condoms". "In 2017 there was a huge conference held at FPAN, with sex workers invited as panelists. People had the opportunity to understand the problems they were facing. One of FPAN’s great successes was to invite the criminal department of police, policy makers and sex workers to come under one roof. We gathered them in the FPAN venue and they made a commitment that from now on the female sex workers will be treated with respect, with dignity, will not be criminalised."   Stories Read more stories about our work with people living with HIV

Lakshmi Kunwar married young, at the age of 17. Shortly afterwards, Lakshmi’s husband, who worked as a migrant labourer in India, was diagnosed with HIV and died. “At that time, I was completely unaware of HIV,” Lakshmi says. “My husband had information that if someone is diagnosed with HIV, they will die very soon. So after he was diagnosed, he didn’t eat anything and he became very ill and after six months he died. He gave up.” Lakshmi contracted HIV too, and the early years of living with it were arduous. “It was a huge burden,” she says. “I didn’t want to eat anything so I ate very little. My weight at the time was 44 kilograms. I had different infections in my skin and allergies in her body. It was really a difficult time for me. … I was just waiting for my death. I got support from my home and in-laws but my neighbours started to discriminate against me – like they said HIV may transfer via different insects and parasites like lice.” Dedicating her life to help others Lakshmi’s life began to improve when she came across an organisation in Palpa that offered support to people living with HIV (PLHIV). “They told me that there is medicine for PLHIV which will prolong our lives,” she explains. “They took me to Kathmandu, where I got training and information on HIV and I started taking ARVs [antiretroviral drugs].” In Kathmandu Lakshmi decided that she would dedicate the rest of her life to supporting people living with HIV. “I made a plan that I would come back home [to Palpa], disclose my status and then do social work with other people living with HIV, so that they too may have hope to live. I said to myself: I will live and I will let others living with HIV live”. Stories Read more stories about our work with people living with HIV