Stories

Over the past 30 years, more than 60 countries and territories have liberalized their abortion laws. Only four have regressed, including the United States. Abortion rights are increasingly becoming recognized as fundamental human rights for millions of people worldwide. The global landscape of abortion rights continues to evolve in 2024, with new legislation and feminist movements fighting for better access. Let's take a trip around the world to see the latest developments.

“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. 

It wasn’t the group meetings, the testing services or the health facilities that attracted Manny Norman, it was the offer of a free subway card and a bite to eat. A friend who was also a substance use told him about the workshops in a basement at a nearby community centre. Manny focused on the subway card which would be worth a few dollars if he sold it on. “I just wanted something to eat,” he says. “I hadn’t eaten in probably 20 hours. And the idea of getting more drugs without stealing sounded good to me.” Thirteen years later and he is still attending the Safety Counts meetings run by Planned Parenthood’s Project Street Beat, and credits them with helping him rebuild a life shattered by drug abuse. At the time, he explains he was neglecting his young family, stealing from them to buy crack cocaine and alcohol. His wife would call the police or lock him out of the home on an almost daily basis. “I was on crack and alcohol, the drugs that led me to dereliction, that led me to stealing, being unmanageable, not responsible, without a care in the world,” he says. “(I) didn’t want to work. I just wanted to feed my drug addiction.” Starting a new life But when he walked into the Safety Counts meetings, he says now, he realised he was among people who understood his life. “They met me where I was at,” he says. “They could tell I was under the influence. They could tell I was hurting, that I wasn’t doing the right thing and they made me feel no less than and no different. They gave me hope to come back the next week.” At first, he just went with the flow, focusing on the food and the subway card, not taking much notice of the services on offer. But eventually, he realised there were other people in the room he had come out the other side and rebuilt their lives. “We talked about harm reduction,” he says. “I could identify with the stories other people were telling. Lying, cheating, stealing, borrowing money knowing you wouldn’t pay it back.” Detox and rehab followed. He used the facilities of the projects mobile medical unit to get himself tested for Hepatitis C and HIV and has managed to stay clean, even training as an HIV outreach worker, and has rebuilt his family life. “It’s a happy home now,” he says. “My daughter got her father back, my wife got her husband back. Most of all I got myself back, thank God.” Without Project Street Beat he says his life would have continued its downward spiral. He would most likely be in prison today. Instead, he works as a supervisor for a cleaning company. And when he bumps into one of his friends from the old days he knows what to do. “When I walk down the street and see someone I know – someone I took drugs with or drank with – I let them know exactly where the mobile might be at,” he said. “I have cards in my pocket I give out to people and let them know this is the new way.” Watch Project Street Beat in action

A young man stops by a pile of rubbish at the side of the road. He fiddles with an abandoned umbrella, snapping off one of its broken ribs and slipping it into his backpack. Eric Fairchild spots the signs. The HIV prevention specialist greets the man like an old friend. “We got condoms, leaflets, testing right here,” he says standing in front of Planned Parenthood’s mobile medical unit. The man refuses initially, stepping into a nearby grocery store, before returning a few minutes later with his girlfriend to hear about the services on offer. The umbrella rib, says Mr Fairchild later, was a giveaway. It makes a perfect tool for scraping the residue from a substance pipe. Understanding and overcoming Eric has worked for Planned Parenthood for 12 years, using his experience growing up in the Brooklyn neighbourhood of Brownsville to help spot others who are in need of help. “I was part of the streets,” he says. “I was a substance abuser. Never injected, but I smoked, sniffed... stuff of that nature.” He has been clean for 26 years but explains that his experiences help him connect with other users. “The first thing I do when I have hardcore substance abusers sitting in front of me, I first show them identification,” he says.  “I let them know I understand just how they feel. I’ve been there feeling hopeless, helpless, confused about where to turn.” Some occasions might mean he has to use the training and education he has received as an outreach worker. Other times it is a case of using his 60 years’ experience of life in Brooklyn. “That’s my benefit to the programme,” he says. “I’m street savvy as well as educated in the classroom. I have the best of both worlds.” Eric already had an extensive background in community work before joining the project, prompted by a desire to learn more about HIV prevention following the death of a relative and a friend died from the illness. He is often the first point of contact for clients, handing out pamphlets on the street corner, conducting HIV tests and explaining Project Beat Street– and the facilities available on the mobile unit to wary newcomers. From there he can offer advice and guidance on other services, from home care managers to sources of funding for people with HIV and setting up appointments at clinics. He follows up with phone calls and meetings, often at every step of a client’s progress. “I saw when they came in,” he says. “I saw them come in from a struggling situation, uncomfortable with their lifestyle at the time. Going from being an unproductive member of society to taking better care of themselves and being in a healthier situation that they were before. I am always happy to know I was part of that process.” Watch Project Street Beat in action