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This World Humanitarian Day we reflect on the incredible work undertaken by our humanitarian response teams over the last 12 months. Last year, IPPF reached approximately 5.5 million people in humanitarian crises through our local Member Associations. This achievement would not have been possible without the dedicated and heroic healthcare teams providing vital sexual and reproductive healthcare in the most fragile humanitarian settings. COVID-19 response in Papua New Guinea Papua New Guinea Family Health Association (PNGFHA) PNGFHA responded to the COVID-19 outbreak in PNG, supported by the Australian government. With access to emergency healthcare facilities now extremely limited, PNGFHA health workers travel to hard-to-reach areas providing sexual and reproductive healthcare to the most marginalized communities.Clients like Vavine Kila receive a consultation at the PNGFHA mobile clinic. Share on Twitter Share on Facebook Share via WhatsApp Share via Email The humanitarian response teams taking healthcare into people's homes in Gaza Palestinian Family Planning and Protection Association (PFPPA) On 10 May 2021, Israel launched airstrikes on the Gaza Strip, killing over 220 people (including women and children) and leaving over 75,000 displaced. At the time, an estimated 87,000 women in the Gaza Strip and nearby areas were pregnant. The PFPPA humanitarian response team visited families in their homes, with each household expected to have four to five women of reproductive age needing healthcare. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Offering holistic care to families in Gaza Palestinian Family Planning and Protection Association (PFPPA) Children account for close to 50% of the population in Gaza. As part of the response, PFPPA youth volunteers entertained the children while their family members received life-saving sexual and reproductive healthcare and psychosocial support by the humanitarian response teams in privacy. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Ensuring ante- and post-natal care in the aftermath of an earthquake in West Sulawesi Indonesia Planned Parenthood Association (IPPA) On 15 January 2021, a 6.2 magnitude earthquake struck the West Sulawesi province in Indonesia leaving over 15,000 displaced, including many pregnant people and nursing mothers.As part of its response efforts, the IPPA set up mobile clinics near the shelters to provide vital ante- and post-natal care. Share on Twitter Share on Facebook Share via WhatsApp Share via Email A super cyclone and a pandemic Family Planning Association of India (FPAI) On 20 May 2020, severe Cyclone Amphan hit the Indian state of West Bengal, affecting millions of people in and around the state capital Kolkata. Emergency crises during the COVID-19 pandemic intensifies the impact of the disaster and puts a strain on health systems and access to sexual and reproductive healthcare.FPAI responded by providing emergency sexual and reproductive healthcare to affected communities, particularly focusing on the most marginalized and vulnerable people including the LGBTI community, sex workers, pregnant women, and survivors of sexual and gender-based violence (SGBV). Share on Twitter Share on Facebook Share via WhatsApp Share via Email Providing healthcare to hardest hit communities after Cyclone Yasa The Reproductive and Family Health Association of Fiji (RFHAF) In mid-December 2020, a category 5 severe Tropical Cyclone Yasa hit the island of Fiji and neighbouring Lau group of Islands. IPPF’s Member Association, RFHAF, was supported by the Australian government to provide life-saving sexual and reproductive healthcare in the hardest hit communities, including counselling on STI risk reduction, first-line support for survivors of SGBV, and contraceptive and ante-natal care. Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Sera Vulavou is the Senior Monitoring and Evaluation Officer with IPPF’s Sub-Regional Office for the Pacific. She was trained as a humanitarian surge roster member in early 2020, to be able to deploy to emergencies to provide technical assistance to Member Associations – here she shares her experience with us. Severe Tropical Cyclone (TC) Yasa was the strongest in the South Pacific since TC Winston in 2016, as well as the fourth most intense TC on record in the basin.  The Reproductive and Family Health Association of Fiji (RFHAF) humanitarian response to TC Yasa has reached some of the most difficult and geographically scattered islands and communities, which included the islands of Moala, Totoya, and Matuku.  Being part of the IPPF humanitarian surge roster team gave me the opportunity to accompany the RFHAF response team during their humanitarian work. This experience was about putting in action what I could only personally describe as being at the right place at the right time. 

Aminata Sonogo listened intently to the group of young volunteers as they explained different types of contraception, and raised her hand with questions. Sitting at a wooden school desk at 22, Aminata is older than most of her classmates, but she shrugs off the looks and comments. She has fought hard to be here. Aminata is studying in Bamako, the capital of Mali. Just a quarter of Malian girls complete secondary school, according to UNICEF. But even if she will graduate later than most, Aminata is conscious of how far she has come. “I wanted to go to high school but I needed to pass some exams to get here. In the end, it took me three years,” she said. At the start of her final year of collège, or middle school, Aminata got pregnant. She is far from alone: 38% of Malian girls will be pregnant or a mother by the age of 18. Abortion is illegal in Mali except in cases of rape, incest or danger to the mother’s life, and even then it is difficult to obtain, according to medical professionals. Determined to take control of her life “I felt a lot of stigma from my classmates and even my teachers. I tried to ignore them and carry on going to school and studying. But I gave birth to my daughter just before my exams, so I couldn’t take them.” Aminata went through her pregnancy with little support, as the father of her daughter, Fatoumata, distanced himself from her after arguments about their situation. “I have had some problems with the father of the baby. We fought a lot and I didn’t see him for most of the pregnancy, right until the birth,” she recalled. The first year of her daughter’s life was a blur of doctors’ appointments, as Fatoumata was often ill. It seemed Aminata’s chances of finishing school were slipping away. But gradually her family began to take a more active role in caring for her daughter, and she began demanding more help from Fatoumata’s father too. She went back to school in the autumn, 18 months after Fatoumata’s birth and with more determination than ever. She no longer had time to hang out with friends after school, but attended classes, took care of her daughter and then studied more. At the end of the academic year, it paid off. “I did it. I passed my exams and now I am in high school,” Aminata said, smiling and relaxing her shoulders.  "Family planning protects girls" Aminata’s next goal is her high school diploma, and obtaining it while trying to navigate the difficult world of relationships and sex. “It’s something you can talk about with your close friends. I would be too ashamed to talk about this with my parents,” she said. She is guided by visits from the young volunteers of the Association Malienne pour la Protection et Promotion de la Famille (AMPPF), and shares her own story with classmates who she sees at risk. “The guys come up to you and tell you that you are beautiful, but if you don’t want to sleep with them they will rape you. That’s the choice. You can accept or you can refuse and they will rape you anyway,” she said. “Girls have to know their rights”. After listening to the volunteers talk about all the different options for contraception, she is reviewing her own choices. “Family planning protects girls,” Aminata said. “It means we can protect ourselves from pregnancies that we don’t want”.

My name is Mariame Doumbia, I am a midwife with the Association Malienne pour la Protection et la Promotion de la Famille (AMPPF), providing family planning and sexual health services to Malians in and around the capital, Bamako. I have worked with AMPPF for almost six years in total, but there was a break two years ago when American funding stopped due to the Global Gag Rule. I was able to come back to work with Canadian funding for the project SheDecides, and they have paid my salary for the last two years. I work at fixed and mobile clinics in Bamako. In the neighbourhood of Kalabancoro, which is on the outskirts of the capital, I receive clients at the clinic who would not be able to afford travel to somewhere farther away. It’s a poor neighbourhood. Providing the correct information The women come with their ideas about sex, sometimes with lots of rumours, but we go through it all with them to explain what sexual health is and how to maintain it. We clarify things for them. More and more they come with their mothers, or their boyfriends or husbands. The youngest ones come to ask about their periods and how they can count their menstrual cycle. Then they start to ask about sex. These days the price of sanitary pads is going down, so they are using bits of fabric less often, which is what I used to see.  Seeing the impact of our work  We see cases of early pregnancy here in Kalabancoro, but the numbers are definitely going down. Most are from 14 years old upwards, though occasionally they are younger. SheDecides has brought so much to this clinic, starting with the fact that before the project’s arrival there was no one here at all for a prolonged period of time. Now the community has the right to information and I try my best to answer all their questions.

My name is Fatoumata Yehiya Maiga. I’m 23-years-old, and I’m an IT specialist. I joined the Youth Action Movement at the end of 2018. The head of the movement in Mali is a friend of mine, and I met her before I knew she was the president. She invited me to their events and over time persuaded me to join. I watched them raising awareness about sexual and reproductive health, using sketches and speeches. I learnt a lot. Overcoming taboos I went home and talked about what I had seen and learnt with my family. In Africa, and even more so in the village where I come from in Gao, northern Mali, people don’t talk about these things. I wanted to take my sisters to the events, but every time I spoke about them my relatives would just say it was to teach girls to have sex, and that it’s taboo. That’s not what I believe. I think the movement helps girls, most of all, to know their sexual rights, their bodies, what to do and what not to do to stay healthy and safe. They don’t understand this concept. My family would say it was just a smokescreen to convince girls to get involved in something dirty.  I have had to tell my younger cousins about their periods, for example, when they came from the village to live in the city. One of my cousins was so scared, and told me she was bleeding from her vagina and didn’t know why. We talk about managing periods in the Youth Action Movement, as well as how to manage cramps and feel better. The devastating impact of FGM But there was a much more important reason for me to join the movement. My parents are educated, so me and my sisters were never cut. I learned about female genital mutilation at a conference I attended in 2016. I didn’t know that there were different types of severity and ways that girls could be cut. I hadn’t understood quite how dangerous this practice is. Then, two years ago, I lost my friend Aïssata. She got married young, at 17. She struggled to conceive until she was 23. The day she gave birth, there were complications and she died. The doctors said that the excision was botched and that’s what killed her. From that day on, I decided I needed to teach all the girls in my community about how harmful this practice is for their health. I was so horrified by the way she died. Normally, girls in Mali are cut when they are three or four years old, though for some it’s done at birth. When they are older and get pregnant, I know they face the same challenges as every woman does giving birth, but they also live with the dangerous consequences of this unhealthy practice.  The importance of talking openly  The problem lies with the families. I want us, as a movement, to talk with the parents and explain to them how they can contribute to their children’s sexual health. I wish it were no longer a taboo between parents and their girls. But if we talk in such direct terms, they only see disobedience, and say that we are encouraging promiscuity. We need to talk to teenagers because they are already parents in many cases. They are the ones who decide to go through with cutting their daughters, or not. A lot of Mali is hard to reach though. We need travelling groups to go to those isolated rural areas and talk to people about sexual health. Pregnancy is the girl’s decision, and girls have a right to be healthy, and to choose their future.

In 2017, the Association Malienne pour la Protection et la Promotion de la Famille (AMPPF), was hit hard by the reinstatement of the Global Gag Rule (GGR). The impact was swift and devastating – depleted budgets meant that AMPPF had to cut back on key staff and suspend education activities and community healthcare provision. The situation turned around with funding from the Canadian Government supporting the SheDecides project, filling the gap left by GGR. AMPPF has been able to employ staff ensuring their team can reach the most vulnerable clients who would otherwise be left without access to sexual healthcare and increase their outreach to youth. Putting communities first Mama Keita Sy Diallo, midwife The SheDecides project has allowed AMPPF to maintain three mobile clinics, travelling to more remote areas where transportation costs and huge distances separate women from access to health and contraceptive care.“SheDecides has helped us a lot, above all in our work outside our own permanent clinics. When we go out in the community we have a lot of clients, and many women come to us who would otherwise not have the means to obtain advice or contraception,” explained Mama Keita Sy Diallo, a midwife and AMPPF board member. She runs consultations at community health centers in underserved areas of the Malian capital. “Everything is free for the women in these sessions.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email SheDecides projects ensures free access to healthcare and contraception Fatoumata Dramé, client By 9am at the Asaco Sekasi community health center in Bamako, its wooden benches are full of clients waiting their turn at a SheDecides outreach session. Fatoumata Dramé, 30, got here early and has already been fitted for a new implant. “I came here for family planning, and it’s my first time. I’ve just moved to the area so I came because it’s close to home,” she said. Bouncing two-month-old Tiemoko on her knee, Dramé said her main motivation was to space the births of her children. “I am a mum of three now. My first child is 7 years old. I try to leave three years between each child. It helps with my health,” she explained. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Targeting youth Mamadou Bah, Youth Action Movement “After the arrival of SheDecides, we intensified our targeting of vulnerable groups with activities in the evening, when domestic workers and those working during the day could attend,” said Mariam Modibo Tandina, who heads the national committee of the Youth Action Movement in Mali. “That means that young people in precarious situations could learn more about safer sex and family planning. Now they know how to protect themselves against sexually transmitted infections and unwanted pregnancies.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Speaking out against FGM Fatoumata Yehiya Maiga, youth volunteer Fatoumata’s decision to join the Youth Action Movement was fueled by a personal loss. “My parents are educated, so me and my sisters were never cut. I learned about female genital mutilation at a conference I attended in 2016. I didn’t know that there were different types of severity and ways that girls could be cut. I hadn’t understood quite how dangerous this practice is. Two years ago, I lost my friend Aïssata. She got married young, at 17. She struggled to conceive until she was 23. The day she gave birth, there were complications and she died. The doctors said that the excision was botched and that’s what killed her. From that day on, I decided I needed to teach all the girls in my community about how harmful this practice is for their health. I was so horrified by the way she died.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Using dance and comedy to talk about sex Abdoulaye Camara, Head of AMPPF dance troupe Abdoulaye’s moves are not just for fun. He is head of the dance troupe of the AMPPF’s Youth Action Movement, which uses dance and comedy sketches to talk about sex. It’s a canny way to deliver messages about everything from using condoms to taking counterfeit antibiotics, to an audience who are often confused and ashamed about such topics. “We distract them with dance and humour and then we transmit those important messages about sex without offending them,” explained Abdoulaye. “We show them that it’s not to insult them or show them up, but just to explain how these things happen.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Determination to graduate Aminata Sonogo, student Sitting at a wooden school desk at 22, Sonogo is older than most of her classmates, but she shrugs off the looks and comments. She has fought hard to be here. “I wanted to go to high school but I needed to pass some exams to get here. In the end, it took me three years,” she said.At the start of her final year of collège, or middle school, Sonogo got pregnant. She went back to school in the autumn, 18 months after Fatoumata’s birth and with more determination than ever. At the end of the academic year, it paid off. “I did it. I passed my exams and now I am in high school,” Sonogo said, smiling and relaxing her shoulders. She is guided by visits from the AMPPF youth volunteers and shares her own story with classmates who she sees at risk of an unwanted pregnancy. Share on Twitter Share on Facebook Share via WhatsApp Share via Email AMPPF’s mobile clinic offers a lifeline to remote communities Mariame Doumbia, midwife “I work at a mobile clinic. It’s important for accessibility, so that the women living in poorly serviced areas can access sexual and reproductive health services, and reliable information.I like what I do. I like helping people, especially the young ones. They know I am always on call to help them, and even if I don’t know the answer at that moment, I will find out. I like everything about my work. Actually, it’s not just work for me, and I became a midwife for that reason. I’ve always been an educator on these issues in my community.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Trust underpins the relationship between AMPPF’s mobile team and the village of Missala Adama Samaké, village elder and chief of the Missala Health Center Adama Samaké, chief of the Missala Health Center, oversees the proceedings as a village elder with deep trust from his community. When the mobile clinic isn’t around, his center offers maternity services and treats the many cases of malaria that are diagnosed in the community. “Given the distance between here and Bamako, most of the villagers around here rely on us for treatment,” he said. “But when we announce that the mobile clinic is coming, the women make sure they are here.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Contraceptive choice Kadidiatou Sogoba, client Kadidiatou Sogoba, a mother of seven, waited nervously for her turn. “I came today because I keep getting ill and I have felt very weak, just not myself, since I had a Caesarean section three years ago. I lost a lot of blood,” she said. “I have been very afraid since the birth of my last child. We have been using condoms and we were getting a bit tired of them, so I am looking for another longer-term type of contraception.”After emerging half an hour later, Sogoba clutched a packet of the contraceptive pill, and said next time she would go for a cervical screening.Photos ©IPPF/Xaume Olleros/Mali Share on Twitter Share on Facebook Share via WhatsApp Share via Email

In early April 2020, the all too familiar destruction of a Tropical Cyclone (TC) – Harold – hit the Solomon Islands, Vanuatu, Fiji and Tonga. One of the worst affected areas was the Eastern part of Fiji. Through support by Department of Foreign Affairs and Trade (DFAT), our Member Association, Reproductive and Family Health Association of Fiji (RFHAF), was quick to respond ensuring access to essential sexual and reproductive healthcare for Kadavu’s women, girls, and vulnerable groups. Fiji's vulnerable coastline Fiji’s worst affected area was the Eastern part, with TC Harold bringing destructive storm force winds and storm surge. RFHAF focused its humanitarian response on the local Kadavu population. This remote area proves a challenge to reach for the team with supplies. Share on Twitter Share on Facebook Share via WhatsApp Share via Email RFHAF's humanitarian response team tackle rough terrain National travel restrictions - due to the current COVID-19 pandemic - on all inter island transfers has slowed the response in some areas, including Kadavu. The island of Kadavu is one of the least developed areas of Fiji, the main source of income is substance living (Yaqona). Transport around the island is difficult, with very few roads, no public water system or electricity. The humanitarian team from RFHAF travels by boat and then on foot. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Asenaca, client Kadavu, the biggest island in the Eastern division has the greatest population (10,897). 197 evacuation centres were activated in total, initially hosting over 6,240 people. Many are women of reproductive age, with an estimated 150 currently pregnant. Asenaca learns about breast cancer self-checks from RFHAF’s healthcare provider, Karo. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Nasi, RFHAF healthcare provider The medical mobile team deliver a broad range of healthcare including contraception, information and counselling on sexual health, pregnancy, HIV and STI care and testing. RFHAF Team in Kadavu performing general health checks after TC Harold. Nasi administers a HPV shot to a client. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Kate, client Young women and girls are at the heart of RFHAF’s healthcare provision. Kate walks home with her dignity kit after a health check at the mobile clinic. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Karo, RFHAF healthcare worker RFHAF offers sexual and reproductive healthcare as well as counselling, and referrals for follow up care. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Alidi, RFHAF healthcare worker The team ensures young people in the community are not forgotten and provide information and education on relationships and sexual health and rights. Alidi conducting a session with a local group of young people at Gasele, Kadavu.Photos ©IPPF/Rob Rickman/Fiji Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Cyclone Winston, which devastated Fiji, was the strongest to ever hit the South Pacific. IPPF’s humanitarian response there was carried out with our Member Association, the Reproductive & Family Health Association of Fiji, and is part of our SPRINT Initiative, funded by the Australian Government. Despite its flourishing international tourism industry, Fiji remains a deeply conservative and traditional society, bound by long-held rules on culture and conduct. In particular, any discussion about sex and sexuality is taboo: including talk of sex, condoms, pregnancy and sexually transmitted infections. Given Fiji’s relatively high rate of teen pregnancy (36 in 1000 in the 15-19 age group, according to UNFPA 2016 statistics), it is an issue of growing concern. It falls upon the village headman to provide guidance on how the issue is tackled: and when there is one who is progressive and not afraid to discuss taboo topics, it augers well for the sexual health of the entire community. Sevuama Sevutia is one such leader. The deputy headman of Naiserelegai village is a proud advocate of condom-use, telling the young people of the village that it is vital to wear them to prevent pregnancy. “My experiences, I share with the kids,” says Sevuama. “I tell the children, get to that stage of knowing what the sexual relationship is all about. Please look after yourself and if you have a problem, with the young boys or if someone is giving you the wrong advice, please tell people. It’s my job to tell them, to call their mother, their father.” “Nowadays, as the education level rises, we have to open up. But in the village, in the olden days, when people would see condoms they would say, 'no no, don’t talk about that'. But I am encouraging them to open up.” His children, too, are encouraged to be open. “I tell them, this is a condom,” he says, brandishing an imaginary condom. “Safe sex. If you want to have sex, use a condom. Use the condom! And protect yourself from the other things.” Sevuama, 53, a former marine engineer, spent decades in Suva before returning to his bayside home village of Naiserelegai. He was in the city at the time of the cyclone but managed to get back three or four days later when the roads had re-opened. He found his home damaged but intact and his five children safe, but much of the village destroyed and his wife still in shock. He received a small amount of money from the government to help fix his roof. Earlier this year, he, along with other men in the village, participated in IPPF information sessions on male sexual health and fertility, which he described as very helpful in complementing and reinforcing his existing knowledge. “We had a lot of questions, like mostly for the man, something might have happened to them during a difficult time. All this information helps the communities.” Stories Read more stories about our work in Fiji after the Cyclone Winston

Cyclone Winston that devastated Fiji was the strongest to ever hit the South Pacific. IPPF’s humanitarian response there is part of our SPRINT Initiative, funded by the Australian Government’s Department of Foreign Affairs and Trade. My name is Elenoa Male and I live in the village of Navala. At the time of Cyclone Winston I was seven-months pregnant. It was already very hard trying to keep my other three children safe. I was alone with them because my husband went out hunting before the cyclone hit. Just before the time of the cyclone, my family was living between our traditional bure (thatched house) and a tin-roofed house. When the warnings first came, I decided to move my family from the bureto to the tin-roofed house. I realised that it would be hard to go to school where the evacuation centre was because I was pregnant. I told the kids we were sleeping under the bed. After we had dinner we prayed and we told God that now it is your will and we ask for your protection. So we lay down, and then my husband arrived and asked for the kids. I told him that we are all lying down under the bed. He said we really didn't know how strong the cyclone would be, but I told him to shut up and prepare for it. We all lay under the bed for hours. All I could hear was the strong winds. Once the winds died down, I came out but found our bure house was completely destroyed. I was sad because we need the bure for relaxation because of its coolness. I received a dignity kit from IPPF containing clothes for my children along with toothpaste and brushes, and this helped a lot in the weeks after Cyclone Winston. What I needed the most was for my kids to be fed properly and to wear good clothes. It really helped us a lot.   Stories Read more stories about our work in Fiji after the Cyclone Winston

Cyclone Winston, which devastated Fiji, was the strongest to ever hit the South Pacific. IPPF’s humanitarian response there was carried out with our Member Association, the Reproductive & Family Health Association of Fiji, and is part of our SPRINT Initiative, funded by the Australian Government. My name is Verenaisi Katerina. I have five children and we live in a remote village in the Ba Highlands. At the time the cyclone hit we were all living in a timber house and I was pregnant. I’ve lived in a bure (traditional timber house with a thatched grass roof) all my life, I’m so used to living in a bure, I’m not used to living in a tin-roofed house. We tried to be prepared when the cyclone came. But we had to all rush to the evacuation centre when the roof blew off our house. My whole family was scared, our house was flooded and our crops were all damaged. My daughter was covering her eyes and ears and crying for help. While I started preparing to move to the local school to take shelter, my husband went to get us some food. I was really, really afraid. I was so worried about my kids. I told my husband not to be late and to help me out with the kids going down to the school. In the end, I managed to get my children to the school on my own, and my husband joined us later. While my family took shelter, lots of other homes in Navala were destroyed. We were lucky: most of their possessions were blown away, but some managed to survive, and our home was damaged, but remained standing. When we came back the next day, my husband tried to start repairing the kitchen so that we could move back. We had a small stove that we were using, and we made a small kitchen so at least we could cook. My husband could only get us what was left over from the farm and that’s basically what we were living on. We had to eat a lot of flour products, a lot of rice, because our farm was badly damaged. I received a dignity kit from IPPF and found it extremely helpful, particularly in clothing my children and the baby. Some of it was worn on the very same day we received it. I later took part in a family planning session conducted by IPPF. I learned a lot from the workshop on that day. I told myself, this is it. I’m only going to have five kids. Having to go through that experience of Cyclone Winston, if I had more children, then it might have been more difficult, too late, for me to run up to that school for shelter. I have had a talk with my husband and we have decided that this one is my last. My fifth is my last.   Stories Read more stories about our work in Fiji after the Cyclone Winston