Stories

Senegal’s IPPF Member Association, Association Sénégalaise pour le Bien-Etre Familial (ASBEF) ran two clinics in the capital, Dakar, until funding was cut in 2017 due to the reinstatement of the Global Gag Rule (GGR) by the US administration. The ASBEF clinic in the struggling suburb of Guediawaye was forced to close as a result of the GGR, leaving just the main headquarters in the heart of the city.    The GGR prohibits foreign non-governmental organizations (NGOs) who receive US assistance from providing abortion care services, even with the NGO’s non-US funds. Abortion is illegal in Senegal except when three doctors agree the procedure is required to save a mother’s life.  ASBEF applied for emergency funds and now offers an alternative service to the population of Guediawaye, offering sexual and reproductive health services through pop-up clinics.   Asba Hann is the president of the Guediawaye chapter of IPPF’s Africa region youth action movement. She explains how the Global Gag Rule (GGR) cuts have deprived youth of a space to ask questions about their sexuality and seek advice on contraception.  “Since the closure of the clinic, the nature of our advocacy has changed. We encounter a lot more problems in our area, above all from young people and women asking for services. ASBEF (Association Sénégalaise pour le Bien-Etre Familial) was a little bit less expensive for them and in this suburb there is a lot of poverty.   Our facilities as volunteers also closed. We offer information to young people but since the closure of the clinic and our space they no longer get it in the same way, because they used to come and visit us.   We still do activities but it’s difficult to get the information out, so young people worry about their sexual health and can’t get the confirmation needed for their questions.   Young people don’t want to be seen going to a pharmacy and getting contraception, at risk of being seen by members of the community. They preferred seeing a midwife, discreetly, and to obtain their contraception privately. Young people often also can’t afford the contraception in the clinics and pharmacies.  It would be much easier for us to have a specific place to hold events with the midwives who could then explain things to young people. A lot of the teenagers here still aren’t connected to the internet and active on social media. Others work all day and can’t look at their phones, and announcements get lost when they look at all their messages at night. Being on the ground is the best way for us to connect to young people.” 

Senegal’s IPPF Member Association, Association Sénégalaise pour le Bien-Etre Familial (ASBEF) ran two clinics in the capital, Dakar, until funding was cut in 2017 due to the reinstatement of the Global Gag Rule (GGR) by the US administration. The ASBEF clinic in the struggling suburb of Guediawaye was forced to close as a result of the GGR, leaving just the main headquarters in the heart of the city.   The GGR prohibits foreign non-governmental organizations (NGOs) who receive US assistance from providing abortion care services, even with the NGO’s non-US funds. Abortion is illegal in Senegal except when three doctors agree the procedure is required to save a mother’s life.  ASBEF applied for emergency funds and now offers an alternative service to the population of Guediawaye, offering sexual and reproductive health services through pop-up clinics.   Betty Guèye is a midwife who used to live in Guediawaye but moved to Dakar after the closure of the clinic in the suburb of Senegal’s capital following global gag rule (GGR) funding cuts. She describes the effects of the closure and how Association Sénégalaise pour le Bien-Etre Familial (ASBEF) staff try to maximise the reduced service they still offer.  “Since the clinic closed in this town everything has been very difficult. The majority of Senegalese are poor and we are losing clients because they cannot access the main clinic in Dakar. If they have an appointment on a Monday, after the weekend they won’t have the 200 francs (35 US cents) needed for the bus, and they will wait until Tuesday or Wednesday to come even though they are in pain.   The clinic was of huge benefit to the community of Guediawaye and the surrounding suburbs as well. What we see now is that women wait until pain or infections are at a more advanced stage before they visit us in Dakar. Another effect is that if they need to update their contraception they will exceed the date required for the new injection or pill and then get pregnant as a result.  In addition, raising awareness of sexual health in schools and neighbourhoods is a key part of our work. Religion and the lack of openness in the parent-child relationship inhibit these conversations in Senegal, and so young people don’t tell their parents when they have sexual health problems. We were very present in this area and now we only appear much more rarely in their lives, which has had negative consequences for the health of our young people.  If we were still there as before, there would be fewer teenage pregnancies as well, with the advice and contraception that we provide.  However, we hand out medication, we care for the community and we educate them when we can, when we are here and we have the money to do so. Our prices remain the same and they are competitive compared with the private clinics and pharmacies in the area.   Young people will tell you that they are closer to the midwives and nurses here than to their parents. They can tell them anything. If a girl tells me she has had sex I can give her the morning after pill, but if she goes to the local health center she may feel she is being watched by her neighbours.” Ndeye Yacine Touré is a midwife who regularly fields calls from young women in Guediawaye seeking advice on their sexual health, and who no longer know where to turn. The closure of the Association Sénégalaise pour le Bien-Etre Familial (ASBEF) clinic in their area has left them seeking often desperate solutions to the taboo of having a child outside of marriage.  “Many of our colleagues lost their jobs, and these were people who were supporting their families. It was a loss for the area as a whole, because this is a very poor neighbourhood where people don’t have many options in life. ASBEF Guediawaye was their main source of help because they came here for consultations but also for confidential advice.  The services we offer at ASBEF are special, in a way, especially in the area of family planning. Women were at ease at the clinic, but since then there is a gap in their lives. The patients call us day and night wanting advice, asking how to find the main clinic in Dakar. Some say they no longer get check-ups or seek help because they lack the money to go elsewhere. Others say they miss certain midwives or nurses.  We make use of emergency funds in several ways. We do pop-up events. I also give them my number and tell them how to get to the clinic in central Dakar, and reassure them that it will all be confidential and that they can seek treatment there.  In Senegal, a girl having sex outside marriage isn’t accepted. Some young women were taking contraception secretly, but since the closure of the clinic it’s no longer possible. Some of them got pregnant as a result. They don’t want to bump into their mother at the public clinic so they just stop taking contraception. In Senegal, a girl having sex outside marriage isn’t accepted. The impact on young people is particularly serious. Some tell me they know they have a sexually transmitted infection but they are too afraid to go to the hospital and get it treated.  Before they could talk to us and tell us that they had sex, and we could help them. They have to hide now and some seek unsafe abortions. ”  

Senegal’s IPPF Member Association, Association Sénégalaise pour le Bien-Etre Familial (ASBEF) ran two clinics in the capital, Dakar, until funding was cut in 2017 due to the reinstatement of the Global Gag Rule (GGR) by the US administration. The ASBEF clinic in the struggling suburb of Guediawaye was forced to close as a result of the GGR, leaving just the main headquarters in the heart of the city.   The GGR prohibits foreign non-governmental organizations (NGOs) who receive US assistance from providing abortion care services, even with the NGO’s non-US funds. Abortion is illegal in Senegal except when three doctors agree the procedure is required to save a mother’s life.  ASBEF applied for emergency funds and now offers an alternative service to the population of Guediawaye, offering sexual and reproductive health services through pop-up clinics. Maguette Mbow, a 33-year-old homemaker, describes how the closure of Association Sénégalaise pour le Bien-Etre Familial clinic in Guediawaye, a suburb of Dakar, has affected her, and explains the difficulties with the alternative providers available. She spoke about how the closure of her local clinic has impacted her life at a pop-up clinic set up for the day at a school in Guediawaye.  “I heard that ASBEF (Association Sénégalaise pour le Bien-Etre Familial),  was doing consultations here today and I dropped everything at home to come. There was a clinic here in Guediawaye but we don’t have it anymore.  I’m here for family planning because that’s what I used to get at the clinic; it was their strong point. I take the Pill and I came to change the type I take, but the midwife advised me today to keep taking the same one. I’ve used the pill between my pregnancies. I have two children aged 2 and 6, but for now I’m not sure if I want a third child.   When the clinic closed, I started going to the public facilities instead. There is always an enormous queue. You can get there in the morning and wait until 3pm for a consultation. (The closure) has affected everyone here very seriously. All my friends and family went to ASBEF Guediawaye, but now we are in the other public and private clinics receiving a really poor service.  I had all of my pre-natal care at ASBEF and when I was younger I used the services for young people as well. They helped me take the morning after pill a few times and that really left its mark on me. They are great with young people; they are knowledgeable and really good with teenagers. There are still taboos surrounding sexuality in Senegal but they know how to handle them.  These days, when ASBEF come to Guediawaye they have to set up in different places each time. It’s a bit annoying because if you know a place well and it’s full of well-trained people who you know personally, you feel more at ease. I would like things to go back to how they were before, and for the clinic to reopen. I would also have liked to send my children there one day when the time came, to benefit from the same service.  Sometimes I travel right into Dakar for a consultation at the ASBEF headquarters, but often I don’t have the money.” Fatou Bimtou Diop, 20, is a final year student at Lycée Seydina Limamou Laye in Guediawaye. She explains why the closure of the Association Sénégalaise pour le Bien-Etre Familial clinic in her area in 2017 means she no longer regularly seeks advice on her sexual health.  “I came here today for a consultation. I haven’t been for two years because the clinic closed. I don’t know why that happened but I would really like that decision to be reversed.   Yes, there are other clinics here but I don’t feel as relaxed as with ASBEF (Association Sénégalaise pour le Bien-Etre Familial). I used to feel really at ease because there were other young people like me there. In the other clinics I know I might see someone’s mother or my aunties and it worries me too much.   They explained things well and the set-up felt secure. We could talk about the intimate problems that were affecting us to the ASBEF staff. I went because I have really painful periods, for example. Sometimes I wouldn’t have the nerve to ask certain questions but my friends who went to the ASBEF clinic would ask and then tell me the responses that they got.  These days we end up talking a lot about girls who are 14,15 years old who are pregnant. When the ASBEF clinic was there it was really rare to see a girl that young with a baby but now it happens very frequently. A friend’s younger sister has a little boy now and she had to have a caesarian section because she’s younger than us.  The clinic in Dakar is too far away. I have to go to school during the day so I can’t take the time off. I came to the session today at school and it was good to discuss my problems, but it took quite a long time to get seen by a midwife.”  Ngouye Cissé, a 30-year-old woman who gave birth to her first child in her early teens, but who has since used regular contraception provided by ASBEF (Association Sénégalaise pour le Bien-Etre Familial). She visits the association’s pop-up clinics whenever they are in Guediawaye.  “I used to attend the clinic regularly and then one day I didn’t know what happened. The clinic just shut down.  Senegal’s economic situation is difficult and we don’t have a lot of money. The fees for a consultation are quite expensive, but when ASBEF does come into the community it’s free.  I most recently visited the pop-up clinic because I was having some vaginal discharge and I didn’t know why. The midwife took care of me and gave me some advice and medication.   Before I came here for my check-up, the public hospital was asking me to do a lot of tests and I was afraid I had some kind of terrible disease. But when I came to the ASBEF midwife simply listened to me, explained what I had, and then gave me the right medication straight away. I feel really relieved.  I’m divorced and I have three boys. I had pre-natal care with ASBEF for the first two pregnancies, but with the third, my 2-year-old son, I had to go to a public hospital. The experiences couldn’t be more different. First, there is a big difference in price, as ASBEF is much cheaper. Also, at the ASBEF clinic we are really listened to. The midwife explains things and gives me information. We can talk about our problems openly and without fear, unlike in other health centers.  What I see now that the clinic has closed is a lot more pregnant young girls, problems with STIs and in order to get treatment we have to go to the public and private clinics.   When people hear that ASBEF is back in town there is a huge rush to get a consultation, because the need is there but people don’t know where else to go. Unfortunately, the transport to go to the clinic in Dakar costs a lot of money for us that we don’t have. Some households don’t even have enough to eat.  There isn’t a huge difference between the consultations in the old clinic and the pop-up events that ASBEF organize. They still listen to you properly and it’s well organized. It just takes longer to get seen.” Moudel Bassoum, a 22-year student studying NGO management in Dakar, explains why she has been unable to replace the welcome and care she received at the now closed Association Sénégalaise pour le Bien-Etre Familial clinic in her hometown of Guediawaye, but still makes us of the pop-up clinic when it is available.  “I used to go to the clinic regularly but since it closed, we only see the staff rarely around here. I came with my friends today for a free check-up. I told the whole neighbourhood that ASBEF (Association Sénégalaise pour le Bien-Etre Familial) were doing a pop-up clinic today so that they could come for free consultations.  It’s not easy to get to the main clinic in Dakar for us. The effects of the closure are numerous, especially on young people. It helped us so much but now I hear a lot more about teenage pregnancies and STIs, not to mention girls trying to abort pregnancies by themselves. When my friend had an infection she went all the way into Dakar for the consultation because the public clinic is more expensive. I would much rather talk to a woman about this type of problem and at the public clinic you don’t get to pick who you talk to. You have to say everything in front of everyone.  I don’t think the service we receive since the closure is different when the ASBEF clinic set up here for the day, but the staff are usually not the same and it’s less frequent. It’s free so when they do come there are a lot of people. I would really like the clinic to be re-established when I have a baby one day. I want that welcome, and to know that they will listen to you.”  

Gertrude Mugala is a teacher in Fort Portal, a town in Western Uganda. While Gertrude considered herself fairly knowledgeable about cancer, she had never considered taking a screening test or imagined herself ever having the disease. Then one day, she heard an announcement on the radio urging women to go for cervical cancer screenings at a Reproductive Health Uganda (RHU) clinic.  “The radio presenter was talking about cervical cancer, and in her message she encouraged all women to get screened. I decided to go and try it out,” she said. Gertrude made her way to RHU's Fort Portal Branch clinic for the free cervical cancer screening. There, she met Ms. Irene Kugonza, an RHU service provider. Ms. Kugonza educated Gertrude and a group of other women about cervical cancer and the importance of routine screening. Gertrude received a type of cervical cancer screening called VIA (visual inspection with acetic acid). "I did not know what was happening" But Gertrude's results were not what she expected; she received a positive result. The good news, however, is that precancerous lesions can be treated if detected early. “I was so shaken when I was told I had pre-cancerous lesions. I did not know what was happening and I didn't believe what I was hearing. I had no idea of my health status. I thought I was healthy, but I was actually harbouring a potential killer disease in me. What would have happened if I didn't go for the screening? If I hadn't heard the radio announcement?” Gertrude was then referred for cryotherapy.  “Following cryotherapy, I am now in the process of healing, and I am supposed to go back for review after three months,” said Gertrude. Community screenings Today, Gertrude advocates for cervical cancer screening in her community. She talks to women about cancer, especially cervical cancer, at her workplace, at the market, in meetings, and any other opportunity she gets.  “I decided to let women know that cervical cancer is real and it is here with us, and that it kills. At the moment, those are the platforms I have, and I will continue educating women about cancer and encourage them to go for routine testing. I am also happy that I was near my radio that day, where I heard that announcement encouraging all women to get tested for cervical cancer. It might be because of that radio announcement that I am here today,” she said.

The Safe Abortion Action Fund (SAAF) which is hosted by IPPF was set up in 2006 in order to support grass-roots organisations to increase access to safe abortion. One such organisation which received support under the last round of funding is called Lady Mermaid's Bureau. I am Pretty Lynn, aged 25. I am a sex worker but I went to university. I graduated with a Bachelor's Degree in Tourism in 2013. But now, during the day I’m sleeping and during the night I’m working. That is how my day goes every day. I got into sex work through friends. Okay it is not good but I am earning.  I tried to get a job when I graduated. I have been applying since I graduated in 2013. I’m still applying but I’m not getting anywhere. You know to get jobs in Uganda; you have to know someone there and no one knows me there. To be a sex worker is like a curse. People look at you like, I don’t know, as someone that has no use in society. People look at you in a bad way. They even don’t consider why you are selling. They just see you as the worst thing that can happen in the society. So it is not comfortable, it is really hard but we try and survive. The fact sex working is illegal means you have to hide yourself when you are selling so that police cannot take you. And then you get diseases, men don’t want to pay. When the police come and take us, sometimes they even use us and don’t pay. So it is really hard. They want a free service. Like if they come and take you and pay that would be fair. But they say it is illegal to sell yourself. But they still use you yet they are saying it is illegal. You can’t report the police because there is no evidence.  Abortion and unwanted pregnancies are really common because men don’t want to use condoms and female condoms are really rare and they are expensive. Though at times we get female condoms from Lady Marmaid’s Bureau (LMB) because there are so many of us they can’t keep on giving you them all the time. At times when we get pregnant we use local methods. You can go and use local herbs but it is not safe. One time I used local herbs and I was successful. Then the other time I used Omo washing powder and tea leaves but it was really hard for me. I almost died. I had a friend who died last year from this. But the good thing is that LMB taught us about safe abortion. I have had a safe abortion too. There are some tabs they are called Miso (misoprostol). It costs about fifty thousand shillings (£10 pounds or $20.) It is a lot of money. But if I’m working and I know I’m pregnant, I can say, "this week I’m working for my safe abortion". So if I’m working for twenty thousand, by the end of the week I will have the money. It is expensive compared to Omo at five hundred shillings but that is risky. So if I say I will work this whole week for Miso (misoprostol) it is better. But I'm working and I'm not eating. A project like this one from Lady Mermaid's can help young girls and women. But to take us from sex work, it would really be hard. They would not have enough money to cater for all of us. So what they have to do is to teach us how to protect ourselves, how to defend ourselves. Safe abortion yes. They will just have to sensitise us more about our lives, protection, female condoms and all that. I don't have a boyfriend but maybe when I get money and leave this job I will. But for now, no man would like a woman who sells. No man will bear the wife selling herself. And that will happen only if I get funds, settle somewhere else and become responsible woman. I don’t want this job. I don’t want to be in this business of sex work all the time. I want be married, with my children happily, not selling myself. Stories Read more stories about the amazing success of SAAF in Uganda

At the end of a long day, Anicia, closes the clinic with praise for her colleagues who never turn anyone away. "We open at 8am. From 8am we will be receiving a variety of clients for different services - whether post-abortion care, whether antenatal care - we have to give them all the services. We may end up to 10pm, because we'll never chase our clients, we'll never close the place when we have a client inside. People come when they have no hope. You receive them, and you give them hope by treating them properly and giving them quality services. The client gets better and will never forget you. And follow them up on the phone. "How are you doing?" It's good for us to know that they're doing well. Others even tell us 'The way you handle us, we love it so much'." Follow a day in the life of our team and clients in Gulu, Uganda 07:00 08:00 9:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 22:00 Prev Next 7am: The team prepare for the long day ahead "Every year tens of thousands of Ugandans come to our clinic. Everyone is welcome. Here are just a few of the people that we served in one day last month." READ MORE 8am: Nancy, 19, becomes a volunteer "I was suffering but when I came here, I was treated and I got better. Now I'm inspired to volunteer here" READ MORE 9am: Monica, 25, a sex worker's story "I am sex working. I came here for Hepatitis B testing and also counselling. I have so many personal problems, but here….they’re so caring." READ MORE 10am: Jane, 23, saved by family planning "After multiple miscarriages, family planning here has helped me a lot. I'm glad we've been able to space the number of children we've had. I am not growing old, I am fresh." READ MORE 11am: Vicky, handling disabilities "I'm deaf so accessing services is hard, but here they really try to speak in sign language." READ MORE 12pm: Dorcus, first time patient "This is the first time I've ever come here, I like the service. They give good counselling so I recommend coming." READ MORE 1pm: Christine, 45, a grandmother's tale of living with HIV "I am living with HIV and had HPV. They treated me and now I'm free of cervical cancer." READ MORE 2pm: Lilian, struggling mother of six with sickle cell " I have sickle cell disease and so do all my children. I want to have my tube removed so that I don't get pregnant again but I don't know if my husband will allow it." READ MORE 3pm: Brenda and Francis get fertility treatments "Fertility treatment is a sensitive issue in Uganda but they help us a lot and we get proper treatment." READ MORE 4pm: Joyce, 25, repected regardless of her disability "I realised that at this place they don't segregate. Us people with disabilities have challenges at the main hospitals. You go there, people around look at you as if you are not a human being and you don't fall sick." READ MORE 5pm: Mobile clinic provides outreach services to remote villages "Our outreach to remote communities is a 'one-stop-centre'. We give family planning, vaccines for HPV, malaria, and Hepatitis B, HIV testing and more." READ MORE 22pm: Still giving the last client our very best "Together, we have great teamwork. Sometimes we're still working up to 10pm because we never chase out our clients. We’ll never close the place when we have a client inside. People come when they have no hope." READ MORE

Every Thursday a team from RHU Gulu district provides a mobile outreach clinic in Atega village in the Omoro district in Northern Uganda. The outreach team goes out into this poor, remote area which would otherwise not have access to sexual and reproductive health services. The night before the outreach clinic RHU driver, Robert Nyeko and Godfrey Bedimot load up tents, chairs, medical equipment and supplies. The clinic needs to be set up and by 7am ready to receive clients from 8am. The outreach clinic provides a range of services including diagnosis, testing and treatment, family planning such as fitting implants, providing condoms and HPV vaccines. Laboratory technician, Denis Bongonyinge carries out testing for malaria, Hepatitis B, HIV/AIDS, pneumonia and other infections. Other members of the team provide immunisations and vaccinations. Typically men, women and children start arriving at the clinic by 7:30am. Two volunteers are on hand to direct them to the appropriate place to get the services they need. Some clients need a range of services. At 8am service provider, Anicia Filda, popularly known a 'Mama' in the community is ready with her team to start the day. There are now more than 200 clients waiting to be seen; with more people arriving to join the long queues. The longest queue is for the immunisation and vaccination services. The majority have come for either the Hepatitis B vaccine, which is a big threat in this community. Priority is given to the many young girls lining up for the Human Papilloma Virus (HPV) vaccine. Denis Bongonyinge takes blood samples for rapid tests for malaria, HIV, HPV and a range of other infections. Each client carries an exercise book where Denis records their results which is then taken to the staff giving out prescriptions. 32-year-Robert Otim pushes his bicycle to the outreach clinic. The single father has ridden 10 kilometres with his two young children. He lost his wife to Hepatitis B when their daughter was just six months. His four-year-old son was born prematurely and is now disabled. He has come today for his last Hepatitis B immunisation. His children need to be vaccinated as well as treated for malaria and coughs. Looking at the long queue, he says he doubts whether he will get the service today but he is lucky as one of the team who once treated his son, Geoffrey, notices Robert and they are given priority for treatment and prescriptions. Already by midday, one of the teams delivering minor surgeries, postnatal services, family planning and post abortion care have seen 47 mothers. This is almost the same as the number of clients they would treat at the Gulu Clinic during a normal day. Anicia Filda sends the driver to collect more supplies from the clinic; the stock is starting to run low because demand is so high There is no break for the team. Samuel Kedi, the only clinician at the outreach camp stands up, and picks up a bottle of water from his backpack for a quick drink before continuing with the next client. The clinic continues to see clients well into the evening. The outreach clinic is scheduled to finish by 5pm but Anicia says there is not one day they have closed on time: “We cannot close when clients are still lining up. It’s the same at the clinic in Gulu,” she says. As the clinic draws to a close for the day, the teams complete their report which records details of the numbers clients served, the types of services delivered and supplies of stock. It has been another busy but successful day for Anicia and her team. Provision of integrated services in such remote areas is vital for the local community; many men, women and children would not be able to receive the types of treatment and care that RHU works diligently to provide. Follow a day in the life of our team and clients in Gulu, Uganda 07:00 08:00 9:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 22:00 Prev Next 7am: The team prepare for the long day ahead "Every year tens of thousands of Ugandans come to our clinic. Everyone is welcome. Here are just a few of the people that we served in one day last month." READ MORE 8am: Nancy, 19, becomes a volunteer "I was suffering but when I came here, I was treated and I got better. Now I'm inspired to volunteer here" READ MORE 9am: Monica, 25, a sex worker's story "I am sex working. I came here for Hepatitis B testing and also counselling. I have so many personal problems, but here….they’re so caring." READ MORE 10am: Jane, 23, saved by family planning "After multiple miscarriages, family planning here has helped me a lot. I'm glad we've been able to space the number of children we've had. I am not growing old, I am fresh." READ MORE 11am: Vicky, handling disabilities "I'm deaf so accessing services is hard, but here they really try to speak in sign language." READ MORE 12pm: Dorcus, first time patient "This is the first time I've ever come here, I like the service. They give good counselling so I recommend coming." READ MORE 1pm: Christine, 45, a grandmother's tale of living with HIV "I am living with HIV and had HPV. They treated me and now I'm free of cervical cancer." READ MORE 2pm: Lilian, struggling mother of six with sickle cell " I have sickle cell disease and so do all my children. I want to have my tube removed so that I don't get pregnant again but I don't know if my husband will allow it." READ MORE 3pm: Brenda and Francis get fertility treatments "Fertility treatment is a sensitive issue in Uganda but they help us a lot and we get proper treatment." READ MORE 4pm: Joyce, 25, repected regardless of her disability "I realised that at this place they don't segregate. Us people with disabilities have challenges at the main hospitals. You go there, people around look at you as if you are not a human being and you don't fall sick." READ MORE 5pm: Mobile clinic provides outreach services to remote villages "Our outreach to remote communities is a 'one-stop-centre'. We give family planning, vaccines for HPV, malaria, and Hepatitis B, HIV testing and more." READ MORE 22pm: Still giving the last client our very best "Together, we have great teamwork. Sometimes we're still working up to 10pm because we never chase out our clients. We’ll never close the place when we have a client inside. People come when they have no hope." READ MORE

Joyce Auma, 25, is a business administration graduate currently working as a data clerk with Gulu Women with Disabilities Union.  The union has partnered with Reproductive Health Uganda to extend sexual and reproductive health services to women living with disabilities in Gulu and neighbouring districts in Acholi. Joyce, who lost the use of her legs in childhood, is one of the women with disabilities that normally receive services at Gulu Clinic. “I found out about RHU because they are our partners at Gulu Women with Disability Union. I first came to the clinic to test for HIV and other STIs. We also receive their other services like family planning and cancer screening to people with disabilities.” “The first time I came here I was warmly welcomed. They're very good at talking to the youth. Though the place was new for me, I was given service as if it was not my first time.” Says Joyce. "Us people with disabilities have challenges at the main hospitals. People around look at you as if you are not a human being and you don’t fall sick.” Joyce has since been a regular client of RHU for HIV testing, cancer screening and other diseases. She says her status exposes her to many risks of infection which has to be regularly checked for. “I always come here for testing, there is also cancer screening. They don’t segregate me because of my disability. They give you the services you need.”  Follow a day in the life of our team and clients in Gulu, Uganda 07:00 08:00 9:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 22:00 Prev Next 7am: The team prepare for the long day ahead "Every year tens of thousands of Ugandans come to our clinic. Everyone is welcome. Here are just a few of the people that we served in one day last month." READ MORE 8am: Nancy, 19, becomes a volunteer "I was suffering but when I came here, I was treated and I got better. Now I'm inspired to volunteer here" READ MORE 9am: Monica, 25, a sex worker's story "I am sex working. I came here for Hepatitis B testing and also counselling. I have so many personal problems, but here….they’re so caring." READ MORE 10am: Jane, 23, saved by family planning "After multiple miscarriages, family planning here has helped me a lot. I'm glad we've been able to space the number of children we've had. I am not growing old, I am fresh." READ MORE 11am: Vicky, handling disabilities "I'm deaf so accessing services is hard, but here they really try to speak in sign language." READ MORE 12pm: Dorcus, first time patient "This is the first time I've ever come here, I like the service. They give good counselling so I recommend coming." READ MORE 1pm: Christine, 45, a grandmother's tale of living with HIV "I am living with HIV and had HPV. They treated me and now I'm free of cervical cancer." READ MORE 2pm: Lilian, struggling mother of six with sickle cell " I have sickle cell disease and so do all my children. I want to have my tube removed so that I don't get pregnant again but I don't know if my husband will allow it." READ MORE 3pm: Brenda and Francis get fertility treatments "Fertility treatment is a sensitive issue in Uganda but they help us a lot and we get proper treatment." READ MORE 4pm: Joyce, 25, repected regardless of her disability "I realised that at this place they don't segregate. Us people with disabilities have challenges at the main hospitals. You go there, people around look at you as if you are not a human being and you don't fall sick." READ MORE 5pm: Mobile clinic provides outreach services to remote villages "Our outreach to remote communities is a 'one-stop-centre'. We give family planning, vaccines for HPV, malaria, and Hepatitis B, HIV testing and more." READ MORE 22pm: Still giving the last client our very best "Together, we have great teamwork. Sometimes we're still working up to 10pm because we never chase out our clients. We’ll never close the place when we have a client inside. People come when they have no hope." READ MORE

After two years of struggling to conceive Brenda Abalo and her husband, Francis Opio, decided to visit Reproductive Health Uganda's clinic in Gulu. Much as there is progressive attitude to modern medicine in this northern Uganda region, fertility treatment remains a sensitive issue for both men and women. Anxious in the waiting room, Francis said he had decided to come to RHU with his wife because he heard their radio show about a similar problem. In addition to fertility treatments, the couple was also given counselling and treatment for another condition. “After sex, my wife was in pain. She was complaining a lot three weeks ago. I also felt some itches. They have given us treatment which we are still continuing with,” said Francis. The couple was given information to ensure that Brenda was in the best possible health to conceive. She is to undergo treatment to reduce the prolactin level in the blood and correct the hormonal imbalance. “This is not my first time at this clinic," says Brenda. “The service here is better in comparison with other health centres. They give much better attention to the patient.” “RHU has been supporting a lot of people. They helped a friend of mine; she was having a problem with miscarriage. So she came here and got properly treated” Follow a day in the life of our team and clients in Gulu, Uganda 07:00 08:00 9:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 22:00 Prev Next 7am: The team prepare for the long day ahead "Every year tens of thousands of Ugandans come to our clinic. Everyone is welcome. Here are just a few of the people that we served in one day last month." READ MORE 8am: Nancy, 19, becomes a volunteer "I was suffering but when I came here, I was treated and I got better. Now I'm inspired to volunteer here" READ MORE 9am: Monica, 25, a sex worker's story "I am sex working. I came here for Hepatitis B testing and also counselling. I have so many personal problems, but here….they’re so caring." READ MORE 10am: Jane, 23, saved by family planning "After multiple miscarriages, family planning here has helped me a lot. I'm glad we've been able to space the number of children we've had. I am not growing old, I am fresh." READ MORE 11am: Vicky, handling disabilities "I'm deaf so accessing services is hard, but here they really try to speak in sign language." READ MORE 12pm: Dorcus, first time patient "This is the first time I've ever come here, I like the service. They give good counselling so I recommend coming." READ MORE 1pm: Christine, 45, a grandmother's tale of living with HIV "I am living with HIV and had HPV. They treated me and now I'm free of cervical cancer." READ MORE 2pm: Lilian, struggling mother of six with sickle cell " I have sickle cell disease and so do all my children. I want to have my tube removed so that I don't get pregnant again but I don't know if my husband will allow it." READ MORE 3pm: Brenda and Francis get fertility treatments "Fertility treatment is a sensitive issue in Uganda but they help us a lot and we get proper treatment." READ MORE 4pm: Joyce, 25, repected regardless of her disability "I realised that at this place they don't segregate. Us people with disabilities have challenges at the main hospitals. You go there, people around look at you as if you are not a human being and you don't fall sick." READ MORE 5pm: Mobile clinic provides outreach services to remote villages "Our outreach to remote communities is a 'one-stop-centre'. We give family planning, vaccines for HPV, malaria, and Hepatitis B, HIV testing and more." READ MORE 22pm: Still giving the last client our very best "Together, we have great teamwork. Sometimes we're still working up to 10pm because we never chase out our clients. We’ll never close the place when we have a client inside. People come when they have no hope." READ MORE

Lillian Lamunu and her husband are both out of work and are struggling to look after their six children who all have Sickle Cell Disease. Lillian is worried that if she doesn’t do something soon she might end up having another baby. She spoke to one of RHU’s clinicians who told her that they saw she had a lot of problems and a lot of children. The clinician suggested that she went and got family planning but Lillian wanted something more permanent. “I want them to remove my tube. Let me remain with these six children. Because my children were all born with Sickle Cell Disease and keeping them is very difficult,” said Lillian. She opted for tubal ligation but her husband was yet to grant her permission to undergo the surgery so that she stops giving birth. “I know that he might be convinced but I don’t know when” Lillian added. One Ugandan commentator said that in Gulu like the rest of Uganda, contraceptive use was still too low and their uptake was still largely driven by male dominated culture and patriarchal values. Lillian said that it was very expensive looking after her six children who all need daily medication. “I don’t have enough money for keeping them,” she said. Much of her time is spent in hospital with her sick children so she says that she is unable to get a job. Follow a day in the life of our team and clients in Gulu, Uganda 07:00 08:00 9:00 10:00 11:00 12:00 13:00 14:00 15:00 16:00 17:00 22:00 Prev Next 7am: The team prepare for the long day ahead "Every year tens of thousands of Ugandans come to our clinic. Everyone is welcome. Here are just a few of the people that we served in one day last month." READ MORE 8am: Nancy, 19, becomes a volunteer "I was suffering but when I came here, I was treated and I got better. Now I'm inspired to volunteer here" READ MORE 9am: Monica, 25, a sex worker's story "I am sex working. I came here for Hepatitis B testing and also counselling. I have so many personal problems, but here….they’re so caring." READ MORE 10am: Jane, 23, saved by family planning "After multiple miscarriages, family planning here has helped me a lot. I'm glad we've been able to space the number of children we've had. I am not growing old, I am fresh." READ MORE 11am: Vicky, handling disabilities "I'm deaf so accessing services is hard, but here they really try to speak in sign language." READ MORE 12pm: Dorcus, first time patient "This is the first time I've ever come here, I like the service. They give good counselling so I recommend coming." READ MORE 1pm: Christine, 45, a grandmother's tale of living with HIV "I am living with HIV and had HPV. They treated me and now I'm free of cervical cancer." READ MORE 2pm: Lilian, struggling mother of six with sickle cell " I have sickle cell disease and so do all my children. I want to have my tube removed so that I don't get pregnant again but I don't know if my husband will allow it." READ MORE 3pm: Brenda and Francis get fertility treatments "Fertility treatment is a sensitive issue in Uganda but they help us a lot and we get proper treatment." READ MORE 4pm: Joyce, 25, repected regardless of her disability "I realised that at this place they don't segregate. Us people with disabilities have challenges at the main hospitals. You go there, people around look at you as if you are not a human being and you don't fall sick." READ MORE 5pm: Mobile clinic provides outreach services to remote villages "Our outreach to remote communities is a 'one-stop-centre'. We give family planning, vaccines for HPV, malaria, and Hepatitis B, HIV testing and more." READ MORE 22pm: Still giving the last client our very best "Together, we have great teamwork. Sometimes we're still working up to 10pm because we never chase out our clients. We’ll never close the place when we have a client inside. People come when they have no hope." READ MORE