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Spotlight

A selection of stories from across the Federation

2024 trends
Story

What does the year 2024 hold for us?

As the new year begins, we take a look at the trends and challenges ahead for sexual and reproductive health and rights.
Midwife Rewda Kedir examines a newborn baby and mother in a health center outside of Jimma, Ethiopia
story

| 16 July 2020

"Before, there was no safe abortion"

Rewda Kedir works as a midwife in a rural area of the Oromia region in southwest Ethiopia. Only 14% of married women are using any method of contraception here.  The government hospital Rewda works in is supported to provide a full range of sexual and reproductive healthcare, which includes providing free contraceptives and comprehensive abortion care. In January 2017, the maternal healthcare clinic faced shortages of contraceptives after the US administration reactivated and expanded the Global Gag Rule, which does not allow any funding to go to organizations associated with providing abortion care. Fortunately in this case, the shortages only lasted a month due to the government of the Netherlands stepping in and matching lost funding. “Before, we had a shortage of contraceptive pills and emergency contraceptives. We would have to give people prescriptions and they would go to private clinics and where they had to pay," Rewda tells us. "When I first came to this clinic, there was a real shortage of people trained in family planning. I was the only one. Now there are many people trained on family planning, and when I’m not here, people can help." "There used to be a shortage of choice and alternatives, and now there are many. And the implant procedures are better because there are newer products that are much smaller so putting them in is less invasive.” Opening a dialogue on contraception  The hospital has been providing medical abortions for six years. “Before, there was no safe abortion," says Rewda. She explains how people would go to 'traditional' healers and then come to the clinic with complications like sepsis, bleeding, anaemia and toxic shock. If they had complications or infections above nine weeks, Rewda and her colleagues would send them to Jimma, the regional capital. "Before, it was very difficult to persuade them to use family planning, and we had to have a lot of conversations. Now, they come 45 days after delivery to speak to us about this and get their babies immunised," she explains. "They want contraceptives to space out their children. Sometimes their husbands don’t like them coming to get family planning so we have to lock their appointment cards away. Their husbands want more children and they think that women who do not keep having their children will go with other men." "More kids, more wealth" Rewda tells us that they've used family counselling to try and persuade men to reconsider their ideas about contraception, by explaining to them that continuously giving birth under unsafe circumstances can affect a woman's health and might lead to maternal death, damage the uterus and lead to long-term complications. "Here, people believe that more kids means more wealth, and religion restricts family planning services. Before, they did not have good training on family planning and abortion. Now, women that have abortions get proper care and the counseling and education has improved. There are still unsafe abortions but they have really reduced. We used to see about 40 a year and now it’s one or two." However, problems still exist. "There are some complications, like irregular bleeding from some contraceptives," Rewda says, and that "women still face conflict with their husbands over family planning and sometimes have to go to court to fight this or divorce them.”

Midwife Rewda Kedir examines a newborn baby and mother in a health center outside of Jimma, Ethiopia
story

| 28 March 2024

"Before, there was no safe abortion"

Rewda Kedir works as a midwife in a rural area of the Oromia region in southwest Ethiopia. Only 14% of married women are using any method of contraception here.  The government hospital Rewda works in is supported to provide a full range of sexual and reproductive healthcare, which includes providing free contraceptives and comprehensive abortion care. In January 2017, the maternal healthcare clinic faced shortages of contraceptives after the US administration reactivated and expanded the Global Gag Rule, which does not allow any funding to go to organizations associated with providing abortion care. Fortunately in this case, the shortages only lasted a month due to the government of the Netherlands stepping in and matching lost funding. “Before, we had a shortage of contraceptive pills and emergency contraceptives. We would have to give people prescriptions and they would go to private clinics and where they had to pay," Rewda tells us. "When I first came to this clinic, there was a real shortage of people trained in family planning. I was the only one. Now there are many people trained on family planning, and when I’m not here, people can help." "There used to be a shortage of choice and alternatives, and now there are many. And the implant procedures are better because there are newer products that are much smaller so putting them in is less invasive.” Opening a dialogue on contraception  The hospital has been providing medical abortions for six years. “Before, there was no safe abortion," says Rewda. She explains how people would go to 'traditional' healers and then come to the clinic with complications like sepsis, bleeding, anaemia and toxic shock. If they had complications or infections above nine weeks, Rewda and her colleagues would send them to Jimma, the regional capital. "Before, it was very difficult to persuade them to use family planning, and we had to have a lot of conversations. Now, they come 45 days after delivery to speak to us about this and get their babies immunised," she explains. "They want contraceptives to space out their children. Sometimes their husbands don’t like them coming to get family planning so we have to lock their appointment cards away. Their husbands want more children and they think that women who do not keep having their children will go with other men." "More kids, more wealth" Rewda tells us that they've used family counselling to try and persuade men to reconsider their ideas about contraception, by explaining to them that continuously giving birth under unsafe circumstances can affect a woman's health and might lead to maternal death, damage the uterus and lead to long-term complications. "Here, people believe that more kids means more wealth, and religion restricts family planning services. Before, they did not have good training on family planning and abortion. Now, women that have abortions get proper care and the counseling and education has improved. There are still unsafe abortions but they have really reduced. We used to see about 40 a year and now it’s one or two." However, problems still exist. "There are some complications, like irregular bleeding from some contraceptives," Rewda says, and that "women still face conflict with their husbands over family planning and sometimes have to go to court to fight this or divorce them.”

Mother and child.
story

| 18 June 2020

In pictures: Healthcare in the face of the climate crisis in Kiribati

Humanitarian crises Largely brought on by sudden onset and slow-onset natural disasters, humanitarian crises are increasingly prevalent in the Pacific. During responses to humanitarian crises in the Pacific, sexual and reproductive healthcare is often under-prioritised and under-resourced. As a result, women and girls of reproductive age and vulnerable and marginalized groups are disproportionately affected and facing increased health and psychosocial risks. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Fragile environments Low topography, rising sea levels and insufficient fresh water supply leaves Kiribati’s population vulnerable to the effects of the climate crisis. The fragility of the outer islands of Kiribati during natural disasters is compounded by their geographic isolation, which makes transportation and communication during post-disaster relief and response both expensive and difficult. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Coastal exposure The majority of the population of 115,000 people live a subsistence lifestyle. Communities are geographically dispersed across 33 atolls covering 3.5 million square kilometres in the central Pacific Ocean. The population and infrastructure within Kiribati are largely concentrated on the coast, where communities face increased exposure to climate threats and natural hazards such as tsunamis, earthquakes, king tides, flooding, droughts, and occasionally cyclones. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Takaria, leader and youth organizer in the Tebikenikua community Takaria will be running to be a Member of Parliament in Kiribati in 2020. “I assist the youth with family problems and family planning and disasters. In our community there are unforeseen pregnancies, domestic violence, and disasters such as high tide waters and strong winds, which can also affect this community. The Kiribati Family Health Association (KFHA) is the key point for us with outreach and training so people in this community know how to prevent and treat STIs, etc. They all know where the KFHA clinic is and that they can get counselling or services there. The problem now is you can’t survive with the sea rise levels. I want all members of my community to live better and have better health and peace.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Susan*, sex worker Susan receives care at the Kiribati Family Health Association (KFHA) including a pap smear. Susan*, 28, is a sex worker from the town of Betio on the main island of Kiribati. Originally from an outlying island, she moved into Tarawa to seek work. Unable to find employment that would fulfill her dream of sending money back to her two children, she was introduced to sex work. With other sex workers, she regularly travels out to the large cargo ships from China, Philippines and Korea anchored off the coast of Kiribati. Despite her new income, she still can’t speak with her children or see them due to the restrictive costs involved of travel between islands.*pseudonym Share on Twitter Share on Facebook Share via WhatsApp Share via Email Theta, 25-year-old mother and youth volunteer Theta is part of the Humanitarian Youth Club set up by the Kiribati Family Health Association in her village. “We face a lot of situations here, one of them is disasters and the second is unemployment and school drop out with our youth. I have helped the Humanitarian Youth Club to apply for financial grants from the Australian High Commission [for $1,000] I am recognized as the smartest member who can write in English. We have learned how to design a disaster plan for the community and share our ideas on sexual and reproductive issues such as STIs. We discuss what we can do for the next strong tide, where we can gather as a community and what we can do if even the maneabe (town hall) floods? If the tide and wind is too strong, we need to go to another safer place, such as another community’s town hall. For now, I want to enjoy the chance to be in our own beloved country. I won’t move until the majority have already left. I want my daughter to grow up in the same place I grew up in.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Beitau, youth volunteer Beitau is the Chairperson of the Humanitarian Youth Club. “I was lucky to be selected as Chairperson as the Humanitarian Youth Club. I feel like I get more respect from the community now I am in this position. I would love advanced training on leadership now, to further assist the club. As I am the Chairperson of the HYC, my main target is to help people during a disaster. I have attended training through KFHA. What I took from this is that when a disaster strikes, we have to do our best for pregnant women, small children and people with disabilities. They more vulnerable and less able to survive a disaster.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Abe, youth officer Abe was involved with KFHA since 2012. “I was inspired by what they KFHA was doing and the issues they were addressing that affects youth. I was surprised to see how many young people come to the clinic as they are affected by STIs, HIV and teenage pregnancy. The lack of education here is a big problem, most people here have a lot of children and yet can’t afford to send them to school. Sexual and reproductive health is our responsibility and we must talk about it with young people. Climate change affects many countries, but Kiribati is small and low lying. I used to go visit a very nice beach with a lot of nice trees and plants. Now, the trees are gone, and the waves have taken over, and the houses have disappeared so no one can build there. In my role as a youth worker and activist, I tell people to fight climate change: to grow more mangroves, to clean up the beach, because we love our Kiribati.”©IPPF/Hannah Maule-Ffinch/Kiribati Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Mother and child.
story

| 28 March 2024

In pictures: Healthcare in the face of the climate crisis in Kiribati

Humanitarian crises Largely brought on by sudden onset and slow-onset natural disasters, humanitarian crises are increasingly prevalent in the Pacific. During responses to humanitarian crises in the Pacific, sexual and reproductive healthcare is often under-prioritised and under-resourced. As a result, women and girls of reproductive age and vulnerable and marginalized groups are disproportionately affected and facing increased health and psychosocial risks. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Fragile environments Low topography, rising sea levels and insufficient fresh water supply leaves Kiribati’s population vulnerable to the effects of the climate crisis. The fragility of the outer islands of Kiribati during natural disasters is compounded by their geographic isolation, which makes transportation and communication during post-disaster relief and response both expensive and difficult. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Coastal exposure The majority of the population of 115,000 people live a subsistence lifestyle. Communities are geographically dispersed across 33 atolls covering 3.5 million square kilometres in the central Pacific Ocean. The population and infrastructure within Kiribati are largely concentrated on the coast, where communities face increased exposure to climate threats and natural hazards such as tsunamis, earthquakes, king tides, flooding, droughts, and occasionally cyclones. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Takaria, leader and youth organizer in the Tebikenikua community Takaria will be running to be a Member of Parliament in Kiribati in 2020. “I assist the youth with family problems and family planning and disasters. In our community there are unforeseen pregnancies, domestic violence, and disasters such as high tide waters and strong winds, which can also affect this community. The Kiribati Family Health Association (KFHA) is the key point for us with outreach and training so people in this community know how to prevent and treat STIs, etc. They all know where the KFHA clinic is and that they can get counselling or services there. The problem now is you can’t survive with the sea rise levels. I want all members of my community to live better and have better health and peace.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Susan*, sex worker Susan receives care at the Kiribati Family Health Association (KFHA) including a pap smear. Susan*, 28, is a sex worker from the town of Betio on the main island of Kiribati. Originally from an outlying island, she moved into Tarawa to seek work. Unable to find employment that would fulfill her dream of sending money back to her two children, she was introduced to sex work. With other sex workers, she regularly travels out to the large cargo ships from China, Philippines and Korea anchored off the coast of Kiribati. Despite her new income, she still can’t speak with her children or see them due to the restrictive costs involved of travel between islands.*pseudonym Share on Twitter Share on Facebook Share via WhatsApp Share via Email Theta, 25-year-old mother and youth volunteer Theta is part of the Humanitarian Youth Club set up by the Kiribati Family Health Association in her village. “We face a lot of situations here, one of them is disasters and the second is unemployment and school drop out with our youth. I have helped the Humanitarian Youth Club to apply for financial grants from the Australian High Commission [for $1,000] I am recognized as the smartest member who can write in English. We have learned how to design a disaster plan for the community and share our ideas on sexual and reproductive issues such as STIs. We discuss what we can do for the next strong tide, where we can gather as a community and what we can do if even the maneabe (town hall) floods? If the tide and wind is too strong, we need to go to another safer place, such as another community’s town hall. For now, I want to enjoy the chance to be in our own beloved country. I won’t move until the majority have already left. I want my daughter to grow up in the same place I grew up in.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Beitau, youth volunteer Beitau is the Chairperson of the Humanitarian Youth Club. “I was lucky to be selected as Chairperson as the Humanitarian Youth Club. I feel like I get more respect from the community now I am in this position. I would love advanced training on leadership now, to further assist the club. As I am the Chairperson of the HYC, my main target is to help people during a disaster. I have attended training through KFHA. What I took from this is that when a disaster strikes, we have to do our best for pregnant women, small children and people with disabilities. They more vulnerable and less able to survive a disaster.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Abe, youth officer Abe was involved with KFHA since 2012. “I was inspired by what they KFHA was doing and the issues they were addressing that affects youth. I was surprised to see how many young people come to the clinic as they are affected by STIs, HIV and teenage pregnancy. The lack of education here is a big problem, most people here have a lot of children and yet can’t afford to send them to school. Sexual and reproductive health is our responsibility and we must talk about it with young people. Climate change affects many countries, but Kiribati is small and low lying. I used to go visit a very nice beach with a lot of nice trees and plants. Now, the trees are gone, and the waves have taken over, and the houses have disappeared so no one can build there. In my role as a youth worker and activist, I tell people to fight climate change: to grow more mangroves, to clean up the beach, because we love our Kiribati.”©IPPF/Hannah Maule-Ffinch/Kiribati Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Staff in PPE
story

| 04 June 2020

In pictures: Resilience and innovation in the face of COVID-19

Healthcare providers in their PPE Lebanon Association for Family Health (SALAMA) “After the extension of the general mobilization and in order to provide the services to the most in need population, we decided to re-open the clinic. For this purpose, we are developing a plan for the work during the next weeks, taking into consideration the protocols and procedures taken in Lebanon. This will include an isolation room before the consultation and an assessment of the patient’s status and any symptoms that may relate to the coronavirus. In addition to all the precaution procedures including separation, our clinic was sterilized by a specialized company.”Lina Sabra, the Executive Director of the Lebanese Association for Family Health (SALAMA) Share on Twitter Share on Facebook Share via WhatsApp Share via Email Youth volunteers sort through medical donations China Family Planning Association The China Youth Network set up a donation working group and with the support of the China Family Planning Association and Hubei Family Planning Association, they received donations of menstruation supplies, and medical equipment. By March they had successfully donated 5,680 sanitary towels, 3,280 medical face shields, 1,200 hand disinfectants, 925 disposable beddings, 500 air disinfectants and some medical machines to 87 hospitals in Hubei Province. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Erbol, 17, is the chair of the youth committee of the Issyk-Kul branch Reproductive Health Alliance of Kyrgyzstan “At the present time we are using Instagram with detailed information about our organization and articles on sexual and reproductive health issues. We found new technologies and approaches to organize online meetings with the youth volunteers and planning of future branch activities through Zoom. It is planned to consider additional options in creation of channels on Telegram and Twitter because they are very popular among young people.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Healthcare providers put together hygiene kits for local communities Family Planning Association of Sri Lanka FPA Sri Lanka assembled 5,000 hygiene kits to be distributed to promote and enable frequent hand washing, personal hygiene and menstrual hygiene among vulnerable women and girls with limited incomes. These women and girls include mothers, widows with children, families who care for a member living with a disability, and women and girls living in slums during lockdown in high-risk areas for COVID-19. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Healthcare outreach teams distribute contraception and hygiene kits Family Health Association Iran “To reduce the number of visits to our clinics, we made some changes in the way we deliver services. We provide counselling services through online systems and creating different groups for clients to provide online educational training about COVID-19 for them, as well as some components of life skills and SGBV. For the vulnerable groups including sex workers and substance users we distribute contraceptives, COVID-19 preventive packages, and food through the outreach team instead of static clinics.”Zahra Fathi, Executive Director of the Family Health Association Iran (FHA Iran) Share on Twitter Share on Facebook Share via WhatsApp Share via Email Outreach teams sanitize people's homes in remote communities Sudan Family Planning Association Staff at the Sudan Family Planning Association conduct outreach work in local communities, including offering to sanitize people's homes. Remote areas in Sudan with no medical services will be affected with discontinued mobile clinics services. Access to all family planning, antenatal care, and postnatal care services will be affected due to restricted movement. Sudan, as will many other countries, will be impacted by any decrease in activity in the supply chain for healthcare supplies. Share on Twitter Share on Facebook Share via WhatsApp Share via Email A watercolour entry for a social media art competition Santé Sexuelle Suisse/Sexuelle Gesundheit Schweiz “With our Youth Network we created an artistic competition on our FB and Instagram platforms on issues such as masturbation, menstruation, coming out, female genitalia, pornography. The aim is to enhance creativity and make young people reflect about sexual and reproductive health and rights in a creative way during the corona pandemic. The aim was also to offer something fun and positive in this difficult time.”Noemi, 24, is the co-founder and coordinator of Santé Sexuelle Suisse/Sexuelle Gesundheit Schweiz's youth network. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Volunteers make hand sanitizer kits at a SFPA clinic. Syria Family Planning Association When the lockdown was announced SFPA had to stop running their mobile clinics but recently resumed this service. To keep the health facilities open they implemented a new shift rota for staff. The clinics are also following an extremely high-standard of sterilization procedures in all facilities to reduce the risk of catching or spreading coronavirus. SFPA started using social media to spread information on COVID-19. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Belmar Franceshi, Executive Director Asociacion Civil de Planificacion Familiar “The work we do is very important – despite being in our homes, we continue to work, research and look for alternatives to serve the hundreds of people who daily seek our services. It is one more challenge that we must face and will strengthen our actions, our interventions and the activities we carry out daily with communities, women and girls.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Enusring client and staff safety with PPE Family Planning Organisation of the Philippines The Family Planning Organisation of the Philippines (FPOP) is working safely with PPE equipment to ensure uninterrupted access to antenatal care and family planning methods for women and young girls through their clinics. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Delivering essential healthcare to women Family Planning Association of Nepal With PPE and hygiene kits FPAN’s healthcare providers can safely engage in delivering essential care to communities, including counselling, contraception methods, safe abortion, HIV/STI care, obstetrics and gynaecology care and sexual and gender-based violence support. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Reaching local communities Family Health Association Bangladesh FPAB key health workers have continued to provide essential sexual and reproductive healthcare in local communities during COVID-19. Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Staff in PPE
story

| 28 March 2024

In pictures: Resilience and innovation in the face of COVID-19

Healthcare providers in their PPE Lebanon Association for Family Health (SALAMA) “After the extension of the general mobilization and in order to provide the services to the most in need population, we decided to re-open the clinic. For this purpose, we are developing a plan for the work during the next weeks, taking into consideration the protocols and procedures taken in Lebanon. This will include an isolation room before the consultation and an assessment of the patient’s status and any symptoms that may relate to the coronavirus. In addition to all the precaution procedures including separation, our clinic was sterilized by a specialized company.”Lina Sabra, the Executive Director of the Lebanese Association for Family Health (SALAMA) Share on Twitter Share on Facebook Share via WhatsApp Share via Email Youth volunteers sort through medical donations China Family Planning Association The China Youth Network set up a donation working group and with the support of the China Family Planning Association and Hubei Family Planning Association, they received donations of menstruation supplies, and medical equipment. By March they had successfully donated 5,680 sanitary towels, 3,280 medical face shields, 1,200 hand disinfectants, 925 disposable beddings, 500 air disinfectants and some medical machines to 87 hospitals in Hubei Province. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Erbol, 17, is the chair of the youth committee of the Issyk-Kul branch Reproductive Health Alliance of Kyrgyzstan “At the present time we are using Instagram with detailed information about our organization and articles on sexual and reproductive health issues. We found new technologies and approaches to organize online meetings with the youth volunteers and planning of future branch activities through Zoom. It is planned to consider additional options in creation of channels on Telegram and Twitter because they are very popular among young people.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Healthcare providers put together hygiene kits for local communities Family Planning Association of Sri Lanka FPA Sri Lanka assembled 5,000 hygiene kits to be distributed to promote and enable frequent hand washing, personal hygiene and menstrual hygiene among vulnerable women and girls with limited incomes. These women and girls include mothers, widows with children, families who care for a member living with a disability, and women and girls living in slums during lockdown in high-risk areas for COVID-19. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Healthcare outreach teams distribute contraception and hygiene kits Family Health Association Iran “To reduce the number of visits to our clinics, we made some changes in the way we deliver services. We provide counselling services through online systems and creating different groups for clients to provide online educational training about COVID-19 for them, as well as some components of life skills and SGBV. For the vulnerable groups including sex workers and substance users we distribute contraceptives, COVID-19 preventive packages, and food through the outreach team instead of static clinics.”Zahra Fathi, Executive Director of the Family Health Association Iran (FHA Iran) Share on Twitter Share on Facebook Share via WhatsApp Share via Email Outreach teams sanitize people's homes in remote communities Sudan Family Planning Association Staff at the Sudan Family Planning Association conduct outreach work in local communities, including offering to sanitize people's homes. Remote areas in Sudan with no medical services will be affected with discontinued mobile clinics services. Access to all family planning, antenatal care, and postnatal care services will be affected due to restricted movement. Sudan, as will many other countries, will be impacted by any decrease in activity in the supply chain for healthcare supplies. Share on Twitter Share on Facebook Share via WhatsApp Share via Email A watercolour entry for a social media art competition Santé Sexuelle Suisse/Sexuelle Gesundheit Schweiz “With our Youth Network we created an artistic competition on our FB and Instagram platforms on issues such as masturbation, menstruation, coming out, female genitalia, pornography. The aim is to enhance creativity and make young people reflect about sexual and reproductive health and rights in a creative way during the corona pandemic. The aim was also to offer something fun and positive in this difficult time.”Noemi, 24, is the co-founder and coordinator of Santé Sexuelle Suisse/Sexuelle Gesundheit Schweiz's youth network. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Volunteers make hand sanitizer kits at a SFPA clinic. Syria Family Planning Association When the lockdown was announced SFPA had to stop running their mobile clinics but recently resumed this service. To keep the health facilities open they implemented a new shift rota for staff. The clinics are also following an extremely high-standard of sterilization procedures in all facilities to reduce the risk of catching or spreading coronavirus. SFPA started using social media to spread information on COVID-19. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Belmar Franceshi, Executive Director Asociacion Civil de Planificacion Familiar “The work we do is very important – despite being in our homes, we continue to work, research and look for alternatives to serve the hundreds of people who daily seek our services. It is one more challenge that we must face and will strengthen our actions, our interventions and the activities we carry out daily with communities, women and girls.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Enusring client and staff safety with PPE Family Planning Organisation of the Philippines The Family Planning Organisation of the Philippines (FPOP) is working safely with PPE equipment to ensure uninterrupted access to antenatal care and family planning methods for women and young girls through their clinics. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Delivering essential healthcare to women Family Planning Association of Nepal With PPE and hygiene kits FPAN’s healthcare providers can safely engage in delivering essential care to communities, including counselling, contraception methods, safe abortion, HIV/STI care, obstetrics and gynaecology care and sexual and gender-based violence support. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Reaching local communities Family Health Association Bangladesh FPAB key health workers have continued to provide essential sexual and reproductive healthcare in local communities during COVID-19. Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Fatima, a midwife at Palestine family Planning and Protection Agency
story

| 04 April 2019

"Women in our communities use many unsafe methods to try to end pregnancies"

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

Fatima, a midwife at Palestine family Planning and Protection Agency
story

| 28 March 2024

"Women in our communities use many unsafe methods to try to end pregnancies"

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

Amani is a 24 year old midwife and volunteer peer educator with the Palestinian Family Planning and Protection Agency.
story

| 03 April 2019

"The students don’t normally ask about abortion as it is such a taboo"

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

Amani is a 24 year old midwife and volunteer peer educator with the Palestinian Family Planning and Protection Agency.
story

| 28 March 2024

"The students don’t normally ask about abortion as it is such a taboo"

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

A woman who received abortion services in Palestine
story

| 02 April 2019

"From my experience the situation in relation to abortion in Palestine is very hard"

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

A woman who received abortion services in Palestine
story

| 28 March 2024

"From my experience the situation in relation to abortion in Palestine is very hard"

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

Midwife Rewda Kedir examines a newborn baby and mother in a health center outside of Jimma, Ethiopia
story

| 16 July 2020

"Before, there was no safe abortion"

Rewda Kedir works as a midwife in a rural area of the Oromia region in southwest Ethiopia. Only 14% of married women are using any method of contraception here.  The government hospital Rewda works in is supported to provide a full range of sexual and reproductive healthcare, which includes providing free contraceptives and comprehensive abortion care. In January 2017, the maternal healthcare clinic faced shortages of contraceptives after the US administration reactivated and expanded the Global Gag Rule, which does not allow any funding to go to organizations associated with providing abortion care. Fortunately in this case, the shortages only lasted a month due to the government of the Netherlands stepping in and matching lost funding. “Before, we had a shortage of contraceptive pills and emergency contraceptives. We would have to give people prescriptions and they would go to private clinics and where they had to pay," Rewda tells us. "When I first came to this clinic, there was a real shortage of people trained in family planning. I was the only one. Now there are many people trained on family planning, and when I’m not here, people can help." "There used to be a shortage of choice and alternatives, and now there are many. And the implant procedures are better because there are newer products that are much smaller so putting them in is less invasive.” Opening a dialogue on contraception  The hospital has been providing medical abortions for six years. “Before, there was no safe abortion," says Rewda. She explains how people would go to 'traditional' healers and then come to the clinic with complications like sepsis, bleeding, anaemia and toxic shock. If they had complications or infections above nine weeks, Rewda and her colleagues would send them to Jimma, the regional capital. "Before, it was very difficult to persuade them to use family planning, and we had to have a lot of conversations. Now, they come 45 days after delivery to speak to us about this and get their babies immunised," she explains. "They want contraceptives to space out their children. Sometimes their husbands don’t like them coming to get family planning so we have to lock their appointment cards away. Their husbands want more children and they think that women who do not keep having their children will go with other men." "More kids, more wealth" Rewda tells us that they've used family counselling to try and persuade men to reconsider their ideas about contraception, by explaining to them that continuously giving birth under unsafe circumstances can affect a woman's health and might lead to maternal death, damage the uterus and lead to long-term complications. "Here, people believe that more kids means more wealth, and religion restricts family planning services. Before, they did not have good training on family planning and abortion. Now, women that have abortions get proper care and the counseling and education has improved. There are still unsafe abortions but they have really reduced. We used to see about 40 a year and now it’s one or two." However, problems still exist. "There are some complications, like irregular bleeding from some contraceptives," Rewda says, and that "women still face conflict with their husbands over family planning and sometimes have to go to court to fight this or divorce them.”

Midwife Rewda Kedir examines a newborn baby and mother in a health center outside of Jimma, Ethiopia
story

| 28 March 2024

"Before, there was no safe abortion"

Rewda Kedir works as a midwife in a rural area of the Oromia region in southwest Ethiopia. Only 14% of married women are using any method of contraception here.  The government hospital Rewda works in is supported to provide a full range of sexual and reproductive healthcare, which includes providing free contraceptives and comprehensive abortion care. In January 2017, the maternal healthcare clinic faced shortages of contraceptives after the US administration reactivated and expanded the Global Gag Rule, which does not allow any funding to go to organizations associated with providing abortion care. Fortunately in this case, the shortages only lasted a month due to the government of the Netherlands stepping in and matching lost funding. “Before, we had a shortage of contraceptive pills and emergency contraceptives. We would have to give people prescriptions and they would go to private clinics and where they had to pay," Rewda tells us. "When I first came to this clinic, there was a real shortage of people trained in family planning. I was the only one. Now there are many people trained on family planning, and when I’m not here, people can help." "There used to be a shortage of choice and alternatives, and now there are many. And the implant procedures are better because there are newer products that are much smaller so putting them in is less invasive.” Opening a dialogue on contraception  The hospital has been providing medical abortions for six years. “Before, there was no safe abortion," says Rewda. She explains how people would go to 'traditional' healers and then come to the clinic with complications like sepsis, bleeding, anaemia and toxic shock. If they had complications or infections above nine weeks, Rewda and her colleagues would send them to Jimma, the regional capital. "Before, it was very difficult to persuade them to use family planning, and we had to have a lot of conversations. Now, they come 45 days after delivery to speak to us about this and get their babies immunised," she explains. "They want contraceptives to space out their children. Sometimes their husbands don’t like them coming to get family planning so we have to lock their appointment cards away. Their husbands want more children and they think that women who do not keep having their children will go with other men." "More kids, more wealth" Rewda tells us that they've used family counselling to try and persuade men to reconsider their ideas about contraception, by explaining to them that continuously giving birth under unsafe circumstances can affect a woman's health and might lead to maternal death, damage the uterus and lead to long-term complications. "Here, people believe that more kids means more wealth, and religion restricts family planning services. Before, they did not have good training on family planning and abortion. Now, women that have abortions get proper care and the counseling and education has improved. There are still unsafe abortions but they have really reduced. We used to see about 40 a year and now it’s one or two." However, problems still exist. "There are some complications, like irregular bleeding from some contraceptives," Rewda says, and that "women still face conflict with their husbands over family planning and sometimes have to go to court to fight this or divorce them.”

Mother and child.
story

| 18 June 2020

In pictures: Healthcare in the face of the climate crisis in Kiribati

Humanitarian crises Largely brought on by sudden onset and slow-onset natural disasters, humanitarian crises are increasingly prevalent in the Pacific. During responses to humanitarian crises in the Pacific, sexual and reproductive healthcare is often under-prioritised and under-resourced. As a result, women and girls of reproductive age and vulnerable and marginalized groups are disproportionately affected and facing increased health and psychosocial risks. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Fragile environments Low topography, rising sea levels and insufficient fresh water supply leaves Kiribati’s population vulnerable to the effects of the climate crisis. The fragility of the outer islands of Kiribati during natural disasters is compounded by their geographic isolation, which makes transportation and communication during post-disaster relief and response both expensive and difficult. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Coastal exposure The majority of the population of 115,000 people live a subsistence lifestyle. Communities are geographically dispersed across 33 atolls covering 3.5 million square kilometres in the central Pacific Ocean. The population and infrastructure within Kiribati are largely concentrated on the coast, where communities face increased exposure to climate threats and natural hazards such as tsunamis, earthquakes, king tides, flooding, droughts, and occasionally cyclones. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Takaria, leader and youth organizer in the Tebikenikua community Takaria will be running to be a Member of Parliament in Kiribati in 2020. “I assist the youth with family problems and family planning and disasters. In our community there are unforeseen pregnancies, domestic violence, and disasters such as high tide waters and strong winds, which can also affect this community. The Kiribati Family Health Association (KFHA) is the key point for us with outreach and training so people in this community know how to prevent and treat STIs, etc. They all know where the KFHA clinic is and that they can get counselling or services there. The problem now is you can’t survive with the sea rise levels. I want all members of my community to live better and have better health and peace.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Susan*, sex worker Susan receives care at the Kiribati Family Health Association (KFHA) including a pap smear. Susan*, 28, is a sex worker from the town of Betio on the main island of Kiribati. Originally from an outlying island, she moved into Tarawa to seek work. Unable to find employment that would fulfill her dream of sending money back to her two children, she was introduced to sex work. With other sex workers, she regularly travels out to the large cargo ships from China, Philippines and Korea anchored off the coast of Kiribati. Despite her new income, she still can’t speak with her children or see them due to the restrictive costs involved of travel between islands.*pseudonym Share on Twitter Share on Facebook Share via WhatsApp Share via Email Theta, 25-year-old mother and youth volunteer Theta is part of the Humanitarian Youth Club set up by the Kiribati Family Health Association in her village. “We face a lot of situations here, one of them is disasters and the second is unemployment and school drop out with our youth. I have helped the Humanitarian Youth Club to apply for financial grants from the Australian High Commission [for $1,000] I am recognized as the smartest member who can write in English. We have learned how to design a disaster plan for the community and share our ideas on sexual and reproductive issues such as STIs. We discuss what we can do for the next strong tide, where we can gather as a community and what we can do if even the maneabe (town hall) floods? If the tide and wind is too strong, we need to go to another safer place, such as another community’s town hall. For now, I want to enjoy the chance to be in our own beloved country. I won’t move until the majority have already left. I want my daughter to grow up in the same place I grew up in.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Beitau, youth volunteer Beitau is the Chairperson of the Humanitarian Youth Club. “I was lucky to be selected as Chairperson as the Humanitarian Youth Club. I feel like I get more respect from the community now I am in this position. I would love advanced training on leadership now, to further assist the club. As I am the Chairperson of the HYC, my main target is to help people during a disaster. I have attended training through KFHA. What I took from this is that when a disaster strikes, we have to do our best for pregnant women, small children and people with disabilities. They more vulnerable and less able to survive a disaster.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Abe, youth officer Abe was involved with KFHA since 2012. “I was inspired by what they KFHA was doing and the issues they were addressing that affects youth. I was surprised to see how many young people come to the clinic as they are affected by STIs, HIV and teenage pregnancy. The lack of education here is a big problem, most people here have a lot of children and yet can’t afford to send them to school. Sexual and reproductive health is our responsibility and we must talk about it with young people. Climate change affects many countries, but Kiribati is small and low lying. I used to go visit a very nice beach with a lot of nice trees and plants. Now, the trees are gone, and the waves have taken over, and the houses have disappeared so no one can build there. In my role as a youth worker and activist, I tell people to fight climate change: to grow more mangroves, to clean up the beach, because we love our Kiribati.”©IPPF/Hannah Maule-Ffinch/Kiribati Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Mother and child.
story

| 28 March 2024

In pictures: Healthcare in the face of the climate crisis in Kiribati

Humanitarian crises Largely brought on by sudden onset and slow-onset natural disasters, humanitarian crises are increasingly prevalent in the Pacific. During responses to humanitarian crises in the Pacific, sexual and reproductive healthcare is often under-prioritised and under-resourced. As a result, women and girls of reproductive age and vulnerable and marginalized groups are disproportionately affected and facing increased health and psychosocial risks. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Fragile environments Low topography, rising sea levels and insufficient fresh water supply leaves Kiribati’s population vulnerable to the effects of the climate crisis. The fragility of the outer islands of Kiribati during natural disasters is compounded by their geographic isolation, which makes transportation and communication during post-disaster relief and response both expensive and difficult. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Coastal exposure The majority of the population of 115,000 people live a subsistence lifestyle. Communities are geographically dispersed across 33 atolls covering 3.5 million square kilometres in the central Pacific Ocean. The population and infrastructure within Kiribati are largely concentrated on the coast, where communities face increased exposure to climate threats and natural hazards such as tsunamis, earthquakes, king tides, flooding, droughts, and occasionally cyclones. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Takaria, leader and youth organizer in the Tebikenikua community Takaria will be running to be a Member of Parliament in Kiribati in 2020. “I assist the youth with family problems and family planning and disasters. In our community there are unforeseen pregnancies, domestic violence, and disasters such as high tide waters and strong winds, which can also affect this community. The Kiribati Family Health Association (KFHA) is the key point for us with outreach and training so people in this community know how to prevent and treat STIs, etc. They all know where the KFHA clinic is and that they can get counselling or services there. The problem now is you can’t survive with the sea rise levels. I want all members of my community to live better and have better health and peace.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Susan*, sex worker Susan receives care at the Kiribati Family Health Association (KFHA) including a pap smear. Susan*, 28, is a sex worker from the town of Betio on the main island of Kiribati. Originally from an outlying island, she moved into Tarawa to seek work. Unable to find employment that would fulfill her dream of sending money back to her two children, she was introduced to sex work. With other sex workers, she regularly travels out to the large cargo ships from China, Philippines and Korea anchored off the coast of Kiribati. Despite her new income, she still can’t speak with her children or see them due to the restrictive costs involved of travel between islands.*pseudonym Share on Twitter Share on Facebook Share via WhatsApp Share via Email Theta, 25-year-old mother and youth volunteer Theta is part of the Humanitarian Youth Club set up by the Kiribati Family Health Association in her village. “We face a lot of situations here, one of them is disasters and the second is unemployment and school drop out with our youth. I have helped the Humanitarian Youth Club to apply for financial grants from the Australian High Commission [for $1,000] I am recognized as the smartest member who can write in English. We have learned how to design a disaster plan for the community and share our ideas on sexual and reproductive issues such as STIs. We discuss what we can do for the next strong tide, where we can gather as a community and what we can do if even the maneabe (town hall) floods? If the tide and wind is too strong, we need to go to another safer place, such as another community’s town hall. For now, I want to enjoy the chance to be in our own beloved country. I won’t move until the majority have already left. I want my daughter to grow up in the same place I grew up in.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Beitau, youth volunteer Beitau is the Chairperson of the Humanitarian Youth Club. “I was lucky to be selected as Chairperson as the Humanitarian Youth Club. I feel like I get more respect from the community now I am in this position. I would love advanced training on leadership now, to further assist the club. As I am the Chairperson of the HYC, my main target is to help people during a disaster. I have attended training through KFHA. What I took from this is that when a disaster strikes, we have to do our best for pregnant women, small children and people with disabilities. They more vulnerable and less able to survive a disaster.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Abe, youth officer Abe was involved with KFHA since 2012. “I was inspired by what they KFHA was doing and the issues they were addressing that affects youth. I was surprised to see how many young people come to the clinic as they are affected by STIs, HIV and teenage pregnancy. The lack of education here is a big problem, most people here have a lot of children and yet can’t afford to send them to school. Sexual and reproductive health is our responsibility and we must talk about it with young people. Climate change affects many countries, but Kiribati is small and low lying. I used to go visit a very nice beach with a lot of nice trees and plants. Now, the trees are gone, and the waves have taken over, and the houses have disappeared so no one can build there. In my role as a youth worker and activist, I tell people to fight climate change: to grow more mangroves, to clean up the beach, because we love our Kiribati.”©IPPF/Hannah Maule-Ffinch/Kiribati Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Staff in PPE
story

| 04 June 2020

In pictures: Resilience and innovation in the face of COVID-19

Healthcare providers in their PPE Lebanon Association for Family Health (SALAMA) “After the extension of the general mobilization and in order to provide the services to the most in need population, we decided to re-open the clinic. For this purpose, we are developing a plan for the work during the next weeks, taking into consideration the protocols and procedures taken in Lebanon. This will include an isolation room before the consultation and an assessment of the patient’s status and any symptoms that may relate to the coronavirus. In addition to all the precaution procedures including separation, our clinic was sterilized by a specialized company.”Lina Sabra, the Executive Director of the Lebanese Association for Family Health (SALAMA) Share on Twitter Share on Facebook Share via WhatsApp Share via Email Youth volunteers sort through medical donations China Family Planning Association The China Youth Network set up a donation working group and with the support of the China Family Planning Association and Hubei Family Planning Association, they received donations of menstruation supplies, and medical equipment. By March they had successfully donated 5,680 sanitary towels, 3,280 medical face shields, 1,200 hand disinfectants, 925 disposable beddings, 500 air disinfectants and some medical machines to 87 hospitals in Hubei Province. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Erbol, 17, is the chair of the youth committee of the Issyk-Kul branch Reproductive Health Alliance of Kyrgyzstan “At the present time we are using Instagram with detailed information about our organization and articles on sexual and reproductive health issues. We found new technologies and approaches to organize online meetings with the youth volunteers and planning of future branch activities through Zoom. It is planned to consider additional options in creation of channels on Telegram and Twitter because they are very popular among young people.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Healthcare providers put together hygiene kits for local communities Family Planning Association of Sri Lanka FPA Sri Lanka assembled 5,000 hygiene kits to be distributed to promote and enable frequent hand washing, personal hygiene and menstrual hygiene among vulnerable women and girls with limited incomes. These women and girls include mothers, widows with children, families who care for a member living with a disability, and women and girls living in slums during lockdown in high-risk areas for COVID-19. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Healthcare outreach teams distribute contraception and hygiene kits Family Health Association Iran “To reduce the number of visits to our clinics, we made some changes in the way we deliver services. We provide counselling services through online systems and creating different groups for clients to provide online educational training about COVID-19 for them, as well as some components of life skills and SGBV. For the vulnerable groups including sex workers and substance users we distribute contraceptives, COVID-19 preventive packages, and food through the outreach team instead of static clinics.”Zahra Fathi, Executive Director of the Family Health Association Iran (FHA Iran) Share on Twitter Share on Facebook Share via WhatsApp Share via Email Outreach teams sanitize people's homes in remote communities Sudan Family Planning Association Staff at the Sudan Family Planning Association conduct outreach work in local communities, including offering to sanitize people's homes. Remote areas in Sudan with no medical services will be affected with discontinued mobile clinics services. Access to all family planning, antenatal care, and postnatal care services will be affected due to restricted movement. Sudan, as will many other countries, will be impacted by any decrease in activity in the supply chain for healthcare supplies. Share on Twitter Share on Facebook Share via WhatsApp Share via Email A watercolour entry for a social media art competition Santé Sexuelle Suisse/Sexuelle Gesundheit Schweiz “With our Youth Network we created an artistic competition on our FB and Instagram platforms on issues such as masturbation, menstruation, coming out, female genitalia, pornography. The aim is to enhance creativity and make young people reflect about sexual and reproductive health and rights in a creative way during the corona pandemic. The aim was also to offer something fun and positive in this difficult time.”Noemi, 24, is the co-founder and coordinator of Santé Sexuelle Suisse/Sexuelle Gesundheit Schweiz's youth network. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Volunteers make hand sanitizer kits at a SFPA clinic. Syria Family Planning Association When the lockdown was announced SFPA had to stop running their mobile clinics but recently resumed this service. To keep the health facilities open they implemented a new shift rota for staff. The clinics are also following an extremely high-standard of sterilization procedures in all facilities to reduce the risk of catching or spreading coronavirus. SFPA started using social media to spread information on COVID-19. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Belmar Franceshi, Executive Director Asociacion Civil de Planificacion Familiar “The work we do is very important – despite being in our homes, we continue to work, research and look for alternatives to serve the hundreds of people who daily seek our services. It is one more challenge that we must face and will strengthen our actions, our interventions and the activities we carry out daily with communities, women and girls.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Enusring client and staff safety with PPE Family Planning Organisation of the Philippines The Family Planning Organisation of the Philippines (FPOP) is working safely with PPE equipment to ensure uninterrupted access to antenatal care and family planning methods for women and young girls through their clinics. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Delivering essential healthcare to women Family Planning Association of Nepal With PPE and hygiene kits FPAN’s healthcare providers can safely engage in delivering essential care to communities, including counselling, contraception methods, safe abortion, HIV/STI care, obstetrics and gynaecology care and sexual and gender-based violence support. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Reaching local communities Family Health Association Bangladesh FPAB key health workers have continued to provide essential sexual and reproductive healthcare in local communities during COVID-19. Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Staff in PPE
story

| 28 March 2024

In pictures: Resilience and innovation in the face of COVID-19

Healthcare providers in their PPE Lebanon Association for Family Health (SALAMA) “After the extension of the general mobilization and in order to provide the services to the most in need population, we decided to re-open the clinic. For this purpose, we are developing a plan for the work during the next weeks, taking into consideration the protocols and procedures taken in Lebanon. This will include an isolation room before the consultation and an assessment of the patient’s status and any symptoms that may relate to the coronavirus. In addition to all the precaution procedures including separation, our clinic was sterilized by a specialized company.”Lina Sabra, the Executive Director of the Lebanese Association for Family Health (SALAMA) Share on Twitter Share on Facebook Share via WhatsApp Share via Email Youth volunteers sort through medical donations China Family Planning Association The China Youth Network set up a donation working group and with the support of the China Family Planning Association and Hubei Family Planning Association, they received donations of menstruation supplies, and medical equipment. By March they had successfully donated 5,680 sanitary towels, 3,280 medical face shields, 1,200 hand disinfectants, 925 disposable beddings, 500 air disinfectants and some medical machines to 87 hospitals in Hubei Province. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Erbol, 17, is the chair of the youth committee of the Issyk-Kul branch Reproductive Health Alliance of Kyrgyzstan “At the present time we are using Instagram with detailed information about our organization and articles on sexual and reproductive health issues. We found new technologies and approaches to organize online meetings with the youth volunteers and planning of future branch activities through Zoom. It is planned to consider additional options in creation of channels on Telegram and Twitter because they are very popular among young people.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Healthcare providers put together hygiene kits for local communities Family Planning Association of Sri Lanka FPA Sri Lanka assembled 5,000 hygiene kits to be distributed to promote and enable frequent hand washing, personal hygiene and menstrual hygiene among vulnerable women and girls with limited incomes. These women and girls include mothers, widows with children, families who care for a member living with a disability, and women and girls living in slums during lockdown in high-risk areas for COVID-19. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Healthcare outreach teams distribute contraception and hygiene kits Family Health Association Iran “To reduce the number of visits to our clinics, we made some changes in the way we deliver services. We provide counselling services through online systems and creating different groups for clients to provide online educational training about COVID-19 for them, as well as some components of life skills and SGBV. For the vulnerable groups including sex workers and substance users we distribute contraceptives, COVID-19 preventive packages, and food through the outreach team instead of static clinics.”Zahra Fathi, Executive Director of the Family Health Association Iran (FHA Iran) Share on Twitter Share on Facebook Share via WhatsApp Share via Email Outreach teams sanitize people's homes in remote communities Sudan Family Planning Association Staff at the Sudan Family Planning Association conduct outreach work in local communities, including offering to sanitize people's homes. Remote areas in Sudan with no medical services will be affected with discontinued mobile clinics services. Access to all family planning, antenatal care, and postnatal care services will be affected due to restricted movement. Sudan, as will many other countries, will be impacted by any decrease in activity in the supply chain for healthcare supplies. Share on Twitter Share on Facebook Share via WhatsApp Share via Email A watercolour entry for a social media art competition Santé Sexuelle Suisse/Sexuelle Gesundheit Schweiz “With our Youth Network we created an artistic competition on our FB and Instagram platforms on issues such as masturbation, menstruation, coming out, female genitalia, pornography. The aim is to enhance creativity and make young people reflect about sexual and reproductive health and rights in a creative way during the corona pandemic. The aim was also to offer something fun and positive in this difficult time.”Noemi, 24, is the co-founder and coordinator of Santé Sexuelle Suisse/Sexuelle Gesundheit Schweiz's youth network. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Volunteers make hand sanitizer kits at a SFPA clinic. Syria Family Planning Association When the lockdown was announced SFPA had to stop running their mobile clinics but recently resumed this service. To keep the health facilities open they implemented a new shift rota for staff. The clinics are also following an extremely high-standard of sterilization procedures in all facilities to reduce the risk of catching or spreading coronavirus. SFPA started using social media to spread information on COVID-19. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Belmar Franceshi, Executive Director Asociacion Civil de Planificacion Familiar “The work we do is very important – despite being in our homes, we continue to work, research and look for alternatives to serve the hundreds of people who daily seek our services. It is one more challenge that we must face and will strengthen our actions, our interventions and the activities we carry out daily with communities, women and girls.” Share on Twitter Share on Facebook Share via WhatsApp Share via Email Enusring client and staff safety with PPE Family Planning Organisation of the Philippines The Family Planning Organisation of the Philippines (FPOP) is working safely with PPE equipment to ensure uninterrupted access to antenatal care and family planning methods for women and young girls through their clinics. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Delivering essential healthcare to women Family Planning Association of Nepal With PPE and hygiene kits FPAN’s healthcare providers can safely engage in delivering essential care to communities, including counselling, contraception methods, safe abortion, HIV/STI care, obstetrics and gynaecology care and sexual and gender-based violence support. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Reaching local communities Family Health Association Bangladesh FPAB key health workers have continued to provide essential sexual and reproductive healthcare in local communities during COVID-19. Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Fatima, a midwife at Palestine family Planning and Protection Agency
story

| 04 April 2019

"Women in our communities use many unsafe methods to try to end pregnancies"

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

Fatima, a midwife at Palestine family Planning and Protection Agency
story

| 28 March 2024

"Women in our communities use many unsafe methods to try to end pregnancies"

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

Amani is a 24 year old midwife and volunteer peer educator with the Palestinian Family Planning and Protection Agency.
story

| 03 April 2019

"The students don’t normally ask about abortion as it is such a taboo"

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

Amani is a 24 year old midwife and volunteer peer educator with the Palestinian Family Planning and Protection Agency.
story

| 28 March 2024

"The students don’t normally ask about abortion as it is such a taboo"

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

A woman who received abortion services in Palestine
story

| 02 April 2019

"From my experience the situation in relation to abortion in Palestine is very hard"

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

A woman who received abortion services in Palestine
story

| 28 March 2024

"From my experience the situation in relation to abortion in Palestine is very hard"

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