- - -
ghana

Stories

Latest stories from IPPF

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.
A humanitarian worker in India
story

| 17 August 2021

In pictures: World Humanitarian Day 2021

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

A humanitarian worker in India
story

| 28 March 2024

In pictures: World Humanitarian Day 2021

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

A photo of Dr Ratni - she is smiling in front of a clinic
story

| 13 May 2021

Dr Ratni: a day in the life of an emergency response volunteer

Dr Ratni Palullungan is a fearless doctor, mother, and selfless volunteer providing sexual and reproductive healthcare to marginalized groups in fragile humanitarian settings.  Currently she is deployed with the Indonesian Planned Parenthood Association’s (IPPA/PKBI) response team in Majene District, West Sulawesi, following a magnitude 6.2 earthquake which occurred in January 2021.   In an open diary, Dr Ratni shares what a day in the life looks like for a volunteer doctor providing care to those affected by the earthquake.   5.30 – 8.30am I get up quite early and have my quiet time (prayer), then I gather my dirty laundry. Currently, I live with other volunteer teams in a place called PKBI Post in Majene, and there is a cooking schedule for everyone. After prayers, chores and breakfast, I get my daughter ready for the day as she accompanies me to work temporarily. After that, the team and I prepare medical equipment and medicine for the day's humanitarian mission. 8.30 – 11am Today the first location is Maliaya Village Health Centre, in Malunda District, Majene. Here, I attend to and examine 25 pregnant women. The pregnant women, on average, get married at a fairly young age. There are definitely risks to their reproductive health. There is a 43-year-old mother who is currently pregnant with her 11th child. To limit health risks, we advise her on the various safe family planning options.   There is also a 38-year-old woman who is eight months pregnant. However, the size of her belly is very small for a woman in her third trimester. In fact, I initially thought that she was only four or five months pregnant. After I examined her, it turns out that she is categorized as a ‘malnourished’ pregnant woman. It is very unfortunate because she admitted that she eats food without paying attention to her nutrition intake. In fact, she tends to eat instant noodles. So I advised her to drink milk, eat only nutritious foods, and always taker her vitamins.  11am – 2pm After visiting Maliaya Village, I travelled to Kabiraan Village. This village was severely affected by the earthquake. Here, I walk around the evacuation camp, most of which is still occupied by displaced people in this post-earthquake period. Even under the evacuation tent, I continue to conduct health examinations for pregnant women.  Due to the large number of cases of young marriages in Kabiiran Village, the team and I decide to conduct counselling sessions for the teenagers here. I advise the teenagers to get to know the risks that might occur to their reproductive health if they marry too young.  2 – 4pm The health volunteer team and I are finally able to take the time for lunch. We have our lunch near the beach, and get to enjoy local seafood as our menu. Enjoying the seafood while looking at the beautiful sea view is a precious time. I certainly won't forget this moment. 4 – 6pm We continue our journey to East Lombong Village. We have many elderly patients here. Yet interestingly, during one of the patients’ examination, there is one mother who wants to get the contraceptive implant. For me, this is quite a shock, given that we rarely find women in this village who want to do family planning. The mother admitted that she did not know much about the family planning program and has many children. She is grateful that the PKBI volunteer team and I came to their shelter camp for the health examination. 6pm The team and I decide to return to the PKBI Post. Today’s journey is quite tiring but there is a sense of pride and emotion for having carried out a humanitarian mission for teenage girls, mothers, the elderly and even toddlers who still stay in the shelter camp. 7 – 8pm At the PKBI Post, after cleaning and tidying up the medical equipment again for the next day’s program, I  prepare dinner for the team and assist my child with her studies. I am so grateful for each and every day that I am involved in this program. I feel encouraged to continue to provide sexual and reproductive healthcare to marginalized groups

A photo of Dr Ratni - she is smiling in front of a clinic
story

| 28 March 2024

Dr Ratni: a day in the life of an emergency response volunteer

Dr Ratni Palullungan is a fearless doctor, mother, and selfless volunteer providing sexual and reproductive healthcare to marginalized groups in fragile humanitarian settings.  Currently she is deployed with the Indonesian Planned Parenthood Association’s (IPPA/PKBI) response team in Majene District, West Sulawesi, following a magnitude 6.2 earthquake which occurred in January 2021.   In an open diary, Dr Ratni shares what a day in the life looks like for a volunteer doctor providing care to those affected by the earthquake.   5.30 – 8.30am I get up quite early and have my quiet time (prayer), then I gather my dirty laundry. Currently, I live with other volunteer teams in a place called PKBI Post in Majene, and there is a cooking schedule for everyone. After prayers, chores and breakfast, I get my daughter ready for the day as she accompanies me to work temporarily. After that, the team and I prepare medical equipment and medicine for the day's humanitarian mission. 8.30 – 11am Today the first location is Maliaya Village Health Centre, in Malunda District, Majene. Here, I attend to and examine 25 pregnant women. The pregnant women, on average, get married at a fairly young age. There are definitely risks to their reproductive health. There is a 43-year-old mother who is currently pregnant with her 11th child. To limit health risks, we advise her on the various safe family planning options.   There is also a 38-year-old woman who is eight months pregnant. However, the size of her belly is very small for a woman in her third trimester. In fact, I initially thought that she was only four or five months pregnant. After I examined her, it turns out that she is categorized as a ‘malnourished’ pregnant woman. It is very unfortunate because she admitted that she eats food without paying attention to her nutrition intake. In fact, she tends to eat instant noodles. So I advised her to drink milk, eat only nutritious foods, and always taker her vitamins.  11am – 2pm After visiting Maliaya Village, I travelled to Kabiraan Village. This village was severely affected by the earthquake. Here, I walk around the evacuation camp, most of which is still occupied by displaced people in this post-earthquake period. Even under the evacuation tent, I continue to conduct health examinations for pregnant women.  Due to the large number of cases of young marriages in Kabiiran Village, the team and I decide to conduct counselling sessions for the teenagers here. I advise the teenagers to get to know the risks that might occur to their reproductive health if they marry too young.  2 – 4pm The health volunteer team and I are finally able to take the time for lunch. We have our lunch near the beach, and get to enjoy local seafood as our menu. Enjoying the seafood while looking at the beautiful sea view is a precious time. I certainly won't forget this moment. 4 – 6pm We continue our journey to East Lombong Village. We have many elderly patients here. Yet interestingly, during one of the patients’ examination, there is one mother who wants to get the contraceptive implant. For me, this is quite a shock, given that we rarely find women in this village who want to do family planning. The mother admitted that she did not know much about the family planning program and has many children. She is grateful that the PKBI volunteer team and I came to their shelter camp for the health examination. 6pm The team and I decide to return to the PKBI Post. Today’s journey is quite tiring but there is a sense of pride and emotion for having carried out a humanitarian mission for teenage girls, mothers, the elderly and even toddlers who still stay in the shelter camp. 7 – 8pm At the PKBI Post, after cleaning and tidying up the medical equipment again for the next day’s program, I  prepare dinner for the team and assist my child with her studies. I am so grateful for each and every day that I am involved in this program. I feel encouraged to continue to provide sexual and reproductive healthcare to marginalized groups

A photo of Dr Ratni - she is smiling in front of a clinic
story

| 13 May 2021

Dr Ratni: a day in the life of an emergency response volunteer

Dr Ratni Palullungan is a fearless doctor, mother, and selfless volunteer providing sexual and reproductive healthcare to marginalized groups in fragile humanitarian settings.  Currently she is deployed with the Indonesian Planned Parenthood Association’s (IPPA/PKBI) response team in Majene District, West Sulawesi, following a magnitude 6.2 earthquake which occurred in January 2021.   In an open diary, Dr Ratni shares what a day in the life looks like for a volunteer doctor providing care to those affected by the earthquake.   5.30 – 8.30am I get up quite early and have my quiet time (prayer), then I gather my dirty laundry. Currently, I live with other volunteer teams in a place called PKBI Post in Majene, and there is a cooking schedule for everyone. After prayers, chores and breakfast, I get my daughter ready for the day as she accompanies me to work temporarily. After that, the team and I prepare medical equipment and medicine for the day's humanitarian mission. 8.30 – 11am Today the first location is Maliaya Village Health Centre, in Malunda District, Majene. Here, I attend to and examine 25 pregnant women. The pregnant women, on average, get married at a fairly young age. There are definitely risks to their reproductive health. There is a 43-year-old mother who is currently pregnant with her 11th child. To limit health risks, we advise her on the various safe family planning options.   There is also a 38-year-old woman who is eight months pregnant. However, the size of her belly is very small for a woman in her third trimester. In fact, I initially thought that she was only four or five months pregnant. After I examined her, it turns out that she is categorized as a ‘malnourished’ pregnant woman. It is very unfortunate because she admitted that she eats food without paying attention to her nutrition intake. In fact, she tends to eat instant noodles. So I advised her to drink milk, eat only nutritious foods, and always taker her vitamins.  11am – 2pm After visiting Maliaya Village, I travelled to Kabiraan Village. This village was severely affected by the earthquake. Here, I walk around the evacuation camp, most of which is still occupied by displaced people in this post-earthquake period. Even under the evacuation tent, I continue to conduct health examinations for pregnant women.  Due to the large number of cases of young marriages in Kabiiran Village, the team and I decide to conduct counselling sessions for the teenagers here. I advise the teenagers to get to know the risks that might occur to their reproductive health if they marry too young.  2 – 4pm The health volunteer team and I are finally able to take the time for lunch. We have our lunch near the beach, and get to enjoy local seafood as our menu. Enjoying the seafood while looking at the beautiful sea view is a precious time. I certainly won't forget this moment. 4 – 6pm We continue our journey to East Lombong Village. We have many elderly patients here. Yet interestingly, during one of the patients’ examination, there is one mother who wants to get the contraceptive implant. For me, this is quite a shock, given that we rarely find women in this village who want to do family planning. The mother admitted that she did not know much about the family planning program and has many children. She is grateful that the PKBI volunteer team and I came to their shelter camp for the health examination. 6pm The team and I decide to return to the PKBI Post. Today’s journey is quite tiring but there is a sense of pride and emotion for having carried out a humanitarian mission for teenage girls, mothers, the elderly and even toddlers who still stay in the shelter camp. 7 – 8pm At the PKBI Post, after cleaning and tidying up the medical equipment again for the next day’s program, I  prepare dinner for the team and assist my child with her studies. I am so grateful for each and every day that I am involved in this program. I feel encouraged to continue to provide sexual and reproductive healthcare to marginalized groups

A photo of Dr Ratni - she is smiling in front of a clinic
story

| 28 March 2024

Dr Ratni: a day in the life of an emergency response volunteer

Dr Ratni Palullungan is a fearless doctor, mother, and selfless volunteer providing sexual and reproductive healthcare to marginalized groups in fragile humanitarian settings.  Currently she is deployed with the Indonesian Planned Parenthood Association’s (IPPA/PKBI) response team in Majene District, West Sulawesi, following a magnitude 6.2 earthquake which occurred in January 2021.   In an open diary, Dr Ratni shares what a day in the life looks like for a volunteer doctor providing care to those affected by the earthquake.   5.30 – 8.30am I get up quite early and have my quiet time (prayer), then I gather my dirty laundry. Currently, I live with other volunteer teams in a place called PKBI Post in Majene, and there is a cooking schedule for everyone. After prayers, chores and breakfast, I get my daughter ready for the day as she accompanies me to work temporarily. After that, the team and I prepare medical equipment and medicine for the day's humanitarian mission. 8.30 – 11am Today the first location is Maliaya Village Health Centre, in Malunda District, Majene. Here, I attend to and examine 25 pregnant women. The pregnant women, on average, get married at a fairly young age. There are definitely risks to their reproductive health. There is a 43-year-old mother who is currently pregnant with her 11th child. To limit health risks, we advise her on the various safe family planning options.   There is also a 38-year-old woman who is eight months pregnant. However, the size of her belly is very small for a woman in her third trimester. In fact, I initially thought that she was only four or five months pregnant. After I examined her, it turns out that she is categorized as a ‘malnourished’ pregnant woman. It is very unfortunate because she admitted that she eats food without paying attention to her nutrition intake. In fact, she tends to eat instant noodles. So I advised her to drink milk, eat only nutritious foods, and always taker her vitamins.  11am – 2pm After visiting Maliaya Village, I travelled to Kabiraan Village. This village was severely affected by the earthquake. Here, I walk around the evacuation camp, most of which is still occupied by displaced people in this post-earthquake period. Even under the evacuation tent, I continue to conduct health examinations for pregnant women.  Due to the large number of cases of young marriages in Kabiiran Village, the team and I decide to conduct counselling sessions for the teenagers here. I advise the teenagers to get to know the risks that might occur to their reproductive health if they marry too young.  2 – 4pm The health volunteer team and I are finally able to take the time for lunch. We have our lunch near the beach, and get to enjoy local seafood as our menu. Enjoying the seafood while looking at the beautiful sea view is a precious time. I certainly won't forget this moment. 4 – 6pm We continue our journey to East Lombong Village. We have many elderly patients here. Yet interestingly, during one of the patients’ examination, there is one mother who wants to get the contraceptive implant. For me, this is quite a shock, given that we rarely find women in this village who want to do family planning. The mother admitted that she did not know much about the family planning program and has many children. She is grateful that the PKBI volunteer team and I came to their shelter camp for the health examination. 6pm The team and I decide to return to the PKBI Post. Today’s journey is quite tiring but there is a sense of pride and emotion for having carried out a humanitarian mission for teenage girls, mothers, the elderly and even toddlers who still stay in the shelter camp. 7 – 8pm At the PKBI Post, after cleaning and tidying up the medical equipment again for the next day’s program, I  prepare dinner for the team and assist my child with her studies. I am so grateful for each and every day that I am involved in this program. I feel encouraged to continue to provide sexual and reproductive healthcare to marginalized groups

Fatoumata Yehiya Maiga
story

| 08 January 2021

"The movement helps girls to know their rights and their bodies"

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

Fatoumata Yehiya Maiga
story

| 28 March 2024

"The movement helps girls to know their rights and their bodies"

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

Woman smiling.
story

| 13 August 2020

In pictures: Delivering healthcare to remote communities in Fiji

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

Woman smiling.
story

| 28 March 2024

In pictures: Delivering healthcare to remote communities in Fiji

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

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.”

A humanitarian worker in India
story

| 17 August 2021

In pictures: World Humanitarian Day 2021

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

A humanitarian worker in India
story

| 28 March 2024

In pictures: World Humanitarian Day 2021

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

A photo of Dr Ratni - she is smiling in front of a clinic
story

| 13 May 2021

Dr Ratni: a day in the life of an emergency response volunteer

Dr Ratni Palullungan is a fearless doctor, mother, and selfless volunteer providing sexual and reproductive healthcare to marginalized groups in fragile humanitarian settings.  Currently she is deployed with the Indonesian Planned Parenthood Association’s (IPPA/PKBI) response team in Majene District, West Sulawesi, following a magnitude 6.2 earthquake which occurred in January 2021.   In an open diary, Dr Ratni shares what a day in the life looks like for a volunteer doctor providing care to those affected by the earthquake.   5.30 – 8.30am I get up quite early and have my quiet time (prayer), then I gather my dirty laundry. Currently, I live with other volunteer teams in a place called PKBI Post in Majene, and there is a cooking schedule for everyone. After prayers, chores and breakfast, I get my daughter ready for the day as she accompanies me to work temporarily. After that, the team and I prepare medical equipment and medicine for the day's humanitarian mission. 8.30 – 11am Today the first location is Maliaya Village Health Centre, in Malunda District, Majene. Here, I attend to and examine 25 pregnant women. The pregnant women, on average, get married at a fairly young age. There are definitely risks to their reproductive health. There is a 43-year-old mother who is currently pregnant with her 11th child. To limit health risks, we advise her on the various safe family planning options.   There is also a 38-year-old woman who is eight months pregnant. However, the size of her belly is very small for a woman in her third trimester. In fact, I initially thought that she was only four or five months pregnant. After I examined her, it turns out that she is categorized as a ‘malnourished’ pregnant woman. It is very unfortunate because she admitted that she eats food without paying attention to her nutrition intake. In fact, she tends to eat instant noodles. So I advised her to drink milk, eat only nutritious foods, and always taker her vitamins.  11am – 2pm After visiting Maliaya Village, I travelled to Kabiraan Village. This village was severely affected by the earthquake. Here, I walk around the evacuation camp, most of which is still occupied by displaced people in this post-earthquake period. Even under the evacuation tent, I continue to conduct health examinations for pregnant women.  Due to the large number of cases of young marriages in Kabiiran Village, the team and I decide to conduct counselling sessions for the teenagers here. I advise the teenagers to get to know the risks that might occur to their reproductive health if they marry too young.  2 – 4pm The health volunteer team and I are finally able to take the time for lunch. We have our lunch near the beach, and get to enjoy local seafood as our menu. Enjoying the seafood while looking at the beautiful sea view is a precious time. I certainly won't forget this moment. 4 – 6pm We continue our journey to East Lombong Village. We have many elderly patients here. Yet interestingly, during one of the patients’ examination, there is one mother who wants to get the contraceptive implant. For me, this is quite a shock, given that we rarely find women in this village who want to do family planning. The mother admitted that she did not know much about the family planning program and has many children. She is grateful that the PKBI volunteer team and I came to their shelter camp for the health examination. 6pm The team and I decide to return to the PKBI Post. Today’s journey is quite tiring but there is a sense of pride and emotion for having carried out a humanitarian mission for teenage girls, mothers, the elderly and even toddlers who still stay in the shelter camp. 7 – 8pm At the PKBI Post, after cleaning and tidying up the medical equipment again for the next day’s program, I  prepare dinner for the team and assist my child with her studies. I am so grateful for each and every day that I am involved in this program. I feel encouraged to continue to provide sexual and reproductive healthcare to marginalized groups

A photo of Dr Ratni - she is smiling in front of a clinic
story

| 28 March 2024

Dr Ratni: a day in the life of an emergency response volunteer

Dr Ratni Palullungan is a fearless doctor, mother, and selfless volunteer providing sexual and reproductive healthcare to marginalized groups in fragile humanitarian settings.  Currently she is deployed with the Indonesian Planned Parenthood Association’s (IPPA/PKBI) response team in Majene District, West Sulawesi, following a magnitude 6.2 earthquake which occurred in January 2021.   In an open diary, Dr Ratni shares what a day in the life looks like for a volunteer doctor providing care to those affected by the earthquake.   5.30 – 8.30am I get up quite early and have my quiet time (prayer), then I gather my dirty laundry. Currently, I live with other volunteer teams in a place called PKBI Post in Majene, and there is a cooking schedule for everyone. After prayers, chores and breakfast, I get my daughter ready for the day as she accompanies me to work temporarily. After that, the team and I prepare medical equipment and medicine for the day's humanitarian mission. 8.30 – 11am Today the first location is Maliaya Village Health Centre, in Malunda District, Majene. Here, I attend to and examine 25 pregnant women. The pregnant women, on average, get married at a fairly young age. There are definitely risks to their reproductive health. There is a 43-year-old mother who is currently pregnant with her 11th child. To limit health risks, we advise her on the various safe family planning options.   There is also a 38-year-old woman who is eight months pregnant. However, the size of her belly is very small for a woman in her third trimester. In fact, I initially thought that she was only four or five months pregnant. After I examined her, it turns out that she is categorized as a ‘malnourished’ pregnant woman. It is very unfortunate because she admitted that she eats food without paying attention to her nutrition intake. In fact, she tends to eat instant noodles. So I advised her to drink milk, eat only nutritious foods, and always taker her vitamins.  11am – 2pm After visiting Maliaya Village, I travelled to Kabiraan Village. This village was severely affected by the earthquake. Here, I walk around the evacuation camp, most of which is still occupied by displaced people in this post-earthquake period. Even under the evacuation tent, I continue to conduct health examinations for pregnant women.  Due to the large number of cases of young marriages in Kabiiran Village, the team and I decide to conduct counselling sessions for the teenagers here. I advise the teenagers to get to know the risks that might occur to their reproductive health if they marry too young.  2 – 4pm The health volunteer team and I are finally able to take the time for lunch. We have our lunch near the beach, and get to enjoy local seafood as our menu. Enjoying the seafood while looking at the beautiful sea view is a precious time. I certainly won't forget this moment. 4 – 6pm We continue our journey to East Lombong Village. We have many elderly patients here. Yet interestingly, during one of the patients’ examination, there is one mother who wants to get the contraceptive implant. For me, this is quite a shock, given that we rarely find women in this village who want to do family planning. The mother admitted that she did not know much about the family planning program and has many children. She is grateful that the PKBI volunteer team and I came to their shelter camp for the health examination. 6pm The team and I decide to return to the PKBI Post. Today’s journey is quite tiring but there is a sense of pride and emotion for having carried out a humanitarian mission for teenage girls, mothers, the elderly and even toddlers who still stay in the shelter camp. 7 – 8pm At the PKBI Post, after cleaning and tidying up the medical equipment again for the next day’s program, I  prepare dinner for the team and assist my child with her studies. I am so grateful for each and every day that I am involved in this program. I feel encouraged to continue to provide sexual and reproductive healthcare to marginalized groups

A photo of Dr Ratni - she is smiling in front of a clinic
story

| 13 May 2021

Dr Ratni: a day in the life of an emergency response volunteer

Dr Ratni Palullungan is a fearless doctor, mother, and selfless volunteer providing sexual and reproductive healthcare to marginalized groups in fragile humanitarian settings.  Currently she is deployed with the Indonesian Planned Parenthood Association’s (IPPA/PKBI) response team in Majene District, West Sulawesi, following a magnitude 6.2 earthquake which occurred in January 2021.   In an open diary, Dr Ratni shares what a day in the life looks like for a volunteer doctor providing care to those affected by the earthquake.   5.30 – 8.30am I get up quite early and have my quiet time (prayer), then I gather my dirty laundry. Currently, I live with other volunteer teams in a place called PKBI Post in Majene, and there is a cooking schedule for everyone. After prayers, chores and breakfast, I get my daughter ready for the day as she accompanies me to work temporarily. After that, the team and I prepare medical equipment and medicine for the day's humanitarian mission. 8.30 – 11am Today the first location is Maliaya Village Health Centre, in Malunda District, Majene. Here, I attend to and examine 25 pregnant women. The pregnant women, on average, get married at a fairly young age. There are definitely risks to their reproductive health. There is a 43-year-old mother who is currently pregnant with her 11th child. To limit health risks, we advise her on the various safe family planning options.   There is also a 38-year-old woman who is eight months pregnant. However, the size of her belly is very small for a woman in her third trimester. In fact, I initially thought that she was only four or five months pregnant. After I examined her, it turns out that she is categorized as a ‘malnourished’ pregnant woman. It is very unfortunate because she admitted that she eats food without paying attention to her nutrition intake. In fact, she tends to eat instant noodles. So I advised her to drink milk, eat only nutritious foods, and always taker her vitamins.  11am – 2pm After visiting Maliaya Village, I travelled to Kabiraan Village. This village was severely affected by the earthquake. Here, I walk around the evacuation camp, most of which is still occupied by displaced people in this post-earthquake period. Even under the evacuation tent, I continue to conduct health examinations for pregnant women.  Due to the large number of cases of young marriages in Kabiiran Village, the team and I decide to conduct counselling sessions for the teenagers here. I advise the teenagers to get to know the risks that might occur to their reproductive health if they marry too young.  2 – 4pm The health volunteer team and I are finally able to take the time for lunch. We have our lunch near the beach, and get to enjoy local seafood as our menu. Enjoying the seafood while looking at the beautiful sea view is a precious time. I certainly won't forget this moment. 4 – 6pm We continue our journey to East Lombong Village. We have many elderly patients here. Yet interestingly, during one of the patients’ examination, there is one mother who wants to get the contraceptive implant. For me, this is quite a shock, given that we rarely find women in this village who want to do family planning. The mother admitted that she did not know much about the family planning program and has many children. She is grateful that the PKBI volunteer team and I came to their shelter camp for the health examination. 6pm The team and I decide to return to the PKBI Post. Today’s journey is quite tiring but there is a sense of pride and emotion for having carried out a humanitarian mission for teenage girls, mothers, the elderly and even toddlers who still stay in the shelter camp. 7 – 8pm At the PKBI Post, after cleaning and tidying up the medical equipment again for the next day’s program, I  prepare dinner for the team and assist my child with her studies. I am so grateful for each and every day that I am involved in this program. I feel encouraged to continue to provide sexual and reproductive healthcare to marginalized groups

A photo of Dr Ratni - she is smiling in front of a clinic
story

| 28 March 2024

Dr Ratni: a day in the life of an emergency response volunteer

Dr Ratni Palullungan is a fearless doctor, mother, and selfless volunteer providing sexual and reproductive healthcare to marginalized groups in fragile humanitarian settings.  Currently she is deployed with the Indonesian Planned Parenthood Association’s (IPPA/PKBI) response team in Majene District, West Sulawesi, following a magnitude 6.2 earthquake which occurred in January 2021.   In an open diary, Dr Ratni shares what a day in the life looks like for a volunteer doctor providing care to those affected by the earthquake.   5.30 – 8.30am I get up quite early and have my quiet time (prayer), then I gather my dirty laundry. Currently, I live with other volunteer teams in a place called PKBI Post in Majene, and there is a cooking schedule for everyone. After prayers, chores and breakfast, I get my daughter ready for the day as she accompanies me to work temporarily. After that, the team and I prepare medical equipment and medicine for the day's humanitarian mission. 8.30 – 11am Today the first location is Maliaya Village Health Centre, in Malunda District, Majene. Here, I attend to and examine 25 pregnant women. The pregnant women, on average, get married at a fairly young age. There are definitely risks to their reproductive health. There is a 43-year-old mother who is currently pregnant with her 11th child. To limit health risks, we advise her on the various safe family planning options.   There is also a 38-year-old woman who is eight months pregnant. However, the size of her belly is very small for a woman in her third trimester. In fact, I initially thought that she was only four or five months pregnant. After I examined her, it turns out that she is categorized as a ‘malnourished’ pregnant woman. It is very unfortunate because she admitted that she eats food without paying attention to her nutrition intake. In fact, she tends to eat instant noodles. So I advised her to drink milk, eat only nutritious foods, and always taker her vitamins.  11am – 2pm After visiting Maliaya Village, I travelled to Kabiraan Village. This village was severely affected by the earthquake. Here, I walk around the evacuation camp, most of which is still occupied by displaced people in this post-earthquake period. Even under the evacuation tent, I continue to conduct health examinations for pregnant women.  Due to the large number of cases of young marriages in Kabiiran Village, the team and I decide to conduct counselling sessions for the teenagers here. I advise the teenagers to get to know the risks that might occur to their reproductive health if they marry too young.  2 – 4pm The health volunteer team and I are finally able to take the time for lunch. We have our lunch near the beach, and get to enjoy local seafood as our menu. Enjoying the seafood while looking at the beautiful sea view is a precious time. I certainly won't forget this moment. 4 – 6pm We continue our journey to East Lombong Village. We have many elderly patients here. Yet interestingly, during one of the patients’ examination, there is one mother who wants to get the contraceptive implant. For me, this is quite a shock, given that we rarely find women in this village who want to do family planning. The mother admitted that she did not know much about the family planning program and has many children. She is grateful that the PKBI volunteer team and I came to their shelter camp for the health examination. 6pm The team and I decide to return to the PKBI Post. Today’s journey is quite tiring but there is a sense of pride and emotion for having carried out a humanitarian mission for teenage girls, mothers, the elderly and even toddlers who still stay in the shelter camp. 7 – 8pm At the PKBI Post, after cleaning and tidying up the medical equipment again for the next day’s program, I  prepare dinner for the team and assist my child with her studies. I am so grateful for each and every day that I am involved in this program. I feel encouraged to continue to provide sexual and reproductive healthcare to marginalized groups

Fatoumata Yehiya Maiga
story

| 08 January 2021

"The movement helps girls to know their rights and their bodies"

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

Fatoumata Yehiya Maiga
story

| 28 March 2024

"The movement helps girls to know their rights and their bodies"

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

Woman smiling.
story

| 13 August 2020

In pictures: Delivering healthcare to remote communities in Fiji

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

Woman smiling.
story

| 28 March 2024

In pictures: Delivering healthcare to remote communities in Fiji

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

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.”