“Girls in rural areas often face more problems than girls in the city,” says 23-year-old Sajana Kergi. “For example, when they’re menstruating they might have to stay at home and not touch any kitchen materials, or have to drop school.  “It varies from family to family, but generally the more traditional and superstitious a family is, the more problems a girl will have.”  For the past two years, Sajana has been volunteering as a peer educator and mentor for the Family Planning Association of Nepal (FPAN), since hearing about the programme on Facebook. After an orientation and training programme, she visited different rural schools to give girls training on menstruation management. She now runs classes in schools in and around Bhaktapur. The classes aim to create a relaxed environment for young people to talk and learn about sexual health and rights. This fills a major gap in their learning and knowledge, Sajana says. “At school, these subjects are in the curriculum, but teachers skip these lessons and don’t talk about these issues openly,” she explains. “The teachers don’t create a comfortable environment, and this makes students hesitant to talk about these issues, so there’s no proper knowledge.” FPAN classes are an opportunity for young people to speak openly about sexual health and sexuality therefore are vital. 

“One time, a sixteen-year-old girl came to see us with an unwanted pregnancy, on the point of suicide,” says Sharad Kumar Argal. “She had been abused by her family and the baby was the result of incest. She was about to commit suicide.”   The girl had never heard of safe abortion, explains Sharad, who works as Kathmandu Valley branch manager for the Family Planning Association of Nepal (FPAN), the country’s leading family planning NGO.  “Then, very luckily, she happened to come to our youth-friendly centre. From there, she found out about abortion services and she had an abortion through FPAN. FPAN brought her back from the brink of suicide.”  For Sharad, FPAN’s youth programmes are the lifeblood of the organisation. In his twenty years at the organisation, he has seen major changes in family planning law and sexual rights in Nepal, from the legalisation of abortion in 2002, to the introduction of National Family Planning Day in 2014.  One of the changes that he talks passionately about is FPAN’s work supporting young people, and the role of youth volunteers in these activities.  “If you go back 20 years, even talking to people about family planning and especially condoms was very difficult,” he says. “People were hesitant and didn’t want to hear about that in a public space. That made family planning very difficult: we needed to do home to home visits to make family planning available.” “But now, with the passage of time, this has become much better and easier. These days even our youth peer educators are involved in distributing condoms and pills.” The data underlines this change. “The use of family planning 20 years’ ago was only 20-25 per cent,” Sharad says. “Whereas now, more than 50 per cent have access to family planning services.” 

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

The Safe Abortion Action Fund (SAAF) which is hosted by IPPF was set up in 2006 in order to support grass-roots organisations to increase access to safe abortion. One such organisation which received support under the last round of funding is called Volunteers for Development Association Uganda (VODA). Unsafe abortion is a huge problem in Uganda with an estimated 400,000 women having an unsafe abortion per year. The law is confusing and unclear, with abortion permitted only under certain circumstances. Post-abortion care is permitted to treat women who have undergone an unsafe abortion, however lack of awareness of the law and stigma surrounding abortion mean that service providers are not always willing to treat patients who arrive seeking care. The VODA project aims to ensure that young women in Uganda are able to lead healthier lives free from unsafe abortion related deaths or complications through reducing abortion stigma in the community, increasing access to abortion-related services and ensuring the providers are trained to provide quality post-abortion care services. I am Helen. I have been a midwife at this small clinic for seven years and I have worked with VODA for four years. Unsafe abortion continues and some schoolgirls are raped. They then go to local herbalists and some of them tell me that they are given emilandira [roots] which they insert inside themselves to rupture the membranes. Some of them even try to induce an abortion by using Omo [douching with detergent or bleach]. At the end of the day they get complications then they land here, so we help them. Unsafe abortion is very common. In one month you can get more than five cases. It is a big problem. We help them, they need to go back to school, and we counsel them. If it is less than 12 weeks, we handle them from here. If they are more than 12 weeks along we refer them to the hospital. Most referrals from VODA are related to unwanted pregnancies, HIV testing, family planning, and youth friendly services. A few parents come for services for their children who are at school. So we counsel them that contraception, other than condoms, will only prevent pregnancy, but you can still get HIV and STIs, so take care. I am Josephine and I work as a midwife at a rural health centre. I deal with pregnant mothers, postnatal mothers, and there are girls who come with problems like unwanted pregnancy. I used to have a negative attitude towards abortion. But then VODA helped us understand the importance of helping someone with the problem because many people were dying in the villages because of unsafe abortion. According to my religion, helping someone to have an abortion was not allowed. But again when you look into it, it’s not good to leave someone to die. So I decided to change my attitude to help people. Post-abortion care has helped many people because these days we don’t have many people in the villages dying because of unsafe abortion. These days I’m proud of what we are doing because before I didn’t know the importance of helping someone with a problem. But these days, since people no longer die, people no longer get problems and I’m proud and happy because we help so many people.   My name is Jonathan. I am married with three children. I have a Bachelor of Social Work and Social Administration. I have worked with VODA as a project officer since 2008. Due to the training that we have done about abortion many people have changed their attitudes and we have helped people to talk about the issue. Most people were against abortion before but they are now realising that if it’s done safely it is important because otherwise many people die from unsafe abortion. I have talked to religious leaders, I have talked to local leaders; I have talked to people of different categories. At first when you approach them, they have a different perception. The health workers were difficult to work with at first. However they knew people were approaching them with the problems of unsafe abortion. Due to religion, communities can be hard against this issue. But after some time we have seen that they have changed their perception toward the issue of safe and unsafe abortion. And now many of them know that in some instances, abortion is inevitable but it should be done in a safe way.   I’m Stevens and I am nurse. We have some clients who come when they have already attempted an unsafe abortion. You find that it is often inevitable. The only solution you have to help those clients is to provide treatment of incomplete abortion as part of post-abortion care. Because of the VODA project there is a very remarkable change in the community. Now, those people who used to have unsafe abortions locally, know where to go for post-abortion care - unlike in the past. I remember a schoolgirl, she was in a very sorry state because she had tried some local remedies to abort. I attended to her and things went well. She went back to school. I feel so proud because that was a big life rescue. A girl like that could have died but now she is alive and I see her carrying on with her studies, I feel so proud. I praise VODA for that encouragement. This service should be legalised because whether they restrict it or not, there is abortion and it is going on. And if it’s not out in the open, so that our people know where to go for such services, it leads to more deaths. Stories Read more stories about the amazing success of SAAF in Uganda

The Safe Abortion Action Fund (SAAF) which is hosted by IPPF was set up in 2006 in order to support grass-roots organisations to increase access to safe abortion. One such organisation which received support under the last round of funding is called Volunteers for Development Association Uganda (VODA). Margaret's daughter, Gladys, was raped by a relative as a teenager and became pregnant. She did not tell her mother what had happened and not wanting to have a child at such a young age conceived through incest, Gladys tried to terminate the pregnancy herself using local herbs but got an infection and died. "My name is Margaret and I am a widow." "I lost my daughter in 2011. She was called Gladys and she was 16. I didn’t know that she was pregnant. She tried to use local herbs to abort. I only found out about it three days later when she was bleeding very heavily. I tried to take her to the hospital but unfortunately she died on the way." Despite being the cause of many deaths in the region, the stigma surrounding abortion means that most people do not mention the cause of death publically. However at Gladys' funeral one of her school friends spoke out and said that she had died due to unsafe abortion. This prompted VODA to start working on the issue and when the project started they included Margaret in their training on how to prevent unsafe abortion. "The training made me stronger to talk about it. Now, I continue to tell my remaining two girls about the dangers of unsafe abortion, sexually transmitted infections and unwanted pregnancies. VODA has really helped us. I think my girl wouldn’t have died if VODA was active then like it is now." "I have used VODA's information to carry on with my parental work. That information has been helpful because we are noticing change. I keep on reminding them, 'didn’t you see what happened to your friend here?'. So they have really changed especially with the ongoing help of the people from VODA." "Unsafe abortion was rampant in the past. We had tried to speak to the students, as parents, but it seemed that our information was not enough. But now we have another helping hand from VODA, especially with those seminars targeting the girls."   Stories Read more stories about the amazing success of SAAF in Uganda

The Safe Abortion Action Fund (SAAF) which is hosted by IPPF was set up in 2006 in order to support grassroots organisations to increase access to safe abortion. One such organisation which received support under the last round of funding is called Volunteers for Development Association Uganda (VODA). Peer educators in schools provide counselling and advice to other students, who otherwise would have no one to turn to in times of crisis. Today, we have the largest generation of young people ever, each one with their own unique needs. Peer educators are critical in gaining the trust and confidence of hundreds of young girls each term, and together they help each other gain more knowledge about their sexual and reproductive health. Peer educators themselves also gain a great deal from the training and experience and VODA has been successful in empowering many of these young girls to feel confident and be able to talk out in public, something that they were not able to do before. Poverty, gender inequality, lack of knowledge about sex and relationships and lack of access to sanitary protection mean that girls in rural Uganda are at high risk of sexual exploitation and abuse. All of this coupled with very little access to contraception means that Uganda has high rates of unintended pregnancies among young girls. Despite abortion being legal in Uganda in cases of rape and incest, most girls are not aware of the law and resort to unsafe abortion often using local herbs or washing liquid. The peer educators trained by VODA are able to listen to other young people's issues and provide support and information a range of issues including safe abortion as well as how to access contraception. My name is Mabel. I am in my final year of O'Levels and I am a peer counsellor at  a Secondary School in Namuganga. I was selected with two others by VODA and my head teacher, and then trained to be a peer counsellor. We were trained to help our colleagues at school to handle various problems. Girls used to get pregnant and some were dropping out of school. So we counselled many of our colleagues about unwanted pregnancies. We have seen a change because we get free condoms from VODA. We could preach abstinence from sex. For those that could not manage abstinence, we could give them male condoms. Unsafe abortion has been a big problem. Girls were using local herbs and sharp instruments like metallic hangers for abortion. Many would get injured and some would die. I remember last year there was a girl who aborted using those local methods but she died and was buried in Seeta. If VODA wasn't here I think things would be very bad because as students, we did not have access to most of the information that we needed. We would have seen a big number of girls out of school because of unwanted pregnancies or unsafe abortion.  I have benefited a lot. I have acquired information which I have used to keep myself safe in terms of unwanted pregnancies. I don’t think I could ever be lured to perform unsafe abortion because I know the risks. In the past, I wasn't able to speak in public but now I can stand and talk freely.  I’m Sharon and I’m a student counsellor at a Secondary School in Namuganga. I counsel fellow students, young people in communities and even adults. Before I was selected for VODA training I thought it was just an organisation to promote abortion. But then I realised they were addressing a big problem that was happening at our school and our villages. I have learnt that when someone gets pregnant I don’t have to force her to abort and I don’t encourage her to go for unsafe abortion. If we hear that a certain girl has a boyfriend, we approach her and counsel her on issues like unwanted pregnancy. Many young girls have been lured into early sex because they need money, which is why we end up with unwanted pregnancies. In a bid to fulfil those needs, they get boyfriends or other guys who use them for money, impregnate them and then leave. The girls know about contraceptives like the pill and we have given some of them referral cards for them to access the contraceptives from the health centres. But there has been debate against giving young girls contraceptives. There are restrictions that the government puts in place but that does not mean that girls are not getting pregnant. I remember the girls who died after aborting through unsafe abortion methods and I think about the lives that would have been saved if they had knowledge about contraceptives. I’m  Rita and I’m 15-years-old. I was twelve when I was selected to be a VODA counsellor in my primary school. I was lucky because many people wanted to be counsellors but I was chosen. My parents were very happy and they got interested. When I joined this school, I introduced myself to other students because I wanted to continue with my work as a counsellor. I told my colleagues to feel free to share with me their issues. We are lucky here because there are many counsellors.  Girls are having unwanted pregnancies because they are lured by men who give them presents and things such as money for sanitary pads that they cannot get from their parents. Before I joined this school, there were many cases of girls terminating pregnancies with unsafe abortions. It was common to hear of or see someone who had aborted. Many would abort so that they would return to school. When I joined this school last year and we intensified the counselling sessions, many came and shared their problems with us. We have learnt that two girls at school gave birth and have since returned to school but we have not had cases of unsafe abortions here since I joined.  I wasn’t as serious with studies before I became a counsellor but because I want to maintain my status, I have improved in my studies because I don’t want to feel ashamed in front of my fellow students. VODA gave us T-shirts for identification purposes which has made people in the community respect me as well. In terms of preventing unwanted pregnancies in schools, most of what we see here originates from the girls' homes. Many parents don’t provide for the girls’ necessities (like sanitary towels) so that makes them vulnerable to be lured by men. Stories Read more stories about the amazing success of SAAF in Uganda