Pann Chandy gave her first sexual education lesson when she was still at school as a volunteer youth social worker with the Reproductive Health Association of Cambodia (RHAC). She had no qualms about standing up in front of her classmates to discuss culturally taboo topics when she was just a teenager. Now aged 25 and in possession of a Bachelor degree in midwifery, Chandy has been employed by RHAC for less than a year, working as part of the organisation’s health outreach team. The job is demanding: she is tasked with regularly visiting four karaoke parlours, eight garment factories and 20 villages in Phnom Penh, with plans to expand to two universities imminently. Travelling for hours A round trip to some communities can take two hours or more on her motorcycle, travelling alone into areas that are not always easily accessible. “Sometimes I have the clinic staff with me, but rarely,” Chandy says. “I promote the health services provided by Reproductive Health Association of Cambodia as well. If they are interested in going to a clinic, I give them a referral,” she says. One of the factories on her regular roster is Propitious garment factory in Takhmao, a small city south of Phnom Penh. Chandy spends two days a month at the factory, where she speaks to groups of women or has one-on-one discussions about sensitive topics. Passionate about the job “Just yesterday during the outreach service, a woman asked me why she didn’t get her period after having an abortion. She wanted to know what was wrong,” she says. “It’s common for women to use unsafe abortion methods. Mainly they take medicine from a pharmacy, and the pharmacy doesn’t give them any advice on how to use it. Often they go to cheap, unlicensed clinics near the factories for medical abortions.” Chandy is passionate about her job at Reproductive Health Association of Cambodia, and dreams about one day setting up her own pharmacy where she could provide comprehensive advice to clients. “There are a lot of unlicensed pharmacists in this country,” she says, many of which prescribe the counterfeit medicines that have inundated the market. “I think I may have the capacity to become a licensed one."

After three years of marriage, Cambodian garment worker Sineang had started to wonder why she hadn’t yet become pregnant. Still in her early 20s, she and her husband wanted to have a baby and were not using contraception. In late 2011 or early 2012, Sineang visited a Reproductive Health Association of Cambodia clinic to seek treatment after she noticed some vaginal discharge. During the appointment, her doctor asked her more details about her sexual and reproductive health history: the issue of infertility soon came up. “I had been wanting to have a child for three years, since I was married,” she says. “I felt down about myself, but my husband gave me encouragement and told me it was okay that I was not pregnant yet.” During the initial examination, Sineang says, she was tested for cervical cancer as well as other reproductive health issues that can interfere with pregnancy. RHAC staff prescribed medication to treat her fertility problems, which she continued taking until they confirmed she was pregnant. “At first, I wasn’t really convinced that there was any relation between the discharge and not having a baby, but later I started to think that there was a connection,” she says. Throughout the whole period, Sineang went to RHAC each month – switching from infertility treatment to prenatal care – until she gave birth to a baby girl in 2013. “I was very happy when my daughter was born,” she says. “She’s healthy.” At the time, RHAC offered a discount to garment workers, which Sineang says was a big help. It’s no longer on offer, but she is an enthusiastic supporter of a plan RHAC is hoping to implement soon – a partnership with the National Social Security Fund that would allow them to visit RHAC clinics for free through the fund. “It would be really great if they could, because having a baby is expensive,” she says. “The clinic at RHAC has better service than the public hospitals. When I had my first baby, I wanted to have good service, because I had this problem with discharge [in the past].” Sineang, who is originally from Kandal province and works at Dewhirst garment factory in Phnom Penh, said she was pleased to see RHAC midwives doing regular outreach sessions at the factory. “It’s good for women to know more about these issues,” she says. And not only that, but Sineang is also an active ambassador for RHAC, spreading the word about the NGO’s services to friends and colleagues who have also struggled to have a baby. “I referred a friend to RHAC after she saw that I finally got pregnant. Now my friend, who didn’t have a baby, has two children,” she says. “I also referred another colleague who is having the same problem, and she is going to go on Sunday.”

Prijani and Chandana were forced to flee their home during the floods of May 2017 in Sri Lanka. They didn’t have time to take any belongings, so ran with their two small children. After the floods, they attended gender based violence training run by Family Planning Association of Sri Lanka, where they learned about child protection needs. “We weren’t informed that the floods were going to come, but when the water reached our knee level we knew we have to move. We just took the kids and left” says Prijani. “I was worried about two things: my kids, as we were staying at a camp in the school, and losing my house. I allowed a workshop run by Family Planning Association of Sri Lanka to be held in my garden as we had the most room. There I learnt a lot about child protection the teacher gave a lot of examples of child protection and what can go wrong. We learned about sexual violence that kids face from older people”. “One day, I saw my son masturbating and I asked him how he knew how to do that, and that’s when he told me about what happened at school. The workshop taught me to look out for these signs” says Chandana, who is planning to report the incident to the school when it re-opens. “I never thought the issue was that bad. Now, we are a lot more attentive to our kids”.   Stories Read more stories from Sri Lanka

Mala Neupane is just 18 years old, but is already an experienced volunteer for the Family Planning Association of Nepal (FPAN). Mala lives in Tansen, the hillside capital of Palpa, a region of rolling hills, pine forests and lush terraced fields in western Nepal. She works as a community home-based care mobiliser focusing on HIV: her job involves travelling to villages around Tansen to provide people with information about HIV and contraception. “Before, the community had very little knowledge regarding HIV and there used to be so much stigma and discrimination,” she says. “But later, when the Community Health Based Carers (CHBCs) started working in those communities, they had more knowledge and less stigma.” The youth of the volunteers proved an effective tool during their conversations with villagers. “At first, when they talked to people about family planning, they were not receptive: they felt resistance to using those devices,” Mala explains. “The CHBCs said to them: ‘young people like us are doing this kind of work, so why are you feeling such hesitation?’ After talking with them, they became ready to use contraceptives.” Her age is also important for connecting with young people, in a society of rapid change, she says. “Because we are young, we may know more about what young people’s needs and wants are. We can talk to young people about what family planning methods might be suitable for them, and what the options are.” “Young people’s involvement [in FPAN programmes] is very important to helping out young people like us.” It’s a simple message, but one reaping rich rewards for the lives and wellbeing of people in Palpa.

“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.”