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Spotlight

A selection of stories from across the Federation

2024 trends
Story

What does the year 2024 hold for us?

As the new year begins, we take a look at the trends and challenges ahead for sexual and reproductive health and rights.
Jackie, 34, sex worker and peer outreach worker
story

| 24 July 2018

“We were dying in large numbers because we were afraid of those clinics”

“I’m a sex worker and peer outreach worker for the Nkaikela Youth Group. We reach the other sex workers because we are the ones that know them. We go to their houses, we go to the hotspots like clubs and the street; we reach them and encourage them to come here [to the Youth Group],” says Jackie Selelo, 34, sitting in one of the temporary office buildings at the Nkaikela Youth Group in Gaborone.   With the support of BOFWA nurses, the Nkaikela Youth Group provides a range of sexual health care to sex workers: “They need health services for STIs, smear tests, HIV tests, and to be enrolling onto antiretroviral treatment for HIV,” Jackie explains.   Female sex workers are in a particularly high-risk group for contracting HIV – the prevalence rate is 61.9% among the community – so having access to testing and treatment is vital. However, Jackie says many women don’t feel safe going to the government clinic. “They don’t accept us. It’s like we’re doing this because we want to, and just bringing disease. We’re not comfortable there and so sex workers are not [being tested and treated] in large numbers. Before BOFWA we were dying in large numbers because we were afraid of those clinics.”     The difference between being treated by the staff at BOFWA is huge, according to Jackie. “We get a good service with BOFWA, they’re helping us to come for tests and they’re treating us good. With BOFWA if you come for HIV testing and were positive they would initiate you on to treatment the same day. Any problem you could discuss with them without fear, like they are your brothers and sisters.”   She’s concerned that if funding continues to be cut, BOFWA nurses will stop coming to the Youth Group completely. “If they stop it will be difficult for us. We will die, we will be infected,” she says.  

Jackie, 34, sex worker and peer outreach worker
story

| 29 March 2024

“We were dying in large numbers because we were afraid of those clinics”

“I’m a sex worker and peer outreach worker for the Nkaikela Youth Group. We reach the other sex workers because we are the ones that know them. We go to their houses, we go to the hotspots like clubs and the street; we reach them and encourage them to come here [to the Youth Group],” says Jackie Selelo, 34, sitting in one of the temporary office buildings at the Nkaikela Youth Group in Gaborone.   With the support of BOFWA nurses, the Nkaikela Youth Group provides a range of sexual health care to sex workers: “They need health services for STIs, smear tests, HIV tests, and to be enrolling onto antiretroviral treatment for HIV,” Jackie explains.   Female sex workers are in a particularly high-risk group for contracting HIV – the prevalence rate is 61.9% among the community – so having access to testing and treatment is vital. However, Jackie says many women don’t feel safe going to the government clinic. “They don’t accept us. It’s like we’re doing this because we want to, and just bringing disease. We’re not comfortable there and so sex workers are not [being tested and treated] in large numbers. Before BOFWA we were dying in large numbers because we were afraid of those clinics.”     The difference between being treated by the staff at BOFWA is huge, according to Jackie. “We get a good service with BOFWA, they’re helping us to come for tests and they’re treating us good. With BOFWA if you come for HIV testing and were positive they would initiate you on to treatment the same day. Any problem you could discuss with them without fear, like they are your brothers and sisters.”   She’s concerned that if funding continues to be cut, BOFWA nurses will stop coming to the Youth Group completely. “If they stop it will be difficult for us. We will die, we will be infected,” she says.  

woman looks in mirror
story

| 18 July 2018

In pictures: Vital HIV care for local communities in Botswana forced to stop

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"I suspect I contracted HIV from my sex work. There were times I had to engage in risky sex, depending on the money on the table." Gabatswane used to go to the BOFWA clinic in Selebi Phikwe for treatment. “I enjoyed the confidentiality that they had there, compared to the government [clinic] where everyone knows everything. It was comfortable talking to the BOFWA providers.” Due to the Global Gag Rule’s funding cuts, the BOFWA clinic has been forced to close. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Goabaone, sex worker & peer outreach worker "I've been a female sex worker for 5 years and a peer outreach worker for the last two. I was looking at the problems that us sex workers encounter, and thought that this peer outreach system might be able to help,” says Goabaone, explaining how she came to work with MCDA. Since the Global Gag Rule funding cuts the scheme has ended, and she now has to refer them to the government clinic. BOFWA was different: “At BOFWA we felt free, there is no stigma. They didn’t ask [how you got the infection], they just treated you every time,” Goabaone says. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Jackie, sex worker & peer outreach worker “I’m a sex worker and peer outreach worker for the Nkaikela Youth Group. We reach the other sex workers because we are the ones that know them. We go to their houses, we go to the hotspots like clubs and the street; we reach them and encourage them to come here [to the Youth Group],” says Jackie, 34. “We get a good service with BOFWA, they’re helping us to come for tests and they’re treating us good. With BOFWA if you come for HIV testing and were positive they would initiate you on to treatment the same day. Any problem you could discuss with them without fear, like they are your brothers and sisters.” Read Jackie's full story here Share on Twitter Share on Facebook Share via WhatsApp Share via Email Joseph, university student Joseph, 19, first came to BOFWA in 2017 when he and his boyfriend decided to start practicing safe sex. “I had put myself in risky situations so thought I should get tested for HIV,” he says. After learning he was HIV positive, Joseph tried out a few clinics to receive his treatment but found BOFWA to be the most confidential and friendly. Sitting in the clinic behind the doctor’s desk, he says, “I never have any problems coming here. I feel comfortable here. At [the government clinic] there is no privacy; most of my friends are there. Sometimes if you go there you find them suspecting something, and everyone will be knowing your status. That’s why I prefer BOFWA.” Read Joseph's full story here Share on Twitter Share on Facebook Share via WhatsApp Share via Email Keanantswe, BOFWA client A few months after beginning her HIV treatment the BOFWA clinic was forced to close due to the Global Gag Rule funding cuts. “In April I received a call from my nurse telling me the clinic is being closed. She gave me tablets for two months up to June 2018. She told me I will get transferred to a government clinic," Keanantswe says. Although getting treatment is now much harder for her, she has to continue going every month or risks getting sick and even dying. “We have lost so much without BOFWA, not only me, but many women. I wish it would open again,” she says. Share on Twitter Share on Facebook Share via WhatsApp Share via Email

woman looks in mirror
story

| 29 March 2024

In pictures: Vital HIV care for local communities in Botswana forced to stop

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"I suspect I contracted HIV from my sex work. There were times I had to engage in risky sex, depending on the money on the table." Gabatswane used to go to the BOFWA clinic in Selebi Phikwe for treatment. “I enjoyed the confidentiality that they had there, compared to the government [clinic] where everyone knows everything. It was comfortable talking to the BOFWA providers.” Due to the Global Gag Rule’s funding cuts, the BOFWA clinic has been forced to close. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Goabaone, sex worker & peer outreach worker "I've been a female sex worker for 5 years and a peer outreach worker for the last two. I was looking at the problems that us sex workers encounter, and thought that this peer outreach system might be able to help,” says Goabaone, explaining how she came to work with MCDA. Since the Global Gag Rule funding cuts the scheme has ended, and she now has to refer them to the government clinic. BOFWA was different: “At BOFWA we felt free, there is no stigma. They didn’t ask [how you got the infection], they just treated you every time,” Goabaone says. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Jackie, sex worker & peer outreach worker “I’m a sex worker and peer outreach worker for the Nkaikela Youth Group. We reach the other sex workers because we are the ones that know them. We go to their houses, we go to the hotspots like clubs and the street; we reach them and encourage them to come here [to the Youth Group],” says Jackie, 34. “We get a good service with BOFWA, they’re helping us to come for tests and they’re treating us good. With BOFWA if you come for HIV testing and were positive they would initiate you on to treatment the same day. Any problem you could discuss with them without fear, like they are your brothers and sisters.” Read Jackie's full story here Share on Twitter Share on Facebook Share via WhatsApp Share via Email Joseph, university student Joseph, 19, first came to BOFWA in 2017 when he and his boyfriend decided to start practicing safe sex. “I had put myself in risky situations so thought I should get tested for HIV,” he says. After learning he was HIV positive, Joseph tried out a few clinics to receive his treatment but found BOFWA to be the most confidential and friendly. Sitting in the clinic behind the doctor’s desk, he says, “I never have any problems coming here. I feel comfortable here. At [the government clinic] there is no privacy; most of my friends are there. Sometimes if you go there you find them suspecting something, and everyone will be knowing your status. That’s why I prefer BOFWA.” Read Joseph's full story here Share on Twitter Share on Facebook Share via WhatsApp Share via Email Keanantswe, BOFWA client A few months after beginning her HIV treatment the BOFWA clinic was forced to close due to the Global Gag Rule funding cuts. “In April I received a call from my nurse telling me the clinic is being closed. She gave me tablets for two months up to June 2018. She told me I will get transferred to a government clinic," Keanantswe says. Although getting treatment is now much harder for her, she has to continue going every month or risks getting sick and even dying. “We have lost so much without BOFWA, not only me, but many women. I wish it would open again,” she says. Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Manny Norman went from a substance abuser to a HIV outreach worker
story

| 12 July 2018

"They gave me hope to come back the next week"

It wasn’t the group meetings, the testing services or the health facilities that attracted Manny Norman, it was the offer of a free subway card and a bite to eat. A friend who was also a substance use told him about the workshops in a basement at a nearby community centre. Manny focused on the subway card which would be worth a few dollars if he sold it on. “I just wanted something to eat,” he says. “I hadn’t eaten in probably 20 hours. And the idea of getting more drugs without stealing sounded good to me.” Thirteen years later and he is still attending the Safety Counts meetings run by Planned Parenthood’s Project Street Beat, and credits them with helping him rebuild a life shattered by drug abuse. At the time, he explains he was neglecting his young family, stealing from them to buy crack cocaine and alcohol. His wife would call the police or lock him out of the home on an almost daily basis. “I was on crack and alcohol, the drugs that led me to dereliction, that led me to stealing, being unmanageable, not responsible, without a care in the world,” he says. “(I) didn’t want to work. I just wanted to feed my drug addiction.” Starting a new life But when he walked into the Safety Counts meetings, he says now, he realised he was among people who understood his life. “They met me where I was at,” he says. “They could tell I was under the influence. They could tell I was hurting, that I wasn’t doing the right thing and they made me feel no less than and no different. They gave me hope to come back the next week.” At first, he just went with the flow, focusing on the food and the subway card, not taking much notice of the services on offer. But eventually, he realised there were other people in the room he had come out the other side and rebuilt their lives. “We talked about harm reduction,” he says. “I could identify with the stories other people were telling. Lying, cheating, stealing, borrowing money knowing you wouldn’t pay it back.” Detox and rehab followed. He used the facilities of the projects mobile medical unit to get himself tested for Hepatitis C and HIV and has managed to stay clean, even training as an HIV outreach worker, and has rebuilt his family life. “It’s a happy home now,” he says. “My daughter got her father back, my wife got her husband back. Most of all I got myself back, thank God.” Without Project Street Beat he says his life would have continued its downward spiral. He would most likely be in prison today. Instead, he works as a supervisor for a cleaning company. And when he bumps into one of his friends from the old days he knows what to do. “When I walk down the street and see someone I know – someone I took drugs with or drank with – I let them know exactly where the mobile might be at,” he said. “I have cards in my pocket I give out to people and let them know this is the new way.” Watch Project Street Beat in action

Manny Norman went from a substance abuser to a HIV outreach worker
story

| 29 March 2024

"They gave me hope to come back the next week"

It wasn’t the group meetings, the testing services or the health facilities that attracted Manny Norman, it was the offer of a free subway card and a bite to eat. A friend who was also a substance use told him about the workshops in a basement at a nearby community centre. Manny focused on the subway card which would be worth a few dollars if he sold it on. “I just wanted something to eat,” he says. “I hadn’t eaten in probably 20 hours. And the idea of getting more drugs without stealing sounded good to me.” Thirteen years later and he is still attending the Safety Counts meetings run by Planned Parenthood’s Project Street Beat, and credits them with helping him rebuild a life shattered by drug abuse. At the time, he explains he was neglecting his young family, stealing from them to buy crack cocaine and alcohol. His wife would call the police or lock him out of the home on an almost daily basis. “I was on crack and alcohol, the drugs that led me to dereliction, that led me to stealing, being unmanageable, not responsible, without a care in the world,” he says. “(I) didn’t want to work. I just wanted to feed my drug addiction.” Starting a new life But when he walked into the Safety Counts meetings, he says now, he realised he was among people who understood his life. “They met me where I was at,” he says. “They could tell I was under the influence. They could tell I was hurting, that I wasn’t doing the right thing and they made me feel no less than and no different. They gave me hope to come back the next week.” At first, he just went with the flow, focusing on the food and the subway card, not taking much notice of the services on offer. But eventually, he realised there were other people in the room he had come out the other side and rebuilt their lives. “We talked about harm reduction,” he says. “I could identify with the stories other people were telling. Lying, cheating, stealing, borrowing money knowing you wouldn’t pay it back.” Detox and rehab followed. He used the facilities of the projects mobile medical unit to get himself tested for Hepatitis C and HIV and has managed to stay clean, even training as an HIV outreach worker, and has rebuilt his family life. “It’s a happy home now,” he says. “My daughter got her father back, my wife got her husband back. Most of all I got myself back, thank God.” Without Project Street Beat he says his life would have continued its downward spiral. He would most likely be in prison today. Instead, he works as a supervisor for a cleaning company. And when he bumps into one of his friends from the old days he knows what to do. “When I walk down the street and see someone I know – someone I took drugs with or drank with – I let them know exactly where the mobile might be at,” he said. “I have cards in my pocket I give out to people and let them know this is the new way.” Watch Project Street Beat in action

Eric Fairchild has worked at Planned Parenthood's Project Street Beat
story

| 11 July 2018

"I was part of the streets...I let them know I understand just how they feel"

A young man stops by a pile of rubbish at the side of the road. He fiddles with an abandoned umbrella, snapping off one of its broken ribs and slipping it into his backpack. Eric Fairchild spots the signs. The HIV prevention specialist greets the man like an old friend. “We got condoms, leaflets, testing right here,” he says standing in front of Planned Parenthood’s mobile medical unit. The man refuses initially, stepping into a nearby grocery store, before returning a few minutes later with his girlfriend to hear about the services on offer. The umbrella rib, says Mr Fairchild later, was a giveaway. It makes a perfect tool for scraping the residue from a substance pipe. Understanding and overcoming Eric has worked for Planned Parenthood for 12 years, using his experience growing up in the Brooklyn neighbourhood of Brownsville to help spot others who are in need of help. “I was part of the streets,” he says. “I was a substance abuser. Never injected, but I smoked, sniffed... stuff of that nature.” He has been clean for 26 years but explains that his experiences help him connect with other users. “The first thing I do when I have hardcore substance abusers sitting in front of me, I first show them identification,” he says.  “I let them know I understand just how they feel. I’ve been there feeling hopeless, helpless, confused about where to turn.” Some occasions might mean he has to use the training and education he has received as an outreach worker. Other times it is a case of using his 60 years’ experience of life in Brooklyn. “That’s my benefit to the programme,” he says. “I’m street savvy as well as educated in the classroom. I have the best of both worlds.” Eric already had an extensive background in community work before joining the project, prompted by a desire to learn more about HIV prevention following the death of a relative and a friend died from the illness. He is often the first point of contact for clients, handing out pamphlets on the street corner, conducting HIV tests and explaining Project Beat Street– and the facilities available on the mobile unit to wary newcomers. From there he can offer advice and guidance on other services, from home care managers to sources of funding for people with HIV and setting up appointments at clinics. He follows up with phone calls and meetings, often at every step of a client’s progress. “I saw when they came in,” he says. “I saw them come in from a struggling situation, uncomfortable with their lifestyle at the time. Going from being an unproductive member of society to taking better care of themselves and being in a healthier situation that they were before. I am always happy to know I was part of that process.” Watch Project Street Beat in action

Eric Fairchild has worked at Planned Parenthood's Project Street Beat
story

| 29 March 2024

"I was part of the streets...I let them know I understand just how they feel"

A young man stops by a pile of rubbish at the side of the road. He fiddles with an abandoned umbrella, snapping off one of its broken ribs and slipping it into his backpack. Eric Fairchild spots the signs. The HIV prevention specialist greets the man like an old friend. “We got condoms, leaflets, testing right here,” he says standing in front of Planned Parenthood’s mobile medical unit. The man refuses initially, stepping into a nearby grocery store, before returning a few minutes later with his girlfriend to hear about the services on offer. The umbrella rib, says Mr Fairchild later, was a giveaway. It makes a perfect tool for scraping the residue from a substance pipe. Understanding and overcoming Eric has worked for Planned Parenthood for 12 years, using his experience growing up in the Brooklyn neighbourhood of Brownsville to help spot others who are in need of help. “I was part of the streets,” he says. “I was a substance abuser. Never injected, but I smoked, sniffed... stuff of that nature.” He has been clean for 26 years but explains that his experiences help him connect with other users. “The first thing I do when I have hardcore substance abusers sitting in front of me, I first show them identification,” he says.  “I let them know I understand just how they feel. I’ve been there feeling hopeless, helpless, confused about where to turn.” Some occasions might mean he has to use the training and education he has received as an outreach worker. Other times it is a case of using his 60 years’ experience of life in Brooklyn. “That’s my benefit to the programme,” he says. “I’m street savvy as well as educated in the classroom. I have the best of both worlds.” Eric already had an extensive background in community work before joining the project, prompted by a desire to learn more about HIV prevention following the death of a relative and a friend died from the illness. He is often the first point of contact for clients, handing out pamphlets on the street corner, conducting HIV tests and explaining Project Beat Street– and the facilities available on the mobile unit to wary newcomers. From there he can offer advice and guidance on other services, from home care managers to sources of funding for people with HIV and setting up appointments at clinics. He follows up with phone calls and meetings, often at every step of a client’s progress. “I saw when they came in,” he says. “I saw them come in from a struggling situation, uncomfortable with their lifestyle at the time. Going from being an unproductive member of society to taking better care of themselves and being in a healthier situation that they were before. I am always happy to know I was part of that process.” Watch Project Street Beat in action

Amal during her outreach work to end FGM in Somaliland
story

| 05 February 2018

"Dignity, respect and bravery are guiding principles for our work on female genital mutilation (FGM)"

I left Somaliland when I was 9 years old with my mother, brother, uncles, aunts and cousins. It was the civil war and we were lucky enough to reach Canada as refugees. I remember that time as a pleasant, warm, loving time where my cousins and I had a lot of freedom to play, walk to school and daydream. I am from Somaliland so of course I am part of the 97-98% or so of girls who undergo the female genital cut. I think it happened when I was around seven years old. I remember being restrained. I remember strangers being around and I remember peeing standing up and it burning. These memories don’t come up often and they don’t cause me pain. It’s a distant, childhood event. A cousin and a niece my age were there and we went through it together and afterwards our mothers and aunts took care of us. I grew up, went to school, questioned the world and my role in it for a time, got married, had kids and eventually went back to Somaliland. There I met Edna Adan Ismail and asked to volunteer with her. She opened her office, hospital and life to me and I became immersed in the maternal health issues of the women in my home country. The effort to end FGM Most were not as lucky as I had been. Because of FGM/C (female genital mutilation/circumcision), most had experienced recurring infections and difficulties in child birth. Some had formed cysts, some became infertile, and some had obstetric fistula. But few linked these problem to the cutting. At SOFHA (Somaliland Family Health Association) we’ve been working to help women (and men) understand these links and get the help they need. That’s only a part of the work. The effort to end FGM/C in Somaliland goes back almost 40 years. FGM/C programs and projects have been happening for at least the last 25 years. We’re now at the point where it’s recognized as a legitimate, critical, health and social issue. We’re on the cusp of a law against the practice and I have personally witnessed a transformation among the individuals who engage in this work. NGO and government staff tasked with working on FGM/C used to go into communities apologetically, “Sorry but we have to talk to you about this ‘issue’, we know it’s unpleasant but bear with us” to “I have 2 daughters and I have not cut them. This is a terrible practice and we must stop it now”. It fills me with great joy to see young women and men taking this personal stance and doing it confidently and proudly. But it’s not easy for most people to do this. It certainly wasn’t for me. This is personal. This is private. Before I got into the work I might have said, “What business is it of yours anyway? Do you really want me digging into your private life? Into your past and history? I am not a victim. I may be a survivor but not in the way you think and not for the reasons you imagine. I am bigger than this. This doesn’t define me.” Dignity, bravery, respect And it may not define most Somali women. I think that’s what confuses many people. Maybe it’s because it happens in childhood and those memories are lost or hidden or maybe because mothers and grandmothers have such good intentions or maybe because it’s so universal within the community? That’s why it’s a completely different experience for a young Somali girl born and brought up somewhere else. The experience is very personal and it varies from person to person. Dignity, respect and bravery are guiding principles for our work on female genital mutilation. In Somaliland, a dynamic young generation connected to the world through the internet, and integrated multi-pronged FGM/C programming, is helping us to influence a generation of Somalis to abandon the cut and break the cycle. It’s still some distance away but we see the end in sight. Words Amal Ahmed, the executive director of our Member Association in Somaliland (SOFHA) 

Amal during her outreach work to end FGM in Somaliland
story

| 29 March 2024

"Dignity, respect and bravery are guiding principles for our work on female genital mutilation (FGM)"

I left Somaliland when I was 9 years old with my mother, brother, uncles, aunts and cousins. It was the civil war and we were lucky enough to reach Canada as refugees. I remember that time as a pleasant, warm, loving time where my cousins and I had a lot of freedom to play, walk to school and daydream. I am from Somaliland so of course I am part of the 97-98% or so of girls who undergo the female genital cut. I think it happened when I was around seven years old. I remember being restrained. I remember strangers being around and I remember peeing standing up and it burning. These memories don’t come up often and they don’t cause me pain. It’s a distant, childhood event. A cousin and a niece my age were there and we went through it together and afterwards our mothers and aunts took care of us. I grew up, went to school, questioned the world and my role in it for a time, got married, had kids and eventually went back to Somaliland. There I met Edna Adan Ismail and asked to volunteer with her. She opened her office, hospital and life to me and I became immersed in the maternal health issues of the women in my home country. The effort to end FGM Most were not as lucky as I had been. Because of FGM/C (female genital mutilation/circumcision), most had experienced recurring infections and difficulties in child birth. Some had formed cysts, some became infertile, and some had obstetric fistula. But few linked these problem to the cutting. At SOFHA (Somaliland Family Health Association) we’ve been working to help women (and men) understand these links and get the help they need. That’s only a part of the work. The effort to end FGM/C in Somaliland goes back almost 40 years. FGM/C programs and projects have been happening for at least the last 25 years. We’re now at the point where it’s recognized as a legitimate, critical, health and social issue. We’re on the cusp of a law against the practice and I have personally witnessed a transformation among the individuals who engage in this work. NGO and government staff tasked with working on FGM/C used to go into communities apologetically, “Sorry but we have to talk to you about this ‘issue’, we know it’s unpleasant but bear with us” to “I have 2 daughters and I have not cut them. This is a terrible practice and we must stop it now”. It fills me with great joy to see young women and men taking this personal stance and doing it confidently and proudly. But it’s not easy for most people to do this. It certainly wasn’t for me. This is personal. This is private. Before I got into the work I might have said, “What business is it of yours anyway? Do you really want me digging into your private life? Into your past and history? I am not a victim. I may be a survivor but not in the way you think and not for the reasons you imagine. I am bigger than this. This doesn’t define me.” Dignity, bravery, respect And it may not define most Somali women. I think that’s what confuses many people. Maybe it’s because it happens in childhood and those memories are lost or hidden or maybe because mothers and grandmothers have such good intentions or maybe because it’s so universal within the community? That’s why it’s a completely different experience for a young Somali girl born and brought up somewhere else. The experience is very personal and it varies from person to person. Dignity, respect and bravery are guiding principles for our work on female genital mutilation. In Somaliland, a dynamic young generation connected to the world through the internet, and integrated multi-pronged FGM/C programming, is helping us to influence a generation of Somalis to abandon the cut and break the cycle. It’s still some distance away but we see the end in sight. Words Amal Ahmed, the executive director of our Member Association in Somaliland (SOFHA) 

Woman - not the person of the story Credits: IPPF/Trenchard/2017
story

| 22 January 2018

“I am a HIV positive sex worker and a peer educator.”

Amina is a peer educator trained by Family Planning Association of Malawi’s (FPAM) Linkages project. “I am a HIV positive sex worker and a peer educator,” she says. “I have 51 other sex workers in my care, I inform them on testing and treatment, also about STI treatment and condom use. I teach about the disadvantages of sharing ART (anti-retroviral therapy) and encourage them to go for tuberculosis testing if they are coughing.” Another educator called Cecilia adds: “I reached out to 60 female sex workers. We are all friends and they trust me. I refer them to services and we address abuse by the police. They rape us and steal our money but through the project, we can follow up since the project has access to the managers of the police.” Basic sexual health information Her colleague Florence says: “It also helped that the rogue and vagabond law was repealed.” The law was a permanent curfew, giving the police the power to round up, fine or jail anybody who was on the streets after eight o’clock at night. Lucy, also a peer educator, says part of the work is giving basic information. “I teach my friends on HIV and GBV (gender-based violence),” she explains. “And I teach how to use condoms and lubricants and how to persuade clients to use condoms. I also talk about family planning. Many female sex workers do not know they need it.” “The project helped me with condoms and I shared that with others,” says another client of the programme, Angela. “Through the project, I got tested for HIV and treated for STIs. I also encourage pregnant sex workers to go for pre-natal care so that they do not infect their babies. It is the first time that an organisation like FPAM worked with us. We got respected within the community because we are knowledgeable.” In the year the Linkages project ran, 627 female sex workers were supported in getting tested for HIV, the initiation of anti-retroviral treatment and therapy adherence. 2,700 women were referred to services and many more received information. The HIV prevalence rate among female sex workers went down from 77% to 62%. Global Gag Rule effects FPAM’s Linkages project was phased out in 2016 due to the Global Gag Rule. The effects are keenly felt amongst those who benefitted from the project: Amina says: “Many stopped taking medication. Healthcare facilities are not for us. I sing in a church choir, which is important to me. If they find out what I do, they will throw me out.” “My family thinks I work at a filling station at night,” says Lucy. Cecilia adds: “This project has to come back, please bring it back. If not, we will all die early.”

Woman - not the person of the story Credits: IPPF/Trenchard/2017
story

| 29 March 2024

“I am a HIV positive sex worker and a peer educator.”

Amina is a peer educator trained by Family Planning Association of Malawi’s (FPAM) Linkages project. “I am a HIV positive sex worker and a peer educator,” she says. “I have 51 other sex workers in my care, I inform them on testing and treatment, also about STI treatment and condom use. I teach about the disadvantages of sharing ART (anti-retroviral therapy) and encourage them to go for tuberculosis testing if they are coughing.” Another educator called Cecilia adds: “I reached out to 60 female sex workers. We are all friends and they trust me. I refer them to services and we address abuse by the police. They rape us and steal our money but through the project, we can follow up since the project has access to the managers of the police.” Basic sexual health information Her colleague Florence says: “It also helped that the rogue and vagabond law was repealed.” The law was a permanent curfew, giving the police the power to round up, fine or jail anybody who was on the streets after eight o’clock at night. Lucy, also a peer educator, says part of the work is giving basic information. “I teach my friends on HIV and GBV (gender-based violence),” she explains. “And I teach how to use condoms and lubricants and how to persuade clients to use condoms. I also talk about family planning. Many female sex workers do not know they need it.” “The project helped me with condoms and I shared that with others,” says another client of the programme, Angela. “Through the project, I got tested for HIV and treated for STIs. I also encourage pregnant sex workers to go for pre-natal care so that they do not infect their babies. It is the first time that an organisation like FPAM worked with us. We got respected within the community because we are knowledgeable.” In the year the Linkages project ran, 627 female sex workers were supported in getting tested for HIV, the initiation of anti-retroviral treatment and therapy adherence. 2,700 women were referred to services and many more received information. The HIV prevalence rate among female sex workers went down from 77% to 62%. Global Gag Rule effects FPAM’s Linkages project was phased out in 2016 due to the Global Gag Rule. The effects are keenly felt amongst those who benefitted from the project: Amina says: “Many stopped taking medication. Healthcare facilities are not for us. I sing in a church choir, which is important to me. If they find out what I do, they will throw me out.” “My family thinks I work at a filling station at night,” says Lucy. Cecilia adds: “This project has to come back, please bring it back. If not, we will all die early.”

Jackie, 34, sex worker and peer outreach worker
story

| 24 July 2018

“We were dying in large numbers because we were afraid of those clinics”

“I’m a sex worker and peer outreach worker for the Nkaikela Youth Group. We reach the other sex workers because we are the ones that know them. We go to their houses, we go to the hotspots like clubs and the street; we reach them and encourage them to come here [to the Youth Group],” says Jackie Selelo, 34, sitting in one of the temporary office buildings at the Nkaikela Youth Group in Gaborone.   With the support of BOFWA nurses, the Nkaikela Youth Group provides a range of sexual health care to sex workers: “They need health services for STIs, smear tests, HIV tests, and to be enrolling onto antiretroviral treatment for HIV,” Jackie explains.   Female sex workers are in a particularly high-risk group for contracting HIV – the prevalence rate is 61.9% among the community – so having access to testing and treatment is vital. However, Jackie says many women don’t feel safe going to the government clinic. “They don’t accept us. It’s like we’re doing this because we want to, and just bringing disease. We’re not comfortable there and so sex workers are not [being tested and treated] in large numbers. Before BOFWA we were dying in large numbers because we were afraid of those clinics.”     The difference between being treated by the staff at BOFWA is huge, according to Jackie. “We get a good service with BOFWA, they’re helping us to come for tests and they’re treating us good. With BOFWA if you come for HIV testing and were positive they would initiate you on to treatment the same day. Any problem you could discuss with them without fear, like they are your brothers and sisters.”   She’s concerned that if funding continues to be cut, BOFWA nurses will stop coming to the Youth Group completely. “If they stop it will be difficult for us. We will die, we will be infected,” she says.  

Jackie, 34, sex worker and peer outreach worker
story

| 29 March 2024

“We were dying in large numbers because we were afraid of those clinics”

“I’m a sex worker and peer outreach worker for the Nkaikela Youth Group. We reach the other sex workers because we are the ones that know them. We go to their houses, we go to the hotspots like clubs and the street; we reach them and encourage them to come here [to the Youth Group],” says Jackie Selelo, 34, sitting in one of the temporary office buildings at the Nkaikela Youth Group in Gaborone.   With the support of BOFWA nurses, the Nkaikela Youth Group provides a range of sexual health care to sex workers: “They need health services for STIs, smear tests, HIV tests, and to be enrolling onto antiretroviral treatment for HIV,” Jackie explains.   Female sex workers are in a particularly high-risk group for contracting HIV – the prevalence rate is 61.9% among the community – so having access to testing and treatment is vital. However, Jackie says many women don’t feel safe going to the government clinic. “They don’t accept us. It’s like we’re doing this because we want to, and just bringing disease. We’re not comfortable there and so sex workers are not [being tested and treated] in large numbers. Before BOFWA we were dying in large numbers because we were afraid of those clinics.”     The difference between being treated by the staff at BOFWA is huge, according to Jackie. “We get a good service with BOFWA, they’re helping us to come for tests and they’re treating us good. With BOFWA if you come for HIV testing and were positive they would initiate you on to treatment the same day. Any problem you could discuss with them without fear, like they are your brothers and sisters.”   She’s concerned that if funding continues to be cut, BOFWA nurses will stop coming to the Youth Group completely. “If they stop it will be difficult for us. We will die, we will be infected,” she says.  

woman looks in mirror
story

| 18 July 2018

In pictures: Vital HIV care for local communities in Botswana forced to stop

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"I suspect I contracted HIV from my sex work. There were times I had to engage in risky sex, depending on the money on the table." Gabatswane used to go to the BOFWA clinic in Selebi Phikwe for treatment. “I enjoyed the confidentiality that they had there, compared to the government [clinic] where everyone knows everything. It was comfortable talking to the BOFWA providers.” Due to the Global Gag Rule’s funding cuts, the BOFWA clinic has been forced to close. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Goabaone, sex worker & peer outreach worker "I've been a female sex worker for 5 years and a peer outreach worker for the last two. I was looking at the problems that us sex workers encounter, and thought that this peer outreach system might be able to help,” says Goabaone, explaining how she came to work with MCDA. Since the Global Gag Rule funding cuts the scheme has ended, and she now has to refer them to the government clinic. BOFWA was different: “At BOFWA we felt free, there is no stigma. They didn’t ask [how you got the infection], they just treated you every time,” Goabaone says. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Jackie, sex worker & peer outreach worker “I’m a sex worker and peer outreach worker for the Nkaikela Youth Group. We reach the other sex workers because we are the ones that know them. We go to their houses, we go to the hotspots like clubs and the street; we reach them and encourage them to come here [to the Youth Group],” says Jackie, 34. “We get a good service with BOFWA, they’re helping us to come for tests and they’re treating us good. With BOFWA if you come for HIV testing and were positive they would initiate you on to treatment the same day. Any problem you could discuss with them without fear, like they are your brothers and sisters.” Read Jackie's full story here Share on Twitter Share on Facebook Share via WhatsApp Share via Email Joseph, university student Joseph, 19, first came to BOFWA in 2017 when he and his boyfriend decided to start practicing safe sex. “I had put myself in risky situations so thought I should get tested for HIV,” he says. After learning he was HIV positive, Joseph tried out a few clinics to receive his treatment but found BOFWA to be the most confidential and friendly. Sitting in the clinic behind the doctor’s desk, he says, “I never have any problems coming here. I feel comfortable here. At [the government clinic] there is no privacy; most of my friends are there. Sometimes if you go there you find them suspecting something, and everyone will be knowing your status. That’s why I prefer BOFWA.” Read Joseph's full story here Share on Twitter Share on Facebook Share via WhatsApp Share via Email Keanantswe, BOFWA client A few months after beginning her HIV treatment the BOFWA clinic was forced to close due to the Global Gag Rule funding cuts. “In April I received a call from my nurse telling me the clinic is being closed. She gave me tablets for two months up to June 2018. She told me I will get transferred to a government clinic," Keanantswe says. Although getting treatment is now much harder for her, she has to continue going every month or risks getting sick and even dying. “We have lost so much without BOFWA, not only me, but many women. I wish it would open again,” she says. Share on Twitter Share on Facebook Share via WhatsApp Share via Email

woman looks in mirror
story

| 29 March 2024

In pictures: Vital HIV care for local communities in Botswana forced to stop

.image-section { display: grid; grid-template-columns: 25% 75%; grid-gap: 60px; overflow: hidden; font-size: 0.9em; line-height: 1.4em; font-weight: 400; margin-bottom:70px; } .img-caption { border-bottom: 5px #00a4e4 solid; margin-bottom: 5px; padding-bottom:30px; } .img-caption p { margin-bottom:30px; } ul.img-section-social{ list-style: none; padding: 0; margin: 0; } .img-section-social li{ padding: 0; margin: 0; float:left; } .img-section-social .twitter a,.img-section-social .facebook a, .img-section-social .google a, .img-section-social .email a, .img-section-social .whatsapp a { height: 40px; width: 40px; text-indent: -1000px; display: block; overflow: hidden; float: left; margin-right: 15px; } .img-section-social .twitter a{ background: url(/themes/ippf/images/social-icons/twitter-whiteonblue.svg) no-repeat; } .img-section-social .facebook a{ background: url(/themes/ippf/images/social-icons/facebook-whiteonblue.svg) no-repeat; } .img-section-social .google a{ background: url(/themes/ippf/images/social-icons/google-whiteonblue.svg) no-repeat; } .img-section-social .email a{ background: url(/themes/ippf/images/social-icons/email-whiteonblue.svg) no-repeat; } .img-section-social .whatsapp a{ background: url(/themes/ippf/images/social-icons/whatsapp-whiteonblue.svg) no-repeat; } .img-section-social .twitter a:hover { background: url(/themes/ippf/images/social-icons/twitter-whiteondrkblue.svg) no-repeat; } .img-section-social .facebook a:hover { background: url(/themes/ippf/images/social-icons/facebook-whiteondrkblue.svg) no-repeat; } .img-section-social .google a:hover { background: url(/themes/ippf/images/social-icons/google-whiteondrkblue.svg) no-repeat; } .img-section-social .email a:hover { background: url(/themes/ippf/images/social-icons/email-whiteondrkblue.svg) no-repeat; } .img-section-social .whatsapp a:hover { background: url(/themes/ippf/images/social-icons/whatsapp-whiteondrkblue.svg) no-repeat; } .img-section-social .email { display:none; } @media all and (max-width: 480px) { .image-section{ grid-template-columns: 100%; grid-gap: 60px; } } Gabatswane, BOFWA client In 2012, Gabatswane learned she was HIV positive. "I suspect I contracted HIV from my sex work. There were times I had to engage in risky sex, depending on the money on the table." Gabatswane used to go to the BOFWA clinic in Selebi Phikwe for treatment. “I enjoyed the confidentiality that they had there, compared to the government [clinic] where everyone knows everything. It was comfortable talking to the BOFWA providers.” Due to the Global Gag Rule’s funding cuts, the BOFWA clinic has been forced to close. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Goabaone, sex worker & peer outreach worker "I've been a female sex worker for 5 years and a peer outreach worker for the last two. I was looking at the problems that us sex workers encounter, and thought that this peer outreach system might be able to help,” says Goabaone, explaining how she came to work with MCDA. Since the Global Gag Rule funding cuts the scheme has ended, and she now has to refer them to the government clinic. BOFWA was different: “At BOFWA we felt free, there is no stigma. They didn’t ask [how you got the infection], they just treated you every time,” Goabaone says. Share on Twitter Share on Facebook Share via WhatsApp Share via Email Jackie, sex worker & peer outreach worker “I’m a sex worker and peer outreach worker for the Nkaikela Youth Group. We reach the other sex workers because we are the ones that know them. We go to their houses, we go to the hotspots like clubs and the street; we reach them and encourage them to come here [to the Youth Group],” says Jackie, 34. “We get a good service with BOFWA, they’re helping us to come for tests and they’re treating us good. With BOFWA if you come for HIV testing and were positive they would initiate you on to treatment the same day. Any problem you could discuss with them without fear, like they are your brothers and sisters.” Read Jackie's full story here Share on Twitter Share on Facebook Share via WhatsApp Share via Email Joseph, university student Joseph, 19, first came to BOFWA in 2017 when he and his boyfriend decided to start practicing safe sex. “I had put myself in risky situations so thought I should get tested for HIV,” he says. After learning he was HIV positive, Joseph tried out a few clinics to receive his treatment but found BOFWA to be the most confidential and friendly. Sitting in the clinic behind the doctor’s desk, he says, “I never have any problems coming here. I feel comfortable here. At [the government clinic] there is no privacy; most of my friends are there. Sometimes if you go there you find them suspecting something, and everyone will be knowing your status. That’s why I prefer BOFWA.” Read Joseph's full story here Share on Twitter Share on Facebook Share via WhatsApp Share via Email Keanantswe, BOFWA client A few months after beginning her HIV treatment the BOFWA clinic was forced to close due to the Global Gag Rule funding cuts. “In April I received a call from my nurse telling me the clinic is being closed. She gave me tablets for two months up to June 2018. She told me I will get transferred to a government clinic," Keanantswe says. Although getting treatment is now much harder for her, she has to continue going every month or risks getting sick and even dying. “We have lost so much without BOFWA, not only me, but many women. I wish it would open again,” she says. Share on Twitter Share on Facebook Share via WhatsApp Share via Email

Manny Norman went from a substance abuser to a HIV outreach worker
story

| 12 July 2018

"They gave me hope to come back the next week"

It wasn’t the group meetings, the testing services or the health facilities that attracted Manny Norman, it was the offer of a free subway card and a bite to eat. A friend who was also a substance use told him about the workshops in a basement at a nearby community centre. Manny focused on the subway card which would be worth a few dollars if he sold it on. “I just wanted something to eat,” he says. “I hadn’t eaten in probably 20 hours. And the idea of getting more drugs without stealing sounded good to me.” Thirteen years later and he is still attending the Safety Counts meetings run by Planned Parenthood’s Project Street Beat, and credits them with helping him rebuild a life shattered by drug abuse. At the time, he explains he was neglecting his young family, stealing from them to buy crack cocaine and alcohol. His wife would call the police or lock him out of the home on an almost daily basis. “I was on crack and alcohol, the drugs that led me to dereliction, that led me to stealing, being unmanageable, not responsible, without a care in the world,” he says. “(I) didn’t want to work. I just wanted to feed my drug addiction.” Starting a new life But when he walked into the Safety Counts meetings, he says now, he realised he was among people who understood his life. “They met me where I was at,” he says. “They could tell I was under the influence. They could tell I was hurting, that I wasn’t doing the right thing and they made me feel no less than and no different. They gave me hope to come back the next week.” At first, he just went with the flow, focusing on the food and the subway card, not taking much notice of the services on offer. But eventually, he realised there were other people in the room he had come out the other side and rebuilt their lives. “We talked about harm reduction,” he says. “I could identify with the stories other people were telling. Lying, cheating, stealing, borrowing money knowing you wouldn’t pay it back.” Detox and rehab followed. He used the facilities of the projects mobile medical unit to get himself tested for Hepatitis C and HIV and has managed to stay clean, even training as an HIV outreach worker, and has rebuilt his family life. “It’s a happy home now,” he says. “My daughter got her father back, my wife got her husband back. Most of all I got myself back, thank God.” Without Project Street Beat he says his life would have continued its downward spiral. He would most likely be in prison today. Instead, he works as a supervisor for a cleaning company. And when he bumps into one of his friends from the old days he knows what to do. “When I walk down the street and see someone I know – someone I took drugs with or drank with – I let them know exactly where the mobile might be at,” he said. “I have cards in my pocket I give out to people and let them know this is the new way.” Watch Project Street Beat in action

Manny Norman went from a substance abuser to a HIV outreach worker
story

| 29 March 2024

"They gave me hope to come back the next week"

It wasn’t the group meetings, the testing services or the health facilities that attracted Manny Norman, it was the offer of a free subway card and a bite to eat. A friend who was also a substance use told him about the workshops in a basement at a nearby community centre. Manny focused on the subway card which would be worth a few dollars if he sold it on. “I just wanted something to eat,” he says. “I hadn’t eaten in probably 20 hours. And the idea of getting more drugs without stealing sounded good to me.” Thirteen years later and he is still attending the Safety Counts meetings run by Planned Parenthood’s Project Street Beat, and credits them with helping him rebuild a life shattered by drug abuse. At the time, he explains he was neglecting his young family, stealing from them to buy crack cocaine and alcohol. His wife would call the police or lock him out of the home on an almost daily basis. “I was on crack and alcohol, the drugs that led me to dereliction, that led me to stealing, being unmanageable, not responsible, without a care in the world,” he says. “(I) didn’t want to work. I just wanted to feed my drug addiction.” Starting a new life But when he walked into the Safety Counts meetings, he says now, he realised he was among people who understood his life. “They met me where I was at,” he says. “They could tell I was under the influence. They could tell I was hurting, that I wasn’t doing the right thing and they made me feel no less than and no different. They gave me hope to come back the next week.” At first, he just went with the flow, focusing on the food and the subway card, not taking much notice of the services on offer. But eventually, he realised there were other people in the room he had come out the other side and rebuilt their lives. “We talked about harm reduction,” he says. “I could identify with the stories other people were telling. Lying, cheating, stealing, borrowing money knowing you wouldn’t pay it back.” Detox and rehab followed. He used the facilities of the projects mobile medical unit to get himself tested for Hepatitis C and HIV and has managed to stay clean, even training as an HIV outreach worker, and has rebuilt his family life. “It’s a happy home now,” he says. “My daughter got her father back, my wife got her husband back. Most of all I got myself back, thank God.” Without Project Street Beat he says his life would have continued its downward spiral. He would most likely be in prison today. Instead, he works as a supervisor for a cleaning company. And when he bumps into one of his friends from the old days he knows what to do. “When I walk down the street and see someone I know – someone I took drugs with or drank with – I let them know exactly where the mobile might be at,” he said. “I have cards in my pocket I give out to people and let them know this is the new way.” Watch Project Street Beat in action

Eric Fairchild has worked at Planned Parenthood's Project Street Beat
story

| 11 July 2018

"I was part of the streets...I let them know I understand just how they feel"

A young man stops by a pile of rubbish at the side of the road. He fiddles with an abandoned umbrella, snapping off one of its broken ribs and slipping it into his backpack. Eric Fairchild spots the signs. The HIV prevention specialist greets the man like an old friend. “We got condoms, leaflets, testing right here,” he says standing in front of Planned Parenthood’s mobile medical unit. The man refuses initially, stepping into a nearby grocery store, before returning a few minutes later with his girlfriend to hear about the services on offer. The umbrella rib, says Mr Fairchild later, was a giveaway. It makes a perfect tool for scraping the residue from a substance pipe. Understanding and overcoming Eric has worked for Planned Parenthood for 12 years, using his experience growing up in the Brooklyn neighbourhood of Brownsville to help spot others who are in need of help. “I was part of the streets,” he says. “I was a substance abuser. Never injected, but I smoked, sniffed... stuff of that nature.” He has been clean for 26 years but explains that his experiences help him connect with other users. “The first thing I do when I have hardcore substance abusers sitting in front of me, I first show them identification,” he says.  “I let them know I understand just how they feel. I’ve been there feeling hopeless, helpless, confused about where to turn.” Some occasions might mean he has to use the training and education he has received as an outreach worker. Other times it is a case of using his 60 years’ experience of life in Brooklyn. “That’s my benefit to the programme,” he says. “I’m street savvy as well as educated in the classroom. I have the best of both worlds.” Eric already had an extensive background in community work before joining the project, prompted by a desire to learn more about HIV prevention following the death of a relative and a friend died from the illness. He is often the first point of contact for clients, handing out pamphlets on the street corner, conducting HIV tests and explaining Project Beat Street– and the facilities available on the mobile unit to wary newcomers. From there he can offer advice and guidance on other services, from home care managers to sources of funding for people with HIV and setting up appointments at clinics. He follows up with phone calls and meetings, often at every step of a client’s progress. “I saw when they came in,” he says. “I saw them come in from a struggling situation, uncomfortable with their lifestyle at the time. Going from being an unproductive member of society to taking better care of themselves and being in a healthier situation that they were before. I am always happy to know I was part of that process.” Watch Project Street Beat in action

Eric Fairchild has worked at Planned Parenthood's Project Street Beat
story

| 29 March 2024

"I was part of the streets...I let them know I understand just how they feel"

A young man stops by a pile of rubbish at the side of the road. He fiddles with an abandoned umbrella, snapping off one of its broken ribs and slipping it into his backpack. Eric Fairchild spots the signs. The HIV prevention specialist greets the man like an old friend. “We got condoms, leaflets, testing right here,” he says standing in front of Planned Parenthood’s mobile medical unit. The man refuses initially, stepping into a nearby grocery store, before returning a few minutes later with his girlfriend to hear about the services on offer. The umbrella rib, says Mr Fairchild later, was a giveaway. It makes a perfect tool for scraping the residue from a substance pipe. Understanding and overcoming Eric has worked for Planned Parenthood for 12 years, using his experience growing up in the Brooklyn neighbourhood of Brownsville to help spot others who are in need of help. “I was part of the streets,” he says. “I was a substance abuser. Never injected, but I smoked, sniffed... stuff of that nature.” He has been clean for 26 years but explains that his experiences help him connect with other users. “The first thing I do when I have hardcore substance abusers sitting in front of me, I first show them identification,” he says.  “I let them know I understand just how they feel. I’ve been there feeling hopeless, helpless, confused about where to turn.” Some occasions might mean he has to use the training and education he has received as an outreach worker. Other times it is a case of using his 60 years’ experience of life in Brooklyn. “That’s my benefit to the programme,” he says. “I’m street savvy as well as educated in the classroom. I have the best of both worlds.” Eric already had an extensive background in community work before joining the project, prompted by a desire to learn more about HIV prevention following the death of a relative and a friend died from the illness. He is often the first point of contact for clients, handing out pamphlets on the street corner, conducting HIV tests and explaining Project Beat Street– and the facilities available on the mobile unit to wary newcomers. From there he can offer advice and guidance on other services, from home care managers to sources of funding for people with HIV and setting up appointments at clinics. He follows up with phone calls and meetings, often at every step of a client’s progress. “I saw when they came in,” he says. “I saw them come in from a struggling situation, uncomfortable with their lifestyle at the time. Going from being an unproductive member of society to taking better care of themselves and being in a healthier situation that they were before. I am always happy to know I was part of that process.” Watch Project Street Beat in action

Amal during her outreach work to end FGM in Somaliland
story

| 05 February 2018

"Dignity, respect and bravery are guiding principles for our work on female genital mutilation (FGM)"

I left Somaliland when I was 9 years old with my mother, brother, uncles, aunts and cousins. It was the civil war and we were lucky enough to reach Canada as refugees. I remember that time as a pleasant, warm, loving time where my cousins and I had a lot of freedom to play, walk to school and daydream. I am from Somaliland so of course I am part of the 97-98% or so of girls who undergo the female genital cut. I think it happened when I was around seven years old. I remember being restrained. I remember strangers being around and I remember peeing standing up and it burning. These memories don’t come up often and they don’t cause me pain. It’s a distant, childhood event. A cousin and a niece my age were there and we went through it together and afterwards our mothers and aunts took care of us. I grew up, went to school, questioned the world and my role in it for a time, got married, had kids and eventually went back to Somaliland. There I met Edna Adan Ismail and asked to volunteer with her. She opened her office, hospital and life to me and I became immersed in the maternal health issues of the women in my home country. The effort to end FGM Most were not as lucky as I had been. Because of FGM/C (female genital mutilation/circumcision), most had experienced recurring infections and difficulties in child birth. Some had formed cysts, some became infertile, and some had obstetric fistula. But few linked these problem to the cutting. At SOFHA (Somaliland Family Health Association) we’ve been working to help women (and men) understand these links and get the help they need. That’s only a part of the work. The effort to end FGM/C in Somaliland goes back almost 40 years. FGM/C programs and projects have been happening for at least the last 25 years. We’re now at the point where it’s recognized as a legitimate, critical, health and social issue. We’re on the cusp of a law against the practice and I have personally witnessed a transformation among the individuals who engage in this work. NGO and government staff tasked with working on FGM/C used to go into communities apologetically, “Sorry but we have to talk to you about this ‘issue’, we know it’s unpleasant but bear with us” to “I have 2 daughters and I have not cut them. This is a terrible practice and we must stop it now”. It fills me with great joy to see young women and men taking this personal stance and doing it confidently and proudly. But it’s not easy for most people to do this. It certainly wasn’t for me. This is personal. This is private. Before I got into the work I might have said, “What business is it of yours anyway? Do you really want me digging into your private life? Into your past and history? I am not a victim. I may be a survivor but not in the way you think and not for the reasons you imagine. I am bigger than this. This doesn’t define me.” Dignity, bravery, respect And it may not define most Somali women. I think that’s what confuses many people. Maybe it’s because it happens in childhood and those memories are lost or hidden or maybe because mothers and grandmothers have such good intentions or maybe because it’s so universal within the community? That’s why it’s a completely different experience for a young Somali girl born and brought up somewhere else. The experience is very personal and it varies from person to person. Dignity, respect and bravery are guiding principles for our work on female genital mutilation. In Somaliland, a dynamic young generation connected to the world through the internet, and integrated multi-pronged FGM/C programming, is helping us to influence a generation of Somalis to abandon the cut and break the cycle. It’s still some distance away but we see the end in sight. Words Amal Ahmed, the executive director of our Member Association in Somaliland (SOFHA) 

Amal during her outreach work to end FGM in Somaliland
story

| 29 March 2024

"Dignity, respect and bravery are guiding principles for our work on female genital mutilation (FGM)"

I left Somaliland when I was 9 years old with my mother, brother, uncles, aunts and cousins. It was the civil war and we were lucky enough to reach Canada as refugees. I remember that time as a pleasant, warm, loving time where my cousins and I had a lot of freedom to play, walk to school and daydream. I am from Somaliland so of course I am part of the 97-98% or so of girls who undergo the female genital cut. I think it happened when I was around seven years old. I remember being restrained. I remember strangers being around and I remember peeing standing up and it burning. These memories don’t come up often and they don’t cause me pain. It’s a distant, childhood event. A cousin and a niece my age were there and we went through it together and afterwards our mothers and aunts took care of us. I grew up, went to school, questioned the world and my role in it for a time, got married, had kids and eventually went back to Somaliland. There I met Edna Adan Ismail and asked to volunteer with her. She opened her office, hospital and life to me and I became immersed in the maternal health issues of the women in my home country. The effort to end FGM Most were not as lucky as I had been. Because of FGM/C (female genital mutilation/circumcision), most had experienced recurring infections and difficulties in child birth. Some had formed cysts, some became infertile, and some had obstetric fistula. But few linked these problem to the cutting. At SOFHA (Somaliland Family Health Association) we’ve been working to help women (and men) understand these links and get the help they need. That’s only a part of the work. The effort to end FGM/C in Somaliland goes back almost 40 years. FGM/C programs and projects have been happening for at least the last 25 years. We’re now at the point where it’s recognized as a legitimate, critical, health and social issue. We’re on the cusp of a law against the practice and I have personally witnessed a transformation among the individuals who engage in this work. NGO and government staff tasked with working on FGM/C used to go into communities apologetically, “Sorry but we have to talk to you about this ‘issue’, we know it’s unpleasant but bear with us” to “I have 2 daughters and I have not cut them. This is a terrible practice and we must stop it now”. It fills me with great joy to see young women and men taking this personal stance and doing it confidently and proudly. But it’s not easy for most people to do this. It certainly wasn’t for me. This is personal. This is private. Before I got into the work I might have said, “What business is it of yours anyway? Do you really want me digging into your private life? Into your past and history? I am not a victim. I may be a survivor but not in the way you think and not for the reasons you imagine. I am bigger than this. This doesn’t define me.” Dignity, bravery, respect And it may not define most Somali women. I think that’s what confuses many people. Maybe it’s because it happens in childhood and those memories are lost or hidden or maybe because mothers and grandmothers have such good intentions or maybe because it’s so universal within the community? That’s why it’s a completely different experience for a young Somali girl born and brought up somewhere else. The experience is very personal and it varies from person to person. Dignity, respect and bravery are guiding principles for our work on female genital mutilation. In Somaliland, a dynamic young generation connected to the world through the internet, and integrated multi-pronged FGM/C programming, is helping us to influence a generation of Somalis to abandon the cut and break the cycle. It’s still some distance away but we see the end in sight. Words Amal Ahmed, the executive director of our Member Association in Somaliland (SOFHA) 

Woman - not the person of the story Credits: IPPF/Trenchard/2017
story

| 22 January 2018

“I am a HIV positive sex worker and a peer educator.”

Amina is a peer educator trained by Family Planning Association of Malawi’s (FPAM) Linkages project. “I am a HIV positive sex worker and a peer educator,” she says. “I have 51 other sex workers in my care, I inform them on testing and treatment, also about STI treatment and condom use. I teach about the disadvantages of sharing ART (anti-retroviral therapy) and encourage them to go for tuberculosis testing if they are coughing.” Another educator called Cecilia adds: “I reached out to 60 female sex workers. We are all friends and they trust me. I refer them to services and we address abuse by the police. They rape us and steal our money but through the project, we can follow up since the project has access to the managers of the police.” Basic sexual health information Her colleague Florence says: “It also helped that the rogue and vagabond law was repealed.” The law was a permanent curfew, giving the police the power to round up, fine or jail anybody who was on the streets after eight o’clock at night. Lucy, also a peer educator, says part of the work is giving basic information. “I teach my friends on HIV and GBV (gender-based violence),” she explains. “And I teach how to use condoms and lubricants and how to persuade clients to use condoms. I also talk about family planning. Many female sex workers do not know they need it.” “The project helped me with condoms and I shared that with others,” says another client of the programme, Angela. “Through the project, I got tested for HIV and treated for STIs. I also encourage pregnant sex workers to go for pre-natal care so that they do not infect their babies. It is the first time that an organisation like FPAM worked with us. We got respected within the community because we are knowledgeable.” In the year the Linkages project ran, 627 female sex workers were supported in getting tested for HIV, the initiation of anti-retroviral treatment and therapy adherence. 2,700 women were referred to services and many more received information. The HIV prevalence rate among female sex workers went down from 77% to 62%. Global Gag Rule effects FPAM’s Linkages project was phased out in 2016 due to the Global Gag Rule. The effects are keenly felt amongst those who benefitted from the project: Amina says: “Many stopped taking medication. Healthcare facilities are not for us. I sing in a church choir, which is important to me. If they find out what I do, they will throw me out.” “My family thinks I work at a filling station at night,” says Lucy. Cecilia adds: “This project has to come back, please bring it back. If not, we will all die early.”

Woman - not the person of the story Credits: IPPF/Trenchard/2017
story

| 29 March 2024

“I am a HIV positive sex worker and a peer educator.”

Amina is a peer educator trained by Family Planning Association of Malawi’s (FPAM) Linkages project. “I am a HIV positive sex worker and a peer educator,” she says. “I have 51 other sex workers in my care, I inform them on testing and treatment, also about STI treatment and condom use. I teach about the disadvantages of sharing ART (anti-retroviral therapy) and encourage them to go for tuberculosis testing if they are coughing.” Another educator called Cecilia adds: “I reached out to 60 female sex workers. We are all friends and they trust me. I refer them to services and we address abuse by the police. They rape us and steal our money but through the project, we can follow up since the project has access to the managers of the police.” Basic sexual health information Her colleague Florence says: “It also helped that the rogue and vagabond law was repealed.” The law was a permanent curfew, giving the police the power to round up, fine or jail anybody who was on the streets after eight o’clock at night. Lucy, also a peer educator, says part of the work is giving basic information. “I teach my friends on HIV and GBV (gender-based violence),” she explains. “And I teach how to use condoms and lubricants and how to persuade clients to use condoms. I also talk about family planning. Many female sex workers do not know they need it.” “The project helped me with condoms and I shared that with others,” says another client of the programme, Angela. “Through the project, I got tested for HIV and treated for STIs. I also encourage pregnant sex workers to go for pre-natal care so that they do not infect their babies. It is the first time that an organisation like FPAM worked with us. We got respected within the community because we are knowledgeable.” In the year the Linkages project ran, 627 female sex workers were supported in getting tested for HIV, the initiation of anti-retroviral treatment and therapy adherence. 2,700 women were referred to services and many more received information. The HIV prevalence rate among female sex workers went down from 77% to 62%. Global Gag Rule effects FPAM’s Linkages project was phased out in 2016 due to the Global Gag Rule. The effects are keenly felt amongst those who benefitted from the project: Amina says: “Many stopped taking medication. Healthcare facilities are not for us. I sing in a church choir, which is important to me. If they find out what I do, they will throw me out.” “My family thinks I work at a filling station at night,” says Lucy. Cecilia adds: “This project has to come back, please bring it back. If not, we will all die early.”