In Palestine sexual violence against women, especially within the family, is common. Women's virginity is linked to the honour of their family, and will face threats of death for dishonouring their family. Mariam needed help to get out of a coerced “relationship”, fearing for her life if her relatives find out. “In the beginning my nephew wanted to kiss me. “I resisted. But then he started touching my body. It became a relationship between lovers. To “preserve” virginity, it was always anal sex.  “I knew it was wrong. But who I should talk to? If my brother found out he would have beaten me - killed me.”  At the Palestinian Family Planning and Protection Association (PFPPA)'s clinics, social workers give awareness sessions on sexual violence in the waiting rooms, hoping to catch the attention of women there for other reasons who are hiding the fact they have been abused. It was this kind of session that proved vital for Mariam. “When my sister was pregnant I went with her to the PFPPA clinic,” she remembers. “The social worker there, Ruba, started speaking about sexual violence. When my sister went in with the doctor, I went to Ruba's office and told her I needed help; I cried.” Mariam kept visiting Ruba, and ended things with her nephew. “What happened to me is not rare. It would have been impossible for me to approach a relative and tell them what was going on; I was too frightened. And nobody would have believed me over a man. “I've found there are other women of my age who've had similar experiences to me but women are frightened to speak about it.  “Before, I despised myself. Now I feel powerful. I leave the house, I meet people. I feel I'm responsible for myself, that I have to protect myself, and that I need to help others if they need me. Everyone's telling me 'you've changed, you're stronger'.” Through its association with religious and community leaders, the PFPPA seeks to persuade the public of the importance of talking openly about sexual health and relationships, and dispel the idea that sexuality education for young people goes against the teachings of Islam.

Julie was a midwife with the Ministry of Health for 20 years before she joined the Vanuatu Family Health Association (VFHA) as nurse and project manager for IPPF's SPRINT Initiative response in Vanuatu. When Cyclone Pam hit Vanuatu, the SPRINT Initiative and VHFA started providing life-saving services to the Island, Tanna, which was the population worst affected by the typhoon. Many communities there live remotely, in grass huts, with no immediate access to medical care.  Julie was there with the VFHA team. “When I first came here we used the kitchen to operate from. On my second trip, we created a clinic in our youth centre, and used the nearby health post for clinical procedures. Soon we saw more patients pouring in, which created a huge demand for space." Health conditions are very low. Even before the cyclone hit the island, it was reported that the average mother loses two pregnancies each, in her lifetime. Every person in the village knows at least one mother who has died during child birth. Access and knowledge to family planning is overlooked as traditional practices are used first. As Julie explains, advocating about family planning is a challenge in the area, also for language barriers. “Talking about birth-spacing and talking in the regional dialect of Tanna is a problem. Most of us in Vanuatu speak Bislama, but people here in Tanna aren’t well versed with it. However, we try our level best with all possible methods including sign language and demos to impart knowledge about family planning.” Family planning services are just a part of the IPPF-SPRINT Cyclone Pam response, that also included general health check-up, counselling and awareness about Sexual and Gender Based Violence, maternal care and awareness and prevention of HIV and Sexually Transmitted Infections (STI).  

Cyclone Pam, one of the most intense storms of the South Pacific Ocean, caused widespread devastation in Vanuatu’s southern provinces of Shefa and Tafea in May 2015. The International Planned Parenthood Federation (IPPF) through its humanitarian wing, the SPRINT Initiative, supported the Tropical Cyclone Pam affected population by providing them life-saving sexual and reproductive health (SRH) services through the Vanuatu Family Health Association (VFHA), a Member Association of IPPF. “The IPPF-SPRINT and the VFHA team walked for more than 2 hours to Labasilis Community Village in North Tanna, Vanuatu. It had rained continuously the previous night, hence it was impossible to use the 4-wheel drive transport and the team made the entire trek by foot, carrying all the medical equipment! We passed a few small settlements on the way, and in one village, Dr William, a MOH (Ministry of Health) medical doctor who had volunteered with VFHA for the mission treated a young man with a chest infection and a lady with musculoskeletal pain. “There was no such thing as a clinic or shelter, and the makeshift table was on a piece of zinc on the ground, where the medical bag was opened,” explains Subatra Jayaraj, SPRINT Regional Manager, The International Planned Parenthood Federation-East & South East and Oceania Region. After crossing the peak of 3 hills, the team arrived at the Labasilis Village and set up clinic in a tent that had been provided to the community by UNICEF. At least it provided shelter from the storm outside. “It had rained heavily the previous night. However, we started early to reach Labasilis. We started walking slowly. Maintaining one’s balance in the slippery muddy road was a real challenge, everyone decided to walk bare foot – walking though the bush was also preferred for better grip. I was relieved to learn that Tanna soil does not have insects or snakes- may be due to volcanic sand deposit. Many of us slipped or almost slipped couple of times. Each time one team member slipped it was counted as one point and if one almost slipped, then half a point is scored. Need not to mention, that we all contributed towards quite a good score for the team. The scenery was indeed beautiful, but continuous rain and the slippery road kept us focusing on each step we took forward,” said Aditi Ghosh, Acting Director, IPPF-SPRINT Initiative. Thanks to IPPF-SPRINT and VRHA, we served four communities via three outreach mission in the Tanna Island, providing Sexual and Reproductive (SRH) services, including HIV/STI and Family Planning services, Maternal, Obstetric and Neonatal Health Care.