After Disaster Struck Indonesia, I Volunteered to Help

When an earthquake struck Central Sulawesi, Indonesia, on 28 September 2018 at around six in the afternoon, I was in a shop around the area of Tondo, East Palu, buying snacks with two of my friends.

I heard a roar, and seconds later the ground swayed. There were people riding motorbikes falling on the streets. I rushed home to the hilly area of town.

Along the way I saw many people already on the side of the road crying. Fear enveloped my heart. I wanted to get home soon.

Once I arrived, I saw a cracked building with its contents scattered. That night there was another earthquake. I was forced to sleep on the road in front of my house.

Previously, I had ventured into the house to pick up a sleeping bag and change of clothes. Four more earthquakes came after that. I tried to call father and my brother many times but I couldn’t contact either of them.

People started to come up from the coastal area. Men were carrying gallons of mineral water and many were wounded and drenched.

We heard that there had been a massive tsunami on the coastal area. Hearing the news, I cried hysterically. I was now even more afraid, because my father lived on the coast.

I almost ventured down to find my father. However, my neighbors and friends tried to calm me down and convinced me not to go right away.

At five o’clock the next morning, I rushed to look for my father. When I arrived, I saw there was no house standing. The cars were all badly damaged by buildings.

I saw a lot of dead bodies. This made me cry and keep looking for my father until I met a teenager, who said he was on the mountain. I ran up to about five kilometers from the location of the tsunami. Then, finally, I found my father.

A month after the disaster, I was invited to join Indonesian Planned Parenthood Association (IPPA) in Central Sulawesi as a youth volunteer, to provide counseling on reproductive health as well as HIV.

I thought to myself, this activity is noble and I can help others this way. I have knowledge about HIV from my Intra-Campus Organization at university. Now, I can share this knowledge with my peers so that they can protect themselves for the sake of their future.

I told myself: I’m still able to undergo activities, I have complete organs, why don’t I use this to help people in need?

Who else will help them, if not people who care about the lives of friends affected by this disaster?

In addition to providing reproductive health and HIV counseling with other IPPA youth volunteers, I advocate for the rights of young people. After they have had counseling, we ask what obstacles the youth experience. We also listen to the complaints they have, such as lack of clean water or being harassed.

After listening to the young people, I – along with other volunteers – follow up on the issue to the concerned institute. This provides security and comfort for youth, and means that their sexual and reproductive health and rights are being fulfilled.

Written by Indri Walean, Youth Volunteer at IPPA Central Sulawesi, Indonesia. 

Politics Affects our Health: the Case of Sudan

‘Social determinants of health’ are the circumstances and surroundings that influence an individual’s health outcomes.

Researchers have focused on social determinants of health for decades and there is now a general consensus that higher socioeconomic status predicts better odds of future health and well-being. While this notion is scientifically accepted, it prompts the question: what creates these social determinants of health? This has brought much needed attention to the ways in which politics affect health – both directly and indirectly.

‘Political determinants of health’ are the factors that shape the social determinants of health. This is a relatively new concept and is of particular significance for women. An example of the link between politics and health can be found in Sudan.

In Sudan, the political climate is shaped by religion and the constitution is based on teachings of Sharia Law. Currently, many communities face extreme financial strain as a result of failed past politics and/or war and insecurity. This has increased pre-existing and vast social inequities, including gaps in financial and educational opportunities.

The political situation in Sudan has had inevitable consequences for health.

Social disadvantage falls heavier on women. Until recently, girls have been denied the same education as their male counterparts. Lack of education leads to limited knowledge of health, which affects an individual’s ability to improve their own health outcomes. 

One example is the issue of sexual and reproductive health. Sexuality and sexual behaviour are sensitive topics rarely discussed in conservative, religious cultures like Sudan’s. Sexual and reproductive health and rights do not enjoy a high-priority status among political agendas, either, and there has been very little consideration of introducing sexual education into classrooms. However, many educators and health officials have started to support sex education in schools, resulting in increasing support by legislators.

Another example is the high prevalence of female genital mutilation (FGM) in Sudan, at a prevalence of approximately 89% countrywide. The harmful practice continues to affect many areas of the country, and although it is legally banned, it is well-known to continue with the open support of many religious leaders. This is a clear example of failed implementation of legislation that has allowed FGM to remain prevalent despite wide-spread efforts by campaigns and NGO peer-education programs.

Under Sudanese constitution, child marriage, forced marriage or marital rape are not against the law.

Much of the country’s legislation does not provide any protection for women’s rights. As a result, many Sudanese women fear persecution.

One case that struck the international community was that of Noura Hussein in 2018. The 19-year-old was sentenced to death for fatally stabbing her husband – who she had allegedly been forced to marry – after he attempted to rape her. In the eyes of the law, marital rape does not exist, and so Hussein had no claims to self-defence as she was viewed as a belonging of her husband. The ruling was thankfully overturned after increasing international pressure on the Sudanese government. Hussein received a reduced sentence of 5 years in prison. 

Historically, women in Sudan have been forced to be subordinate to men. Although this is changing and vast improvements have been made, drastic changes to the country’s politics and constitution are needed to ensure full protection of women’s rights – especially their rights to health and wellbeing. 

 

Campaigning for Care & Compassion in Ireland

I’m 23 years old and I grew up in a particularly rural and conservative part of Ireland.  

The only time I ever heard the word ‘abortion’ mentioned in school was when we were doing a play in the Irish language. There was a scene where the characters were discussing abortion. I remember asking the teacher what the word translated as. She replied, “It means murder”.

I know now that if you break the translation down it would be similar to the word for a fetus. It doesn’t literally translate as murder. But that was how it was explained it to us.  

I studied reproductive biology at university and did my dissertation project in an abortion clinic in 2017. This involved interviewing doctors and nurses working in the clinic in Edinburgh about their relationship with their patients. I saw how the patients were talked about with such respect and compassion. It really brought home the stark contrast of how women in Ireland were treated.

This spurred me into action. I decided to go home and help with the Yes campaign, ahead of the 2018 referendum. Legislation is how social change is made and how rights are created.  

It was exciting to be part of a big campaign. My colleagues have been in this fight for decades, but they’d never had a national referendum like this before. For the first time ever, they said it felt like everything was to play for.

The pressure was immense because it felt like every woman in Ireland, both past and present generations, was counting on us to get this right.  

My role involved researching policy briefs or answering questions for journalists, such as abortion rates in Switzerland and Portugal after their referendums. I was also answering the phone to women ringing the Irish Family Planning Association (IFPA) in floods of tears, saying, “I’m pregnant and I don’t know what to do”.   

For decades, every single day, women experiencing an unintended or crisis pregnancy have been ringing the IFPA to access information and counselling. Trying to calm each woman, telling her what we could do, hearing her relief and hoping I’d made a bit of difference to her just made it all incredibly real for me.   

Many people found the No campaign posters distressing due to their incredibly negative and violent language, for example, ‘a license to kill’. I think that negativity backfired for the No campaign, as I think the Yes campaign was seen as more sensible.

I think recent scandals in the Catholic church played a role too because the No campaign was using messaging like, “Oh yes, the 8th Amendment has led to an island where we really treasure our children”. This felt tone deaf in a country where there have been so many child abuse scandals in recent years.

I also think it drove people away from the No campaign because it clearly wasn’t based on the reality of the Ireland we’ve all been living in. No campaigners displayed a kind of moral snobbery which felt like preaching. It might have worked on the Ireland of another lifetime, but not now.  

On the other end of the spectrum, the vote Yes posters appeared in rural communities for the first time, which I think was very powerful for people who might have felt quite isolated or just hadn’t talked to anyone in their community about abortion before.

In the final weeks leading up to the vote, the most important conversations were happening at the school gates or at kitchen tables over cups of tea.  

It still feels like a dream that we won. It wasn’t until they called out the two tally boxes from my home village and I heard Yes passed there by 57% that I realized what was truly happening. That’s when I knew it wasn’t just Dublin and the cities. The whole country was behind us. This realisation made me cry. It made me very proud to be from rural Ireland. 

I went to Dublin castle to celebrate. At one point, the crowd spontaneously started chanting Savita’s name. Even in a moment of celebration, we all remembered her death, and that felt very emotional.

I recall watching some kids playing, and their mothers were standing hands on hips just watching them, and they were all wearing repeal jumpers. One of them was pregnant and there were two men there with their child too. For me that was such a beautiful symbolic image of how far Ireland has come. 

For me, abortion is about motherhood at the end of the day. It’s about allowing us the right to be the best mothers we can be, if and only when we decide to do so.

Read other personal experiences like Áine’s on the Irish referendum.

As of January 2019, the Irish Family Planning Association (IFPA) provides early medical abortion up to 9 weeks of pregnancy. Abortion care is free for women living in the Republic of Ireland.

The Impact of HIV on Adolescent Girls & Young Women

World AIDS Day celebrates its 30th anniversary this year with the theme of ‘Know Your Status’.

Great progress has been made since the first World AIDS Day in 1988 – 3 in 4 people living with HIV today know their status.

However, the work is not yet done – especially for women. Women account for more than half of the people living with HIV worldwide. In particular, adolescent girls (10-19 years) and young women (15-24 years) are significantly affected by HIV and have high prevalence rates.

In Eastern and Southern Africa, women make up 26% of new HIV infections despite making up only 10% of the population. Statistically, young women will acquire HIV five to seven years earlier than their male counterparts.

Why are women and girls at high risk of infection?

HIV disproportionately affects young women and girls because of their unequal social, cultural and economic status in society. These challenges include gender based violence, laws and policies that undermine women, and harmful cultural and traditional practices that reinforce stigma and the dynamic of male dominance.

Here some other reasons why gender inequality leaves women vulnerable to HIV:

  1. Lack of access to healthcare services – women encounter barriers to health services on individual, interpersonal, community and societal levels.
  2. Lack of access to education – studies show that educated girls and women are more likely to make safer decisions regarding sexual and reproductive health and have lower risk of partner violence.
  3. Poverty – an existing and overarching factor that increases the impact of HIV.
  4. Gender-based violence & intimate partner violence – these types of violence prevent young women from protecting themselves from HIV.
  5. ‘Blesser/Sugar Daddy’ culture and transactional sex – sex with older men for monetary or material benefits, exposes young women and girls to low condom use, unsafe sexual practices and increased rates of STIs.
  6. Child marriage – girls who marry as children are likely to be abused by their husbands and forced into sexual practices.
  7. Biological factors – adolescent girls are susceptible to higher rates of genital inflammation, which may increase the risk of HIV infection through vaginal intercourse.

Importance of HIV testing

HIV testing in young women and girls is essential. Many receive access to treatment and care services after testing. Some important determinants of testing are:

  • Going through antenatal care
  • Being married
  • Having primary and secondary education

We need to aim for more young women and girls to being tested so that they know their status, and can access adequate care and treatment services. HIV testing is necessary for expanding on treatment and ensuring that people with HIV have healthy, productive lives.

Addressing the Impact

To address the impact of HIV on young women and girls we need to have approaches and interventions that incorporate the diverse perspectives of women and girls. This is needed on all platforms from campaigning and policy-making to program design. As the World Health Organization recommends, a woman-centred approach that includes women as participants is required, so that our needs, rights and preferences are considered.

Better strategies are needed across all health system to improve accessibility, acceptability, affordability, uptake, equitable coverage, quality, effectiveness and efficiency of services, particularly for adolescent girls worldwide.