PART II— IRC Contraception Changemakers

There is perhaps nothing more disempowering than a humanitarian crisis. Whether overnight or over months, citizens become outsiders, towns become targets, families leave everything and everyone they’ve ever known with as little as the clothes on their backs. 65 million people — the largest number since the Second World War — endure exactly that today.

Even after escaping violence, women and girls in crisis settings continue to face threats to their lives — lacking access to essential services and facing the dire, and often fatal, consequences as a result. That’s why family planning is, and remains, one of the most transformative interventions in humanitarian assistance, making the difference between surviving and thriving, life and death, for millions of women around the world. Despite an overwhelming need, it also remains one of the biggest gaps in humanitarian response.

The IRC is dedicated to helping women and girls survive and take control of their lives from the earliest stages of crisis through recovery, recognizing the unique vulnerability of women and girls in wars without law, crises without end. Most of all, the IRC’s experience has demonstrated that women and girls in the most hostile and remote places in the world want access to reproductive health services — and will use them overwhelmingly when they are available.

As the second part of our two-part series on contraceptive access, here are some IRC changemakers around the world helping women and girls realize their rights — to survive, to recover, and to gain control of their futures.

Dr. Cynthia Maung

A Burmese refugee, Dr. Cynthia founded the Mae Tao Clinic — the only source of adequate healthcare, including family planning, thirty years ago on the Thai-Burma border. Today, the clinic serves 150,000 displaced patients a year. She recalls why she created the clinic thirty years ago, in the midst of the world’s longest-running civil war.

Dr. Cynthia holds up a photograph of herself in 1991, when she first created the Mae Tao clinic to meet the needs of thousands of Burmese refugees fleeing for the Thai border.
I will never forget the first delivery I saw in the jungle.
Fighting was fierce between the Karen people and the Burmese military, people were running away all around us — it was 1991. It was late at night, and someone came to fetch me, telling me a woman was giving birth between the trees. I had never seen a delivery outside a home or a hospital at the time. She was a young woman, leaning against a huge tree trunk, screaming in the dark — with an older lady helping her give birth, bare hands and no instruments, with the shaking beam of a flashlight held above her head. She on the other hand was silent, ignoring the panicked voices of those around her — I wasn’t even sure how well she could see. By the time we arrived there, the baby was already on its way, and I was shocked.
That’s when I realized how much we needed to do for women’s health there, in this war zone.

Dr. Jessica Kakesa

A native of Goma, North Kivu, Dr. Jessica grew up witnessing waves of displacement and the extreme vulnerability of women and girls in this corner of the DRC. Today, she leads efforts as Reproductive Health Coordinator in expanding free access to comprehensive contraception, safeguarding both the health and independence of women in a country so marred by gender inequality and violence.

Dr. Jessica on her way to a training for care of survivors of gender-based violence in Eastern Congo.
I wasn’t initially interested in reproductive health. Then the civil wars started when I was young and I could see that those that suffered most were women and children. I didn’t live too far from the border, and I would stand on the side of the road watching Rwandan refugees come in, not able to cover their babies, giving birth along the road, or pregnant and just waiting.
I also saw this inequality in everyday life. I saw that women were marginalized and men had more advantages compared to them. As soon as I got the opportunity to work in reproductive health, I said yes. I realize that it’s nothing in comparison to the multitude of problems women and girls face — but at least, it’s a way for me to contribute to their fight. And it’s a battle worth fighting.
I’ve realized this truth in my own life. I’ve lost close family members because they were not capable of choosing a family planning method and consequently lost their lives. Someone else made the decision for them and it was a fatal one.
A world where women have reproductive health rights is a better world.

Esther Nyambu

As Reproductive Health Coordinator for the IRC, Esther spearheads reproductive health services for women and girls during acute emergencies. Esther’s work took her into parts of the DRC controlled by rebels, where she was tasked with re-establishing health services at health facilities that had been destroyed. In just five months, Esther and her colleagues brought 16 of 17 facilities back to service.

Esther informs Burundian refugees that a reproductive health clinic awaits them at the Nyarugusu Refugee Camp, Tanzania.
At the beginning, it was scary. But your passion supersedes your fear. We were not sure if we’d come out alive — and we had to evacuate. Heavy artillery followed us on the road to keep us safe while we made our escape. Even when we were leaving, my heart was still left behind — we still had work to do. All I could think was, ‘Who will finish what we’ve started?’
My motivation comes from my passion for women and girls. When I think of how they need these services — by being there, in emergencies, helping people in need — it inspires me.

Ali Ahmed Oumer

As religious community leader in Beninshangul Gumuz Region, Ethiopia, Ali is a central figure in keeping his village healthy. After working with the IRC on family planning activities, Ali transcended religion, culture and context to promote this essential service at home.

Ali in Beninshangul Gumuz Region, Ethiopia.
In past years, mothers rarely used family planning services because they thought it was not supported by our religion. We religious leaders had a chance to learn about the relationship between family planning and religion, and the Quran tells us that birth spacing is important. We want mothers to use the family planning methods according to her choice. So we shared this important knowledge and used it to teach our community. Mothers started to seek and receive family planning services.
It’s easy to say that there has been a big change.

Lucie Mutemi

As a community health worker in Tanganyika province, DRC, Lucie does the essential work of reaching out to women and girls in local communities — informing them about the comprehensive contraceptive methods available, for free, at the IRC-supported clinics in the area.

Lucie meeting IRC health staff to plan community health activities in Tanganyika province.
Before this program started, I wanted a family planning method myself. I asked someone to bring it to me from Bukavu, South Kivu. It was very expensive, and I chose to administer it myself. I already have six children, five sons and one daughter — I needed it.
I am proud to be a community health worker and to work for family planning. For girls in this environment, family planning means an opportunity to pursue an education. Often times, a girl may become pregnant and abandon her education. In the community, a lot of people like and love family planning.
If I had my choice, every girl in this community would be able to use family planning and go to school.

Doreen Ababiku Ambayo

From South Sudan to Liberia during the Ebola epidemic, Doreen has long worked to provide reproductive healthcare in emergencies for women and girls. Today she works in Uganda, her home country, as Reproductive Health Coordinator of Bidibidi refugee camp, Yumbe.

Doreen poses with Yasin and Winnie to her sides, both IRC midwives, in the Yumbe health center, Uganda.
We absolutely have to focus on reproductive health in refugee settings. Women refugees are constantly on the move. Some have traveled long distances alone, lived through traumatic experiences and need support. As healthcare providers, we need to have better attitudes about contraception; our job is to help these clients. We can counsel women on side effects and discuss which method is the best fit. You don’t judge.
In Liberia, I used myself as an example. My husband was not positive or accepting initially about family planning. So I went for it, as my own decision. I don’t want a child by chance; I want a child by choice. After hearing my story, five women asked me for access to family planning methods.
I am very affected by my work. I can’t forget these women.