“I didn’t know about reproductive and sexual rights issues myself,” says Abe, 29, the Assistant Youth Officer from the Kiribati Family Health Association (KFHA), the leading NGO service provider in advocating for reproductive health care and in fostering the rights for all individuals in Kiribati. “So that’s why I recommend to young people in Kiribati. It’s time to be talking about SRHR early on, let’s not wait until young people get in trouble.”

Abe voice reveals the energy and passion of someone who is doing what they were destined to do. His bright smile widens when he tells me he is a proud member of the LGBTI community. He is also a proud member of his local church. I ask him how he tackles the two divergent worlds of sexual and reproductive health and rights, as the teachings of his church forbids modern contraception methods.

He has clearly given this topic a lot of thought. “Even during my Sunday school sessions, I speak about SRH (sexual and reproductive health). I speak with them about family planning and the issue in Kiribati of over population. I know my community. I ask them what they think about this. And then they ask for the KFHA nurses to visit our community, that’s why we have visited at least three times over the past years with free services.”

The challenge of climate change

Kiribati, a tiny atoll in the middle of the Pacific Ocean, covers 3.5 million square kilometres. Formed by the coral that once rimmed a volcano, the little organic material available in the soil means agriculture is difficult. Low topography, rising sea levels and insufficient fresh water supply leaves Kiribati’s population vulnerable to the effects of climate change – particularly during the king tides each month.

It also experiences urban over-population issues; half of the entire population of Kiribati live on the main island of Tarawa. There are many issues affecting the youth population: too few employment opportunities, and rates of teenage pregnancy, unprotected sex and STIs (sexually-transmitted infection) are reported to be high.

“SRH is one of the main issues in Kiribati as most of the young people don’t know enough about SRH from home or school. In our culture we cannot talk to children about these issues as its considered rude. Because of this, young people grow up with little knowledge about SRH, which is why teenage pregnancy is so high in Kiribati – the second highest in the Pacific” Abe says.

“But sometimes, even when they have the knowledge, they still don’t come to the KFHA clinic as they are worried their family will find out and ask them what is happening. That is why they keep their problems to themselves and end up with STI/HIV issues. But our mobile clinics are one way to combat this issue and provide outreach to the community directly.”

KFHA’s mobile clinics travel from village to village providing sexual and reproductive heath and advice, such as STI testing and treatment and contraceptives. They even travel out to the remote outer islands.

“Climate change affects many countries, but Kiribati is so small and low lying. For us, the issue of over population is linked to climate change. People feel like they are not safe here. In my role as a youth worker and activist, I tell people to fight climate change: to grow more mangroves and to clean up the beach. Because we love our Kiribati.”