“Marsa tries to make people more aware of how to have safe sex, of what it’s like to be LGBT, and of how to treat marginalised groups with respect.”
The word “Marsa” means “dock”, “port” or “harbour” in Arabic – an appropriate name for a space offering free, non-judgemental sexual healthcare and advice to young people of all genders and sexual orientations in Lebanon.
But as the first sexual health clinic of its kind in the wider Middle East and North Africa (MENA) region, Marsa does not limit itself to the “harbour” of its own clinic. Since 2012, the organisation has been running online campaigns to address the rights of young transgender people, myths surrounding menstruation, as well as women’s relationships with their bodies. In 2014, Marsa won a Red Ribbon award from the United Nations Programme on HIV/AIDS (UNAIDS) for its outstanding work preventing sexually transmitted infections.
The IPF spoke to Marsa’s Manager, Diane Abou Abbas, about how this small clinic in Beirut has become an influential force for change; breaking down stigmas in sexual attitudes across Lebanon and the MENA region.
Equal access to healthcare through Marsa
Marsa was founded in 2010 as an offshoot from HELEM, the first LGBT community centre in MENA. HELEM (Lebanese Protection for Lesbian, Gay and Bisexual People) is also the Arabic word for “dream”.
Unfortunately, equal legal and social protection is a dream as yet unrealised for the LGBT community in Lebanon. Although Lebanese law does not explicitly criminalise homosexuality, Article 534 prohibits “sexual intercourse contrary to the order of nature”. The lack of any legal definition of “nature” means that Article 534 is often used to prosecute LGBT people. Diane explained:
“You couldn’t go to a doctor or counsellor and tell them you were with someone of the same sex. Many doctors would take you out of their offices, or reprimand you.”
Marsa invites resident doctors in family medicine to train at the clinic on rotation, giving them a unique opportunity to learn about sexual health needs of the local community in a stigma-free environment. When they leave, they take the centre’s approach with them, passing it onto a wider pool of community-based colleagues.
While recalling the decision to establish Marsa to establish Marsa as an organisation independent from HELEM, Diane said: “We realised that there was a need for young people of all sexual orientations to be able to access stigma-free sexual health services.
“HIV/AIDS prevalence is getting lower in the world at large, but higher in Middle East and North Africa regions, and it’s largely due to the lack of sexual education in schools and universities.”
Only the private schools or universities address sexual health, but even this is usually a one-off session on sexual anatomy from a psychologist or doctor. There is often nothing on LGBT acceptance, diversity or even sexual consent, which Diane explained is an important factor in building young people’s sense of agency over their own bodies.
As well as doing outreach sessions at universities and scouts groups, Marsa collaborates with other NGOs. They have worked alongside addiction centres for young people and coordinated awareness drives for International Music Day, World AIDS Day and summer festivals.
“We’re trying to make people more aware of how to have safe sex, of what it’s like to be LGBT and of how to treat marginalised groups with respect.”
There is a particularly pronounced contradiction between Lebanon’s cultural conservatism and the reality of women’s lives in the country.
“You will still find some families who are willing to murder their daughters if they are sexually active outside marriage, and unmarried women seeking sexual healthcare are discriminated against by gynaecologists.”
The stigma leaves women vulnerable to sexually transmitted infections. In the absence of public dialogue or educational tools, many trust that HIV/AIDS cannot be transmitted within marriage or by the men they know. Understandably, many are reluctant to get tested.
Diane explained that when the centre first opened, 85% of visitors were men. To increase the number of women visiting the centre, Marsa started offering free tests to screen for cervical cancer in 2012. It also designed two brochures discussing contraception and STIs. When the centre opened, 85% of visitors were men.
She said: “Women started telling their friends because they were happy with the service they received. They found they could talk about their sexual practices even though they were not yet married. Now the gender balance is fairly even.”
Addressing Lebanon’s taboo subject
But Marsa’s engagement with women goes far beyond the walls of the centre.
In 2012, the Beirut-based team began creating campaigns to bring sexual education to a wider, national audience. In Marsa’s video for International Women’s Day 2014, we hear the voices of women sharing, in moving and often lyrical detail, their relationship with their own vagina: from alienation, to shame, to admiration.
She said: “This is an über taboo subject in Lebanon.
“Women don’t look at their vaginas, they don’t look at their bodies; they feel a profound detachment from their sexuality.”
Marsa conducted a survey with a group of about 20 women, asking them about their most intimate thoughts and feelings about their own bodies.
Diana explained: “In the film we decided to talk about the vagina without mentioning the word. By working through implication, we highlighted the taboo that still prevents women from speaking out.”
Next came Leila the Spy – a funny but, nonetheless, radical film tackling popular fear and misinformation around women’s menstruation.
“It went viral naturally,” Diane said. “Young girls are watching it in their schools. We’ve had organisations contacting us from Kenya and around the world, asking us if they could replicate the video or translate it into their own language. It has had a global effect as well.”
The Trans* Project
The Trans* Project, Marsa’s latest campaign, addresses the health needs of transgender young people in Lebanon.
“We did a needs-assessment with the transgender community, and found many people lacking vital information.”
She said: “In a strategic move, we asked the best known voice-over artist in Lebanon, Tanya Awad Ghorra, to do the voice-over – she’s the voice of all mobile carriers, television shows, and announcements at the international airport.”
Diane added: “Her voice is instantly recognisable, everybody knows her. The video contains new information for most Lebanese people, but her voice creates a subconscious sense of familiarity with the subject.”