Family planning has been specifically introduced within the climate change environmental context as a cost-effective means of mitigating global warming. It has also been lauded as a means of helping vulnerable families adapt to the increasingly harsh local conditions anticipated as a consequence of global warming.13-15 While global environmental challenges are important, the focus herein is on environmental issues at the local level—specifically in remote, ecologically fragile areas where access to organized health services (including family planning) is limited. It is at this local level where the strength of the family planning/environment (FP/E) relationship is most acute and where programmatic experiences integrating the two are richest.