Life style
Towards a disability-friendly health system
Gaps in the health care system burden those with disabilities with an added cross. In the backdrop of the International Day of Persons with Disabilities which fell on December 3, we spoke to many stakeholders to push for collective national interventions to enhance the quality of life of those with disability.
by Randima Attygalle
Nisha Shareef from Kandy was born with a rare spinal cord abnormality which left her wheelchair-bound for life. Introduced to rehabilitation at age 11, Nisha’s quality of life improved. Thanks to the vocational training she received through the Ragama Vocational Training School, she learned the art of watch-mending. Today at 50-years, she runs her own business in the Kandy town, her example empowering fellow wheelchair users.
Health challenges for those in Nisha’s shoes are many. Inability to control the passing of urine, catheter and diaper dependency, frequent urine infections and bed sores are among them. Management of all these issues is costly says Nisha who lobbies for a special concession for adult diapers and other medication required by those with disabilities. “Accessibility to public toilets including those at hospitals is a nightmare for us,” she says. Nisha urges the health authorities to have disability-friendly infrastructure at hospitals and to dedicate a help desk and a hotline at least at Teaching Hospitals to assist those with disabilities.
Many young girls and women with mental disabilities and those who are vision impaired left alone at homes are often sexually exploited, she points out proposing a state-supported day-care system to shelter them while their parents or other care givers are at work. This would help ensure their safety.
Having fallen off a rambutan tree at ten, Lasantha Chandimal from Dampe off Madapatha, became paralyzed. Having lost both his parents by 15, Lasantha’s life took a turn for the worse. The Samaritans at the Ragama Rehabilitation Hospital not only uplifted him from a bedridden patient to a wheelchair user but also trained him to maneuver a special tricycle. Lasantha, 36-years old today, has lost his job with the closure of the plastic factory he worked at. His wife, a wheelchair user herself, also worked there.
A spinal cord injury makes Lasantha often susceptible to kidney dysfunction. “I’m a catheter-user and I developed a urine infection during the lockdown which left me helpless with no access to medical treatment. With my temperature running high due to the infection, I called for an ambulance several times to no avail. Finally I had no choice but to scrape my savings and get treatment at a private hospital.”
The absence of special assistance at OPDs, indifference of the support staff and exploitation of those with disability by some, makes matters worse. Improving disabled-health literacy at ground level, improving sanitation facilities for people with disability in hospitals, sensitizing support staff and creating awareness on available help devices are among Lasantha’s suggestions to ease the burden of this community.
Over a billion of people, about 15% of the world’s population, according to the World Health Organization (WHO) have some form of disability. Half those with disability cannot afford healthcare, compared to a third of those without disability. People with disability are more than twice as likely to find healthcare providers’ skills inadequate and people with disability are four times more likely to report being treated badly; and they are nearly three times more likely to be denied healthcare, WHO affirms. The World Bank literature on ‘Disability Inclusion’ documents that ‘many persons with disabilities have additional underlying health needs that make them particularly vulnerable to severe symptoms of COVID-19, if they contract it. Persons with disabilities may also be at increased risk of contracting COVID-19 because information about the disease, including the symptoms and prevention, are not provided in accessible formats such as print material in Braille, sign language interpretation, captions, audio provision, and graphics.’
Translating sensitization on ‘disability and rehabilitation’ into practical reality is urgent, points out Manique Gunaratne, Manager Specialized Training and Disability Resource Centre of the Employers’ Federation of Ceylon. Manique who lost her vision in her 20s due to Retinitis pigmentosa had no proper local guidance to a rehabilitation system. The overseas doctors whom she consulted empowered her on ICT systems available for vision impaired people. “This has made me what I am today,” says the activist who lobbies for help desks which could offer guidance for people with disabilities and their families to make informed decisions. “Very often when a child with a disability is born, parents have no clue what to do with it. If the medical condition turns out to be disability, they are even more helpless,” notes Manique who also proposes a ‘Priority Card’ on health nee

ds and making disability representation stronger at policy-level within the health sector.
The role of collaboration between doctors, physiotherapists and the beneficiary in determining the best assistive device cannot be understated says H.D. Mala Nandani, Administrative Officer, Rehab Lanka which manufactures s
uch devices. “An assistive device has to be a customized and very often there is little awareness among the poorest of the poor who depend on a donated wheelchair which could very often compound the disability.” The National Secretariat for Persons with Disability provides a stipend for such devices, she adds. The local manufacturing volume of assistive devices should be increased for better availability, notes Mala who lost the use of one leg due to a vaccination mishap as a child. “At ground level, the knowledge of personal hygiene among those with disabilities is very poor; hence there should be a system similar to that of midwives to help the families of the disabled in terms of knowledge and guidance to proper health channels.”
The COVID emergency situation which put the local public health system under unprecedented strain has driven the health authorities to design new interventions including meeting the needs of people with disabilities, notes Dr. Shiromi Maduwage, Consultant Community Physician from the Youth, Elderly and Disability Unit of the Ministry of the Health. “We are now developing a system to reach out to those in need in future emergencies. We have already launched a programme to empower care givers during the pandemic. This is facilitated by the National Secretariat for Persons with Disability.

“
A system to improve the COVID-related health messages through Braille and sign language is also underway she says. While the state provides a monthly disability allowance, certain gaps in the system including the need for disabled-friendly infrastructure have been identified; and these need to be bridged, says Maduwage. “The elderly population is growing and disability will be an added burden. Community based rehabilitation is already being strengthened by the health sector to mitigate the challenges and ground level officials sensitized though the MOH divisions.”
Upgrading the school curriculum to incorporate health issues of those with disabilities including their sexual an
d reproductive health and safety can help sensitize future health policy makers to
catering for their needs, remarks Dr. Harischandra Yakandawala, Medical Director of the Family Planning Association and Consultant to the project on sexual and reproductive health during emergencies. “People with disabilities often have barriers in accessing information and we are collaborating with several agencies in addressing this including making online counseling services accessible by victims of gender based violence.” Women and girls with disabilities are the most vulnerable to sexual violence which could result in unwanted pregnancies and sexually transmitted diseases, he says citing the need for organized shelters to provide care for young girls and women enabling their caregivers to be productively employed during day time.
Encouraging all parents to “dream for their child” despite odds, Samanmali Sumanasena, Professor in Paedeatric Disability and Head of the Department of Disability Studies, Faculty of Medicine, University of Kelaniya, urges all partners in paediatric health services to support families with children with mental and physical disabilities. “Research shows that early intervention can make children more cognitively competent and they can be developed into very productive citizens”. In this process, access to correct information, proper referral systems, child intervention services, updated technology for optimum benefits, access to general health care and family support systems are imperative, she says. Training parents and caregivers to routinely intervene to improve their children’s quality of life is important, she points out. Lack of specialists who

can address the concerns of children with special needs in the country is a major bottleneck in enabling wider reach. The Special Needs Programme which was launched in Colombo District in July to meet this challenge is being expanded to the rest of the island as well, says Prof. Sumanasena.
Rehabilitation which is recognized as a human right by the United Nations’ Convention on the Rights of Persons with Disabilities, improves the functioning status of people with disability to achieve the highest possible functional outcome, notes Dr. Sachithra Adhikari, Acting Consultant in Rehabilitation Medicine from the Rheumatology and Rehabilitation Hospital, Ragama.
“Lack of an established care pathway directed towards rehabilitation following initial treatment of disability, is a major drawback. Rehabilitation services are provided only by a few hospitals which hardly meet the need.” She goes on to note that the need to generate awareness on the importance of rehabilitation and its cost benefit both among the healthcare professionals and the public is urgent. Drawing attention to limitations in available rehabilitation personnel and infrastructure, she said the lack of coordinated service provision, leadership for financial and administrative support required for rehabilitation service are problems that need addressing. Also, social acceptance of those with disabilities rather than mere sympathy is important together with sensitivity to their plight.
Life style
Rediscovery of Strobilanthes pentandra after 48 years
A Flower Returns From Silence:
Nearly half a century after it slipped into botanical silence, a ghost flower of Sri Lanka’s misty highlands has returned—quietly, improbably, and beautifully—from the folds of the Knuckles mountain range.
In a discovery that blends patience, intuition and sheer field grit, Strobilanthes pentandra, one of Sri Lanka’s most elusive endemic flowering plants, has been rediscovered after 48 years with no confirmed records of its existence in the wild. For decades, it lived only as a name, a drawing, and a herbarium sheet. Until now.
This rare nelu species was first introduced to science in 1995 by renowned botanist J. R. I. Wood, based solely on a specimen collected in 1978 by Kostermans from the Lebnon Estate area. Remarkably, Wood himself had never seen the plant alive. The scientific illustration that accompanied its description was drawn entirely from dried herbarium material—an act of scholarly faith in a plant already vanishing from memory.
From then on, Strobilanthes pentandra faded into obscurity. For 47 long years, there were no sightings, no photographs, no field notes. By the time Sri Lanka’s 2020 National Red List was compiled, the species had been classified as Critically Endangered, feared by many to be lost, if not extinct.
The turning point came not from a planned expedition, but from curiosity.
In October 2025, Induwara Sachinthana, a fourth-year medical student at the University of Peradeniya with a sharp eye for plants, stumbled upon an unfamiliar flowering shrub while trekking in the Knuckles region.
Sensing its importance, he photographed the plant and sent the images for verification, asking a simple but crucial question: Could this be the recently described Strobilanthes sripadensis, discovered from the Sri Pada sanctuary in 2022?
At first glance, the resemblance was striking. But something didn’t quite add up.
Based on the location, morphology, and subtle floral traits, the initial response was cautious: it was neither S. sripadensis nor S. pentandra—or perhaps something entirely new. Yet, as the pieces slowly aligned, and as the habitat details became clearer, the possibility grew stronger: this long-lost species had quietly persisted in the rugged heart of Knuckles.
The confirmation followed through collaborative expertise. Leading Strobilanthes specialist Dr. Renuka Nilanthi Rajapakse, together with Dr. Himesh Dilruwan Jayasinghe and other researchers, carefully examined the evidence. After detailed comparison with historical descriptions and herbarium material, the verdict was clear and electrifying: this was indeed Strobilanthes pentandra.
What followed was not easy.
A challenging hike through unforgiving terrain led to the first live confirmation of the species in nearly five decades. Fresh specimens were documented and collected, breathing life into what had long been a botanical myth.
Adding further weight to the rediscovery, naturalist Aruna Wijenayaka and others subsequently recorded the same species from several additional locations within the Knuckles landscape.
The full scientific credit for this rediscovery rightfully belongs to Induwara Sachinthana, whose curiosity set the chain in motion, and to the dedicated field teams that followed through with persistence and precision.
Interestingly, the journey also resolved an important taxonomic question. Strobilanthes pentandra bears a strong resemblance to Strobilanthes sripadensis, raising early doubts about whether the Sri Pada species might have been misidentified.
Detailed analysis now confirms they are distinct species, each possessing unique diagnostic characters that separate them from each other—and from all other known nelu species in Sri Lanka. That said, as with all living systems, future taxonomic revisions remain possible. Nature, after all, is never finished telling her story.
Although the research paper is yet to be formally published, the team decided to share the news sooner than planned. With many hikers and locals already encountering the plant in Knuckles, its existence was no longer a secret. Transparency, in this case, serves conservation better than silence.
This rediscovery is more than a scientific milestone. It is a reminder of how much remains unseen in Sri Lanka’s biodiversity hotspots—and how easily such treasures can vanish without notice. It also highlights the power of collaboration across generations, disciplines and institutions.
Researchers thanked the Department of Wildlife Conservation and the Forest Department for granting research permissions, and to the many individuals who supported fieldwork in visible and invisible ways.
After 48 years in the shadows, Strobilanthes pentandra has stepped back into the light—fragile, rare, and reminding us that extinction is not always the final chapter.
Sometimes, nature waits.
By Ifham Nizam ✍️
Life style
Desire to connection. understanding sexual health in modern relationships
A conversation about intimacy, belonging and relationships with Dr Yasuni Manikkage
In an age where relationships are shaped as much by emotional awareness as by digital connection, conversations about sexual health are finally stepping out of the shadows.
As Dr. Yasuni Manikkage explains, sexual health is not just a medical issue but a lived experience woven through communication, consent, mental wellbeing and self-respect. Many couples share a home, a bed, even children, yet still feel like “Roommates with responsibilities” rather than lovers, which often signal a lack of emotional safety rather than a lack of physical contact. When desire shifts, they may panic, blame themselves or fear the relationship is dying, instead of recognising that changes in desire are common, understandable, and often transformable with knowledge, honest dialogue, and small daily acts of connection.
Q: Why did you decide to talk about sexual desire and connection now?
A: Because so many couples quietly suffer here. They love each other, share a home, raise children, but feel like “roommates with responsibilities” rather than lovers. They rarely talk about sex openly, so when desire changes, they panic, blame themselves, or assume the relationship is dying. I want people to know shifts in desire are common, understandable, and often treatable with knowledge, communication, and small daily changes.
Q: You say there is an “education gap” in sexual health. What do you mean by that?
A: Most women have never been properly taught about their own sexual anatomy, especially where and how they feel pleasure. Many men, on the other hand, have been left to “figure it out” from pornography, jokes, and guesswork. That’s a terrible training manual for real bodies and real emotions. This gap affects how easily women reach orgasm, how safe they feel in bed, and how satisfied both partners feel in the relationship.
Q: We hear about the “orgasm gap.” Is it really not biological?
A: There are biological factors, yes, but the main gap we see between men’s and women’s orgasm rates in heterosexual relationships comes from communication, knowledge, and what I call “pleasure equity.” In many bedrooms, the script is focused on penetration, speed, and the man’s climax. Women’s pleasure is often treated as optional or “extra.” When couples learn anatomy, slow down, focus on both bodies, and talk about what feels good, that gap narrows dramatically.
Q: Most people think desire should be spontaneous. Is that a myth?
A: It’s one of the biggest myths. Movies show desire as a spark that appears out of nowhere: one glance across the room and suddenly you’re tearing each other’s clothes off. That kind of spontaneous desire does happen, especially early in a relationship. But for many people, especially women, desire is often “responsive”. That means they start feeling desire after some warmth, touch, emotional closeness, or stimulation, not before.
So, if you’re waiting to “feel like it” before you touch or connect, you may wait a very long time. For many, desire comes “after” they start, not before.
Q: How would you scientifically describe sexual desire?
A: Desire is not just a physical urge. It’s a blend of attraction to your partner’s body and personality, emotional connection and feeling cared for, a sense of self-expansion or growth, learning, feeling alive with them, trust and safety, both emotionally and physically. It’s contextual: it changes with stress, health, life stages, and relationship quality. It’s relational: it lives between two nervous systems, not just in one body. And for many, it’s responsive: you get in the mood “after” a hug, a joke, a shower together, not randomly at 3 p.m. on a Tuesday.
Q: You mentioned an “updated sexual response cycle.” What does that look like in real life?
A: Older models suggested a straight line: desire, arousal, orgasm and resolution. That’s tidy, but human beings are messy and complex. Modern understanding is more like a circle or loop. You can enter the cycle at different points: maybe you start with touch, or a feeling of closeness, or even just a decision to connect. Desire doesn’t always come first; sometimes it shows up halfway through.
For example, you may feel tired and not “in the mood,” but you agree to cuddle and share some gentle touch. As you relax and feel appreciated, arousal builds, and then desire appears. That’s normal, not fake.
Q: Are there real gender differences in how desire works?
A: There are common patterns, though individuals vary a lot. Many women tend to enter through emotional intimacy: feeling heard, understood, and safe. Physical touch then wakes up arousal, and desire follows.
Many men more often start with physical attraction or arousal. They may feel desire quickly in response to visual or physical cues, and emotional intimacy can deepen later.
Both patterns are healthy and normal. The problem starts when each partner assumes the other should work exactly like them, and if they don’t, they must be “cold” “needy” or “broken.” Understanding these differences turns conflict into curiosity.
Q: How does desire change as a relationship ages?
A: Think of three broad stages.
stage 1 – Early Attraction (0-6 months): High novelty, strong chemistry, lots of dopamine. You’re discovering each other; desire often feels effortless. stage 2 – Deepening Intimacy (6 months-2 years): You know each other better. The high settles. Desire becomes more linked to emotional closeness. Frequency may drop, and that is “normal”.
stage 3 – Maintenance and Maturity (2-10+ years): Life arrives -work, kids, money, health. Desire usually doesn’t feel automatic. It needs conscious attention, novelty, and emotional safety.
A common mistake is comparing stage 3 desire to Stage 1 and assuming, “we’ve failed.” Actually, you’ve just moved into a different phase that requires new skills.
Q: What are some main things that influence desire?
A:We can think in three layers.
Biological: hormones (testosterone, estrogen), brain chemicals (dopamine, serotonin), medical conditions like diabetes, heart disease, cancer, chronic pain, sleep problems, menopause, and genital issues such as vaginal dryness or pelvic floor pain.
Psychological: negative early sexual experiences, trauma or abuse, body image concerns, low self-esteem, anxiety, depression, and certain mental health conditions.
Relational and social: how safe and respected you feel, attachment style, quality of communication, power imbalances, work and financial stress, caregiving burdens, privacy, and cultural messages that centre on penetration over pleasure. Desire is never “just in your head” or “just in your hormones” – it’s all three interacting.
Q: What tends to kill desire in long-term relationships?
A: Several patterns show up again and again:
Resentment and unresolved conflict – small hurts that never get repaired.
Lack of emotional safety – fear of being judged, rejected, or punished for being vulnerable.
Poor communication – avoiding difficult topics, sarcasm instead of honesty.
Body image shame – feeling unattractive, “too old,” “too fat,” or “not enough.”
Power imbalance -one partner controlling decisions, money, or sex.
Sexual guilt or religious shame messages that sex is dirty, selfish, or only for reproduction.
Stress, burnout, depression -when your nervous system is in survival mode, it doesn’t prioritise pleasure.
You can’t expect desire to flourish in an environment that feels unsafe, unfair, or constantly tense.
Q: And what actually builds desire?
A: Desire thrives in a combination of safety and aliveness.
Emotional intimacy: feeling seen, heard, and valued.
Nervous system calm: your body is relaxed enough to feel pleasure, not just guard against danger.
Open communication: you can talk about wants, limits, and fantasies without mocking or shutting each other down.
Continued growth: doing new things together, seeing new sides of each other, evolving as a team.
I often say: stagnation is desire’s enemy; growth is its ally. Even small adventures -trying a new cafe, dancing in the living room, travelling a different route-can reawaken curiosity.
Q: Can you give couples a simple framework to reconnect?
A: Yes, I often share a six-step framework that’s practical and gentle.
1. Check in: Ask, “How connected do we feel lately?” Not just “How often are we having sex?”
2. Non-sexual touch: Hugs, stroking hair, holding hands – without expecting sex at the end.
3. Novelty: Try something new together: a class, a walk in a different place, a game, a shared hobby.
4. Appreciation: Tell your partner what you notice and value about them, including non-sexual qualities.
5. vulnerability: Share one fear, one hope, or one truth you usually hide.
6. Initiation: Don’t wait for desire to fall from the sky. Gently invite connection; sometimes the mood follows the movement.
You don’t need to do all of this perfectly. Even one or two steps, done consistently, can shift the energy between you.
Q: How can someone tell if their desire problem needs more attention or professional help?
A: some warning signs include:
You feel emotionally distant, even though you still love each other.
Desire has dropped sharply and is tied to stress, shame, or unspoken conflict.
You feel unable to talk about sex without fighting or shutting down.
sex is used to avoid real intimacy, or to keep the peace, rather than to connect.
You feel afraid or ashamed to say what you truly want-or what you don’t want. In these situations, talking to a doctor, a sexual medicine specialist, or a therapist can be very helpful. You are not “broken” for needing support.
Q: Many couples say, “We love each other but there’s no spark.” What do you tell them?
A: I often say, “Let’s first normalise where you are.” If you’ve been together for years, maybe raising children and navigating financial pressures, it’s normal that your desire doesn’t look like the early days. That doesn’t mean your relationship is dying.
usually, you’re in the maintenance phase. Desire is quieter but can be reawakened with intentional effort: scheduling time for each other, bringing in novelty, and rebuilding emotional safety. It’s less about chasing fireworks and more about tending a fire so it doesn’t go out.
Q: what about couples with mismatched desires – one wants sex often, the other rarely?
A: This is extremely common. The mistake is to frame it as “the pursuer is demanding” and “the less-desiring partner is rejecting.” underneath, there are often two different nervous systems trying to feel safe.
one partner might use physical closeness to feel secure and loved. The other might need emotional safety first before their body can relax into physical intimacy. When couples understand this, they stop seeing each other as enemies and start cooperating: “How can we meet ‘both’ our needs, instead of arguing about who is right?”
Q: Many people, especially women, say sex feels like an obligation. What does that signal to you as a doctor?
A: It’s a red flag – not that the person is broken, but that something important is missing. sex should be about connection, pleasure, and mutual choice. when it becomes a duty, I look for:
Emotional disconnection or resentment.
Fear of conflict or abandonment if they say no.
Lack of felt safety or freedom to express preferences.
The solution is not to “force yourself more.” It is to rebuild emotional safety, renegotiate consent and expectations, and often to have very honest conversations about what feels missing or painful.
Q: If you could leave couples with a few key messages about desire and connection, what would they be?
A: I’d highlight four truths:
Desire and emotional intimacy are deeply connected. When you feel safe, loved, and seen, desire has space to grow.
Desire changes across life and relationship stages. That’s normal, not evidence of failure.
Safety is the foundation. without trust and a calm nervous system, no technique or position will fix desire.
You have agency. Through communication, intentional connection, and sometimes professional help, it is possible to revive and reshape your sexual relationship. If you are reading this and thinking, “This sounds like us,” my invitation is simple: start with one honest conversation. Ask your partner, “Where do you naturally enter the cycle -through emotions, touch, or arousal? What helps you feel desire? What do you need from me to feel safe and wanted?”
Those questions, asked with kindness and curiosity, can quietly change the entire trajectory of a relationship.
Life style
Ramazan spirit comes alive at ‘Marhaba’
At Muslim Ladies College
The spirit of Ramadan came alive at the Muslim Ladies as the much-awaited pre-Ramadan sale “Marabha” organised by MLC PPA unfolded at SLEC the event drew students, parents and old girls to a colourful celebration filled with the aromas of traditional delicacies and the buzz of excitement from the buzzling stalls
Behind the seamless flow and refined presentation were Feroza Muzzamil and Zamani Nazeem. Whose dedication and eye for detail elevated the entire occasion. Their work reflected not only efficiency but a deep understanding of the institution’s values. It was an event, reflected teamwork, vision and a shared commitment to doing things so beautifully. The shoppers were treated to an exquisite selection of Abayas, hijabs and modern fashion essentials, carefully curated to blend contemporary trends with classic elegance. Each stall offered unique piece from intricately embroidered dresses to chic modern designs. The event also highlighted local entrepreneurs a chance to support homegrown talent. Traditional Ramazan goods and refreshment added a delighted touch, making it as much a cultural celebration as a shopping experience.
- Endless deals,endless possibilities
- Goods at reasonable prices
- Zamani and Feroza setting the bar high
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