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Realizing a holistic sexual and reproductive health care system

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Speaking to Sunday Island, Dr. Pramilla Senanayake, International Consultant in Sexual and Reproductive Health, former President of the Family Planning Association of Sri Lanka and Trustee of the AIDS Foundation, Sri Lanka, elucidates on the need for a more open dialogue about sexual and reproductive health among masses and enlightens on ‘myths and facts’ of sexual health which need to be mainstreamed. Following are the excerpts:

By Randima Attygalle

Q: As a woman who made a mark at a time when only a few women professionals were visible in sexual and reproductive health care, when you look back at your early years in the profession and now, do you notice any notable progress?

A:

If we look at statistics and numbers, we have done well. In terms of our contraceptive prevalence we are on par even with more developed countries. Our maternal mortality is quite low because our maternal health care system is effective. But still there are a lot of gaps – we see many unwanted pregnancies and abortions. Today the sexual debut is very early. A few decades ago, pre-marital sex was not as common as it is today. Yes, things have changed, we have moved on, but we still have a long way to go.

Q: In our much lauded public health care setting, what is the positioning of sexual and reproductive health care?

A: It is because of this effective public health care system that we have been able to introduce to it various elements that are relevant to reproductive health. But having said that, I must add that sexual and reproductive health is one of the neglected areas in the health setting. It is a subject that people are still reluctant to talk about openly as it involves sex and many ‘hush-hush’ aspects. Although more liberal-minded social levels of society are open about it, it is only a minority and sometimes they too can get wrong information about sexual health which needs to be dispelled. Certain other classes find the subject matter uncomfortable and even the term ‘sex education’ drives people into giggles and embarrassment. This is why we are trying to bring family life education into the school curriculum.

Q) What are your proposals to move forward and enable wider sexual health literacy?

A:

We need to talk to the public – parents, teachers, employers, employees etc. in a simple language without complicating things. For this, we need to engage competent professionals who can answer questions and debunk myths. The Family Planning Association of Sri Lanka has initiated programmes to reach out to young girls in the Free Trade Zone – to educate them on sexual health. This kind of intervention needs to be replicated in several other settings. Especially in this pandemic situation where there are lockdowns and restricted movement, sexual abuse is on the rise and the flipside is there is more opportunity now to get the message across. Our voices can be those in wilderness unless mass media joins hands. Mass media is an effective vehicle in communicating the message of sexual wellbeing.

Q: Sexual and reproductive health of those with disabilities still remains a less-talked about subject. Sexual needs of those with disabilities are often overlooked. What are your thoughts?

A:

We are all sexual beings including those with disabilities. Every human being has a right to a safe and rewarding sexual life and sexual health. We cannot afford to exclude those with disabilities; instead we need to assist them in finding other ways of gratification and work around such areas of gratification. Sexual life does not necessarily have to entail penetrative sex in a traditional sense, but it could involve sexual gratification in a broader sense which can be enjoyed by people with certain disabilities.

The issue is we don’t talk to them enough and educate them on sexual and reproductive health, clouded by the misconception that they have problems other than sexual needs to be burdened with. This is wrong. We need to be conscious of the fact that girls and women with disabilities are the most vulnerable to rape and sexual abuse. Institutions such as Ayathi affiliated to Ragama Rehabilitation Hospital addresses the concerns of those with disabilities, but there is an urgent need for many more similar institutions in the country.

Q: The aging population is on the rise worldover and Sri Lanka is no exception. In this context how important do you think it is to address the emotional and sexual concerns of this population?

A: It is very important to address their concerns. It is again similar to the case of those with disabilities – an often neglected topic. I’m a trustee of the Sunshine Senior Foundation which is dedicated to addressing areas of particular interest to senior citizens and we do enable dialogue on this topic. Yet we need to create a better dialogue at national level, challenging as it may be given our cultural context in which intimacy in old age is almost a taboo.

Q: Although Sri Lanka still remains an HIV low-prevalence country in a global context, HIV-positive cases are accelerating. As an activist fighting HIV, what are your comments on this rising trend?

A:

It is a very worrying situation, especially since we are still considered a low-prevalence country. The biggest bottleneck in the fight against HIV is social stigma. Through the AIDS Foundation of Sri Lanka, we try to assist in providing accommodation for HIV-positive people. Despite our ability to fund houses for them, many landlords were reluctant to rent out houses and in certain situations, although the landlord was willing, there was enormous protest from neighbours.

Despite the country having a system for voluntary testing and counseling for HIV, not many come forward to be tested. Today there are many commercial sex workers and men who have sex with men, those with multiple partners. These are high risk groups. We should also not forget prison inmates who are another high risk group. Although the Family Planning Association of Sri Lanka and some other agencies are working with prison communities on this, there should be more muscle given to their work in preventing HIV.

In Sri Lanka many of the HIV positive cases are detected through pre-natal clinics where pregnant women are tested for it. But this is just the tip of the iceberg as a considerable percentage go unreported. Today with COVID taking the centre stage, many other health concerns including HIV have gone backstage. Yet we cannot afford to be complacent about these health issues which will take a toll on the entire national fabric of the country.

Although we have done quite well in our other health domains, the same cannot be said of HIV education. Several of our regional counterparts including Pakistan and India are using very innovative means of addressing this issue. Countries such as Japan, South Korea and Singapore have very good models on combating HIV from which we could learn a lot.

 

 

FACTS Vs MYTHS

 

*Myth: All birth control methods are equally effective at preventing pregnancy

*Fact: Each method has a different level of effectiveness. The ones that are best at preventing pregnancy (over 99% effective) are sterilization, IUDs, implants, and injectables. Pills, patches and the ring are about 91% effective. Condoms are 79-85% effective, emergency contraceptive pills are 89-95% effective, and withdrawal is much less effective. Using birth control consistently and correctly each and every time will increase the chances of their effectiveness

*Myth: Emergency contraception is only effective the morning after unprotected sex

*Fact: The emergency contraception pill (ECP) is sometimes called the ‘morning-after-pill’. Although the ECP should be taken as soon as possible, it does not have to be taken in the morning. There are two types of ECP that work for up to four or five days after sex and they are both more effective when taken as soon as possible. The ECP is not an abortion pill. If you are already pregnant, ECP will not work.

*Myth:

You can’t get pregnant during your period

*Fact:

It is unlikely, but still possible—especially if you’re not using birth control. Some women have long periods that overlap with the beginning of ovulation, which means they can be fertile even though they’re menstruating. If you have a short cycle (21 days, for example) and your period lasts a week and you have sex close to the end of your period, you could become pregnant since sperm can live for up to 72 hours in your reproductive tract.There’s also the infamous late-in-life pregnancy that can occur during perimenopause, when periods are erratic. It is not safe to ditch birth control until you haven’t had a period for a year.

*Myth:

You only need to worry about sexually transmitted infections (STIs) if you have multiple partners

*FACT:

As long as you are sexually active you should remember that contracting an STI is a possibility, even if you only have one sexual partner. It’s a good idea to make sure you and your partner(s) are tested for STIs before having sexual intercourse together for the first time. It’s also recommended that you regularly test for STIs if you are sexually active. 

*Myth:

You can’t get STIs if you don’t have penetrative sex.

* FACT:

STIs can spread from skin-to-skin contact and from bodily fluids. This means you can catch STIs from having any type of sex, including penetrative vaginal sex, but also from anal sex, oral sex , using your hands, intimate skin contact and sharing sex toys.

 

 



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Two centuries tick by on Dockyard clock

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The Belfry Gate of the Trincomalee Naval Dockyard, a national architectural monument, is unknown to many. The once twin-towered belfry is now a single tower with its twin long gone. It has served as loyal timekeeper for sailors in the dockyard for 200 years and continues to do so

by Randima Attygalle

The strategically located natural deep water harbour in Trincomalee has been coveted by traders and colonists since ancient times. The earliest reference to this port of call once known as ‘Gokanna’ is found in Mahavamsa – the great chronicle of Sri Lanka. During the colonial days, Trincomalee or Trinco as it’s commonly called, was occupied by the Portuguese, Dutch, French and the British. The fort which was built by the Portuguese to keep rival sea faring nations at bay was expanded by the Dutch.

The British captured Trincomalee from the Dutch in 1795 during the Napoleonic Wars. Under the Treaty of Amiens of 1802, the Dutch ceded Ceylon to the British. H.A Colgate in his, The Royal Navy and Trincomalee- the history of their connection (The Ceylon Journal of Historical and Social Studies, Volume 1, Issue 1) documents that ‘in the days of sail, Trincomalee owed its importance to the variations of the monsoon, the prevailing winds in the Indian Ocean. A squadron defending India had to lie to the windward of the continent. It also required a safe harbour in which to shelter during the violent weather occasioned by the change of the monsoons in October and to a less extent in April. Only Trincomalee could fulfill these conditions. Thus its use was the key to the defence of India and the inestimably valuable British trade with India and China, which passed through the adjacent seas.’

The British used Trinco as an anchorage for Royal Navy ships in the Indian Ocean and when the steam powered ships were launched, the Royal Navy erected a coaling station to support bases throughout the British empire. Lieutenant Commander (Rtd) Somasiri Devendra, an authority on maritime archaeology, says that the Royal Navy constructed all its dockyard-related buildings along the coastline at the entrance to the port.

“The buildings were completed by 1812 and soon after this, the conclusion of the Napoleonic wars ended the threat to the Royal Navy from the French and the Dutch and the expansion of the dockyard was halted. Trincomalee became a backwater for most of the 19th Century with its major role being that of a coaling station. Coal was stored in bulk on old ships at anchor known as coaling hulks.”

Devendra explains that all buildings within the dockyard premises were accessed through the gates popularly known as Belfry Gates. These with their twin towers were built by the British in 1821. Only one tower remains today. The exact reason for the demolition of the twin and when it was done is not established. It is presumed that one of the towers was demolished when roads were being widened for heavier traffic. “This must have been somewhere between the first and the second World Wars,” says Devendra.

Most of the civilian labour working for the Navy lived outside the dockyard and the bell possibly would have been rung to mark the time of opening and closing of the gate, he said.

“The large house near the dockyard gate known as as Belfry House in which I once lived is now two houses,” he recollects. The belfry gate stands where three roads meet, marked by a traffic light believed to be the first in the country. The lights that still work well were probably needed to manage and ensure the safety of numerous vehicles carrying building material, ammunition, artillery, spare parts, and sailors and soldiers who were busy fortifying the naval dockyard and attending to the needs of ships and craft anchored in the harbour.

“When I got my driving license, there was only one set of traffic lights in Colombo – at the Kollupitiya junction. So the Trinco traffic light is probably the first in the country,” says Devendra. He adds that one of the roads controlled by these lights goes uphill to the Dutch Fort Ostenburg where the Dockyard Signal Station was situated. “It’s a steep road through forest and made of concrete, supposedly the first such road built here.”

Those who served in the Dockyard remember the belfry very well. “Traditionally, when naval officers who long served there are transferred they’re presented a replica of this landmark for display in their homes to remember their time at the dockyard,” says Rear Admiral (Rtd) Niraja Attygalle who had served many years there during his naval career.

“Two hundred years is certainly a long period for a clock to tick giving the accurate time for men in white and men in overalls in workshops as well as for naval civilian workers in the dockyard. Also, the gear mechanism and electrical circuits of the traffic lights still work perfectly.”

The responsibility of maintaining both the belfry clock and traffic lights lie with the technical staff of the dockyard and their work needs to be appreciated, says Attygalle. “Even though the original bell has not rung for years to ensure its conservation, a smaller version has taken over that duty. The quartermaster of today’s Navy Dock, standing in the shadow of the belfry, announces the time by ringing the bell as done onboard on a man-o’-war,” he says.

Although unknown to many, the Naval Dockyard Belfry which marks its bicentennial this year (its exact date of unveiling is unknown) is an iconic landmark. “This unique structure reflecting British architecture during the occupation of the Dockyard by the Royal Navy must be acknowledged for its 200-year history as part and parcel of the Dockyard fraternity,” reflects Deputy Area Commander (East), Rear Admiral Anura Danapala. “Every single Naval Officer and sailor serving today and those who have retired will undoubtedly recall with sentimental pride, the unique service the belfry has rendered over two centuries.”

“The belfy had been the timekeeper for the naval fraternity in the dockyard and may it continue to serve for several more centuries,” says the officer.

(Pic credit: Somasiri Devendra, Niraja Attygalle)

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Subtle make-up to make you glow

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by Zanita Careem

Ramani Fernando, beautician and hairstylist has many experience in the beauty industry ,. juggling homelife while climbing up the corporate ladder. She is a lover of minimalism! on par with international beauticians: She creates signature styles that are one of a kind.You must be a marketeer of yourself in order to establish trust, respect and support amongst your clientele says Ra,ami .

A self possessed ‘beauty icon’ Ramani knows how to sell herself, with her charming demeanor, she offers the total package of beauty and brain.

What is beauty?

To me beauty is an energy, we all possess that comes from the soul and radiates through the skin and face. Beauty is personal but it is also universal. Beauty is everywhere and it inspires us all the time.

Make up is indefinite, it has many possibilities of making someone confident For me it took me sometime to step out of my comfort zone and use different colours on different people, but when I started there was no stopping, it was admired by many clients,Most importantly, when clients pay me compliments I am so happy. Beauty industry is challenging and this challenges honed my artistic skills.

Beauty comes from within and everyone has a way of portraying thier looks by colours. Makeup simply enhance s ‘ an individual’s existing features.

How would you describe your makeup style and what sets you apart from others What are your signature styles as an artist?

I am an individual and as an individual I have own creative styles to suit one’s facial looks and features. Nothing can beat the feeling of making someone feel and look beautiful.

What is your beauty philosophy?

I strongly believes in natural beauty. I believe that behind every face there is individuality, which becomes evident from client to client my style differs widely from others. I apply makeup to suit one facial feature and to fit their personality. My signature style is creating a flawless finish complemented with neutral colours on the eyes. It is simple, clean, sophisticated and elegant.

How do you keep up with all the new trends and styles?

Where do you find your inspiration for your makeup looks?

I always keep in mind to watch on TV international fashion shows and trends In my travels.I am inspired by all things around me

In your opinion. What are common mistakes you see women make on their makeup

?

The most common mistakes are bold dark lines on brows.The lipliner should not be too harsh.

What do make up artists do?

Makeup Artists are professionals with artistic skills and they are experts in the use of colours to enhance the beauty and physical attributes.

How do you get your start in the industry?

After travelling to UK, I saw an opportunity to develop my skills, I started working as a junior stylist in a very popular salons in Harrow.

It was at this point that I discovered the potential in me. I came back to Sri Lanka with many innovative ideas. I soon became a trail blazer in the industry, new techniques and new innovative ideas used in my salon that were not available at the time. became the talk of the town.

What do you love most about makeup?

It’s a passion that I loved . I wanted to make people feel more confident with new styles and colours,

Does everyone look better with make up?

Personally, all women are beautiful with or without makeup. It really depends on the individual and their purpose of why they choose to wear makeup. I agree, makeup can completely change the appearance of a women. However, some people who have more blemishes on their faces, acne or any other skin issues usually benefit more from wearing extra pigmented creams and powders in order to lesson the effects of skin imperfections. A strict beauty regime is a must. A good foundation talks volumes about your beaty and looks

What do brides ask for in the post-covid era?

This entire pandemic has made everyone so cautious. It doesn’t change much for brides. When the bride/family decides to go through with the wedding, nothing changes for the bride. She still wants to look the best, she wants her makeup to last through all her functions, She wants to be free of stress and strains So, when it comes to what they’re asking, they aren’t asking for much or anything different

What are your safety measures?

At the end of the day, it’s about who you book as your artiste and how much about the safety in mind.

Do you offer trial makeup?

YES – I not only offer trial makeup, but I also emphasize it. Irrespective of whether they are busy or travelling or whatever may the reason be, it is important. For the simplest reason that if anything needs to be changed or needs to be figured out, it can be done in due time and not the day of the wedding. The best part about having a trial is you can experiment not only with one but with as many styles as you like and finalize what you like best so you know exactly what is happening and you are stress-free on the day of your wedding. It also gives you the opportunity to bond with your bride so she can trust you to deliver your best work on one of her most important day.

How have things changed for you in these times?

2020 has actually been quite a game-changer because it’s something that nobody had imagined could happen; for the whole world to come to a standstill. Like everyone was living through a fast-paced life and someone just hit the pause button. It has affected a lot of businesses because nobody wants to step out and take a chance or risk their health or that of their loved ones – which is the right thing to do right now as well. I think that is the major change this year.

What advice would you give brides that are planning to get married in 2020-21?

They should match their face mask with their bridal trousseau… ha-ha just kidding but on a serious note, the advice for brides planning to get married this year or in the coming year is that NOT let the pandemic dampen their spirits. It is still their day; they still deserve to look the best and feel the best on their wedding day. So, engage an artist they like but also someone who is high on safety standards.

What are the trends in bridal makeup/hairstyles are in right now?

Fashion, Styles, and Trends are indispensable. They don’t go away. What has been trending is the concept of natural beauty and people understand the meaning of natural beauty and they want to see themselves as more than just makeup and that is also the beauty of it. When you do Airbrush makeup or HD makeup, it’s about accentuating your natural beauty. That is what today’s trends are about. It is basically only playing with natural beauty and highlights and contours. Makeup has never been something that you just go in and do. It is about seeing the face and understanding the structure and then creating a look. You have to understand where exactly a contour stops and how much depth you need to give a face and what parts of the face need highlighting. That, I think is something artists know and a professional will understand and is what is trending right now.

What are brides asking for in the post-covid era?

This entire pandemic has made everyone so cautious. It doesn’t change much for brides. When the bride/family decides to go through with the wedding, nothing changes for the bride. She still wants to look the best, she wants her makeup to last through all her functions, she still wants to be treated like the bride and not have any stress.

At the end of the day, it’s about who you book as your artiste and how much you trust them to know they have your safety in mind.

Do you offer trial makeup?

YES – I not only offer trial makeup, but I also emphasize it. Irrespective of whether they are busy or travelling or whatever may the reason be, it is important. For the simplest reason that if anything needs to be changed or needs to be figured out, it can be done in due time and not the day of the wedding. The best part about having a trial is you can experiment not only with one but with as many styles as you like and finalize what you like best so you know exactly what is happening and you are stress-free on the day of your wedding. It also gives you the opportunity to bond with your bride so she can trust you to deliver your best work on one of her most important day.

How have things changed for you in these times?

2020 has actually been quite a game-changer because it’s something that nobody had imagined could happen; for the whole world to come to a standstill. Like everyone was living through a fast-paced life and someone just hit the pause button. It has affected a lot of businesses because nobody wants to step out and take a chance or risk their health or that of their loved ones – which is the right thing to do right now as well. I think that is the major change this year.

What advice would you give brides that are planning to get married in 2020-21?

They should match their face mask with their bridal trousseau… that is if possible. The advice for brides planning to get married this year or in the coming year is NOT let the pandemic dampen their spirits. It is still your day; they still deserve to look the best and feel the best on their wedding day. So, engage an artiste they like but also someone who is high on safety standards.

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Conserving Horton Plains: What the Science Tells Us

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WNPS Monthly Lecture

by Dr Rohan Pethiyagoda

Pix by Ranjan Josiah

20th May 2021, 6.00 pm, via Zoom

Just about everyone who visits a protected area in Sri Lanka comes away with many ideas of how its management could be improved, and Horton Plains is no exception. Despite its small size, Horton Plains is one of our country’s most unique and priceless biodiversity assets—and sadly it faces graver threats than most other protected areas. Over-visitation, fires, alien species, pest species, illegal mining, forest dieback, population declines, pollution, climate change… the list goes on and on.

While a great deal of research has been done on most of these problems, translating scientific findings into management interventions remains a formidable challenge. In this lecture, Rohan Pethiyagoda explores the threats that confront Horton Plains and discusses how he could respond to these. The solutions he proposes are often provocative, controversial, and perhaps even aggressive—but unless these recommendations are openly discussed among serious-minded conservationists, the decline of this jewel in the crown of Sri Lankan biodiversity is set to continue. The 40-minute lecture will be followed by an extended discussion time so that listeners can ask questions or challenge the solutions he offers.

Dr. Rohan Pethiyagoda is a biodiversity scientist who has published widely on Sri Lanka’s fauna and flora. He has published more than 60 research papers, in addition to authoring several books on Sri Lanka’s fauna and flora, through the Wildlife Heritage Trust (WHT), a foundation he endowed in 1991. WHT built up Sri Lanka’s largest specimen collection for research, which was gifted to the National Museum in 2009.

WHT has also helped several outstanding young biodiversity researchers expand their careers by undertaking postgraduate research and some 150 new species were discovered and described through this work. Rohan is also an editor of the journal Zootaxa, has headed several state entities, served as Environment Advisor to the government, and as deputy chair of the Species Survival Commission. He has won wide international recognition for his work, including a Rolex Award.

Conducted successfully over two decades, the Wildlife & Nature Protection Society’s Monthly Lecture series plays an important role in sharing scientific information and knowledge with the public and also acts as a launchpad for conservation initiatives. Please join us online at this month’s WNPS Monthly Lecture, focusing on Horton Plains National Park and what science tells us, about its future.

The WNPS Public Lecture is presented in association with Nations Trust Bank and open to all

Please sign up here https://forms.gle/GSAjK2S1kPBDWD7h7

 

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