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World AIDS day

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by Dr. Sujatha Samarakoon

First recognized in 1988, World AIDS Day falls on December 1 each year. Every year, on December 1, the world commemorates World AIDS Day. On this day, people around the world unite to show support for people living with and affected by HIV and to remember those who lost their lives to AIDS.

An estimated 40 million people worldwide have died of AIDS since 1981, and an estimated 38 million are living with HIV by end 20191 and 1.7 million became newly infected in 20191 making it one of the most important global public health issues in recorded history. Despite recent improvements in treatment, the AIDS epidemic still claims an estimated two million lives each year, of which more than 250,000 are children1.

Since 1988, Sri Lanka has been commemorating World AIDS day which is dedicated to spreading awareness of the AIDS pandemic and the need to prevent and control of HIV in the country and to remember those who have died of the disease.

The red ribbon has become an internationally recognized symbol for AIDS awareness, worn by people throughout the year in support of people living with HIV and in remembrance of those who have died.

Sri Lanka is categorized as a country with a low prevalence of HIV infection as the HIV prevalence among adults above 15 years of age was 0.1% as of end 20192. At the end of 2019, it is estimated that around 3,600 people are living with HIV in the country2. The main mode of transmission is through unprotected sex2. The National STD/AIDS Control Program (NSACP) of the Ministry of Health, which spearheads the national response to HIV/AIDS commenced interventions even before the first HIV infection was diagnosed in the country in 1986. The initial programs were mainly to create awareness among the general population especially the youth and women on methods of prevention. Concomitantly HIV testing services were introduced free of charge in the government sector where people were able to get the HIV test done to know their status maintaining confidentiality.

A policy decision was made to screen all donated blood for HIV infection in the public sector and also the private sector. The outcome of this timely decision was that since year 2000 no blood transfusion associated HIV infections have been reported to the national programme. This was a great achievement for the health sector and the people of Sri Lanka. Awareness programs were then expanded to involve the key population groups or populations most at risk to HIV infection due to a variety of reasons including high risk sexual behaviors. The highest prevalence of HIV is reported among men who have sex with men (MSM) at 1.5%2. HIV prevalence is also reported among trans-gender women (TGW), female sex workers (FSW), beach boys (BB) and injecting drug users (PWID)2. Other high-risk groups include prisoners, drug users and migrant workers. Between 2011 and 2019, new HIV infections among adult males have been increasing exponentially from 78 cases to 359 cases, which is a 460% increase2. Currently, the national programme is reaching out to key population groups using several approaches especially to reach the hidden high risk populations.

In 2004, a policy decision was made to provide anti-retroviral therapy (ART) to people living with HIV (PLHIV) through the national programme. As of end 2019, a total of 2,302 (64%)2 knew their HIV status and 1,845 (51%)2 registered for treatment which is offered free of charge.

AIDS Foundation Lanka (AFL) was established in 2008 after the Eigth International Conference on AIDS in Asia & Pacific (ICAAP) was held in Sri Lanka. The objectives of the AFL is to support the National STD/AIDS Control Programme in conducting awareness programmes to educate the general population and key population groups on basic facts of HIV/AIDS, access and availability of services and support people living with HIV.

Throughout the years, AIDS Foundation Lanka has reached out to several population groups such as out-of school youth, formal and informal sector workers and healthcare workers in educating them on basic facts of HIV which includes the methods of transmission and prevention, availability of services and the need to dispel stigma and discrimination. Several awareness programs were held at workplaces, hospitals and communities. These programs are conducted to support prevention efforts and also the “test and treat” policy of the national program by encouraging those who are living with HIV and do not know their status to get themselves tested for HIV. People with HIV who are aware of their status, take ART daily as prescribed which helps to control the replication of the virus and keep an undetectable viral load which enables to live healthy lives and have effectively no risk of sexually transmitting HIV to their HIV-negative partners.

Every year, AFL commemorates the World AIDS Day by conducting awareness programs for the general public including women and youth.

Although a non-profit organization, AIDS Foundation Lanka, continuously supports people living with HIV by providing them a nutritious food package monthly, educational grants, book vouchers, school bags and shoes, tuition and transport fees for children infected and affected by HIV. Some are supported in initiating self-employment income generating projects and by paying overdue housing loans. One objective of these support schemes is to strengthen the link of PLHIV with the national programme as around 10-20% of patients registered with the national program defaults attending services.

During the COVID-19 period, the national program has made every effort to provide HIV testing services, treatment and care. The AFL has supported these endeavors by increasing the food package allowances, transport allowances to travel to HIV service providing clinics and on-line tuition fees for students.

AIDS Foundation Lanka is supported by several well-wishers who have undertaken to look after an individual or a family. The well-wisher provides the nutrition package or tuition fees to AFL and AFL handles all donations maintaining confidentiality. Some school children through their social clubs, interact clubs have come forward to donate nutrition packages, school books and other utilities. HIV positive pregnant women are provided with additional nutrition support and a maternity kit which contains baby clothes and other utilities for mother and baby worth SLR 8,000/=. All PLHIV related support activities are carried out maintaining confidentiality of donors and recipients. AFL is located at the first Floor of Sri Lanka Medical Association (SLMA), No 6, Wijerama Mawatha Colombo 7. Phone number 011-2690230.

(The writer is a Consultant Venereologist and President AIDS Foundation Lanka)

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Don’t shun sunshine Vitamin

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While most of us avoid the hot sun at noon, we deprive ourselves of ‘Sunshine Vitamin’ or Vitamin D which is at its peak during that time of the day. In an interview with the Sunday Island, Head of the Department of Nutrition at the Medical Research Institute (MRI) and President of the Sri Lanka Medical Nutrition Association (SLMNA), Dr. Renuka Jayatissa throws light on the latest research which has unearthed new knowledge about this natural nutrient boosting our immunity which we often take for granted.

by Randima Attygalle

Known as ‘Sunshine Vitamin’, Vitamin D is produced by the body when the skin is exposed to sunlight. Vitamin D also functions as a hormone and every body cell has a receptor for it. Sun exposure at mid-day (from 10 a.m. to 3 p.m.) is the best way to boost vitamin D levels, says Head of Nutrition at the Medical Research Institute (MRI), Dr. Renuka Jayatissa. “Although morning sunlight was traditionally believed to be the best source of vitamin D, new knowledge confirms that 10 to 15 minutes of exposure to midday sun is the best time to make use of sunshine. The exposure becomes even more important as dietary intake of vitamin D is not sufficient.

The findings of local research speak for the changing nature of vitamin D intake, contrary to the popular belief that those from tropical nations are the most benefitted by this nature’s panacea. While the population from the Central and Sabaragamuwa Provinces are the most vulnerable to the deficiency due to the climatic patterns, the North Central Province is the least vulnerable given the hot climate of the region and the agrarian lifestyle. “The findings also reveal that 50% of adolescents of the country and nearly 95% of women are vitamin D deficient. This situation is alarming as it is a precursor to a host of other health issues including immunity problems, loss of bone density and muscle weakness,” explains Dr. Jayatissa who warns that COVID-19 pandemic has compounded the situation with restricted movement and children being home bound.

The vitamin D intake from the sun depends on the degree of exposure to sunlight. “If you wear long sleeved shirts/ blouses and trousers, it is most likely that you will get only about 10% of exposure with only your face and neck exposed. However if you wear a short-sleeved shirt/blouse and a mid-length skirt or a frock, you will get about 30% exposed,” points out the physician. “What is recommended is about 10 to 15 minutes of exposure daily. However, overweight people and those with a darker skin complexion will require more. While peak period is between 12 noon to 1 p.m. in the afternoon, ironically this is the time that most Sri Lankans tend to avoid the sun, given the humidity of the environment, says Dr. Jayatissa.

“The school interval is limited only to half an hour and this too during mid-morning. As most children may take their first meal for the day during the interval, there is hardly time for play,” observes the nutrition specialist. Recommendations have already being made to the School Committees of the Education Ministry to give children another mid-day break so that they are exposed to the peak period of sun, says Dr. Jayatissa. “Vitamin D is crucial for children on the threshold of puberty (10-15 years) as it affects growth and immunity.”

The rising elderly population in the country too calls for interventions to mitigate vitamin D deficiency as fractures are a common repercussion. Vitamin D deficiency can lead to a loss of bone density which in turn can cause osteoporosis and fractures. “With the elderly population multiplying in years, disability will be an added burden,” warns Dr. Jayatissa. Vitamin D is crucial for calcium absorption and bone metabolism. Low bone density results in loss of calcium and other minerals in bones. Older adults, especially women are at an increased risk of fractures due to this.

Risk factors for vitamin D deficiency are many. Besides lack of exposure to sunlight, having dark skin, being overweight or obese, being elderly, lack of dairy and fish in diet, excessive use of sun screen are among them. “Obesity is a risk factor for the deficiency as increased fat cells in the body require larger doses of vitamin D,” observes the physician who goes onto note that lifestyle patterns too trigger the condition. “Although those who live far from the equator are traditionally considered to be lacking vitamin D, their understanding of this drives them to be exposed to the sun as much as possible. Walking or cycling to work, walking to a cafeteria, traveling to tropical regions during summer etc. push them to bridge the gap. Ironically in our part of the world, apart from farmers and other workers such as those in the construction industry and the manual labour force, people are deprived of sun exposure.”

Since symptoms of vitamin D deficiency are often subtle, many people will not realize that they are lacking it. “However this could affect the quality of life,” remarks Dr. Jayatissa. Height gain is seriously threatened by the condition, she says. “Compared to taller communities such as the Dutch whose average height for males is about 180 cm, Sri Lankan average height is about 168 for men and 153 for women. This may even decrease in time to come, unless the situation is urgently addressed”. Sun exposure as the vitamin D booster cannot be undermined, especially because very few foods such as fish, fish liver oils, egg yolks and fortified dairy and grain products contain vitamin D, notes the nutrition specialist.

Keeping the immune system strong is one of the key roles of vitamin D. During the pandemic, this becomes even more valid as a strong immune system can fight off viruses and even bacteria that cause illness. Studies have confirmed that vitamin D can reduce the risk of respiratory tract infections. “Migraines in young people could also be a cause of the deficiency and muscle cramps in the night among the elderly could also be a strong symptom,” points out Dr. Jayatissa. Bone and back pain, impaired wound healing and even low moods are among the other symptoms.

Certain studies have also found that vitamin D can help treat skin conditions such as psoriasis and eczema. While sunshine can do wonders to your skin and body, too much of it can be risky, points out the physician. “Sun spots as a result of sunburn, skin aging, heat stroke and skin cancer are among them.” Administering vitamin D supplements should always be done on clinical advise as vitamin D toxicity entails its own dangers, concludes Dr. Jayatissa.

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Leopard human coexistence

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WNPS Monthly Lecture

Insights from Jawai India by Shatrunjay Pratap Singh

6 pm, 21st January 2021 via zoom and FB live

Jawai sits right between Jodhpur and Udaipur India. It is known as the land of shepherds and leopards. It is one of the few regions in India perhaps in the world, where human beings and big cats have peacefully coexisted for over 100 years.

Leopards of Jawai is a story of the harmonious relationships shared by the leopards and the local Rabari tribes of the region. Yet this pastoral region of just less than eight square miles in the Aravalli hills between the tourist meccas of Udaipur and Jodhpur contains the largest concentration of leopards on the planet. The leopards’ conspicuous presence is due to a unique relationship with the Rabari, a tribal caste of semi-nomadic cattle herders and shepherds.

With Sri Lanka coming out of the worst ever year for it big cats, with over 13 reported deliberate killings, its important to look at unique stories of harmony between man and the leopards of the region and adapt possible best practices.

Shatrunjay Pratap, a wine-maker-turned-conservationist and wildlife cameraman. He co-authored the book Leopards & Shepherds of Jawai and was the cameraman on National Geographic’s special programme Wild Cats of India. After spending almost all his life with wild animals, he’s learnt and understood nature’s rules and has witnessed the cruel outcome of human beings who don’t respect or abide by those rules.

“There is a deep rooted synchrony between everything we find in nature. Animals and plants, all know their place and responsibilities, while understanding that they are a part of the natural order. We, as humans, foolishly think that we are separate from all of this and therein lies the problem. If we can be humble and accept that we are a part of nature, and not separate from it, we can learn to do things in synchrony with nature, all in a way that is sustainable to all life.” 

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Bridal and hair trends for 2021

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by Zanita Careem

Simplicity in bridals, =short bridal veils, =fresh faced looks and coloured hair

Ramani Fernando of Ramani Salons, an experienced hairstylist who is renowned for her excellent hair cuts and sublime hair colouring.

I have looked after hundreds of brides and its always a privelege being involved in thier big day says Ramani.

Though the big wedding may seem like a distant memory in 2020, brides around the country aren’t giving up on the dream altogether: Adapting to he new normal, this year’s chaos has had a significant impact on the way brides choose to wed, setting a new tone for 2021.

With the arrival of 2021 we’ve tapped Ramani Fernando to give us the lowdown on how bridal fashion has been thrown up- side down in 2021.

“It’s been heart-warming to watch everyone pivot and adjust and continue to celebrate beautiful moments of love in a safe and different format,” says Ramani . Our experience was very interesting, it’s always a little nerve-wracking lexperience something completely new and different, but the more I thought about it, the more it felt like 2021 bride needs right now—simple. elegant, luxurious dresses or sarees.

And through it all, we’ve seen couples get creative with their nuptials, and do away with all of the frills to embrace the day for what it is: a celebration!

So, with that in mind, these are the bridal trends we’re tipping to be huge this upcoming year, from the gown and bridesmaids dresses to the decor and flower arrangements.

Bridal Gown Trends 2021

Arguably the main event for many of us, gowns are usually where we see the most changes happening year-on-year. But this year, all trends seem to embrace individuality and bold statements that aren’t too fussy It’s all about fun and ease in 2021.

According to Ramani, we can expect versatility to be a major point for bridal gowns come 2021. “Brides are opting for chic and simple silhouettes. an understated elegance that results in a dress which can be worn on more than one occasion, rather than living in storage for years to come,” she says.

With this shift,this popular hairdresser says we can expect a continuation of off-whites and neutral tones to dominate. as well as an increased demand in “high quality, luxe dresses which are designed to last a lifetime.”

I think we’ll see splashes of pastel accents. You can never go wrong with a soft colour says Ramani adding that “it doesn’t take away from the bride but it adds beautiful. feminine touch-points throughout the day and experience.”

‘We’re big fans of unconventionally-coloured weddings dresses and with 2020 being such a gloomy affair for many, we’re hoping to see lots of bright aisle’ moments taking place in the new year.

And, while vibrant hues may not be everyone’s cup of tea, the key to making them classic is all in the silhouette. Unlike day-to-day dressing where we recommend keeping shapes and fits simple when playing around with colour, for your big day. Opt for a show-stopping shape that keeps the look chic and elegant

For the brides daring to bare, we suggest opting for a full-length dress that doesn’t distract from the main event.

 

The best part?

It does wonders to flatter but the flexible elastic allows you to freely mingle and dance without being held down by tight fabric—a win, in the looks.

It goes without saving that a dress just isn’t for everyone. And even those who always pictured themselves wearing a Princess Diana-style monument have found that sarees indian or Kandyan are more suited to some.

And luckily, a host of designers in Sri Lanka are starting to do bridal attires to suit the shape of brides.

 

We’re particularly loving the chunky tie-up styles as well as the spaghetti strap versions that add a whimsical touch to even the most classic of silhouettes.

Forget sweetheart and scoop, 2021 will be all about square necklines said one the bridal designers.

As we’ve seen in the fashion trend cycle, straight, minimalist necklines are an instant way to dress up an outfit, and can be just as flattering as the deeper-cut options said one of these designers.

The simplicity of this elegant shape means it can be worn with just about any shape or dress length. too.

Bridal Accessory Trends 2021

You’d be forgiven for wanting to keep your accessories low-key-especially if you’ve splashed out on a gown—since it’s a common mistake that they can steal the limelight. Bold and colourful accessorises peacefully coexist with the rest of your took, but it can compliment and even elevate an entire bridal look.

High Impact Headwear

Understated looks certainly have their place, but statement headwear is an exciting addition to any outfit.

Between all the options out there, the world is your oyster, but we’re loving the new classics like chunky headbands and embroidered veils.

The golden rule with these accessories is to keep your makeup and hair looks relatively classic. Nothing suits a headpiece more than a chic. slicked bun a la Miranda Kerr.

Pearls have been the reigning accessory trend this year. and so of course they’ll be popping up everywhere in the bridal sphere.

Look out for pearl-encrusted stilettos and hair accessories that inject a bit of old-school Hollywood glamour.

Non-traditional Footwear I _, , ,

Something that we’re definitely going to be seeing more of in 2021 are darker colour – or the bride and groom parties/

To make sure the looks are more classic than risque or even boring, Ramani has created silhouettes that are flattering and have thoughtful touches like bow details and frilled hems that keep them interesting, all while not stealing any attention.

Traditionally thought to be a bit of taboo when it comes to bridesmaids dresses, prints are slowly gaining traction as a way to introduce some fun into the mix.

Even better, having each bridesmaid in a different dress has also become the go-dewy with a touch of glow. Neutral eyes with shimmer and contour to enhance one’s look. will be popular.

Q: Hair styles, hair colours and haircuts: What do you think the trends will be?

A:

Sleek low buns, hair combed backwards and clipped behind the ears. Even lose hair with waves will be popular.

Q: The haircuts and colours?

A:

Tousled bob haircuts, the hair bobs texlined hair cuts but this will change according to the client’s requirements.

Talking about

the young teenagers they love to colour their hair in purple, red and green. The older folks will be having their perennial favourite colour brown or bronze with darker roots and lighted ends..

A new year beckons new changers. Switching things up with brand new hair colours are fashionable for 2021. The trends right now reflect all that has been happening in our world and our lives says Ramani Fernando.

People are looking to lift up their spirits with new shades or make their lives easier with less maintenance. We hope 2021 will be a brighter year for all. Fashions change style remains.

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