An award for family planning 

By Dharisha Bastians 

When the issues of reproductive health are still spoken of in hushed whispers in several parts of the Western world, it is natural that in some of the more conservative democracies the subject matter is virtually taboo. The result - misconception, unplanned parenthood, abortion and sexually transmitted disease. Ignorance, though bliss in some aspects of life, wreaks havoc on lives and has widespread implications for the community at large.

Armed with the banner 'everyone has the right to know,' the Family Planning Association of Sri Lanka has battled every socio-religious prejudice, conflict and controversy to take lessons about reproductive health to the people. Their path has not been rosy, in fact it is strewn with impediments even today, but the association has fought against all odds to counsel and educate, and half a century down the line, their efforts have been lauded by the international health care community.

The Sasakawa Award for outstanding contributions to improving the health status of a society includes a prize of upto US $ 100,000 to enable the selected organisation to continue its projects. This year's Sasakawa was awarded to Sri Lanka's FPA, which was nominated by the Health Ministry and administered by the World Health Organisation in Geneva.

"Our strength lies in the peripherals," said Executive Director, FPA, Ariya Abeysinghe. "It is in the villages that you can actually see change taking place. In the last 50 years in Sri Lanka, we have trained over 50,000 grassroots volunteers and it is truly a success story to see them cut across social barriers and inhibitions to educate their people," Abeysinghe added.

Speaking to The Sunday Leader about the award and what it will mean for the FPA in the year ahead, the association's President, Major Shirley Silva said that they had been awarded US $ 40,000 as prize money, the bulk of which will go towards reproductive health awareness in the war-ravaged north and east. "During the implementation period of two years, the FPA will focus on building the capacity of local grassroots organisations, all of which are completely accountable to the association," the Major said adding that all these programmes would focus specifically on women, adolescents and youth. Silva said that since the association did not have the necessary human resources to reach across the country, they opted to train young people and women in the rural areas to help themselves and their communities. "Women are surprisingly very influential figures in villages. They command respect and people really listen to what they have to say, far more than in the urban areas," Silva said.

So what does the FPA really advocate? There are many conspiracy theories about what 'family planning' really is - some believe that the organisation is actively lobbying for the legalisation of abortion while religious fanatics are of the opinion that the FPA and other NGOs are actively involved in a systematic attempt to wipe out one ethnic group or the other.

"In all matters of reproductive health, the FPA firmly believes in every person's right to know what options are available to them. Our primary concern is the health of both the mother and the child. We don't advocate one child families or two child families or over say four or five children. We just educate people and women in particular about how improper birth spacing could effect their physical health," Major Silva said, adding that every couple should know what temporary and permanent contraceptive methods are available.

The FPA's trained volunteers take messages to their communities about how these birth control methods work and where they are available. The association's representative teams go out to schools across the country teaching children about their bodies, puberty and healthy lifestyle practices. Misconception and inhibition is what the association wants to wipe out, putting in its place a generation of reproductively healthy, self aware individuals.

"Education is the key. It is our literacy rate that is our strength. Our people understand and that is the biggest hurdle crossed," Silva said, adding that the peoples' capacity for comprehension was one of the reasons Sri Lanka's current replacement ratio is stable, meaning that the country does not have a population problem since the number of births is set off by the number of deaths each year.

As for abortion, the topic everyone's interested in, Major Silva said that the FPA's sole lobby is for the elimination of unsafe abortion in the country. "We do not advocate abortion. We are only concerned about the fact that there are over 650 terminations a day, and almost 90% of those are unsafe procedures carried out by quacks and sometimes by expectant mothers themselves," Silva said. The FPA says it does not, under any circumstances promote abortion as a means of birth control, despite what their critics may say. "We believe rather, that if the causes of abortion, such as unprotected sexual intercourse and ignorance about body cycles  can be eliminated, then this problem of abortion would not come up at all," Silva said.

He made a valid point. The question to be asked is not whether abortion should be legalised or not, but whether there would exist a need for a pro-choice/pro-life lobby at all if we were to address cause as opposed to effect. Instead of which, we are a nation that prefers to bury our collective noses in the sand like the proverbial ostrich, pulling them out only to scream blue murder when someone or something threatens to upset this illusory perfect world we've created in our minds. "It can't happen to me" - that's what we all echo inside. We have the same apathy towards HIV/AIDS, quite content in the belief that it can't touch us, unwilling to face the prospect that it could become a very serious problem in the near future, especially given the size of the country. Think again. The day HIV and other STDs really hit us, it isn't going to be pretty.  And it is going to affect everyone of us, in one way or the other. When we lose a friend to AIDS or an unsafe abortion, we'll know it has caught up with us. But by then, will it be too late?

Reproductive health is not just a concern in the rural areas where there is a perception that people are naive and far removed from the realities of modern life. In the urban areas, healthy sexual practices and family planning is ever more important given the unlimited exposure to west-dominated media, urban night life and how early people are starting to become sexually active.

With diseases like HIV looming in the horizon, these days we can't be too careful. The key to great reproductive health is, as the FPA says, education, awareness and empowerment. If there was ever a time to take matters into our own hands and get off our moral high horses and quit being the insufferable prudes we so often are, it is now. If you feel strongly about the rights of the unborn foetus, do your bit to make sure unwanted pregnancies don't take place; educate your peers, your children, your household.