A bold woman educates the ignorant on sex - with startling results!

by Jayampathy Jayasinghe

Dr Kanthi Jayewardena who runs a reproductive health clinic of her own, at Melfort Estate Pusselewa relates the following incident:

A woman from Nuwera-Eliya called over at her clinic to seek her help. The problem was related to her spouse and was an embarrassing one. Her friends in the village persuaded her to meet Dr. Jayawardan's at her clinic. After meeting Dr. Jayawardena she confided her problem to her.

It was a typical problem confronted by most newly married women. The fear of having sexual intercourse with their husbands. She was scared that penetration of the man's penis could cause excruciating pain to her. It was a notion she had in her mind based from a past experience.

The patient was now a dancing teacher by profession. Although she was married for seven years, she has never had sexual intercourse with her husband. This eventually led to other thorny issues within her family circle.

Pressure was mounting on her husband to divorce her for not being able to bear children. Her mother-in-law was behind the move. But, despite his mother's instigation, her husband didn't accede to her request. He loved her a lot despite not being able to enjoy marital bliss.

Initial fear

However, Doctor Jayawerdena realised the situation. She knew the patient needed counselling to overcome her fears. Doctor Jayawrdena interviewed the woman and got to know that she had previously worked at a medical clinic. It was long before her marriage, when a particular incident frightened her.

A married woman brought to the clinic had screamed while a loop was being inserted into her vagina. The particular incident had a devastating effect on her life. Being a virgin she thought silently that sexual intercourse could be as painful as inserting a loop. It was a lingering fear she harboured until she got married.

Even after marriage she was frightened of engaging in sexual intercourse with her husband. After several sessions of counselling she was completely cured of her malady. She is now pregnant, says the doctor.

Doctor Jayawardena told us a case of incest where a drunken father had raped his own daughter while she was at her grandmother's house. The father was living alone in his house after his wife had been sent to the Middle East for employment. His two daughters were living at their grandmother's home. The father one day raped his daughter while she was alone at her grandmother's house.

The girl later told her grandmother and the victim was sent to the clinic. "Luckily for the girl she was not pregnant." said the doctor. "Several months ago a schoolgirl who was reported missing from home was found at a home run by the Probation Department. She is back home and attends the clinic regularly for counselling." Dr. Jayawardena spoke of a startling case where a mother had brought her school going daughter to her clinic. It was on October 1, 2002, on the day of the World Children's Day.

She had a peculiar problem which she did not want to discuss in the presence of her mother. She had a fearful sadness in her eyes. The question that ran through her mind was whether to divulge everything to the doctor.

Later, she confided to the doctor that a boy who lived next door had raped her after she returned from school. It all happened while she was taking off her school uniform in her room. The boy had entered her room through the ceiling. According to her mother the girl was only 12 years old when she had attained age. But, her problem was that she had mensurated since then.

On careful examination Dr. Jayawardena learnt the girl was pregnant for seven months. Soon, her parents flared up when they came to know about the issue. Her mother attempted to commit suicide by swallowing poison and her father too nearly set himself ablaze.

The catastrophe was prevented by the villagers in the neighborhood. The twelve year school girl was in an advanced stage of pregnancy and her baby was delivered by a caesarian operation. Thereafter, something of a miracle happened. A childless couple who called on the doctor agreed to adopt the infant on the advice of Dr. Jayawardena. Today, the four year old baby is being looked after by his foster parents. Meanwhile, the girl had left her village and the boy is now before the courts.

Towards noon, there were women patients hanging around at the Melfort estate clinic at Pusellewa to receive medication from Dr. Kanthi Jayawardena, the dedicated Estate Medical Assistant who had been serving the community for long. It was another hectic day for her, diagnosing patients and giving them medication with specific instructions. It is the only clinic available at the Melfort estate -- to cater to about 386 families living in the estate , although the government district hospital is located a few miles away.

Doctor Jayawardena with her long years of experience is quite aware of the social issues confronting young people in the estate. She knows the importance of educating young people on reproductive health, in a rustic village like hers where the poor do not have recourse to family planning clinics.

She had heard of unwanted pregnancies in her own estate area a few years back. The young women had explained to her why they become pregnant. In part, ignorance of reproductive health and in part, sometimes, because of the attitude towards sex prior to marriage.

Dr. Jayawardena was mindful of the threat of AIDS knocking on the doorstep. She also has heard about programmes like the Reproductive Heath Initiative for Youth in Asia (RHIYA) which conducts therapy sessions on reproductive health for young people.

The RHIYA project came to Pusellawa in 1999. It was a European Union (EU) funded project implemented by the UNFPA program. The programme is overseen by Eshani Ruwanpura, the National Programme Officer of the UNFPA. She says the RHIYA project had became popular among estate workers in the region on finding solutions to problems of young persons on reproductive and sexual issues.

Openly discussed

According to Doctor Jayawardena RHIYA has helped create awareness among young people and schoolchildren on matters of reproductive health. She says, women who had followed clinical sessions now boldly discuss sexual problems with friends in the village. "It wasn't so before. Sex was a taboo subject in many estate areas probably due to cultural taboos. Most women then were too shy to discuss such topics frankly."

She said, the situation had changed with more women from estate areas participating in clinical sessions on reproductive health.

They have learnt to discuss sexual matters quite openly at group discussions. But women who are shy to discuss such topics write to me discreetly, seeking my advice." There are twenty two volunteer health workers from her clinic to help young people discuss their sexual problems.

When asked about the type of sexual problems confronted by young, Dr, Jayawardena says the biggest problem was related to unwanted pregnancies. There were quite a number of unwanted pregnancies in the village due to ignorance on sexual matters.

Counselling

Dr. Jayawardena said people initially were reluctant to be counselled on reproductive health education but now they have realised the importance and attend clinic regularly. EU\ UNFPA's National Programme Officer Eshani Ruwanpura says her organisation works in rural areas like Nuwera -Eliya, Moneragalla and in the North Central province to create an awareness among young people on sexual education.

Young people today are more sexually active than in the past. Especially young people in rural areas have limited access to sexual and reproductive information. "About six per cent of young people have admitted that they are sexually active. It is not at all a high percentage when compared to other countries." she says. We are now working with the Ministry of Health to provide female condoms to the young people."

Meanwhile Dr Jayawardena conducts clinical sessions every month for volunteer health educators drawn from the village to prevent unwanted pregnancies and AIDS. Miss Chandra Devi from Melfort Estate is one such health educator who keeps in touch with the village people. She lectures to them on unwanted pregnancies, etc. However serious cases are referred to Dr. Jayawardena's attention.

The Reproductive Health Initiative for Youth in Asia (RHIYA) project has worked wonders even in an isolated village like Doragala-Paradeka in the Pusselawa area.

An interesting open air theatre drama was staged by the schoolchildren of Doragala school at Pussellawa. It was all about the prevention of unwanted pregnancies and AIDS. Asoka Ekanakaye of Sri Lanka Association for Voluntary Surgical Contraception (SLAVSC) in the Kandy district says they have fifteen projects in the Kandy area alone. The main projects are based in Mahiyawa, Nugawela and Medawela.