The uterus wars


600 abortions a day in Sri Lanka. Those are the chilling statistics. But it is a hundred times more traumatic to sit in a seedy abortion centre and watch while scores of women pass through those doors, some nonchalant, others obviously devastated. These are the places everyone knows the addresses to, but nobody talks about. Outside the gates, young boys stand like hawkers, ready to peddle the abortionist’s ‘wares’ to wary and uncertain couples who make their way to the centre, but are too afraid to go in. It is unimaginable that hundreds of women go through the ordeal each day, when even the fake pregnancy and abortion seeking, proved quite overwhelming, as The Nation learnt on a recent ‘undercover’ investigation….

Abortion: it may be spoken of in hushed tones, and rarely the subject of national discourse. But the statistics (180,000 terminated pregnancies a year) are ample evidence that it should be. In the raging pro- choice debate, Sri Lanka has taken an almost absurd backseat, refusing to change archaic laws, despite the fact that our more conservative neighbours and even staunchly Catholic nations around the world, ha ve begun to review their laws on abortion. In India, Pakistan and Bangladesh, abortion has been legal for decades, and countries such a New Mexico and Portugal have recently relaxed their formerly stringent laws on abortion. Conversely, Sri Lanka has begun to clamp down on abortion centres, starting with what was perhaps the most legal entity amongst them, the Marie Stopes clinics. The fact the authorities and lawmakers appear to have missed, is that dogmatic anti-abortion laws only ensure that women without access to proper medical attention are forced into the hole- in- the wall clinics, or quack practitioners, to terminate unwanted pregnancies at great danger to their lives. Far from reducing the number of abortions taking place in the country, such clampdowns only make the procedures more and more unsafe for the thousands of women who seek terminations every day. Has the time come for Sri Lanka to take a closer look at the abortion issue, from a more modern perspective?

By Dharisha Bastians
It was late on a Monday when my Rivira colleague, Rasika Jayakoddy informed me that we would undertake this ‘tour’ of sorts, of abortion centres around the city the next day. Neither of us being too familiar with the usual ‘joints’, there was a lot of asking around – and surprisingly, the same addresses and names of clinics kept popping up. Obviously, everybody can rattle off some of the tried and tested spots around Colombo city at a moment’s notice.
The second problem was to come up with a fake name – and a story. Not feeling particularly creative at the time, I assumed the name ‘Sonali Perera’ for the day, uttering a silent apology to all those ladies out there whose identities I was usurping for my journalistic purposes. It was also decided that I would be employed at a travel agency and my boyfriend for the day, Rasika in this case, would be a university student. Why couldn’t we get married and have the baby? Because Rasika was still studying and our parents were not entirely happy with the match. I also had to mentally prepare myself for a possible abdominal scan and/or a urine test.

We practised our ‘story’ for a few minutes, before finally getting around to leaving the office premises. I could feel my palms sweating and something in my stomach, (and it was no foetus) was lurching. I kept telling myself that both Sonali Perera and our ‘story’ were figments of our imagination, but it didn’t quite help to settle the butterflies that were taking up residence in my abdominal area.
Our first visit was to a fairly reputable medical clinic in the Borella area. As we sat on the plastic orange chairs waiting for the OPD doctor to call us in, we re-hashed the story a couple more times in hushed tones. The nurses were beginning to give us odd looks. I wondered if they knew why we were there.

We were finally ushered into the room of a young and friendly looking doctor. He seemed to gauge our little situation quite accurately as soon as he laid eyes on us. I wondered if my nervousness was beginning to show. Rasika started the ball rolling:
“Doctor, we’re having a small problem,” he said.
“Life is full of problems. And no problem is insurmountable. We learn to face them and move on. So go on, tell me what it is,” the doctor answered.
The imaginary pregnant girl inside me felt herself warming to the man. He was inviting our confidences in such a way that I wondered whether our preconceptions of mercenary, heartless quacks were in fact, slightly misguided.
I had to speak then. I informed him of the appropriate symptoms I was experiencing (having talked the matter over previously with a colleague who recently had a child), and the doctor soon interrupted saying, “So you think you might be pregnant?”
I said “Yes”, to which he replied, “And you are thinking of an abortion?”
“Yes,” answered Rasika. “I am still studying and there are some obstacles from our families, so we can’t marry.”
By this time, I was starting to feel distinctly uneasy. I didn’t have very many more answers left, so I was hoping there would be no more questions – unless I was asking them.
The young doctor however was comforting. “Sex is a wonderful thing,” he said, “but there are simple ways to ensure that it doesn’t lead to mistakes like this one.”
He continued to explain to us that while he did not perform the procedure himself, he would refer us to a senior obstetrician, one who was practicing at a leading government maternity hospital in the vicinity. “Think of him as your father. You may have to cry a little bit and tell him that this was a big problem for you. He will then set up a proper time and place, and perform the procedure for you,” he advised.

I would have had no trouble faking the tears if it ever got to that stage, I thought, as there were already real tears forming at the mere thought of a scalpel scooping something out of me. Fortunately, it only made the act seem that much more real.

Determined to use my watery eyes to my best advantage, I asked the doctor timidly, “Is it a surgery that will be performed on me?”
Of course I already knew the answer. “No it’s just a simple procedure. The doctor will insert an instrument and wash your womb out.”

I winced for real. He noticed and reached out to pat my arm. “I can see you’re nervous. Please don’t be. It’s a simple thing, any doctor could do it, even me. He will give you something to sedate you and you won’t feel anything. They will let you lie down for about an hour and you can go home soon afterwards. You will only feel mild discomfort,” he assured.

According to our information, the clinic performed these abortion procedures on the second floor of the building. But the wise doctor refused to say whether I would be ‘treated’ at the premises or not, telling me instead that the obstetrician would decide the appropriate place. In any event, the specialist did see patients at this private clinic. The OPD doctor also refused to name a price, claiming that since he did not perform the procedures, he had no idea.

Having decided we had the necessary information, it was time to move. “The first thing to do is to take a urine test. If it is positive, come back tomorrow morning and I will refer you to the doctor. You can see him then and there. If not, there’s nothing to worry about and I will tell you both how to ensure such a thing doesn’t happen again,” the doctor said, writing a prescription for a test to be performed on me and giving it to the nurse with the relevant instructions.

“Even if you are pregnant, it is not the end of the world. The main thing is to have no regrets. It is simply a bad time for you two. Have it done, move on and be happy” – those were the doctor’s last words to us as we left his office.
The nurse attempted to lead me to the lab for my ‘test’. Not one bit enthused at the prospect of doing the test, Rasika and I told the nurse we had a prior appointment, and that we would be back in an hour and got out of there.
The first visit had been a surprisingly positive one. We thought to ourselves that if all abortion clinics were like that one, then it is almost as good as having legal centres in the city, with the appropriate counselling and explanation for couples. In fact, if they were all like this last one, then we didn’t really have a story. At least not the one we’d imagined.

Having hidden the press board in our vehicle under a seat, we then made our way to another infamous clinic in Rajagiriya. About this particular spot, we had tonnes of information, including the names of the doctors who performed abortions, the price and the hygiene conditions. It would cost approximately Rs. 30,000 per abortion – a slightly expensive option, but the upside was that the doctors were well known, especially among the older generation. It was one of the places your mother would probably take you, if she were to know you were pregnant and it was an unwanted pregnancy.

The clinic is situated at the end of a cul-de-sac along a main road. There is only one, beaten down sign to point patients to the clinic. The place looked deserted and when we walked in, an elderly gentleman was chatting to another man and writing down an address for him. He proceeded to give him directions to an address in Bambalapitiya. “That’s the place we recommend,” he said.
Rasika and I were seated waiting for the man to finish. Looking around, there was not much life in the place. It had some ancient curtains and a few rooms that looked nothing like doctor’s offices. “Why are you here? Is it something to do with a pregnancy?” asked the gentleman, turning to us suddenly. We nodded. “Well we can’t help you here. We don’t do that after the police started raiding. The doctors are too scared. They don’t come here anymore. This clinic is now closed,” he said, adding, “If you like, I can recommend a place. It’s where we send everyone who comes here.”

He proceeded to write down the address for us – the same one he gave the other guy we noticed. We took the piece of paper and left, realising that the clinic had obviously existed all these years, for the sole purpose of getting rid of unwanted pregnancies for a steep fee. The place gave us the creeps.

We made our way to Bambalapitiya. Well hidden by tall trees and buildings, the residence on a main road looked quite commonplace, and ordinarily would not have warranted a second glance. And yet, since we were looking closely, the signs were all there. Outside the gates of the house there were several young men. They were huddled in corners chatting with several couples. We realised later that they were the peddlers, stationed outside to make sure people don’t lose their nerve. They would cajole the couple, promising that it would not cost much and that it was no big deal.

Inside, the operation was much bigger. A small boy of no more than 11 years, came up to us and asked us what we wanted. We had wandered into a sitting room that led to an upstair section. When we told the boy that we wanted to meet with the doctor, he made it obvious that we were in the wrong place and pointed us into a small and dingy waiting room. All the while, women – some of them accompanied by men, came downstairs and outside of the sitting room we had wandered into.

The waiting room was pretty typical. It was dimly lit, bright orange chairs again, but way more people. The ‘patients’ played a surreal game of musical chairs, as they moved closer to the doctor’s room. With each patient that went inside, the whole lot would have to stand up and move one chair closer to the door. We were outside for more than 45 minutes. In that time, at least 15 people had filled the chairs behind us. The continuous stream of people seemed unending. I found it disconcerting how you could observe the body language and facial expressions of the couples who were in the waiting room and guess their stories. There were the very much in love teenagers, the obvious married couples, they were all there, each with a different reaction to their doubt and fear about an unwanted pregnancy. I wondered what they guessed about me, since neither Rasika nor I seemed in the least bit distraught, chatting and even laughing occasionally. We were saving our ‘act’ for the doctor. Scan

When Rasika and I walked in, it was a diametrically opposite bedside manner that we were met with. This doctor was not so much into the small talk. “When did you get your last period?” he barked, not even looking up at us, at first. I mumbled a date praying that it was not so arbitrary as to be ludicrous that I was even there. “I need to do a scan. Pay 1250,” he said. A shocked Rasika handed over the money while I fought against all my better instincts to run screaming out of the room.

The scanning room was adjacent to his office. I walked in with Rasika in tow. This was a tad more than I had bargained for. A million issues had entered my head: from the hygiene of the bed I was going to be lying down on, to how I was going to let this very scary man lay his hands on me.

I lay down on the bed as quickly as I could. He wanted to scan my stomach. When my trembling hands didn’t get the skirt I was wearing lowered fast enough, he barked, “quickly, quickly, I have other patients!” and pushed my skirt down. I was horrified. Naturally the scan showed nothing, so he gave me a prescription for a tablet that he said should work. “If not come back in two weeks for another scan,” he said, and Rasika asked, “What happens if she’s pregnant?”

He replied that he would wash the womb. “Where would you do it,” Rasika asked, since I was struck dumb following the scan. “Upstairs,” he replied. I did the maths in my head and realised that all those women descending the stairs earlier must have been people he had already performed the abortions on. “How much,?”, asked Rasika, the all important question. “Rs. 12,500” he replied. Since this doctor hardly lent himself to conversation, we had to leave the questioning at that.

I breathed a sigh of relief as I walked back out of the dingy premises, and into the fresh air. I was queasy and uncomfortable with the thought that I had subjected myself to an ultrasound scan at his hands. Obviously, we deduced, the scan is how he makes his money. Everyone who enters his office gets scanned. His only patients are those who suspect pregnancy and need his services to terminate it. To the doctor, it was a business that much was certain. Wasting time on one patient meant he could not see the maximum number he could otherwise see in a day. So the women are shuffled in there like cattle and hustled out as soon as possible. No counselling and small talk here. This was strictly ‘business.’

The bottom line though was that we had obviously visited the ‘cleaner’ ‘safer’ places during our tour. An expert on the subject of reproductive health told us later that even the most hole- in- the- wall clinics now perform fairly safe procedures. It is mostly in rural areas of the island, where access is limited, that the bicycle chain or metal wire methods are resorted to.

‘Sonali Perera’ did not have a good day that Tuesday. I felt for her. Lost in my ‘acting’ (which Rasika vouches was extremely realistic – no doubt because the fear felt pretty darn real) I really felt her pain for those few hours. She was a frightened, guilt-stricken and utterly helpless young girl. Sonali Perera felt the baby inside of her and the thought of having it removed moved her to tears. She imagined herself at the hands of quack doctors in those dirty rooms and wished the decision was not quite so hard.
All in all, I was glad to become Dharisha Bastians again that evening. I’ve held on to the prescriptions and the appointment chits. It’ll serve as an eternal reminder of the countless, nameless women who make one of the most difficult decisions of their lives, deep inside dungeon-like abortion clinics all over the country.

(With reporting by Rasika Jayakody – rasika@rivira.lk)


Clampdown in Sri Lanka

The recent raid and shut down of a well known international reproductive health clinic functioning in several parts of the island, has caused an uproar since the same entity was invited to commence operations in Sri Lanka under the J.R. Jayewardene regime.

The move has raised many eyebrows, since it came in the wake of a meeting between a prominent global pro-life organisation and First Lady, Shiranthi Rajapaksa. The meeting was publicised in a Catholic periodical published in Sri Lanka, and explained how the clinic in question was, killing Sri Lankan babies.

Ironically, the raided clinic was one of the few centres in the country that provided emergency menstrual regulation (EMR) with proper counselling and certified medical professionals performing the procedures.

“It is ironic that Sri Lanka is so behind the times on this issue,” said an expert in the area of reproductive health, speaking to The Nation on grounds of anonymity. “Despite the fact that Sri Lanka is a country whose Catholic population amounts to a mere 7% overall, the influence they wield is stunning. Even 100 percent Catholic nations like Portugal and New Mexico have re-thought these anti-abortion laws and have recently amended them. And yet, we are moving backwards,” he explained.

According to the statistics, countries in which abortion has been legalised have shown a remarkable reduction in terminations of pregnancy, since the legal abortion is supplemented with greater access to education about birth control and in some cases, even the provision of contraception free of charge to prevent unwanted pregnancies, the expert said.
It is ironic that every part of a woman’s body is her own, except for her uterus, he added, saying that religious and state laws world over controlled that part of the woman’s anatomy.

In Sri Lanka two thirds of women seeking abortions are married, putting paid to the theory of law makers in the country who claim that legalising abortion would lead to a more promiscuous society.
“Of course nobody is proposing that abortion be used as a method of birth control. Sadly, despite the perception that abortion is sought by those living ‘loose’ lives and those who engage in casual sex, the truth of the matter is that very often, the victims are the innocent,” the expert said.

He told stories of how there were instances that the raided centre had to deal discreetly with cases of Catholic and Buddhist nuns who had gotten pregnant. “These are not promiscuous people. These are those people who in a moment of weakness make a mistake that could ruin them. Should they be left helpless?” he asks.


From the frying pan into the fire – Sociologist

By Rasika Jayakody
Stringent anti-abortion laws place women who are already in a precarious position into a much worse one, says Professor S.T. Hettige of the Sociology Department, University of Colombo. “While the laws exist to prevent abortion, lawmakers have failed to observe the myriad reasons why abortions are sought in the first place,” he told The Nation.
According to Prof. Hettige, there are many ways to prevent so many abortions taking place in the island, beginning with sex education and awareness about birth control methods.

He says that while a total ban on abortions or completely legalizing the procedure cannot be condoned, at the very least, existing laws need to be relaxed to allow rape or incest victims to seek an abortion if they so wish. “Current abortion laws only allow for termination of the pregnancy if there is a threat to the mother’s life,” he explained.









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