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Anti-abortion law spurs abortions
“Every time striking statistics of illegal abortions come out in the press, Sri Lankans debate intensely about the need to amend the law against abortion. But soon the debate dies down and no action is taken”

By P. K. Balachandran
Sri Lanka's stern anti-abortion law, which allows medical termination of pregnancy only when the mother's life is in danger, has spurred illegal abortions, instead of bringing them down. Being illegal and done mostly by quacks, they are fraught with danger.

Every day, about 1000 abortions are carried out in the island as a whole, and 700 of these are done in Colombo. This is an unacceptably high rate for a country with a population of just 19 million. "We get at least two bad cases a month," says Dr. Neil Seneviratne, a gynaecologist at the Kurunegala Teaching Hospital.

Among those carrying out illegal terminations of pregnancy are an international family planning and mother care NGO, and some government doctors moonlighting in secret private clinics.

Dividends
Illegal abortions are catching up in the provincial towns. Kurunegala may displace Colombo as the ‘abortion capital’ of Sri Lanka, with the mushrooming of clinics in the bustling commercial hub. Five major highways intersect at Kurunegala and these bring clients from every direction.

Interestingly, with the opening of the road from Vavuniya to Jaffna a large number of Tamil girls from Jaffna and the Wanni are coming down to Kurunegala for abortion. As a wag remarked, this is one of the ‘dividends’ of the peace process!

The business is so lucrative, that a government doctor is allegedly moonlighting in a private clinic and paying another doctor to stand in for him at the hospital! It is believed that this truant doctor gets LKRs 40,000 a month from the private clinic, plus a fee for every case.

One abortion clinic in Kurunegala is said to be located a few yards from the police quarters.

Regulating
Doctors also allege that the Sri Lankan branch of a well known international NGO is carrying out abortions in the guise of "regularising the menstrual cycle". This NGO, which is a pioneer in family planning, caters mainly to the middle and upper classes, charging LKRs 2,800/- for a termination, they say.

"We can understand international NGOs working for poverty alleviation or increasing the nutritional levels among poor Sri Lankans, but why for regularisation of the menstrual cycle?" asked a Sri Lankan gynaecologist.

However, apart from a few clinics like the NGO alluded to, most have no expertise whatsoever, "95% of those carrying out abortion in Sri Lanka are quacks," says Dr. Senaviratne.

And that leads to complications. Sources in the Kurunegala government hospital said that it was getting at least two bad cases a month because of the quacks. "Apart from the death of the mother there could be a perforation of the womb or the uterus. It could affect fertility," Dr. Seneviratne said.

Amendment
Every time striking statistics of illegal abortions come out in the press, Sri Lankans debate intensely about the need to amend the law against abortion. But soon the debate dies down and no action is taken.

"Even a child resulting from rape cannot be aborted under the present law," noted Dr. Anuruddha Padeniya of the Kurunegala Teaching Hospital. Hence the rush to illegal private clinics. Legalising abortion is not an easy task in Sri Lankan society, which, despite a degree of Westernisation, is in some ways very conservative.

The Roman Catholic community, which is very strong and vocal despite being a minority, will howl. There are enough influential Catholics in government and civil society to press the case for keeping the anti-abortion law in its rigid, pristine form.
The majority Buddhist community is also against abortion. The Buddhist clergy, who have great political influence, have said that relaxing or dropping the anti-abortion law will lead to irresponsible sex, moral turpitude, and the breaking down of the family.

Growing ignorance
But, opportunities for unprotected sex are growing with each passing day, with both men and women going out for work in increasing numbers and coming home late.
Indeed, in the garment factories, which employ very young village girls, illicit sex, including rape, are a recognised problem. It is the subject of an award winning Sinhalese feature film ‘Sulang Kirilli’.

When it comes to illicit sex leading to complications, there is an unfair tendency to point an accusing finger only at the poor village girl venturing into the city or to the factories in the Free Trade Zones. What is overlooked is that illicit and unprotected sex is a problem in the upper classes also.

A recent report in the media said that night clubs in Colombo's five star hotels were dispensing "through special agents", a drug called methamphetamine or Ecstacy, which makes the revellers go on dancing to the wee hours, lose their shyness and become more "accommodating." Doctors fear that this tablet may lead to unprotected sex and unwanted pregnancies.

Solutions?
The medical profession in Sri Lanka would like the anti-abortion law to be amended, but not abandoned. It should exist with expanded provisions for allowing termination, but abortions should be carried out by doctors with the requisite qualifications.

But this again will leave a lot of genuine problems unattended. "50% of those who go in for abortion are married women, not wanting another child for various social or economic reasons. The child in question may be one too many in the family, or the mother may be too old to have another child without embarrassment," says Dr. Sriyani Basnayake, Medical Director at the Sri Lanka Family Planning Association (SLFPA).

Dr. Basnayake recommends sex education and other preventive measures. "About five years ago, the SLFPA introduced the drug Postinor-2, which prevents implantation, if taken within 72 hours of copulation. Found to be effective, the drug's acceptance has grown. Five years ago, we sold 500 packets a month. Today we are selling 26,000 packets a month," she said.-Hindustan Times

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