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A 60th anniversary tribute:

IPPF and the Family Health of Sri Lankans

This, probably, is a story that would have unknowingly eclipsed in the minds of our historians, who chronicled the past of the country into chapters and books. But it is factual, epoch-making and has been responsible for guiding the destinies of a large majority of Sri Lankan families at least for the past 50 years, and for sure, will continue to do so for the next many centuries to come. It is, therefore, considered pertinent in the current perspectives of the country and its people, especially the generations of young people.

The first episode of the story began when a Canadian Gynaecologist by the name Mary Helen Irwin, got married to a Tamil Ceylonese Teacher, Samuel Christian Kanagar Rutnam, whom she had met while in New York. Dr. Irwin followed Mr. Rutnam to Ceylon in 1896 to join the American Medical Mission in Jaffna, and moved to Colombo to get married to him two years later. While taking up private practice, Dr Mary Rutnam also assisted her husband, who later founded the Central College in Colombo, in his educational and mission work. The following October, the doctor in charge of the newly-opened Lady Havelock Hospital for Women and Children went on sick leave, and Dr. Mary Rutnam was requested by the Medical Department to act for her. Here she performed the first orthopaedic surgery in Ceylon, and lectured to the first group of women medical students, then in their final year.

At the Lady Havelock Hospital, Dr Rutnam had "some of the very pathetic experiences of my life pertaining to poor women, who came with anaemic problems due to child births, every year for five or six years, pregnant mothers delivering their third or the fourth child in three years, and little children with weight-related complications and malnutrition, and so on." To cut a long story short, these experiences moved her so much so, that her concern for Ceylonese rural and suburban poorer families sank deeper and deeper, and resultantly, with the cooperation of several public-spirited so called 'elite' ladies, most of them from Cinnamon Garden area, she organised many health related social service activities and societies, to help women and children, who were vulnerable and in difficulty. In 1930, she launched the Family Welfare Association focussing mainly on maternal health leading to spacing of child birth, milk for children and the moral and physical well-being of both mothers and children. However, Two World Wars interfered with all social service activities of Dr. Rutnam, and everything came to a standstill, denying the poor families of Ceylon the benefits of her mission.

Child care

The second episode of the story commenced at this stage. Though Dr. Rutnam's age dictated retirement, she never gave in, and many years after the Second World War, at the age of 80, she re-commenced her former activities, with a galaxy of reputed doctors and social service-oriented ladies in Colombo. By then, Dr. Rutnam was a very popular figure in the whole country, due to her leadership in women and child welfare, and also as she was elected by popular vote much earlier, as the first woman member of the Colombo Municipal Council. Nevertheless, when her team introduced the concept of 'Family Planning', there was thundering opposition from many quarters and despite the affluence nature of its members, they were jeered, hooted at, and were even subjected to receiving rotten eggs and perished tomatoes.

Undaunted, and yet more encouraged to sustain her mission, Dr Rutnam, together with her friends, went straight in to her dream, and formed The Family Planning Association (FPA) of Ceylon on January 15, 1953. She contributed all the funds and the resources of her former Family Welfare Association to the new FPA, and continued direct dialogue not only with young and married women, but with even the married men on family health, based on spacing of child birth and maternal and child care. In formulating its concepts, vision and mission, the FPA believed that a woman must be allowed to enjoy her right to control her own fertility, and every child born in the country should be a wanted child, thus causing men and women lead a family life with dignity and well-being.

Married couples

It was during this period of time that the FPA was recognised by the International Planned Parenthood Federation (IPPF) founded in Bombay an year earlier, amidst lots of controversy. Much like in Sri Lanka, in many other countries of the world as well, concepts of family planning, though a human right, became a challenge to the social conventions and traditions. Campaigners and advocates of family planning were threatened, harassed and even imprisoned, even though its one and only agenda was to improve the lives of women and children around the world. However, after the Third International Conference on Planned Parenthood held in India in 1952, eight Family Planning Associations got together to launch the IPPF. Now in its 60th year, the IPPF is a world renowned Federation, with its headquarters based in London England, with 152 member associations, including the FPA Sri Lanka, working in 172 countries, conducting over 65,000 service points worldwide. According to IPPF records, last year alone, and through those service points, 89 million sexual and reproductive health services have been provided. IPPF's 60th anniversary falls on October 12.

IPPF aims to improve the quality of life of individuals by providing and campaigning for sexual and reproductive health (SRH) rights through advocacy and services, especially for poor and vulnerable people. It defends the right of all people to enjoy sexual lives free from ill-health, un-wanted pregnancy, violence and discrimination. IPPF works to ensure that women are not put at unnecessary risk of injury, illness, and death as a result of pregnancy and childbirth. It also supports a woman's right to choose to terminate her pregnancy legally and safely. It strives to eliminate sexually transmitted infections, and to reduce the spread and impact of HIV and AIDS. Having engaged in such a diverse and multifaceted activities for the past six decades world over, the Federation celebrates its 60th anniversary on October 12 this year.

Editorial 'Forward' in The Golden Jubilee Souvenir (2003) of the FPA Sri Lanka narrates its relationship with IPPF as follows:

"Our affiliation to the IPPF was a happy circumstance. Established in 1952, just a year before FPA Sri Lanka was inaugurated, our Association was sponsored by that great philanthropist couple, George and Barbara Cadbury. Our membership in this august body has brought us much needed financial support, but more so, validated our identity in the eyes of the international donor community. Consequently, we have reaped a rich harvest of technical and training support and exposure to the invaluable work carried out by our sister Associations in the region and the world over."

Public service

With the membership in the IPPF well established, and with the guidance and support extended unreserved, the FPA Sri Lanka grew from strength to strength. An important landmark of such cooperation was the IPPF training to the volunteers of the Association, the staff, the medical personnel and the medical officers in the public service.

The training included education, communication, awareness raising, motivation and promotion on issues relating to family health, sexual and reproductive health, conduct of medical centres and clinics, and strategies on social marketing of family planning material, but no compulsion to accept or practise family planning. Following IPPF leadership, FPA Sri Lanka started showing great respect towards the rights and the needs of the people, leaving them to decide the number of children they would have, or the size of the family they like to have. It also provided with medical expertise for those who wished to practise family planning. Emphasising that married couples should have at least one child, as a way of family planning, the Association helped sub-fertile or infertile couples to conceive.

The third and the final episode of the story began with the advent of the futuristic visionary Daya Abeywickrema to the chair of the Executive Director of the FPA Sri Lanka in the year 1975.

Daya cut his teeth as a formidable leader during his association with the Jaycees Movement in his younger days, and then engaging in much larger projects as a unique planner and implementer being a member of the Lions International. No sooner he took over the captaincy of the FPA team, using the experiences gained during his previous international exposures, Daya firmly brought about a wave of vision and mission based policy changes, dramatically convincing the then highly sophisticated volunteer leadership of the Association, comprising some of the most dominant and brilliant advocates belonging to the public, private and the social sectors.

Hailing from rural Morawaka down South, and having lived with both rural and urban folks, he knew the needs of the people and that the messages and services in family planning were most needed in the rural Sri Lanka, where nearly two-thirds of the population of the country domiciled.

He felt the pulse of the youth, and was particularly emphatic on the involvement of the young people in education, awareness creation, dissemination of messages on family health and motivation among the peers. All his project proposals year after year for funding were targetting the age group from 21 to 40 years mostly in the rural Sri Lanka, and the IPPF saw the reality plus validity of the vision of the Executive Director of the FPA Sri Lanka, and provided adequate funding for their implementation.

In other words, IPPF was largely responsible for supporting the FPA to promote knowledge, services and practices pertaining to safe motherhood, spacing of child birth as a means of protecting the health of both mother and child, prevention of HIV/AIDS and Sexually Transmitted Infections, hailing womens' and childrens' rights and a gamut of health related other services and information, all of which became components of the full package called Family Health.

Incidentally, IPPF was also fortunate to have obtained the services of several academically and professionally distinguished Sri Lankans in its London Headquarters and Regional Offices. Well known Civil Servant, Mr. Bradman Weerakoon was the Regional Director of the Indian Ocean Region (IOR) of the IPPF from 1976 to 1977, and later was appointed to the IPPF's most prestigious position of the Secretary General for the period 1984 to 1989.

Another Civil Servant with an exceptional public service record in the country, Mr. Francis Pietersz also served as the Regional Director - IOR. The incumbent President of the FPA Sri Lanka, Dr. Pramilla Senanayake served the IPPF as its Medical Director from 1976 until 1987, and then as its Assistant Director General from 1987 t0 2003. She left the IPPF to return home to Sri Lanka, where she joined the FPA as a volunteer.

Dr. Steve W. Sinding, one time Director General of the IPPF had this to say once, highlighting the relationship between the IPPF and the FPA Sri Lanka:

"FPA Sri Lanka has always been a model of success within the IPPF family, and a leader in so many areas of its work. The commitment and the strength of its volunteers and staff have also made a tremendous contribution to the IPPF as a whole."

Thank you IPPF! We Sri Lankans deeply appreciate and gratefully acknowledge your contribution during the past 60 years, through our FPA Sri Lanka and our respective governments, to guide hundreds and thousands of our people to improve their personal and family health status, by way of education, awareness creation and promotion of healthy practices. We congratulate you on your wonderful achievements in the past, and wish you a splendid future with greater strength to continue your glorious global work programmes.

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