Sarah Soysa has been committed to working on sexual and reproductive health and rights (SRHR) since she volunteered at the Family Planning Association as a university student. She continues her challenging work as an SRHR educator, a feminist, and an advocate for women’s rights. In this interview, Sarah talks about working on SRHR in the plantations sector and postwar areas, access to accurate information on safe medical abortion, myths surrounding the discourse on women’s bodies and abortion, and training thousands of youth as peer educators on SRHR.
You have years of experience working in sexual and reproductive health and rights (SRHR). You are a feminist and a women’s rights advocate. You have an extensive portfolio of local and global voluntary work. What got you interested in a line of work that intersects with diverse areas of human rights?
While doing my degree in social work, some of our friends volunteered at the Family Planning Association (FPA). A lot of people who are in the field of SRHR have started at the FPA. They have a youth advisory committee and I took part in some of their events. We did projects with children living with HIV. I learnt things that I had never heard of and issues that I did not know of.
As volunteers of the organisation, we were working at the governance level. We were involved in advising and managing the organisation, as young people. We were contributing in terms of what kind of things they should do to ensure meaningful youth participation. We were taking on the whole youth aspect of SRHR. Being a volunteer there was kind of different. We were really young, but we got our own space and opportunities on decision-making forums and tables.
Certain realizations begin to form when we were discussing and going deep into issues. I was a very mischievous child in school; wearing the uniform short, shouting in the class, running around, and doing sports. Things like that bothered my teachers a lot. I was labelled as the black sheep. Some of the things we discussed in the trainings made me realize that there is nothing wrong with me. It is just the way people perceive and women are expected to behave in a certain way. Now with exposure to the whole gender conversation, I was passionate to take it forward.
My mom is someone who reads a lot. We talk about things, and she as well as my whole family are quite open-minded. That also triggered the feminist within me to continue the work.
I became the chairperson of the advisory committee at FPA. I started taking on more responsibilities. That was the first time I ever made a project, ever made a budget, and realized how things need to happen. Seeing a lot of other young people who were passionate from all the corners of the country was also inspiring. I met young people from different cultures, different traditions, and got exposed to different ways of how people experienced gender inequalities. That is how I started.
What are some of the key current work that you have done and are doing in relation to SRHR and women’s rights?
After my work at the FPA, I got trained by UNFPA, as a peer educator on SRHR. Through that I have trained more than 1000 young people as peer educators by now. We train them and make them aware. We expect them to go to their communities and do the same thing with other young people.
After completing my degree, I started working at the Young Women’s Christian Association (YWCA). Working with a faith based organisation on SRHR was very interesting. We were doing sessions in the church. Many were quite open about issues; even in Jaffna, and this was in 2012. Girls from Kayts and the islands of the North came in. They talked about issues relating to virginity and menstruation.
Working with a faith based organisation on a taboo topic like this broadened my horizons. I got a lot of experience, talking to difficult people. We also had to talk to the parents first, before training the young girls, because that is one of the key points. We sometimes also had to talk to some of the girls’ boyfriends and husbands, to say that they are going to be peer educators. That made me more interested in working in the field.
I did my Master’s at the University of Melbourne and came back. I wanted to get more field experience. So, I started working with Doctors of the World (Médecins du Monde). It is a French medical organisation. We particularly work in the plantations sector in Sri Lanka – in Kandy, Nuwaraeliya, and Kegalle districts and in postwar areas in the North, mainly Jaffna, Kilinochchi, Mullaitivu. Both the projects are on improving access to SRHR services and information for women and young people. It is close to two years since I started with them. It has been quite a journey.
What was it like to have worked with a faith based organisations on SRHR, two things that mostly don’t go together?
YWCA has good networks across the country. First of all, we spoke to the church leaders and parents. We wanted them to come up with issues in the area, without us imposing anything on them. Of course, they don’t look at it in a very rights based aspect. But everyone wants to find solutions to these issues. They were quite keen for us to train young people.
When we go to communities in the North it is very difficult because they are very conservative. They judge you from the way you dress and the way you speak to everything else. Because they see us as people from Colombo coming and talking about these issues.
But because it was the church, it was more trustworthy and parents got involved. Because the parents were involved and YWCA has good reputation, the church was also ready to accept our program.
Some of the young girls are really amazing. They still do the work we initiated. They faced a lot of difficulties when they were working in the community. In the North, some people even reported to the police, saying that these girls were talking about unwanted things. But because the parents knew, they stood up for their children. After about a year, these girls were sharing their success stories. Some organisations sent them vehicles, asking them to come and do a session because they were really good and such resource people in the area were very scarce. People were acknowledging them. It empowered a lot of young women.
In relation to your SRHR work in the plantation sector, could you elaborate on the contexts and challenges of working in these areas?
If I talk about the plantation sector, it is like an island within an island. They are completely out of this world. We all have a free national health and education system, but in the plantation sector, it is still not the case. Because they are managed by companies, there is a different system. They have to access private health care, at times, when it comes to accessing health services, so it is not entirely free health care.
They still have this set up called EMAs – estate medical agents. It has been continuing since the British colonial period. During that time, they could not find doctors to work in these areas. So, they trained some lay people on medical care. That system is still there. So, it is not the doctors who have educational and professional qualifications who work there, but it is these EMAs that give medical information and medicine. When it comes to quality assurance, you do not know where to draw the line, what kind of information do they provide, and it is very difficult to monitor. Because of this, there are so many other issues as well.
We work in very rural plantations where in some they still don’t have infrastructure and roads. Even in 2017, women have given birth on hanging bridges (wal paalam). The maternal mortality rate is very high in these areas, compared to other areas. The literacy rate and education for girls is also very low. As Sri Lanka, we are very proud of our achievements in relation to our health and education systems and access girls have to secondary education. We have reached the targets and ticked all the boxes. But the regional disparities, are not taken into account.
What are the major SRHR issues that are existing in the plantation sector, speaking from your experiences in the field?
In the plantations, there are so many sexual and reproductive health issues, such as underage pregnancies and teenage marriages, which are very common and also accepted. Last time I went, I met a 14-year-old girl who is pregnant and she is married somehow, which is not allowed by the law. They must have produced some sort of ID, with a fake age. When our volunteers tried to give her information on birth control the husband has completely denied, saying that he wants the child. So, she is fourteen and she is pregnant. And she is really small.
There are lots of incidents like that, including unsafe abortions. In Sri Lanka, generally more than 1000 unsafe abortions happen everyday. The law is very restrictive, which only allows an abortion if the mother’s life is in danger. But abortions are very common and rampant in the plantation sector. Violence is at a different level. Alcoholism is very high because people don’t have anything much to do after men finish work around 2 o’clock. There are no leisure activities or sports, so they end up drinking. Both domestic violence and harassment in public transport is also very high. The other day, we were talking to two young girls who have stopped schooling because of public transport harassment. The same person follows them and harasses them. They have informed their parents, and the parents prevent them from going school now. It is unbelievable that in 2017 young girls have to stop schooling for public transport harassment.
Cyber bullying is very high in the plantation sector. People don’t have food to eat but they have mobile phones. And that means they have access to the internet. Facebook issues, missed call issues, blackmailing using nude photographs of girls, it is common in the plantation sector and in the North as well as it is here.
How do you create awareness in terms of some of these issues within the communities where you work?
We are trying to improve access by training the midwives and doctors on gender-based violence (GBV), non-judgmental attitudes, and on the importance of providing services to everybody without a difference. Because according to the law, everyone over 16 should have access to information services on SRHR. There can be no difference. Any marginalized person, a lesbian, a gay person, a transgender person, a sex worker, a widow, everyone should have access to information services. But the midwives and some of the MOH officers are not aware of this. They don’t know what to do if a woman comes to them after being beaten or if someone is raped; different midwives were telling different things. They didn’t have clear information and referral systems.
When we ask the community if they had an issue like that where would they go, they would definitely say the midwife. That is the trusted person who is in the community with the people. But then the midwife or the PHI does not know the referrals or what to do with such cases. So, it was very problematic.
We implement our work through a local organisation who has been there for more than 30 years. And they work through community volunteers, mostly women, who live in the community. When we first started the project it took over eight months for these volunteers to start the conversation. They were not wiling to talk about it at first.
Now it has been almost one and a half years. And when we go to the community, it could be me, it could be anybody, women just start speaking out about issues. And we have teen groups, young teenagers who get together every month and talk about issues that affect them. They are not afraid. So, people from the community definitely goes to the volunteers and we have trained them on referrals. The referral mechanisms are working very well.
It is the same setting in the North. Even in the North, it is quite difficult. In the North, we have a different model where in each grama niladhari division, we get all the decision makers to come, such as the the grama niladhari officer, farmers’ association leader, disability organisation leader, women development officer, rural development officer, and principal. They meet every month to talk about issues in the area. We introduced SRHR issues into that circle. Then they started talking about it. So, that is a different model.
You initiated the first hotline in Sri Lanka for providing information on safe medical abortion and you are a Steering Committee Member of the Asia Safe Abortion Partnership. With a lot of debate going on at the moment on abortion and women’s bodies in Sri Lanka, could you elaborate on the significance of women and girls having access to accurate information on safe medical abortion and contraceptives?
Generally, when we talk about abortion the numbers are very high. More than 80 percent of abortions are accessed by married women. The first reason is economic difficulties.
The current legal propositions that they have put forward is for abortion under rape and fetal abnormalities. It is a very public health perspective. It is about infant mortality rate and things like that. But most women access it for different reasons.
There are two types of abortions – surgical abortion and medical abortion. Surgical abortion is done by tools whereas medical abortion is by using a pill. It is not a registered drug, it is not legal in Sri Lanka, but it is freely available. People just buy it and self-administer it. But the issue with this is, it is not regulated. Medicines of different quality can be found. And then when the pharmacies give it to people, many do not ask how to take it. It is a different process and people don’t know how to administer it. But with the support of the internet, most people Google now and they figure things out. And economic exploitation takes place at large.
So, we set up a hotline to help people with information, according to WHO guidelines. There are only a very few organisations working on safe abortions. We need to have a bigger discourse on this. More people need to speak out about this.
At the moment, with the bill, we are trying to push as civil society to have a women’s rights aspect in the conversations. Some government health officials have had a meeting with the religious leaders. But it is sad to see that the life of the unborn is given a lot of priority over the woman who is already living. Because even at the meeting, many accepted abortions for fetal abnormalities because the child will die after being born, but they opposed using abortion for pregnancies resulting from rape. They were still coming up with solutions like if it is rape the child could be adopted and so on. They were not thinking about the trauma or the status of the woman.
What are the major myths surrounding abortions?
One would be that young people will start having sex, if these laws get approved. I don’t think anybody would use abortion as a family planning procedure. It is a very different and difficult process. When we look at our statistics, it is not mostly young people who access it. It is married women over 30 and 40.
The reason being, we have so many myths around condoms. We don’t use condoms. People in Sri Lanka use emergency contraceptive pills very often. It is an emergency pill and it is not a family planning method. If you use it five/six times a month, it obviously fails. Many married women use ECPs. And after 40, women think that they will not get pregnant but they end up getting pregnant. There is also a lot of marital rape in Sri Lanka. It is not even acknowledged by the laws. And basically, not having proper awareness. They have never learnt about using a condom properly.
Another myth is the argument that this will lead into an increase in sex work. These arguments don’t even have a base. All the arguments are more about controlling women and their freedom. For rape and incest, they say that all the children are given by god and you should be able to adopt at least.
But this could go horribly wrong. In particular, in the North, there is this concept called safe houses. So, when young girls get pregnant, sometimes the families send them to safe houses. They live there and deliver the child, give them for adoption to the probation office, and then come back home. But in the safe house, they don’t get any information on contraceptive. Some girls have come there due to pregnancies from rape. After giving birth, they come back to the community where the perpetrator is. There is no legal or any other support for these young girls.
This is the fourth time a repeal has been requested to the bill, under various grounds. The National Child Protection Authority is very concerned because five rapes happen, just the reported number, in Sri Lanka everyday. And out of that, three are under 18. Incest is also very common but this proposition does not even talk about incest.
So, there are so many issues with our laws. Our law is over a 100 years old. It is not even our law; it is the British law. No body wants to talk about this for political reasons.
What is the reception you get, in particular as a woman, when talking about SRHR issues in Sri Lanka, which tends to be a very taboo social topic?
When I first started volunteering I was quite young. So, I didn’t know how to handle this. If you talk about sex, obviously, you are a bad person, in Sri Lanka. A lot of men used to think that because I talk about sex that means I am available to have sex. Where is this even coming from? Then I realised that this maybe because I keep talking about issues. I look a certain way, I behave a certain way, I am loud, I travel at night – when women are independent, men see independent women as loose women, which had been the case forever.
It had been quite difficult for me since the beginning. There is a lot of cyberbullying. Especially, if you openly say you are a feminist, it is a very toxic word. I have had comments about my looks, about my behaviour, and they commented on very violent things they wanted to do to me, on Twitter, on Instagram, on Facebook. It used to be wild.
With time it reduced a bit, because I accomplished certain things academically and professionally. And then people started accepting it more and believing that there maybe something more to this; for me to be able to get a job and do Master’s. Why would she get a scholarship if she talks about sex – that kind of thinking.
We, as activists or people who work in the field, definitely, we need to focus a lot on self-care. Because we tend to get drained out, listening to issues and criticism. Now the concept of self-care is very popular among feminists and those who work in the human rights field; because if not, we tend to burn out and get depressed. We must make sure that we appreciate each other and support each other.
You have a bachelor’s in social work in Sri Lanka and a Master’s in Gender and Development Studies from the University of Melbourne as an Australia Awards Scholarship recipient. Was it important to have this educational background for your work in the field?
For my bachelor’s in social work, I got to do field placements. It is the only social work degree in Sri Lanka. Only a few people get to do that. We had a very multicultural multiethnic setting in the classroom. It was also a very practical course.
I did my first field placement in a certified girls’ school where young girls who were underage was in a mini-prison, although it was a different sense of a prison. It was one of the most eye-opening moments in my life. Some girls there were about nine years old and they have been doing sex work since they were five. There were some girls who had robbed banks who were about twelve years old. There were also young girls there for stealing a coconut. All of them were together. There was a lot of violence on them. I did a bit of SRHR work and counselling there.
I then got an Australia Awards scholarship to do my Master’s in Development Studies at the University of Melbourne. That actually helped me to overcome a lot of challenges, in particular how people used to perceive my work. That gave more credibility to what I was saying and am saying now. It broadened my horizons. I also got to work a little with the research department at the University. I got to teach an online course with the Royal Melbourne Hospital. The academic staff, the arguments, feminist theories, the things I learned, and meeting Australian feminists – it was one of the most amazing experiences in my life. It also made me stronger as an individual. I became very independent.
Can having stronger relationship and sexuality education in schools help create meaningful conversations about SRHR in Sri Lanka?
The current curriculum that was revised in 2016 also has a section about sexuality and sexual orientation. But the issue is they don’t teach it in schools. Because the teachers are not trained and they don’t have the necessary skills and knowledge to do that. So, we are focusing a lot on training the teachers and principals to teach the kids with whatever is existing.
We have been going to PTA meetings in the North. They are quite open. Parents in the North who had children in grade six told us to teach them SRHR. Because they know these children are using phones; they know the children are doing certain things.
So, the need is there and the government also acknowledges it, but there are practicalities in coming up with a comprehensive curriculum, which has still not taken place.
In the meantime, what we can do is train and encourage the teachers and give them all the support to talk to the children. One of the main reasons they don’t want to talk is because of the language. When we look at SRHR, the terminology we use are associated with filthy words. They don’t know the technical words to talk about these. We came up with a glossary, together with UNFPA and Family Planning Association. It has all the terms related to SRHR. When we go to schools we give it to the teachers. We are now coming up with a curriculum to train the teachers. There is one already happening in the Western Province. It is progressing very slowly but the need has been identified by everybody.
FRIDA is an amazing setting where we support young feminist groups, globally. You don’t have to be registered and you don’t have to be a formal group. If a couple of us want to do something genuinely on feminism, it could be awareness building, it could be drawing, it could be a research, it could be anything of that sort or it could even be in a rural area, you can apply for support. You feel the whole sisterhood feeling and the support. Accessing finance is very difficult for young feminists. Even we find it so difficult to access finance for SRHR. In that sense, FRIDA is very flexible. I am an advisor in the Asia Pacific region. We open grants twice a year. We screen the proposals and give the grants through a participatory voting system.
Any future projects to follow?
With the Youth Advocacy Network, we are planning to work with medical students and nursing students to relook at their curriculums. These curriculums are very technical and they don’t have a rights or gender responsive perspective in the content. So, we are working with a couple of universities. We also have a group of experts from other countries and Sri Lanka to propose certain changes at least to the way these curriculums are being taught. It matters a lot. These are the doctors, midwives, and nurses who will go to rural areas and then when people come they could be very judgmental. They may not look at it in a human rights or gender responsive perspective.
Other than that we are going to have discussions with the civil society and health authorities on the current abortion law. We have an issue because we don’t have much evidence and data to talk about some of the SRHR matters. So, the organisation that I work with and we are focusing on building more evidence. It is not only just doing research but it is also collecting case studies and stories to use as advocacy tools. We have done two studies so far. One is on analyzing policies in the plantation sector, affecting their health. We have also done an anthropological study to look at the attitude perceptions and access to services. So, like that, we are thinking of building more evidence and data.
Sri Lanka is now a middle income country. Because of that we have lost a lot of funding and resources due to donor priorities. This has impacted our work a lot because it is very difficult to find funding, especially for these issues. Our health and education indicators are pretty good. So, now the priority is only policy changes. But when you look at the reality, there is a lot that needs to be done. So, it is very difficult for us to work with limited resources. This is one other challenge we have.
Date of Interview: 15 October 2017
Interviewer and photos: Shashini Ruwanthi Gamage