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Political Context. Sri Lanka underwent a protracted civil war from 1983-2009, which led to a high incidence of impairment and inadvertently stratified disabled people in terms of gender and civilian-veteran status. State initiatives to meet the needs of veterans became a catalyst for disability policy reform and service provision. Limited initiatives in relation to the sexual and reproductive health and rights (SRHR) of disabled people can be traced back to efforts to meet the reproductive needs of veterans The LILI (Light to Life) project, (2) set up by the Family Planning Association (FPA) in 2009, was a veteran-led sexual and reproductive health (SRH) service that is now partially available to disabled civilians. Efforts have been made under the radar in the past, primarily in the personal capacity of advocates at the FPA, to conduct SRHR workshops for disabled people in collaboration with community organizations. However, these have been suspended due to lack of funding and exclusion of disabled people's SRHR from state and non-state agendas. (3) Disabled civilian women in a post-war setting are largely excluded from SRHR discourse and consequently from related legal rights. They are also highly under-represented in leadership and agendas of Disabled People's Organizations (DPO). (4) Their needs and rights, including SRHR, are subsumed by DPO priority areas like access and livelihood. This hierarchical approach to rights often leads to the exclusion of SRHR from transformative agendas. It is reflective of the general sexuality taboo that has led to resistance towards perceiving SRHR as human rights in Sri Lanka. This signals the need to bring women to the forefront of the disability rights landscape and in doing so to build strategic alliances with both the women's and SRHR movements.

Cultural Context. Sexual and Reproductive Health (SRH) in Sri Lanka is closely enmeshed within larger cultural frameworks like marriage and is regulated through socio-cultural discourses like stigma and shame. Marriage is the primary gateway for accessing mainstream sexual and reproductive health services for most women in Sri Lanka. Unmarried women who are sexually active often have to claim that they are married in order to access services.

Disabled women are stereotypically associated with non-sexuality, fragility, and innocence. The pseudo-Buddhistic notions of hiri othap (shame and fear) discursively regulate the fulfilment of duties and morality in Sri Lanka. Hence social status and approval are of paramount importance. Shame is linked to karmic understanding of disability in a Sri Lankan Buddhist context. Disability is seen as a stigma that leads to diminished status and social disapproval. Marrying a disabled woman may lead to the stigmatization and devaluation of the husband and his family, which acts as a deterrence to such marriages. These beliefs render disabled women "unmarriageable" in popular view. This is one of the key reasons why disabled women are automatically omitted from mainstream reproductive health discourses and legal rights.

During the course of Sri Lanka's 26-year civil war, women experienced abandonment upon acquiring impairments. Others had to navigate the intersectional stigma of being disabled war widows. In the case of psychosocial disabilities, there are accounts of women who have been viewed as hypersexual or unfit to perform their marital duties and were forcibly incarcerated by families. The diminished marriageability of disabled women in Sri Lanka is a manifestation of systemic oppression brought about by exclusionary institutional practices as opposed to inherent undesirability. They may have informal relationships but are often precluded from marriage, which is the primary avenue for sexual validation and the sanctum of reproduction. Hence, they are denied socially valued gendered roles like wife and mother. This has a significant impact on their experienced and perceived worthiness and social standing and their ability to exercise their SRHR.

A DPO representative (5) said that local men in his constituency try to convince disabled women to enter covert sexual arrangements claiming "it's the best they will get." These casual arrangements make women particularly vulnerable to exploitation. They have limited or no access to contraception and are susceptible to contracting STIs while falling outside the radar of the SRH sector.

Care Economy. Many disabled women in Sri Lanka are institutionalized in charitable care homes. (6) These institutions mediate their rights and their movement; privacy and autonomy are subsumed by institutional guardianship. If not institutionalized, many live as wards of their families. This is primarily due to the lack of state services, lack of access to the public sphere, and a dearth of services for independent living. It is also an outcome of a culture that heavily relies on family-based care.

Given the assumed un-marriageability of disabled women, they may become pregnant outside wedlock under a range of circumstances, which compounds the associative stigma for families. Hence, they are unlikely to receive formal and adequate maternity care.

Even those who become pregnant within wedlock are viewed with suspicion. There is a biomedical hysteria regarding the potential transmission of undesirable impairments through the reproductive bodies of disabled women. The genetic perpetuation of impairments in families compounds shame and stigma. There are concerns regarding disabled women's fitness and capacity to become mothers and parent children. Hence the pregnant disabled woman is viewed as adding to the family care burden.

In a society where women who experience rape and disabled women who reproduce are heavily stigmatised, sterilization and forced abortion are seen as a convenient means of brushing both under the carpet. Although there is a 20year sentence stipulated for institutional abuse, there is no transparent system of accountability for the protection of those under the guardianship of charity homes. (7) This renders disabled women in such homes and those dependent on the larger care economy highly vulnerable.

Accessibility. Given the taboo surrounding sexuality, any content regarding reproduction, leave aside sexuality education, is glossed over in Sri Lankan public and private school curriculums. A representative of the Sri Lanka Federation of the Deaf said that reproduction was completely excluded from the curriculum at the special school she attended on the basis that it was deemed irrelevant to hearing-impaired students. (8) This reflects the assumed non-sexuality and un-marriageability of the students, as well as fears that they would be corrupted through exposure to a taboo subject, given the stereotypes about their purity and innocence.

Most facilities, including private SRH clinics, remain inaccessible to those with physical impairments. The representative of the Federation of the Deaf (9) said that communication was a key barrier for hearing-impaired individuals when accessing SRH-related information and services. There is a dearth of sign language interpreters in Sri Lanka, and most healthcare facilities are inaccessible on that basis. The representative narrated how a deaf woman known to her died shortly after giving birth, as she was unable to communicate high blood pressure symptoms to the medical staff.

Disability Movement. It is only recently that the disability movement in Sri Lanka has begun to address the issue of sexual violence. SRHR is yet to be engaged with meaningfully. While this initial dialogue on sexual violence is encouraging, the framing of sexuality primarily in terms of vulnerability may detract from a conceptualization of sexuality and reproduction as universal rights. What is required is a balance between addressing vulnerability and developing sex-positive rights frameworks. This entails building alliances with the broader SRH sector, which requires active, community-level outreach and recognition of disabled women as a key constituency. Efforts are currently underway to establish a Women with Disabilities wing by the Disability Organizations Joint Front (DOJF), (10) the national umbrella organization for DPOs, to facilitate such collaboration.

Legal Framework and Recommendations. The Sri Lankan government acceded to the United Nations Convention on the Rights of Persons with Disabilities (CRPD) in February 2016. A draft Disability Rights Act, which reflects the state's obligations to the CRPD, is currently under review. Article 19, sub clause 3 states that all disabled people should have access to reproductive and family planning information and services to exercise their choices. This sets a strong foundation for the assertion of the SRHR of disabled people and provides a basis for legal reform. It is imperative to address these barriers through affirmative measures like sensitization, family support, access to information and facilities, and the regulation of institutions. Such interventions are a vital aspect of the state's compliance with the CRPD, which will give efficacy to formal legal reform. It is also imperative to prioritize the SRHR of disabled women in state and non-state agendas, especially in terms of funding, resource allocation, and legislative reform.

By Niluka Gunawardena

Secondary educator, Colombo International

School; Visiting Lecturer, University of Kelaniya, Sri Lanka.


Notes & References

(1.) Special thanks to Katrina Anderson for her critical comments and feedback.

(2.) t&view=article&id=i27&ltemid=587&lang=en.

(3.) Interview with FPA Reproductive Health Instructor, July 15, 2017.

(4.) For an overview of women's exclusion from DPOs and civil society, see Women's Refugee Commission, "Working to Improve Our Own Futures: Strengthening Women and Girls with Disabilities in Humanitarian Action," New York, 2016.

(5.) Phone conversation, April 20, 2017.

(6.) For an overview of the relationship between the care economy and disability see Graham G. MacDonald, Disabled by Nature? The Care Economy: History, Critique, and Ethnography, (Ontario: Carleton University, 2014).

(7.) Attorney, Human Rights Commission of Sri Lanka.

(8.) DOJF Women with Disabilities Workshop, May 2017.

(9.) Ibid.

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Title Annotation:spotlight
Author:Gunawardena, Niluka
Publication:Arrows For Change
Geographic Code:9SRIL
Date:Dec 1, 2017
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