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Colombo

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OVERVIEW

Colombo.JPG

As the largest city and capital of Sri Lanka, you will find many health care resources in Colombo. Birth control pills can be purchased without a prescription at pharmacies. For women who don't want to purchase birth control in person, it can also be bought online. You can also obtain emergency contraception ("the morning after pill") at pharmacies. There are no official travel restrictions attached to STI status in Sri Lanka. The main centers for getting STI tests are Durdans Hospital and Family Planning Association (FPA). Many people have recommended FPA because they tend to be more progressive (i.e. they don't judge as harshly as some other facilities if unmarried women want to get tested). Currently, Sri Lanka has no PrEP programs or a national HPV vaccination program. You can find pads and pantyliners in most shops. Tampons are less common, and we have no evidence of any menstrual cups being sold. Regarding abortion, it is only legally permitted when a woman's life is endangered by the pregnancy. We have provided some resources below in the "Abortion" section that can give more details.

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Sri Lanka, you can purchase condoms and birth control pills at pharmacies without a prescription.[1] [2] However, for other forms of birth control, such as implants, injectables, and IUDs, you may need to directly visit a hospital or clinic to obtain them.

In the 1970s, Sri Lanka emphasized sterilization as a contraceptive method. But, since the 1980s, Sri Lanka has increasingly emphasized reversible contraceptive methods. This helped bring down the total birth rate in the 1990s. In 1987, it was estimated that 31% of Sri Lankan women had unmet family planning needs. By 2007, this dropped to a range between 1.6% (by narrowest definition) to 19.3% (under the broadest definition of unmet needs). As reported by the Guttmacher Institute: "Reliance on traditional contraceptive methods declined between 1987 and 2007, whereas modern method use increased (from 41% to 53%). This greater reliance on modern contraceptives was facilitated by the increased availability of reversible methods, as reflected by a shift in the ratio of sterilization to reversible modern methods from 3 to 1 in 1987 to 1 to 2 in 2007."[3]

What to Get & Where to Get It

  • For a comprehensive list of contraceptive options available in Sri Lanka, click here.
  • You can buy condoms in pharmacies, shops or supermarkets. You can also buy condoms online from the online store Wow.lk, a Sri Lankan company. They sell brands like Preethi, Life Style and Durex, ranging in price from Rs 50-230. You should remember that Durex, Moods and FPA are the good brands. There are many other cheap brands that aren't recommended. FPA Preethi is the cheapest (most basic) condom that is widely used in Sri Lanka.
  • You can get condoms for 1/3 of the price of Durex at Family Medical Practice. They have a range of condoms.
  • You can obtain birth control pills in Sri Lanka without a prescription at pharmacies. The leading brand in Sri Lanka is Mithuri, which is a combined oral contraceptive. Other brands you can expect to see are Diane, Diane-35, Eugynon, Ovral, Microgest, Microgynon, Minulet, Nordette, Trinordiol, Yasmin and Yaz.[4]
  • If you cannot access any pharmacies, you can also obtain Mithuri birth control pills from Family Planning Association for Rs 100. Click here for details.
  • Some of the best pharmacies in Colombo are Union Chemists (460, Union Place Colombo, WP 02) and Raj Pharmacy (189 W A. Silva Mawatha, Colombo 00600, Sri Lanka).
  • If you want contraceptive implants, you can find Jadelle and Implanon in Sri Lanka.[5]
  • If you want a contraceptive injectable/shot, you can find Depo-Provera SAS 150mg/ml in Sri Lanka.[6]
  • Regarding IUDs, you can find Mirena in Sri Lanka. One local has reported: "IUD's are a fairly popular option, especially the copper one because it's long lasting and affordable. I know several friends who were offered it after giving birth, and I personally was offered it twice when I saw two doctors about birth control options (not married). I had mine (copper) inserted at Nine Wells Hospital in one of the labour rooms (very clean), and then my second one under anaesthesia at Asiri Surgical Hospital (operation theatre). My doctor also offered to do it at Joseph Frazer Memorial Hospital but I would have had to buy the IUD from an agent and bring it with me, which I found a little strange so I went with the Nine Wells, where I just paid for it in my final bill."

Note: If you're interested in using lubricant, you should use a water-based lube. It's common for people in Sri Lanka to use Vaseline or baby oil as lubricant, which is not recommended. There's only one lube you can buy from pharmacies, shops and supermarkets. It is Easy Glide. Eurex lube can be bought online. Some lingerie stalls sell Durex Lube. You can buy lubricant online as well.

Costs

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

In Sri Lanka, you can obtain emergency contraception (the morning after pill) without a prescription.

What to Get & Where to Get It

  • In Sri Lanka, you can buy emergency contraception (the morning after pill) at pharmacies. There are quite a few dedicated emergency contraception brands that you can purchase, including Emcon, Madonna, Pill 72, Postinor-2 and Pregnon. For all of these brands, you should take 2 pills within a maximum of 120 hours after unprotected sex.[7]
  • If you can't access dedicated EC, you can also use oral contraceptives as replacement EC. Remember that, in 28-day packs, only the first 21 pills can be used. You can use Eugynon or Ovral (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can also use Microgest, Microgynon, Mithuri and Nordette (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later).[8]

Costs

Postinor and Mithuri cost RS 100.

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

There are no travel restrictions attached to STI status in Sri Lanka. If a foreigner is found to be HIV+, that person will be referred to the HIV Division at the National Hospital in Colombo for care. However, as reported by HIVTravel, "Sri Lankan law does allow immigration officials to refer visitors and foreign residents to a physician for examination if a public health risk is suspected. In practice this is a rare occurrence, but travelers should be aware that Sri Lankan law allows for the denial of entry to any foreigner who, upon referral from an immigration officer, is certified by a physician as posing a public health risk. Travelers who refuse a medical examination under these circumstances may be refused entry. Please verify this information with the Embassy of Sri Lanka before traveling."[9]

In Sri Lanka, workers cannot be terminated from their jobs or barred from employment due to their HIV status.[10]

According to a 2010 report, "Sri Lanka is classified as a country with a low-level HIV epidemic in the South East Asia region. According to UNAIDS estimates, up to the end of December 2009, around 3000 people were living with HIV. The estimated HIV prevalence among adults (15-49 years) is less than 0.1%. Even among individuals considered at higher risk of infection, based on their occupation, behaviors and practices, HIV prevalence is below 1%. Yet, there are certain demographic, socioeconomic and behavioral factors which may fuel an epidemic. Female sex workers and their clients, men who have sex with men, injecting drug users, are identified as the most at risk populations in the country."[11]

What to Get & Where to Get It

Testing Facilities

  • Durdans Hospital: This is a private hospital. From a local: "I was told that Durdans is the only private hospital that covers all the tests. But that too with lots of judgement and they make it very uncomfortable for the patient." Address: 3 Alfred Pl, Colombo 00300, Sri Lanka. Phone: +94 11 2 140000.
  • Family Planning Association of Sri Lanka: They may be less judgmental than Durdans Hospital but they may also test for a smaller range of STIs/STDs. "They are the only people as far as I know who offer post test counselling after HIV testing." Location: Bullers Lane, Colombo 07. Tel : 2555 455. Clinic is open from 9am to 3.30pm in weekdays.
  • National STD/AIDS Control Programme Sri Lanka: Tests for HIV, viral load, PAP, etc. Address: No.29, De Saram place, Colombo 10, Sri Lanka. Tel: +94 011 26 67163. Fax: +94 011 533 6873 / +94 011 2682859. Email: info@aidscontrol.gov.lk.

Note from a local: "Lanka hospitals and Nawaloka are particularly awful, with friends and acquaintances having really terrible experience with the medical staff. I've easily come across at least ten instances where a patient who went to get checked for an STD was reprimanded for having sex outside of marriage. The Family Planning Association (FPA) is a lot better in that department but in general, trying to get any of the such services, particularly if you are unmarried, is a fairly uncomfortable process at any normal hospital. "

Support

  • National STD/AIDS Control Programme Sri Lanka: "The National STD/AIDS Control Programme (NSACP), Ministry of Health, spearheads the national response to HIV/AIDS in Sri Lanka. NSACP is the focal point for planning and implementation of HIV/AIDS National Strategic Plan and AIDS Policy together with all stakeholders. The headquarters of the NSACP is situated at 29, De Saram Place Colombo 10, Sri Lanka and it networks with 30 full-time STD clinics and 23 branch STD clinics (as of end 2015)."
  • HIV Division - National Hospital, Colombo: Address: E W Perera Mawatha, Colombo 00700, Sri Lanka. Phone: +94 11 2 691111.
  • Companions on a Journey (Wattala): This LGBT organization conducts HIV prevention activities and provides care and support for people living with HIV/AIDS. E-mail: coj@sri.lanka.net or ilgaasia@sri.lanka.net.

Costs

Medications & Vaccines

Laws & Social Stigmas

What to Get & Where to Get It

  • Sri Lanka currently has no national HPV vaccination program in place (as of 2016).[12]
  • There are currently no known providers or programs for PrEP in Sri Lanka.[13]

Costs

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

Laws & Social Stigmas

In Sri Lanka, there are many stigmas and misunderstandings attached to menstruation. One Sri Lankan woman reports, "They teach about menstruation is Health and Physical Science but it is no way sufficient." You can read this article about beliefs and practices attached to menstruation in Sri Lanka.

A stigma that is common across Sri Lanka is the "Kili Concept". The word "Kili" means dirty or impure. Therefore menstruation and menstrual blood is considered impure. Women are not allowed into certain religious places while those women are on their period.

What to Get & Where to Get It

In Sri Lanka, pads are widely available in supermarkets, pharmacies, grocery stories and boutiques. The leading brands are Eva, Fems and Whisper. The pads brands tend to be bulky, and some are cheaply made. Tampons are rarely available, and some people in Sri Lanka report that they don't seem to be available at all. In the past, people saw Ria tampons in the markets, but they're not sure if they're available anymore. As for menstrual cups, there are no known sellers of major brands (i.e. DivaCup, MoonCup, LadyCup, Lunette) in Sri Lanka, so you should look to buy a menstrual cup online through an international seller.

Costs

Gynecological Exams

Laws & Social Stigmas

What to Get & Where to Get It

  • Family Planning Association - Sri Lanka: "FPA offers a lot more services and they offer the cheapest SRH services in Colombo." "FPA is really good because its the area of their expertise and they are bound as an organisation to serve the community non-judgementally. It's the Sri Lankan member association of IPPF." Address: Colombo 00700, Sri Lanka. Phone: +94 11 2 555455.
  • Vindana Reproductive Health Centre: Recommended doctor: Dr. Sumitra Tissera (she was formerly at FPA). "I also heard there are many good doctors ....get gyn exams, STI tests." No. 09, Barnes Place, Colombo 07. Sri Lanka., Tel : +94 112 667 422 / +94 112 682 102 / +94 112 689 685. e-mail : vindana.ivf@sltnet.lk.
  • Lanka Hospital's Women's Wellness Center: Recommended doctor: Dr. Nishendra Karunaratne, Pro. Chandrika or Dr. Kamani Mayadunne. From the website: "No matter which stage of your life you’re in, we are equipped and ready to help you with services, offered by our highly professional team of consultants in order to live a healthy life. We respect your privacy and want of seasoned and professional care. That is why we believe, Lanka Hospital’s Women’s wellness Center will become your ally in your pursuit of a fulfilling and a healthy life."
  • Durdans Hospital: Recommended doctor: Dr. Rajan Colonne. Address: No: 3, Alfred Pl, Colombo 03., Tel: +94 (0) 11 541 0000, Consultations\Appointment Desk: +94 (0) 11 5410 42 / +94 (0)11 5410 419, Helpline: 1544 (Short code) +94 (0)11 5410 000, Fax: +94 (0)11 2575302. Email: contactus@durdans.com.
  • Castle Street Hospital for Women: "The Castle Street Hospital for Women is the premier women’s hospital in Sri Lanka. Able to serve a wide array of services to women, it currently has a strength of 442 beds. It provides services to expecting mothers, gynecological patients, sub fertile patients and neonates. " Address: Castle Street, Colombo 00800, Sri Lanka. Phone:+94 11 2 695529.
  • Nine Wells Hospital: "Ninewells is the only specialized private maternity hospital in Sri Lanka, located in Colombo. It provides treatment and care throughout pregnancy, childbirth, IVF treatment, sub-fertile and post-reproductive age." Address: NINEWELLS CARE - Mother and Baby Hospital (Pvt) Ltd., 55/1, Kirimandala Mawatha, Narahenpita, Colombo 05. Tel +94 11 4520999. E-mail inquiries@ninewellscare.com

Costs

Pregnancy

Laws & Social Stigmas

What to Get & Where to Get It

Costs

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

Abortion is generally illegal in Sri Lanka, according to the Penal Code of 1883. If anyone voluntarily causes a pregnant woman to miscarry, that person is subject to up to three years in prison or to paying a fine. The one exception is if the miscarriage was done with the intention of saving the life of the woman.

According to a UN Report, "Although any abortion wilfully induced without the specific intent to save the life of the mother constitutes illegal abortion in Sri Lanka, in practice, indictments for criminal abortion rarely occur and convictions are even rarer. The incidence of abortion is believed to be considerably higher than is commonly acknowledged. A rural survey suggests that 54 abortions per 1,000 population are performed each year."

There is a high rate of unsafe underground abortions in Sri Lanka. Be careful and only go to trusted providers.

What to Get & Where to Get It

  • You can try to get an abortion pill online through Women on Web.
  • Marie Stopes Sri Lanka: MSI Sri Lanka does not provide abortions, which are illegal in Sri Lanka, and they only provide services that are legally allowed according to the Ministry of Health. However, you may be able to consult them about your options.
  • ASAP Sri Lanka Telephone Hotline: +94 (0) 715903414, +94 (0) 715903417

Costs

Advocacy & Counseling

Laws & Social Stigmas

What to Get & Where to Get It

  • Alokaya Counseling Center: "Their speciality is they are experts on SRHR and they are very chill."
  • Women in Need: Founded by a team of Sri Lankan Women Dedicated to the cause of elimination of Domestic Violence and other forms of Violence Against Women. "Women In Need operates in 8 crisis centres: Colombo, Matara, Kandy, Anuradhapura, Badulla, Kurunagala, Batticalo, Puttlam and Jaffna. WIN also maintains the only specific shelter for Women and Children who ar subject to Domestic Violence in the Island." Call: 011-2671411. Email: win@eureka.lk
  • Dr. Kapila Ranasinghe: He's an LGBT-friendly psychiatrist who has had queer and trans clients/patients. You can read an interview with him here.
  • Happy Life: Provides SMS counseling and real-time chat services. "The goal of the project was to increase SRH knowledge and awareness in the community, especially the youth. Socio-cultural norms passed down by older generations continue to view the discussion of sex/sexuality as taboo. With the advancement of information technology, young people are exposed to vast amounts of information on SRH from various sources mostly being unreliable and misleading. Yet, they are unable to discuss questions they have within family, friends, teachers, or even with the family physician due to embarrassment; resulting in isolation and confusion relating to SRH issues." E-Mail: srhict@fpasrilanka.org.

Costs

List of Additional Resources

  • Equal Ground: "EQUAL GROUND is a nonprofit organisation seeking human and political rights for the Lesbian, Gay, Bisexual, Transgender, Intersex and Questioning (LGBTIQ) community of Sri Lanka. We are committed to creating a safe space for all LGBTIQ individuals and to providing opportunities for self help including mental well being, economic, social and political empowerment, access to health, education, housing and legal protection for the LGBTIQ community. EQUAL GROUND is the only truly mixed organisation in Sri Lanka which includes the wider identities of the Queer community in Sri Lanka as well as our heterosexual allies and friends."
  • Women's Development Centre: "WDC through mobilized rural women leaders within the operational regions of its network of women, facilitates an environment for victimized women and children, persons with special needs, youth and other vulnerable groups to achieve positive changes in their lives by resolving or minimizing their problems through active participation in decision making within the socioeconomic process."
  • Women's Centre Sri Lanka: "As a result of the emergence of Free Trade Zones with the advent of the open economic system in Sri Lanka, many women were suffered due to the oppressive policies of the government existing at that time. Especially the working class was subjected to extreme exploitation. In this historic background, the Women’s Centre was established at Tudella in Ja-Ela in August 1982 to protect women, rights of women and rights of women worker."
  • The Grassrooted Trust: "The Grassrooted Trust was set up to provide a safe space for marginalized communities, online and in the real world. The issues we discuss and work on, the issues that drive us, have their beginning in the world of HIV.... People living with HIV, people who use drugs, people who sell sex, those who identify as transgender, those who are gay, lesbian or bi-sexual, those who struggle to or refuse to be defined and neatly parceled, those who have survived intimate partner violence, stigma, discrimination… these are the people we choose to represent, and they represent us..." Address: The Grassrooted Trust (Guarantee) Limited. 14 Pirivena Road, Mount Lavinia, Sri Lanka. Phone: +94 11 42 82 550. Email: trust@grassrooted.net.
  • Bakamoono.lk: "bakamoono.lk promotes respect for self, respect for the other, and respect for difference. bakamoono.lk is about being sensible, even wise, in our dealing with issues around relationships, sexual and reproductive health, HIV, gender, and our right to be who we are."
  • Women and Media Collective: "The Women and Media Collective was formed in 1984 by a group of Sri Lankan feminists interested in exploring ideological and practical issues of concern to women in Sri Lanka. Since then we have been actively engaged in bringing about change based on feminist principles in creating a just society that does not discriminate based on gender. " Address: No. 56/1, Sarasavi Lane, Castle Street, Colombo 08, Sri Lanka. Phone: + 94-11-2690201 / 5632045 / 5635900. Fax: +94-11-2690192. Email: wmcsrilanka@gmail.com.
  • Rural Women's Front (RWF): "Rural Women’s Front (RWF) started working in 1988 to voice the unique issues of rural women. RWF’s work draws from human rights and women’s rights, and connects women across ethno-religious and cultural divides." Address: 28C, Banawattha China Garden, Galle, Sri Lanka. Phone: (+94) 912 231 886. Email: srwfg18@sltnet.lk

References