Smriti Daniel

Shehan Karunatilaka: What to expect from Shehan ‘Chinaman’ Karunatilaka’s new novel (hint: think ghosts)

In Scroll.In, Writers on May 12, 2016 at 7:47 am

What to expect from Shehan ‘Chinaman’ Karunatilaka’s new novel (hint: think ghosts)

The sastra karaya could see a ghost standing behind Shehan Karunatilaka’s shoulder.

He said the spirit was a woman, someone Karunatilaka had known and who was now his guardian. Now, in his airy living room in Colombo, Karunatilaka admits he didn’t sense anything himself, and that he was a little bit disappointed with the experience. “There is the sceptic in me that thinks he [the astrologer] was just doing some cold reading,” he admits, but when advised to do a Bodhi pooja, Karunatilaka lit some lamps and made offerings of flowers under the sacred fig tree anyway.

Karunatilaka never attempted to become better acquainted with his ghost. One of Sri Lanka’s most celebrated contemporary writers, you wouldn’t imagine his wry intellect lends itself to a belief in the paranormal. But while he’s not a man of (any) faith, his thinking on the matter is simple – “I am not a believer in this stuff, but I fear it. If it is out there, you don’t want to be messing with it.”

Yet an astrologer’s office is far from the strangest place he has been in pursuit of material. In the last few years, the author has taken an interest in subjects as diverse as Sri Lankan death squads, Colombo’s haunted houses, the pilgrimage to the sacred city of Kataragama and Buddhist notions of the afterlife and rebirth.

In fact, the last time I met Karunatilaka, he was lurking among the graves in Borella cemetery, scouting for ghosts. Then his sunglasses, pierced nose and sharp beard, threaded with white streaks, gave him the air of an insouciant rock star. It is an air he retains, perhaps because even though his band Powercut Circus no longer exists, Karunatilaka still plays the bass guitar every other morning, treating it as a form of meditation.

While the music remains a constant, Karunatilaka’s other interests shift with each new novel. With Chinaman: The Legend of Pradeep Mathew, it was cricket games and old, alcoholic uncles. Certainly, his friendly ghost brought him good fortune back then – the book he had self-published in Sri Lanka first won the Gratiaen Prize, then gathered up the Commonwealth Book Prize and the DSC Prize for South Asian Literature even as it found publishers in India, the US and the UK.

And now, a new novel

That was in 2012, but Karunatilaka is finally ready to unveil his follow-up. In his home office, he has walls covered in post it notes and newspaper cuttings, wireless neon lighting he controls from his smartphone and several writing projects in various stages of progress. His present focus is the unpublished manuscript Devil Dance, which is currently in the running for the Gratiaen Prize. Founded by Michael Ondaatje with his Booker Prize winnings in 1992 and named for Ondaatje’s mother, the Gratiaen is one of Sri Lanka’s best known literary awards. Karunatilaka has won twice before, and will only find out if he has won again on May 12. In any case, Devil Dance should be in bookstores by the end of this year.

Karunatilaka writes for a Sri Lankan audience and is canny enough to know that it’s that very specificity that makes him interesting to the wider world. When we first meet Devil Dance’s protagonist, the intrepid investigative journalist Riyal Ratnam Almeida, he is already dead; tethered to his own corpse, even as it is being inefficiently disposed off in Beira Lake. Born in 1955, dead by 1990, Riyal’s obituaries will describe him as “a brilliant, erratic, homosexual leftist,” and “Sri Lanka’s premiere war photographer.” He has lived through some of the most tumultuous years in Sri Lankan history, and is about to be a spectral spectator to a few more.

But first, some background

Post-independence Sri Lanka has been wracked by violence. The war between the state and the separatist terrorist outfit Liberation Tigers of Tamil Eelam (LTTE) stretched out over nearly three decades, and was brought to a bloody end under former President Mahinda Rajapaksa only in 2009. Meanwhile, the Indian Peace Keeping Force, which was deployed following the Indo-Sri Lankan Accord of 1987, is remembered with little fondness by Sri Lankans.

But lesser known outside these shores are the insurgencies in the south of the island. The party Janathā Vimukthi Peramuṇa led armed uprisings against the ruling governments in 1971 and then again in 1987. Young, poorly armed and barely trained though they may have been, the JVP earned a reputation for pure brutality, one that would only be outdone by the state’s response. Thousands upon thousands died.

“It was the perfect storm,” says Karunatilaka now. “And all this stuff happened between the third A-ha album and the fifth A-ha album.” However, while the novel relies on this context, he did not delve deep into the historical record, but he has his premise: “If a ghost is someone who died unfairly, Sri Lanka is obviously swarming with them.”

In Riyal, Karunatilaka created an angry ghost, hungry for justice. The dead journalist suspects he was put on a hit list thanks to his determined attempts to ferret out the killers of a certain Elsa Loganathan. The young woman’s corpse was found floating in a tank on the roof of the Hotel Rio. Unfortunately, even surviving his own death has left Riyal no wiser about who murdered Elsa.

Was it the LTTE or the India’s intelligence agency RAW or a Sri Lankan state-sanctioned death squad? What role does the suspicious US Fund for Peace play? As Riyal sets out to unravel the mystery, he is also simultaneously working up an ethereal sweat, struggling to master the skills that will allow him to visit pain and havoc on the men responsible.

Yesterday, today, and maybe tomorrow

The story plays out in a world that is completely contemporary in its concerns yet populated by creatures out of folktales, Buddhist philosophy and Sri Lankan legend. Grease Yakas go diving in the wrecks with mermaids and “tsunami drowners”, the Crowman in his office serves up justice on cheating husbands with a little help from the other side, and hordes of the disappeared dead ride the winds as they await their killers in the afterlife.

While this shadow world exerts a powerful influence on our own, the horrors who inhabit it pale in comparison to those which living men make – the torture rooms hidden in the middle of a bustling city, the mass graves packed with the bones of entire villages.

This is undoubtedly grim raw material, but Karunatilaka finds a very Sri Lankan way of approaching it. In his writing, irreverence and humour leaven despair. (The general attitude seems to be, there may be bombs in the street and mass graves in the forest, but life goes on, so why not face it with a glass of arrack in hand?) And if this plot sounds like he has many balls in the air, it’s because Karunatilaka has never juggled so hard before.

Like his famously hard drinking predecessor, the perpetually inebriated 64-year-old WG Karunasena who was the star of Chinaman, Riyal is also a determined journalist with a strong appetite for self-destruction. But where Chinaman appealed in part because of the intimacy of its plot, and the deep familiarity and affection its lead evoked in readers, Karunatilaka is at work on a much larger canvas with Devil’s Dance. He was taken by surprise to have Chinaman hailed as the ‘great Sri Lankan novel,’ and in that success lie the seeds of his present doubt – “perhaps, it is when you try to write the ‘great Sri Lankan novel’ that you are most likely to fail,” he says.

That this career in writing fiction brings with it no surety of success is not a surprise to him. Consequently, he is yet to take fully to it as a profession, still committing some of his time to advertising work. The latter has paid his bills for a long time – arrived at after trialling life working at food courts, in data entry, and perhaps most memorably, digging graves – it is a job that he is decidedly good at and he has the awards to prove it.

But once he has earned his keep, he settles back into Sri Lanka and the house he grew up in. He has made a routine out of discipline – rising at 4am to write a bit every day, and spending his afternoons in charge of his young daughter. He says becoming a father has somehow made him a more prolific: “You become more aware of the scarcity of time and the need to fill pages.”

It helps that being in the land of his birth is also the best antidote to this writer’s doubt. It inspires a kind of certainty – it is the only place he could have produced Devil Dance. His voice, his stories, even his sense of humour, are somehow inextricably of this place. He admits sometimes to struggling with writing in the gloom of London, or in relentless Singapore.

“When I am here, in Sri Lanka, it’s just not an issue. I can’t imagine writing anywhere else,” he says. It is an approach that has served him well. By just staying home, Shehan Karunatilaka has found, again and again, stories the world wants to read.

Published on Scroll.in on May 8, 2016. By Smriti Daniel with picture courtesy Shehan Karunatilaka. 

Seran Sivananthamoorthy, Kopinath Thillainathan: Sri Lankan Tamils around the world have built an online library to replace one torched in 1981

In Academics, Activists, Archivists, Scroll.In on May 12, 2016 at 7:43 am

Sri Lankan Tamils around the world have built an online library to replace one torched in 1981

Seran Sivananthamoorthy is only 25 years old which is why his knowledge of the Jaffna Public Library is limited to memory and anecdote. The library with some 95,000 volumes including the only original copy of the Yalpana Vaipavamalai or the History of the Kingdom of Jaffna was set alight by a mob in 1981 as tensions rose between the island’s Sinhalese and Tamil communities in the prelude to Sri Lanka’s civil war. Miniature editions of the Ramayana, accounts of early explorers in Ceylon and a trove of ancient palm-leaf manuscripts important to Sri Lanka’s Tamil-speaking communities were also lost in the fire.

“There are chances it could happen again,” said Seran. This is not a reference to the possibility of renewed conflict or arson, but to the fact that the integrity of such collections are threatened by a host of factors – from pests and mould to censorship imposed by casteism and patriarchy.

This was also on Kopinath Thillainathan’s mind when he, along with a friend Mauran Muralitharan, established the Noolaham Foundation that set up the Noolaham Digital Library in 2005 whose 16,000 documents now make it one of the largest Tamil digital archives available online.

A rare repository

Sri Lanka’s colonisation and subsequent political movements have been particularly effective in marginalising voices that belong to the nation’s minority Tamil-speaking communities. Outsiders perhaps see Sri Lankan Tamils as a homogeneous group but the community comprises not just the Tamils of the north and east of Sri Lanka, but Indian Tamils whose ancestors were brought over by the British from India to work on plantations, Coast Veddas from the island’s indigenous population, and Tamil-speaking Muslim communities.

The archive is funded by the community and driven overwhelmingly by volunteers. Its contents include photographs of 5,000 timeworn pages that make up 24 palm-leaf manuscripts, and books such asYalpana Samaya Nilai or Religion in Jaffna that date to 1893. The longest documents it has stored on its servers are four volumes ofTolkappiyam, one of the oldest Tamil grammar books.

At present, the archive also collects thirty magazines and eight newspapers. This includes the regional newspaper Valampuri, which continued to report through some of the most violent years of the island nation’s civil war, as well as Paathukavalan, the oldest Catholic weekly to be published from Jaffna, which was first printed in 1876.

Extensive archives

The library gives scholars access to documents they will not find elsewhere including pamphlets produced by Sri Lanka’s Muslim political parties and traditional documents Tamil families produce as a kind of a comprehensive obituary for their deceased loved ones.

The foundation has also started building what its members call a “biographical dictionary.” “So far we have collected details of about 2,500 personalities,” said Kopinath.

He added, “This is the first ever reference resource of this magnitude on Tamil people. We expect to document 5,000 personalities by the end of 2016 and are planning to publish print volumes as well.”

Noolaham hopes to create audio, video and photo archives too.

A passion project

Its core members make time for the foundation from their busy schedules. For instance, Kopinath, who lives in Australia, is a production manager at a factory, while young Seran has just begun to work as an engineer. Seran confesses that in many ways his heart lies with Noolaham: “I don’t want to say this archive is my part-time work. This is my spiritual work. This is what I want to do with my life.”

With three offices in Sri Lanka and working groups in the UK, Canada, Norway, Australia and USA, and more than 200 volunteers and 350 individual donors across the world, the Noolaham Digital Library seems like an extended community project. Nevertheless funding is a constant challenge as is handling copyright permissions.

An engaged community

Kopinath credits the group’s commitment to their passion project with having pulled them through a challenging decade. He judges their success by the importance the archive is seen to have among the people. A majority of visitors to the site come from Sri Lanka itself.

“Our communities are using Noolaham as a repository where they can store, preserve and retrieve their documents and knowledge,” said Kopinath, citing increasing requests for the foundation to archive personal and institutional records.

Kopinath said he feels a deep joy when he looks at the books and manuscripts the digital library has now. Born on a small island off Sri Lanka’s northern coast, he reminisced how keenly he, as a child, felt the loss of his family’s large collection of books because of their multiple displacements. After being displaced for the third time, Kopinath recalled “I had nothing in my hands.” To him and the others involved with this project, Noolaham offers a promise that such losses are not permanent. That somewhere all that lost knowledge is waiting for them to find and preserve it.

Published on Scroll.in on February 18, 2016. By Smriti Daniel, pic courtesy Noolaham.

Ariyaseeli Gunaweera, Dr Ruwan Wijayamuni,Dr Kapila Jayaratne: Why Sri Lanka beats India in maternal mortality ratios

In Al Jazeera, Doctors, Healthcare professionals, Researchers on May 12, 2016 at 7:38 am

Colombo, Sri Lanka – Ariyaseeli Gunaweera, known as Ari to all, is a supervising public health midwife in Sri Lanka. She is, as a result, a person of some importance.

Ajith Kumarasiri certainly thinks so – when Ari sends him on an errand, he hurries to get it done, returning with a large 10cc syringe in just a few minutes.

“Here, cut it from here,” says public health midwife Kumudini Kumari as she shows the young father where to shear through the syringe so that the end with the needle falls away.

Having plied his blue hacksaw blade enthusiastically, Ajith is taught how to manipulate the plunger so that finally he has in his hands a crude yet effective breast pump. The midwives’ affordable, DIY solution is perfect for this corner of Colombo – a set of apartment blocks occupied by working-class families on low incomes.

In one of the apartment’s two small bedrooms, just the sight of Ari is enough to bring a smile to Shanthini Kumarasiri’s face. At only three-days-old, her little boy doesn’t have a name yet.

Shanthini has been worried. Her son is so thin that the bones in his chest protrude. Ajith’s mother Kumari Manel shares her daughter-in-law’s relief at Ari’s arrival. She is sure all will be well now, and remembers that reassuring feeling from when she was pregnant with her own son and the midwives came to visit. This is an intimate relationship with the state that spans generations.

With kind eyes and gentle hands, Ari and Kumudini work with the young mother to check the flow of milk from her breasts and quickly determine that one is blocked. Chatting all the while, they find a way to ease her discomfort, feed the child, and teach the first-time parents how to prevent the problem from recurring.

The baby calms and stretches in his grandmother’s lap as he hungrily empties the cup of milk that the midwife spoons into his mouth.

According to their official schedule Ari and Kumudini are on track – midwives are expected to pay four postpartum visits; two in the first 10 days, and another two within the first two months. In 2013, according to data collected by Sri Lanka’s Family Health Bureau, 92.2 percent of new mothers who were identified and registered were visited at least once by a midwife in that critical postpartum period.

Each visit involves a thorough check-up of mother and child. As the boy grows, he and his parents will also visit the nearby clinic. The midwives will watch him closely until he is five years old, checking his growth and development and ensuring that he is up to date on critical vaccine shots. The attention and support provided by the midwives feels deeply personal, and it is free.

As the midwives finish up and prepare to leave, Kumari Manel serves them a glass of cold, sweet, neon orange soda. She is full of gratitude. “No one else will come to help us, only the midwives come,” she says.

A mother cradles her child at a clinic dedicated to babies just over a month old. Her baby is registered at this centre and will be carefully monitored until he turns five [Suda Shanmugaraja/Al Jazeera]

‘Womb to tomb’ healthcare

Sri Lanka’s commitment to maternal and child health goes back more than a century.

In 1879, the doors of the De Soysa Lying-in-Home, possibly the very first maternity hospital in Asia, were thrown open to expectant mothers. It was here that the first training school for Sri Lankan midwives began operating in 1881. Between 1941 and 2009, the number of trained midwives in the country multiplied from 347 to 8,741.

Like most modern midwives, Ari received her diploma from the National Institute of Health Sciences – that was more than two decades ago.

Today, the country has at least 7,000 midwives, and along with a cadre of public health inspectors, they are the “ultimate grassroots workers,” says Dr Ruwan Wijayamuni, the chief medical officer of health at the Public Health Department.

They offer what he describes as “womb to tomb” coverage, with each public health midwife responsible on average for some 3,000 people. According to officialestimates, nearly 15 million people come under the purview of the Family Health Programme.

‘An inspiring success’: Sri Lanka’s maternal mortality ratio

The system is so successful that Sri Lanka has a maternal and child health record that is the envy of South Asia. Nowhere is this better reflected than in the maternal mortality ratio or MMR.

These two girls know Ari well. Sri Lanka’s School Health Programme includes assessments of nutritional status, detection of health problems and provides immunisation [Suda Shanmugaraja/Al Jazeera]

This critical figure is drawn from the number of maternal deaths per 100,000 live births, in a given time.

In 1955, less than a decade after Sri Lanka celebrated its independence, some 405 women died for every 100,000 live births. In 2013, Sri Lanka’s MMR was 32. Compare this with the island’s closest neighbours: in India, 189 women died for every 100,000 live births in 2013, in Nepal, it was 291 that same year, while in Bangladesh it was 201.

“Sri Lanka represents a unique and inspiring success story in terms of the country’s achievements in maternal health,” says Ana Langer, the director of the Women and Health Initiative and the Maternal Health Task Force at the Harvard TH Chan School of Public Health.

She attributes the steady decline of maternal mortality over the past 60 years to factors such as consistent political will, universal health coverage, skilled birth attendance at 97 percent of deliveries and “the quality of care offered by the trained midwives, who are distributed across the country ensuring women’s access to it”.

Registers for life

Painstaking, accurate data-gathering has proved critical to Sri Lanka’s healthcare successes, and Ari and the other midwives devote much of their time to record keeping.

Ari maintains three registers. Young couples are entered into the Eligible Family Register. In theory at least, cohabiting couples, and women between the ages of 15 and 49 are also included in this list. Ari offers anyone who needs it advice on family planning, distributes contraception for free and even sits down with couples for informal counselling. Women who want to conceive are advised on how to space out pregnancies, prescribed certain supplements and vaccinated against rubella and tetanus.

Ari, right, is a supervisor with more than 25 years of experience as a midwife. Fewer younger women are signing up to be midwives in Sri Lanka [Suda Shanmugaraja/Al Jazeera]

When a woman becomes pregnant she is entered into a second register where her progress is tracked carefully. Registered women are offered an exhaustive package of services and are carefully monitored.

Those identified as having high-risk pregnancies are given specialist care. Once the child is born, he or she is given his own column in a new register – the Birth and Immunisation Register.

The attention of the midwife continues into the child’s adolescence when they will make contact again to impart sex education.

According to Ari, common problems faced by mothers include poverty, domestic violence and cantankerous mother-in-laws. She relies on her personal relationship with her charges to allow her to speak frankly to husband and wife, and takes an interest in everyone in the household, and even in the neighbours. They all have a role to play in the mother’s health, she believes.

It helps that she has known some of these people since they were children. “I am part of the family now,” says the 54-year-old, “so they listen to me.”

When things go wrong: ‘Every time a pregnant woman dies, two people die’

When things go wrong, midwives are the first to be held accountable.

Each maternal death is expected to be reported within 24 hours to the regional director of Health Services and the Family Health Bureau by the Ministry of Health, explains Dr KD Liyanaarachchi, the deputy chief medical officer and Ari’s immediate supervisor.

“We do a thorough investigation of each case. A doctor, a nursing sister and a midwife will all go into the field to talk to the families and to see if the mother was given proper service,” she says.

Fathima Rizana says it’s thanks to the midwives that her sons Mohammed Rafi, Mohammed Rashi and Mohammed Raheem (pictured with his mother) are all doing well [Suda Shanmugaraja/Al Jazeera]

The data collected from the visit is compiled into a “maternal death case scenario”, a document that includes a post-mortem report, bedhead tickets and clinical, pregnancy, family planning and other field records.

Each scenario is reviewed at the field, institutional, district and national levels by the Family Health Bureau, in consultation with independent experts – allowing the authorities to systematically identify problems with the healthcare delivery.

“When we look at how other countries are doing in this region, we can boast that up to 99.4 percent of women in this country are cared for in hospitals,” says Dr Kapila Jayaratne, a national programme manager for the Family Health Bureau overseeing maternal and child morbidity and mortality surveillance. “In India, for instance, it is around 40 percent. For the other 60 percent you don’t know where they deliver, how they die, nothing.”

 

In the past year and a half alone, some 14 countries, including Bangladesh and Afghanistan have sent delegations to study Sri Lanka’s approach, says Jayaratne. The team is also often invited to conferences abroad to share their programme’s successes. “Always we get the applause for nearly five minutes when we make our presentation.”

For Ari, there are real women behind the statistics. She speaks of the last time she lost a mother, many years ago. Though Ari had her rushed to the hospital, the woman and her child died of blood pressure related complications.

“I felt worse than if I had driven a car and run over someone on the road,” she says. “We are responsible for these women, some we have taken care of for years.” Behind her glasses, her eyes shine with tears. She adds in a quiet voice: “Every time a pregnant mother dies, two people die.”

Shanthini Kumarasiri cradles her newborn son. In 1955, some 405 women died for every 100,000 live births. By 2013, that figure dropped to 32 [Suda Shanmugaraja/Al Jazeera]

Can Sri Lanka keep it up?

Ari’s job is not getting any easier. One of the most commonly cited problems is the perennial shortage of midwives. Dr Wijayamuni says thanks to such staffing issues in the Colombo area, a midwife may be responsible for as many as 6,000 to 12,000 people, considerably more than the ideal of 3,000 per midwife.

The challenges of providing care for pregnant mothers and vaccinations for children are even greater than they first appear when you take into consideration the city’s large migrant population.

“I think it is remarkable, even though we have a large floating population which does not remain static like those in the villages, our immunisation coverage has been excellent,” he says of the Colombo area. “This is why we have no neonatal tetanus or diphtheria. We have eradicated polio and whooping cough.”

But will the public health services be able to maintain their stellar record without enough midwives to go into communities?

Ari believes the situation might improve if women are allowed to serve in the areas they are from instead of being assigned to distant locations.

Ari came to work in Colombo, though she was originally from the island’s southern province. She faced the practical challenges – the shocking cost of living in the city, the dearth of good accommodation – but also the social and emotional trials of adapting to her new profession.

Ari and her brother were orphaned in their 20s and went through some tough times. She found her husband on the job, as it were, when a more senior midwife took a shine to her and proposed that Ari marry her son, Don Nihal Wickramarachchi.

She has been a widow for several years now and lives close to her place of work, but says her colleagues at the Wanathamulla Mother and Child Welfare Centre all hail from outside Colombo. Some even commute 161km a day.

Jayaratne says that when the Family Health Bureau advertised for 5,000 new midwife positions, they received only 2,700 applications. In response they have begun relaxing the requirement that midwives have studied science in school, and are instead recruiting people from an arts and commerce background as well.

Although government jobs are usually sought after for their stability, it’s also easy to see why the basic salary for a new midwife, approximately 15,000 Sri Lankan rupees or just over a $100 a month, would have potential employees opting for careers in the private sector.

Ari says midwives are having to learn new skills to cope with the steep rise in non-communicable diseases. She now routinely encounters gestational diabetes and hypertensive disorders. In 2013, heart disease and respiratory diseases were the leading causes of maternal death in Sri Lanka.

When women develop such complications far away from good healthcare centres, or in areas with poor coverage, their lives are at risk.

“A large majority of the women who died due to a pregnancy-related cause in 2014 were either from rural (65 percent) or estate (10 percent) sectors,” Jayaratne noted in a report. He went on to flag that “it is also noticeable that a significant number of single females (10 percent) contributes to maternal deaths”.

In the face of social stigma, many unmarried pregnant women hesitate to utilise public services and others risk illegal abortions.

“The healthcare system is still lagging behind in encouraging single women to come forward to address their sexual health needs,” says Dr Sepali Kottegoda, the director of the Women and Media Collective in Sri Lanka. “There has to be a clear institutional response in terms of making it known that irrespective of your marital status, as a citizen you have the right to healthcare and as a person who is in need of it, you should seek it out.”

To improve maternal and child healthcare, Sri Lanka must now focus on quality.

“We have to prioritise quality over quantity, to take care of individual women now,” says Wijayamuni .”Each and every mother counts, each and every pregnancy counts.”

He would like to see midwives and public health inspectors given more training and allowed to pursue bachelor and master’s degrees in their field.

“They are the very first contact people at the grassroot level for the Ministry of Health, and their education is critical.”

A little girl attends a clinic with her mother. In Sri Lanka, growth monitoring is done through serial measurement of infants, young children and preschoolers [Suda Shanmugaraja/Al Jazeera]

‘I’m going to stay at home and rest’ 

Back on her rounds, Ari’s meets more families. Her unhurried pace is deceptive – typically she will make some 30 house calls in a day.

Following her white clad figure through a neighbourhood, it becomes evident that she is a magnet for both men and women. Mothers walking their children home from school stop on the street to have a quick word; others accost her on the stairs, waving test results and asking her to interpret the numbers.

In a largely patriarchal society, Ari says midwives like herself are the ones who tell the men what do when their partners experience morning sickness or how they can “talk” to the baby while he or she is still in the womb during the last trimester.

Even disapproving mother-in-laws will take her advice.

A devoted Buddhist, Ari sees her job as “not actually just caring for a person and combating disease. It is about bringing life to earth”.

This has been her calling, but when she retires in less than a decade, Ari says she is keeping her plans simple. “I am going to stay at home and rest.”

Public health midwives have proved themselves integral to the success of the primary healthcare system in Sri Lanka since early in the 20th century [Suda Shanmugaraja/Al Jazeera]

Published in Al Jazeera on March 14, 2016. By Smriti Daniel with pictures by Suda Shanmugaraja. 

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