After tsunami, a drive to rebuild families

MATARA, Sri Lanka -- It was Oct. 11, 2004, and the world looked beautiful to K.M.G. Prinsika.

She had given birth to her third child, a wide-eyed girl she and her husband named Pushmi Moonesha. The happy parents told the gynecologist that they'd had enough children, and it was time for Prinsika to be sterilized.

On Dec. 26, 2004, the world became a horror.

The Asian tsunami six months ago took away Pushmi Moonesha -- ''blooming flower" in the Sinhalese language -- and the couple's 7-year-old son, Panitha. Their 11-year-old daughter, Pujitha, survived.

Now, Prinsika, 31, is joining many other Sri Lankan mothers in seeking a reversal of her tubal ligation to allow her to have more babies.

''I want my other children back," said Prinsika, sitting in the family's two-room apartment in this town on Sri Lanka's southern coast.

But those children are not coming back, she knows.

While no statistics are available on how many women want to have the reversal surgery, doctors and officials say the number has grown since the tsunami.

''We will see more and more cases like these in coming months," said Dr. Gamini Perera, an obstetrician in the tsunami-battered town of Galle, about 25 miles west of Matara.

''Until now, the basic issue was how to survive. Now some have started to think how to get the family together again," Perera said.

Prinsika has spoken to the gynecologist who sterilized her and is awaiting word from the hospital on what tests need to be done to determine whether she can have the surgery.

''The moment she entered my chamber, she started crying and then told me what the tsunami did to her family," said Dr. P.M. Liyanage at Colombo's Nawaloka Hospital.

The waves killed more than 31,000 people on this tropical island. Forty percent of them were children.

The Sri Lankan government says it will help families pay for surgery to reverse sterilizations. Some private hospitals, including Nawaloka, say they will perform the operations at reduced or no cost.

''It is an important issue and, if we are requested, we will help," Sri Lanka's minister for health, Nimal Siripala De Silva, told the Associated Press. ''Nothing is more important than seeing life emerging again from the devastation of tsunami."

Sri Lanka, a nation of 19 million people with many working women, has one of the region's most successful family-planning programs.

Many Sri Lankan mothers choose to be sterilized after their second or third child, normally through tubal ligations. The surgery involves cutting a woman's fallopian tubes, then tying or closing them to prevent pregnancies. In the reversal surgery, the tubes are reconnected.

The surgery to reconnect the tubes is expensive by Sri Lankan standards -- about 50,000 rupees, the equivalent of $500 -- and success is far from guaranteed.

It first requires a small incision in the abdomen to see whether the tubes are large enough to be rejoined. No national data are available on the success rate. Before the tsunami, most reversals were requested by women after second marriages.

The other option, artificial fertilization, costs as much as $4,000. Prinsika does not work, and her husband earns $160 a month working as a driver for the state electricity company.

Perera said he was approached by a mother who lost all three of her children in the tsunami and wanted the reversal surgery.

''Her husband had gone to the market when the waves struck," Perera said. ''She told me she held onto something and managed to escape the waves, but all her three children were gone."

Aid workers are encouraged that these women are looking to the future, but they also are eager for people to remember the children orphaned by the waves.

The tsunami disaster killed a total of more than 176,000 people in 11 countries and left about 50,000 missing and hundreds of thousands homeless.

''It is important for mothers to come to this state of mind by rising above the grief," said Maleec Calyaneratne, spokeswoman for Save the Children in Sri Lanka.

''But some mothers can go for other options, like looking after the children who have lost parents," she said.

For Prinsika, the choice is simple.

''I am waiting for the day when I will have my babies back," she said.