Dr. Aleksander (Sasha) Bodiroza, UNFPA
Regional Director a.i. for Asia and the Pacific
COLOMBO :The road to Meeriyabedda winds through the hills above Passara, past tea estates and small communities where distance makes basic health care hard to reach. At the end of that road sits a small, pale pink clinic. Newly renovated, it is a lifeline for the women and families who depend on it.
During my recent visit to Sri Lanka, I held important discussions in Parliament, at the Prime Minister’s Office, and with government partners about population change, development and the country’s future. I was deeply struck by the national determination to protect Sri Lanka’s hard-won human development gains.
But Meeriyabedda gave those conversations a human shape.
There, mothers waited with newborns for routine check-ups and health workers moved with practiced purpose. In that small clinic in Badulla district, the future felt less like an abstract policy debate and more like a promise being kept, one family at a time.
Sri Lanka is entering a defining chapter. Its population is ageing, fertility patterns are shifting, and young people are navigating rapid economic and social change. At the same time, climate-related disasters are placing unprecedented pressure on communities and essential services.
The challenge is not simply to preserve Sri Lanka’s progress in health and education but to make that progress resilient to a changing demographic and climate shocks.
Cyclone Ditwah demonstrated what this challenge looks like on the ground.
When the cyclone struck Sri Lanka late last year, more than 2 million people across all 25 districts were affected. Floods and landslides damaged roads, disrupted communications and made essential services harder to reach. Among them were an estimated 520,000 women of reproductive age, including over 22,570 pregnant women and 193,000 older women.
For a pregnant woman, that isolation can quickly become dangerous. A short trip to a health facility can suddenly turn into hours, across damaged roads, putting routine check-ups and skilled care out of reach.
Working alongside local health authorities, UNFPA, the United Nations Population Fund, helped restore community health services in some of the hardest-to-reach areas, including Meeriyabedda. An abandoned building has been transformed into a fully functioning community clinic, complete with living quarters for a resident midwife to ensure uninterrupted care.
When I visited, a midwife told me the community had begun to make the space their own. Mothers were bringing potted plants to decorate the newly renovated building, so it would feel less like an institution and more like home.
There is profound power in that gesture.
A plant on a clinic windowsill speaks of trust. It signals that people expect the clinic to remain. True recovery is not merely about repairing what a storm destroyed. It is about rebuilding something communities can rely on long after the emergency recedes.
In Nuwara Eliya, a public badminton court had become a temporary shelter for 35 displaced families. Without partitioning, privacy was non-existent. For a breastfeeding mother, or an adolescent girl managing her period, this absence of privacy e was an erosion of basic dignity.
UNFPA helped establish a safe space where women and girls could access counselling, protection services, and, importantly, a door they could close. Staff explained that this safe space also enabled women to seek help for violence and discrimination that had begun long before the cyclone.
Humanitarian response cannot be measured solely in supplies delivered or structures rebuilt. Shelter, food and medicine matter, but so do privacy, safety, bodily autonomy, and the ability to ask for help without fear.
In Kandy, the true meaning of resilience became even clearer.
At the Medical Office of Health in Doluwa, doctors and midwives recalled the days after the cyclone when communication lines went down. With no cellular signal and roads blocked, they used what they had: physical registers, walking routes, and hand-delivered messages. Pregnant women were tracked, and care reached them despite the complete blackout.
We often talk about resilient health systems as if they are built purely of concrete, technology, and policy documents. They are. But in Doluwa, resilience was also a midwife carrying a register, a doctor who knew which road was blocked, and a message passed from one person to another until it reached the right home.
These frontline realities point to Sri Lanka’s central task: ensuring development gains endure as the population ages and climate stresses intensify.
Demographic shifts are not problems to be solved. They are signals that policies must adapt to how people live today. This requires data-driven decision-making, strong primary health networks, and sustained investment in the frontline health workers who hold the line when crisis hits.
Sri Lanka’s experience offers a lesson that resonates across Asia and the Pacific: resilience is not a slogan.
It is a clinic that reopens. A safe space inside a crowded shelter. A midwife carrying a register on foot when the networks fail. And a nation determined to plan beyond today’s crisis to prepare for tomorrow’s changes.
UNFPA is proud to work alongside the Government and people of Sri Lanka on this journey, using evidence to inform policy, strengthening systems that protect health and dignity, and ensuring that demographic change becomes an opportunity to expand rights and choices for all.
Sri Lanka’s next chapter will be written in national strategies, but its heart will be found in places like Meeriyabedda, where a small clinic, a resident midwife, and a few plants on a windowsill show us what lasting progress and hope look like.
