Action is underway to address a fundamental flaw in human progress that is causing more than half a million women to die every year from childbirth and the risks of pregnancy.
A woman's lifetime risk of thus dying, according to the World Health Organization, is still 1/24 in Africa, 1/90 in Latin America, 1/ 870 in East Asia — as compared with 1/1750 in developed countries. This maternal suffering, now being termed the ‘greatest health divide in the world’, extends far beyond survival during pregnancy and delivery. For each woman who dies, another 20 will suffer birthing-related consequences, such as bladder and rectal fistulas. Annually, an estimated 10 million women who survive their pregnancies will suffer such adverse outcomes, often prolonged and directly affecting their families.
Another fundamental flaw is the consistently high level of child mortality, particularly in sub-Saharan Africa and South Asia, according to UNICEF. Little or no progress since the year 2000, has been made in reducing the number of these deaths. One out of every 10 children dies before the age of five — in developing nations. With so many mothers at risk, the lives of unborn and newborn infants are at risk as well. Global failure to cooperate in effectively reducing these death levels, is being highlighted in a campaign emerging from nurses, midwives and other community health workers who daily address this suffering. They are focusing their celebration of the 2010 International Year of the Nurse on these two key issues, citing critical concern for human survival and for the moral progress of global conscience. They are seeking to broaden the base of public awareness, also urging collaborative action among all of the 192 Member States of the United Nations and to advance the UN MIllennium Development Goals (MDG's) adopted by the UN General Assembly in 2000.
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High level of child mortality
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All eight of the UN MDGs touch upon key issues of critical concern to human survival. Only three— related to child and maternal death, HIV /AIDS, malaria, TB and other diseases — are specifically global health goals. The other five — related to poverty, hunger, illiteracy, lack of women's rights, environmental hazards, war and conflict — do involve factors known to increase susceptibility to diseases, injury and premature death, worldwide. The President of of the UN Economic and Social Council — Ambassador Sylvie Lucas, of Luxembourg — has called for ‘Health’ to be at the core of all sustainable development, noting that all UN MDGs are, indeed, determinants of health.
For each of the Goals adopted by the General Assembly, related targets have been set as benchmarks to be achieved by the year 2015. Currently, MDG 4 — “Reduce Child Mortality” and MDG 5 — “Improve Maternal Health” — are the two Goals most likely to fail in reaching their targets unless world-wide concern for the high levels of unnecessary death, produces greater collaborative action immediately. These continued failures — with nurses and midwives remaining the only witnesses, struggling mightily against the sufferings, looking after the grief and fallout from these deaths, and reporting these sad statistics to Member States' governments of the UN — are “unfair, unjust and unnecessary,” say nursing leaders.
UN Secretary General Ban Ki Moon has recently said “I am determined to push global health as one of my key priorities... not only because global health is an enormous challenge, but because we can do something about it. New actors and resources are pouring into the global health space as never before…. But this won't amount to much if we don't ensure coherent and decisive action.”
Nurses and midwives — responsible for fully 80% of the world's health care delivery — have decided to mobilize world public opinion and broaden the base of responsibility for actually confronting these weaknesses. From their on-site 'grassroots positions' on the ground and in the field, where they seek to prevent the deaths of children and women otherwise counted in these statistics, nurses have taken on this challenge of the Secretary General — by now asking Ambassadors and Delegations from all 192 UN Member States to adopt a related UN Resolution proposed for the current General Assembly. The draft resolution simply suggests that the Assembly acknowledge the world community of nurses and midwives, recognizing their concerns, encouraging and commending their campaign being launched in the 2010 International Year of the Nurse to mobilize global public opinion in support of all Millennium Development Goals, particularly 4 and 5.
The acute shortage — of nurses and midwives — and the further need for training to bring "nursing and midwifery” skills to others who can help — are two of the multifaceted reasons why Goals 4 and 5 continue to fail. Some 57 countries — 36 in sub-Saharan Africa — have less than the WHO-determined minimum threshold of 2.28 health workers per 1,000 population. In these places, many pregnant women die, and their babies, then alone or yet unborn, die with them, with no nurses or midwives there, perhaps no one there, at all.
It is for all these reasons and because of their direct experiences with human suffering — that the nurses of the world have decided to pro-actively advocate for all eight MDGs during their 2010 International Year of the Nurse. They will also celebrate 2010 as the Centennial of Florence Nightingale, who was vigorously pro-active in promoting all these same issues in her own time and on a global scale that is formally honored today in China, India, Japan, Pakistan, Turkey and widely beyond.
UNICEF's 2009 State of the World's Children states that “these challenges are not insurmountable. But they will require commitment on behalf of all key partners to work together to meet obligations to mothers, newborns and children... The Millennium Development Goals provide a firm reference point for action in the coming years. Achieving these Goals will require building firm links between all contributing partners — national governments, donors, global health partnerships and programmes, international agencies, civil society organizations, the private sector, and communities and families themselves.”
“It is appaling that these preventable deaths continue to haunt humanity well into the technologically-advanced 21st century," said nursing leader Dr. Deva-Marie Beck of the Nightingale Initiative for Global Health (NIGH). "Catalytic networks of nurses, midwives and other health workers, are encouraging full support of these UN Goals — while they themselves work with those most at risk: mothers, children and their families — to actually achieve these critical health targets. Nurses are now becoming advocates to increase global public awareness, widening concern and inviting relevant action. They have created this innovative communications strategy to call upon all stakeholders — from individuals to national and global leaders — for renewed commitment to the health and well-being of all ’peoples of the United Nations.’ At this time," she added, “recognition of nurses by the United Nations General Assembly — as they prepare to celebrate their 'International Year of the Nurse’ with a global campaign of support for the UN Millennium Development Goals — would encourage their initiatives to broaden the base and strengthen the commitment of all citizens.”
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* Eight United Nations Development Goals
Goal 1: Eradicate extreme poverty and hunger
Goal 2: Achieve universal primary education
Goal 3: Promote gender equality and empower women
Goal 4: Reduce child mortality
Goal 5: Improve maternal health
Goal 6: Combat HIV, AIDS, Malaria, TB and other diseases
Goal 7: Ensure environmental sustainability
Goal 8: Develop a global partnership for development
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