International Confederation of Midwives

President,

Distinguished delegates

Midwives of the world,

There are probably thousands of professional congresses taking place around the world right now.

But this conference is unique.

It is devoted to life.

It is driven by care and compassion.

What a great resource you all are, and how proud we are to have you as guests in our country.

As the tree behind me signifies - life is evolution. Birth, there follows hope, for childhood, adolescence, maturity, aging and finally, there is the end of life - for all of us one day, - while life lives on in new generations.

Life is hope.

In every new-born, there is hope what we cannot live without and what you are privileged to see.

I shall never forget the first time I witnessed a child being born. I was a young medical student, working as a summer trainee in what was then Yugoslavia. The mother was having her sixth child, and the baby virtually shot out, - to the far end of the bed. It was a stunning, breath-taking moment - still so vividly in my mind.

The year after, I had my first child at the age of 22.

Now, it is common in Norway that the father is present during the birth. It was not then.

It was just me, my apprehension, and the midwife.

Her comforting presence.

To this day, I have a vivid impression of the features of her face. In her tiny wrinkles on that face, there was stored generations of knowledge and experience of that moment, - the time before it , and the time to come, when the mother takes her baby in her arms, - full of hope.

Human babies are remarkably vulnerable. There is hardly any other species on earth that is so dependent, after being born, on care and protection. And there is no other profession in this world, no other single group of people, that have devoted their lives to provide care and protection, to this the most vulnerable period in the life of human beings.

But we are all born into an inequitable world. Life itself is not fair. And the opportunity to live it is fundamentally unequal. I have come here to say that the role of the midwife has not received the world-wide recognition it rightly deserves.

It is high time that your work is rightly appreciated. But the countries if the world cannot rectify this unjust situation by words of appreciation alone. No medal or diploma will do.

As long as children are born in utmost poverty. As long as children open their eyes only to die of curable causes. As long as there is available only unsafe water, and as long as children die or suffer because their families lack basic knowledge. That is how long we live in a distorted, unfair world.

In many countries, childbearing is in itself a threat to life and health, owing to the neglect of primary health care. Mothers, living far from the paved roads of the urban centers, will often belatedly receive even the most minimal care. Too short a space between pregnancies leaves too little time for regaining physical strength. Together with inadequate treatment, too many mothers are even catapulted into convulsion, coma, and death leaving families bereft, with no mother to look after the children already born.

Ten years of experience as a physician and 20 as a politician have taught me that improved life conditions for all , a greater range of choice for all , access to information and essential health and social services, are the sources of human progress.

At important UN conferences over the past few years, the countries of the world have made pledges and promises to allocate more resources next year than they did this year to health care systems, to education, family planning, and the struggle against diseases. They have promise to make men and women equal, to rectify disparities, and to promote women's needs more actively than men's until we can safely say that equality is reached. This is what the Cairo Conference was about. This is what Beijing was about.

There we promised better access to education and basic reproductive health services for all, including family planning as a universal human right. Now, it is time to deliver.

Our inability so far to hit down on poverty haunts our common political record. Our history of dealing with poverty and basic human needs is an epic of protracted stalemates, indifference, bureaucracy and empty rhetoric. People and countries of good will have made serious efforts, only to suffocate in the quagmire of inefficiency, and inconsistent policies.

The cost of poverty, in human suffering, in the wasteful use of human resources and in environmental degradation has been grossly neglected. Most countries have a social policy, an environmental policy and a redistributive system. Only a minority of countries are welfare states.

The international redistributive system, what we have today as seeds of an international public sector, is in a shameful, neglected condition.

It is not possible to meet basic human needs without allocating at least 20 per cent of national budgets to basic social services. The destitute poor have for too long been kept at arms length by good wishes and the rest in promissory notes. As Martin Luther King said, the check has come back from the bank of justice marked "insufficient funds".

The people is every country's greatest resource. In the past, and many places also at present, the pregnant mother, the moment of birth and the baby child have been neglected. It is considered irresponsible not to insure valuables and assets. Why is it so difficult to ensure that "Safe Motherhood" is realized on a global scale. We have relied too long on the ancient craft of the midwife, and neglected the art and science of that vital profession.

These are excerpts from letters written in the 1920s to the Maternal Health Care office in Oslo:

"I I am 38 years old. I have had 12 children, the last 3 of which were aborted".

"I have been married for 8 years and have had 7 children"

I have had 19 children in 20 years. Six of them died. The last one was allowed to live".

Today, Norway has almost abolished maternity deaths. But many other countries have a long way to go.

Norway is in the fortunate position that parents may take one full year leave of absence with 80 per cent pay.

But to most parents in this world, our success and our policy will sound almost insulting, - irrelevant to their daily struggle for survival and for providing for a growing family.

Many countries are where we were in the 1920s. And many governments seem unable or unwilling to change policies, and to put people first.

There is a need for international solidarity to cushion the negative impact of poverty. But why, in the light of what we know, are the military budgets still senselessly high in a number of countries? In the fifties, already, President Eisenhower said: "every gun that is fired, every warship launched, every rocket fired signifies, in the final sense a theft from those who are not fed". Today we must see, and act on the fact, that the future lies, not in arming, but in educating - a healthy population.

Infant mortality and perinatal death serve as a measure of the general health of a population, and as a measure of the prospects for its future. Nations can hardly make a more sound investment that strengthening prenatal care, basic health services, obstretical services, and - ultimately education. Such investment is a yardstick by which human progress can be measured. The tragedy of it is that most of these services are affordable and yet not attainable, for all those who need them.

We can afford them in developed countries, and the poor countries can do two basic things: One: They redirect resources towards heath services and education away from military or conspicuous spending, and two: they should expect support from the international community through international redistribution.

I say so with confidence since Norway maintains a development aid of about 1 per cent of our gross domestic product, a large share of which goes to poverty alleviation, health services and basic education.

It is a moral obligation to care and to share. Across borders, across generations. We have the knowledge and the combined resources to eradicate most challenges to mother and child. By what means or argument can we defend not doing so?

So let the torch go forth, from this Congress,

• to your home countries,
• to your clinics and colleagues,
• to your minister's of health, finance and indeed the whole cabinet, to all those who are accountable.

You are the custodians of hope, but you cannot walk alone.

- You need tangible political support, not for your own sake, but for humanity's sake. Yes, we are all accountable.

If we lay our ears to the ground, and listen to the yet unborn millions, who will inherit and inhabit this one earth we will hear a song of freedom and equality.

We hear the tide of generations yet unborn , and we know, in our hearts, that this world must and can become a fair and equitable place.

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