The global struggle to reduce preventable maternal and infant deaths has suffered a significant setback after top midwives from countries with the highest mortality rates were denied visas to attend a crucial summit in Lisbon, Portugal. The International Confederation of Midwives (ICM) congress, which brings together politicians, donors, and UN agencies, was marred by last-minute visa refusals that prevented experts from Africa and Asia from participating.
Midwives from nations including Nigeria, Ghana, Rwanda, Burundi, Uganda, Ethiopia, Sierra Leone, Bangladesh, India, and Indonesia – where the majority of the estimated 260,000 annual maternal deaths occur – were among those barred entry. This is particularly concerning given that a mother dies every two minutes due to pregnancy or birth, with 1.9 million stillborn babies and 2.3 million newborn deaths also reported annually. ICM advisor Kate Stringer highlighted the severity of the situation, stating, "These midwives are leaders working in countries that bear the highest burden of deaths. A mother dies every two minutes due to pregnancy or birth. How can we intervene if the researchers and professors at the heart of it are banned?"
Harriet Akello, a Ugandan midwife whose life-saving initiative has garnered attention from the World Health Organization (WHO), was unable to attend despite being scheduled to speak on reorienting fragmented maternity systems towards a "midwifery model of care". Akello expressed her dismay, stating, "The world’s policymakers are in Lisbon, yet here I am in Uganda, trying to explain to an embassy why I should have the right to travel. I am gutted and insulted."
The visa denials have also raised concerns about gender inequity. Two Bangladeshi midwifery union leaders were denied visas despite a male government official from their country attending the summit to pledge an additional 25,000 midwives. Dr Arthur Munkana from the Democratic Republic of the Congo, one of the few delegates from his nation to secure a visa, voiced frustration for four midwives who were unable to travel, noting, "Our country is devastated by mothers dying. Good quality midwives are a key solution – yet only I got a visa." Alison Perry, a researcher at Imperial College London, described the situation as "overt discrimination against equitable participation in international conferences."
Portugal’s Ministry of Foreign Affairs responded to the outcry by stating that visa assessments are conducted "rigorously, objectively and factually" in line with Schengen rules. However, the global midwifery community argues that these rejections undermine critical efforts to address a worldwide health crisis. The WHO has called on governments, including the UK, to integrate "midwifery models" as a core service, particularly as the world faces a shortage of a million midwives to meet safe staffing levels.