"1370 mothers reported killed during physiological duty. Thousands more seriously injured"

"1370 mothers reported killed during physiological duty. Thousands more seriously injured." That was the startling news headline envisioned by Dr. Mahmoud Fathalla of Egypt in a statement to the first regional congress of the Medical Women's International Association for the Near East and Africa. If there was a global newspaper on reproductive health, it could publish that same headline every day, year after year, Dr Fathalla said. Maternal mortality is more than a health issue, it is a human rights issue, Dr Fathalla told participants at the congress, held 29 November to 3 December last year in Nairobi, Kenya. Malaria kills more than the half-million women who die of maternal causes each year, but to compare maternal mortality with deaths from disease is to miss the point, he said. "Pregnancy is not a disease," Dr. Fathalla told the congress. It is good if people do not get diseases such as tuberculosis or cancer, but if the human race is to survive women must become pregnant. They should not have to pay with their lives, because the knowledge and skills to prevent maternal deaths are attainable if the political will exists." Dr. Fathalla was pessimistic about prospects for attaining the Safe Motherhood goals of cutting maternal mortality by half by the year 2000. Mothers continue to die from pregnancy-related causes because societies make a rational decision not to invest in the lives of women, he said. Women's unpaid work in production and reproduction does not feature in national accounting, Dr. Fathalla pointed out. Women suffer discrimination from the start of their lives in terms of nutrition, access to health care and education. Expectations of women are so low it may even seem rational not to invest resources to prevent maternal mortality. Many of the countries with the highest levels of maternal mortality continue to allocate more of their scarce resources to "men's dangerous hobby, war, euphemistically called defense" than to health and education, he added. It is time to get angry, Dr. Fathalla concluded. He called on congress participants to demand that societies invest in women, not simply because of the benefits to children but because women deserve no less than the best.