LISBON — Midwives from various African and Asian countries were unable to attend the 34th International Confederation of Midwives congress in Lisbon, Portugal, due to last-minute visa refusals. The event convened politicians, donors, and U.N. agencies.

Visa appeals had been submitted for delegates from 11 countries, including Nigeria, Ghana, Rwanda, Burundi, Uganda, Tunisia, Ethiopia, Sierra Leone, Bangladesh, India, and Indonesia. These individuals were scheduled to attend the congress, where discussions often involve global maternal health.

Kate Stringer, an advisor to the International Confederation of Midwives, said these midwives are leaders in countries with high rates of maternal mortality. Stringer noted that a mother dies every two minutes due to pregnancy or birth. She asked how interventions could occur if researchers and professors at the center of these efforts were banned.

Harriet Akello, a midwife, operates a maternal health initiative in Uganda that has garnered attention from the World Health Organization. Akello was scheduled to speak at the conference regarding the transition of high-risk maternity systems to a midwifery model of care. Akello collaborates with Mother Health International, a non-governmental organization, to help public maternity centers adopt World Health Organization standards. Her initiative operates in a remote post-conflict region near the border with South Sudan, approximately 95 kilometers from a referral hospital. Akello had traveled to Sweden for work within the past year and did not overstay her visa.

Two midwifery union leaders from Bangladesh were also denied visas to attend the conference. A male government official from Bangladesh did travel to Lisbon, where he pledged 25,000 additional midwives for his country. Dr. Arthur Munkana, a medical doctor, stated that his country is experiencing high rates of maternal deaths. He said that good quality midwives are a key solution, but he was the only one who received a visa.

The Ministry of Foreign Affairs of Portugal stated that visa assessments were conducted rigorously, objectively, and factually, in line with Schengen rules. Approximately 260,000 women die annually worldwide from childbirth-related causes. About 70 percent of global maternal deaths occur in sub-Saharan Africa. The International Confederation of Midwives reports a global shortage of one million midwives needed to meet safe staffing levels. The World Health Organization has urged governments to implement midwifery models as a core healthcare service.