Six U.N. staffers and two Afghan security guards are killed in an attack on their guest house in central Kabul. A Taliban spokesman takes credit, siting the U.N.’s involvement in Afghanistan’s presidential elections as the reason for the attack.

Ahmed Wali Karzai, the brother of Afghan president Hamid Karzai and a suspected drug trafficker, has been on the CIA’s payroll for much of the past eight years.

Voters go to the polls in Mozambique’s fourth democratic election since a civil war ended in 1992. Incumbent President Armando Guebuza, whose economic reforms made Mozambique’s economy one of the fastest growing in the world at one point, is poised to win.

Birth of a Surgeon follows Emilia Cumbane, one of the first midwives-in-training. She performs Cesarean sections and hysterectomies in makeshift operating rooms in rural Mozambique. We follow Cumbane from her home in the Mozambican capital Maputo, into intensive medical classes, through night shifts in the delivery wards, and watch as she fights for recognition of her surgical competence.

Originally aired in 2008, for the episode’s 2009 encore presentation WIDE ANGLE host Aaron Brown meets with Cumbane to see how both she and the program are faring. Cumbane, now the head of the maternal ward, has a two-week-old baby herself, and Brown explores the successes and obstacles she has faced over the last year, as she has tried to juggle her personal and professional commitments, all the while working to help save women’s lives.

“Feel-good programming that makes you think, too”
–Canwest News Service

ABOUT THE ISSUE

Sub-Saharan Africa is the world’s deadliest place to give birth. Each year over a quarter of a million women die in childbirth in the region. But Mozambique is combating high maternal death rates by implementing unconventional programs.

After the country declared its independence from 400 years of Portuguese rule in 1975, a civil war raged for 16 years, killing a million people and wrecking the country’s infrastructure. By the time the war ended in 1992, the health care system was devastated and one in ten women were dying in childbirth. There were only 18 obstetricians for a population of 19 million. Since then, Mozambique has cut the maternal death rate in half.

As the figures now stand, the country is one of the few countries on track to achieve the fifth United Nations Millennium Development goal to reduce the maternal death rate by 75 percent by 2015. In 2004, Mozambique introduced a new health care initiative to train midwives in emergency obstetric care in an attempt to guarantee access to quality medical care during pregnancy and childbirth.

ABOUT THE FILM

The film Birth of a Surgeon follows Emilia Cumbane, one of the first midwives-in-training. She performs Cesareans and hysterectomies in makeshift operating rooms in rural Mozambique. We follow Cumbane from her home in the Mozambican capital Maputo, into intensive medical classes, through night shifts in the delivery wards, and watch as she fights for recognition of her surgical competence.

With more than half a million women dying in pregnancy or childbirth worldwide, Mozambique’s surgical training programs are being hailed as a model solution in confronting the maternal health crisis facing developing countries. The film captures one woman’s story on the frontlines of improving maternal mortality but it also demonstrates how low-cost, community-based health initiatives are changing the face of public health in Africa.

“I like to be a midwife,” Cumbane says. “I think it’s a good profession – to produce people.”

The first class of almost 30 surgical midwives trained in delivery techniques and advanced surgery graduate in July 2008. For the 2009 update, WIDE ANGLE host Aaron Brown travels to a rural hospital in Mozambique to meet with Cumbane to see how both she and the program are faring. Cumbane, now the head of the maternal ward, has a two-week-old baby herself, and Brown explores the successes and obstacles she has faced over the last year, as she has tried to juggle her personal and professional commitments, all the while working to help save women’s lives.

Viewers donated $2,000 which we deposited in a bank account we set up with the grassroots organization, Africa Groups of Sweden. Then in April 2009 we received an additional $2,000 when we won the Overseas Press Club’s Carl Spielvogel Award. When we went back to film WIDE ANGLE’s follow-up interview with Emilia, we decided that would be the perfect time to fix the generator. Loui wrote letters to several generator manufacturers and asked them to contribute to the project. A South African company, Plan My Power, responded and gave us a battery charger and batteries for below retail price!

The hospital’s electrician installed the battery with help from our friend, Sven Grip. A local man built a cage to safeguard the installation. Now if there is a power failure during an operation, the hospital workers have one hour to finish. We thank you all for your wonderful engagement in the film and the reality behind it.

Click on the video below to see the installation.

She spoke with WIDE ANGLE multimedia producer Renee Feltz about the imbalance in maternal health care in the United States versus the developing world.

Click below to learn why Cheyney says U.S. spending on medical interventions during childbirth should be directed more toward low-tech care, and why the opposite is true for countries such as Mozambique.

CIA World Factbook: Mozambique
Information about Mozambique’s geography, population, government, military and economy.

BBC Country Profile: Mozambique
Information about Mozambique’s history, leadership, and media, with links to BBC stories on the country.

New York Times Topics: Mozambique
The New York Times page includes breaking news and archival articles about Mozambique.

MOZAMBIQUE AND UNITED NATIONS ORGANIZATIONS (GENERAL)

UNICEF: Mozambique
An overview of United Nations Children’s Fund information and statistics on Mozambique.

World Health Organization Country Profile: Mozambique
An overview of health concerns in Mozambique that includes a country profile, a page dedicated to the WHO’s actions in Mozambique, a page dedicated to the UN pilot initiative in Mozambique, and the WHO’s areas of work in Mozambique.

UN Mozambique: 2008 Mozambique Report on the Millennium Development Goals
Report evaluates Mozambique’s progress, during the last five years, towards achieving its Millennium Development Goals with a focus on the areas of economic growth, access to education, reductions in infant mortality rates, and improvements in environmental use regulation.

MDG Monitor: Mozambique (Progress in Reducing Poverty and Child Mortality)
An initiative of the United Nations that tracks the efforts of the second national poverty reduction strategy developed by the government of Mozambique, but with deadlines guided by the MDG targets. The site includes a breakdown of progress by goal for Mozambique.

CHILD AND MATERNAL MORTALITY

White Ribbon Alliance
The White Ribbon Alliance for Safe Motherhood is an international coalition of individuals and organizations formed to promote increased public awareness of the need to make pregnancy and childbirth safe for all women and newborns in the developing, as well as, developed countries. It has members active in 140 countries around the globe.

World Health Organization: Maternal Health
A compendium of information from the United Nations agency that directs and coordinates global public health policies including the issue of maternal health- site includes general information on maternal mortality, statistics and technical information, publications, multimedia, and information on WHO programs and activities.

World Health Organization: Making Pregnancy Safer in Mozambique
A situation analysis of the state of maternal health in Mozambique over the last ten years. The Demographic and Health Surveys highlight national improvements related to the use of reproductive health services in the country. In 2007, the WHO released a Report on Iniquities in Maternal and Child Health in Mozambique (PDF).

UNICEF: The State of the World’s Children 2009 (Maternal and Newborn Health)
A report that examines important issues in maternal and newborn health and outlines the latest paradigms in health programming and policies for mothers and newborns aimed at improving maternal and neonatal health with a focus on Africa.

Averting Maternal Death and Disability Program
Columbia University’s Mailman School of Public Health works with developing countries and international agencies to improve availability, quality and utilization of emergency obstetric care. The program’s midlevelproviders.org compiles research about mid-level providers, also known as non-physician clinicians, who deliver essential clinical services and emergency obstetric care.

Women Deliver
A global initiative to reduce the maternal and newborn death and disability rate in the developing world. Family Care International is the host organization for the Women Deliver program.

MIDWIFERY IN THE UNITED STATES

North American Registry of Midwives
The North American Registry of Midwives (NARM) is an international certification agency that establishes and administers certification for the credential of “Certified Professional Midwife” (CPM). A CPM is a credentialed, independent practitioner who has met entry-level NARM standards who has completed both a written examination and a skills assessment both inside and outside of hospital settings.

Midwives Alliance of North America
The Midwives Alliance of North America is a professional organization for all midwives that aims to unify and strengthen the midwifery profession in order to improve the quality of health care for mothers and babies.

American College of Nurse-Midwives
The American College of Nurse-Midwives is a professional organization that represents certified nurse-midwives and certified midwives. It administers and promotes continuing-education programs, establishes clinical practice standards, and provides research for nurse-midwives and midwives in the United States.

Midwifery Education Accreditation Council
The Midwifery Education Accreditation Council is a federally-recognized accrediting agency approved by the Department of Education that has developed education standards and criteria for midwives.

American Midwifery Certification Board
The American Midwifery Certification Board is a American organization that administers certification for Certified Nurse-Midwives and Certified Midwives.

“It’s an honor to be nominated for an Emmy, especially in such fantastic company, with our colleagues over at Now, Worldfocus, Frontline, P.O.V, and Independent Lens,” said Pamela Hogan, Executive Producer of both films.

Lord’s Children, by Oliver Stoltz and Ali Samadi Ahadi, tells the story of three former child soldiers who fought in Uganda’s Lord’s Resistance Army, escaped from the bush, and have since taken refuge in a rehabilitation center.

Birth of a Surgeon, by Karin Falk and Loui Bernal, travels to Mozambique where, for the first time, midwives are being trained to perform Cesarean sections and other life-saving surgery, significantly reducing the country’s maternal mortality rate.

“It’s really exciting to participate in a film about a subject that’s so important — maternal mortality, an unnecessary loss of life that effects generations — and to be able to find a hopeful story,” said Hogan. “It’s a great example of an African solution to an African problem.”

Coincidentally, Birth of a Surgeon is scheduled to be re-broadcast this week (check your local listings for airtimes). For the encore presentation, host Aaron Brown travels to Mozambique to check in with the film’s main character, Emilia Cumbane, one of the first midwives to go through the training program. She is now the head of the maternity ward at a rural hospital.

The Emmy Awards will be presented on September 21st. Both Lord’s Children and Birth of a Surgeon will compete in the category of Outstanding Coverage of a News Story — Long Form.

“Part of the reason this is so important is that throughout Africa, the rate of infant mortality but also maternal mortality is still far too high,” Obama told the pool of reporters following him. Ghana’s maternal mortality ratio is about 40 times that of the United States.

Obama’s visit put the spotlight on a United Nation’s Millenium Development Goal (MDG) that, according to a new report (PDF), has seen the least progress so far out of the collection of goals aimed at halving extreme poverty by 2015. The sluggish gains made in reducing maternal mortality over the past eight years – MDG 5 – may even be reversed, especially in the poverty-stricken countries of sub-Saharan Africa and South Asia. In fact, the global economic crisis could hamper progress on all eight of the targets established by world leaders in this “blueprint for a better world.”

“Maybe this is an opportunity,” notes Francesca Perucci, chief of Statistical Planning and Development for the U.N. Statistical Division, which coordinated data gathering and preparation of the 2009 report. “Maybe donor countries will finally start giving attention to the message that is loud and clear: We don’t see progress on MDG 5.”

The halfway progress assessment shows that the developing world still accounts for 99 percent of women who die from complications during pregnancy and childbirth. The U.N. and its partner agencies measure progress on maternal mortality by tracking cause of death and monitoring access to emergency obstetric care and prenatal visits. Over the last decade, the U.N. figures have barely changed.

So far, donor countries have expressed their intention to maintain the funding targets they set for the Millenium Development Goals in 2000, but the targets are a percentage of their gross domestic product and the actual dollar amount will be reduced as the economy contracts.

“You have to consider this is a time when the poorest countries will see their own internal domestic resources decrease, so they’ll need additional money, not less,” said Perucci. “If aid decreases, this will jeopardize any positive trends.”

The limited resources have led agencies to focus on projects that deliver immediate results, such as purchasing and delivering bed nets to reduce malaria. This will likely mean less less funding for equipping hospitals with staff that can treat pregnancy complications.

“With maternal mortality, you have to rethink the overall health system. It’s a lot more complicated,” said Perucci. To reduce maternal mortality, the U.N. suggests building more hospitals, improving transportation systems so that women can reach them in time, and informing expectant mothers of what they need to do when complications arise.

Access to family planning services could also improve maternal health. Contraceptive access hovers around 22 percent in sub-Saharan Africa, and is especially limited in refugee camps. But even these programs may be hard to expand. The U.N. report points out that funding gaps for family planning programs have been conspicuous since the mid-1990s.

This week WIDE ANGLE travels to Mozambique, where a bold grassroots initiative to train midwives in advanced life-saving surgery has significantly reduced the country’s maternal mortality rate. The film Birth of a Surgeon follows Emilia Cumbane, one of the first midwives-in-training. She performs cesarean sections and hysterectomies in makeshift operating rooms in rural Mozambique.  Check your local PBS listings for air times.

Host Aaron Brown reporting from Ethiopia in June, 2009

Hello Again,

I am sitting in my office at home, the jet lag from a two week WIDE ANGLE trip to Africa finally clearing. I am so excited about the season ahead and the nature of the films we have.

I should write here how they are important pieces of international reporting and that WIDE ANGLE is the only program devoted to exploring international issues in long form pieces on TV. I could go on and write about the shrinking world we live in which makes our attention to international issues all that more important. The events in Iran this week, I could add, make that point so clearly.

And all of that is true. WIDE ANGLE takes great pride in the fact that long form international journalism pretty much belongs to us alone. There may be the odd piece here or there on American TV, but no program so thoughtfully and carefully looks at the world beyond our borders.

The filmmakers we work with come from across the globe — we worked with a young British filmmaker in Ethiopia and a Swede in Mozambique; a South Korean team will begin our season. It is the combination of their perspective and that of the WIDE ANGLE staff — a pretty varied group as well — that makes the program what it is.

I could go on about that, about the importance of the season that begins July 1st in this changing and complicated world and it would all be true. But it would miss the real point of my excitement about the season ahead and why I think you will fall in love with the pieces as well.

They are simply great stories. The season opens with a thriller about the escape from North Korea to the South through China. Setting aside all the “big issues,” it is a great story of perseverance and risk with a bit of daring journalism thrown in for good measure.

And there are others like it. In truth — and I hope this doesn’t disappoint any regular viewers — there isn’t a wonkish piece on the list. Which isn’t to say that they aren’t substantive. They are. But you could easily miss “importance” for the depth of the characters, their hearts or courage and often their sacrifice. It is going to be a fabulous season.

And I can’t tell you how excited and blessed I feel to be a part of it again this year. And I hope we can find new and better ways to use this space this season as well. See you July 1st.

Aaron Brown
Wide Angle
New York

Last night, WIDE ANGLE’s Birth of a Surgeon received an Overseas Press Club award for the best international reporting in the broadcast medium showing concern for the human condition.

In the film Birth of a Surgeon, WIDE ANGLE travels to Mozambique, where a new public health initiative has helped to cut the rate of women dying in childbirth in half. The program, which trains midwives to perform emergency Cesarean operations, demonstrates how low-cost, community-based health initiatives are changing the face of public health in Africa. The film follows Emilia Cumbane, one of the first midwives-in-training, from her home in the Mozambican capital Maputo, into intensive medical classes, through night shifts in the delivery wards and to the operating table as she fights for recognition of her surgical competence.

Click here to watch the full episode.

Our world today is so interconnected that the collapse of the subprime mortgage market in the U.S. has led to a global financial crisis on a scale not seen since the Great Depression. Here’s a round-up of how the countries around the world are dealing with the economic meltdown.

Europe

The 15-country eurozone is officially in recession for the first time since its formation in 1999. From French President Nicolas Sarkozy’s newly announced economic summit to Iceland’s collective sigh of relief over a bailout (the International Monetary Fund’s first loan to Western Europe since Britain got a helping hand in 1976), Europe is struggling with its own brand of turmoil as the financial crisis tears through the continent.

But in the German cities of Eisenach and Bochum, residents are feeling a special empathy for the U.S. Both are home to Opel car plants, shut down as parent company General Motors pleads with Capitol Hill for a loan.

Opel has approached the German government in an attempt to secure liquidity should GM go bankrupt. German Chancellor Angela Merkel agreed to consider a loan, but immediately faced resistance even within her own party from lawmakers concerned that funds might find their way back to Detroit to prop up the ailing American parent company. All this comes at an inopportune time for Opel. Their Insignia model just won the title of European Car of the Year for 2009 — the first time in 22 years that a GM car has taken top honors. Perhaps the Insignia is a bit more stylish than 1987’s Opel Omega…

As the head of Europe’s second largest economy, French President Sarkozy announced a $25 billion investment fund yesterday. The bailout is part of a plan launched last month aimed at protecting French companies from foreign take-overs. Despite payback clauses and caps placed on executive pay, the bailout has angered France’s powerful unions who are staging massive strikes this week in air and rail travel, and postal and telecom services.

Sarkozy, who currently holds the rotating presidency of the E.U., has been so vocal about the excesses of laissez-faire capitalism and the necessity for better market regulation, that The Economist semi-jokingly questions whether the global financial crisis has turned him into a “closet socialist.” Sarkozy was instrumental in arranging the recent G-20 summit, but returned from Washington disappointed by its outcome. On Tuesday, he announced that he and former British Prime Minister Tony Blair will co-host another meeting of world leaders and financial experts in January 2009 in Paris to continue looking for ways out of the crisis.

In 2001, two-fifths of Turkey’s banks failed after an irresponsible lending spree. Taking over the banks and restructuring them cost the state a crippling 30 percent of GDP and plunged the economy into a deep recession, triggering one of the I.M.F.’s biggest-ever loans. At the G-20 summit in Washington last weekend, Turkish Prime Minister Reccep Tayyip Erdogan announced his country may be close to reaching an agreement to receive yet another emergency loan from the I.M.F. But Prime Minister Erdogan has warned the Turkish business community not to expect a government bailout this time: “Nobody should expect everything from the government. It’s not like the government is going to inject cash into the emptied safes of companies. Let me put it clearly, such a thing is out of the question.”

Asia

After months of avoiding the global financial crisis and years of excess money in the banks, Japan has also slipped into a recession. The world’s second largest economy has seen a recent appreciation of the yen and consequently, a decline in the demand for exports, especially among its most loyal customers. In the United States, the world’s largest auto market, the price of Japanese vehicles is rising and sales are dropping. Japanese car manufacturers Honda, Nissan and Toyota are reporting steep declines in sales and profits. Sony is also predicting a 59 percent plunge in profits due to deteriorating sales of gadgets and flat-screen TVs.

Prime Minister Taro Aso announced a $51 billion stimulus package last month, which included 2 trillion yen ($20.3 billion) in special benefits to all households. Aso hoped to encourage domestic consumption by distributing $600 to each family of four. Some economists predict that the worst is yet to come in Japan, but the bleak outlook hasn’t stopped Japanese consumers from snatching up an entire stock of diamond-encrusted mobile phones. Studded with 537 diamonds – a total of 18.34 carats – and a price tag of 13 million yen ($134,000 dollars), the line of 10 phones sold out within three days.

South Koreans have begun to fear a repeat of their 1997-1998 economic collapse, when the I.M.F. had to step in with a $58 million bailout. The government of South Korea responded to the current downturn by setting up a $30 billion currency swap with the Federal Reserve of the United States, which was designed to alleviate the pressure on the country’s banks. On November 14^th, China and Japan also agreed on a currency swap with South Korea, contributing $4 billion and $15 billion respectively.

Despite a slowdown in garment exports and tourists, Cambodian Prime Minister Sun Hen sees the silver lining. At a summit with Thailand and Vietnam earlier this month, Sen said, “’The rich people in Europe, the buyers in America, will not buy expensive clothes produced in Europe anymore but the cheaper goods produced in Cambodia and Vietnam.”

In the first weeks of the global financial crisis, China — the world’s fastest growing economy and largest holder of foreign-exchange reserves — was hopeful the slowdown would pass it by. But figures released in mid-October showed growth dipping to its lowest in five years, down from 11.9 percent last year to 9 percent this quarter, confirming that no nation is immune. With foreign exports and investments shrinking, Chinese unemployment is on the rise, and could reach up to 2.7 million laid-off workers by January 2009. Time Magazine calls it “China’s worst nightmare,” due to the labor unrest that might result. This week, Chinese authorities issued an order to companies in the big manufacturing regions of Shandong and Hubei provinces: they must now seek government consent in order to fire more than 40 people at a time. To shore up domestic growth and market confidence, on November 9 President Hu Jintao announced a 2-year $586 billion stimulus package — four times as large as America’s current bailout plan — focused on tax reform, increased spending on education, health, and housing, and major infrastructure projects such as roads, railways, airports, and the power grid.

China suffered from two major recessions in the past 30 years, in the aftermath of the Tiananmen uprising in 1989 and during the Asian financial crisis in the late 1990s, when it last adopted a big stimulus plan. The Economist argues that this time China might “genuinely avoid a hard landing: the underlying economy, while far from perfect, is in better shape, and the government has more room to boost its spending… [M]ost economists think the stimulus package will be enough to keep growth at 7.5-8 percent for the year as a whole. If so, of the world’s eight biggest economies, China will be the only one to enjoy any growth next year.” Chinese consumers may help keep the rest of us afloat.

As the West increasingly relies on China to help it weather the storm, geo-political compromises may be in the offing. The U.K. is rumored to have secured a Chinese donation to the I.M.F. by agreeing to reverse its century-old position on Tibet: since late October, Briatin no longer recognizes Tibet as an autonomous entity but rather as a part of the People’s Republic of China.

The Middle East and Central Asia

Iranian hardliners have hailed the economic crisis as divine punishment for the perceived greed and corruption of the West and its allies. “The oppressors and the corrupt will be replaced by the pious and believers,” according to Iran’s firebrand President Mahmoud Ahmadinejad, who sees the downturn as signaling “the end of capitalism.”

He’s not the only one to see this crisis as a turning point in the culture war between East and West. Dubai’s once-booming economy has been hit hard, but some see the downturn as a chance to save the local culture. Traditional Bedouin culture has been all but lost in Dubai’s rush to become an international center of business, media and tourism. “The city needs to slow down and relax,” says Abdul Khaleq Abdullah, a political science professor at United Arab Emirates University. “It’s good for the identity of our country.”

The U.S. is expected to spend close to $200 billion on the ongoing wars in Iraq and Afghanistan this year alone. With the economic crisis wreaking havoc in the homeland, something has to give. Peter Beinart, a Senior Fellow at the Council on Foreign Relations says that “the economic environment is making a speedy drawdown of U.S. troops [in Iraq] more likely.” That might sound like good news to some. But experts warn that the financial crisis might fuel instability in fragile nations from the Middle East to Pakistan. On November 15th, a struggling Pakistan reluctantly accepted a $7.6 billion loan from the I.M.F. But still, there is fear that economic troubles will hinder Pakistan’s ability to fight the Taliban insurgency in the country’s tribal regions.

Africa

Last month, former U.N. secretary general Kofi Annan said that we cannot use the global financial crisis as “an excuse for inaction” in combating poverty and food shortages in Africa. In times of financial crisis governments often renege on promises of financial aid. In fact, the U.N. Food Agency reported that only a tenth of 22 billion euros in food and agriculture assistance pledged to the U.N. for 2008 has actually been paid.

But there are some who feel the time is ripe for Africa to excel as an economic force. Kuseni Dlamini, the South African head of the multinational mining firm Anglo American, said that now is the “great era of opportunity for Africa to rise and shine in the global scheme of things and be met as an economic giant.” Kuseni cited Botswana as a “shining example” of a country that has managed its natural resources (diamonds) in a responsible way, which has delivered long term benefits in education, infrastructure and healthcare to the country. John Simon, U.S. ambassador to the African Union has called Africa “the new frontier” in the global economy.

According to Antoinette Sayeh, director of the I.M.F.’s African Department, growth in sub-Saharan Africa, the continent’s poorest region, will remain strong. Sub-Saharan Africa experienced one of its highest growth rates in decades in 2007, growing at a rate of 6.5 percent. In the midst of the global financial crisis, the I.M.F. projects that growth in sub-Saharan Africa will fall by only half a percent in 2008 and 2009. However, Sayeh warns that sub-Saharan Africa’s economic growth could weaken with a lower inflow of capital, i.e. through foreign aid, and a reduction in commodity pricing. The I.M.F. has also identified eight sub-Saharan African countries — Botswana, Ghana, Kenya, Mozambique, Nigeria, Tanzania, Uganda and Zambia – as having enough growth and investment to be considered emerging markets.

Latin America

With oil dropping below $50 a barrel, the Venezuelan economy may be at risk. More than 90 percent of export revenue and more than half of the government’s budget derives from oil. With these economic risks come political risks for a government whose extensive social programs are funded with oil revenues. Venezuela holds regional elections on Sunday, November 23, and economic troubles could reduce outspoken President Hugo Chavez’s hold on power. Among other challenges, Chavez allies will have to compete with Chavez’s ex-wife, Marisabel Rodriguez (she has since married her tennis coach).

Like Venezuela, Mexico relies heavily on oil revenues. The country also relies on remittances sent home by Mexican migrants abroad. Both have declined in response to the international financial crisis. In August, the collapse of the U.S. housing market (which employs many Hispanic immigrants in construction jobs) and increased illegal immigration raids contributed to a 12 percent drop in remittances, the largest monthly drop on record. Fortunately, September figures were more optimistic. Mexico receives the third-largest amount of remittances worldwide, and receives by far the largest amount coming from migrants based in the U.S. Interestingly, the decline in remittances has not been seen (pdf) in other Latin American countries that rely on them.

Mexico is also strongly connected to U.S. investment, which could prove problematic in weathering the financial crisis. Colombia, perhaps the strongest U.S. ally in South America, is less entangled with investments, but will be affected now that U.S. banks are reducing loans to developing countries. In addition, a trade agreement that would open some areas of trade between Colombia and the U.S. could be threatened by the the recent U.S. election. One outcome of the 2008 U.S. election was the ascendance of legislators advocating “fair trade” platforms, as opposed to “free trade” platforms. President-elect Obama, for example, has advocated for stronger labor protections in the Colombia agreement, citing violence against Colombian labor leaders. President Bush and out-going Republicans, however, have pushed for the deal to be signed as soon as possible.

The Planet

There may be some surprise winners and losers in the financial crisis, but the outlook for the planet seems to teeter back and forth between the two poles. U.N. climate honcho Yvo de Boer fears renewable energies and conservation will suffer from sinking oil prices, while countries will spend less money on protecting the environment as they fork over cash to rescue banks. Validating his concerns, at a recent E.U. summit, some Eastern European countries talked about backing away from CO2 emissions targets, citing the expense. Italian Prime Minister Silvio Berlusconi added, “We do not think that now is the time to be playing the role of Don Quixote, when the big producers of CO2, such as the United States or China, are totally against adherence to our targets.”

But what’s bad news for some may actually make climate change activists pleased. With high rates of unemployment and foreclosure, populations are commuting less and shifting away from areas of suburban sprawl. Until the economic downturn, California was not set to meet its ambitious and trend-setting greenhouse gas emissions target. Now it seems as though they’re back on track. Less consumer demand likely translates into lower energy use – fewer road trips, fewer flights and a greater willingness to utilize public transportation. And, as the Christian Science Monitor reports, “One silver lining of the financial crisis is that investment decisions may not be as short-term as they have been.” Renewable energy and green technology projects might attract investors as safer bets for the long term.

WIDE ANGLE has also reported on the economic crisis in Ireland and Argentina.

The film Birth of a Surgeon follows Emilia Cumbane, one of the first midwives-in-training. She performs Cesareans and hysterectomies in makeshift operating rooms in rural Mozambique. We follow Cumbane from her home in the Mozambican capital Maputo, into intensive medical classes, through night shifts in the delivery wards, and watch as she fights for recognition of her surgical competence.

Click below to listen to a discussion about the causes of maternal death, the importance of maternal health and the progress that is being made in Mozambique and around the world now that this issue is on the international development agenda.
Lynn Freedman is a human rights attorney and the Director of AMDD, Averting Maternal Death and Disability.
Helen de Pinho is a physician from South Africa who works with AMDD. She recently traveled to Mozambique to meet with mid-level medical providers there. EXPERT INTERVIEW TRANSCRIPT:
LYNN FREEDMAN AND HELEN de PINHO

LYNN FREEDMAN: Women everywhere in the world who die in childbirth die from basically the same set of causes. Mostly direct obstetric causes—things like bleeding, or hemorrhaging, infection, obstructed labor. We know the medical interventions that will save a woman’s life if she has one of those complications. The big, big issue is getting those medical interventions to the women who need them, and so that’s where the big challenge comes in—ensuring that women in remote rural areas, women who perhaps don’t have the money to get to a facility much less get into the facility, pay for the services. To make sure women in that position get access to life-saving care.

There’s no question that the current number of surgeons and surgical technicians in Mozambique cannot meet the enormous need for emergency obstetric care.

HELEN DE PINHO: There are 26 obstetricians in Mozambique. Fourteen of them are in the central hospital in Maputo, and I think only about three or four or five are actually out in the rural area, so that gives you an idea of distribution and numbers. And a similar kind of distribution pattern for surgeons in Mozambique. The role of the non-physician clinician has always been there in many of these countries; that’s not new. The surgical midwife, yes, that is new. And that will change, but what that would do is strengthen what’s already happening. It doesn’t shift…it doesn’t displace doctors in any way, because they’re just simply not there.

WIDE ANGLE: Lynn, you mentioned that there’s this new energy about addressing maternal mortality. Can you speak about this new energy, where it’s come from, and why now?

LYNN FREEDMAN: Well, I think maternal mortality has…has certainly risen to the top of the development agenda, helped enormously by the fact that it is one of the Millennium Development Goals.

The Millennium Development Goals are a set of eight goals that the U.N. general assembly passed at the turn of the millennium in the year 2000 to guide poverty reduction efforts in the world in the coming millennium, or at least the coming 15 years.

But they also include three health goals. One is HIV, TB and Malaria. Another is to reduce child mortality. And MDG 5 is to improve maternal health with two goals: one is to reduce maternal mortality by 75% and the second target under improved maternal health is to have universal access to reproductive health services.

So that has put maternal mortality itself on the health and development agenda.

HELEN DE PINHO: …if I can just talk to what’s happening in Mozambique at that. What we see is first of all very high-level commitment to reducing maternal mortality. And then also to—recognizing the sort of continuum of care, from when the woman first becomes pregnant or even before she comes pregnant, to make sure that –that young girls are adequately fed, that—that they are nutritionally well—well-nourished. That there is family planning accessible. The policies are good, they’re there. And now it’s a matter of actually getting them implemented in all the areas.

WIDE ANGLE: How will that later affect the health of the entire system?

LYNN FREEDMAN: Well, there’s no question that a huge proportion of newborn deaths are actually attributable to the things that happen during pregnancy and delivery. We certainly want to make sure we pay attention to and care about the woman herself and her survival. But, we also acknowledge that the survival and life of a newborn is very closely linked to what happens to the mother and indeed, the life, well-being and survival of the rest of her family, not just thethe baby she’s giving birth to right then. The ramifications of maternal death or maternal survival go well beyond just her children. It’s her family, it’s her community, it’s productive work for the country, and it’s her own right to be a participating member for society.

WIDE ANGLE: Thank you Lynn, and thank you, Helen.

LYNN FREEDMAN: Our pleasure.

HELEN DE PINHO: It is a pleasure, thank you.

Download the mp3 of this interview