Professor Tony Ryan:

I wish to respond to Deputy Eric Byrne's question about the millennium development goals. For a long time the millennium goals in childhood looked at the major things for under-fives – gastroenteritis and immunisation - and the newborn was ignored. After a number of years it became clear that one could not reach the objectives until one addressed what we call neonatal wastage – the massive number of deaths in the newborn period. That is why the investment began into newborn wastage. It is a terrible phrase but it represents the notion that, as I said earlier, Selma is young and she can have another baby next year. That attitude puts Selma at great risk because she has a one in 18 chance of dying during her childbirth years. Having more babies means more health complications. She could get an obstructed birth. She could get a fistula where her rectum will empty into her vagina and she will be isolated from her community - left out in the villages - and unless she is close to a city she will never get repaired. Her life could be over because of something like that.

There is also the question of whether having more babies increases the world population. It does not. The reason she is having more babies is because she is poor. People do not have more babies because of religious beliefs. They have more babies because of poverty and because they do not know if their children will survive. That is well established. Saving babies in the newborn period does not increase the world population. Also, saving babies well in the newborn period reduces damaged babies which is another reason for proper resuscitation of babies in the newborn period. I hope Deputy Byrne's daughter will contribute to that in her work in Great Ormond Street as well.