504

clearly took account of the dangers he faced, The Lancet pointed tohis "true spirit of philosophy and keen judgment" and saw fit toaccord "him a place amongst the benefactors of sufferinghumanity"_3 3

1. Kennedy E. A cultural history of the French revolution. New York: Yale, 1989: 33.2. Roa A. The French revolution and its impact m medicine. Rev Med Chile 1991; 119:

222-30.

3. Anonymous. Biographical notice of M. Pinel. Lancet 1826-27; XII: 262-64.

Safe Motherhood Initiative NigeriaDistressed by persistently high rates of maternal mortalityl-3

-often exceeding 10 per 1000-some societies of obstetricians indeveloping countries have held Safe Motherhood conferences torefocus public attention on an apparently intractable calamity.4,5 Inlaunching its Safe Motherhood Initiative Nigeria 1990 the Societyof Gynaecology and Obstetrics of Nigeria (SOGON) adopted a newstrategy: the main Safe Motherhood conference was preceded byfour zonal consultative seminars attended by lay individuals (ruraland village people, traditional rulers, representatives of professionaland religious organisations, and so on) at the headquarters of thecountry’s four health zones at Enugu, Ibadan, Kaduna, and Bauchi.Their ideas were used to enrich the main conference. The reports ofthe preconference seminars and the safe motherhood conference(held last September at Abuja, the new capital city of Nigeria) havenow been published in three volumes.* One of the highlights is aposition paper by Prof Kelsey Harrison. He identifies as the crux ofthe problem the unbooked emergencies and concludes that "for thepresent, top priority should be given to universal basic formaleducation and free antenatal care services, with midwives, notphysicians, providing the bulk of it". SOGON is recommendingthis innovative approach to Safe Motherhood to sister organi-sations. The pathway to safer motherhood in Nigeria, andpresumably, most other developing countries, is now recognised.What is needed is the will to translate the dreams into realities for a

group of women who, being mainly poor and underprivileged, lackpolitical muscle.

*The three volumes are available for US$55 inclusive of postage by courier.Inquiries to Prof N. D. Briggs, Secretary-General of SOGON, PO Box 124,University of Port Harcourt, Ghoba, Port Harcourt, Nigeria.

1. Briggs ND. Maternal mortality in booked and unbooked patients: University of PortHarcourt Teaching Hospital experience. Trop J Obstet Gynaecol 1988; 1: 26-29.

2. Harrison KA. Childbearing, health and social priorities. Br J Obstet Gynaecol 1985; 92suppl 5: 100-16.

3. Main D, Wray J, Kamara A, Ravaonoromalala V, Rosenfield A. Maternal mortality indeveloping countries. Br J Obstet Gynaecol 1989; 96: 1120-21.

4. Preventing the tragedy of maternal deaths. Report on the International SafeMotherhood Conference, Nairobi, February, 1987.

5. Safe Motherhood South Asia: challenge for the nineties. Conference held in Lahore,Pakistan, March, 1990 by PAASBAN and Family Care International.

Political determinescence

It is increasingly clear that Irish law and condoms don’t mix.When the Irish Family Planning Association was fined IR500 forselling a condom in the Virgin record store in January (Lancet 1991;337: 548), Prime Minister Charles Haughey took the lead inpromising legislation (Lancet 1991; 337: 970) to overturn whatmany people perceive to be anachronistic legislation and in doing sohe received support from all the Dail opposition parties.The consensus, however, rapidly collapsed in the face of Church

opposition. Archbishop Cathal Daly and the Bishop of Dublin,Desmond Connell, have led an increasingly vocal opposition to theproposed legislation. In a desperate attempt to pass the buck, theGovernment released a draft legislation on Aug 3, purporting tomake condoms more widely available but leaving to the discretionof the regional health boards the "suitability" of prospectivecondom sales outlets. A telephone poll of regional health boards hasdemonstrated what most Irish expected-27 out of 40 boardsopposed the sale of condoms in shops or pubs. "I would support theseverest restriction on the availability of condoms... the permissivesociety has cost this country millions of pounds", said one memberof the Midland Health Board.The Government probably hopes the public will wear itself out

before the Dail reassembles for the October session. On Aug 14,however, a policeman identified himself as the purchaser of acondom in Mr Richard Branson’s Virgin record store in Dublin(where the Irish FPA continues to sell condoms) and it seems likelyanother prosecution may take place.

Class, sex, and physical activityAre women more active than men? In a telephone survey of 574

people in Pittsburgh, Ford and colleagues! found that women ofhigher socioeconomic status were more active than their malecounterparts (2079 vs 1952 minutes of physical activity weekly), andmuch more active than women of lower socioeconomic class (1536min/week). The striking difference between women from differentbackgrounds seemed to reflect a much higher proportion of womenfrom privileged backgrounds participating in leisure-time physicalactivity; among women who were active, the chosen amount andtypes of leisure exercise were similar-apart from golf. The authorssuggest that different levels of physical activity might contribute tohealth differences between social groups. However, independentcorroboration of activity is hard to establish from a telephoneinquiry: the authors’ suggested metabolic equivalents for leisureactivity include household chores (2-5), weightlifting (3-0), bowling(3-0), mowing the lawn (4-0), softball (4-5), callisthenics (4-5), homeexercise (4-5), gardening (5-0), and aerobics (5-5). Could onewoman’s household chores be another’s vigorous home exercise?Anyway, the observed differences may all be the fault of themenfolk: men with lower socioeconomic status spent significantlymore time each week helping out in the house.

1. Ford ES, Merritt RK, Heath GW, et al. Physical activity behaviors in lower and highersocioeconomic status populations. Am J Epidemiol 1991; 133: 1246-56.

International Diary

1991

A conference entitled Medical Exchange, Aid to and Trade with theSoviet Union is to be held in London on Tuesday, Sept 3: UK-USSRMedical Exchange Programme, 9D Stanhope Road, London N6 5NE, UK(081-347 8852).

A conference on Sickle Cell Disease-Setting Standards of Care willbe held in Cardiff on Thursday, Sept 19: Mrs Judith Shankleman, CardiffSickle Cell and Thalassaemia Centre, Butetown Health Centre, LoudounSquare, Cardiff CF1 5UZ, UK (0222 471055).

A symposium entitled Support For Children With HIV and TheirFamilies is to take place in London on Monday, Sept 23: SymposiumSecretary, Royal Postgraduate Medical School, Institute of Obstetrics andGynaecology, Queen Charlotte’s and Chelsea Hospital, Goldhawk Road,London W6 OXG, UK (081-740 3904).

A course in Surgical Oncology will take place in London on Oct 2-5:The Manager, Education and Conference Centre, Royal Marsden Hospital,Fulham Road, London SW3 6JJ, UK (071-352 8171 ext 2921).

Six-part European Course in Pharmaceutical Medicine will be heldin Basel beginning Oct 7-9: Dr Ruth Amstein, Programme Director, ECPMSecretariat, Department of Research, University Hospitals, CH-4031 Basel,Switzerland (1161 265 2363).

An international conference entitled New Drugs for Asthma is to be heldin London on Nov 14-15: Georgina Mason, IBC Technical Services

Limited, Bath House, 56 Holborn Viaduct, London EC1A 2EX, UK(071-236 4080).

A seminar in Diagnostic Tumour Pathology is to be held in London onNov 28-29: The Manager, Education and Conference Centre, RoyalMarsden Hospital, Fulham Road, London SW3 6JJ, UK (071-3518171 ext2921). ).

23rd annual meeting and equipment exhibition of the British MedicalUltrasound Society will be held in Bournemouth, Dorset on Dec 10-12:Miss L. A. Summers, BMUS, 36 Portland Place, London WIN 3DG, UK(071-636 3714).