great expectations

2020’s designation as the International Year of the Nurse and the Midwife by the WHO was nothing to do with Coronavirus. The initiative came because entering 2020 signalled a decade left to achieve the United Nations Sustainable Development Goals (SDGs), 17 goals that all UN Member States agreed to strive to achieve by the year 2030. One of the goals is Good Health and Wellbeing, and the WHO recognises that nurses and midwives are absolutely essential to its accomplishment. In 2017, less than half the global population was covered by essential health services. [1] The WHO aspires to see universal health coverage by 2030, and for that to happen, the world needs 9 million more nurses and midwives. [2]Cue 2020: A year to recognise and celebrate the integral role of nurses and midwives worldwide. A role so vital that even when 50 per cent of the global health workforce are nurses and midwives, we still need nine million more. That’s why celebrating would never be enough. The International Year of the Nurse and the Midwife was also a call to action – highlighting the challenging conditions nurses and midwives often face, and advocating for increased investments in the workforce. [3] 2020 of course held further significance because it marked 200 years since the birth of the founder of modern nursing, Florence Nightingale.

However, it was the year that took us all by surprise and it’s fair to say that nothing quite went to plan. In some ways, the Coronavirus pandemic was a great help in spotlighting the vital work of nurses and midwives around the world. In our own country, we received a weekly applause and priority access to supermarkets. Perhaps some have been inspired to join the profession and help fill the 40,000 nursing vacancies in health and care settings in England alone [4] (hopefully not just to get to the front of the queue at Asda). But in other ways, 2020 has been a global health disaster.

As part of its Good Health and Wellbeing goal, the UN is aiming to end preventable deaths of newborns and children under five years of age, with all countries aiming to reduce under-five mortality to at least as low as 25 per 1,000 live births by 2030 5. However, their statistics expected hundreds of thousands of additional under-five deaths in 2020 alone. Another target was to end the epidemic of malaria, but in late 2020 the UN predicted that Covid-related service cancellations would lead to a 100 per cent increase in malaria deaths in Sub-Saharan Africa. 2020: The year that was supposed to rapidly accelerate progress towards the SDGs through a concerted focus on nursing and midwifery. Instead, the year where a global pandemic reversed decades of improvement and countries ended the year further from the goals than they were at the start. A year for progression became a year of regression. What a source of depression.

Or is it? The UN set out a vision for a world free from poverty, hunger and disease. But the Christian knows that as long as we’re living in a fallen world, suffering and death is par for the course. We know that their wonderful vision, regardless of ambition and effort, will only become a reality in the new creation. That doesn’t mean we don’t lament between now and then. We do – as does God.It doesn’t mean we don’t use our privileged position as nurses and midwives to shape a better world. But it does mean that when our best efforts and initiatives completely backfire and the outlook is bleak, we take heart, because we know a day is coming when all healthcare workers will be out of a job. Can you imagine? I dare you. The staffing shortages we know, replaced, and not by a temporary furlough scheme, but permanent eternal redundancy. No illness to treat, no birth pangs to be heard, from your patients or from our world.

For we know that the whole creation has been groaning together in the pains of childbirth until now. And not only the creation, but we ourselves, who have the first fruits of the Spirit, groan inwardly as we wait eagerly for adoption as sons, the redemption of our bodies. For in this hope we were saved. Now hope that is seen is not hope. For who hopes for what he sees? But if we hope for what we do not see, we wait for it with patience. (Romans 8:22-25 ESV)

Georgie Coster is a staff nurse in a Critical Care Unit and CMF Associate Head of Nurses and Midwives