Midwives Group Committee: Luciana Xuereb, Chairperson: 79538562; Marie Claire, Secretary: 99827852
MUMN Council Members
Paul Pace - President: 79033033
Colin Galea - General Secretary: 79425718
Alex Manche’ - Vice-President: 77678038
George Saliba - Financial Secretary: 79231283
Alexander Lautier: 99478982
Geoffrey Axiak: 99822288
William Grech: 79011981
Claire Zerafa: 99217063
Joseph Aquilina: 99467687
Alexandra Abela Fiorentino: 79642163
MUMN Office: 21448542
Editorial Board
Joseph Camilleri (Editor) CN M1 MDH
William Grech: 79011981
Alexander Lautier: 99478982
Pubblikat: Malta Union of Midwives and Nurses
Warner Complex, MUMN, Triq il-Vitorja, Qormi QRM 2508 • Tel/Fax: 2144 8542 • Website: www.mumn.org • E-mail: administrator@mumn.org
Il-fehmiet li jidhru f’dan il-æurnal mhux neçessarjament jirriflettu l-fehma jew il-policy tal-MUMN.
L-MUMN ma tistax tinÿamm responsabbli gœal xi œsara jew konsegwenzi oœra li jiæu kkawÿati meta tintuÿa informazzjoni minn dan il-æurnal.
L-ebda parti mill-æurnal ma tista’ tiæi riprodotta mingœajr il-permess bil-miktub tal-MUMN. Çirkulazzjoni: 5,000 kopja.
Il-Musbieœ jiæi ppubblikat 4 darbiet f’sena.
Dan il-æurnal jitqassam b’xejn lill-membri kollha u lill-entitajiet oœra, li l-bord editorjali flimkien mad-direzzjoni tal-MUMN jiddeçiedi fuqhom.
Il-bord editorjali jiggarantixxi d-dritt tar-riservatezza fuq l-indirizzi ta’ kull min jirçievi dan il-æurnal.
Kull bdil fl-indirizzi gœandu jiæi kkomunikat mas-Segretarja mill-aktar fis possibbli.
Ritratti tal-faççata: MUMN
Coping with a Nurse Coworker’s Death
Recently we lost some fine nurses, coworkers and friends of ours, even at a comparatively young age. Malta has truly lost some hardworking and talented nurses and midwives who have hugely contributed to the nursing profession and towards our patients.
We are no strangers to death. We constantly show empathy, compassion and comfort towards our clients and their families but when it comes to bereaving our colleagues, it is something else. We at often become immune when showing feelings and emotions with grieving families but not with coworkers. That boundary completely changes especially when death is sudden or unexpected. No one will understand this, except us nurses and midwives.
We feel so deeply when “one of our own” has passed, and it pains us to see someone who has given
their whole life to our profession, succumb to it. How do people deal with watching “our own” on the other side of the bed or have passed? We are all shocked and confused when we hear of someone who is sick and passing. We grief, because caregivers need caregivers for support and comfort.
We care, because we’re professionals by our own right. We’re hurt, a lot. We cry, but that’s alright. We sometimes require spiritual, psychological or emotional support. Staff needs to cope with the loss of our colleagues. Bereavement support is sometimes useful and remembering our loved ones through funeral services, memorials and tributes are important too.
This editorial is dedicated to nurses, colleagues of ours who have succumbed and dedicated their whole life working hard in hospitals, outpatients, clinics, health centres, schools and universities. These are colleagues of ours who
have become second family, our buddies, our mentors, our confidantes. We share difficult moments, impossible and challenging tasks, laughter, failures and success. Nurses spend their careers taking care of others. In death, nurses take care of one another.
It is just a privilege and an honour to assist the late nurses’ or midwives’ families. It is just as important to commemorate these beloved nurses in the community as a thank you for their services rendered. When one “of our own” is gone we recite the Nurses Prayer: Give me strength and wisdom when others need my touch; a soothing work to speak to them, their hearts yearn for so much. Give me joy and laughter, to lift a weary soul; pour in me compassion to make the broken whole. Give me gentle healing hands, for those placed in my care; a blessing to those who need me, this is a nurse’s prayer.
Reflecting on this prayer, we think of our own careers and appreciate how much the late nurse and midwife contributed to society with a life well-lived. We therefore honour and cherish every passed unsung hero of healthcare who have soothed, comforted, compassioned, healed and was a source of light.
Thank you for the life we shared, you are forever in our hearts.
President’s message
From this year, all allowances of the sectorial agreement of the nurses and midwives has come into effect. The latest allowance being the overtime allowance which will be given from now on every year to all nurses and midwives who work overtime such as the 46.6 hours. Nurses and Midwives working in MDH, SVP, Home and PHC will receive such allowances in payroll 3.
Next year further allowances will be given but this time it will not be through the Nurses and Midwives sectorial agreement but through the Civil Service Collective Agreement. Next year the loyalty service allowances will be given which will be accompanied with a further increase in the basic salary pay. The increase in the basic salary pay will be throughout
Currently MUMN is negotiating the sectorial agreement of the social workers which will expire in June this year. MUMN represents the social workers not just of the Health Sector but also of the Education sector and the Social Workers of the Church Schools. It is important that such an agreement address the shortage of shortage of Social workers in both the Chruch schools and the Government Ministries.
There are further issues which MUMN is pursuing in the name of its members. The vandalism of MUMN member’s cars in the car park of MDH. MUMN is pushing that CCTV cameras need to be installed and the CEO of MDH promised that by June this year, the car park of the MDH will have all the necessary CCTV cameras installed.
Another issue being pursed by MUMN is the replacement of breaks of the carers doing constant watches. While SVP have a relieve pool of the carers to replace carers during the break times doing constant watches, MDH has no relieve pool for the constant watches. Constant watches is treatment and therefore there is a huge legal aspect placed on the ward nurses including the Charge Nurses.
It is important that the constant watch is observed in all times and having the carers doing the constant watches having a two hour break imposes huge legal aspect on the nurses in the wards. This is compounded by the fact that the constant watches are increasing exponentially. In SVP, there are more than 240 constant watches while in MDH the number is well above 100 constant watches. So it is important to address this issue in MDH.
Recently violence took place in MDH against one of the nurses by a patient. Although the nurses was not assaulted but the verbal harassment was so harsh that the nurse was fearing for her life. The add salt to injury, the Panic Button in MDH had stopped from functioning. MUMN has bee trying to address the Panic Button issue for the last six months. MUMN is pleased to inform all its members that in three month’s time, the CEO of MDH assured MUMN, the Panic Button issue in MDH will be resolved.
Another issue is the insurance for all nurses and midwives who risk their lives in the emergency department in both Malta and Gozo. Gozo nurses have also an added risk which is that of the helicopter. Again, these issues would soon be addressed.
The last but not the least, there is the issue of the sick leave. It is not right and not acceptable that nurses and midwives who avail of a night sick leave will have three days deducted from their sick leave entitlement. This is nothing less than injustice to MUMN members who work night duty. Also having all off days during the sick leave counted
as sick leave is also not right. MUMN is working with the collaboration of the other unions throughout all the Public Service to address this injustice which have been taking place for many years.
“It is important that the constant watch is observed in all times and having the carers doing the constant watches having a two hour break imposes huge legal aspect on the nurses in the wards”
As one can see, the work of MUMN to continue to address issues which our members are facing is continuous. Issues which re not always easy to address but all issues listed above have the support of the Health Minister.
The Health Minister committed himself to support MUMN on these issues which are very important since all members of MUMN offer their sterling service to the patients in Malta and Gozo.
MUMN would like to thank all its members for the trust and support given to MUMN which union is always at the service of its members.
Paul Pace President
mis-Segretarju Æenerali
Reæa’ wasal il-waqt li niktbu ÿewæ kelmiet biex ngœaddu l-informazzjoni dwar dak li qed iseœœ fl-MUMN u x’hemm ippjanat. Gœadna kemm bdejna Sena Ædida u diæà qed noqorbu lejn l-aœœar ta’ Marzu. Iÿ-ÿmien qed jiæri. Dalwaqt jasal l-Gœid il-Kbir!
Student Nurses/Midwives tad-3rd Years waslu fl-aœœar u jekk Alla jrid, aktar tard din is-sena, ser ikollna qrib il-140 nurse u midwives æodda. Din is-sena l-istudenti li jattendu l-course tan-Northumbria University fl-MCAST kellhom ftit turbolanzi mhux œaÿin minœabba l-inkwiet industrijali però bis-support ta’ kulœadd taffew œafna mill-ostakoli li kellhom. Dan ix-xahar ser inkunu laqqajna lil dawn l-istudenti kollha fil-union biex ninfurmahom fuq materji li jolqtu lilhom hekk kif jiggradwaw b’suççess u jibdew ilœidma tagœhom.
Fil-mument gœaddejin bin-negozjati biex isir Ftehim Settorali Ædid gœasSocial Workers li jaœdmu mall-Gvern. S’issa jidher li l-Gvern qed jifhem ilœtieæa uræenti li dawn il-professjonisti li jingœataw skoss ’il fuq fuq diversi aspetti. Dan il-Ftehim jagœlaq f’Æunju li æej u gœalhekk ninsabu kunfidenti li ser jirnexxielna naslu qabel jagœlaq iÿÿmien li jiskadi.
Dan il-waqt gœadna gœaddejjin b’ÿewæ kawÿi fil-Qorti. Kawÿa minnhom hija dik li fetœilna l-Gvern wara li kien
WhenWhen I was YOUNG, I found it DIFFICULT to WAKE UP. When I am OLD, I find it DIFFICULT to SLEEP.
When I was YOUNG, I was WORRIED about MY PIMPLES. When I am OLD, I am WORRIED about MY WRINKLES.
When I was YOUNG, I was WAITING to HOLD someone’s HAND. When I am OLD, I am WAITING for SOMEONE to HOLD MY HAND.
gœamlilna Mandat dwar id-Direttivi marbuta man-nuqqas ta’ nurses fl-SVP u l-Kawÿa l-oœra li ftaœna lill-Gvern hija dwar id-dritt Minoritarju li gœandu jkollna meta nirrapreÿentaw kategoriji ta’ œaddiema li gœalkemm ma’ jkollniex l-Gœarfien Ewlieni, nkunu ngawdu l-maææoranza tagœhom fuq post taxxogœol partikolari.
Bœal dawn fil-mument gœandna tlieta –Technicians fl-Engineering Division MDH, ICT Officers MDH u l-Physiotherapisti. Dawn iÿ-ÿewæ kawÿi waslu fl-aœœar. Sa Sajf nisperaw li jkollna r-riÿultati.
Is-sena d-dieœla l-MUMN tagœlaq it30 anniversarju filwaqt li l-Florence Nightingale Benevolent Fund jagœlaq il-25 anniversarju. Fl-aœœar laqgœa talKunsill æie diskuss kif ikun l-aœjar li jiæu ççelebrati dawn iÿ-ÿewæ anniversarji importanti. Ÿewæ punti li nista’ nitkellem fuqhom huma li fil-premises tal-union ser jinfetaœ Muÿew li ser jilqa’ fih oææetti li kienu jintuÿaw fl-antik minn nurses, midwives u professjonisti oœra fil-qasam tas-saœœa. Dan ser ikun pass ’il quddiem biex inkomplu nippreservaw l-istorja talmembri tagœna. Kull min irid jagœmel donation lil union jew jislifna xi affarjiet biex jiæu esebiti, inkunu œafna grati lejh. Diæà gœandna xi affarjiet sbieœ però ÿgur li ser ikollna bÿonn aktar. Mill-union ÿgur li ser jitgawdew u jiæu apprezzati anki mill-istudenti li jiæu jÿuru l-union kif ukoll minn numru ta’ barannin u mistiedna distinti li jattendu l-MUMN.
Punt ieœor marbut mat-30 anniversarju huwa r-restawr tal-Monument li kien
When I was YOUNG, I wanted my parents to leave me alone. When I am OLD, I am worried about being left alone.
When I was YOUNG, I HATED being ADVISED. When I am OLD, there is NO ONE around to TALK or ADVISE.
When I was YOUNG, I ADMIRED BEAUTIFUL THINGS. When I am OLD, I see BEAUTY in THINGS around ME.
When I was YOUNG, I felt I was ETERNAL. When I am OLD, I know SOON it will be MY TURN.
æie mogœti lilna mill-Gvern fl-2011 biex jinawgura l-Konferenza talInternational Council of Nurses f’pajjiÿna fejn æew iÿuruna qrib l-4000 nurse mid-dinja kollha. Wara 14-il sena dan il-Monument gœandu bÿonn dawra tajba. Jekk jista’ jiæi rranæat tajjeb, jekk le nagœmlu wieœed ædid li jkollu l-istess tema. Dan il-Monument jinsab il-Furjana fil-ænien li jmiss ma’ ex-sptar Boffa, inti u tiela’ t-telgœa li twasslek gœall-Beræa ta’ Kastilja.
Qegœdin nippreparaw bis-sœiœ gœallKonferenza Edukattiva tal-European Midwives Association li ser norganizzaw aœna fil-lukanda Double Tree by Hilton f’Ottubru. Din il-konferenza fiha œafna xogœol u preparamenti.
Qed nistennew madwar 400 Midwife mill-Ewropa kollha. Ÿgur li ser tkun esperjenza ta’ darba gœall-Midwives Maltin li gœandhom jagœmlu minn kollox biex jattendu. Ser tkun fuq jumejn sœaœ. L-E.T Roberta Metsola diæà aççettat li tindirizza din il-konferenza. Nagœtu informazzjoni aktar ’il quddiem. Min irid jista’ jidœol fil-website tal-konferenza u jkollu l-informazzjoni kollha - https:// emaconference2025.com/conferencelocation-and-accommodation/mobile versiontoo-https://emaconference2025. com/
Gœal llum ser nieqaf hawn. Nieœu l-opportunità biex nawgura lilek u lil dawk qrib tiegœek, l-Gœid it-Tajjeb.
Colin Galea Segretarju Æenerali
When I was YOUNG, I CELEBRATED the MOMENTS. When I am OLD, I am CHERISHING MY MEMORIES.
When I was YOUNG, I WANTED to be a HEART - THROB. When I am OLD, I am WORRIED when will MY HEART STOP.
At EXTREME STAGES of OUR LIFE, WE WORRY but WE DON’T REALIZE, LIFE NEEDS to BE EXPERIENCED.
It DOESN’T MATTER whether YOUNG or OLD. LIFE needs to be lived and LIVED WITH LOVE & LOVED ONES.
You are surely one of these.*
ICN welcomes WHO and WEF focus on nursing but warns of effect of US withdrawal from WHO on nurse-led services
“Now is the time to put sustainable financing at the top of our global health agenda.”
Geneva, Switzerland; 14 February 2025 - Nursing was high on the agenda at this year’s World Health Organization Executive Board (WHO EB) sessions in Geneva, with key discussions on extending the Global Strategic Directions for Nursing and Midwifery as well as WHO’s “Workforce 2030” plan on human resources for health. However, the International Council of Nurses (ICN) warned that the withdrawal of the United States from WHO has already halted some nurseled services, including vaccination programmes and care for people with HIV/AIDS.
Echoing ICN’s statement in January, Dr Pamela Cipriano, ICN’s President, said: “The US decision to withdraw from WHO means it is imperative that we accelerate our efforts to ensure sustainable and equitable global health financing. Without sustained investment in nursing and health, we will not be able to achieve our shared global goals to make sure that everyone, everywhere can access the care they need”.
Throughout the WHO EB meetings, ICN made interventions, followed the debates and participated in side meetings. Speaking at the closure, ICN Chief Executive Officer Howard Catton said that while important progress was made in recognizing the need to strengthen the nursing workforce, President Trump’s executive order to leave WHO weighed heavily on the week’s proceedings as member states began to prioritize their budgets and finances. Additional US action to stop other crucial development aid funding through the dismantling of USAID has also compounded the vulnerability of thousands of people who rely on programmes that provide basic humanitarian and health care.
Our concern is that it will make it even more difficult to reach the Sustainable Development Goals and Universal Health Coverage.”
ICN intervened on critical topics at the WHO EB including Universal Health Coverage, climate change, mental health issues, the health care workforce and WHO’s Nursing and Midwifery Strategy. ICN’s statements highlighted the central role of nurses in all of these issues and called on WHO Member States to urgently address workforce shortages and strengthen nurse retention, education, leadership and practice to build resilient health systems worldwide.
To achieve our universal health coverage goals, we must ensure that health care is both accessible and affordable.
solutions to many of them, but only if the profession has the investment it needs to expand and meet growing global health care needs. In light of the US decision, ICN’s work to advocate for prioritizing nurses and health is more important than ever.”
Investment in health was also a central topic at the recent World Economic Forum meeting in Davos, Switzerland. ICN has supported the WEF’s work on health care, including as part of the Global Future Council on the Future of the Care Economy, and closely monitored the meetings, where several sessions highlighted the need for equitable and sustainable health financing. Key topics included debt relief for low- and middle-income countries, funding for prevention and innovation, investing in women’s health, and improving international financing flows to address the health impacts of climate change.
Decisions made at the WHO EB meeting will now go to the World Health Assembly in May to be ratified before they can be acted on. A key focus will be extending the Global Strategic Directions for Nursing and Midwifery, which will be informed by the next State of the World’s Nursing report, due to be published in May.
Dr Cipriano said: “Several WEF meetings drew attention to a global crisis in health financing that is depriving billions of care. To achieve our universal health coverage goals, we must ensure that health care is both accessible and affordable. Currently, out-of-pocket medical costs are pushing billions into poverty and nurses are seeing patients forced to choose between basic needs and lifesaving care while they themselves work in understaffed, under-resourced facilities.
Mr Catton said: “Let’s not forget that there are many hundreds of nurses in countries delivering public health programmes for people with HIV and AIDS, which have just stopped because the money has stopped. Our thoughts are very much with those colleagues.
Mr Catton highlighted the significance of nursing throughout the proceedings: “It was really pleasing to hear Members States talk about the positive contributions nurses are making in their countries, from expanding health care to improving access and addressing non-communicable diseases, and to hear them agree on the need to do more to support nurses and other health care workers.
‘This recognition must now spark real change. Currently, there are huge risks to global health; nursing can provide
‘Furthermore, many low- and middleincome countries are trapped in cycles of debt distress, where they are spending more on servicing their debts than on services like health and education. We will be watching closely as countries convene this summer for the Fourth International Conference on Financing for Development where restructuring of international financing and reducing crippling debt burdens are needed to open fiscal space for more investment in health and, ultimately, in nursing. Both the WHO Executive Board and WEF meetings show that now is the time to put sustainable financing at the top of our global health agenda.”
A pastoral approach through ten powerful names of God (5)
Another name of God which helps us understand through and through God’s incredible healing nature is surely that of (Yahwe Rapha). This term means the “Healer, the Lord who heals you”.
When one thinks a bit that the verb (rapha) in Hebrew means becoming fresh, is completely healed, heal, healed, healing, heals, purified, reappeared, repaired and take care, one comes to the conclusion that God’s healing in the bible is not a one time event. God’s healing is ongoing! It essentially involves a process of healing. Every healing event is part of the great and final healing.
The biblical image of God as healer is so rich and abundant. It is helpful to pinpoint the main points which open us for the healing power of God’s Word. In biblical hebrew three concepts that can aid us comprehend God’s healing are (hesed), lovingkindness; grace (hen); and truth (emet). To begin with, Loving-kindness, (hesed) is frequently referred to God in the Bible. God’s loving-kindness in the Bible is employed as mercy, compassion and faithful love. This kind of healing is identified within the entire Hebrew Scriptures. Hence, this sort of healing reaches its climax in the person of Jesus. In fact, it is Jesus who is the complete articulation of the Father’s lovingkindness (hesed) for humanity. What sounds interesting is the fact that when one takes time to read the Bible one can easily notice that the words mercy, compassion and faithful come up very
often in the Biblical text as well as they are linked with God himself.
Grace and favour (hen in Hebrew) refer to gifts given, but more particularly, to the manner in which God acts. It signifies an infinitely good and almighty God who lovingly condescends to reach us, humans, much on the same lines as a parent would bend down to support a needy child. God generously reaches out to transform hearts, to raise up all who are fallen and desperately need assistance, giving protection in the shadow of the divine wings. God’s grace and favour start and fulfil every good human thought, desire and action we go through in our lives. The fullness of the Father’s hen (grace/favour) has been given to us through Christ. It is really interesting that when we read the Bible we can easily notice how regularly God is depicted as gracious, showing favour, protecting and sheltering the poor and those in need.
Truth (emet in Hebrew) conveys the Hebrew understanding that God founded creation in agreement with divine laws that are immutable and true. The truth of God’s word in the Hebrew Scriptures is wholly made manifest in Jesus. Through him, with him, and in him, we have unwavering hope in the truth of God’s promises that accompany us to the totality of life. As we read the Bible let us notice how dependence on the truth of God’s care and promises is revealed to us.
As a merciful Father God acts in transgressions towards us. The more
human rationality suggests that He should isolate himself from sinful humanity the more He gets closer to it, animated of course by what Pope Francis describes as closeness, compassion, tenderness. In his Angelus address of Sunday 14 February 2021, the Holy Father explains this powerful dynamic of God’s healing through Jesus when he beautifully presents the encounter between Jesus and a sick man with leprosy, an account we find in Mk 1:40-45.
The first transgression is that of the leper: despite the prescriptions of the Law, he comes out of his isolation and goes to Jesus. His illness was considered a divine punishment, but, in Jesus, he is able to see another aspect of God: not the God who punishes, but the Father of compassion and love who frees us from sin and never excludes us from his mercy. Thus, that man can emerge from his isolation because in Jesus he finds God who shares his pain. Jesus’ behaviour attracts him, pushes him to come out of isolation and entrust Him with his painful story. And allow me a thought here for the many good priest confessors who have this behaviour of attracting people, and many people who feel that they are nothing, who feel they are “flat on the ground” because of their sins... But with tenderness, with compassion... Good confessors who do not have a whip in their hands, but just welcome, listen and say that God is good and that God always forgives, that God does not get tired of forgiving.
continued on page 19
The World’s biggest quango
NHS England - will be abolished in a bid to cut red tape and “free up” cash for front line services, Sir Keir Starmer has announced
Up to 10,000 jobs will be axed, with plans in place to reduce the overall workforce across the agency and the Department for Health by 50 per cent.
Sir Keir Starmer said he can’t explain to the British people why they should spend money on ‘two layers of bureaucracy.
The PM said the move will put the NHS “back at the heart of Government where it belongs”. Health Secretary Wes Streeting added it will result in “hundreds of millions of pounds in savings”.
His comments came as he delivered a speech in Yorkshire on reshaping the “flabby” state and slashing the cost of bureaucracy. NHS England is the world’s biggest quangoan unelected body in charge of managing England’s health service.
Set up in 2013, it controls a whopping £200billion-a-year budget, overseeing hospitals, GPs and healthcare across the country.
What is NHS England?
UNDER the Tories, the NHS underwent the biggest shake-up since its inception in 1948. David Cameron’s Health Secretary Andrew Lansley delegated the running of the health service to an arms-length body called NHS England in 2013.
The idea was to take the NHS out of politics and let officials oversee the dozens of Trusts around the country.
But it was hugely controversialcreating more bloat and bureaucracy throughout the system. And every year the NHS would come begging ministers for more money, leading to accusations that without ministerial involvement it has become a “bottomless pit”.
Unveiling the move, the PM said: “In Government there was a clear moment when the Tories crossed the Rubiconit was early, and it was decisive, and it sent a signal across Whitehall that was never undone.
“So today I’m going to reverse it because I don’t see why decisions about £200billion of taxpayer money on something as fundamental to our security as the NHS should be taken by an arms-length body, NHS England.
“And I can’t in all honesty explain to the British people why they should spend their money on two layers of bureaucracy.
“That money could and should be spent on nurses, doctors, GP appointments.
“So today I can announce we’re going to cut bureaucracy across the state... I’m bringing management of the NHS back under democratic control by abolishing the arms-length body NHS England.
“That will put the NHS at the heart of government, where it belongs.”
In the Commons, Mr Streeting blasted the NHS for delivering “worse care for patients” but being “more expensive than ever”. The Health Secretary said the budget for NHS England’s 15,000 staff and admin alone “has soared to £2billion”. Mr Streeting hit out at being “left with two large organisations doing the same roles with an enormous amount of duplication”.
Answering a question from a cancer patient on how the decision would improve NHS services, Sir Keir said: “Amongst the reasons we are abolishing it is because of the duplication. “So, if you can believe it, we’ve got a communications team in NHS England, we’ve got a communications team in the health department of government.
“We’ve got a strategy team in NHS England, a strategy team in the government department. “We are duplicating things that could be done once. “If we strip that out, which is what we are doing today, that then allows us to free up that money to put it where it needs to be, which is the front line.”
The move comes amid growing pressure on the Government to tackle spiralling waiting times, improve patient satisfaction, and restore public
continued on page 38
Graffiti Storiçi f’Lazzarett
L-Ewwel Parti
Kitba ta’ Joe Camilleri, C.N.
Din is-sensiela ta’ artikli fi tlett partijiet se titratta suææett interessanti dwar il-graffiti storiçi. Imma gœaliex gœaÿilt dan is-suææett dwar il-graffiti, propju mal-bini ta’ Lazzarett? Gœaliex wieœed millpassatempi tiegœi huwa Manoel Island fl-intier tiegœu. Mhux biss gœax gœandi xi ftit nostalæija lejn din il-gÿira, peress li ta’ tifel millGÿira stess kont nimraœ fiha (u gœadni) bœallikieku kienet speçi ta’ playground tiegœi personali, imma wkoll gœaliex jinteressani ferm kif kienu jqattgœu il-œin il-pazjenti, il-vjaææaturi u s-suldati æewwa Lazzarett u l-Forti Manoel fl-eqqel tal-imxiji waqt xi kwarantina u anke fi ÿminijiet oœra.
Qabel nitkellmu fuq il-pazjenti u l-vizitaturi u dak kollu li thaÿÿes minnhom, tajjeb li f’din l-ewwel parti nitkellmu x’kien u x’gœad baqa’ fuq il-gÿira ta’ Manoel (gœal Manoel de Vilhena), gœalxiex serviet u gœaliex kienet importanti. F’partijiet oœra se nitkellmu min kienu dawk li ÿaruha (kultant bilforza tal-liæijiet tal-kwarantina) u aktar tard nittrattaw il-graffiti nfushom li jinsabu f’Lazzarett, li saru f’medda ta’ 364 sena. Se nanalizzaw gœalfejn setgœu saru, gœalfejn huma importanti
Pjanta tal-Lazzarett tal-1916, qabel il-bumbardamenti tat-Tieni Gwerra li tinsab f’ https://arkivji.org.mt/share/Plans/PDM60072
Fuq Manoel Island jew kif kienet magœrufa l-Isolotto jew il-Gÿira tal-Isqof kien inbena l-ewwel Lazzarett fis-sena 1592 minœabba l-ewwel imxija talpesta u l-kolera li seœœew f’dik il-œabta. Il-bini oriæinali kien tal-injam li nbena’ mill-Ordni ta’ San Æwann, u li filfatt jista’ jkun li kien l-ewwel bini li nbena’ fuq il-gÿira, kien twaqqa’ malajr wara li
nstabu pedamenti maqtugœn filblat, illum gœadhom jidhru fl-ilma, ta’ possibbilment parti minn kumpless ta’ struttura Rumana jew struttura assoçjata ma’ attivitá marittima. Il-bini li hemm illum beda jinbena xi œamsin sena wara (1643) mill-Gran Mastru Fra’ Jean-Paul de Lascaris-Castellar, flimkien ma çimiterju fejn wara nbniet kappella funerarja ta’ San Æoræ.
Gœidna jista’ jkun gœaliex fuq Manoel Island xi esperti jaœsbu li
L-aktar parti antika jgœidulha Il-Palazz jew Palazzo Vecchio li fuq kull naœa tagœha nbnew strutturi kbar u arjuÿi. Ilkumpless inbena fuq sistemi ta’ mœazen kbar enormi fil-pjan terran u sensiela ta’ swali/kmamar fejn wieœed jista’ jgœix jew jaœdem fihom. L-imœazen tant huma kbar li skont rapport ta’ John Howard tal-1785, Lazzarett seta’ jilqa’ fih merkanzija ta’ sitta jew seba’ galeri, xwieni jew vapuri biex jibqgœu segregati.
Interessanti wkoll huwa l-istil talarkitettura ta’ Lazzarett li tixxiebaœ immens ma’ dik ta’ Ploce Lazaretti ta’ Dubrovnik, il-Kroazja. Il-Gran Mastri Cotoner u Carafa komplew jirranæaw f’Lazzarett sakemm inbniet ukoll il-Forti Manoel mill-Gran Mastru de Vilhena fis-seklu 18 fejn, anke fih kienet issir il-kwarantina gœas-suspettati morda
Il-Bini
ikompli minn paæna 12
bil-pesta. Fl-1834 ÿdiedu xi façilitajiet t’akkomodazzjoni f’Lazzarett u ntefqu mat-£800. Fl-1860 il-parti tal-lvant ta’ Lazzarett æiet okkupata bœala l-married quarters tal-garrison waqt li fl-1891 l-ewwel sular serva ta’ skola gœat-tfal tal-familji li kienu jghixu hemm, waqt li is-sulari t’isfel servew ta’ barracks gœal aktar minn 200 suldat.
Fl-1870 sar titjib sostanzjali fil-binja hekk kif telqet l-Army u saru xogœolijiet minn Dr. Ghio, it-Tabib tal-Pulizija. Fl-1940 ilLazzaret (is-Civil Infectious Hospital) ma baqax iservi l-iskop tiegœu gœaliex ilBritish Admiralty uÿat il-post bœala baÿi tas-sottomarin u gœalhekk mar l-Imtarfa. Per eÿempju fil-15 ta’ Novembru 1942 sottomarin daœal æewwa Manoel Island u ittrasferixxa 25 ferut (7 Taljani u 18 eks priæunieri tal-gwerra Brittaniçi) æewwa l-isptar militari No.45 li kien sptar æenerali æewwa s-Sandhurst Barrack Block ta’ St Patricks f’Pembroke.
Il-Lazzarett waqt il-gwerra kien laqqatha æmielu fejn id-disinfection station, ringiela swali tal-kwarantina u œafna mill-imœaÿen kienu jew inqerdu jew sofrew œafna œsarat (u œadd ma rranæa xejn). L-aktar li sofra dan il-bini kien fit-13, 15 u s-27 ta’ Frar 1942 fejn œafna bombi waqgœu fuq il-Forti Manoel u l-HMS Talbolt (il-baÿi tassottomarini), fost postijiet oœra. Imma fl-1946, minœabba l-imxija tal-æidri, Lazzarett kellu jeræa’ jopera bœala sptar, imbagœad reæa’ ntuÿa fl-1949 u baqa’ hekk sakemm telqu r-Royal Navy minn Malta fis-sebgœinijiet.
Il-Lazzaretti fl-Ewropa u l-kumplament kienu kemm f’forma ta’ galeri u vapuri bl-ankri fil-port, fuq gÿejjer isolati u anke bini. L-FHMS Dreadnought
L-inçiÿjoni ‘A view of the City of Malta on the side of the Lazarette or Pest House, where Ships perform Quarantine area’ ta’ M-A. Benoist, c.1770 u J.Goupy c.1725. (Ritratt, https://commons.wikimedia.org/)
pereÿempju, li kien tar-Royal Navy kien ikkommissjonat fl-1827 bœala lazaretto fuq il-baœar stess (quarantine ship) æewwa Milford on Sea. F’pajjiÿi oœra ssib Lazzaretti oœra bœall-Lazzaretto Vecchio ta’ Venezja, id-Dubrovnic Lazaret, il-Hospital Island æewwa Passamaquoddy Bay f’Maine, Quail Island f’New Zealand u Spinalonga Island fi Kreta. Oriæinarjament il-post ma nbeniex bœala sptar ta’ isolament jew gœall-pesta imma bœala Maritime Quarantine Station gœas-sekluÿjoni permezz ta’ kwarantina ta’ passiææieri normalment gœonja, dawk li qed jakkumpanjawhom u l-oææetti mobbli tagœhom. Fil-Lazzarett u l-Forti ta’ Malta kienu ikollok ukoll pazjenti morda kultant b’deni qawwi u allura serva ta’ sptar u kwartieri fejn il-vjaææaturi, permezz ta’ xwieni, galeri u vapuri li zaru ‘l Malta kellhom bilfors jagœmlu
ikomplu gœal triqthom bil-baœar hekk kif ikollhom il-‘clean bill of health’ jew ‘patenta’.
Huwa dokumentat li l-ewwel kaÿi talimxija f’Malta li seœœet fl-1865 bdiet fost il-familji tas-suldati miÿÿewæin flisptar tal-pesta stess u mxiet fost dawk ittrasferiti fil-counterguard ta’ San Salvatore. Ftit wara it-29th Regiment wasal Malta u tpoææew fil-Forti Ricasoli u fil-kamp ta’ Pembroke.
F‘The Diary of Henry Teonge 16751679’, chaplain abbord l-HMS Assistance, meta iddeskriva l-isptar talkwarantina qal: “The Lazaretta (a place on purpose for such as are sick of the plague or other pestilential diseases; which in regard of the heate of that country doth often rage there;) lyes closse under their outermost wall, and
F’ittra li bagœat Robert Grieves, Supretendent tal-Kwarantina f’Malta fil11 ta’ Mejju 1819, kiteb li “In reference to my report under date of the 9th ult. relative to the bombard “La Trinita” which arrived in this port on 28th March last from Susa, infected with plague, I have the honour to inform you that the means resorted to for the purpose of overcoming that contagion in the lazaretto, have been crowned with complete and happy success”.
Peró fuq il-Gÿira ta’ Manoel mhux imxiji biss kien hemm. Fl-1912 kien hemm xejn inqas minn 418 pazjent jieœdu t-trattament gœall-iskabbja, kundizzjoni fejn ikun hemm œakk kbir minœabba l-baqq fejn din kienet tittieœed minn persuna gœall-oœra.
Skont ir-regolamenti tal-kwarantina (ilVilhena’s Code of Laws), ÿewæ dgœajjes tal-kwarantina kienu jkunu gœassa bil-lejl u bi nhar mal-galeri ankrati f’Marsamxett. It-tgœabija u l-iskjavi kienu jitniÿÿlu fl-Imœaÿen, u ssir id-disinfezzjoni jew il- fumigazzjoni. Il-passiææieri kienu jiæu iddisinfettati darbtejn flimkien mattgœabija, l-ewwel taœt is-superviÿjoni talgwardjan u t-tieni taœt is-suprviÿjoni talPurificatore. L-ittri tal-passiææieri kienu wkoll jiæu iffumugati jew ‘ippurfumati’. Il-bhejjem, l-aktar il-barrin kienu jittieœdu fil-bovile jew it-tinda tal-baqar gœallkwarantina wkoll. Inçidentalment dan ilbini seta’ serva wkoll bœala çentru gœaddistribuzzjoni tal-birra xi ÿmien wara.
Biex nieœdu idea ta’ kemm-il darba kellna mxija tal-pesta bubonika f’Malta
tajjeb insemmu dawn is-snin li fih Lazzarett kien effettiv biex jikkontrolla l-marda. Dawn kienu bejn l-1592 u l-1593, fl-1623, fl-1655, bejn l-1675 u l-1676 (l-aktar pesta li qatlet nies f’Malta), bejn l-1813 u l-1814, fl-1917, bejn l-1936 u l-1937. Ma dawn irridu nÿidu l-epidemija tal-kolera tal-1865 fejn din ta’ l-aœœar qatlet mhux inqas minn 1,731 persuna f’Malta u Gœawdex. Biss dawn id-dati ma jirriflettux bilfors meta æie utilizzat il-Lazzarett gœaliex bejniet dawn is-snin il-kumpless laqa’ fih morda u visitaturi oœra bil-bosta. Per eÿempju waqt il-gwerra tal-Krimea (Ottubru 1853 sa Frar 1856) Lazzarett serva ta’ sptar militari gœas-suldati Ingliÿi, Françiÿi u Taljani, possibilment morda bid-disenterija. Lazzarett u l-Isptar talPesta kien lest jilqa’ sa 1000 raæel.
Xi œadd fil-Marine Police kien œaÿÿes “CORANTENA 25/10/99 A.*.*. MARINE POLICE W. 92”. Dan ifisser li min œaÿÿes il-graffiti kien Marine Police f’Malta u jidher li laqqat il-kwarantina ta’ madwar 40 gurnata, jekk mhux aktar. Dawn ilMarine Police kienu jkunu stazzjonati eÿatt faççata ta’ Lazzarett max-xatt ta’ Marsamxett f’Valletta. Skont l-annu li gœandna (1899) jidher li dik il-œabta kien hemm l-imxija tal-Enteric Fever jew il-Malta Fever, li dak iÿ-ÿmien kienet predominanti fost is-Servizzi f’Malta fejn kienu jdumu sa anke 90 æurnata æo sptar. Il-Bruçellosi kienet marda endemika Maltija u æieli kienet ukoll epidemija, bœat-tifojde. Fl-1899 jidher li kien hemm l-imxija tal-pesta wkoll, gœalhekk m’aœniex se nkunu nafu bilpreçiÿ dan il-pulizjott x’laqqat jew gœal xieh kien hemm.
Galea, Joseph (1966), The Quarantine Service and the Lazzaretto of Malta, University of Malta
Graffiti
ikompli f’œaræa oœra
The Malta Healthcare, Wellness, Beauty and Best Spa Awards
On 7th March Malta Business Review through Dynamic Events organised the Malta Healthcare, Wellness, Beauty and Best Spa Awards. In this Gala night several nominees from diverse sectors in the private healthcare, beauty and wellness setting were nominated for their work, contribution and innovation in their respective categories.
Physiocare clinic which is a multidisciplinary team setting consisting of physiotherapists, a nutritionist, a health psychologist and fitness trainers, was nominated in two categories and won the best healthcare provider of the year and best sports injury recovery, prevention, rehabilitation and readaptation Physiotherapy Award. This clinic is led by Pauline Fenech a physiotherapist by profession who has launched this set up 15 years ago in a home based – casa bottega model. Pauline is the MUMN Chairperson for the Physiotherapists.
As described by the owner herself setting such a home business in physiotherapy and exercise wasn’t easy especially in a highly competitive environment were large companies and business people both medical or not have ventured into as part of their business portfolio.
The struggle to get permits, approvals, paper work, the lack of help anywhere in the system and the bureaucracy which is faced by small business owners as compared to large establishments is a true reality. She kept describing that all the investment done through the years was all self funded and the clinic wasn’t found ready converted & equipped but set up bit by bit through considerable amount of sacrifices, hard work and disappointments whilst still giving alot of energy, input into the profession within the public service.
Due to personal family commitments, Pauline described how setting up this venture was her only remaining option to remain within the profession, whilst earning a living. Pauline went on the describe how the mindset from doing private physiotherapy work as a side hustle for more than 20 years to a more sustainable and competitive set up was also a struggle.
The expenses, running costs, the administrative work plus to keep up to date with new research and ever evolving technologies which develop every couple of years is a stream
of challenges in itself. However the passion to see clients and patients improve in their wellbeing and targets, is what kept her going, and this is the message she portrays with her colleagues: Providing care to patients and clients through honest communication, whilst educating them how to lead an independent health life from all aspects of physical and mental well being in case of patients and for athletes to return back in the game and back to performance.
Well done, Pauline, keep it up.
A pastoral approach through ten powerful names of God (5) continued from page 9
I ask all of you here today in the Square to give a round of applause for these merciful confessors.
The second transgression is that of Jesus: even though the Law prohibited touching lepers, He is moved, extends His hand and touches him, to heal him. Someone would have said: He sinned. He did something the law prohibits. He is a transgressor. It is true: He is a transgressor. He does not limit Himself to words, but touches him. To touch with love means to establish a relationship, to enter into communion, to become involved in the life of another person even to the point of sharing their wounds. With that gesture, Jesus reveals that God, who is not indifferent, does not keep himself at a “safe distance”. Rather, he draws near out of compassion and touches
our life to heal it with tenderness. It is God’s style: closeness, compassion and tenderness. God’s transgression. He is a great transgressor in this sense.
The pastoral approach of God’s name (Yahwe Rapha) makes me ask the following questions: (1) Do I reflect in my sacramental presence and pastoral action a God who is the Father of compassion and love who frees us from sin and never excludes us from his mercy? (2) Do I present a God who in Jesus shares the pain of the people I serve? (3) Do I present a God who, with his characteristic tenderness and compassion, always forgives? How am I letting a God who does not get tired of forgiving emerge from the way I carry out pastoral care? Or do I tragically convey a God who whips those who approach him? (4)
Am I really a welcoming, listening and compassionate presence for those who feel afflicted by their past mistakes? (5) In what sense is God moved, extending His hand and touching others to heal them through me? (6) Am I lowering down my innate resistance to let the Lord establish relationships of communion to become involved in the life of other people to the point of sharing their wounds? (6) Am I letting God be a great transgressor through me in this sense?
What an overarching shades of meaning does the phrase (Yahwe Rapha), the Lord who heals you, have for the pastoral carer who just simply wants to be himself touched by God so that he can then let God touch others through him!
Fr Mario Attard OFM Cap
ITU Nurses sending their Christmas greetings
MUMN Council decided to facilitate a Museum at the union’s premises. Construction work is on the way. We are accepting donations to be exhibited
The Institute for Health Care Professionals continued to organise the monthly seminars at the Conference Hall at the MUMN premises
MIU4 placed second in the nomination award ‘Premju Team tas-Sena’ organised by the Awards Nazzjonali Haddiem tas-Sena.
Congratulations to the Social Workers Department at the National Mental Health Services who won the award ‘Social Work Services of The Year 2024’ organised by the Maltese Association of Social Workers.
The Florence Nightingale Benevolent Fund organised their annual ceremony to celebrate those MUMN Members who retired from work after a long career taking care of their patients and relatives. A Mass was also celebrated by Fr. Ivan who is also a nurse. This ceremony was a very special one organised at the Training Centre.
Marc Galdes - Times of Malta
An asylum seeker nursing student honours his mother’s memory after fleeing Sudan at 12 and making it to Malta at 16 following an epic and dangerous journey across the desert, landmines and sea.
‘I saw myself as a stranger’
Loss of a close friend
“It was a bit challenging to integrate into society”
The Importance of Co-Production in Mental Health: Integrating Peer Expertise for Enhanced Recovery
In recent years, the mental health sector has increasingly recognized the value of co-production—a collaborative approach that involves service users, professionals, and other stakeholders in the design, delivery, and evaluation of mental health services. Central to this approach is the inclusion of peer experts—individuals with lived experience of mental health challenges—whose insights and contributions are invaluable in creating effective and responsive services.
This short article explores the significance of co-production in mental health, examines research on the utilization of peer experts, discusses the role of Recovery and Well-being Academies, and considers the application of these concepts within the Maltese context. It delves into the CHIME model’s relevance to co-production and underscores the importance of training peer experts to maximize their impact.
Introduction Understanding Co-Production in Mental Health
Co-production in mental health refers to the active partnership between service users and professionals in all aspects of mental health care. This collaborative model challenges traditional hierarchical structures by valuing the experiential knowledge of individuals who have navigated mental health issues. Such partnerships aim to create services that are more attuned to the needs and preferences of users, thereby enhancing their effectiveness and accessibility (Slay & Stephens, 2013).
The Role of Peer Experts in Co-Production
Peer experts, (sometimes also referred as peer support workers) are individuals who draw upon their personal experiences with mental health challenges to support others facing similar issues. Their involvement in co-production brings several benefits:
1. Enhanced Empathy and Trust: Peer experts can establish rapport and trust with service users through shared experiences, fostering a sense
of understanding and acceptance that is crucial for effective support.
2. Empowerment and Hope: By exemplifying recovery, peer experts serve as tangible proof that improvement is possible, instilling hope and motivation in service users.
3. Bridging Gaps in Services: Peer experts often act as intermediaries between service users and professionals, facilitating communication and ensuring that services are responsive to user needs.
Research highlights these benefits. A scoping review by Skogens et al. (2023) identified that peer workers often function as providers of peer support, offering practical, emotional, and social assistance based on their lived experiences. However, the study also noted that peer workers are rarely engaged as partners in co-creation, indicating an area for potential growth in their roles within mental health services.
The CHIME Model and Its Relation to Co-Production
The CHIME model, developed by Leamy et al. (2011), outlines five key components essential to personal recovery in mental health:
1. Connectedness: Building positive relationships and social networks.
2. Hope and Optimism: Fostering belief in the possibility of recovery.
3. Identity: Developing a positive sense of self.
4. Meaning in Life: Finding purpose and meaning beyond mental health challenges.
5. Empowerment: Gaining control over one’s life and decisions.
Co-production aligns seamlessly with the CHIME model. By involving service users in the creation and delivery of services, co-production fosters connectedness and empowerment. Peer experts, sharing their recovery journeys, instill hope and help others reconstruct their identities and find meaning. This collaborative approach ensures that services are not only designed for users but with them,
embodying the principles of the CHIME framework (Repper & Perkins, 2012).
Recovery and Well-being Academies
Recovery and Well-being Academies are educational initiatives designed to support individuals in their mental health recovery journey. These academies offer courses and workshops that equip participants with knowledge and skills to manage their mental health effectively. Key features include:
• Collaborative Curriculum Development: Courses are often co-designed by professionals and individuals with lived experience, ensuring that content is relevant and practical.
• Focus on Self-Management: Emphasis is placed on empowering individuals to take control of their recovery through education and skill development.
• Community Building: Academies provide a supportive environment where participants can share experiences and build networks, reducing isolation.
The co-production model is fundamental to the success of these academies. By involving peer experts in the development and delivery of educational content, academies ensure that the support offered is grounded in real-world experiences, making it more relatable and effective for participants (McGregor et al., 2022).
Co-Production and Peer Expertise in Malta
In Malta, mental health services have begun to embrace the principles of coproduction and peer involvement. The Mental Health Strategy for Malta 20202030 emphasizes the importance of service user involvement in the design and delivery of mental health services (Ministry for Health, 2020).
This strategic document highlights the need for a shift towards a more inclusive approach, recognizing that the insights of those with lived experience are crucial for the development of effective mental health care systems.
A significant recent initiative in Malta is the Malta Recovery and Well-being Academy, established as a 2023 budget measure in conjunction with the EU-funded Joint Action Implemental project. The Malta Recovery and Wellbeing Academy integrates a multidisciplinary team that includes professionals from psychiatry, psychiatric nursing, and occupational therapy, alongside individuals with lived experience of mental health challenges.
of ensuring that peer experts receive adequate support and recognition.
The Malta Recovery and Well-being Academy is modelled after international “Recovery Colleges,” which emphasize education as a means to promote social connection, hope, identity, meaning, and empowerment. A defining feature of is its strong commitment to co-production: individuals with lived experience play a crucial role in curriculum development, course delivery, and quality assurance. Despite these efforts, challenges persist, including the voluntary nature of peer contributions, which is not in line with WHO recommendations advocating for paid peer roles in mental health services.
Initial efforts have focused on developing its vision, team structure, and course offerings. It has launched two evening courses aimed at accessibility for working individuals:
• The Five Ways to Well-beingbased on international evidence promoting mental well-being.
• CHIME to Recovery - specifically designed for adults in recovery, directly applying the CHIME framework.
These courses were supported by trained staff from the Paola Rehab Centre, who assisted in recruitment, communication, and logistical arrangements.
Malta has also benefited from a collaborative initiative with RAMH - North Ayrshire Wellbeing & Recovery College in Scotland that specialize in peer support and coproduction. This partnership facilitated knowledge exchange and best practice implementation, allowing Malta to
refine its approach to integrating peer experts in mental health services. Through such collaborations, Malta continues to strengthen its commitment to embedding co-production in its mental health landscape.
The Importance of Training Peer Experts
While the integration of peer experts into mental health services offers numerous benefits, their effectiveness largely depends on the quality of training they receive. Comprehensive training equips peer experts with the necessary skills to support others effectively and navigate the complexities of mental health care environments. Key aspects of training include:
• Understanding Professional Boundaries: Training helps peer experts maintain appropriate boundaries, ensuring that their support remains professional and effective.
• Developing Communication Skills: Effective communication is crucial for peer support. Training programs focus on active listening, empathy, and conveying information clearly.
• Coping Strategies and Self-Care: Given the potential emotional toll of supporting others, training emphasizes the importance of self-care and provides strategies to manage stress and prevent burnout.
A study by Moll et al. (2021) emphasized the necessity of structured training for peer workers, covering ethical considerations, practical support skills, and role clarity. This is particularly relevant in Malta, where initiatives like Recovery and Wellbeing Academy highlight the importance
Co-production in mental health, particularly through the integration of peer experts, represents a transformative approach to service design and delivery. By valuing and incorporating the lived experiences of individuals who have navigated mental health challenges, services become more empathetic, effective, and responsive to the needs of users. Through collaborations with international partners and the establishment of initiatives like Malta Recovery and Wellbeing Academy Malta is making significant strides toward a more inclusive and co-produced mental health system.
Note: If you or someone you know could benefit from participating in future courses organized by the Malta Recovery and Wellbeing Academy, please feel free to reach out via email at recovery.academy@gov.mt.
References
Leamy, M., Bird, V., Le Boutillier, C., Williams, J., & Slade, M. (2011). Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. The British Journal of Psychiatry, 199(6), 445-452. McGregor, J., Repper, J., & Brown, H. (2022). The role of peer support in mental health recovery. Mental Health Practice, 25(4), 22-28.
Ministry for Health. (2020). Building Resilience, Transforming Services: A Mental Health Strategy for Malta 20202030. Malta.
Moll, S., et al. (2021). Training mental health peer support workers: A consensus study. Psychiatric Services, 72(5), 574-582.
Repper, J., & Perkins, R. (2012). Social inclusion and recovery: A model for mental health practice. Baillière Tindall.
Kevin Gafà Maltese Association of Psychiatric Nurses (MAPN) Psychiatric Mental Helath Nurse / Practice Nurse – National Mental Health Services
by Marisa Galea Vella
Ethical Issues in Breastfeeding
The World Health Organization and the United Nation’s Children Fund have unremittingly declared that breastfeeding is in fact a global health priority, emphasizing that all women should be empowered and supported to breastfeed their baby exclusively for the first six months of life. The commitment and drive from these world-renowned organisations have put breastfeeding on the agenda for decades within countless health organisations and entities with the main aim of ensuring children’s right to adequate nutrition. This right is largely uncontested and hence related ethical issues that may emerge are left unaddressed if not unnoticed too.
The evidence and literature have maintained that the early initiation and exclusive breastfeeding are effective interventions to reduce morbidity and mortality in children, where increased breastfeeding rates being an important public health target. Related interventions include encouraging breastfeeding immediately after birth, promoting skin-to-skin for all babies throughout the first few days of life, teaching parents to recognise early feeding cues, support the mother in identifying different breastfeeding positions, encourage the mother to adopt a relaxed approach to breastfeeding which may include relaxation techniques that can support this.
Breastfeeding is a contemporary public health issue where the effective implementation of effective interventions can improve global health. There are many contemporary public health topics and related interventions such as smoking cessation, weight management, screening and so on, which have been at length, with ethical guidance becoming increasingly available even though at times these can be contentious. Breastfeeding
however is not as widely discussed in this context and hence it is deemed relevant to give this important global health priority some attention here.
Subramani et al. (2024) carried out a scoping review to explore the current ethical considerations addressed in breastfeeding and lactation interventions. The scoping review considered twenty-six publications where the recurring ethical issues identified were normative assumptions of motherhood; maternal autonomy and informed choice; information disclosure, balancing risks and benefits and counselling practices; stigma and the social context; the ethics of health communication in breastfeeding campaigns; and the ethical acceptability of financial incentives in breastfeeding interventions.
It is evident that there is a broad element of ethical issues. Looking at maternal autonomy, it is vital that mother’s are making independent autonomous choices and these are not challenged against population health. The mother’s experiences emerging from her own narrative influenced by social, cultural economic contexts must be
appreciated and acknowledged. This is supported with a robust informed consent process that is developed over a period of time. Health professionals that teach mothers how to breastfeed and recommend supportive interventions need to ensure that their practice is effective and evidencebased to promote the best interests and outcomes for mother and baby.
Health communication that promotes breastfeeding need to adopt ethical frameworks particularly for breastfeeding interventions as noted by Subramani et al. (2024). They explain that this can be done by identifying and critically assessing ethical issues in the design and implementation processes. The ethical acceptability of financial incentives to promote breastfeeding. Several ethical considerations need to be made here. Financial incentives to promote behavioural change can lead to ethical concerns that include personal responsibility, shame, fairness, and nudging which affect the mother’s decision and possibly her autonomy.
Finally, a significant recurring issue found by Subramani et al. (2024) is children’s right to breastfeed, based on the significant importance of the child’s healthy development and the mother’s responsibility to her baby. This would include adopting appropriate breastfeeding practices to avoid harm.
Developing an awareness that ethical issues in breastfeeding and lactation interventions are present and that there is limited knowledge on the topic is crucial. The scoping review referred to here has effectively highlighted numerous issues related to the topic, but these do need to be explore further in varying contexts. Understanding women’s narrative in essential to achieve positive outcomes in breastfeeding.
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Nurse suffers ‘life-changing’ injuries after being stabbed with scissors at hospital
A nurse was stabbed at Royal Oldham Hospital’s A&E department
A nurse was left with life-changing injuries after being stabbed with a pair of scissors in hospital, it has emerged.
The woman, in her 50s, was left in critical condition after the attack at Royal Oldham Hospital at around 11:30pm on Saturday, Greater Manchester Police (GMP) said.
Initial reports said the attack was carried out with a sharp instrument that was not a knife. GMP later revealed the weapon was a pair of scissors.
A 37-year-old man was arrested at the scene on suspicion of attempted murder and remains in custody. Detectives are not looking for anyone else in connection to the incident.
Oldham district’s Detective Sergeant Craig Roters said that the police would continue to provide support to the victim’s colleagues and family throughout the investigation.
He added that the local community could expect an “increase in police presence” while they carry out enquires, adding: “they are also there to offer reassurance and answer any questions you may have.”
“We know that news of this nature will come as a shock, and if you have any concerns or anything you would like to share, please speak to them,” he said.
The Chief Nursing Officer at Northern Care Alliance NHS Foundation Trust, Heather Caudle, said: “We are
incredibly shocked and saddened by last night’s incident and our focus is on supporting the colleague involved and their family.”
“Our thoughts are also with colleagues and patients who were there at the time of the incident and for whom this has been distressing and frightening. We will continue to support Greater Manchester Police with their inquiries.”
She confirmed that all of Royal Oldham Hospital’s services would remain open. Health Secretary Wes Streeting shared a statement on X about the incident, as he said that “nurses are the backbone of the NHS”.
“My thoughts are with the nurse and her loved ones following this horrific attack at The Royal Oldham Hospital”, he wrote. “Nurses are the backbone of our NHS and should be able to care for patients without fear of violence. We’re
in touch with the Trust and will update further as we can.”
The Royal College of Nursing general secretary and chief executive, Professor Nicola Ranger, said: “This attack on a nurse is truly shocking and our thoughts are with the victim, her family and colleagues.”
“Nursing staff go to work to care for others and have every right to do so without fear of violence”, she said, before reiterating the duty of care that employers have to keep their staff safe. “Authorities must ensure those endangering healthcare professionals face the full force of the law,” she concluded.
Oldham West MP Jim McMahon posted on Facebook his shock at the “senseless attack”, extending his thoughts to the nurse and her family and friends: “We wish a full recovery.”
Royal Oldham Hospital remains open with all services working following an attack
Advancing Your Career in Public Health and Elderly Care Management with IDEA College
The healthcare sector is constantly evolving, demanding highly skilled professionals who can lead with confidence and compassion. Nurses, midwives, and other healthcare professionals play a vital role in ensuring the well-being of patients, making continuous education and professional development essential for career growth.
In recognition of this, IDEA College is offering two specialised postgraduate degrees designed to empower healthcare professionals: M.Sc. in Public Health and M.Sc. in Elderly Care Management. These programmes are tailored to equip students with the necessary skills to take on leadership roles, enhance patient care, and contribute to the advancement of the healthcare system. As a further incentive, Malta Union of Midwives and Nurses (MUMN) members are eligible for a 20% scholarship on these programmes, making it even more accessible to further one’s education.
M.SC. IN PUBLIC HEALTH
A Programme Designed for Future Public Health Leaders
Public health is at the forefront of ensuring communities are healthy, safe, and well-supported through evidence-based policies and strategic interventions. The M.Sc. in Public Health is designed for healthcare professionals looking to expand their expertise in epidemiology, healthcare policy, and disease prevention while gaining leadership skills to drive systemic change in public health systems.
KEY LEARNING OUTCOMES:
• Understand the principles of public health, epidemiology, and health promotion.
• Develop strategies for disease prevention and control at a population level.
• Gain expertise in healthcare policy, governance, and ethical considerations.
• Learn how to manage health crises, pandemics, and environmental health challenges.
• Strengthen leadership and decision-making skills to improve healthcare systems.
WHO SHOULD APPLY?
This programme is ideal for nurses, midwives, healthcare administrators, and public health professionals who want to influence healthcare policy, develop preventive health programmes, and contribute to improving healthcare at a community and national level. With a strong focus on data-driven solutions, graduates of this programme will be wellequipped to shape the future of public health.
Full course outline at: https://mt.ideaeducation. com/courses/master-of-science-in-publichealth/
M.SC. IN ELDERLY CARE MANAGEMENT
Meeting the Growing Demand for Elderly Care Specialists
Full course outline at: https://mt.ideaeducation. com/courses/m-sc-in-elderly-care-management/
WHY CHOOSE IDEA COLLEGE?
• Practical Learning Approach: Courses are designed with real-world applications in mind, combining theoretical knowledge with case studies, simulations, and industry insights.
• Flexible Study Options: Both programmes cater to working professionals, with parttime evening classes that allow students to balance work and study commitments.
With an aging population, the need for professionals specialised in elderly care is increasing rapidly. The M.Sc. in Elderly Care Management prepares healthcare workers to take on the challenges and opportunities of this growing sector, ensuring that elderly patients receive high-quality, compassionate care.
• Experienced Faculty: Learn from industry experts and academic professionals with extensive experience in public health and elderly care.
• Accredited Programmes: Both degrees are accredited at MQF Level 7, ensuring international recognition and quality education standards.
KEY LEARNING OUTCOMES:
KEY LEARNING OUTCOMES:
• Understand the complexities of gerontology, including age-related diseases and long-term care strategies.
• Develop leadership skills to manage elderly care facilities and community-based services.
• Learn ethical and policy considerations specific to elderly care.
• Implement evidence-based practices to enhance the quality of life for elderly patients.
• Gain insights into psychological and social aspects of aging to provide holistic care.
• 20% Scholarship for MUMN Members: To support professional development in the healthcare sector, members of the Malta Union of Midwives and Nurses are eligible for a 20% tuition fee reduction.
INVEST IN YOUR FUTURE
The healthcare sector is in need of skilled professionals who can lead, innovate, and provide exceptional patient care. Whether you are looking to take on a leadership role in public health or specialise in elderly care, IDEA College’s M.Sc. in Public Health and M.Sc. in Elderly Care Management provide the perfect opportunity to advance your career.
WHO SHOULD APPLY?
WHO SHOULD APPLY?
This programme is ideal for nurses, midwives, care home managers, and other healthcare professionals who wish to specialise in elderly care or take on leadership roles in long-term care facilities, community services, or policymaking bodies.
Don’t miss out on this opportunity to gain the skills and knowledge that will set you apart in the healthcare industry.
For more information, visit mt.ideaeducation. com or speak to your student recruitment advisor on WhatsApp at 2317 4632.
The Public Service Management Code (PSMC) serves as a cornerstone of governance in Malta, establishing clear standards, practices, and regulations to guide the operation of public service entities. It aims to ensure that public services are delivered consistently, ethically, and efficiently, while aligning with Malta’s legal and policy frameworks. This comprehensive guide provides directives on employment policies, workplace conduct, employee benefits, and performance standards, fostering a professional and accountable public service that meets the needs of its citizens.
The Public Service Management Code (PSMC) for Malta is available online, providing a comprehensive and accessible resource for public service employees, managers, and the public. By visiting the designated link (https:// publicservice.gov.mt/en/public-servicemanagement-code-page), users can explore the various sections and updates of the code, which governs operations, policies, and ethical standards within the public service. The PSMC is also constantly changing and update according to present needs.
The online version ensures ease of access, allowing users to view it conveniently from any device with an internet connection. It reflects the latest updates and amendments, ensuring that users stay informed about current procedure and policies. The structured layout of the PSMC enables quick navigation through its sections and chapters, making it easy to find information on recruitment, leave policies, workplace ethics, and more. As the official source hosted by the Maltese Public Service, it serves as a reliable reference for public service regulations and promotes awareness, accessibility, and compliance across all levels of government. The digitization of the PSMC underscores
the government’s commitment to transparency and efficiency, ensuring that essential regulatory information is readily available to all stakeholders.
The Public Service Management Code (PSMC) is supported by a range of detailed manuals that provide additional guidelines and procedures for specific areas of public service management in Malta. These manuals make access to and understanding of the PSMC easier, offering in-depth explanations and structured processes for various policies and operational aspects. The key manuals include:
• Manual on Resourcing Policies and Procedures:
Focuses on recruitment, appointments, advertisements of vacancies, progression, promotions, resourcing and others within the public service, ensuring transparency and fairness in staffing processes.
• Manual Regarding Headship and Assistant Director Positions in the Malta Public Service:
Provides detailed procedures for the renumeration, probation period, different appointments, duties and other roles within the public service.
• Manual on the Procedure and Computation of Salaries:
Explains and gives information on the procedure for salary payments, methods for calculating salaries including overtime, bonuses, ductions, addressing increments, allowances, and deductions in compliance with applicable policies.
• Manual of Allowances: Details the types of allowances available to public service employees, including eligibility criteria and application procedures.
• Manual on Special Leaves: Defines policies for special leave
entitlements, such as bereavement leave, study leave, and other exceptional circumstances.
• Manual on Work-Life Balance Measures:
Promotes initiatives for flexible work arrangements, parental leave, and other measures designed to support employees in balancing personal and professional responsibilities.
• Manual on Transport and Travel Policies and Procedures:
Outlines rules for official travel, transport allowances, and reimbursement procedures for travelrelated expenses.
• Manual on Social Security Contributions, Benefits, and Pensions:
Provides a comprehensive overview of social security obligations, entitlements, and the management of pension schemes for public service employees.
• Service Pensions Manual: Details policies and procedures related to the administration and computation of service pensions for eligible retirees.
• Manual on the Procedure of the Medical Board:
Describes the role, responsibilities, and processes of the Medical Board in assessing fitness for work, medical conditions, and related matters.
These manuals, designed to complement the PSMC, provide clarity and consistency in managing various facets of public service. They serve as practical tools for employees and administrators, ensuring a uniform approach to public service operations and compliance with established regulations.
William Grech Deputy General Secretary, MUMN
Dear MUMN Members, We have received this important position statement of a report on the Primary Health Care from the International Council of Nurses. We are going to publish a part of the position statement in every edition until we cover it all. Those who are interested to read the whole report please send us an email on union@mumn.org
MUMN Council
Position Statement
Primary health care
Primary health care (PHC) is essential for building resilient, sustainable health systems that ensure health for all, and the nursing profession is at the forefront of this effort. The International Council of Nurses (ICN) fully supports and endorses the term Primary Health Care (PHC) as defined by the World Health Organization (WHO) which states: “PHC is a whole-of-society approach to health that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people’s needs and as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care, and as close as feasible to people’s everyday environment”.1
Nurses play a critical role in developing high-performing, safe, appropriate, and sustainable PHC systems. PHC is a comprehensive, principle-based framework designed to guide the delivery of services to maximize health outcomes and equity by focusing on the needs and preferences of individuals, families, and communities across the entire continuum of care from health promotion and disease prevention to treatment, rehabilitation, and palliative care.2 This approach prioritizes the creation of conditions that advance the health and well-being of all people, with a central focus on placing the individuals receiving care at the core of all health service delivery. ICN agrees with this approach, but in practicality, many health systems differ in their application of PHC. Thus, this position statement describes PHC, the means for addressing health promotion and well-being, as the core component of a comprehensive health system.
The global commitment to PHC began with the 1978 Alma-Ata declaration, which was reaffirmed in 2018 with the Astana Declaration. The world continues to recognise that strengthening PHC is the most inclusive, effective and efficient way to achieve universal health coverage (UHC).3 In the 2023 United Nations Political Declaration on UHC, Heads of State and world leaders committed to using a PHC approach to accelerate progress towards UHC by 2030.4
The core principles of PHC are universal access; solidarity and equity; holistic approach; multisectoral policy and action; community engagement to co-create health; and high-quality, affordable care. 2 PHC encompasses three inter-related and synergistic core components: 5
by Tessa Koumoundouros
Scientists Identify New Blood Group after 50 year mystery
Electron micrograph of red and white human blood cells
When a pregnant woman had her blood sampled back in 1972, doctors discovered it was mysteriously missing a surface molecule found on all other known red blood cells at the time. After 50 years, this strange molecular absence finally led to researchers from the UK and Israel describing a new blood group system in humans. In September, the team published their paper on the discovery.
“It represents a huge achievement, and the culmination of a long team effort, to finally establish this new blood group system and be able to offer the best care to rare, but important, patients,” UK National Health Service haematologist Louise Tilley said, after nearly 20 years of personally researching this bloody quirk.
While we’re all more familiar with the ABO blood group system and the Rh factor (that’s the plus or minus part),
humans actually have many different blood group systems based on the wide variety of cell-surface proteins and sugars that coat our blood cells.
Our bodies use these antigen molecules, amongst their other purposes, as identification markers to separate ‘self’ from potentially harmful notselves. Blood type (or blood group) is determined, in part, by the ABO blood group antigens present on red blood cells. Antibodies in our blood plasma detect when a foreign antigen marker is present. If these markers do not match up when receiving a blood transfusion, this life-saving tactic can cause reactions or even end up being fatal.
Most major blood groups were identified early in the 20th century. Many discovered since, like the Er blood system first described by researchers in 2022, only impact a small number of people. This is also the case for the new blood group. “The work was
difficult because the genetic cases are very rare,” explained Tilley. Transfusion reactions can be severe. Previous research found more than 99.9 percent of people have the AnWj antigen that was missing from the 1972 patient’s blood. This antigen lives on a myelin and lymphocyte protein, leading the researchers to call the newly described system the MAL blood group.
When someone has a mutated version of both copies of their MAL genes, they end up with an AnWj-negative blood type, like the pregnant patient. Tilley and team identified three patients with the rare blood type that didn’t have this mutation, suggesting that sometimes blood disorders can also cause the antigen to be suppressed. “MAL is a very small protein with some interesting properties which made it difficult to identify and meant we needed to pursue multiple lines of investigation to accumulate the proof we needed to establish this blood group system,” explained University of the West of England cell biologist Tim Satchwell.
To determine they had the correct gene, after decades of research, the team inserted the normal MAL gene into blood cells that were AnWj-negative. This effectively delivered the AnWj antigen to those cells. The MAL protein is known to play a vital role in keeping cell membranes stable and aiding in cell transport. What’s more, previous research found that the AnWj isn’t actually present in newborn babies but appears soon after birth.
Interestingly, all the AnWj-negative patients included in the study shared
continued on page 37
ICN says COP29 climate finance shortfall threatens the planet’s health
Geneva, Switzerland, 29 November 2024 - The International Council of Nurses (ICN) has expressed profound disappointment with the outcomes of COP29, held in Baku, particularly the New Collective Quantified Goal (NCQG) on climate finance that was passed despite significant objections from developing countries.
ICN President, Dr Pamela Cipriano, said: “Developing nations called for $1.3 trillion annually, which was already a conservative estimate, and wealthy countries responded with less than a quarter of that amount. The rich nations most responsible for the climate crisis have failed to meet their Paris Agreement obligations by pushing through a deal that is wholly insufficient to enable a just climate transition and support the world’s most vulnerable nations to deal with the devastating environmental impacts they are facing. The least developed countries are right to call this a betrayal, and one that sacrifices the very health and survival of their populations.”
Prior to the conference, ICN endorsed a joint call, from the Global Climate and Health Alliance (GCHA), urging leaders to commit to ending expansion of fossil fuels, transitioning to renewable energies, and securing finance for the
Scientists Identify New Blood Group after 50 year mystery
continued from page 36
the same mutation. However, no other cell abnormalities or diseases were found to be associated with this mutation. Now that the researchers have identified the genetic markers behind the MAL mutation, patients can be tested to see if their negative MAL blood type is inherited or due to suppression, which could be a sign of another underlying medical problem.
These rare blood quirks can have devastating impacts on patients, so the more of them we can understand, the more lives can be saved.
This research was published in Blood.
ambitious action needed to address climate change, which ICN has called, in its position statement “the single greatest health threat facing humanity with profound implications for human health and well-being”.
ICN also voiced frustration with limited progress in terms of tangible commitments to phasing out fossil fuels, the single biggest contributor to climate change, and a major cause of health harms from respiratory disease to exacerbated mental health issues.
Howard Catton, ICN’s Chief Executive said: “At the start of COP29, the Azerbaijan President called fossil fuels ‘a gift of the God’: we say health is the greatest gift and one we all too often take for granted. If our leaders forget that, we’ll all be fossils. That’s why we must invest in our nurses who are on the frontline in the battle against climate change.”
Reflecting the importance of the nursing voice in climate action, several nurses were in attendance, including Cara Cook, Director of Programs at the Alliance of Nurses for Healthy Environments (ANHE), and Charlotte McArdle, Deputy Chief Nursing Officer England, an alumnus of ICN’s Global Nursing Leadership Institute who attended as a Sigma Nursing UN Representative. ICN Nursing and Health
Policy Analyst Dr Gill Adynski monitored the sessions remotely. Dr Cipriano added: “Nurses know that behind every climate change statistic, there are millions of real people suffering. Every day, they treat elderly patients collapsing during heat waves, children struggling to breathe due to air pollution or wildfires, and entire communities devastated by floods and storms, all within increasingly overburdened health systems. Funding a strong and resilient nursing workforce that can lead climate change prevention and mitigation efforts must be a top priority.
We are finally seeing greater recognition of health as the argument for climate action at COP - last year, we had the Declaration on Climate and Health and this year, the newly-formed Presidencies Continuity Coalition for Climate and Health. But recognition is not enough. Without decisive action, we will see more preventable illnesses and deaths and more overwhelmed health systems, above all in the developing countries and small island nations that bear the brunt of the damage.
ICN calls on the world’s leaders to urgently step up with the ambitious climate financing needed to protect global health and build equitable, sustainable, and climate-resilient societies. The health of our planet and its people cannot wait.”
A Nursing Student was crowned winner of Miss America
winner Abbie Stockard
The 97th annual Miss America pageant has officially crowned their winner with the beautiful and talented Abbie Stockard from Alabama now taking on the coveted title.
On Sunday, January 6, the Miss America finals ceremony was held at the Walt Disney Theater in Orlando, Florida, where Abbie was presented the incredible honour. And as Abbie becomes the next Miss America, we’re taking a closer look at the life of the 22-year-old who brought home a staggering $50,000 in tuition scholarship money and the chance to travel America as the brand ambassador for the Miss America Organization.
Abbie is a 22-year-old college student from Birmingham, Alabama, and is currently a student at Auburn University, where she is studying nursing. The blonde beauty shared that her long-term goal is to earn an advanced degree, a doctorate of nurse anaesthesia practice, and specialize in paediatrics.
Outside of her studies, Abbie is a college athlete and a member of the Tiger Paws Dance Team, which is a nationally ranked competition dance team that focuses on Jazz, Kick and Pom Technique. According to her Instagram, Abbie is in a happy relationship with her boyfriend Utah Jazz Center Walker Kessler.
The World’s biggest quango
continued from page 10
confidence in the NHS. This month, Mr Streeting also announced staff numbers at NHS headquarters will be halved as part of an overhaul.
A further three senior board members also announced they will resign at the end of March, joining chief executive Amanda Pritchard and its most senior doctor, Prof Sir Stephen Powis, in an exodus.
Having initially planned to reduce the number of central office workers at
Ahead of the Miss America competition, Abbie shared a post to her followers reflecting on her journey to the pageant. She penned, “As I step into this evening, I am filled with excitement, honour, and gratitude. Thanking the Lord for placing me here this week and giving me one of the most incredible experiences of my life.”
She continued, “Regardless of the outcome, I want to express my deepest thanks to my friends, family, the amazing Miss Alabama board, and the wonderful people of Alabama for making me feel so appreciated and loved. I hope I’ve made you proud and represented you well.” Abbie concluded her post with a Bible verse from Romans 8:28 that read, “And we know that God causes all things to work together for good for those who love God, to those who are called according to His plan and purpose.”
Abbie performed a contemporary dance for the talent portion. Abbie won the title as she competed against 51 other women. Abbie was crowned Miss America among 52 other women that travelled from all across the country, one from each state plus Washington D.C. and Puerto Rico, as they competed in several categories. Throughout the competition, Abbie shined in seven different categories including the Private Interview, Fitness, Talent, Evening Wear and On Stage Question.
NHS England by about 15 per cent, an updated announcement said it would now be 50 per cent.
Elsewhere during his speech, the Prime Minister said that “strength abroad” demands “security back at home,” saying the Government must go “further and faster” in delivering reform.
He said: “Given what’s happening globally, given the insecurity in our country, now is the time, in my belief, for greater urgency and to go further and faster on what we need to do on
In the Hot Topics category, contestants were asked a series of questions focused on technology, immigration, health care, climate change, censorship, among other pressing issues facing the United States today. As for the talent portion of the night, Abbie brought out her dancing skills as she performed a flawless contemporary dance to Lauren Daigle’s hit song ‘You Say.’
Abbie is the fourth Miss Alabama to be crowned Miss America, following in the footsteps of past winners including Deidre Downs, Miss America 2005; Heather Whitestone, Miss America 1995; and Yolande Betbeze, Miss America 1951.
By Caroline Gaspich, The US Mirror
security and renewal,” he said.
“So every pound that we spend, every regulation, every decision must deliver for working people. And I don’t just mean efficiency, although doing what you’re doing, you’ll know how important efficiency is. “I mean something else which is allowing the state, the Government, to operate what I call maximum power. “So, reforming it so it’s closer to its communities, tearing down the walls of Westminster, inviting the British people in as partners in the business of change.”
