The writing is on the wall: posters advertise a candlelit vigil for Savita Halappanavar, an Indian who died in Ireland in October last year after medical staff refused to perform an abortion © Reuters

Savita Halappanavar checked into a hospital in Galway, a city on the west coast of Ireland, on October 21 last year with back pain and was found to be having a miscarriage. A week later the 31-year-old dentist from India, who was 17 weeks pregnant, died of septicaemia following the refusal of medical staff to perform an abortion.

“They told my wife they couldn’t terminate the foetus when there was still a foetal heart beat even though the baby could not survive. They said it was because this was a Catholic country,” says Praveen Halappanavar. “I have no doubt that Savita would still be with us if we lived in another country. How can this happen in a country like Ireland in the 21st century?”

It is a question that is resonating loudly throughout the whole country as Dublin assumes the presidency of the EU this month and battles to emerge from the financial crisis. Mrs Halappanavar’s death has become the focal point of public outrage and broader debate about the influence of the Catholic church on an increasingly diverse society in the throes of a rapid transformation.

In immediate terms, the Fine Gael/Labour ruling coalition are planning to pass a new abortion lawin the wake of the tragedy. But this is only one step of a longer process as Ireland wrestles with a new national identity and values. One of the most striking changes comes in the composition of the population. Its decade-long Celtic Tiger boom attracted 199 different nationalities into the country. One in eight residents were not born in Ireland, double the number of foreign nationals present in 2002. Despite a surge in emigration following its economic crash Ireland accepts 50,000 immigrants a year.

Dublin is a global financial centre and one of Europe’s most trendy and multicultural cities. Tens of thousands of immigrants, including Mr Halappanavar, work in more than 1,000 multinational companies, including Google, Facebook and Boston Scientific, which have transformed Ireland into a technological powerhouse.

The presidency of the EU comes as Dublin celebrates its 40th anniversary of joining the union, an event that has facilitated phenomenal social and economic change. In the 1970s Ireland was one of Europe’s most impoverished countries with a predominantly agricultural economy and rural population. It is now still one of the richest countries in Europe, despite its current difficulties.

The country of 4.5m also has the youngest population and highest birth rate in the EU. The status of women has changed radically with EU equality laws enforcing equal pay for equal work and removing a ban on married women working in public jobs in the mid-1970s.

The Halappanavar case, however, is one of the most visible examples of how Irish politics and institutions have failed to keep pace.

“This episode has been very damaging for Ireland’s reputation abroad – people are labelling us as some kind of medieval people,” says Brid Dunne, one of tens of thousands of demonstrators who have taken to the streets in recent weeks to protest. “It is a generational issue. Young people have more freedom of thought than their parents. I think the politicians are out of touch,” she says.

Against the symbolic backdrop of Dublin’s General Post Office, the building where Irish rebels famously read out the 1916 Proclamation of the Irish Republic, which promised “equal rights and equal opportunities” to all citizens, pro choice protesters bemoaned the state’s failure to safeguard women’s health.

“I think it is a question of our legislators displaying arrogance to the electorate,” says Dee Kirwan, who was clutching a placard, referring to parliament, with the message: “85% men in Dáil Éireann – 100 per cent of whom will never be pregnant.”

Ireland is one of the most Catholic countries in Europe and until recently the church wielded significant influence over politics and society. Everyday at midday and 6pm the Angelus bells are broadcast live on television and radio. The power of the pulpit helped to delay legal contraception until 1980, while divorce was only introduced in 1997, together with the toughest restrictions in Europe.

“If you look at a whole range of social issues in Ireland, from the legalisation of homosexuality to women’s rights and contraception, change generally was forced through by court decisions or European directives,” says Diarmaid Ferriter, professor of history at University College Dublin.

“Public opinion was frequently ahead of the political class, with politicians dragged behind it,” he says.

Irish politicians are sensitive to lobbying from well organised groups such as the church because of an electoral system which sees candidates from the same party compete in small constituencies. Older people, who are generally more conservative, enjoy significant influence in politics as they tend to vote more.

Abortion remains one of the most deeply divisive issues in the country with five bitterly fought referendums held on the topic since 1983. Ireland remains one of only two EU states (the other is Malta) where women in many cases cannot practically access an abortion even when their lives are endangered.

In the aftermath of the death of Savita Halappanavar – just a week before Christmas – the coalition finally agreed to introduce legislation to implement a 1992 court judgment, which would allow abortions when the life of the mother was in danger.

The debate on the legislation will prove a test of strength for the church, which is vociferously opposed but is losing influence in the aftermath of two decades of child sex abuse scandals.

This was perhaps best illustrated when Enda Kenny, Ireland’s prime minister, last year accused the Vatican of downplaying “the rape and torture of children” to uphold the primacy of the institution. Shortly after this speech Dublin closed its embassy to the Vatican.

“The revelations of these scandals, their mismanagement and cover up where it occurred, have shaken totally and radically the trust, not only of citizens, but of many clerics,” says Noel Treanor, Bishop of Down and Connor.

Secularism is growing. The number of people with no religion doubled to 277,237 in 2011, when compared with 2002. And in a clear reflection of immigration, the fastest growing religion in Ireland is now Islam, which has about 50,000 followers, up from just 400 in 1971.

Catholicism is also changing. About 84 per cent of people say they are Catholic, down from 92 per cent in 1971. Weekly mass attendance has fallen to 35 per cent, down from 80 per cent in the 1980s. One survey by the Dublin diocese recently found about one in seven Catholics now attend weekly mass in the city. In 2011, just six men were ordained priests while the average age of Irish priests is now 64 years.

“There is a shift towards ‘cultural Catholicism’ rather than the kind of rules-based Catholicism associated with regular mass attendance,” says Niamh Hourigan, lecturer in sociology at University College Cork.

This decline in strict observance is reflected in the 35 per cent of babies now born outside of wedlock, compared with below 5 per cent in the 1970s. There has also been a 10-fold increase in the number of divorced people since 1996.

When it comes to education the church is still in command. It controls 90 per cent of the 3,169 primary schools as well as many publicly funded hospitals.

The dominance of Catholic patronage has left little or no choice for parents who want to bring their children up with no religious influence or who have another faith – a situation criticised by the UN and the Council of Europe, which serves in part as Europe’s human rights watchdog.

“Many parents have to register their children in Catholic schools because there is simply no other options in Ireland,” says Michaela Omojola, a German evangelical Christian who has four young children.

She lives with her Nigerian husband in the Dublin suburb of Tyrrelstown, a new town where almost half of the population are immigrants and scores of languages are spoken.

“For us it is important to have a choice of schools because they have so much influence on children as they grow up,” Mrs Omojola says.

The coalition is changing policy to extend parental choice in education by attempting to switch the patronage of up to 100 schools from Catholic to multi-denominational education and encouraging new multi-denominational schools.

Earlier this year one of only 65 Educate Together multidenominational primary schools opened in the town beside a Catholic school. But progress is slow and a proposal to build a multidenominational secondary school in Tyrrelstown was recently turned down.

A visit to the community centre at Tyrrelstown, which stands directly between the local Catholic and Educate Together primary schools graphically illustrates multicultural Ireland. In a music class, four out of five of the children have parents who were not born in Ireland, according to Ms Omojola, who sits on the local social integration board.

The rapid pace of immigration has created significant challenges for Ireland, which until recently was one of the most homogeneous countries in Europe. The murder of a 15-year-old Nigerian boy in Tyrrelstown in April 2010 was flagged by media as one of the first examples of a racist killing in the country. However, locals insist this was an isolated incident and does not reflect the relative success of integration.

Paul Rowe, chief executive of the Educate Together organisation, says Ireland’s experience of immigration is very different from the UK where many communities have become polarised with individual ethnic groups dominating single areas.

“One of the big differences when compared to the UK experience is that equality legislation was already in place in Ireland because immigration is a relatively recent phenomenon. This has led to less polarisation and discrimination,” he says.

The biggest immigrant group are Poles, who arrived in hundreds of thousands when they joined the EU in 2004 and Ireland was in the middle of its boom. Many have stayed and made their home in Ireland despite the economic crisis, attracted by Ireland’s higher wages and a Catholic culture similar to their own.

How long this Catholic culture pervades is open to question. Veterans of three decades of abortion wars in Ireland point to a radical power shift away from the church.

“It is a consequence of globalisation, television and the electronic media,” says Brendan Halligan, a former general secretary of the Labour party.

“The Labour party was the subject of many hits from a belt of the crozier back in the 1970s. But I think what we are seeing now from the church is the dying kicks of a once powerful beast.”

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