It takes courage to save a life. For Ms. Florence Butler, however, the heroism required to save a baby's life requires something more.

As you and I read our early morning paper, Florence Butler is knocking on doors near her Carey Street office. She is searching for a young, pregnant woman who moved without leaving a forwarding address.

Florence Butler is determined to find the young woman, to convince her that the survival of her unborn baby depends upon regular visits to the local maternity clinic and some important changes in her lifestyle.

People from the neighborhood know Florence Butler. She is one of them - a "neighborhood health advocate," not some official from across town. She has worked very hard to retain her neighbors' trust.

Florence Butler will keep searching, door-to-door, until someone gives her the information she needs. In all probability, Ms. Butler's determination will once again make her a hero in an unborn baby's life.

Every infant should have a healthy start in life, but every hour of every day, another 4 American babies die. If a baby's parents are poor and African American, moreover, the child is twice as likely to join the 30,000 other American infants who will die this year.

Despite our enormous national expenditures for maternal health care - and despite our continuing efforts to expand Medicaid eligibility to every pregnant mother who needs our help - more than twenty other industrialized nations remain more successful than the United States in limiting infant mortality.

These are the tragic facts of life and death for poor children in America, appalling statistics which neighborhood health advocates like Florence Butler and her colleagues at Baltimore Healthy Start are committed to changing.

We know that most infant deaths could be prevented if every mother received effective perinatal health care beginning in her first trimester of pregnancy. In struggling neighborhoods across the country, Healthy Start is playing an essential, grass-roots role in giving poor babies that better chance to survive.

Ten years ago, in the Sandtown-Winchester and Middle East neighborhoods of Baltimore, 20 of every 1000 infants did not live to see their first birthday. Today, because of Healthy Start, that infant mortality rate has been cut to 12 deaths per1000 - still unacceptably high, but an improvement which promises to continue.

In Baltimore, Healthy Start programs offer poor mothers education, referral and eligibility assistance which can be decisive in the often-confusing bureaucratic environment of "welfare reform" and "managed care." Community-based neighborhood centers also provide GED and parenting classes, substance abuse assistance and a very effective parenting program for young fathers.

Nationwide, federally-funded Healthy Start "demonstration projects" have brought together neighborhoods, local governments and medical providers, creating infant survival efforts with broad community support. That is why I worked so hard to sustain federal funding for Baltimore's Healthy Start demonstration program in 1997.

That also is why Congress must act this year to establish Healthy Start as a permanent program of financial assistance to the 140 communities across America which have the highest rates of infant mortality and related perinatal health problems.

I have once again sponsored legislation in the 106th Congress to create a permanent Healthy Start program, as I will in every session of Congress until it becomes the law of the land.

Assuring every American child a healthy start in life is a moral imperative.