Sue England is a midwife and has worked in South Sudan.
It’s a far cry from teaching midwives in the suburbs of Sydney to caring for patients in the dusty plains of southern Sudan but my nine months in Akuem (near the borders of the Central African Republic and Chad) were more than worthwhile. Sudan is one of the forgotten places of the world with a whole generation growing up knowing nothing but war, hunger and human rights abuses. It was a learning experience from day one. I learned how to cope with the frogs in the latrines and the odd snake appearing when I was cleaning up the dressing table. I learned to dodge the saliva which the Dinkas spit from the gap in their front teeth, completely unaware of the unseen bacteria, viruses or parasites which they might be spreading. I learned tropical medicine from the doctors and they learned obstetrics from me. But we all learned from the Dinkas.
I had to learn to judge time by the moon. I would ask my patient if she had had her last period before or after the harvest moon or before the moon in the wet season. Only then could I determine whether her labour was premature. I’ve been a midwife for 15 years but I had never encountered some of the problems I faced in Akuem. Because most Sudanese women choose to birth at home, the women we saw at the centre were the ones with severe complications. I managed obstructed labours, vacuum deliveries, prematurity, breech deliveries and a lot of twin births. This mission showed me more than anything the value of trained midwives in primary health settings such as these. I hope my time there made a difference to the people of Akuem. I know it made a difference to me.