You Can't Take Africa Out of the Child

By Marion Walker

Marion Walker gives an account of her life as a nurse in Rhodesia known as Zimbabwe since 1980.She describes the early days of the War of Independence 1972 through to 1981 which saw the handing over the country from the colonial regime to the Mugabe administration. The bravery of the indigenous people who carried on living through impossible situations that took all their ingenuity and strength of character to survive the combat at all was admirable.

After qualifying as a midwife she went back to general nursing into ‘Accident and Emergency’ doing her bit for Queen and Country. Circumstances caused the family to immigrate to England. After nine interesting years of N.H.S midwifery hospital experience she obtained the job of her dreams in another war zone of sorts.

• Language: English
• Publisher: Lulu Publishing Services
• Release date: Nov 19, 2015
• ISBN: 9781483438078

Book preview

Author

Prologue

The first few years of my childhood in Southern Rhodesia were idyllic. I was one of many children brought up and educated for the first five years on my liberal-minded father’s farm by my beloved mother who was all things to us folk who lived on the farm; teacher, doctor, judge and jury over the entire work-force. There was only the bush veldt; the sunshine, natural swimming pools complete with crocodiles and bilharzias, the glorious countryside with its magnificent animals, superb sunsets and a vision that nothing would ever change. We belonged to a large, noisy happy family; at one with each other who shared everything; the friendships lasting into eternity. There was no politics, culture differences or awareness of class or colour. Alas the farm did not prosper and father was forced to change his plans for the future. We moved to a small town, Rusape, and he became a native commissioner. He was not a well man after suffering complications from the severe injuries he received becoming a hero in the 1st World War.

Sadly, he succumbed and died in my eighth year and our lives changed as Mother had to abandon her previous life as she struggled to bring up a wild child and find herself at the same time. After the freedom of my previous life, I hated junior school but thrived once I got to High School and became a responsible member of the human race at last.

I started a four year nurse training course in 1960 and enjoyed a great social life with many boyfriends but my one true love took me into another dimension. I had only done two years of the four year course when I met Richard. We were engaged within six weeks and married after seven months on 5th January, 1963. It was not permitted for married women to remain student nurses at that time. I qualified as bookkeeper and computer operator and worked in commerce for the first few years of our marriage.

I enjoyed being married and we had almost four years learning to live together. We also had some fabulous holidays in Africa and Europe before returning to Rhodesia to build a home of our own and settle down eventually to parenthood.

The birth of my first child at the end of 1966 was a mismanagement nightmare. The pain and damage done to my person was unbelievable but did result in a lovely little girl, Karen. She sadly, was starved of oxygen during the long twenty-four hours of agonising labour with no monitoring of the unborn baby’s heart. This resulted in her suffering a degree of morbidity. Nearly three years later my second child Christopher was born. This was also a disastrous chapter of near-death mishaps. Thanks to the expertise and dedication of two people, a wonderful paediatrician and his nursing sister who never left my son’s incubator until he was on the mend, my beautiful son recovered unscathed this time. It was three weeks before I got to hold my son and care for him. However, it was these horrible birthing experiences that made me even more determined I would return to nursing one day and become a midwife myself. I vowed to do better. However, I could not possibly think about nurse training again anyway until the children were older and I had sorted out childcare first.

The 1966 Salmon report enhanced the status of nurses and introduced nursing officers and managers to the profession which in my opinion did not do the quality of patient care any good. The Briggs report 1972 made it possible for mature people to train as nurses and midwives. I started re-training in September 1973 qualifying as a State Registered Nurse by September. 1976. I then became a student midwife in January, 1977 and by the end of that year was a State Certified Midwife too. Richard was totally supportive during these years of studying. He cared for our children so well that really they hardly missed their mother at all.

Chapter 1

I realise that with increasing age, distance lends enchantment. I accept that ‘Perceived memory’ is a dangerous thing for a writer. I apologise unreservedly if I have written anything that is not strictly true. To my knowledge I have been true to myself. A few names have been changed for obvious reasons. Rhodesia has gone but life goes on. I have moved on too and have found a life and an adopted land that I love as much.

A New Beginning

It was a quiet Saturday, which was unusual for Chumwari Maternity Unit, the public address call came over the whole system. This was used more often than not to call the student midwives to a delivery. You had to witness twenty before you could start to deliver babies yourself. Never mind the poor women undergoing a life changing experience, becoming mothers. There was no such thing as privacy or the chance of having your own midwife to deliver you or the choice not to have a student audience at all. They all had to submit to the system if they were to have their babies in hospital. No wonder most babies were born in the kraal.

‘Would all nurses not involved in delivering babies report immediately to the front of the hospital with greatest speed.’ It seems there was a national emergency requiring all hands. The next few hours were the stuff of nightmares. We were transported by ambulance to the scene of the atrocity. A terrorist bomb had exploded in Woolworths on a busy Saturday lunch time. This was urban terrorism most horrible.

My jaw dropped. The whole of one wall of the building had been blown out and all I could see was a river of blood flowing slowly down the stairs from the top floor to the bottom; a grotesque real life doll’s house with the front removed. I perceived bits of the dolls lying discarded by some spoilt giant child who had grown bored with the play. I realised with horror that the pieces lying about were bits of people. The victims were shoppers who had had their lives brutally terminated whilst going about their ordinary business. I was not much use. Shock left me gasping, in tears, cowering in a corner, incapable of breathing let alone saving lives. I grew up very rapidly that day, leaving my comfortable suburban life behind forever. It had started with attacks on isolated farms in 1972. The country was at war. Where would it all end?

One of worst atrocities of that War of Independence was committed by the ZANLA Zimbabwe African National Liberation Army, the military wing of Zanu firstly led by Ndabaningi Sithole, who preceded Robert Mugabe. It was common knowledge, by the troops, that certain mission stations in the North West of the country near Mount Darwin area were sheltering and feeding the guerrillas. There was a mission station in the Eastern Highlands in the Vumba, run by the Pentecostal Elim Missionaries. The missionaries had refused to be identified with the Rhodesian government and despite their isolated position had declined military protection. God would protect them.

It was a cold night in June 1978, when the Elim Mission was attacked by twenty Zanla terrorists. They rounded up nine adults and four children, one a three week old baby. A middle aged woman with her hair in pink curlers was publicly raped before having an axe buried in her scalp. A man had his face hacked open before being kicked to death. The children were beaten, kicked and bayoneted. Their little bodies were left to lie on the mission football field where they fell. These terrorists then rounded up all two hundred and fifty mission pupils and harangued them on the evils of the ‘Internal Settlement.’ The government was trying to negotiate a peaceful end to the hostilities.

There was one survivor warned by his servant who barricaded himself in his room. Why didn’t he warn the others and alert the security forces? Perhaps there was no time? I wonder how he is living with himself now. The world blamed the Selous Scouts. It had apparently been the work of Mugabe’s thuggish brutal henchmen. They claimed responsibility for the deed. There was no word of condemnation from either the British or the Americans.

Another atrocity in 1978 occurred when an Air Rhodesia Viscount named ‘Hunyani’ was shot down by a heat seeking missile on its way back from Kariba Dam. This is a vast expanse of water measuring over 5,230 sq kilometres. The passengers would be mainly tourists enjoying the wonder that was that huge man-made dam providing hydro electric power to both Rhodesia and Zambia. The plane came down in the Vuti African purchase area. There were sixty-six passengers and crew of which eight were killed in the crash. Ten survivors were subsequently brutally murdered by AK wielding thugs who apparently raped the women before killing them. A local dentist survived to tell the tale to the disinterested world. The survivor told a harrowing tale of a woman, who having survived the crash, was killed in the process of ripping up her petticoats to bandage her fellow survivors. Joshua Nkoma was seen on British television claiming responsibility for this atrocity. He laughed as he claimed the aircraft was a military aircraft. This was a lie. I knew it wasn’t a military aircraft as I’m sure the rest of the world would know as well.

John da Costa, the Anglican Dean of Salisbury Cathedral went on to preach a damning sermon in the Salisbury Cathedral at the memorial service entitled the ‘Deafening Silence’ The rest of the world remained ‘deafeningly silent’ in regards the condemnation of the shooting down and subsequent murder of the innocents. Disgraceful, but at least the Western politicians couldn’t blame the Selous Scouts for this particular atrocity. They always seemed to be the fall-guys in the Western World’s eyes.

One dreadful night we were alerted to another night of cruel atrocity. A small village containing old men, women and children was attacked by the so called Freedom fighters. Apparently, they accused the villagers of betraying them to the security forces. On the evidence of no able-bodied men being present and therefore the village being deemed to be on the side of the government, they herded all the people into a central thatched meeting hut then set fire to the building and incinerated them all. The pitiful remains were brought into Andrew Fleming Hospital in the backs of pick-up trucks. The extreme heat of the fire had reduced the bodies to charred gruesome caricatures of their living selves. They looked like those harrowing moulds of the victims of Pompey who perished in the eruption of Vesuvius in AD79. It was unbelievable that these particular horrors happened in my lifetime.

* Never Quite a Soldier- a policeman’s war 1971-1983 by David Lemon. This is a brutally honest story about a policeman’s role in the dying days of Rhodesia and the birth of Zimbabwe. He was one of the few white officers to serve Ian Smith, Bishop Muzorewa and Robert Mugabe.

Life and midwifery training goes on; I would finish my midwifery training as I determined to do when I started. I would strive to be the best nurse and ultimately the best midwife too.

Chapter 2

Chumwari Hospital

Midwifery was the happiness business for the most part; interesting for us four, the only white girls in a group of twenty-one and revolutionary for that particular time in Africa. I spoke the language of the mines, called Chilapa-la-pa. It was a bastard African language which was an amalgamation of all the hundreds of different dialogues that went to make up the tribes from all over the continent. These tribesmen flocked to the mines in South Africa where there was plenty of well paid work digging for diamonds and gold. It was the language used from Cape to Cairo.

Ante-natal Clinic

The ante-natal clinic was extremely busy. Hundreds of different women used to present themselves for spasmodic ante-natal care every day. Most who attended had compromised pregnancies as they usually left ante-natal care to God and good luck. If we got a woman attending for the first time at thirty-six weeks we thought we had an ‘early’ booker. They would quite often never return. The contact details they gave us in regards personal information was sketchy at best. It was almost impossible to do a follow up with blood tests which diagnosed life threatening disorders. They simply disappeared, never to be seen again unless they came back with obstructed labours. Quite often, when or if they did return, the mothers and babies were quite moribund and beyond help. We used to do as many instant result tests as possible. Thank God for the instant haemoglobin instrument test which determined whether the women were anaemic or not. Many were, of course, because of malnutrition, bilharzias or other parasites. Then there was the danger of pelvic disproportion problems as so many of our clients had Ricketsia type, a male type pelvis, due to lack of vitamin D and/or malnutrition which resulted in obstructed labours. These women would give themselves trial of labour with babies far too big to be delivered normally through the bony pelvis.

I was working with an English girl called Susan Summersgill.

‘God they pong! Why don’t they wash before coming to clinic?’ I turned on her with fury.

‘Don’t you realise that these women have journeyed with great difficult from their homelands? They have travelled, when they could afford them on overcrowded, expensive buses. They walk for the most part, long miles across our dangerous war-torn country. All the kids have to walk behind their mum in bisto-kid fashion, like the gravy adverts, with the largest to the smallest child in crocodile-style lines. Inevitably there is a breast feeding baby on the mother’s back as well. Washing, whilst en route to the hospital is an impossibility.’

She stepped back horrified by this furious onslaught. I drew back before I hit her. I surprised myself at the strength of my emotions. How dare this arrogant woman pass judgement on the African women! I continued.

‘At home, in their villages they attend to their personal hygiene by washing in the river at the same time as they collect the daily ration of water for their cooking and drinking use. It has to be carried from the river which was usually some distance from the kraal to avoid contamination by human excreta. Perhaps if the Brit politicians would stop sending money to the despots who are power crazy maniacs who spend the aid on themselves, shifting the loot they get to Swiss bank accounts. The money that does stay in the country is used to fund their own armies buying arms to ensure they stay in power. Why don’t the Brits wise up and spend the money on educating the people, teaching them good land husbandry? They try to sustain themselves by farming traditionally. Digging wells, one per village would be a good place to start. A well with a constant supply of clean water is a rare luxury in Central Africa. The women have to carry every drop in five gallon paraffin tins on their heads balancing with the grace that only African women seem to have. Do you know that a gallon of water weighs ten pounds? I couldn’t do it and nor could you coming here with your attitude problems. Look and learn my friend!’

Chapter 3

Most of the out-lying clinics had been closed due to the danger of attack by terrorists who thought nothing of going for the soft targets, killing medical staff and patients with total indiscrimination. Still these women would wait patiently for hours in the sun, for ante-natal assessment. They used to sing, and how they could sing; African melodies and the songs learnt from the missionaries. These were heavenly sounds with absolutely no musical instrumental accompaniments; true music in its purest form.

Ante-natal wards.

Ante-natal wards were another part of our training that made life interesting. At the onset of every shift, the hand-over report was given in Shona, spoken by the Mashona tribe. It was tough if you didn’t speak the language and dangerous too. I had used Shona in the playground, on Dad’s farm with my pals, the kids of my father’s work force. The ward held twenty-eight ante-natal women, all with life threatening disorders to either themselves or their unborn babies. As a student midwife who had the S.R.N, State Registered Nurse qualification, I was more often than not the only trained nurse on night duty, working with an auxiliary nurse. We were expected to do four hour observations on both mother and unborn baby and to carry out all treatments and medicines. It was hard; impossible. Honesty has to prevail always and I only recorded the vital signs I had detected, not so with the aide who use to fill in the gaps on the records.

I remember one memorable night when this imperious man strode briskly into the ward just as I was trying to get them settled for the night.

‘Where is the woman?’

‘Which women, sir, there are twenty eight of them in the ward?’

‘The one with ascites of course!’

‘Who are you? I am in charge of the ward and my name is Walker.’

He looked me up and down as though I was something unsavoury he’d picked up on his shoe.

‘Professor Rogers from London England and I’ve come to see this woman.’

He thrust the lady’s records into my face.

‘Nunga Sibanda and I haven’t got all night.’

I had a bedpan full of evil smelling contents in my hand. I should have dropped it at his feet.

‘I’ve been expecting you all day and have set up the trolley for you to drain the abdomen. I won’t be long.’

He didn’t wait. He looked on the board to locate which bed she was in. Striding down the ward he approached the bed of Nunga Sibanda, a little woman who didn’t speak a word of English. She was lying cowering in her bed, terrified. Poor lady, she had abdominal ascites, a swollen stomach, and was very jaundiced from cause unknown. She would have to have a paracentesis, which means the doctors would have to insert a trochar and cannula into the abdomen to drain off some of the fluids and send it off to the laboratory to be examined. This ghastly man, who had no bedside manner or personal skills whatsoever, approached the lady with the apparatus he needed, threw back the bed covers and proceeded. He didn’t even wait for me to accompany him. As there was no money for individual curtains, around the bed, we used portable screens. He simply went ahead without a word of explanation. I was there to assist. It was essential that the poor woman had an explanation and was allowed to ask questions about this most terrifying painful invasive surgical procedure. She needed an explanation in a language she understood. Human kindness was something alien to this arrogant monster of a consultant. We had a treatment room for this kind of procedure. He should have used it for cleanliness at least. The ward was not the place to be doing this sort of thing. I would have ensured her privacy as well from the eyes of the other interested patients who were watching in fascination.

He then proceeded to clean the area with iodine without ascertaining firstly that she was not allergic to the substance before inserting local anaesthetic. He stabbed her with the trochar, a dagger-shaped instrument, intending to attach the cannula which was a tubing and funnel of sorts. This was used to drain some fluid off and relieve the woman’s discomfort as well as diagnose the cause. Of course, she gave a screech of abject terror, pulled the dagger out of her abdomen and, knocking him to the floor, ran straight out the door and was never seen again. Chances are, the cause was liver cancer, and this poor unfortunate lady would die in agony somewhere in the bush unattended. Her condition would cause the pregnancy to be compromised and therefore unlikely to result in a healthy baby. Two people condemned to death by this unfeeling, heartless man who should never have been allowed to practise obstetrics. I would be writing a lengthy report to report his unethical behaviour to the authorities.

Before the War of Independence the numbers were a manageable, four hundred plus hospital births a month. The civil war caused all the external clinics to be closed down so, of course, the Chumwari Maternity Hospital numbers soared to over 1,200 births per month.

As the women who attended in labour were far too many to be accommodated in the small delivery unit they were all herded together in a big assessment or first stage room. There were no curtains to allow them privacy or to accommodate their preferred birth companions. These were usually women, either T.B.A. traditional birth attendants, or a member of the family. Men were not allowed in. Two members of staff were allocated to look after the women in labour and most days there were over twenty labouring women per midwifery shift.

One of the tremendous achievements that the Southern African health services can be proud of was the partogram. It is used all over the world to this day in every maternity unit. This was a simple birth chart devised and invented by the midwives and obstetricians I was privileged to work with in the early 1970s. It was a life saver, a chart which at a glance, would demonstrate progress or alert the midwife that a labouring woman was not progressing normally. It gave the carers a clear cut off point which ensured the attendant had time to alert the medical services that an impending emergency was developing. This ensured that the obstetricians could either arrange instant transfer to a Centre of Excellence, the main Chumwari Maternity Hospital with all its resources, or to give clear instructions if a transfer was not possible, on how to deal with the emergency themselves. These carers worked in isolation. Being born, is the most hazardous journey a human being makes in its life and these women attendants were worth their weight in gold, accepting such awesome but necessary responsibility.

Of course the maternal death statistics were very high, as were the peri-natal statistics; the latter covers the period from twenty-eight weeks gestation to four weeks after birth. The year I did my training the statistics were 23 per 1000 women who died in labour. This number apparently increased to 64 per 1,000 in 2000. Dreadful, I know when Britain’s at the time were under 4 per 1000. The peri-natal statistics were counted in percentages which were approximately ten percent of deliveries a year. These were horrific statistics indeed.

Chapter 4

Chumwari Maternity Hospital had a reputation for being the best in regards quality tuition and experience. Doctors and midwives came from all over Africa and from Europe to train in this centre of excellence. My group was made up a mixture of indigenous girls, British girls and a lass from India. We were a boisterous crowd who gelled immediately and were joined by two Irish doctor siblings Mary and James O’Malley. We worked and played together enjoying the excellent facilities available to us in the way of various sports clubs in the City of Salisbury not too far from Harare. Life was hectic and fun.

The admission suite was the initial point of contact. Once the woman had been assessed and was in labour nature decreed that the back passage cleared prior to the birth. This happens in all childbirth. As the African women’s normal diet consisted of bulk high fibre maize meals three or four times a day it was absolutely essential for every woman to receive an enema of a lot of green soapy water. Without an enema, it would be quite possible to lose the baby in the products of defecation or at