Tag: South Sudan

The Final Stages of the Hero’s Journey for the Frontline Midwife

In a previous post, I discussed the story of Anna Kent as a midwife volunteering in South Sudan in terms of the first 8 stages of the Hero’s Journey.  What I will discuss now is her Sudan story expressed in terms of the final stages of the hero’s journey (Stage 9-12).  I’ll be drawing again on her book, Frontline Midwife: My Story of Survival and Keeping Others Safe, in which she tells her story in graphic detail.

The final four stages of the hero’s journey – stages 9 to 12

The final four stages of her hero’s journey in South Sudan were deeply formative and life-changing and enabled Anna to develop a new perspective, skills and determination to help others in need wherever they were in the world:

9. Reward – there is no doubt that Anna emerged a stronger person as a result of overcoming personal challenges, including self-doubts and questioning of her obsession with volunteering.  The reward, too, that she experienced involved saving the lives of mothers, children and babies.  However, she had to deal with the sense of guilt she felt for the death of baby Mariam.  James tried to reassure her that she was not responsible for the death of the baby – in his words, “it was everyone in the world’s fault”.  She accepted intellectually that “every aid worker has a patient they carry in their conscience”.   Emotionally, though it was a continuous challenge to overcome the sense of guilt which pervaded her nightmares as she relived the traumatic event.  Unfortunately, our brains carry a negative bias – we see the negative much more strongly than the positive.  For a time, Anna found that her negative thoughts overwhelmed her rewarding thoughts – her personal satisfaction that she had saved many lives who otherwise would have died without her skilled and brave intervention.

10. The Road Back – this is both a physical journey and a metaphorical one.  On the physical level, it involves returning to her “ordinary world” – life with her boyfriend Jack in their comfy home in Nottingham.  The metaphorical aspect relates to being comfortable with her new self in an environment that is starkly different on every dimension to the one she was leaving in South Sudan.  It also meant dealing with the grief of leaving her mentor, James, her colleagues and the Sudanese people who she grew to love and admire for their courage, gentleness and stoicism.  Her short recreation spells during her volunteering in South Sudan forewarned her of the pending difficulty of the “road back”.  She found on her brief recreation trips that she could not share with Jack the horrors and traumas she had experienced and realised that she was totally lacking in libido.  Friends would ask about the exciting bits of her story but all she could share were her stories about snakes, not the reality of the poverty, harshness, and deprivation of the basic rights of women in South Sudan.  She found that she and Jack had so little to talk about, and their time together involved lots of silence as Anna tried to come to grips with crossing the threshold back into her former life. 

11. Resurrection – on her return home Anna broke off her relationship with Jack and moved to her parent’s home.  This created significant stress for her as she was unable to talk to her parents about her Sudan experiences or her reasons for breaking up with Jack – both these topics were too raw and traumatic.  In speaking with James her mentor, she shared her angst and he informed her that he had experienced similar dislocation and disorientation on his return from volunteering abroad.  James suggested that he made the mistake of “trying to be the person I once was when that person has gone”.  Anna recognised that everything changes with overseas service in a different culture and land where deprivation is rife – your values and perspectives change and you see “luxuries” and waste with new, intolerant eyes.  The way home for her involved a dying to the old person she once was and becoming a new, stronger, values-driven person. 

12. Return with the Elixir – another phase in Anna’s transition to her new persona began with entering a share house with two other nurses.  What she found was the ability to party together and share their experiences in a way that was cathartic.  Out of this period came a very strong resolution by Anna to build on her newly acquired midwife capabilities.  She enrolled in a midwifery degree at Nottingham University and had a very rewarding and enlightening work experience in Ethiopia as a student midwife.  She felt stronger and better prepared for subsequent volunteering missions involving Haiti following the earthquake in 2010 and Bangladesh working with Rohingya refugees – and these experiences entailed different journeys with new challenges and companions (as discussed in her book). 

Reflection

Throughout her hero’s journey in Sudan and beyond, Anna had to face her traumas which had “many heads” and in the process develop her resilience.  An experienced volunteer nurse, Anita, had told her “you’re gonna have to work out how to sit with these painful feelings without reacting to them”.  Like James, Anita suggested that meditation would be helpful as well as focusing on what has been achieved, not what her inner critic perceived as a “failure”.  James even suggested that Anna meditate for “an hour every day” and often encouraged her to be in the moment and experience what was before her – e.g., children playing with kites made from sticks, and the earth glowing from the setting sun. 

Anna demonstrated that as we grow in mindfulness through meditation (no matter how difficult we find it) and other mindfulness practices such as being in the moment, we can learn to regulate our emotions, deepen our self-awareness and develop resilience.

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Image by Steve Buissinne from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group, and the resources to support the blog.

Mindfulness on the Path of a Hero’s Journey

Anna Kent has provided a thought-provoking memoir in her book, Frontline Midwife: My Story of Survival and Keeping Others Safe.  The “frontline” theme of her memoir enriches our understanding of this concept.  Anna’s story recounts how she undertook nine months service with Doctors Without Borders (Médecins Sans Frontières, MSF) in South Sudan – where the population had suffered civil war for fifty years, with ongoing outbreaks of conflict despite a peace settlement.

Anna whose background was as a nurse in a hospital Emergency Department (ED) in the UK found herself as an accidental midwife.  There was no one else available to do the task because there were no trained midwives in South Sudan at the time because of the civil war and its impacts.  As I read her “heart-wrenching tale”, I recalled Joseph Campbell’s book, The Hero’s Journey. 

Anna’s story is told with unassumed humility, raw emotion, and acknowledgement of her fears, frailties and vulnerability.  As nurses tend to do, she provides graphic descriptions of the medical challenges she confronts and provides a warning at the front of the book in terms of potential triggers for people who have experienced birth-related injuries, maternal death, loss of a baby or gender-based violence.

The first eight stages of the hero’s journey – a structured view

As  you read Anna’s memoir, you can begin to map Joseph Campbell’s twelve stages of the hero’s journey throughout her account.  I have attempted to link her story to the first eight stages in this blog post:

  1. Ordinary world – Before her journey, Anna enjoyed a comfortable life with her kind and musically talented boyfriend, Jack, and a home in Nottingham which included “an airy, high-ceilinged bedroom”.  Her normal professional world was that of a highly qualified ED nurse at the Queen’s Medical Centre, Nottingham, where she coordinated a major trauma unit.  To prepare herself for her work in South Sudan, she undertook a number of voluntary shifts in the maternity unit while on leave, completed a diploma in tropical nursing and volunteered for a brief placement at a Zambian Hospital in a rural district.  Additionally, she completed a pre-departure course conducted in Germany by Doctors Without Borders (MSF).
  2. Call to adventure: Ever since an early age in her childhood, Anna felt the call to do something about the suffering and pain she saw every day on TV and in the newspapers.   She felt a strong urge to help alleviate the overwhelming suffering she observed, especially that experienced by children like herself.  As an adult, she experienced “complicated reasons” for wanting to volunteer and help those in need of relief from pain and suffering.
  3. Refusal of the call:  As she was packing for her trip, Anna was almost overcome by her fears and uncertainty.  She felt ill-prepared for what lay ahead and concerned about leaving her boyfriend and all the comforts of her everyday existence.   She could acutely feel the tug to stay and not take the perilous journey involved in work in South Sudan.  She also wondered about her comfy life, “Why isn’t this enough for me?”
  4. Meeting the mentor: At Loki, in north-west Kenya, Anna underwent a week-long training that included how to survive a kidnapping, emergency evacuation, and working in isolation.  She was informed that there was no internet access because computers melted in the heat and was warned about landmines, poisonous snakes and scorpions.   She was told about her onsite mentor who she would meet on arrival in Tam, South Sudan.  All she knew about him was that he was over sixty years old and “eccentric”.
  5. Crossing the threshold: Anna crossed the threshold in more ways than one.  She flew to Tam in a rambling, old aid plane which was the main transport for people and supplies to this remote area of South Sudan.  The flight itself involved being thrown into the reality of war-torn Sudan with bandaged passengers and a woman covered in a bundle of rags lying on a stretcher on the floor of the plane.  She was dying and had an IV line connected to her arm and attached via string to the seat’s edge.  The French nurse attending to her indicated that the woman would be delivered to the MSF Hospital in Leer, the State’s capital.  Anna was very aware that back in the UK, this woman would have had the best of care including drips and monitors and would not have had to suffer the indignity of travelling on the floor’s plane.  She was informed that Tam itself suffers from a drastic shortage of pain relievers, antibiotics and other medical necessities.  After offloading the dying woman and other passengers in need of urgent medical attention, the plane flew onto Tam where Anna would be working.  Her plane eventually lands roughly on the mud landing strip that reflected the terrain – hot, barren and forbidding. 
  6. Tests, Allies, Enemies: The heat and oppressive conditions are the enemy.  Anna meets her mentor, James, a very experienced nurse and she took an immediate dislike to him.  His joviality in the face of unmitigated horrors does not ring true and she can’t make him out.  This uncertain relationship with someone whom she will have to depend on, added to her discomfiture.  She identified an ally in another female nurse who supports her in the early days of her volunteer work in Tam.  However, she is horrified by her sleeping conditions – she is in a tent with James nearby in another tent, both located within the dirt compound that is also traversed by poisonous snakes and scorpions.   On top of this are the conditions for patients, many of whom walk many miles to attend the clinic even when seriously ill.   The waiting room is effectively the “Waiting Tree” where patients huddle under the limited protection provided by a tree within the dirt compound.  The stream of patients is endless (Anna and James treat 1,000 patients in a month) and the diversity and complexity of illnesses is scarry.   The makeshift wards are overrun with some patients having to lie on mattresses in the dirt compound.  There are continuous life and death decisions determining who will be airlifted to the hospital in Leer, given the restricted availability and limited capacity of the aid plane, and the resources at the hospital itself.  
  7. Approach to the inmost cave: The death of a young boy became a crisis point for Anna.  Her inner conflict intensified, doubts about her own capability in such trying conditions resurfaced, and she experienced emotional turmoil and overwhelm at the sight of unmitigated suffering, pain and death.  She was tense about what further trauma lay ahead.  Her salvation came in the form of lengthy, tent-to-tent conversations at night with James , her mentor.  Unburdening herself with him and talking through what she was experiencing in an open and honest way changed their relationship.  It helped her deal with her emotional crisis  These conversations  enabled her to reflect on her challenging experiences as they occurred and voice her worst fears.  He offered her reassurance and emotional support.  James introduced her to the power of mindfulness for dealing with turbulent emotions.  Anna came to value his advice, his philosophy of life and his positive psychology.
  8. Ordeal: The ultimate ordeal for Anna and the medical team arrived in the form a 16 year old pregnant girl who was in deep distress and agonising pain.  Anna played a major role in successfully delivering premature triplets and helping to save the young girl’s life as she was in acute danger of dying from excessive bleeding resulting from “postpartum haemorrhage”.  This experience gave Anna the ultimate high so that she felt like a “hero” and suddenly understood why she had volunteered for such physically and emotionally draining work. She believed at the time that the high from this event would enable her to ride out the lows.  The image of the young mother walking home with her triplets in a basket on her head reminded Anna of what was possible in saving others and to value her own contribution.

Reflection

Anna’s story lends itself to mindful reading which according to Mirabai Bush “moves the reader into a calm awareness, allowing for a profound experience and understanding”.  It requires full attention, avoidance of distractions and openness to thoughts and feelings as they emerge throughout the reading process.  This story is rich in self-disclosure, replete with expression of emotions and immersive in its description of the context and physical environment.  Anna encourages us to join her on her hero’s journey into the challenging unknown and land of profound suffering.

Her efforts to grow in mindfulness through micro-practices increased her self-awareness and emotional regulation and enabled her to deal more effectively with the challenges that she had to meet on a daily basis.

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Image by Eszter Hornyai from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group, and the resources to support the blog.