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They're all special deliveries

Saturday 5 May is International Day of the Midwife, designed to highlight the work of midwives around the globe. Joan Gibson has worked as a midwife in Britain, Zambia and Zimbabwe and found a world of difference in the way their health services worked, as she explains to Claire Brine

Birth is a very precious and spiritual moment

JOAN GIBSON was just 22 years old when she left her home in Scotland and travelled to Zambia to work as a nurse and midwife at a Salvation Army hospital.

‘I’d only been on a plane once before,’ she recalls. ‘And yet off I went to Africa on my own, not really knowing what lay ahead of me. Working at the Chikankata Hospital was a steep learning curve for a relatively new midwife like me.’

Today Joan is The Salvation Army’s international health services co-ordinator, supporting the Movement’s work in hospitals and clinics across the world. A teacher of midwifery and nursing, she has always been driven by the desire to help people.

‘In 1972 I began my training as a general nurse at the Glasgow Royal Infirmary,’ she says. ‘During that time, I did an eight-week placement on the maternity unit and thought it was what I should do when I qualified. So three months after qualifying as a nurse, I started my midwifery training at the Aberdeen Maternity Hospital.

‘Supporting and assisting women as they brought their babies into the world gave me great joy. I wanted to help mums do the best job they could and give them the support they needed.

‘I felt privileged and blessed because of the opportunity I had been given. I knew The Salvation Army had hospitals overseas, so I offered my services as a nurse and midwife in order to repay God for seeing me through my training. Before I knew it I had been accepted to work at Chikankata Hospital in Zambia.’

Joan signed up for three years’ service. Full of enthusiasm, she packed her bags and headed off with no idea of what was in store for her.

‘My last Sunday before I left for Zambia, the Salvation Army officer at Aberdeen Citadel – which was my church – asked me how big Chikankata Hospital was,’ she says. ‘I told him that I didn’t know. He then asked me what kind of work I’d be doing when I got there. I replied that I would be using some of my nursing skills. But looking back on it, I can see that I didn’t really have a clue. I was a young nurse and midwife with less than a year’s experience.

‘When I arrived at the hospital, I was amazed at what was expected of me. On my first day the matron showed me round and said: “Tomorrow this ward will be yours to look after.” Then we went next door and she said: “This ward will be yours as well.” From there, she took me to the antenatal clinic, where there were four benches with screens around them and student midwives at each. She smiled and said: “The student nurses need someone to check what they are doing.”

‘Suddenly I realised that it was time to start work. Ten minutes later the matron was called away. Before she came back, a student came rushing into the clinic from the labour ward, saying: “We need a qualified midwife in here. Can you come and assist?” I said yes and went.

‘So, on my very first day, I ended up teaching student midwives how to support and care for a woman in labour and helping them to bring another healthy baby into the world. Once the baby was born, I went back to the antenatal clinic, hoping the matron hadn’t missed me in my absence.’

It wasn’t the last time Joan was thrown in at the deep end. Towards the end of her first week, a staff member talked her through what happened during the night shifts.

‘The next night, I was left in charge of the entire hospital,’ she recalls. ‘It was all mine from 4 pm to 8 am! It is a night that I will never forget. I was still trying to learn my way around. Halfway through my first night, a nurse came to me and said she needed blood. I had no idea what the key for the laboratory looked like, or even where the blood might be kept, but gradually I learnt these things.’

As well as getting to grips with her new role, Joan had to adapt to different practices in a new country and treating medical conditions she had not encountered before. She also discovered that some jobs that would be carried out by a doctor in the UK now fell to her.

‘I was expected to suture and to deliver babies that were breech, so I dug out my textbooks and made sure I had those skills down to a fine art.’

After three years Joan headed back to the UK. During her time in Zambia, she had been on call as a nurse – but now she felt another call which she couldn’t ignore.

‘I felt as though God was saying to me: “I need a full commitment from you, not a three-year contract.” I knew God wanted me to become a Salvation Army officer.

‘At first, I hadn’t been willing to give up my nursing – becoming an officer meant being prepared to leave my nursing behind, and that didn’t feel right. But I knew God wanted me to trust him. So I did and went to the Salvation Army training college in 1980.’

After being commissioned as an officer in 1982, Joan was appointed back to the Chikankata Hospital in Zambia. During her time there she worked in almost every department. Three years later she was transferred to The Salvation Army’s Howard Hospital in Zimbabwe, where she worked as the midwifery teacher.

‘From those early days in Zambia, I have always felt that God has blessed me with the gift of teaching,’ she says. ‘So over the years I have tried to impart to others what knowledge and skills I have received.’

As well as training student nurses, Joan took on preaching duties at the hospital and the local Salvation Army church. She led children’s Bible studies and ran Sunday schools. Some of the children from those groups went on to become student midwives.

‘In many ways, I saw similarities between being a nurse and being a minister,’ she explains. ‘Both are caring professions. An officer comes alongside an individual and their family and a midwife comes alongside a woman and her family. They both offer support and guidance.

‘Birth is a very precious and spiritual moment. Every time a baby is born, joy comes into the world. The Bible tells us that we are wonderfully made by God.’

After working for 40 years as a midwife, Joan has lost count of the number of babies she has delivered. But one of the most dramatic stories that Joan can remember is the night when two women needed an emergency caesarean section.

‘One woman had ruptured her uterus. The other had a cord prolapse. They both needed caesareans immediately, but we only had one theatre. So we had to turn one of the delivery rooms into an operating theatre. Both mothers survived and recovered well.’

As much as Joan enjoys talking about the babies she has delivered, there have also been times of sadness during her career as a midwife. Occasionally mothers and babies have died – and coping with the loss never gets any easier.

‘I remember my first maternal death and how difficult it was,’ she says. ‘I was in Zambia but, because the neighbouring country of Rhodesia (now Zimbabwe) was still fighting for independence, there was tension in the area. The mother-to-be was from the valley. She had been pushing all night at home. Her family didn’t want to bring her to the hospital before morning, as they were afraid of possible landmines on the road.

‘At about 10 am, someone said to me: “There’s a lady in an ox cart outside, and she’s delivering.” I went to see her, pulled back the covers and saw that the baby’s arm was out, up to the shoulder. Quickly, we got the woman into the labour ward and then to theatre, where the doctors tried to save her life, but she died on the operating table. She had arrived too late for us to be able to help her. The family were left wondering if they should have taken the risk and left the night before.’

After dedicating her entire working life to caring for others, in April 2015 Joan moved back to the UK, where she enjoys her present role based in London. She plans to retire in just over two years. Until then she wants to continue travelling to the many hospitals and clinics The Salvation Army runs around the world, which mainly treat some of the poorest people in isolated areas.

She hopes to provide support and encouragement to staff and, where possible, continue to train midwives, enabling them to provide the best care they can to mothers and babies.

‘I’ve learnt that it is so important to live for the moment, to take every opportunity that comes to us,’ she says. ‘Possessions have never had much of a hold on me, but my work has certainly taught me to be grateful for all that I have: good health, strength, family, friends and my faith. I hope that I will be able to continue to use all the knowledge and skills that I have been blessed with to serve others.’

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