Anna Kent Spills All About Her New Book: Frontline Midwife

Being honest, reading your book is quite a fear-inducing experience, even from page one - the idea of being in my mid-twenties, packing my bags and heading to a conflict zone is pretty terrifying. How did you deal with it all back then?
Because I was young and inexperienced, I had this naive view of aid work that meant I was pretty fearless when I decided to make the move abroad. But that wasn’t necessarily positive. The thing about fear is that it’s a really primitive human instinct that can help you to think and plan for high-risk situations to ensure you avoid them. The problem with being fearless is that it can drop you into scenarios that you aren’t ready for, and because I wasn’t feeling scared, I think I definitely went into that venture unprepared. 

So you were fearless before heading out to these dangerous places, but was there a moment when the reality of your situation kicked in? 
The flight over to South Sudan was a huge wake-up call. I was sitting on the plane with my back-pack, wearing my DWB logo, feeling all cool, and then suddenly the cargo ramp lowered and in came the heat - it was fifty degrees and I didn’t know if I’d be able to breathe, never mind work. 

We stayed in a tent and worked out of a mud hut, so it wasn’t grand by any stretch of the imagination. Then I met my first patient, who was a woman who had suffered the death of her baby, had no midwife, and the impact of that on her body was horrific. It was an injury I’d never seen before. That provided a huge moment of realisation as to what I had signed up for. 

As much as I worried for my own safety - I once had a black mamba slither past my foot, we had to watch out for red cobras, we often heard gunshots firing in the background - my biggest fear was failing these patients. From a selfish point of view, I was definitely scared about living with that sense of grief and guilt, believing that I’d let someone down. The outcome of that fear was that I became hyper-vigilant. I worked for three months straight without a break, we were on call 24/7, we only got tiny amounts of rest. And while there is a place for hyper-vigilance, the problem with that long-term is that you reach a breaking point without seeing it coming, and then suddenly you’re off a cliff-edge mentally. 

In the book you talk about how you had experienced some dangerous situations working in our hospitals’ emergency departments, such as when a man pulled a knife on you. Did your time here prepare you for the unpredictable nature of your future work more than you imagined it would? 
The ED at QMC was the busiest in Europe at the time. I loved it there, we had a brilliant team, but we were met with complex cases - we saw gunshots, we saw stabbings, I saw some dreadful incidents. That definitely prepared me for trauma care in general, but it couldn’t really prepare me for not having access to an x-ray machine, or a lab, or running water - or for the types of illnesses that only come from living in absolute poverty, as many of my patients in war zones were forced to. That was definitely difficult to come to terms with.

And now that you’re back in the UK, you’re obviously working under completely different circumstances for the NHS than you were for Doctors Without Borders. But does that fear of failing your patients still live with you? 
I think every NHS worker has the fear of doing something wrong. It drives us to work harder, to do more. But what makes this more challenging is that there’s chronic underfunding and a severe staff shortage. None of us want to miss anything - that’s our biggest fear, missing something that could have helped someone - but we’re being asked to provide more services with less time and fewer resources. 

To look after my own mental health, I now practise mindfulness and gratitude. I know some people think that’s a bit naff, but I’ve found that being aware of what I’m saying and doing, as well as regularly taking time to appreciate the ways in which I’m really fortunate, helps to sustain me. I also try to practise grassroots kindness. I like people, even difficult people, and I want to really care for them, rather than rushing them through and moving them on. Taking this personable approach is so important for staying motivated and positive.

Finally, this is a very personal book, diving into some really intimate stories and life lessons. How did you find writing this up knowing that it would be available to the wider public? 
You mean knowing my parents would read it? Look, as a healthcare worker, I have to talk to my patients about things like sex, and vaginas, and emergency contraception, and my thinking was that if I can’t be honest about these things myself, how can I expect other people to talk about them? There are a lot of things in the book that are quite taboo, and gritty, and raw. But everything that’s in there is there on purpose. 

One of the reasons for this is that taboos can kill women - if people don’t get access to timely contraceptives, for example, it can be deadly. I’ve got the agency and the privilege to speak out without massive repercussions. Maybe some people will find it awkward to take in, but I can say things and not be silenced. What I hope is that if I can speak out about topics that matter, then maybe that can somehow help people who don’t have that ability, because it creates a dialogue that might improve situations for them.  

Frontline Midwife: My Story of Survival and Keeping Others Safe is now available in bookstores and online

@AnnaLouiseKent