Mabel Wolff and the Midwifery School (1920): Counter-Colonization (1-2)

Abdullah Ali Ibrahim

Dr. Hassan Balla Al-Amin, The Barefoot Doctors of Sudan: A Story of Worldwide Success, Khartoum University Press, 2012 (Second Edition, Al-Musawarat 2025)

(I was honored by Dr. Hassan Balla Al-Amin’s request to write the preface to his book. Below is what I wrote.)

This book warmly celebrates the training of midwives at the Midwifery School established in Omdurman in 1920. Its admiration for the experiment is so profound that the author describes it as an early example of barefoot doctors—practitioners providing basic health care without formal professional degrees—preceding the famous Chinese barefoot doctors by several decades. The author laments that Sudan’s midwifery experience did not receive the same recognition that China’s barefoot doctors did. It remains unacknowledged even within the corridors of the Faculty of Medicine, established later in 1924. As a graduate of this Faculty, the author personally regrets not learning during his years there about this brilliant chapter in the art of obstetrics. He describes the success of the Midwifery Institution as a form of genius, noting the astonishment of everyone who heard his lectures about it. A Sudanese surgeon once stood up after hearing his talk abroad and said:
“You made me feel proud as a Sudanese as I never felt before.”

The author’s aim in documenting the Midwifery School was to inspire the incorporation of its genius into national health policy, particularly to benefit rural health care. For forty years, he remained deeply engaged with the experience of barefoot doctors at the school, meeting those who were behind the training of those pioneering women and conducting research within the framework of his specialty in family medicine. He first wrote his works in English but was dismayed that they did not reach his own people, prompting him to write this book in Arabic—a culmination of knowledge accumulated over four decades expressed in a foreign tongue. He states: “I hope this book expresses my love for my homeland and for those among its people who are most in need of support.”

The author had the chance to meet Mabel Wolff, the founder of the Midwifery School in 1920, as she lived to be a centenarian. She welcomed him warmly, pleased that a young Sudanese doctor sought to learn about their early experiences in Sudan. He also met with Ellen Kendall, the last British principal of the school, and searched for Miss E. Hales-Young, who succeeded Mabel as headmistress. In Sudan, he met with Batoul Mohamed Issa, the school’s first head midwife and later its long-serving principal, as well as Set Al-Doun, one of the school’s early graduates and later principal of the Madani Midwifery School, and Set Hawa Mohamed Saleh, a pioneer in nursing and midwifery.

The midwife training program was initiated under Mabel Wolff, who was later joined by her sister Gertrude to assist when Mabel fell ill in 1929. Once recovered, Mabel resumed her role with Gertrude as her assistant. Mabel had come to Sudan from Egypt, where she served as the Head of Nursing in Fayoum. The goal of the school was to ensure a trained midwife in every village to combat harmful practices affecting women’s health and to care for women and their children.

Mabel’s approach was to advocate maternal health through kindness, not authoritarianism. She did not view resistance from traditional birth attendants as premeditated rebellion but as the natural pride of experienced women in their profession. She wisely incorporated these traditional midwives into the new system rather than alienating them. During her inspection visits, she promoted the school and engaged the public rather than seeing the traditional midwives’ opposition as sabotage. She organized what she called “talks on midwifery” to soften their resistance. Resistance was real—even student midwives disliked boarding at the school. A traditional midwife once jabbed Mabel and said, “I delivered babies before your mother was born!”
Her first class included two traditional midwives aged 68 and 70. She quickly graduated midwives like Aziza Percy (68) and Mastoura Khidr, who was slightly younger, to counter the perception that as a foreigner she lacked knowledge of Sudanese birthing traditions. Jundia Saleh, although illiterate, played a special role in bridging the professions of nursing and midwifery among women.

Mabel’s key method was her exceptional sense of camaraderie with her team. She said of Batoul Issa:
“She is truly an extraordinary woman in her attitude towards life, in raising her son, and in her deep sense of responsibility. Work comes first for her, no matter the cost. She spares no effort. Her steadfast adherence to the values and honor of the Midwifery School was the dearest thing to her.”
Mabel and her sister Gertrude described the late Jundia Saleh, who died of cancer in 1936, as a “warrior fighter” and wrote an epitaph for her grave. A granddaughter of Jundia was moved to tears when the author shared Mabel and Gertrude’s tribute.

One of Mabel’s most remarkable gestures of solidarity was learning the Sudanese vernacular to deliver her message of modernization in the people’s language. She did not settle for her knowledge of Egyptian Arabic. She mastered Sudanese colloquial Arabic so fluently that during the author’s visit to her home in England, when a colleague broke a vase, Mabel exclaimed in perfect Sudanese:
“Inkasar al-shar!” (“May the evil break!”)

Her command of the vernacular allowed her to compile a glossary of Sudanese terms related to pregnancy and childbirth to aid in midwife training. She emphasized starting from the client’s and provider’s cultural base rather than imposing an assumed superior culture. She authored The Sudanese Arabic Handbook for Midwives, translating scientific terms into accessible local language with vivid imagery:

The body is described as “like a furnished house, with each piece serving a special function.”

The heart is like a pump that “sucks out bad blood.”

The chest is likened to a bony cage, and the lungs to windows in a house.

The stomach is compared to a “grinding stone,” pulverizing food like flour.

Mabel creatively employed daily routines to deliver medical advice. To convince women to abandon the custom of forty days’ bedrest after childbirth, she used the metaphor of coffee brewing: describing the uterus as a pot of coffee that, if left still, would retain residue, just as retained postpartum fluids could harm a resting woman. Her training books were richly illustrated by her own hand, as she was also a talented artist—perhaps it was her love for art that allowed her to approach her colonial subjects with such graceful empathy.

Mabel even brought kitchen metaphors into training: she coined “lifting the pot’s lid” as a way to encourage women to attend prenatal checkups, asking them:
“If you had a pot on the fire, would you let the food burn, or would you lift the lid from time to time to check on it?”
The phrase “lifting the pot” became a common expression for prenatal care.

She also used religious imagery in training:
“Remember, every baby you help bring from the darkness of the womb into the light of life is a gift from God, and you must honor this divine gift.”
The curriculum even leveraged folk religious beliefs: a traditional saying promised that a midwife who delivers ninety-nine firstborns would earn paradise. The author laments that this spiritual richness—echoing Professor Abdullah Al-Tayyib’s call for the integration of native blessings into education—has been largely lost in modern medical education and practice, where material wealth and prestige often prevail.

One cannot avoid comparing the Midwifery School with Bakht Al-Rida Institute, given that both were educational initiatives launched by the same colonial power ostensibly to lift the colonized from poverty into modernity. However, such a comparison would do a great injustice to the Midwifery School.
While both institutions recognized the limited resources of Sudanese culture in their respective fields, their philosophies differed sharply.
Bakht Al-Rida aimed to replace the presumed poverty of indigenous culture with an imported richness, constructing an elite school for a poor environment (or “a stupid one,” as some put it).
In contrast, the Midwifery School sought to invest in women’s cultural knowledge to achieve modernity from within. Midwives were trained to work inside the poorest homes, utilizing available resources.
They were taught to memorize medication uses and dosages and use their senses—taste and smell—to identify medicines in the absence of lighting. Childbirth and infant care were practiced on locally made dolls crafted by the trainees themselves, fostering participatory learning. A doll named “Zarifa” (“the graceful one”) was used for teaching delivery. Stitches were practiced on old tire tubes.
Mabel respected her trainees’ illiteracy, providing color-coded discs to monitor postpartum danger signs, thus accepting the midwives as they were and offering accessible means for them to master their profession and its language.

The two institutions also differed significantly regarding institutional hierarchy and the colonial power’s attitude toward its subjects.

(To be continued…)