Young women with elderly woman spinning cotton, Abdal Galil village, Sudan.

      I was there at the invitation of Besaina, the midwife of the village of Abdal Galil (pronounced AB-dal ja-LEEL). I had arrived in the village only a few days before, planning to spend several weeks doing participant observation as part of the study I was doing for the Sudanese Ministry of Social Affairs on the utilization of health and social services in Gezira Province. My research assistants had already carried out interviews in a sample of villages and at schools and clinics we had selected throughout the region. But as an anthropologist, I knew the findings would not be complete without looking at the sociocultural context of people’s decisions to use or not use the government services. We also needed to include information on the alternatives to these services that drew upon people’s traditional ways of meeting their educational and medical treatment needs.

      A colleague at the University of Khartoum convinced me to include Abdal Galil village as the site of the more ethnographic piece of the study, one that would be useful both for the Ministry of Social Affairs study and for my dissertation on health services and health in Sudan’s irrigation schemes (Gruenbaum 1982). Thus began my long association with Abdal Galil. Gezira Province was the site of the most extensive irrigated agricultural scheme in the world at that time, a feat made possible by the abundant water of the Blue Nile, fertile soil, ample sunlight, and extremely flat land that gently sloped to the north, allowing for gravity-fed irrigation canals. During the period when Sudan was under the control of the British, pilot projects were conducted and a massive dam, a network of canals, and an infrastructure of railroads, roads, and management offices were constructed, imposing new social and economic arrangements on the people of the area, including some population migration to provide additional labor.

      My colleague Ibrahim Hassan Abdal Galil, then director of the Economic and Social Research Council of Sudan’s National Council for Research, thought this village would be particularly appropriate for study because it was a fairly old village (about one hundred years old) with a strong tradition of education and religious observance and it was led by an influential family of which Ibrahim was a member. His father had been a prominent leader in the trade union the farmers had formed during the colonial days. Others in the family had achieved high levels of education and were prominent in regional and national politics; his brother had been the minister of agriculture for several years. The village founder was Ibrahim’s grandfather, Abdal Galil Hassan, who had gathered kin and supporters at a new well site to build their homes, following a dispute in the nearby village where they had been living near the end of the nineteenth century. The new village had flourished under his and his sons’ leadership, attracting educated religious scholars to teach the children of the region at a mahad, or school for the study of the Qur’an and religion, literacy, and mathematics. Families housed children of distant kin who came as students. Although it was boys who studied there in its early years, Abdal Galil and his family were early supporters of education for girls, donating money to the famed “father of girls’ education,” Babikr Bedri. Bedri founded the school in Omdurman (across the Nile from Khartoum) that has become the foremost women’s university in the country, Ahfad University. When the government began providing teachers to teach a government curriculum, the inhabitants of Abdal Galil raised money to build a school for girls shortly after they built one for boys.

      Abdal Galil offered an ideal situation for research. The village had electricity (as only about half of the villages of the irrigated area did), clean well water in a tall water tank that fed the local taps in homes of the better-off families of farmers, and a fairly good dirt road. There was a clinic that was much superior to the one-person “dressing stations” found in many places. Abdal Galil’s clinic was a “health center” that boasted a trained medical assistant, a lab technician, clerical staff, cleaning staff, and even a health visitor, whose duty was to supervise the midwives of the surrounding villages.

      My research assistant and I were invited to stay at the home of Ibrahim’s widowed, elderly mother, which afforded a respectable niche and easy entree for two women on their own among strangers. Hajja Fatma welcomed us with gracious hospitality. The title hajja recognized that she had gone on the Muslim pilgrimage to Mecca. My assistant, a researcher from the Ministry of Social Affairs named Awatif Al-Imam, was unmarried, and although she was educated, employed, and the daughter of liberal parents who did not disapprove of her pursuit of a career that necessitated rural research, this respectable and reasonably comfortable living arrangement was valued. We were both used to Sudanese urban middle-class lifestyles (with electricity, telephones, refrigeration, plumbing, and cold-water showers), so the latrine without a door (requiring a discreet cough as one approached in case someone else was already there) and the sometimes muddy and poorly lit paths of the village took some getting used to. Hajja Fatima offered us beds on a screened porch, fine for the warm nights. She had a refrigerator, so we could drink cold water after a hot morning of visiting and interviewing, and we did not need to cook for ourselves.

      The house was well located, just a short distance from the mosque at the center of the settlement. The lofty minaret—from which the call to prayer was chanted at the five prayer times of the day—was visible from a great distance and served to orient me to our house. After hearing about the village midwife from the clinic staff, I met her in our neighborhood.

      Besaina was an extremely capable and confident woman, and I liked her immediately. A widow with five children, she was a farmer who held claim on a ten-acre tenancy in the irrigation scheme. She had made the difficult decision some ten years before to spend an entire year living away from her family to undergo the government’s midwifery training in a distant town. Literacy was the prerequisite for the training (Besaina had had a few years of elementary school), which consisted of courses and ample direct experience under the supervision of a health visitor with advanced nurse-midwifery training. The class of thirty-six students went to many villages to attend births, and each student had to do twenty deliveries by herself before she could be certified.

      So that prospective midwives would apply themselves to their studies and not forget what they had learned, the government’s midwifery training schools did not allow students to go home for the entire twelve-month period. Their children could be brought for visits only on Fridays, and those who attended schools at some distance from their homes seldom saw their families.

      Despite the hardship, Besaina was very pleased to have had the training, as she could earn additional income and her role had earned her respect in Abdal Galil and the neighboring villages. She earned a reputation for never having any problem deliveries because she referred difficult births to the nearby hospital early and she had done several successful breech deliveries. When I first met her in the 1970s, however, Besaina’s government salary was the equivalent of only thirty dollars a month, a very small sum even by local standards. The midwives had been passed over when government raises were set that year; she explained that the government believes that the additional payments and gifts midwives receive from clients provide adequate income. But those sources are not much. At that time she reported such payments to be very small—about five dollars for a circumcision and eight to fifteen dollars for a birth. She was also expected—and was willing—to perform services for free if a family could not afford to pay. Families usually also gave the midwife gifts on both occasions, usually soap, perhaps perfume or incense, and some of the meat if an animal was sacrificed for a celebration.

      Once certified as a government midwife, Besaina had been issued some basic equipment she kept in a metal box she carried with her when she went to see clients. Midwives were entitled to ask for supplies at the health clinics, but she told me they usually did not have what she needed, so she bought her supplies in the market in town: razors, disinfectant, antibiotic powder, a plastic