TMRI emphasizes the holistic approach of TM that takes in consideration man in his totality within his ecological, socio—cultural and economic contexts.
In the Sudan, modern medicine is no more than a century old but it made major changes in man’s life. However, total coverage with basic services is far from satisfactory. And even when modern facilities are available they are either inaccessible or not the first choice of the ill or their attendant relatives. However, TM is deeply rooted in the Sudan. Its practices are wide and varied in keeping with the varied ethnic groups, tongues and religions. It has always been the first line of defense and in many instances the last or only resort. It is, in general, available, accessible, relatively cheap and above all trusted.
Nonetheless, traditional medicine and its practitioners have generally been kept away from the main stream of modern bio—medicine. Currently and concurrently with all other activities, various steps are directed at increasing general interest in TM. These are directed towards increasing objective rational debate in the media and through seminars, symposia, public lectures and publications.
Two decades ago, the Sudan adopted the Primary Health approach in health care delivery as it offers the most viable strategy for attaining the collective goal of HFA/2000, not only for its economic appeal but also because it offered, then, the most appropriate solution to the pattern of morbidity and mortality. The approach called for the utilization of appropriate and available local resources, including traditional medicine—-practitioners and practices.
A basic approach, therefore, is to bring together modern scientific medicine with the proven useful traditional practices within the framework of the local health system. This will entail supporting the formulation of relevant national policies and the development of practical organizational and coordination mechanisms between the health institutions, related social sectors and community agencies.
These villages are time—honoured realities throughout the Muslim Sudan. Some villages are more than 300 years old. A major approach is, thus, to identify these villages & make use of the system by grafting psychiatric and other components of modern health care in them. This is in addition to making the best out of collaboration with the respected and trusted faith healers. A basic approach is to involve them in planning, implementation and evaluation of community health activities and to enhance work relationships between them, and other members of the health team.
Integration of other types of traditional practitioners has started in the Sudan as early as 1920 with the training of the rope midwives (dayat al—habl). The experiment which has matured twenty years ago into a successful experience, will be endorsed and reinforced so that through midwives relevant health messages will be imparted to the households.
In TM the harmful practices and taboos are many. FC is undoubtedly the most tenacious and indeed the most brutal and inhuman. In the Sudan there are many activist groups campaigning against female circumcision (FC), a practice that is more than 99% prevalent among Muslim women. Efforts will be directed towards the promotion of communication between the different interested campaigners and researchers for more effective combat.
An important part of TMRI activities will be the dissemination of knowledge and experience in TM through technical cooperation and information exchange. In this direction TMRI has just finished compiling the literature on TM and related sciences and arts in the Sudan up to 2000. The data is now available for researchers as computer printout, and online.
Once there is an established policy, the second main approach is to develop the knowledge, skill and favourably change the attitude of manpower resources. Within an established integrational approach, relative training activities for traditional health practitioners for improving their competence and proper deployment have to be developed.
The store of local flora is rich. It provides in addition to medicinal ingredients, useful poisons like the moluscicides, insecticides and fish and arrow poisons (narcotics, brain stimulants, convlsants and muscle relaxants). The classical Arabic and Muslim literature abounds in herbal remedies. These classics in their various versions and abstracts make the basis of the knowledge of the Sudanese herbalist and indeed all healers in Muslim-dominated countries.
Research in traditional flora includes their ethno botanical, medico—anthropological, clinical and epidemiological aspects.
Identification of potent remedies for tropical disease that constitute a serious menace in the Sudan is a priority. Research will also continue on the different medicinal plants and medicaments that could be promoted for wider use in basic health services. It is high time to leave the mere screening of herbs (though undoubtedly needed) and move on to the production and clinical preparation of medications from those indigenous herbs that grow in abundance in the country. Their efficacy and safety should be validated. This approach needs more than good will and hopeful wishes. It needs dynamism and open—minded dialogue with the private sector, the main financiers for such ventures and with international donor agencies for support of pilot projects.
TMRI and Medicinal and Aromatic Herbs Research Institute take a fundamental approach aiming at strengthening their research capabilities to initiate, coordinate and foster the efforts of workers throughout the country to undertake research relevant to the needs of the country. TMRI endorses action—oriented and micro—case studies in all fields of TM.
As early as 1948, Tigani El Mahi has clearly coined the concept of "The Therapeutic Village". He befriended traditional healers and established bilateral referral systems with many of them. The concept of the village system which he propounded has been tested in practice and has proved its worth in treating the mentally ill elsewhere in Africa.
The TMRI Four Years Research Programme will also develop collaborative activities and establish links with concerned institutions as part of inter—country and inter—regional network and international bilateral collaborative projects. It is envisaged that local institutions will serve as the forefront for research methodological studies and advanced training.
On reviewing early socio—cultural literature in the Sudan especially that of last century and to some extent that of the early 20th century, it has been noted that (authors were more of curiosity hunters whose predilection was obtrusively for the strange and whimsical. Their writings created more enigma than they solved. The gulf between the observer and the observed was seemingly immense). To obviate this danger it has been suggested that (the research worker should in the first place be able to rid himself of his partiality and his bias, and especially of his own values as a yardstick for others. As a further proviso, he should make himself acquainted with the culture and with the sense of utility, of worth and of propriety behind its institutions before proceeding to formulate his findings. One cannot be a patriarch to a people with whom one has no common medium of understanding).
TMRI emphasizes a basic approach towards the entire field of TM that entails the identification and enhancement of the often unnoted health protective and promotive ideas, ideals and values which are scattered throughout the social matrix. These are of great importance in defining all the facets of the integrative model. Even the unanimously labeled harmful practices and taboos might reveal themselves, on close study, to be (wrong) manifestations of (right) values.