Traditional health practitioners

	Since many practitioners perform functions related to health matters in general and do not restrict their activities to treating diseases, the term traditional health practitioner (THP) has recently been introduced in research institutions.
	British anthropologists who had worked in the Sudan during the Anglo-Egyptian Condominium, classified the healers they encountered in several regions in the country. For instance, most healers in the southern and western regions were categorised as medicine-men, witch-doctors, or shamans; those in the northern parts included faqirs, basirs, and habl midwives. Edward Evans-Pritchard described the witchdoctors and medicine-men of the Azande and Nuer; Lienhardt, the medicine-men of the Dinka; Nadel, the shamans of the Nuba Mountains; Jean Buxton, the medicine-men of the Mandari, and Oyler, the medicine-men of the Shilluk.
	If we retain the terminology that early researchers have used, it will be necessary to bear in mind the epistemological differences between these terms, and to note when, how, and in which area each term was first used.[1] Also, whichever names researchers or historians give, and whichever system of classification they adopt, should be flexible enough to include any type of healer in any ethnic or cultural group.
	G. W. Titherington reported in Sudan Notes and Records on Raik Dinka healers, saying:
	“One often sees lists of such people and their different activities written out for other tribes but among the Raik there is very little that is hard and fast and universal practice. The clans vary greatly in this as in other things, and much depends on individual caprice. Practitioners often invent new ceremonial for themselves, and among such credulous people any new magic which is either invented or introduced spreads rapidly at first, but is gradually added to the long list of the old ones that sometimes work, but more often fail.”[2]
	Titherington identified several Raik healers. A Ben Bit (Mone-bit in the East) owns an ancestral spear and cures sickness by sacrifice; he makes peace, brings rain and presides at sacrifices to eminent ancestors. He has a good deal of general influence and is regarded as sacrosanct. An Alueng or Awudweng is a doctor and cures cattle sickness; he is often master of ceremonies at weddings and arranges for the first child to be a son. A Doll, however, may be a man or a woman; he or she spits on infants to cure sickness.
	Traditional practitioners attend to the sick and manage health in several ways. Some are full-time healers for whom healing is their main job and source of income, while others work on a part-time basis. Some healers are beneficent, the type a Dinka calls teitt; others are instruments of evil, such as those known in northern Sudan as sahhars. The Shilluks, Oyler reports, think of the witch-doctors or medicine-men as good, not because their lives are good, nor yet because their practice is good, but because they are looked upon as the channels through which occult powers may be transmitted to men. Their powers are for sale, and man in his need may go to them for help. The patient who brings no fee will not be treated, as they do no charity work. In the contest between good and evil, they seem to typify the good, combating the powers of the evil medicine man.[3]
	Professional healers include general practitioners and specialists. General practitioners include religious healers, witchdoctors, and magic-mongers, all of whom have specific skills with which they manage a variety of diseases. Specialists include herbalists, zar practitioners, basirs (bone-setters), dayas (midwives), and shallaqs (eye surgeons). Among the Shilluk, for example, many of the witchdoctors are specialists, while others undertake to work charms for many different things. In practically every undertaking the witchdoctor is consulted. If a man is going on a journey he lets the medicine-man work over him to protect him from dangers seen and unseen. Diseases are supposed to yield to their charms. The power to cure snake bites, and to heal a burn by spitting on it, are special powers belonging to only a few. Many are able to provide a fetish, which protects its owner.[4]
	Bone-setters and midwives do not only practise their respective specialties; they sometimes diagnose and manage other diseases. Some street vendors and grocers sell medicinal herbs amongst other merchandise, occasionally contributing a diagnosis, and, if necessary, writing amulets. Witch-doctors are also experts in preparing and using poisons.
	With the exception of zar practitioners, midwives, and a few basiras, most healers are middle-aged or elderly. However, a young breed has appeared, making extravagant claims as healers, soothsayers, diviners, or astrologers. Some of them have inherited a reputable family name that has bestowed on them a measure of public confidence their meagre experience would not otherwise have inspired.
	Tabib (tabbabi in Darfur) is a term generally given to a wise or a skilful person who attends the sick among other functions. Hakim is a popular synonym that is frequently used to designate any member of the medical profession: a nurse in a dressing-station, a medical assistant or technician, or a medical doctor.[5] Faqirs in northern Sudan perform general healing but mainly specialise in managing mental illness. Though we do not categorize them separately, faki and mu’raqi practice black magic that is intended to harm people, property and possessions. (See also Magic page 73).
	A lay person frequently initiates his or her own treatment. Sometimes a patient diagnoses his illness, suspects a cause, consults a diviner for confirmation, and finally visits a healer, who will prescribe treatment or issue an amulet.
	Modern medical facilities have not affected healers until recently. In the last few years, bone-setters have started ordering X-ray pictures, and a notable religious healer on the outskirts of Wad Medani, has mixed mihaya with crushed phenobarbitone tablets and given it to calm agitated patients. Healers in major cities are now ordering laboratory tests, and asking their patients to have their blood pressure checked by a physician before reporting to them. In doing so, healers genuinely believe that they are acquiring new skills that improve their efficiency. At the same time, patients are constantly assured that healers are keeping pace with rival modern medical technology.
	Among healers there are specialists who deal with only one type of disease and no more. Um Dubban’s maseed does not accept epileptic patients, who instead are referred to hillat (village of) Hasan Wad Husuna, who specialises in the management of epilepsy. Musa Al-‘Azab and Ahmad Wad Al-Turabi have been notable in treating rabies. Tinat (clay from) Ahmad Wad Al-Tiraifi of Talha village in the Gezira region, is so famous for curing rabies that Wad Al-Tiraifi is nicknamed dabi al-wa’ar wa khasim al-sa’ar (viper of the wilderness and enemy of rabies). A diviner is another sort of specialist. Diviners diagnose diseases, identify social grievances, triggers of misfortune, and interpersonal grudges, before suggesting appropriate remedies. They rarely, however, involve themselves in the actual implementation of solutions, health-related or otherwise.
	Whole tribes in the Sudan are famous for certain kinds of magic that are used sometimes in healing. The Zabali’a of Abu Jarid, for instance, are versed in magic and witchcraft.[6] The Um Bararu tribes of western Sudan are animal specialists and masters of arrow poisons.[7] The Rubatab of northern Sudan who are famous for their sharp repartee, have also acquired a wide reputation throughout Muslim Sudan for bewitching through verbal constructions. Consequently, a member of any of these tribes is always feared lest he should possess the dangerous expertise of his kinsmen.
	Some healers are identified by name but have no designation, other than that of a skilled technician. For example, shulukh (facial marks) tattoos, lip, nose and ear perforation, lip splitting, and tooth extraction, are performed by anyone who cares to learn the tricks. Others are persons who have magical powers that serve general social functions, such as the dambbari. As in early Europe, a kind of barber is known; he carries his circumcision clamp and a bleeding horn wherever he goes. And in the end, as in the beginning, there are mothers. They are the helpers and healers at home.
	Jean Buxton carried out research in Mandari in 1950-1952, and described healing and healers in the region in a posthumous volume, Religion and Healing in Mandari.[8] She described briefly a few types of healers. Bunit lo tu’ya (the doctor of the rattle), for instance, divines with the rattle (tu’ya). This practice is described as ‘smelling-out’ (wowondu), or ‘following with a rattle’ (dadoa ko tu’ya). These doctors use general medicines and recommend and assist at sacrifices to traditional agents of disease (particularly Spirit-of-the-Above and ancestral ghosts), and carry out purifications and hunting rituals. They supply protective charms and talismans to pregnant women and people in critical conditions, and advise on suspected bewitching and nightmares. Bunit lo ki (specialists of Celestial sickness) specialize in Spirit-of-the-Above, working either traditionally with the rattle and medicines, or with a celestial guide and a shrine. A kagorkeit (exorcist) banishes evil spirits, and komuryeit (extractor) removes witchcraft objects.
	Patients should satisfy the practitioner, and pay him an amount consonant with his social status or the importance of the task accomplished. If they do not, his ill-will will cause the treatment, amulet, spell, or divination procedure to loose its efficacy or potency. In fact, divination procedures are rarely conducted without an expression of faith in the healer in the form of an advance nominal fee called bayad in northern Sudan. When the procedure is concluded, full payment is settled.
	Religious healers in Muslim Sudan run regular clinics in maseeds or at home. They also keep inmates in special cells for long-term treatment. The patients are mainly the mentally-ill and schizophrenics. In addition to treatment, the maseed provides them with food and shelter, a reasonable occupation, and various methods of entertainment.[9]

Muslim religious healers

	Religious healers have always been important and influential in their communities. For different reasons, officials in all governments (national and colonial), have held them in great esteem. They have granted them land, money, and, more importantly, the right to intercede for their people. In exchange, the laity have respected, venerated, and always feared them. They have consulted them in religious and secular matters, and frequently sought their intercession. Tigani Al-Mahi has noted that religious healers are spearheads and exponents of religion, and, by virtue of their alleged omnipotence, possess tremendous powers of suggestion and persuasion. They are, hence, capable of resolving symptoms in their sick followers by the development of religious transference of an intensive kind. He expanded on this, saying:
	“Religious therapy is founded on ancestor cult and is based on animistic conceptions closely linked with religious doctrines. Its psychopathology emphasizes sinfulness and stresses the conflict between ‘good and evil’ and ‘religious and irreligious’ as productive of symptoms which are sometimes regarded as retribution. These good and evil influences are no doubt the prototypes and personifications of the Id and Superego which were later postulated by Freud.”[10]
	Faqirs are usually descendants of walis and salihin (holy men) from whom they inherit baraka[11] and office. They have gained credibility among the masses because they are believed to commune with God, to intercede between Him and man, and to control supernatural powers and manipulate them, producing health or disease, fortune or misfortune; their supplications, prayers and blessings are always effective. Faqirs are exclusively men, apparently because men rather than women are the main regulators of Islamic religious life in the Sudan. Their literacy, in a predominantly illiterate society, has added to their power and authority; it has also enhanced their knowledge and improved their skills. Access to Arabic medical books has improved their diagnostic abilities and enriched their repertoire of recipes. Faqirs also function as sources of local and Arab materia medica for other healers.
	Religious healers, many of whom are Sufi shaikhs, have combined political, social, spiritual, and healing powers in varying degrees. In the last two centuries, they have enjoyed the encouragement and sanction of the state, and have become enormously rich. We read in Trimingham’s Islam in the Sudan that:
	“The shaikhs were mainly powerful in the Jezira under the Funj. They were highly regarded and subsidized by the Funj kings and would intercede with them and could rebuke them with impunity. We read of Salih ibn Ban an-Naqa (1681-1773), who, we are told, ‘was the third of the khalifas who lit the fire of Shaikh Abd Al-Qadir in the land of the Funj’, that ‘the court gave him a share in the river-lands and rain-lands’, which, however, ‘he divided among the people as though it had been a banquet’. Of powers of intercession with kings (ashshifa’a ‘ind al-muluk) we read of Hamad b. Al-Majdhub (d. 1776) that ‘God made him exceedingly popular with both great and small. He used to intercede frequently with kings and sultans, especially the Ja’al, and normally his intercession was not rejected for he who rejected it could be quickly blighted.”[12]
	Their forefathers were of Arab stock; they arrived in different parts of the Sudan, and each started a fraternity,[13] attracted followers and established a shaikhdom. Several attained such fame that their names have become eponyms for towns, villages, hafirs (local ponds), and medicinal recipes. To give one’s offspring a holy man’s name, is enough to guarantee the child blessing and protection through life. A Sudanese may still be identified and probably traced to a certain region in the country or to a specific Sufi order, by his or her name, or, in rural communities, shullukh (facial markings).

Types of healers

There are two types of religious healers in Muslim Sudan: fakis and faqirs. A faki is a peddler of religious recipes, an itinerant cleric travelling from village to village selling his merchandise. His healing abilities are not as wide as those of the faqir, but people genuinely fear him because he practises black magic. Because of this, women ask him to work on their flirting husbands or incapacitate a rival second wife. Le Comte d’Escayrac de Lauture’s remarks still hold good in the Sudan:[14]

“We find in the villages only a clergy of a secondary order; a clergy low and poor, unknown elsewhere, holding their powers only by the general confidence, living on alms and privations. … Men of this category are called fekis. Many have accomplished the pilgrimage to Mecca, all can read (more or less fluently). All read the Qur’an and some know it by heart. Each village at all important has its feki, it is he who teaches reading and writing to the children, presides at marriages and burials, fills the functions of judge or qadi in all minor disputes. He adds to these functions that of exorcist; he evokes at the bedside of the sick the demon who agitates them, writes on bits of paper the surat al-Falaq, a talisman which protects him who carries it from the obsessions of the enemy of men, and even, according to some, the injuries and illnesses to which they might be subjected. He draws from the sale of these talismans some small profits which enable him to live. This industry is quite innocent, the talismans do no one any harm and always produce a favourable effect upon the imagination. Besides, the feki does not seek to deceive others, he believes as fervently as they in the efficacy of these hamail (charms). Nor does he limit himself always to exorcising the sick or administering to them bits of paper or the water in which a pious invocation has been washed, he often adds to this illusory medication the employment of vegetable essences of whose efficacy he has learnt through long experience or the traditions of his predecessors.”[15]

Organization of practice

	Every shaikh has a distinctive ‘path,’ and heads a well-knit organization comprehending a huge fellowship. The headquarters of the ‘path’ is usually associated with a particular maseed, village, or town that frequently carries the name of the holy person.
	Faqirs control and organize activities within maseeds[16], and sometimes those in the village or town. They establish a well-knit hierarchy of ‘urafa’s (delegates) (sing. ‘arif), who are equally endowed with baraka as long as they are in the realm of the holy man. ‘Arifs may thus function as therapists. They sift cases coming to the maseed and refer difficult ones to the more competent faqir in his khalwa (sanctuary). Many towns and villages, for instance Kadabas,[17] Um Dubban,[18] and Shikeiniba, have become centres of worship and healing. Their maseeds contain asylums for patients with mental disorders. While under religious treatment, inmates, unless aggressive or suffering an acute attack of illness, are not detained. They are left free to move, though in chains. Hence, a striking feature of these villages is the sight of chained people roaming around or working as builders, farmers, wood-cutters, or servants.
	Most inmates spend long periods under treatment, and, when they recover, they frequently opt to stay and work for the shaikh, to whom they credit their well-being. Some of them have been abandoned by their families and have no other place to go; they spend the rest of their lives there. They marry in the area and start families that maintain allegiance to the shaikh and bonds with the maseed.[19]

Healer’s roles

The functions of religious healers are closely bound up with everyday people and their daily concerns, and healing is usually incidental to their other roles in society. They frequently claim knowledge of the magical interpretation of astrology, numerology, and divination for the diagnosis, treatment and prognosis of diseases. Primarily, they officiate at most religious and social functions, sanctify rites, and assist safe passage through the critical periods of life. They are often in charge at wedding ceremonies, and act as judges and arbitrators in local disputes. They divine for the auspicious times for certain activities, and interpret Muslim shari’a (Muslim jurisprudence). As healers, they prescribe amulets that are believed to prevent illness, to protect against evil spirits, the evil eye, someone’s jealousy or anger, or to attain success in different spheres of life.

Occult powers and healing abilities

Faqirs’ healing techniques are based on Islamic teaching, animist vestiges, beliefs in spirits, magic, and witchcraft. These techniques are neither standard nor uniform, but they are ultimately based on the Islamic faith and divine ethics. They draw on a rich legacy of Arabian materia medica. Customers are mainly ‘followers of the path’—village or urban dwellers with various physical and mental diseases; all are seeking a holy blessing from the healer, whom they respect and trust. Researchers have frequently reported that healers give their patients personal care and spend enough time listening to them. Patients were, then, able to describe their complaints, ventilate their grievances, vent their bent-ups, and probably confess. Though this is typical of a zar healer, is typical of religious healers only when they are modest in practice and prestige. Reputable healers rarely have time to give to each patient. Wad Al-Ubiyyid at the outskirts of Wad Medani was a reputable religious healer with a busy clinic in which he sees patients by himself. In a moderate size room a crowd of over a hundred customers would gather waiting for his help. No privacy is provided, and the nearest to the shaikh would literally shout out his complaints. The shaikh transfers the baraka to his patient across the room through the waving of his palms. In Umm Dubban, few patients are granted audience by the late Khalifa Yusuf Wad Badr. To see him in person, one has to go through a rigid protocol. Customers are received in the maseed compound, and the Khalifa’s secretary admits them to the reception room. There, while waiting, are offered camel’s milk to drink and qarad (Sunt tree pods, Acacia nilotica) to suck. When their turn comes, the Khalifa receives them in a most gracious manner and listens to them attentively, and concludes the encounter by blessing them by reading the opening chapter of the Holy Quran. Further treatment is relegated to his delegates.

The efficacy of a healer’s treatment is believed to be due to God’s grace. Therefore, a healer should not ask for money in return for his services. Since customers are considered devotees, what they pay is seen as a nominal fee that supports the group and endorses the functions of the maseed. Thomas Arnold, writing about Islamic da’wa (propagation), advocated a missionary role for fakis. He offered what he thought was an effective means of recruiting new members to the faith. He said that fakis should strike a bargain in return for the amulets and incantations they prescribe for infertile women; if the woman has a baby, she should raise the child as a Muslim![20]

Shamans (kujurs)

	Kujurs are individuals capable of producing a state of trance and mental dissociation interpreted as spirit possession. During these states, a kujur is believed to possess powers beyond those of ordinary people, powers that heal, bring down rain or protect the harvest against invading locusts. Nadel described the kujurs’ religious cult in the Nuba Mountains as proper shamanism, because it corresponds in all essentials to the classical shamanism of central Asia and North West America.[21] This cult of spirit possession is not confined to the Nuba Mountains only. Other southern tribes have their shamans. The jok doctors of Mandari tribes and the medicine-men of the Nuer, Dinka, and Azande, are examples though not as typical as the Nuba’s.
	A kujur (pl. kujara and kanajir), a kujuriya for a female (plural kujuriyat) in the Nuba Mountains is a human being in whose body the spirit of God or of another powerful deity such as the uro spirits among the Dilling tribes, is incarnated. Most incarnations occur in men at any time between 17 and 50 years of age. A person becomes a kujur after passing through a near-fatal sickness, such as epilepsy or madness, and then recovering. The spirit that is to be manifested in him reveals itself in dreams.
	A kujur has to prove his powers before the community accepts him, and before he assumes his role. The consecration process is arduous and lengthy. It takes several years of various ceremonies loaded with sacrifices and elaborate rituals. In the last consecration ceremony, the kujur assumes the emblems and insignia of priesthood and office.[22] From now onwards his powers—spiritual, political, and social—that are traced back to the original power-god, permeate all aspects of life in his community. From now onwards too, he should obey certain ritual rules: he lives up on the hill, alone with his family; he must not walk down into the village or sit in other people’s houses; and he must obey, more strictly than others, the seasonal food avoidances of the tribe.[23]
	During a trance, a kujur divines for the unknown, brings down rain, helps to secure a good harvest, alleviates illness, and wards off epidemics and other evils. In healing, mainly manages serious mental illnesses, and refers simple ones to other healers in the vicinity.

Zar bori practitioners

	A zar bori practitioner is known as shaikhat al-zar; ummiya, usta, and kudiya.[24] Nobody as yet has described shaikhas as dhakariyyat (masculine) though a suggestive description has been given by Constantinidis:
	“The cult leaders’ sexual status is also low. Most are either divorced or widowed and several are childless. In a few cases known to me, shaikhas had engineered their own divorce: by persistent absconding; by refusing to make themselves attractive and submissive; by refusing to modify their forthright views before their husbands; or by insisting on drumming the zar against the husband’s wishes. It is a theme among these women that powerful healers and mediators with the spirits such as themselves have no need of men, nor of their own sexuality—a theme borne out by their successful existence in a society antithetical to the lone woman. Indeed, ideas concerning the need for ritual purity in a cult leader clash entirely with the requirements of marriage. In order to retain the closeness of her relationship with the spirits, the cult leader should not have anything to do with such polluting things as sexual intercourse.”[25]
	Shaikhas are predominantly elderly or middle-aged women, and are sometimes from poor families, or ethnically discriminated against because they are of slave descent. Alternatively, they might be the offspring of freeborn fathers and slave mothers, or Muslims of non-Arab stock, or descendants of anyone presumed to be slaves because of their dark colour.[26]
	Male zar shaikhs are few but nonetheless remarkably famous. Al-Mabark shaikh Al-zahar[27] of the Shaiqiyya tribe has been so skilful that he has been frequently quoted in songs as an unchallengeable healer. Wad Hulla, a contemporary zar healer, is stirring society with his innovative musical ceremonies.
	Ranks and offices: A shaikha[28] is invariably a promoted tabbaliya (drummer) who has inherited her skills from her mother or a near relative. She is consecrated and girdled with a zar belt after a revelation. The powers and equipment are then passed on symbolically, and actually, through the handing over of an ‘ilba (box).[29] By this time she is versed in the knowledge of zar spirits or mashaiykh (sing. shaikh),[30] has mastered the tunes that summon them, and deciphered their esoteric language.
	Functions: A Shaikha in general possesses a well-integrated body of knowledge and a technique that enjoys a high degree of consistency. She knows her clients’ social background and, indeed, some of their daily troubles. With that knowledge in mind, she divines for the possessing spirits through fath al-‘ilba (literally ‘opening of the tin’ ). The divination procedure involves a battery of rituals, sacrifices, and feasting. Diviner and client dress for the occasion in special costumes. Drumming music is started to summon the blameworthy spirits. The divination ceremonies, though limited, may take a full week for the shaikha to identify the spirits, find out their demands, and take the necessary steps to satisfy them. When the spirits are identified, their demands are conveyed to the novice and, more importantly, to her family, and they have to be fulfilled before the spirits are calmed, and the patient recovers.
	In zar bori, the shaikha gives her client close personal attention. First, the client is enrolled for life-long membership of the zar group. In their ceremonies, the client is so much the centre of attention that she is called a zar bride. The zar rituals and taboos are elaborate, and are held in an atmosphere of intimate social interaction; devotees are invited in name to every zar ceremony in the vicinity, and each is given special attention on every occasion.

Zar tumbura practitioners

	The hierarchy of zar tumbura is more elaborate than that of bori, and its practitioners are so well-linked that their organization resembles a society.[31] Each group has offices and ranks, and each person has a definite job. All tumbura practitioners are ex-patients who have been cured through tumbura, and have been members of the cult ever since.
	Ranks and offices: A Daliel (guide) is the senior leader of several cult groups or tanabir (pl. of tumbura). He occupies the highest rank in the organization, and is consulted on every aspect of the practice. He decides on the appropriate times for the ceremonies, and no ‘playing’ is ever performed in his absence or without his consent. Out of the four contemporary leaders in the greater Khartoum area, Jibril Idris Hasan, nicknamed Abuya Sambu, is the senior daliel.[32] A Sanjak is leader of a particular tumbura group and officiant of its ceremonies. He is the most eligible to become daliel in due course if he so wishes. In contrast to the bori practice, a sanjak is a male installed into office in a special ceremony. Occasionally, a woman occupies this post, and then she is called ummiya as in bori. The sanjak or sometimes ummiya conducts the dancing ceremonies, and plays tumbura (rababa) tunes that summon the spirits.
	Every sanjak has his entourage: awlad al-‘idda, literally ‘sons of the instrument’ (male devotees), and banat al-‘idda, literally ‘daughters of the instruments’ (female devotees). Every member of the entourage must have been a tumbura patient, and have specifically ‘killed’ an animal in sacrifice. Devotees do not change their tumbura group; they do not even visit other tanabir unless accompanied by a sanjak or ummiya. When they do so, they march in a single file after their leader.
	Tanin al-sanjak (the sanjak’s deputy) is called a brigdar (brigadier). He serves awlad al-‘ilba, ‘sons of the tin’ (male participants), and takes care of any formalities and courtesies due to guest sanjaks. When there is a vacancy, a brigdar may be promoted to the rank of sanjak if he so wishes.
	Taninat al-ummiya (the ummiya’s deputy) also known as jaliesa (lady companion), is the ummiya’s delegate and is entrusted with various important functions. She guards the tumbura against the malice of envious sanjaks. She keeps the majamir (incense burners) alight, and adds incense at every jawab (tune). She also keeps a watchful eye on all womenfolk present at the tumbura ceremony in case they take advantage of the gathering to practise infidelity. Abuya Sambu is proud that he maintains strict discipline and has an impeccable reputation in his practice. He says that when his late aunt Amna Abonei was alive, no girl would dare to look up during practice; all their eyes were cast to the ground. Any irregular behaviour was punished with the whip. Amna used to escort every female—married or unmarried—back home when the ceremony was over and make sure that each was delivered safely there.
	The muttariq (vocalist) recites tirraiq ‘incantations’ during the killing of the sacrificial animal, and during the serving of coffee. The sawtary, on the other hand, looks after discipline and keeps a watchful eye on any unbecoming behaviour, especially among menfolk. The najieba serves womenfolk, and the jarraya (runner), the errand girl, invites women for the ceremonies. The habobiya (grand mother) or habobiat al-kanoun (stove grand mother) is the cook; she also brews marisa (a local alcoholic beverage) for the occasion.
	The Installation of a sanjak or an unmiya: The installation or girdling (tahzima) of a sanjak or an ummiya is described by Ahmad Al-Safi,[33] and Makris.[34] This is performed after certain conditions are fulfilled. The candidate should be versed in tumbura, should be able to interpret the language and demands of the rih ‘spirits’, and should have had a near-fatal sickness that has been cured by tumbura. The case of Abuya Sambu[35] illustrates this process. Sambu was born in Deim Salman in Khartoum 70 to 80 years ago; his father was a Hamar, and a follower of Sultan Abd Al-Malik. His mother, Zahara Hasan Barsi, was a Ja’fariyya. He had three sisters and an elder brother. When his father died, in about 1924, his mother took up tumbura and practised till her death in 1926. Abuya Sambu was installed as a sanjak in 1932. This is his story as he narrated it to me late in 1987 in his house in Um Badda in Omdurman:
	“I was naughty when young. I used to line young boys in front of my father’s tumbura, pass urine over the bawariq (banners), and run away. The tumbura and my father were both very angry, and I had to pay for my misconduct. I suffered a sudden paralysis from the waist downwards, and was crippled for six months. My father, because of his anger, refused to help me. Grandfather Faraj (of the Zubaydia tribe) was kind to me. He fumigated me with incense for seven days and ordered a qadah bayad (a dish of porridge and milk stew) to be made. He then carried me over his shoulder to the wilderness where he left me. I had to come back, and indeed, I came back walking. The happy occasion was celebrated with the ‘killing’ of a sheep in sacrifice to tumbura. This happened in 1928, after which I started learning the arts and crafts of tumbura, and in 1932 I was installed as a sanjak.”
	For the installation of a sanjak the following items have to be provided: sugar, coffee beans, sweets, dates, a bottle of perfume and two shawls—a green one for Shaikh Abd Al-Qadir Al-Jilani[36] and a red one for Bilal,[37] and a sheep. The Sanjak is sat on a chair. Two Sanjaks are present to serve as witnesses: one stands on his right and the other on the left. One of the Sanjaks put the two shawls over the new Sanjak, one on each shoulder and cross them in front of his chest. A sheep is then sacrificed, and the Sanjak is dabbed with blood and handed the ‘idda (the instruments) for safe custody. The sweets and dates are distributed among the audience, and perfume sprayed over the new Sanjak and audience. A similar procedure exists for the installation of a new ummiya.

Habl midwives (dayat al-habl)

	Till 1920, midwifery in most of northern Sudan had been entirely in the hands of dayat al-habl (the midwife of the rope),[38]and other traditional midwives in the rest of the country.[39]
	When the School of Midwifery started recruitment, candidates included habl midwives.[40] They were selected by nomination by tribal chiefs or by other senior persons agreed upon by the villagers. This lead gradually to the incorporation of many traditional birth attendants in the mainstream of health delivery. However, the programme gradually changed its recruitment criteria so much that the traditional midwives were excluded at the end. There are now more than 22 midwifery schools in the Sudan, and since 1920, 8641 midwives of all types were trained, unfortunately the number of habl midwives among them is unknown.
	A daya attends birth at home, and assumes all the functions necessary for the well-being and health of a woman in labour and her newly-born baby. She is also a consultant for women’s diseases, advises on fertility problems, suggests contraceptive methods, and induces abortion. Because women are invariably circumcised, delivery is always preceded by surgical widening of the introitus. The midwife first undoes the circumcision by slitting the scar open,[41]delivers the baby and placenta, re-circumcises, and usually re-infibulates. She then ties the umbilical cord, and attends the newly-born if it needs any help. The instruments a habl midwife uses may be dirty if not actually rusty, and the dressings, if any, are not prepared to any medical standards.
	Habl midwives also circumcise girls, perform tas-hiem (plastic de-circumcision) of the newly-wedded, ‘adal (correction) for women going out of confinement, and re-infibulate divorced women, or any other women who desire it, to bring them back to ‘virginity’ or tightening the introitus, as the case may be, by stitching the vaginal opening.
	The midwife attends women in the days following delivery, making dressings and giving advice on relevant matters. When the wound is clean, the woman ambulant and the baby has been named, the midwife is paid for her services in money and kind. She is given the best of everything available in the house and sizable chunks of the meat of the sacrificed animal.

Herbalists

	Several medicinal and poisonous plants are known to almost all Sudanese. Jean Buxton noted, for example, that the Mandari keep household remedies such as herbal purgatives, the pungent roots of wild garlic chewed to relieve colds, and herbs used for treating infected wounds.[42]
	However, special herbal knowledge is the prerogative of herbalists who have inherited the craft from their forefathers through apprenticeship; to these are added some others who have no family history of healing, and have labored to acquire the necessary experience.
	Apart from Al-taiman[43] (the twins) in Omdurman, herbalists are not recognized as specialists in the same way as, for instance, faki and kujur are. They have no designations in Riverain Sudan, though they are sometimes called ‘ashshab or ‘attar.[44] Herbal shops are few, and lack any special name; medicinal ingredients are sold there alongside other groceries.
	Some herbalists, notably mu’raqis (root dealers), peddle their merchandize in the marketplace. Mu’raqis are almost all Nigerian or local inhabitants of western Sudan who have acquired a wide reputation as being exceptionally skilful in practising effective black magic. They sell roots that are alleged to have aphrodisiac properties, protect against snake bites, scorpion stings, gunshot injuries and stab wounds. They also sell love potions, prescribe amulets, and ‘do’ and ‘undo’ magic.
	Dutu ko winiko (the medicine owners) of the Mandari tribe possess simple remedies for various illnesses as well as cures for snake bites. Snake bite cures are pounded and tied to the bitten area. Sometimes they are cooked, and the resulting fumes are inhaled for protection before travelling at night. Small stocks of other medicines may be bought from a healer who may also show the user where to dig for new supplies to continue treatment or to help friends and relatives.[45]

 Bone-setters (basirs)

	A basir (basira for a female)[46] sets broken bones, treats sprains, contusions, dislocations, and advises on matters relating to pain and disabilities in the joints. They massage wry-necks and ailing muscles. Frequently, basirs advise customers to take special foods to speed up the healing of fractured bones. Popular recommendations include eating turmus (Lupinus termis), dates, and chicken. They also prepare and prescribe medicines. Jean Buxton described bonesetters in the Mandari tribe as practised people who set broken bones, sprains, and dislocations by tying them firmly with creepers, often to wood splints. Hot poultices are placed on swellings; incision may be made at the point of a break, and the bones pushed together.[47] Ostrich oil is the treatment of choice for muscle contracture, over which it is rubbed and then massaged for a few weeks until the stiff joint relaxes.
	Some basirs circumcise boys, and perform cupping and cautery. An atitt among the Raik Dinka is a bone-setter who sets broken bones, trephines skulls, and may also be a spear-haft straightener. Other basirs make artificial limbs for the handicapped. Wad Ghiyama of Katotab village is a basir in the widest sense. He is a skilled bone-setter, and an experienced and resourceful innovator in other fields. He makes artificial limbs that are thought to be lighter and more competitive than imported ones. He is also a healer of man and animal, an astrologer, a renowned diviner, and a poet, to mention just a few of his talents.
	Bone-setting is a typical craft that runs in families, learnt through apprenticeship to older basirs who are senior members of the family. Basirs such as Al-Badri of Al-Abassiya (Omdurman), Wad Mukhtar of Al-Saggana and Wad ‘Agib of Al-‘Azozab (Khartoum), the late Mustafa Ahmad Bati of Omdurman (Wad Bati), and his daughter Zeinab Mustafa Bati (Bit Bati), have been the most famous.[48] The craft usually passes from grandfather, to father to son. Mustafa, however, inherited the craft from his uncle Arbab Bati, and handed it over to his daughter Zeinab, who is still practicing in Omdurman.
	Zeinab Bit Bati has described how she learnt the art and how she practices. She says she learnt bone-setting, as a gift from God (wahbiya min Allah), and through watching (bi al-shawf) her father practising. Then, whenever her father was away, she used to act on his behalf managing easy cases. Although she treats people li wajh Allah (for God’s sake), she will accept their gifts gladly.
	She classifies a bone or a muscle injury as radkh (a contusion), fakak (a dislocation), and kasr (a fracture). The method she follows in setting bones is universal among Sudanese bone-setters. She first manipulates the fractured bone until it is set in good alignment, and then pads the site with cotton gauze or cloth. Next, she applies tabb or jabiras (splints) made of palm fronds, and tightens them. Finally, she bandages the injury. The tie should be firm enough to hold the fractured parts in place, but not too tight to stop al-dawra al-damawiyia (blood circulation).
	Bit Bati has treated all types of fractures including compound injuries.[49] She says that she applies sulpha compounds to ‘treat’ bleeding, and refers infected cases to hospital. She attributes infection either to neglecting the wound, or starting treatment with an incompetent bone-setter. She does not mention any other drugs, but her father used to use harjal (Solenostemma argel). Although she knows that children’s fractures heal in a week or so, and those of grown-ups take longer, she is also aware that children’s fractures are difficult to handle because they are intolerant to pain. She uses no banj (anaesthesia); the only analgesic available to her, she said, is al-sabr (endurance).
	Though bone-setters are ignorant of the exact relation of nerves, vessels, and bones, they yet manage all sorts of fractures—multiple, compound or those that need special handling such as supracondylar, and spine fractures. The successes of basirs are widely circulated, but their failures rarely mentioned. Their interventions have frequently been accompanied by complications, some of them very serious indeed. These include Volkmann’s contracture of the extremities,[50] mal-union or nonunion of fractured bones, and sometimes amputation of fingers or limbs.

Witch-doctors & medicine men

	Beliefs in witchcraft and magic are widely held throughout the country but are remarkably prevalent among southern tribes. (See Witchcraft page 87).
	Evans-Pritchard, who described witchcraft among the Azande, clearly portrayed the witch-doctors in the following words:
	“The Zande witch-doctor is both diviner and magician. As diviner he exposes witches; as magician he thwarts them. But chiefly he is a diviner. In this capacity he is often known as ira avure, possessor of avure, the word avure being contained also in the expression do avure, ‘to dance avure’, which describes the dance of witch-doctors and in a more general sense the whole séance at which they perform. When he acts as a leech he is known as a binza, but this word and ira avure are interchangeable in reference to his divinatory functions, though binza is alone used in reference to his leechcraft. In both roles his task is the same—to counteract witchcraft. As a diviner he discovers the location of witchcraft, and as a leech he repairs its ravages.”[51]
	Evans-Pritchard added that a witch-doctor also:
	“exercises supernatural powers solely because he knows the right medicines and has eaten them in the right manner. His prophesies are derived from the magic inside him. His inspiration does not spring from the Supreme Being nor from the ghosts of the dead,”[52]
	He also added that a witch-doctor:
	“possesses also other types of magic such as baybuduma, vengeance-magic. This type of magic, mangu, which they possess they say is quite different from that of witches—the biological one found in their bellies. Theirs is generated by magic.”[53]
	Oyler, who described the witch-doctors and medicine-men of the Shilluk, noted that many of the medicine-men of that tribe have physical defects, and their children are usually sickly, and many of them are deformed. The local people say that this is caused by the fact that the shades of their victims bring a curse on the medicine-man, and also on his family. The medicine-man is usually well-to-do because of his exorbitant charges, and he can afford to, and does, take many wives, but he usually only has a few children. He also noted that a witch-doctor will not treat himself when ill, and he does not treat the members of his own family. He goes to some other witch-doctor to be helped.[54]
	Women in Zandeland rarely become witch-doctors, and when they do, they are usually past their youth and often widows. On the other hand, princes or members of the royal family, and commoners with political power or holding important rank, do not become witches either. Witch-doctoring is learnt by apprenticeship. It is handed down from father to son gradually over the years, or, as a short cut, learnt quickly from other witch-doctors in return for payment.
	“A novice begins to eat medicines with other witch-doctors to strengthen his soul and give him powers of prophesy; he is initiated into the corporation by public burial; he is given witchcraft-phlegm to swallow; and he is taken to a stream-source and shown the various herbs and shrubs and trees from which the medicines are derived.”[55]
	How witch-doctors and medicine-men receive their powers, and acquire witchcraft has always been a subject of speculation. Some Shilluks, for example, maintain that the power comes from God, and others, that it is hereditary; but the distinction is not absolute; those who think of the power as coming from ancestors, would also say that the first person of the line to possess the power, received it from God. A medicine-man is usually followed by one of his sons. The child to receive the power is designated by the father, and is usually either the oldest or youngest son, though a daughter may also be possessed of the power to work charms. The occult power may also skip generations, passing to the descendants of a son or a daughter of a medicine-man who did not inherit that power. The fact that the power of working charms can come to a person whose father was not a witch-doctor is seen as a proof of the return of the power of some forgotten ancestor.[56]
	Witchcraft may be attained through the possession of special artifacts. The story of how Mattiang Goh of the Agar Dinka possessed a special root that made him a famous witchdoctor, illustrates this method well. In fact, it was reported that Mattiang became possessed of great riches, and the deadly effects of the medicine became so exaggerated as to instill fear into all the Agar, who lost no time in procuring the root to protect themselves. V. Fergusson, then Governor of eastern District, southern Sudan since 1919, reported on this witchcraft. He said that at the time the medicine was universally used throughout the entire eastern and Rumbek District, and many Dinkas were enriching themselves by introducing it into the Nuer country. Fergusson himself did not pay any special attention to the practice until it was forced on his notice by a certain chief being reported as using it to lower the prestige of the Government in the eyes of the Nuers.[57]
	The story goes that, about the year 1902, Mattiang, in special circumstances, acquired a special root from a Jur man who also instructed him on how to use it. The root, which is only known to important medicine men, is to be carefully covered with fat, rolled up in leaves or a piece of cloth, placed in a small pot and then hung up on the roof of the owner’s house. Other roots of the same kind may also be worn round the neck or wrist if desired. The root is merely a visible sign that the owner is possessed of a wonderful ‘Spirit’ known to the Jurs as ‘Mongork’. This spirit only appears before medicine men as a kind of mist, taking no special form. It is extremely faithful to its owner who, however, must be careful not to offend it in any way. The owner cannot give an order to do anything at all, but must comply with its wishes. ‘Mongork’ lives in the wall of its owner’s house and should be offered a dish of either meat or fish potage every evening. The food will not be taken by it but should be eaten by the owner after he has allowed a reasonable time for the spirit to see that his dish has been prepared. It will protect the owner against the loss of his belongings by theft, and, should a theft take place, the spirit on its own will attack the thief and strike him down. The form of punishment inflicted on the thief lies in the hands of the spirit; his cattle may die of disease, his house be burnt down, his goats eaten by wild animals or he and his relatives may be rendered ill. In causing illness or death, ‘Mongork’ only attacks the stomach and kidneys. If the theft has been serious, the stomach will swell out to an abnormal size, causing severe pain accompanied by acute diarrhoea, and the stricken enemy will die within an hour. On the other hand if the offence has been light, the stomach or kidneys may swell and remain so until the stolen property has been returned with suitable compensation. The spirit strongly objects to people wailing over any of its victims and if people do so they immediately die.[58]

Eye healers (shallanqin)

Shallaqs (couchers) are mostly Nigerians and on rare occasions they are of western Sudan.[59] They move from village to village offering their service for a fee. The shallaq is the only type of eye healer known in the Sudan. He is the eye surgeon who performs tashliq (couching). Couching is the surgical displacement of the opaque lens in cataract. In this operation, a fine incision is made into the inside of the eye using a thorn or fine needle. The lens is displaced inside the eye and left there. This obviously improves eye sight temporarily if there are no other concomitant eye diseases. However, the operation is always followed by complications caused by the lens that is left inside.

The dambbari

Some persons such as the dambbari among the Fur of western Sudan, perform specific jobs that are not directly related to health. Nonetheless, they are feared and their help to maintain health is frequently sought. The Dambbari of the Masalit and the Zaghawa tribes, possesses knowledge of special roots that through magical attributes protect crops and trees against the ravages of locusts. He diverts locust invasions by pointing his stick towards the sky; the clouds of locusts then move away in the direction indicated.

A new breed of healers

	In the last few years, many Sudanese, some highly educated, have made extravagant claims of their success in treating various diseases. The late Abd Al-Karim Mirghani, Minister of Finance during Nimeiri’s rule and once an ambassador of the Sudan in India, is a typical example. Mirghani admitted that he was acquainted with India’s Ayurvedic and Unani medicine. He made his own recipes, and claimed a high rate of success in treating various illnesses including piles, diabetes, hypertension, and other intractable diseases.
	Professor Hasan Al-Fatih Gharib Allah, Ex-Vice Chancellor of Omdurman Islamic University, has similarly claimed to treat several diseases including infertility, epilepsy, and mental illnesses, employing Quranic verses, and Al-Tibbb Al-Nabawi (Prophet Muhammad’s Medicine).[60]
	Al-Naiyal Abd Al-Qadir Abu Quroun, a practising judge, claims that he has treated an ‘uncountable’ number of patients suffering from different diseases including cancer, allergic bronchitis, epilepsy, snake bites, scorpion stings, and the evil eye. He claims that he uses the computer in diagnosing diseases, and that he treats his patients with herbs, honey, sesame oil and bakhras (paper incense), as well as other Quranic methods.[61]
	Osman Abd Al-Monem’s story is interesting. In the early seventies, Osman claimed experience in using medicinal plants, and that he had discovered break-through medicines for curing several intractable diseases, including cancer. He made a big fuss and the media took up his case. He said that he sought recognition from all those concerned with health and research. However, he met with no response. Indeed, he was ignored and sometimes scorned. Nimeiri, then President of the State, intervened personally to have his case vindicated. He was employed in the Medicinal and Aromatic Plants Research Unit of the National Council for Research as a specialist in medicinal plants, a post he is still holding. Osman collaborated with researchers in the Unit in field surveys, ensuring that he is acknowledged in publications. He has also helped the Unit in carrying out its annual field surveys of medicinal plants in different parts of the country. He has proved to be hardy, knowledgeable, and dependable. He is still assuming his role as a traditional practitioner clandestinely from within the Unit. Interestingly enough his breakthrough recipes have never come to light, though claims made on their behalf may still be heard here and there.