In their oral literature, the Sudanese described their health norms and explained ill-health. They offered various forms of treatment. However, they did not write down explicitly what causes disease, disability and harm. Neither did they write their recipes. These we had to reconstruct by analyzing available data, and to do this we had to conduct intensive field surveys and dig into several sources. These include archeological relics, oral tradition, information scattered in historical chronicles, travellers’ accounts, and literary sources. All contributed remarkably to our knowledge of many tribes, and documented and preserved valuable data. The appended Bibliography in page 529 illustrates this variety.

Earlier records of Sudanese life existed in Sudanese chronicles and medieval historical records, where scattered observations on health problems, prevalent diseases and their management were reported anecdotally.

In addition to these scattered records, early travellers and historians have played an important part in studying or describing the state of health, hygiene, sanitation and medical practices in the early times (see Foreign Impressions page 439). Also during the Anglo-Egyptian Condominium, government officials contributed remarkably. Naom Shuqair, for example, compiled a massive treatise on the history and geography of the 19^th century Sudan with sizable sections on prevalent health customs and diseases and their treatment in different parts of the Sudan.[1]

Without belittling the efforts of certain institutions in preserving the Sudanese healing practices, especially the Institute of African and Asian Studies of the University of Khartoum, the Aromatic and Medicinal Plants Research Unit and Traditional Medicine Research Institute of the National Council for Research, whose efforts to study the field in an organized fashion will be dealt with more critically later (see the Profession of Traditional Medicine, page 344), an appreciative amount of data related to health among different tribes has been collected by individual researchers.

Anthropologists, for example, have contributed immensely to this field by studying the systems of healing in several Sudanese societies. Edwards Evans-Pritchard studied the Azande,[2] the Nuer, the Ingassana,[3]the Bongo, the Mberidi and Mbegumba of Bahr Al-Ghazal; R.G. Lienhardt,[4]the Dinka; Jean Buxton,[5]the Mandari; Charles and Brenda Seligman the pagan tribes of the White Nile and southern Sudan and Harold MacMichael[6] drew a history of Arabs in the Sudan. In J.S. Trimingham’s studies on Islam in the Sudan,[7]we find a perceptive analysis of the magico-religious beliefs and practices associated with affliction and misfortune. Ian Cunnison studied the Humur tribes of southern Kordofan[8] and Harold Barclay Burri Al-Lamab, a suburban village in central Sudan.[9]

Several case studies in healing practices were carried out in partial fulfillment of postgraduate degrees in anthropology, folklore, medicine, pharmacy, and veterinary sciences, agriculture or for other academic pursuits. For a more comprehensive coverage of these dissertations, please refer to the appended Bibliography. However, a representative sample include Holy[10] and Abdullahi Osman Al-Tom, studying the Berti of Darfur,[11],[12] Nadel, the Nuba of southern Kordofan,[13]Sharaf Al-Din Abd Al-Salam the saints’ cult in the Sudan,[14]Abdullahi Ali Ibrahim,[15]the impact of Rubatab metaphor on social, political and health life of that tribe and their neighbours, and Sayyid Hamid Hurreiz, birth, marriage, death and initiation customs and beliefs[16] and rites of passage[17] in central Sudan. Idris Salim Al-Hasan studied Um Dawan Ban Religious institutions,[18]Awad Al-Basha, couching techniques in Kordofan,[19]Amira Hasan female circumcision,[20] Amir Ali Hasan the maseed system in the Gezira,[21],[22]Pamela Constantinidis[23] and Samia Al-Nagar,[24]women institutions specially the zar cult, and Makris, and Ahmad Al-Safi,[25]the tumbura cult in Omdurman.

Several other works appeared outside the postgraduate field, namely Ahmad Al-Safi Native Medicine in the Sudan: Sources, Concepts and Methods,[26]which was prepared for the Salamabi prize competition launched by the Sudan Research Unit in 1968, and Hamid Rushwan Female Circumcision: prevalence, complications, attitudes and change[27] and Asma Al-Darir Woman, why do you weep?[28]Both of which were reports on a WHO-sponsored survey that spanned almost all northern Sudan.

The Sudan shared in the recent worldwide resurgence of interest in studies of culture, in search of identity, self-sufficiency and for fulfilling national pride. In this endeavour Tigani Al-Mahi unequivocally pioneered this search with much enthusiasm, devotion and talent.

Tigani was a Sudanese psychiatrist and social scientist of great distinction; he lived with an unequaled love of the culture he was born and brought up in. Over and above his interest, his psychiatric career brought him into contact with invaluable sources and key informants in research fields. Tigani Al-Mahi contributed significantly to the inception and promotion of an African model of psychiatric health delivery that came to be known as the “village-system” as typified by that of the village of Aro in Abeokota in western Nigeria. The system permitted treatment of the mentally-ill by utilization of the inherent dynamic resources of the social environment as the principal therapeutic technique.

Earlier, T. Adeoyo Lambo (a Nigerian pioneer psychiatrist) and Tigani Al-Mahi postulated that under stress—emotional or otherwise—newly-acquired and highly-differentiated social attitudes and ideologies are more susceptible to ‘damage,’ leaving the basic traditional beliefs and indigenous moral philosophy functionally overactive.[29] This insight led them to recognize the part played by indigenous psychotherapeutic approaches in the total management of patients, without any lowering of standards of medical practice. They also found, through long practice in Africa, that a multi-disciplinary approach and collaboration with traditional healers is necessary for better scientific understanding of man and his environment.

Also Tigani’s insights in problems of fieldwork and methodology in the social sciences are shrewd and should be carefully studied by all field workers in the social sciences, especially the uninitiated. Much is to be found in his book An Introduction to the History of Arabic Medicine[30] published in Arabic, and in his papers in the two volumes of collected essays edited by Ahmad Al-Safi and Taha Baasher and published by Khartoum University Press in 1981[31] and 1984.[32]

Broun and Massey[33] and Andrews[34] early in this century compiled two books on Sudanese flora that have become indispensable sources for researchers, and particularly useful for those studying traditional medicine, even though they have not dealt specifically with medicinal plants. During the Anglo-Egyptian Condominium (1899-1956) medical doctors in the Egyptian Medical Corps, scientists, and administrators contributed a lot to our knowledge of the local practices in the various parts of the country. The articles they wrote were pioneering in every sense. Some of these articles were published in the Wellcome Research Laboratories reports (1906-1911),[35]edited by Sir Andrew Balfour;[36]others appeared in Sudan Notes and Records (1918-).

Bimbashi RG Anderson, while Senior Medical Officer in Kordofan, described the medical practices and superstitions amongst the people of that region.[37]Later, he also described the tribal customs of the Nyam-Nyam[38] and Gour people inhabiting the eastern Bahr Al-Ghazal region, and the relation of these customs to the medicine and morale of these tribes.[39]Bimbashi L. Bousfield, an Egyptian Medical Corps and Senior Medical Officer in Kasala in the eastern Sudan, has described the local methods of treatment of diseases in that region.[40]Bimbashi Hasan Effendi Zeki, of the Sudan Medical Department and Medical Officer at Gordon Memorial College, has described the healing art of the dervishes during the rule of the Mahdi and his Khalifa (successor).[41]Zeki had been taken captive to Omdurman by the Mahdi after he had captured the city, and had worked during his captivity as the Mahdi’s medical adviser and attended him during his death. Sir Rudolph Baron von Slatin Pasha, Inspector General, Sudan Government, has contributed brief but interesting notes on the health of the Sudanese. He has furnished the Wellcome Laboratories Reports with notes on the local methods of the dervish healing practices and customs.[42]

Abd Al-Hamid Ibrahim reviewed the medicinal plants and minerals that appeared in the publications of the Wellcome Research Laboratory Reports for the years 1906, 1908, and 1911, and compiled an inventory of the cited plants and minerals with their catalogue numbers in the Wellcome Museum of Medicine in Khartoum.[43]The inventories have been appended to the Annual Reports of the Government Analyst, Wellcome Chemical Laboratories Reports for the years 1958-59 and 1959-60. These appendices would have been of much help to researchers if the museum[44] and its contents had not been lost.[45]

Some researchers in the last few years have made some efforts to document herbal medicines in the Sudan. Gamal Al-Ghazali has produced a small booklet entitled Medicinal Plants of the Sudan.[46] The book covers twenty medicinal plants that are popular in Erkowit. The author has described and illustrated the plants in line drawings. Each plant entry includes the vernacular and taxonomic names, habitat, distribution, chemical constituents and a brief mention of uses. The booklet has the relevant references.

The Khartoum Trading and Projects, a private company in Khartoum, has published a similar booklet[47] describing 41 plants. Each entry in this booklet includes the vernacular and the taxonomic names, habitat, distribution in the Sudan, chemical constituents, and uses. It is neither illustrated nor referenced.

The Arab Organization for Agricultural Development published in 1988 Al-Nabatat Al-Tibbiyya WAl-‘Itriyya WAl-Samma Fi Al-Watan Al-Arabi. The book contains profiles for 256 entries. Many plants have been illustrated in line drawings, and some were reproduced in coloured photographs. Each entry contains the common Arabic names and the English and Latin equivalents. The book also describes each plant, its habitat, active principles, and uses.[48]Many plants listed in this book were drawn from the Sudan.

Several poisonous plants occur naturally in the Sudan. Early researchers, including Sir Andrew Balfour, described some of these plants in the early reports of the Wellcome Research Laboratories in the first decade of this century.[49] Robert Kirk[50] in 1946 and Mansour Ali Haseeb[51] in 1972 updated the knowledge in this field. Some minor accounts have appeared in Arabic describing the chemistry and pharmacology of some of these plants.[52]Professor Salah Adam of the College of Veterinary Sciences researched extensively (and helped researchers) in toxic and poisonous plants that affect animal and man.[53]