An Inside Look at Traditional Medicine in Sudan

Throughout history, health has been an integral part of human development. In search of well-being, humans discovered different ways to heal themselves and maintain their health. Those discoveries of the early ages led to the development of Traditional Medicine (TM) in Sudan. 

TM is widely practiced in Sudan where people commonly use herbal and other natural ingredients to maintain their health or treat illnesses. 

According to the World Health Organization (WHO), TM is defined as ‘the sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness’. TM is based on the concept that diseases occur because of an imbalance between humans and their environment. It involves many areas such as women’s health, fertility control, child nutrition habits, mood stabilisers, narcotics and more.

TM in Sudan is unique. It represents a mixture of the indigenous cultures of Islamic, Arabic and African traditions. As result, treatments exist for different diseases, both epidemic and endemic.

Some of the commonly used herbs in TM include hibiscus, which is known as karkade in Sudan. Whether hot or cold, most Sudanese drink karkade with ginger to relieve symptoms of the common flu. Karkade has long been known for its medicinal uses. The flowers and leaves can be made into teas and liquid extracts that can help treat a variety of conditions such as upset stomach, high blood pressure, bacterial infections, fever, weight loss and cancer. In addition to karkade, gongalez has great health benefits. The baobab tree, which gongalez comes from, has fruits, leaves and other parts that are not only edible, but also rich in important vitamins, trace minerals and antioxidants. 

Another popular custom is going to a traditional healer called an Albasir, who treats broken and dislocated bones and joints. If one is surfacing from a mental illness, some Sudanese people believe it could be treated by visiting a sheikh or fakih, a religious man who combines both spiritual and herbal medicines, prescribing verses of Quran along with herbs to treat people.

Although, there is a lack of accurate statistics on the practice of TM in Sudan, according to Dr Ahmed Alsafi, TM is affordable, available, and convenient for the majority of the population. He believes it is essential to make healthcare providers culturally competent with regards to TM. 

While it has many positive benefits, TM comes with a potential risk of toxicity caused by an interaction of herbs and drugs. In addition, TM might lead to mal-healing of fractures or cause a delay in seeking professional healthcare among psychiatric patients. 

It is essential to understand and integrate TM into the current healthcare system and research must be done on how best to do it. Traditional healers must be educated and trained to be medical assistants. In addition, exploring the field of evidence-based herbal medicine is a promising and effective way to incorporate herbal medicines into modern medical practices.  

The survey presents

While conducting a survey on TM practices in Sudan, targeting medical students or aspiring doctors who will observe the practices of traditional healers, it was found that the majority of respondents believe that traditional medicine uses traditional knowledge of herbal products and methods that precedes modern medicine. Some respondents believe it to be a process of diagnosing and curing using inherited knowledge which differs from country to country. Most of the respondents showed a deep understanding of what TM is.

TM is very popular in Sudan as agreed by 93.8% of respondents. On why people tend to prefer TM instead of modern ones, majority of the surveyees (76%) said it was because it is cheap and accessible; 6% believed that it may be because of poor experiences with doctors; while others believe it is because of a lack of knowledge and education. Moreover, while 6% believe that these medications are harmful another 6% feel that people are convinced that traditional and herbal medications have no future harmful effect. 

On the benefits of TM, 12.5% of the respondents believe that it is beneficial; 56.3% believe it might be beneficial; while 31.3% believe that TM is not beneficial. The ones who feel it can be beneficial say that it can be helpful as long as the herbs and medicines are natural. While 6% claim to have heard stories of people who benefited from herbs rather than medications, 31% believe it can be helpful in certain situations but it could be harmful in other situations. An additional small percentage of the respondents believe TM will not help as it is not scientifically proven to be beneficial. 

On the affordability of TM, half of the respondents believe TM does not reduce costs on medical bills as patients won’t be completely healed and still want go to a doctor. In case of minor headaches and abdominal pains, the majority of the respondents stated that they would use herbs while others preferred seeing a doctor. A small percentage of the respondents stated that they would decide on whether to visit a doctor or seek TM treatments, depending on the severity of the ailment.

The survey portrayed that many medical students believe that TM is widespread in Sudan. However, 62.5% of the surveyees claimed to have concerns about TM as they feel the results are unpredictable and that it is not based on scientific evidence. The efficacy of TM in Sudan has not been proven. However, it’s important to point that many of the healthcare services and treatments, may not always be available or affordable in Sudan; therefore, many seek TM to treat their injuries or illnesses.

Where is the evidence?

There are examples of people benefitting from TM. An interesting study was conducted on an 11-year-old with end-stage renal failure. Conservative medical management and Arabic gum were used in this study. After four years of follow-up, the patient showed improvement and was free from renal dialysis. It is believed that four years is the longest dialysis-free period for children with end-stage renal failure. In addition, thousands of similar experiments have been conducted on animals.

Advocating for evidence-based herbal medication, Ammar Ajool, a broadcast journalist at Al Jazeera Media Network, studied chemistry and herbal medication to help understand his son’s illness, which doctors were unable to diagnose for two years. Once doctors diagnosed his son with a rare disease and identified a treatment, Ajool was not satisfied with doctor’s treatment so he began to learn about herbal medication.

Ajool believes the way medicines are made, by extracting chemicals out of a plant and synthesising them in laboratories, is wrong. He believes that the entire plant or herb must be used in certain doses. Ajool shares many of his studies on herbal trials on his social media platforms. One of the most interesting studies he shared, argues that, drugs are the third cause of death following heart diseases and cancer in the United States and Europe. Ajool believes that Sudan has laboratories and medical cadre who are competent enough to conduct clinical trials on herbs. He believes that it is the responsibility of the Ministry of Health to provide funding for this work. He feels doctors must put in efforts and create lobbying groups to convince the authorities. 

Accepted by the general population, TM has many advantages, such as being cost-effective, affordable and accessible. In addition, adopting evidence-based herbal medicine is another way to make use of the traditional knowledge and make it applicable in modern medical practice.   

TM can be promising if integrated into Sudanese’s healthcare system, which can make medical treatments more cost-effective and accessible to the Sudanese population. The herbs are available, accessible and affordable. Most importantly, there is existing evidence to suggest that herbal medication can help treat certain illnesses as well as injuries. With the current healthcare challenges in Sudan, the country can benefit a great deal by putting an effort in the development of TM.

Azza Abdelmagid is a 21-year-old Sudanese medical student (and finalist) at University of Alzaiem Alazhari and a freelance translator. She is an active member of Medical Students’ International Network-Sudan (MedSIN-Sudan), a student organisation, uniting Sudanese medical students and giving them a voice. She is interested in Sudanese culture, traditional heritage, and public health specifically women’s health. She believes in youth and women empowerment, and enjoys volunteering, travelling and writing. She is inspired by Helen Keller’s quote: ‘Life is either a daring adventure or nothing’.