My Mission in Western Sudan
Early in 1959, I returned to Sudan and applied for a job with the Ministry of Health. I was appointed a Medical Officer with the Ministry of Health in March of 1959. I was transferred to Kurdufan Province and worked in Al Obayed Hospital for 3 month, after which I was transferred to Abu Jebeha Hospital. It was a newly built hospital in Tagaly in the District of Southern Kurdufan. The population of the district was about 50,000 and was a mixture of Nuba, Hawazma, Kinana and Awlad Hemed tribes. The medical services were highly organized at the level of the district; the rural hospital was surrounded by a satellite of health centers referred to as dispensaries and ran by Medical Assistants. Around each of these dispensaries, there was a number of dressing stations ran by senior nurses. The Medical Officer looks after the district assisted by a Public Health Officer and his staff. I think this was a perfect system for primary health care delivery at that time.
I spent 2 years in Abu Jebeha and cared for thousands of patients. The most important event in this period was the discovery of the cause of a fever used to be known as PUO (Pyrexia of Unknown Origin), that the natives referred to as “Um Sallowki”. This fever was very high and lead wasting the body enlargement of the abdomen caused by Splenomegaly. I found the organism in the blood and lymph nodes of the blood of patients. I gave the patients “Intostam” and the response was dramatic. The patients were cured and their weight improved from skin on bone to double their weight. The news spread in Kurdufan and patients rushed from various provinces seeking treatment. I was then called Hakeem Um Sallooki (The Doctor of Um Sallooki.) The Ministry of Health did not approve of my work on this matter because they did not consider Tagaly District as a Kalazar area. A Senior Bacteriologist was sent to Abu Jebeha to see if I could convince him that the PUO is a really a “Kalazar”. After months of this epidemic, the area was designated by the Ministry of Health and the World Health Organization (WHO) as an area of Kalazar without any mention of my efforts. The second important event is my tour in Tagaly District when I vaccinated 35,000 of the population. The importance of the Yellow Fever vaccine is that it protects the recipients for 10 years. I came to understanding the importance of vaccination in the last 50 years.
My family in Abu Jebeha was comprised of my wife Aziza and my daughter Eman who was one year old in 1959.
Abu Jebeha was a green village, the soil was fertile and the rainy season spans from June to October. Many mango trees were grown in Abu Jebeha. The village consisted of a market area, a merchant quarter, schools quarters, and the Ginning Factory quarter. I was very satisfied with my work in Abu Jebeha and the people were appreciative of my work. All the tribes lived in harmony without any evidence of violence or tensions amongst the tribes. After spending 2 years in Tagaly District, I was transferred to a new station in Southern Sudan in 1961.
My mission In the South
Mr. Muwafi Abdel Fattah was Wao’s Province Medical Officer of Health (P.M.O.H) at Wao Hospital in the Capital of Bahr Al Ghazal Province in Southern Sudan. Wao is an extremely pretty town during the rainy season. When I arrived at Wao, I found a number of doctors looking after medicine. They wanted me to care for the surgical patients, and I accepted. I spent one year caring for surgical patients with assistance from a number of sisters and nurses who were affiliated with the Catholic Church. The sisters and nurses assisted on voluntary basis in the outpatient surgical work and theatre and were dedicated to their work.
In Wao Hospital, I operated on a number of patients. During this period the head of the Department of Surgery for the Faculty of Medicine of University of Khartoum visited me in Wao. He was interested in tropical source, and I prepared various types of tropical source for him. He was highly impressed of my surgical work and wondered why I didn't apply for surgery. I explained to him that the Senior British Surgeon is biased against graduates from Egyptian Universities. He promised to support me and to apply for surgery, and he did. The name of this surgeon is Dr. Crocket.
My son Mohammed was born in Omrwaba in 1960 and joined us as the new addition to the family, he was one year old when we moved to Wao, and Eman was 3 years old.
One of the major events at that time was the extension of Sudan Railways from the City of Babanusa in Western Sudan to the city of Wao in Southern Sudan. The head of the Military Council Gen. Abbood visited Wao for the opening ceremony.
The Fellowship of the Royal College of Surgeons
In May 1962 I was chosen as a Surgical Registrar, then transferred to Khartoum Hospital where I spent 2 years. I spent the first year preparing for the Part One of the Fellowship Royal College of Surgeons (F.R.C.S), and I completed Part One Diploma in Khartoum.
I lived in a small house in Alhilla Al-Jadeeda facing the Molid Square. My son Yasser was born in June 1962 when I started my journey in surgery. After passing Part one, I spent another year in Khartoum Hospital as a Surgical Registrar under the direction of Mr. Bayomi and Prof. Nichols.
I left Khartoum in mid 1964 for the U.K., and was assigned to Saint Georges Hospital; part of the hospital was in the Hide Park corner and the second part was located south of London in Tooting Grove. I lived in a small house in the hospital called The Bleak, where a number of Resident Registrars shared this residence.
I worked in the surgical unit presided over by Mr. Victor Riddle, and assisted by Bradley and Effron, my associate was Richard Let. I passed my final Fellowship exam on May 13, 1965. My colleagues Abdel-Aal Abdulla Osman and Hassan Goreish passed their final exam on the same day. I returned to Sudan to be told that I was chosen as Surgeon of Darfur Province. I took my family, Aziza, Eman, Mohammed and Yasser to the City of Al-Fashir where we spent almost 4 years.
Darfur
I took over from Mr. Kamal Bushra at Al-Fashir Hospital. The GYNC Department was headed by Dr. Hadi Alzain Annahass and then Dr. Sharaf Aldien Al Tayeb took over. Dr. Abdel Jaleel Mohammed Awad Alkareem was the Medical Department head. A. Kabbashi was the P.M.O.H followed by Dr. Kamal Madani. I looked after a huge number of cases from various parts of Darfur, and operated on numerous cases. The pattern of surgical patients in Darfur included trauma to various parts of the body, acute abdomen, renal stones, Snail prostate, Madora foot, Goiter, CA breast, hernia and other surgical conditions. The results of my surgeries were gratifying and I was satisfied with the work I have performed in Darfur. To add to my gratification, the people of Darfur were kind to me and appreciated my work. I spent almost all my time in the hospital and did not engage in private practice.
I had some social activities in Al-Fashir Club and Al-Fashir Secondary High School in a form of lectures and presentations. I also had some relations with some of the Sufi sheikhs in the region.
The Ministry of Health Started the Super Specialties and I was chosen to start a Neurosurgery Department in Sudan. I was then exhausted from the previous post, but I accepted the challenge. I met Professor Ahmed Al Banhawi who was considered to be one of the pioneers of Neurosurgery in Egypt, in Khartoum while he was attending the Arab Medical Conference in 1968. Professor Banhawi offered me to join his Neurosurgery team in the Department of Neurosurgery at Ain Shams University in Cairo. I accepted his offer to join his department Al-Damardash Hospital at Ain Shams University. It seemed that the Royal College were not pleased that a Fellow acquires further training in a place other than U.K. But, that was the right place for someone who is going to start from the scratch. So, I moved to Cairo to pursue this endevour. Under guidance of Professor Banhawi, I witnessed a broad spectrum of neurosurgical cases, assisted and operated on a number of cases and made good contacts with all the neurosurgical sections in Egypt at that time.
My daughter Manasik was born in Cairo in 1969, I returned to Khartoum in early 1971 to start the first Neurosurgical Section in Sudan.
The First Neurosurgery Section in Sudan
Establishing a Neurosurgical Section was a real challenge. I wrote to a group of leading figures in the Ministry of Health whom I thought would be helpful for establishing the Neurosurgical Section. I wrote to Senior Surgeon Dr. Ahmed Adel Aziz who was a great help as he was also in charge of Cardiac Surgery and who was also involved in building an Operation Theatre Block at Al Shaab Hospital in Khartoum. Dr. Ahmed has agreed that we share the same Theatre Block.
I also wrote to Professor Dawood Mustafa (Senior Physician), and Dr. Khalid Mohammed Alhaj (Senior Radiologist) asking for their help in the establishment of the first Neurosurgical Section in the country.
Dr. Abdulla Yousif was having formal training in Neuroradiology and that was a step forward. I wrote to Dr. Taha Baashar who was the Minister of Health to help with the budget for the section.
When I came back to Sudan I was hosted in Al Shaab Hospital, and stared the Neurosurgery Section with 4 beds and expanded gradually till it reached 48 beds. The Ministry of Health approved the budge for more theatre equipments and instruments.
On the nursing side, some nurses were sent for training in theatre work, Sister Um Salama and Sister Asia. They both completed their training in Egypt and returned to join the Neurosurgery Section at Al Shaab Hospital Khartoum.
I used to operate in Khartoum Hospital before the theatre in Al Shaab Hospital was fully equipped. I also cared for head injury patients in the Casualty Section at Khartoum Hospital. Medical Officers with special duties joined the section; the first two were Mr. Ali Abdel Rahman and Mr. Younis Salih. Medical Officers who expressed interest in Neurosurgery were sent abroad for Post Graduate training. These Medical Officers include:
Ali Abdel Rahman, Sweden;
Younis Salih, Former U.S.S.R.;
Muhsin Hussein, U.K.;
M Abdel Rahman, Sweden;
Abdel Rahman Alzaki ,Former U.S.S.R.;
Jalal Elnour, China;
Ibrahim Mahjoub, Egypt;
Safwat Matias, Egypt;
Al Hadi Bakhiet, Holland;
Mohammed Mohyaldien Abusaif, Where UK
Mohammed Osman Hamid, U.S.A. and Egypt.
Thos gentlemen are considered the pioneers of neurosurgery in Sudan.
In the New Neurosurgery Section at Al Shaab Hospital, I used to investigate cases of my patients and performed Angiograms, Myelograms, and air studies until Dr. Abdulla Yousif and Abdel Rahman Al Lidir started the new Radiology Department. Step by step the section was established and reached a point covering the brain and spine.
My daughter Nura was born in 1975. I lived in Omdurman at the time from 1971 to 1977 near my family home in Al-Morada. In that period I acquired a piece of Land in Riyadh, Khartoum and built a small house in which I currently live since July 1977.
My son Suleiman was born in September 1977, and we celebrated his birth at the new house in Riyadh, Khartoum.
The work in the Neurosurgery Section was very exhausting, I was on call duty for about 7 years until Dr. Ali Abdel Rahman, Dr. Younis Salih, and Dr Muhsin Hussein returned back to Sudan after completing their qualifications in Neurosurgery. Shortly after, I wrote a book about neurosurgery in the Seventies at Khartoum Hospital and Sudan.
In 1983 I was elected as President of the Doctors Syndicate for Khartoum and Al Shaab Complex. The number of Medical Officers and Specialists in this complex was over 500 at that time. Unfortunately during that time, the government of Sudan was under pressure from the World Bank and the International Monetary Fund (I.M.F.) to reform the country’s economy. The government policies adopted for Medical Institutions were inadequate, and have in turn affected the health services to a great extent. Salaries were poor, and maintenance of buildings, equipments, and instruments has ceased. While we were fighting for excellence, the health services deteriorated before our eyes. That was the cause of the big confrontation between the Doctors Union and the Government of Sudan, which ended with the famous strike in 1984 when all the doctors of the Sudan submitted their resignations to the Ministry of Health.
I was arrested by the Intelligent Forces and sent to Political Confinement for several days to be called along with Dr. Al Juzooli Dafaalla (The president of Sudan Doctors Union) to meet with President Jaafar Numeiry in the Republican Palace. That was an important meeting and was attended by General Omer Mohammed Altayeb (Vice President and Director of the Security Forces.) The meeting lasted for 4 hours, and a solution for the conflict was reached. We were released from political detention. Yet, less than 2 months later the Doctors Union was disbanded and dissolved by the government.