Physicians of Sudan: historical perspective

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1 Physicians of Sudan: historical perspective Siddiq Ibrahim Khalil, FRCP, FESC, FACC, Professor of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan. Background Modern medical service was introduced in the country by the Turco-Egyptian army that invaded and ruled Sudan during the period The first hospital was built in Khartoum by 1830 and remained open until 1885 when it was abandoned during the Mahdia rule. Following the beginning of the Anglo-Egyptian Condominium the hospital was reopened in 1901 and functioned as the Egyptian Army Military Hospital (EAMH). It played an important role during the 1924 White Flag Revolution and later became the River Hospital. Presently it houses the offices of the Federal Ministry of Health (1). Few hospitals were built in the main provinces as in Dongola, Berber and Medani. The first physician in Sudan to be appointed to a senior medical post was Dr Hassan Bey Hashim (1862). Dr Hashim, who initially studied pharmacy in the Pharmaceutical School at Cairo, was sent to France in 1847 for further studies in pharmacy, but instead he took studies in medicine and went on to specialize in obstetrics. On his return to Egypt in 1862, he took up the post of Assistant Director of the Egyptian School of Medicine. He was sent on several missions to the Sudan, and in 1863 he was appointed Chief Medical Officer of Khartoum during the tenure of the Sudanese notable, Sheikh Ahmed Bey Awad Alkariem Abu Sinn, Governor of Khartoum and Sennar (2). During Al Mahdia the achievements of the Egyptian practitioners were widely recognized in the Sudan. Hassan Zaki, an Egyptian trained medical officer of the Turco-Egyptian Hospital in Khartoum acted as a medical advisor to the Mahdia government. When The Mahdia fell ill with typhus, Dr Hassan Zaki was called to attend to his illness and provide medical care (3). The era of the Condominium started in September 1889 and was characterized by the creation of a modern elaborate health system and hospitals. Most of the early physicians were members of the Royal Army Military Corps and when the Egyptian Military Hospital was re-built in 1901 its senior medical officer was Bimbashi Steven Lyle Cummins, a distinguished Irish physician from Cork. Lyle Cummins was a member of the RAMC who was part of Kitchener army during the re-conquest of Sudan. The first three civilian doctors arrived in Sudan in They were; Dr EA Gates, Dr Web Jones and Dr ES Crispen. Nurse Pye Moore arrived in 1907 and should be remembered as the first nurse in Sudan and the first matron of Khartoum Civil Hospital. She retired unwillingly in 1930 (4). Dr JB Christopherson (MRCP, FRCS) arrived in January 1902 was posted to Omdurman Civil Hospital (OCH) and later in 1903 he was also appointed the physician in charge of the first Khartoum Civil Hospital (KCH). Dr V Hudson arrived in 1903 and was appointed physician to Atbara and Barber region while Dr ES Crispen was appointed to Port Sudan Hospital (4). The start of civil medicine was not particularly civil as the first officially named director of the Sudan medical department, appointed on 1 March 1905, was in fact a military doctor GD Hunter principal medical officer of the Egyptian Army (PMO). The civil and military departments were split as of 1 November Medical responsibility of Khartoum, Omdurman, Khartoum North, Halfa, Dongola, Berber, White Nile Province, Port Sudan, Suakin and 53

2 the railway administration were given to the acting head Christopherson. Despite the fact that Christopherson was nominated as director of medical service in 1904 the medical administration remained under the PMO until 1916 except for a short experiment in civilian administration under Christopherson in (5). This period ended in 1 January 1909 by the Governor General (Sir Reginald Wingate) decision to relieve Christopherson of his duties as director of the medical service. Christopherson had a most successful career in Sudan during which he introduced the use of antimonial, for the first time, as a treatment for Bilharziasis in 1917 at KCH. A plaque commemorating that event can be seen at the southern west veranda of the old hospital building (now housing Sudan Medical Specialization Board) He retired in By the beginning of 1924 KCH was well staffed with highly renowned physician and surgeons. Among the physician were Dr Squire, Dr Hudson and Dr Humphreys they were all MRCP holders. All the surgeons; Mr Waterfiled, Mr Atkey and Mr Footner were qualified as FRCS. With the Kitchener Medical School (KMS) starting in February 1924 it was decided that the beds at KCH be divided into surgical and medical sections and consequently the job of senior physician and surgeon was introduced (4). Dr Squire became the first senior physician and first lecturer in medicine at KSM. Following his retirement from service in Sudan he was appointed physician to the Sudan Government in London until He has contributed immensely to promotion of medical teaching and was well remembered by those whom he taught; among them was Dr Ali Badri a graduate of the first batch and the first Sudanese minister of health. Dr Squire encounter with Al Zubair Pasha and the succinct report that he wrote about Al Zubair medical condition and cause of death is already documented (6). Squire retired in 1930 and was followed by Humphreys who was succeeded by Cruickshank in Buchanan followed Cruickshank and both served immediately after the end of the Second World War. Buchanan who was the last to become British senior physician, retired in 1953 and was succeeded by the first Sudanese senior physician Abdul Halim Mohamed. It is of interest to add that Christopherson, Hudson, Humphreys, Buchanan and Abdul Halim served both as senior physicians and directors of KCH during their tenure. Dr Abdul Halim Mohamed was the first Sudanese to obtain MRCP in 1947 and in 1962 he was also the first Sudanese to be elected Fellow of the Royal Physician of London. Following independence in 1956 the department of medicine, University of Khartoum (UK) was partly staffed by British physicians among them were Professor Morgan, Dr Carter and Dr Grant who was a chest physician. In 1965 the new independent department of pediatrics was founded by Professor Neil who was the first professor of pediatrics in Sudan. Professor Daoud Mustafa became the first Sudanese head of department of medicine in 1963 and by 1965 he was the first Sudanese professor of medicine. Sudan Association of Physicians In 1966 Dr Halim, Dr Daoud Mstafa, Dr Mohi Aldin Mahdi, Dr Abdel Razaq Al Mubarak, Dr Mohd Hassan Abubakr, Dr Abdel Monem Wasfi and Dr Mohamed Hassan Gabir agreed to form the first physician s forum in Sudan. It was given the name of Sudan Association of Physicians. The objective was to bring the physicians of Sudan together socially and professionally. The first conference was held in It was agreed that each two years a new president, a secretary and treasurer be elected. The first president was Dr Halim Mohamed who was the only president to be elected for two consecutive terms. 54

3 Since the launching of the Association 28 conferences (Fig 1) have been held, the last one being in El Obied and twenty four presidents were elected (Figs 2,3,4,5). The next, the 29 th Conference, will have a great bearing on all physicians as it will commemorate the 50th anniversary since the founding of the association. Fig 1: SAP conference in Port Sudan 2013 Fig 2: Some of the Brithish physicians who worked in Sudan between

4 Fig 3: Founders and first generation of Presidents Sudan Association of Physicians Fig 4: Presidents of SAP

5 Fig 5: Presidents of SAP To qualify as physician a doctor has to pass a selection examination for registrarship in medicine which may last up to three years after which he should pass the MRCP or other equivalent qualifications. Members of the association must be registered as physician in Sudan Medical Council (SMC). In 1994 Sudan Medical Specialization Board (SMSB) was formed by a presidential decree to train registrars from the different specialties of medicine. Those who complete the prescribed course of 4 years and the qualifying examination are granted the fellowship or (MD) of the Board. SMC presently consider MD as the standard registration prerequisite. Until the early sixties of the last century subspecialization was rare and only few physicians declared their sub-specialty, they were Dr Abdul Halim (cardiology), Dr Daoud Mustafa (neurology) and Dr Mohi Aldin Mahdi (pulmonology). Sub-specialization became a reality following the return of of Dr Siddiq A Ismaeel as cardiologist and Dr Abdul Rahman Mousa as first nephrologist. The trend at that time was to finish training as medical registrar and then travel to United Kingdom for specialization and obtaining the MRCP. Some of the physicians continue training in special departments and return with both the MRCP and sub-specialty training. With the establishment of the SMSB subspecialization is made available in most disciplines. That was a short historical document on physicians of Sudan both expatriates and native. I expect that future changes are inventible both in persons and achievements and that another report will be needed especially if written after the next fifty years. Hopefully some of you who read this report will be alive to view the next one. 57

6 References 1. Siddiq Khalil. The first hospital in Sudan Sudan Med J 2014;50: Elhadd TA. Commentary: The first hospital in Sudan and the modern medical service during the Turco- Egyptian era Sudan Med J 2014;50: Siddiq Khalil. Medical services in Sudan: a historical perspective. Sudan Med J 2012;48: Squire HC. Sudan Medical Service. London: William Heinemann;1958.p Martin W Daly. Empire on the Nile: the Anglo-Egyptian Sudan, Cambridge, England: Cambridge University Press;1986. pp Siddiq I Khalil. Al Zubair Pasha ( ): a medical report on health profile and cause of death. Sudan JMS 2012;7: