Nectar

NHS heroes find way for patients at Royal London to avoid long hospital admission

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Sun, 6 Mar 2016 00:30:00 GMT

http://www.eastlondonadvertiser.co.uk/news/health/nhs_heroes_find_way_for_patients_at_royal_london_to_avoid_long_hospital_admission_1_4438736

A medical team that set up a project in east London to let patients be treated with injected antibiotics at home or as an outpatient rather than having to stay in hospital has been recognised as “NHS heroes” and awarded £1,000.

Their project at the Royal London Hospital in Whitechapel means 450 patients since 2012 have managed to avoid admission or at least had their stay in hospital reduced.

That has meant freeing up 1,200 ‘bed days’ which have been used for more urgent medical cases.

The team was nominated for Barts Health NHS Trust ‘heroes’ awards by a GP in London’s East End after it helped one of her elderly patients avoid admission.

“It made a big difference to my patient,” Dr Shera Chok explained. “She was able to attend hospital every day for a week, rather than having to be admitted. It was brilliant. They deserve this award for testing such new ideas.”

Four Barts Health Trust staff involved in the fight against Ebola in West Africa last year were also recognised as “heroes” and presented with ‘Ebola’ medals.

NHS “heroes” are nominated by patients, families, colleagues and other health professionals for the annual Barts Health recognition awards.

Barts Trust has a-million patients every year being looked after at its five east London hospitals, Royal London, Mile End, Newham University, St Batholemew’s and Whipps Cross.

Source: The Docklands & East London Advertiser http://www.eastlondonadvertiser.co.uk/home

Antibiotics scheme reduces admissions and length of stay

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Sat, 5 Mar 2016 21:30:00 GMT

http://www.bartshealth.nhs.uk/media/latest-news/2016/january/antibiotics-scheme-reduces-admissions-and-length-of-stay/

An innovative scheme at The Royal London Hospital to enable some patients with difficult to treat infections to have intravenous (injected) antibiotic treatment at home or as an outpatient has prevented admission or reduced the length of hospital stay for 450 people and freed up 1,200 hospital bed days.

The usual care plan for people with serious infections often sees them admitted to hospital, sometimes for weeks.

Provided since 2012 by a team of nurses, infectious disease consultants and microbiologists, the outpatient parenteral antimicrobial therapy (OPAT) service aims to improve the patient experience by avoiding admission or reducing their stay, as well as reducing associated costs to the Trust.

The hospital and community based team offers A&E patients, as well as inpatients who are well enough to leave hospital, the opportunity to receive injections containing powerful antibiotics at home or daily at hospital outpatient clinics. So far 60% of patients have chosen to receive treatment at home, with 40% opting for outpatient care.

The OPAT team treat a range of conditions including lower limb cellulitis and multi-drug resistant urinary tract infections as well as chronic infections such as bone and joint infections.

Mark Melzer, Infectious Disease and Microbiology Consultant at Barts Health NHS Trust said: “No-one should be in a hospital bed unless they absolutely have to be. Patients often tell us that they are more comfortable when treated at home or as an outpatient, and their risk of hospital-acquired infections is reduced."

People can be referred by local GPs, Fast Response Team nurses or the hospital Emergency Department. Patients on wards recovering from a severe infection can also be reviewed and if appropriate offered the rest of their treatment at home.

- ENDS -

NOTES TO EDITORS

Barts Health NHS Trust
With a turnover of £1.1 billion and a workforce of 14,000, Barts Health is the largest NHS trust in the country, and one of Britain’s leading healthcare providers. The Trust’s five hospitals – St Bartholomew’s Hospital in the City, including the Barts Heart Centre, The Royal London Hospital in Whitechapel, Newham University Hospital in Plaistow, Whipps Cross University Hospital in Leytonstone and Mile End – deliver high quality compassionate care to the 2.5 million people of East London and beyond.

Source: Barts Health NHS Trust

www.bartshealth.nhs.uk

مدينتك الهدى والنور

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Sat, 5 Mar 2016 18:53:00 GMT

مدينتك القباب

ودمعة التقوى ووجه النور

وتسبيح الملائك في ذؤابات النخيل

وفي الحصى المنثور

مدينتك الحقيقة والسلام

على السجوف حمامة

وعلى الربى عصفور

*****

مدينتك الحديقة يا رسول الله

كل حدائق الدنيا اقل وسامة وحضور

هنالك للهواء أريجه النبوي

موصولاً بأنفاس السماء وكأسها الكافور

هنالك للثرى طيبٌ

بدمع العاشقين ولؤلؤٌ منثور

هنالك للضحى حجلٌ بأسوار البقيع

وخفةٌ وحبور

هنالك للصلاة رياضها الفيحاء

والقرآن فجرياً

تضيء به لهىً وصدور

بساعات الإجابة تحفل الدنيا

وأنهار الدعاء تمور

*****

سلام الله يا أنحاء يثرب

يا قصيدة حبنا العصماء

سلام الله يا أبوابها

وبيتها ونخلها اللفاء

سلاما يا مآذنها وفوج حمامها البكَّاء،

ويا جبل الشهادة والبقيع سلام

*****

على أثل الحجاز وضالها

وعلى خزاماها

تهب قصيدة الصحراء

إلى تلك البساتين المعرجة الجداول

والقباب الخضر،

يهفو خاطر الدنيا

وتحدى العيس في الصحراء

مدائح لم تقل لبني الزمان

ترددت عبر القرون ليثرب الخضراء

قصائد من رهافة وجدها

شقَّت جليد الصخر

واجتازت عباب الماء،

قوافل ما انقطعن عن السَّرى

صلًّتْ عليك

وأوجفت عبر القرون

إلى قصيدة حبها العصماء

*****

ببابك يستجير الخائفون

ويجلس الفقراء

بابك تدخل التقوى فتوح الفاتحين

وحكمة الحكماء

وفي نعماء عدلك ترتع الدنيا

وميزان الحساب يقام

حفاة الرأس والأقدام

ندخل في نبوتك الرحيبة

من الزمن الكئيب وناسه لذنا بنورك

ومن شح النفوس ودائها المودي

لنا بجمالك استعصام

مدينتك الهدى والنور

وتسبيح الملائك في ذؤابات النخيل

وفي الحصى المنثور

مدينتك الحقيقة والسلام

على السجوف حمامة

وعلى الربى عصفور

مدينتك الحديقة اقرب الدنيا

إلى باب السماء وسقفها المعمور

محمد المكي إبراهيم

لندن 1983

من ديوان يختبئ البستان في الوردة

Conversation with Rachel: Why Doctors Leave?

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Sun, 6 Oct 2013 11:34:00 +0100

This is a conversation I had with Rachel Millard, reporter from the Croydon Advertiser (www.croydonadvertiser.co.uk) in the spring of 2012. An abridged version of this interview was submitted to the Guardian’s international development journalism competition

http://www.theguardian.com/journalismcompetition/longlist-why-doctors-leave

1) Is there a shortage of qualified healthcare workers in Sudan and if so, why? Are some geographical areas affected worse than others and if so, which? Are some skills more lacking than others, and if so, which?

There is generally a dearth of information about the numbers of doctors working inside or outside Sudan. According to WHO, Sudan (pre-secession of south Sudan) has a low doctor density of 22 per 100 000 population http://www.who.int/whr/2006/whr06_en.pdf. I am inclined to think this might be a rather generous estimate given when I worked for MSF in eastern Sudan I was the only doctor serving a rural population of around 200 000.

Historically, Sudan had 3 medical schools with an annual intake of about 300 students. However, since the early 1990s there has been a rapid expansion of medical schools (both public and private sector owned) giving rise to at least another 25 new medical schools. The intake of the “old medical schools” was also increased. Nevertheless, this perceived improvement in “quantity” did not necessarily lead to improvement in the “quality” of medical education mainly due difficulties in recruiting adequately qualified medical educators as well as financial constraints.

In a meeting organised by UK-based diaspora groups with the then first under secretary of the ministry of health (January 2009, Brighton), he stated that the ratio of newly qualified doctors to nurses was 6:1 in Sudan. I believe this anomaly in workforce planning has aggravated the already existing imbalances in the healthcare system in Sudan.

Khartoum state has always had the lion’s share of doctors, the majority of whom worked in private clinics to boost their income.

Road traffic accidents are a leading cause of mortality in sub-saharan Africa and a quick look at Sudan’s medical workforce reveals that 99% of orthopaedic surgeons and anaesthetists are based in Khartoum. Similarly, Sudan has a staggeringly high maternal mortality rate of 1107 per 100 000 live births (Sudan household health survey 2006) but there are tens of newly qualified obstetricians facing unemployment after completion of their 4-year postgraduate training scheme. The reasons for this are not entirely clear but I was told that most of them are not keen to work in remote areas (where there is little to no prospect of private work) but the irony is that MoH does not employ those who are willing to work there due to shortage of funds and poor workforce planning.

Women in Sudan have made great strides in terms of educational achievements and career progression despite all what western media say about women living in Muslim countries. When I was at university (1989-1995), our teachers used to say to us that they only had one or two female colleagues when they were medical students. Well, a third of my classmates were females. Nowadays, 50-60% of medical students/doctors are women. While the NHS might be have been able to afford relatively generous maternity leaves and accommodate part-time working pattern for its employees, the MoH in Sudan has struggled to cope with these challenges (The NHS budget alone is >10 times the total budget of the entire government of Sudan). Unlike British women, Sudanese women (irrespective of being a doctor or cleaner) are expected to marry, have children, and dedicate significant time and effort to their families.

2) Briefly, why is there a shortage?

Brain drain is the short answer. It is estimated that Sudan continues to lose nearly two thirds of its doctors to migration, mainly to Saudi Arabia, United Kingdom, Republic of Ireland, and more recently the United States. The main triggers for this mass exodus are: poor pay, unsatisfactory work conditions, lack of prospects for advancing medical careers, political reasons, personal and professional ambitions, etc. You will be surprised to know that at present newly qualified doctors in Sudan have to stay at home or do casual jobs for over a year or more before they are appointed by the ministry of health. The same scenario repeats its self when you are moving from one level to the other (e.g. house-office to medical officer to registrar to specialist or consultant). Very poor job planning and disputes over pay has led to a series of highly publicised strikes by doctors in 2010 http://www.sudantribune.com/Sudanese-doctors-released-after,35501 . Furthermore, fresh medical graduates find themselves pulled in different directions by the MoH and the “compulsory military service” officials.

3) What do you think can be done to reverse the shortage?

There is no easy answer to this. The current geo-political climate in Sudan is not conducive to change. MoH has been dismantled over the past 2 decades in favour of the growing private sector. Corruption is at record high in Sudan. Interestingly, migration patterns have also changed. Previously, Sudanese doctors came to the UK to spend a few months/years specialising or sitting exams and then returning home to a satisfactory job with MoH or a university. Since the early 1990s (post Bashir’s coup) this pattern has become unidirectional with a growing desire to settle in the adopted country while keeping social/educational links with their homeland. I think this trend stems from the political instability in Sudan, vulnerability of the “intellectual elites” to oppressive regimes, and genuine lack of prospects for any career progression upon return to the homeland.

4) What role do you think Sudanese doctors working abroad can have in healthcare in Sudan (e.g. sharing skills, advice, articles etc)?

Various diaspora groups have been focusing on transfer of skills and knowledge through active participating in local scientific conferences and training workshops/symposia. Examples of these are: Sudan doctors union (UK&I) http://www.sdu.org.uk/, Sudanese medical association (UK&I) http://www.sma-ukandireland.org/ , Sudanese-American Medical Association http://sama-sd.org/ , and the Sudan HIV/AIDS Working Group (SHAWG) http://www.shawg.org . Recently, the British-Sudanese Association of Medical Specialities (B-SAMS) has been established in 2010 as joint venture between the Royal Colleges in the UK, the Federal Ministry of Health in Sudan, and the Sudan Doctors Union (UK&I) on behalf of expatriate groups. The following documents will give more info on this partnership.

http://sdu.org.uk/upload/newsletter%20%20october%2010.pdf

http://sdu.org.uk/upload/newsletter%20may10.pdf

http://sdu.org.uk/upload/TAPP%20Document%20April%202010%20.pdf

Some expatriate doctors have managed to facilitate training for their Sudan-based colleagues and although the vast majority of these contributions go unnoticed at least one did manage to attract the attention of the media in Ireland http://www.medicalindependent.ie/page.aspx?title=university_hospital_galway_teams_with_sudan_on_diabetes_training_project

A few expatriate doctors (or ex-expatriate doctors) are members of editorial boards of the local medical journals e.g. Sudan medical journal http://www.sudanmedicaljournal.org/english/, Sudanese journal of public health http://www.sjph.net.sd/ . A few expatriates -including myself- have written articles for one of these journals http://www.sudanmedicaljournal.org/pdf/SMJ-volume%203.no.46-2010.pdf . However, these journals have their own editorial problems and most importantly are not yet indexed by major medical databases such as Medline or Embase and this might be an explanation why some expatriate doctors are not keen on contributing to them.

5) Why did you take part in the TOKTEN programme and what do you think it has achieved?

I grew up in Sudan in an era during which education was provided free of charge. I saw how this induced greater social mobility and helped thousands of bright students of humble backgrounds shape even brighter futures. Unfortunately, this is no longer the case in Sudan. I accept that it is beyond me to provide free education for all in Sudan. However, I believe I have the ability to contribute to the active process of transfer of up-to-date knowledge and skills to healthcare professionals in Sudan.

It was a word of mouth that led me to TOKTEN in 2008. At the time, we were in discussion with the Sudan National AIDS programme about organising training to 50 medical officers and they pointed out that TOKTEN might be of help in sponsoring our training activities. We found TOKTEN team incredibly helpful and they actually helped us launch our HIV charity SHAWG in August 2008 http://www.sd.undp.org/story%20tokten.htm

Not all diaspora groups were as successful as we were with TOKTEN. I do not have full explanations to this but I think we were lucky in having both keen and reliable local partners and that we -as expatriates- were happy to go out of our way to help them fill out the necessary paper work for the mission.

Expatriates have to register themselves in TOKTEN’s database and upon receipt of requests from local hosts a matching process begins. TOKTEN missions have to be initiated by local hosts who would identify their terms of reference for the mission and then fill in a detailed application form in English. However, I believe this process is constrained by some socio-cultural barriers. Sudan has an oral culture and most people who have spent a great deal of their lives in Sudan find it hard to cope with detailed paper work required by Western agencies. In addition, most people blame the current government for adopting an educational policy focused on Arabicisation of curricula and deliberately ignoring English language (the only exception has been medical education). This policy ultimately weakened the ability of younger generations to communicate effectively in English.

6) Why did you leave Sudan to work in England? (Not meaning to pry, just interested in the motivations of doctors who go abroad.. e.g. training, facilities..)

Following completion of my internship in Sudan, I declined to do the “compulsory military service”. I simply refused to serve in an army that was killing its own people. Furthermore, my father was unjustly sacked from his high-ranking civil service post shortly after El Bashir’s coup in 1989 simply because impartiality, fairness, and professionalisms were alien terms to the new political masters. After taking that decision, I tried to register for the local postgraduate medical exams but I was asked to produce evidence of completion of military service (key eligibility criterion). I was facing the prospects of unemployment at the tender age of 26 before another life-changing event occurred. I joined Medicines Sans Frontiers (March 1998) who were desperately looking for a local doctor to replace an expatriate doctor who had to cut his mission short because of some family reasons. The government of Sudan was –and maybe still is- notoriously slow in processing visa applications for international aid workers and I guess that’s why MSF resorted to hiring a local doctor on that occasion. I worked for MSF for 3½ years during which I travelled to remote parts of Sudan (Blue Nile region + Eastern Sudan close to the boarder with Ethiopia) and had first-hand experience of war as well as the disparities of healthcare provision in Sudan. Although I nearly lost my life in the troubled region of Blue Nile a few months after joining MSF, I deeply treasure every moment I spent with MSF giving help to people who would have otherwise died in silence.

I have always been pre-occupied with my career progression. I was realised that MSF was not a training institution per se and therefore I had to have an exit plan. Working for MSF has been the highlight of my career so far but I remember times during which I felt my career advancement ambitions were slowly rotting in remote unheard of places. MSF threw another lifeline to me by agreeing to sponsor my first postgraduate course in 2000 (diploma of tropical medicine and hygiene, the London School of Tropical Medicine and Hygiene). Furthermore, MSF gave the opportunity to work alongside distinguished colleagues (e.g. Jill Seaman, who has been a godmother to me http://www.youtube.com/watch?v=vV-ywVW-W0o) who inspired me to develop interest in infectious diseases as a future career (I wanted to be a paediatrician when I graduated from medical school!). There was no way I could pursue any training in Sudan because of my military service issue. That’s why I did all the pre-registration exams run by the GMC (UK) when I came back to the London School of Tropical Medicine and Hygiene in 2001 for my MSc degree. Moving to Britain gave me a wonderful lifetime opportunity to pursue high-level specialist training in infectious diseases and virology.

7) Would you consider working in Sudan again and if so under what circumstances?

I must say I found it strange dealing with the very people who a few years ago nearly derailed my career progression plans. However, looking at the big picture there are now opportunities to influence health policy in Sudan (hopefully to the better) given the high quality training I received in the UK in a highly prestigious medical specialty. Thanks to my British passport, I no longer have to worry about the military service issue whenever I go through the checks at Khartoum airport. Sudan is currently staring into the abyss and as long as the political turmoil continues, no one will consider going back. Furthermore, there are some practices that I find difficult if not impossible to cope with. For example, the owner of the largest private hospital/medical school in Sudan was recently appointed as the minister of health for Khartoum state. I just find it very hard to accept this glaringly obvious conflict of interest.

8) What, if anything, have you seen in the English healthcare system that could be usefully replicated in Sudan? (For example, I noticed on the blog praise for the clinical guidance system)

The clinical governance system implemented by the NHS focuses on improving standards of care and ensuring accountability to the public. Such a system is completely lacking in Sudan. In fact, the healthcare system in Sudan (if one truly exists) has become highly fragmented thanks to invasion by private sector providers. Moreover, the government spends < 1.4% of its GDP on health (the largest expenditure is actually on defence and security) and until there is a political will to prioritise health there is effectively no chance of making significant improvements on this front.

Contributions made by expatriate doctors are not always greeted with enthusiasm. The responses could be: indifference, resistance, and sometimes enthusiasm. Most of expatriate doctors have learned to be tactful and careful when they talk about change otherwise they will be accused of being arrogant, out of touch, or motivated by private agendas. I also know that change does not happen over time and therefore we have to be patient. One of my colleagues in SHAWG keeps saying “lighting is a candle is better than cursing the darkness” to fellow expatriates who have be frustrated by previous attempts to reach out to MoH or other institutions. I hope one day (might not be in our lifetime) our efforts will bear some fruits.

9) To the best of your knowledge, in what ways has the secession of the south affected healthcare in Sudan?

Provision of healthcare in south Sudan is generally poor and over many years has been dependent on international aid agencies. The Sudan household health survey 2006 painted a bleak picture when it revealed that access to antenatal care in the Unity state in south Sudan (where the largest and richest oil fields are located!) was a big fat zero. This compared to 89% in Khartoum state in northern Sudan. However, the same survey indicated that >50% of accessible services in Khartoum and elsewhere did not meet expected basic standards of antenatal care.

As previously pointed out, the expenditure on health by the central government in Khartoum was and continues to be below 2% of GDP. In view of this, they cannot claim any savings post-secession of south Sudan. The only impact has been on healthcare indicators as Sudan’s revised morbidity and mortality figures have allegedly “improved” post-secession of south Sudan (e.g. HIV prevalence in adults “dropped” from 1.6% to 0.67% !).

A song to the sun

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Fri, 22 Apr 2011 17:21:00 +0100

أغنية للشمس

********

يا خليلَ الهمَّ

والحُزن ِ المؤرِّق ِ هدأة َ البال ِ، ومرآة َ الذهول

كلُّ شمس ٍ عظيمة ٍ عشقتها

ترنّحت عند خط ِّ الأفق

تهاوت لمقبرة ِ الأفول

أولا تحب ُّ الآفلين؟

الذ ٌّاهبينَ في الأيام ِ كما البروق ِ تومض ُ في ثغر ِ سحابةٍ عجول

الحاملين َ حقائب َ الذكري

وجداً

و تحراقاً

و مسغبةً

و أسفاً يطول

قل لى بربِّكَ

فيم انتظارك َ اشارات ِ القبول؟

ودونك َ الجوعى لخبز ِ محبَّةٍ ترجى

قد رأيتهم صرعى

بين خسران ِ التقدم ِ و خذلان ِ العدول

قل لى بربِّك

كيف تمحوها الهزيمة

عارَ التردد

و انهيارَ العزيمة

كيف َ السبيلُ لظل ِّ غمامة ٍ تحنو

تسقى غرسَ محبةٍ ينمو

تسح ُّ الغيث َ مدراراً هطول

قل لى بربِّك

فيم ارتجاؤكَ بشاراتِ الوصول

حلاوةِ الظفر المهيمن

نداوة َ الزهر

وانتشاءَ الفصول

كيف تحلم بالوصول؟

وكل ُّ الدروب ِ تشابهت بؤساً

طويل المكث يأبى أن يحول

وفيم انتظاركَ اشاراتِ القبول

تفتق الزهر

وانتشاءَ الفصول

وكلُّ شمس ٍ عشقتها

ترنحت عند خط َّ الأفق

ثمّ تهاوت لمقبرة الأفول

زاهر عثمان الطاهر

Sudan HIV/AIDS Working Group (SHAWG)

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Sun, 11 Jan 2009 20:09:00 GMT

I have recently been involved with the newly founded Sudan HIV/AIDS Working Group (SHAWG) http://www.shawg.org . SHAWG is a voluntary network of healthcare professionals with special interest in HIV/AIDS aiming to contribute to the HIV/AIDS control activities in the Sudan. SHAWG delivered an advanced training workshop on the management of HIV in August 2008, which was attended by 51 physicians from all over Sudan. Further rounds of training are planned with 6 monthly intervals.

The birth of SHAWG gives further impetus to the HIV control efforts in Sudan. The UNDP/TOKTEN (SUDAN) programme has warmly embraced SHAWG and facilitated our activities http://www.sd.undp.org/story%20tokten.htm

Sudan doctors in the spotlight: A rapid response to Osman Mirghani's article

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Tue, 29 Apr 2008 16:49:00 +0100

Dear Osman,

I have read with interest what you wrote today on Alsudani newspaper.

I find it hard to believe that the Sudan constitution (or any constitution) may endorse bestowing unlimited power or authority on the medical profession (or indeed any other profession). I think it would have been fairer to say that the rules regulating the medical profession, which should be there to protect patients, are not clear and therefore not easily enforceable by law.

Doctors in Sudan are held in high regard by the society and this makes most of us (the public) shy away from questioning their authority. This is further complicated by the fact that spiritual and religious dimensions to illness and death in our society make it easier to accept these events even if they were a direct result of medical negligence!! This is particularly a powerful coping mechanism for many bereaved relatives in Sudan; especially we all believe that every one of us live numbered days in this world. However, I fully subscribe to the notion that doctors and -other professionals- should be held accountable for their acts whether good or bad. The question is how to create accountability systems for each profession in Sudan?

I agree with you that uttering a few words in a ceremonial atmosphere is not worthy the effort and money spent in such gatherings. Instead, we should be seriously looking into establishing accountability within the healthcare system whereby doctors (and nurses, midwives, .. etc) are judged on their performance. For example, here in the UK we have what is known as clinical governance system which aims at ensuring the highest possible safety and quality of clinical care in each hospital by using certain tools. A good example of such tools is clinical audit (in which doctors/nurses etc compare the outcomes of certain aspects of their clinical practice with an agreed national standard of care). Clinical audit has indeed enlightened the practice of many doctors and helped bring about changes that contributed to better quality of care. By contrast, national standards of care are almost non-existent in Sudan (I will be pleasantly surprised if somebody proves the opposite) let a lone the practice of audit in itself. Furthermore, the number of private practitioners in Sudan has rocketed over the past decade and this poses more difficult questions than ever as to how to regulate their practice.

The tradition in Sudan, and other countries, has been to rely on national medical councils to regulate the practice. Of interest, this concept is being increasingly challenged in the Western hemisphere as the medical council (usually led and partly funded by doctors through regular compulsory subscriptions) is by definition committed to promoting the interests of doctors and therefore cannot be seen as an impartial referee in disputes or complaints made against doctors. In response to such concerns, most Western medical councils have got lay members (selected from the public) represented in various committees in order to bring a sense of balance. However, some doctors view the council as unfair and heavy-handed on doctors whenever a dispute arises and they think this is driven by a desire to please the public at the expense of their careers.

On reflection on the Sudan situation, the medical council in Sudan found itself in the media spotlight on several occasions recently because of reports of medical mishaps or misconduct in the profession. This is certainly indicative of rising awareness among the public with regards to their basic rights and we should all welcome this. A note of caution, however, is that trying to demonize doctors is not going to be particularly helpful. We have to remember that the vast majority of doctors work in poorly resourced healthcare facilities and that they have to make ends meet in their day to day life (just like anybody else) in order to support their families.

The challenge facing the medical council in Sudan now is to rejuvenate itself, engage in a constructive dialogue with both doctors and patients, and work towards protecting patients’ interests whilst promoting good medical practice. This process should be matched by a similar effort from the Ministry of Health to establish transparency and accountability within the existing healthcare system. Medical schools should also play a key role in ensuring that our would-be doctors have good grounding in communication skills (doctor-patient relationship, bedside manners, etc) and medical ethics (patient’s right to confidentiality, respect of patient’s autonomy, etc)

I have no doubt that the Sudanese people deserve first class healthcare services but we need to work TOGETHER to fulfil this objective. Of course, everybody should be conscientious when they go about their daily jobs as this is part and parcel of our religious and moral values. Therefore, I would expect not only doctors but also shopkeepers, plumbers, mechanics, local politicians, …etc.. etc to bear this in mind when we (the public) ask them to serve us!

For the full article by Osman Mirghani, please click on the link below

http://www.alsudani.info/index.php?type=6&issue_id=1592&col_id=132&bk=1

Mentoring healthcare professionals in the developing world

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Fri, 11 Apr 2008 20:46:00 +0100

I spoke earlier this week to one of my GU colleagues who returned recently from a six-week trip to South Africa. She was very excited telling me about her mentoring experience in South Africa. She joined an NGO called International Center for Equal Healthcare Access (ICEHA) which collaborates with sister organisations working in HIV care. The latter has to be engaged in a partnership with local bodies, e.g. Ministry of Health or other national agencies.

My colleague's role, along with another expatriate nurse practitioner from the US, was to support clinicians working in a government-run HIV clinic. This involved a one-to-one training in WHO guidelines on the management of HIV/AIDS, improving note-keeping systems, basic management of drugs and other consumables, etc. My colleague made it clear that they wanted to work with what's available locally rather than imposing solutions from outside that are unlikely to be sustained in the long run.

While listening to her, my mind kept travelling to Sudan and I wished I, or others, could do a similar job. HIV/AIDS care in Sudan is still in its infancy and the high degree of stigma attached to its name make medical practitioners steer away from taking part in it. This will ultimately result in undermining an already struggling service.

For further information on ICEHA model, please visit their website at http://www.iceha.org/model/

WHO annouces erradication of Polio in Somalia

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Wed, 26 Mar 2008 17:13:00 GMT

The Global Polio Eradication Initiative (GPEI) announced yesterday that Somalia has not reported a single case of Polio over the past 12 months. Based on that, Somalia has been declared polio-free. For full details of the press release, please click on the link below

http://www.who.int/mediacentre/news/releases/2008/pr09/en/index.html

I feel a little bit concerned about such statements. In view of the decaying security situation, I feel under reporting of polio cases, due to insecurity for example, could give a false impression of eradication. The recent surge in violence in Somalia has prompted 40 aid agencies to sign a press release warning about impending catastrophe in the war-torn East African country. Please click on the link below for further information.

http://news.bbc.co.uk/2/hi/africa/7313911.stm

The New Horizons' Sun

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Thu, 13 Mar 2008 20:53:00 GMT

شمسُ المدارات ِ الجديدة

***١***
الأنَ تسطعُ فى سمائكَ

شمسُ المدارات ِ الجديدة

ِتعبرُ خط استوائكَ

لتهديكَ امراءةً تشعلُ النارَوتزهو بانتمائكَ

تذيبُ الحشا منكَ قوافياً هزها هولُ احتراقكَ
***٢***
ما زانَ مجدَكَ غيرُ بهائها

حفي سلامها

ندي كلامها يسرى فى دمائكَ

ما المنى بكفيكَ حيالها

إلا مدائنُ من وحى خيالها

شادها صبرُ انتظاركَ

اه ِ لو كنتَ تعلمُ أنها

وهبتكَ أعظمَ سرها

من حور ِ الجنان ِ كأنها

أو أنها

من قبيل ِ الملائكة

الأنَ تسطعُ فى سمائكَ

شمسُ المدارات ِ الجديدة

ِتعبرُ خط استوائكَ

لتهديكَ امراءةً

تشعلُ النارَ

وتزهو بانتمائكَ

زاهر عثمان الطاهر

The US government pledges large funds for neglected tropical diseases

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Sat, 23 Feb 2008 18:55:00 GMT

The director of the World Health Organisation (WHO) has welcomed the recent announcement by the US administration "to vastly increase funding for the integrated treatment of seven of the most important neglected tropical diseases: lymphatic filariasis, schistosomiasis, blinding trachoma, onchocerciasis, and three soil-transmitted helminthiases". The US government has indeed pledged 350 million US dollars over five years to treat these diseases. A "mass-prevention" approached, similar to immunization campaigns, is likely to be adopted in order to control these diseases.

http://www.who.int/mediacentre/news/statements/2008/s03/en/index.html

The term "neglected diseases" has been coined by public health specialists/activists as an expression of their growing frustration (or even anger) at the extreme lack of attention paid to diseases afflicting poor people in the third world. The harsh reality is that giant pharmaceutical companies are not usually enthusiastic to develop drugs for these diseases as the vast majority of countries where these diseases are endemic can not afford the cost of their drugs. Furthermore, the current intellectual property regulations bar other companies from producing cheaper generic versions of the drug concerned.

The leading medical charity Médecins Sans Frontières (MSF) has been campaigning to improve access to essential drugs in resource-poor settings as well as exerting pressure on the pharmaceutical industry to facilitate production of cheap generic medicines.

http://www.accessmed-msf.org/

Suspected Whooping Cough Outbreak in West Darfur

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Sat, 9 Feb 2008 14:07:00 GMT

There are strong suspicions of an outbreak of whooping cough (Pertussis) in a rural area in the western part of the war-torn region of Darfur. MEDAIR, an international medical NGO, has reported at least 147 cases from the region. MEDAIR has also reported major difficulties impeding their efforts to provide basic healthcare access to those affected.

Whooping cough is a vaccine-preventable infection that usually affects children and can cause life-threatening illness. However, in the Darfur situation the adult population will also be at risk of the diseases owing to poor coverage of routine immunization programmes during the pre-conflict era. The escalating conflict in neighbouring Chad may add further insult to injury by disrupting humanitarian aid efforts.

Whooping cough outbreaks are no stranger to the Sudanese people as the last documented epidemic occurred in southern Sudan in 2003 in the Equatoria state during the civil war.

Click on the link below for further information.

http://www.irinnews.org/Report.aspx?ReportId=76583

Rift Valley Fever: have we really seen the back of it?

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Thu, 24 Jan 2008 13:49:00 GMT

WHO has released a report on 22/01/08 on the current Rift Valley Fever (RVF) situation in Sudan. It appears that the epidemic is waning with only one region (Gezira state) reporting new cases in 2008. In total, 698 cases have been reported from 6 states (Gezira, White Nile, Kassala, Sennar, River Nile and Khartoum) up until 15 January 2008. The overall case fatality rate (CFR) was 32.4% (222/698). Interestingly, some patients had occular manifestations (inflammation of the back of the eye, which can lead to blindness), a clinical finding reminiscent of the previous RVF outbreaks in Egypt in the 1990s and 1970s. For full WHO press release, please go to

http://www.who.int/csr/don/2008_01_22/en/index.html

Al-Saddiq Al-Raddi: A leading Young Sudanese Poet

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Mon, 14 Jan 2008 22:56:00 GMT

Al-Saddiq Al-Raddi is a young poet from Sudan whose "imaginative approach to poetry as well as the delicacy and emotional frankness of his lyrics" earned him a leading position among Arabic-speaking poets. I still have vivid memories of him dating back to the time when I was a student listening to his poetic readings. Al-Saddiq comes across as a shy person but he never fails to capture the imagination of his audience when he starts reciting his poems . He has so far produced the following collections: Songs of Solitude, The Sultan's Labyrinth, and The Far Reaches of the Screen.

His works have been deservedly celebrated by the School of Oriental & African Studies (SOAS). Below is an example of one of his works:

لهاثْ
كأنَّها تَقتربُ من الباب

تسمعُ دقات قلبِكَ

و كأنك في انتظارِها

تَحْضُر طيورُ الضُّحى وتَصْطَفُّ على النافذةْ

........

ساعةٌ من الصَّبرِ

غابةٌ من الهديلِ والشقشقةْ

Breathless

Your heart thumps —

as if she were already at your door.
Or — as if expecting her —

all the birds in the midday sky

arrive to clamor at your window.
****
An age of patience.

A forest of fluttering.

(Translation By: Sarah Maguire)

For further examples of Al-Saddiq Al-Raddi's poems, please click on the link below

http://www.poetrytranslation.soas.ac.uk/poets/index.cfm?type=1&poet=19

Al-Saddiq Al-Raddi was also interviewed by the Guardian newspaper. To read the full interview, please click on the link below.

http://books.guardian.co.uk/poetry/features/0,,1889574,00.html

The bird flu threat

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Wed, 9 Jan 2008 20:32:00 GMT

Egypt has recently declared 43 confirmed human cases of Avian Influenza (deadly strain H5N1) with 19 reported deaths. This news has alarmed the public in Sudan. Poultry producers were particularly upset as they saw consumers confidence in their products take a deep nose dive!

The public in Sudan has recently been concerned about the Rift Valley Fever outbreak and this has resulted in an unprecedented demand on poultry as an alternative to red meat products. This has certainly inflicted hardship on beef and lamb producers and it seems it is now time for poultry producers to feel the heat.

The news of bird flu in neighbouring Egypt leaves Sudanese consumers bewildered as they feel they are between a rock and a hard place. The public relations damage caused by the Rift Valley Fever saga makes it difficult to restore public confidence in official statements. It seems that becoming a vegetarian might be an attractive option in Sudan these days!

So far, there have been no reports on bird flu cases in Sudan by WHO or local authorities.

http://www.who.int/csr/disease/avian_influenza/en/index.html

A special moment

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Fri, 28 Dec 2007 20:44:00 GMT

بطاقة دعوة .... معرض فنان .... ورقة ، وفرشاة ، وألوان . أحاول ُ رسم

تفاصيلك ِ الدقيقة: عيناك ِ لحظة الألق ... أنفاسك ِ ساعة الغرق ... يداك ِ آن

الحسم ِ وساعة القلق ... والشامة الصغيرة .. البسمة النضيرة .. والمشية

الوئيدة عندما يعتدل ُ المزاج . تتمازج ُ الألوان .. ترسم ُ فتاة ً خلاسية تحكى

حلما ً عن بركان ... عن لحظة أمان ... وعن

(postcard painted by the Sudanses artisit Islam )

A sip of memory nectar!

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Tue, 18 Dec 2007 11:05:00 GMT

رشفة من رحيق الذاكرة

(١)

عند ما التقينا للمرةِ الأولى

سرى ذلكَ الشئُ الذى نحسهُ ولا نعرفه

اشتعلت عيناىَ بالدهشة

تلون وجهُكِ طيفاً يحبذ البنفسج

وذابَ فوقَ شفاهنا الكلام

(٢)

نهز الأنَ جذع اللغةِ

فتساقط علينا حدائقاً من الصدق

لألئا ً من الشعر تقرؤنا السلام

عليكم السلام

الجو ابتسام

العيونُ تومضُ بالبريق ِ المستهام

وفجأة ً يسرى ذالكَ الشئُ مرة ً أخرى

يسودُ الصمتُ برهة

ثم تورق أزهارُ الكلام

فنعودُ نثقلُ مائدة َ الحديث ِ بأنخاب ِ الهوي

وفاكهة ِ الهيام

زاهر عثمان الطاهر

Further twists in the story of Rift Valley Fever!

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Sat, 15 Dec 2007 17:04:00 GMT

The Sudanese Ministry of Animal Resources announced today that Sudan is free from Rift Valley Fever (RVF) as per a testimony by a visiting team from South Africa. This comes immediately after the Federal Ministry of Health (FMoH) declared that 200 people have died from RVF so far and that more than 600 cases were reported in Gezira, Sennar, White Nile and lately River Nile states.

I was not particularly surprised by the announcement made by the Ministry of Animal Resources as they have been stubborn in their denial of RVF. What I am concerned about is the barrage of conflicting messages sent by the FMoH and the Ministry of Animal Resources. Furthermore, a fatwa and counter-fatwa war has erupted among religious scholars as to whether it is appropriate to slaughter animals for Eid Aladha.

I really feel that our people in Sudan deserve better!

Rift Valley Fever (RVF): the story so far...

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Thu, 13 Dec 2007 12:37:00 GMT

Unfortunately, the government of Sudan continues to drag its feet on the issue of Rift Valley Fever (RVF) outbreak in central Sudan. The latest news from Khartoum paint a bleak picture in terms of lack of transparency as the government continues to send mixed messages to the public. It appears that the Ministry of Animal Resources has finally admitted the existence of the outbreak after 6 weeks of denial in a futile attempt to protect the interest of a handful of livestock exporters.

The outbreak news were first broken on the WHO website on 05 November 07. They said that they received a request from the Sudanese Federal Ministry of Health on 18 October to investigate an outbreak of haemorrhagic fever in the White Nile, Sennar and Gezira states. Appropriate samples were sent to a WHO collaborating laboratory based in Cairo (US Naval Medical Research Unit - NAMRU), and a confirmation of the virus responsible for RVF was made. The FMoH appears to have accepted these results but officials in the Ministry of Animal Resources kept denying RVF and subsequently decided to send further samples to a reference laboratory in South Africa hoping against all odds that the results might reveal something else. Some overzealous officials were thinking ahead of themselves and went to the press and announced that the Sudanese livestock is free from RVF even before the samples had arrived in South Africa. Anyway, these samples took a long time before they finally arrived in South Africa and to cut a long story short they, to the embarrassment of the Ministry of Animal Resources, also confirmed RVF virus.

This massive delay in accepting that we have a problem with RVF has devastating effects on the credibility of the government of the day in Sudan. Major livestock importers in the Gulf region will, of course, listen to reputable and credible bodies like WHO and will not wait for vague and long-winded answers from a bunch of incompetent officials who did nothing but dither around and therefore put the lives of the people of Sudan at considerable risk. Moreover, some officials tried to falsely reassure the public by saying that all livestock will be vaccinated against RVF- exactly the WRONG measure to take in an epidemic situation as this will only augment the transmission of the RVF virus! (see fact sheet from WHO below).

It is saddening but also heartwarming to hear that the people of Sudan have decided to take their own precautionary measures (although extreme in some situations). Our people have been massively let down by the government of the day. With Eid Al-Adha (Muslims Festival of Sacrifice) coming up in a few days time, I wish to hear President Elbashir saying he will sacrifice on behalf of all the Sudanese nation by slaughtering one sheep (which has been properly tested) in order not to exacerbate the current situation. I know for sure that a lot of people in Sudan have wisely decided not to slaughter animals on this occasion on health and safety grounds. An outspoken politician from SPLM was reported to say that the government appears to value animals more than humans in Sudan!

In terms of why this outbreak has occurred in Sudan, there are suggestions that climate change in the Horn of Africa might be responsible for optimizing the habitat for the virus and its vectors. Recently, a large outbreak was reported in north east Kenya in the period between December 06-April 07 and the most significant environmental factor was a sharp increase in annual rainfall. The first alarming signs have been an increase in deaths and abortions among livestock with humans in close contact (usually shepherds or vets) falling sick with unexplained illness. In terms of other outbreaks in the region, Tanzania, Somalia, Yemen, Saudi Arabia, and Egypt have all suffered significant outbreaks over the last 30 years. Interestingly, it took Saudi Arabia 48 hours to confirm the outbreak in 2000 (Madani T et al, 2003. CID, 37: 1084-1092) while it took our officials more than 48 days to quietly admit RVF outbreak!

Finally, just a few words on RVF. This is an acute viral illness that can cause a spectrum of disease in humans ranging from flu-like illness to fatal bleeding. Other forms of the illness can manifest itself as retinitis (inflammation of the back of the eye), meningio-encephalitis (inflammation of the brain and its surrounding layers), and hepatitis (inflammation of the liver). Transmission to humans usually happens through close contact with sheep, cattle, and other animals as well as by being bitten by insects such as mosquitoes which took a blood meal from an infected animal. There is no documented human to human transmission of the RVF virus but specific treatment is lacking once the virus infects humans. Furthermore, there is no evidence that vaccination is effective in human beings, unlike the situation in animals.

I do hope that lessons will be learned from this epidemic despite that fact that this came about the hard way. I sincerely hope that someone somewhere in the FMoH is looking at the standards of care that patients with RVF received as well as documenting their clinical characteristics and outcomes. I also would like to pay tribute to those who succumbed to RVF (161 people died out of 436 according to WHO figures). I pray for them and their families to be blessed by the mercy and compassion of Allah.

The links below take you to a leaflet produced by FMoH & WHO in Arabic, the WHO fact sheet on RVF as well as their latest press release on the RVF situation in Sudan.

http://www.who.int/csr/disease/riftvalleyfev/RFVleafletFMOH.pdf

http://www.who.int/csr/don/2007_11_22/en/index.html

http://www.who.int/mediacentre/factsheets/fs207/en/index.html

WHO reports 91% fall in measles deaths in Africa

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Sun, 9 Dec 2007 19:02:00 GMT

The World Health Organisation released a report on Progress in Global Measles Control and Mortality Reduction (2000-2006) in its bulletin the Weekly Epidemiology Report. This report indicated that mortality from measles has fallen by 91% in Africa. Other parts in the world have reported a similar trend with the exception of the Indian subcontinent in which a far smaller mortality drop of 26% was reported.

The findings of this report confirmed improved coverage of routine immunisation programmes and further support WHO strategies of targeted campaigns to ensure that children had a second chance to be vaccinated.

http://www.who.int/wer/2007/wer8248.pdf

Comment: The above report appears too good to be true, at least for me. Maybe I have become a natural skeptic but here you go. Remember, this report came out a few days after WHO revised its figures on HIV/AIDS prevalence and thus revealing that the methods used early on were not as rigorous as one would expect them to be.

A moment of despair

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Sat, 8 Dec 2007 20:53:00 GMT

لحظة يأس

لا شئ يستحقُ الأنَ كل هذا الأرق

كل هذى الثوانى المستبداتِ عذاباً وقلق

شمسكَ التى كانت

استدارت

ثم خانت حمرة الشفق

لأجل حفنةٍ من ورق

لا شئ يستحقُ الأنَ كل هذا الرهق

زاهر عثمان الطاهر

Repeated patterns

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Sat, 8 Dec 2007 12:39:00 GMT

Square, triangle, hexagon, and so forth ...

Thanks to my little co-editor Sarah!

The last song

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Fri, 7 Dec 2007 21:40:00 GMT

الأغنية الأخيرة

صدئت حنجرةُ الغناء

والكلماتُ الندية

ضلت طريقها فى دهاليز البكاء

أزهر الحزنُ بعدكِ موسمين للشتاء

حين ضاع القلبُ بين فواجع النهاياتِ وأصداءِ الإبتداء

يا قافيةََ الرجاء

أنكر البحرُ زرقتهُ

وانحسرت عن حضنِ السواحلِ أمواج الإشتهاء

لم يبقَ - مليكتى - غيرُ زبدكِ الذاهبِ جفاء

غيرُ الصدأ يعلو حنجرةَ الغناء

******

كل الأشياءِ تحاصرنى بكِ

عطرُ البهجةِ

زهوُ اللحظةِ

واحتفاءُ المكان

كل السعادةِ تورقُ من ذكراكِ ، والأحزان

نصبت سرادق الكلمة

كل الحروفِ احترقت عشقاً

كل المشاعرتوهجت صدقاً

أفاضَ الألقَ مذاباً

على نقوش الهوى و تذكاراتِ الحنان

فخُذِى ما استطعتِ من ذكرى وارتحلى

فمنذُ الأن

لا دمع يطفئُ لهيبَ الشوقِ والحريق

ولا الوهمُ الراكض فى مداركِ يعاودهُ البريق

وهاهى الحقائقُ من سباتِ الأمانى تفيق

تلدُ شمساً تخوضُ أبحرة الضباب

تعُبُ الملحَ

تنكأ الجُرحَ المصلى فى العيونِ البلوريةِ النقاء

يتوضأ الصبحُ

يُغرقُ الحروفَ فى مقاماتِ الدعاء

تتصدعُ الحناجرُ بالغناء

ترددُ اسمكِ الوضاءَ أطيبَ الأسماء

فخُذِى ما استطعتِ من ذكرى وارتحلى

يا أروعَ روائع الأشياء

زاهر عثمان الطاهر

Antibiotic use in Sudan: An alarming situation

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Fri, 7 Dec 2007 12:13:00 GMT

According to Alsudani newspaper (06 Dec 07; issue 740), a survey conducted on behalf of the Federal Ministry of Health revealed that 68% of respondents in 5 states (Northern, Gedaref, Khartoum, White Nile, and Northern Kordofan) had inappropriate antibiotics prescribed. Moreover, 48% used unsafe injections. Overall, 40% of respondents did not use antibiotics correctly.

Comment: It is not clear how representative this sample was. Furthermore, the terms used in the report were loose and therefore I did my best to try and infer what they possibly meant by them. A final thought, I wonder whether there is actually any active role or support for clinical pharmacists (if they exist) to ensure rational drug prescribing as well as safe use. As I far as I know, anybody can walk into any pharmacy and buy whatever medication they wish. It is equally true to say that any doctor of any grade or expertise can prescribe any medication at any dose without having the safety net of a qualified pharmacist checking that. Below is the Arabic version of the article by Alsudani newspaper.

إدارة الصيدلة تحذّر من سوء استخدام المضادات الحيوية

الخرطوم: إبتسام حسن

كشف بحث أجرته إدارة الصيدلة الاتحادية عن قياس مؤشرات الاستخدام الرشيد للدواء في المرافق الصحية العامة شمل (5) ولايات وأن %68

من السكان يستخدمون المضادات الحيوية استخداماً غير رشيد. وحسب منظمة الصحة العالمية ان لا يتجاوز الاستخدام غير الرشيد

نسبة الـ(30%).وحذرت نتائج البحث من سوء الاستخدام غير الرشيد للمضادات الحيوية الذي يؤدي لمقاومة المرض ويؤثر على الصحة

والاقتصاد، مؤكدة ان استخدامها في الولايات الشمالية أعلى من نسبة (90%).وقالت مسؤولة الاستخدام الرشيد للدواء بإدارة الصيدلة د. غادة عمر ان استخدام الحقن بطريقة غير رشيدة نسبته عالية حيث وصلت إلى (48%)، وحسب منظمة الصحة العالمية من المفترض أن تكون أقل من (20%)، واضافت ان (40%) من المرضى لا يعرفون استخدام الدواء، ودعت إلى ضرورة وضع المعالجات اللازمة للاستخدام الرشيد، مشيرة إلى القوانين والتشريعات التي تمنع صرف الدواء.واوضحت د. غادة عمر ان البحث الذي استهدف (5) ولايات هي؛ الشمالية، القضارف، الخرطوم، شمال كردفان والنيل الابيض يهدف لمعرفة مدى الاستعمال غير الرشيد عند الاطباء والصيادلة والمرضى.

To Sami and others

zahir_babiker@yahoo.co.uk (Zahir Osman Eltahir) — Wed, 5 Dec 2007 21:57:00 GMT

إلى سامى ،....، وأخرين

بالأمس، يا حديقة الشذى، كانت السماء مزركشة

النجيمات كانت فى أنسها الليلى

والغيمات ذابت مطراً رذاذ

وكنتَ تختال ضاحكاَ

بين نجمةٍ مغازلة وزهرةٍ موشوشة

أهداكَ القمر قنديلاًَ

وإزميلاً

وفرشاة

ومحبرةً تنسكب أطفالاً رائعين

وروداً ورياحين

كانت أيامك مثقلةً بالرضى

كانت بحقٍ مدهشة

وكنت حينها أمان الخائفين

حنان البائسين

يا أيها المحبوب والمغضوب عليه بعد حين

حدثنى عن أحبابك

عن مصابك

عن الحزن ساعة حط رحله ببابك

فأقفر المكان

حدثنى عن الخذلان

وكيف صارت دنياك موحشة

عن النصل ساعة قد ظهركَ واستطاب

تغور الجرح المزلزل جأشكَ بالعذاب

يا سيدى

عبثٌ مرضاةُ الأحباب

عبثٌ تلهفُ اللقيا

سرابُ السقيا

واحتراقُ الأعصاب

عبثٌ هى مرضاةُ الأحباب

زاهر عثمان الطاهر