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Figure 1: An illustrative preparation of herbal remedies as part of Sudan's rich traditional medicine cited in Bourke, M. (2023) in The Fascinating Traditions of Healing and Medicine in African Cultures

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Blog 1: Sudanese Herbal and Spiritual Medicine

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Blog 1: Sudanese Herbal and Spiritual Medicine

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The Republic of Sudan, situated in the North-East region of Africa, has a vibrant history of traditional medicine (Karar &Kuhnet, 2017). According to Mohamed et al., (2024), the prevalence of herbal medicine in Sudan was 89.5% by 2021. Mohamed et al., (2024) reiterated that the most common herbs used by Sudan’s herbal healers include fenugreek, ginger, acacia, and hibiscus. Babikir, (2015) established a substantial prevalence of spiritual medicine, characterised by incantations, ritual incensing, and spitting cure for some disorders such as epilepsy. A nurse must consider the cultural inclination to herbal and spiritual medicine when caring for Sudanese refugees.

References

1. Babikir, H. E. H. (2015). Traditional and Spiritual Medicine among Sudanese Children with Epilepsy. Sudanese Journal of Paediatrics, 15(1), 122.

2. Karar, M. G. E., & Kuhnert, N. (2017). Herbal Drugs from Sudan: Traditional Uses and Phytoconstituents. Pharmacognosy Reviews, 11(22), 83–103. https://doi.org/10.4103/phrev.phrev_15_15

3. Mohamed, R., Mohamed, R., Dafalla, R., Ahmed, A., & Abdeldaim, A. (2024). The Prevalence of Herbal Medicine among Sudanese Adults: A Cross-Sectional Study 2021. BMC Complementary Medicine and Therapies, 24(1), 308. https://doi.org/10.1186/s12906-024-04584-1.

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Figure 2: The ongoing civil war in Sudan as cited by StratNews Global in One Year of Sudan Civil War: Fighting Intense, Refugee Numbers Swell

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Having gained context on the lived experiences of Sudanese refugees, standard 1.2 of the clinical expert domain is the most crucial in caring for Sudanese immigrants and refugees. Sudanese refugees have encountered prolonged civil wars, creating the need for trauma-informed care (Hebbani &Obijio 2012) . In my assessment and development of treatment plans, standard 1.2 of Migrant and Refugee Women’s Partnership. (2019) will guide me towards modifying my approach to achieve quality and person-centred care that respects cultural inclination and trauma experiences (Peprah & Harris, 2024). I will factor in the presenting barriers to effective screening, treatment acceptance, and medication adherence, as well as the role of trauma in the presenting symptoms.

References

1. Hebbani, A. G., Obijio, L., & Bristed, H. (2012). Acculturation challenges that confront Sudanese former refugees in Australia. Journal of Intercultural Communication, 28.

2. Migrant and Refugee Women’s Partnership. (2019). Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds: Competency Standards Framework for Clinicians January 2019. Migrant and Refugee Women’s Partnership.

3. Peprah, P., Lloyd, J., & Harris, M. (2024). Responding to health literacy of refugees in Australian primary health care settings: a qualitative study of barriers and potential solutions. BMC Health Services Research, 24(1), 1–15. https://doi.org/10.1186/s12913-024-11192-9

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Figure 3: An illustration of care provision to a Sudanese victim of civil war cited by UNHCR

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Blog 3: Social Inclusion and Non-Discrimination

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Blog 3: Social Inclusion and Non-Discrimination

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The World Health Organisation lists social inclusion and non-discrimination as critical social determinants of health . For migrants and refugees fleeing from civil wars and other socio-economic challenges, social inclusion and non-discrimination are strong determinants of overall well-being and quality of life (Pobjoy,2010) . Migrants from Sudan often present with trauma symptoms, which include PTSD, anxiety, and depression, and require optimal social inclusion and non-discrimination for adequate care (Hebbani et al., 2012) . According to Hamdy Sr (2024), social inclusion and non-discrimination impact the health-seeking behaviour of migrants and refugees. Nurses and clinicians must, therefore, promote social inclusion and non-discrimination to ensure equitable access and prompt health-seeking behaviour by Sudanese migrants.

References

1. Hebbani, A. G., Obijio, L., & Bristed, H. (2012). Acculturation challenges that confront Sudanese former refugees in Australia. Journal of Intercultural Communication, 28.

2. Hamdy Sr, S. H. (2024). Beyond Borders: Exploring the Quality of Life, Health-Seeking Behavior, and Perceived Barriers in Health Services Utilization Among Sudanese Immigrants in Egypt. Cureus, 16(1). https://doi.org/10.7759%2Fcureus.52442.

3. Pobjoy, J. (2010). Treating like alike: The principle of non-discrimination as a tool to mandate the equal treatment of refugees and beneficiaries of complementary protection. Melbourne University Law Review, 34(1), 181-229.

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Figure 4: Victims of Sudan Civil War Fleeing the Country with Potential Trauma-Related Mental Health Issues as Cited by BBC News

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Blog 4: Mental Health among Sudanese Migrants and Refugees

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Blog 4: Mental Health among Sudanese Migrants and Refugees

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Refugees and migrants from Sudan present with mental health issues that include PTSD, anxiety, and depression (Hebbani, et al,. 2012). Civil wars subject populations to traumatic experiences that leave the victims with diverse psychological effects. Sudan continues to experience prolonged civil wars, explaining the findings by Sullivan et al., (2020) on the prevalence of PTSD, depression, and anxiety among Sudanese migrants. It is imperative that post-arrival screening includes emotional well-being and mental health assessment (Wittick &Furler, 2018). The screening and treatment plans should factor in cultural inclination, avoid direct questions on traumatic experiences, and centre on education and resilience building for dealing with trauma-related mental health issues.

References

1. Hebbani, A. G., Obijio, L., & Bristed, H. (2012). Acculturation challenges that confront Sudanese former refugees in Australia. Journal of Intercultural Communication, 28.

2. Wittick, T., Walker, K., Furler, J., & Lau, P. (2018). An online resource supporting refugee healthcare in Australian general practice:'An exploratory study'. Australian Journal of General Practice, 47(11), 802-806.

3. Sullivan, C., Vaughan, C., & Wright, J. (2020). Migrant and refugee women’s mental health in Australia: a literature review. School of Population and Global Health, University of Melbourne: Melbourne, Australia.

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Blog 5: Religious and Spiritual Beliefs and Healthcare

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Blog 5: Religious and Spiritual Beliefs and Healthcare

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Sudanese are primarily Muslims and exhibit intense spirituality that determines their health-seeking behaviours (Ikafa,2015). The Sudanese attribute some conditions, such as epilepsy, to the spiritual realm and opt for spiritual healing as the first intervention (Babikir, 2015). Moreover, the Sudanese are largely stoic and celebrate physical courage, resilience, and self-restraint. These attributes may hinder mental health intervention as the Sudanese are more likely to resort to religion and spirituality over modern healthcare for mental health issues that affect the migrants and refugees from the country (Savic et al., 2016). Therefore, religious inclination and spiritual beliefs should be incorporated in treatment plans to provide culturally safe and patient-centred care for quality care outcomes.

References

1. Babikir, H. E. H. (2015). Traditional and Spiritual Medicine among Sudanese Children with Epilepsy. Sudanese Journal of Paediatrics, 15(1), 122.

2. Ikafa, I. (2015). Changing worlds: The resettlement experiences of African migrants in Australia and an evaluation of current support services.

3. Savic, M., Chur-Hansen, A., Mahmood, M. A., & Moore, V. M. (2016). ‘We don’t have to go and see a special person to solve this problem’: Trauma, mental health beliefs and processes for addressing ‘mental health issues’ among Sudanese refugees in Australia. International Journal of Social Psychiatry, 62(1), 76–83. https://doi.org/10.1177/0020764015595664

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Figure 6:The Flag of the Republic of Sudan

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Sudanese are predominantly Arabic language speakers with over 70% speaking Arabic. About 10% of Sudanese speak English, which is the official foreign language. Additionally, there are over 100 ethnic dialects including Nubian, Fur, and Ta Bedawie (Perry, 2020). Being a multilingual nation, it is possible to encounter Sudanese migrants and refugees who do not speak English, necessitating the presence of translators during post-arrival screening and assessment (Hebbani et al., 2012). In the absence of qualified translator, language can be a major barrier to effective screening and assessment (Ali and Watson, 2018). This explains the need for adequate diversity in nursing personnel for effective, efficient, and culturally safe nursing care for migrants and refugees.

References

1. Ali, P. A., & Watson, R. (2018). Language barriers and their impact on provision of care to patients with limited English proficiency: Nurses’ perspectives. Journal of Clinical Nursing, 27(5–6), e1152–e1160. https://doi.org/10.1111/jocn.14204

2. Hebbani, A. G., Obijio, L., & Bristed, H. (2012). Acculturation challenges that confront Sudanese former refugees in Australia. Journal of Intercultural Communication, 28.

3. Perry, K. H. (2020). Sharing stories, linking lives: Literacy practices among Sudanese refugees. In Cultural practices of literacy (pp. 57-84). Routledge.

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Figure 7: A collection of Sudan's staple foods including eggs and dried meat

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Sudanese are generally healthy feeders who prefer dried meat, kasra, and spiced cuisine . Sudan’s cuisine is influenced by Egyptian, Arabian, Levantine, and Turkish cuisines (Crofts, 2012). Sudanese have a total ban on local, resorting to other forms of beverages (Elzaki et al., 2021). Food is an essential element of lifestyle and culture among the Sudanese, implying that medication advice must be issued considering the cultural food inclination and lifestyle (Abusalih &Sabeib, 2020). Assessments should consider the impact of the spices, and the lifestyle change and adaptation in line with presenting medical conditions must be explained and collaboratively agreed with regarding the cultural values.

References

1. Abusalih, H., & Sabeib, Z. A. (2020). Update of the nutritional situation in the Republic of the Sudan. The North African Journal of Food and Nutrition Research, 4(9), S17-S24.

2. Crofts, A. V. (2010). Silver lining: building a shared Sudanese identity through food. Gastronomica, 10(1), 110-116.

3. Elzaki, R., Sisman, M. Y., & Al-Mahish, M. (2021). Rural Sudanese household food consumption patterns. Journal of the Saudi Society of Agricultural Sciences, 20(1), 58-65. https://doi.org/10.1016/j.jssas.2020.11.004.