text:
Mahdist Omdurman
Summary and Keywords
It is tempting to seek an auspicious beginning for the Sudanese city of Omdurman, given its eventual significance, but there is none to be found. From its humble origins as a watering place for local pastoralists on the west bank of the Nile, and a mere hamlet and waystation for travelers by the early 19th century, it grew rapidly in the 1880s into a crowded market center, an administrative capital, and even a holy city: all due to the tumultuous events of the Sudanese Mahdist movement (or Mahdiyyah) of 1881–1898. And while it was not the intention of Muhammad Ahmad al-Mahdi to found anything—he considered Omdurman just another "spot" (buq'a) among the many he had camped at—the policies of his successor and the devotion of his followers enlarged and ennobled the place, transforming it into the dominant urban center of the Nilotic Sudan.
As a holy city, Omdurman can hardly be compared to such places as Jerusalem, Rome, or Mecca, with their centuries or even millennia of existence; and although it resembles Shaykh 'Uthman dan Fodio's city of Sokoto in northern Nigeria as the capital of an expansionist jihadist state, it also differs from it in some important ways. Ultimately, whether one considers its messianic or economic importance, its military or administrative functions, its planned or spontaneous origins, Omdurman is remarkable for becoming, in just over a decade's time, one of the most important cities across Sudanic Africa. Moreover, the experience of the Sudanese people in so tribally and ethnically diverse an urban environment, under such concentrated and extreme conditions, both impelled by the policies of the state and inspired by fervent Mahdist belief, helped to accelerate ongoing social changes, which ultimately led to the formation of a more coherent national identity.
Keywords: Islam, jihad, Khalifah, Khartoum, Mahdi, Mahdiyya, messianic, Omdurman, Sudan urbanization
The Creation of the City
Early Years
Omdurman's early history, as well as the meaning of its name ("Mother of Durman"), remains obscure.1 The first settlement there for which we have written evidence was associated with the Qur'an school (khalwah) of a local holy man, Shaykh Hamad wad Umm Maryam (c. 1646–1730), who in any event did not remain there long. European travel accounts and Sudanese sources indicate that by the early 19th century, Omdurman had become a lightly inhabited village favored by local merchants for its access to the Nile confluence and important trade routes to the west (e.g., Darfur) and north (e.g., Dongola and Egypt). After 1820, officials of the Turco-Egyptian regime traveling upriver often conducted government business there before crossing over to Khartoum on the east bank, suggesting that Omdurman had acquired at least rudimentary facilities and resources by that time (Figure 1).
However, the official recognition of Khartoum as the government capital in 1824 removed the possibility of any further planned development of the site.
With the spread of the Mahdist movement after 1881, Omdurman became more important to the Turco-Egyptian regime: first as a staging area for the ill-advised military expedition of General William Hicks Pasha, which set out in September 1883 to put down the revolt and was annihilated one month later in Kordofan Province; and after the arrival of General Charles Gordon at Khartoum in 1884, as the location of a Turco-Egyptian fortress guarding the capital's western flank. Gordon mentions in a journal entry that 240 men were stationed there, and it seems likely that the local Sudanese population also grew to serve the various needs of the garrison. In October 1884, the Mahdi encamped just south of Omdurman in support of his army's siege of Khartoum, and he invited the commandant of the Omdurman fortress, Farajallah Raghib Pasha, to surrender. Having little choice, surrounded as he was by a far larger force and cut off from the capital, Farajallah eventually surrendered on January 5, 1885. The fall of the Omdurman fortress struck a grave blow against the morale of Khartoum's inhabitants, and desertions to the Mahdi increased. A mere three weeks later, on January 26, 1885, the Mahdists captured Khartoum in an early morning attack. The fall of the city, along with the deaths of Gordon and many of his staff, spelled the end of Turco-Egyptian rule in most of the Sudan and signaled the rise of a new Mahdist state, whose capital was to become Omdurman.
Given that the Mahdi's stated mission was one of universal religious reform, buttressed by his messianic claim to be "the divinely guided one" expected at the End of Time, it is clear that he had no interest in Omdurman per se, and certainly he had no intention of governing a territorial state. Rather, his sights were set on Mecca, Jerusalem, and Istanbul: in short, world domination and the culmination of God's plan for humankind.2 Accordingly, the Mahdi initially remained south of Omdurman while many of his followers took up homes in the captured Turco-Egyptian capital. Later, he joined his troops in the burgeoning campsite that was Omdurman, settling in a spot close to the river. Khartoum held no attraction for him: like El Obeid before it, it was regarded as spiritually contaminated by the unbelievers, and although he occasionally crossed over to Khartoum to pray in its mosque and deliver a sermon, he chided those of his followers—including his kinsmen—who had settled there.
A mere five months after his greatest success, the Mahdi died on June 22 after a brief illness, possibly typhus. Buried in his home, as was customary for a holy man, leadership of the movement now passed to his most powerful and trusted lieutenant, 'Abdallahi al-Ta'ayshi, known popularly as "the Khalifah."3 For his followers, the Mahdi's death presented a moment of cognitive dissonance, and many grappled to understand this shocking divergence from the divine plan. For the Khalifah, the concern was more immediate: how to govern an extremely diverse (and not altogether cohesive) collection of Sudanese tribes and ethnic groups, whose unquestioned leader and spiritual guide was now, inexplicably, gone. Sheer necessity, the need for established order, led the Khalifah to oversee the rise of a fixed state; and its capital, for a host of reasons both symbolic and practical, had to be Omdurman, known already as Buq'at al-Mahdi ("the Mahdi's place").
The Policy of Hijrah
Emptying Khartoum of its inhabitants, in the interests of both centralizing important government personnel and exercising greater control over the Mahdi's followers, proved difficult. On July 27, one month after the Mahdi's death, the Khalifah issued a summons under his formal title of Khalifat al-Siddiq ("Successor of the Caliph Abu Bakr") ordering everyone to abandon Khartoum and resettle in Omdurman. Although presented not only as official policy but as a matter of Mahdist faith, the summons was largely ignored by the Ashraf, the Mahdi's kinsmen, and the Khalifah was forced to relent.4 For the next year Khartoum remained occupied by a variety of people, while the Khalifah sought to supervise conditions there as best he could. By late 1886, however, he was in a better position politically to assert his will, and in September he again ordered the evacuation of the former capital; this time it was carried out, allegedly within 10 days. Henceforth, Omdurman was indisputably the Mahdist capital, while Khartoum, picked over for its building materials, lay virtually in ruins.
By this time, the Khalifah had already begun a policy of inviting (and often, requiring) Sudanese from throughout the territory under Mahdist control to come to Omdurman to swear an oath of loyalty (bay'a). Oral as well as written summons, addressed to both important individuals and entire tribes, were widely disseminated, indicating that all should be present in "the Mahdi's city" by the feast of 'Id al-Adha (i.e., September 20, 1885). Subsequently, many thousands of Sudanese poured into Omdurman and remained there, so that by mid-1886 the city apparently stretched for almost four miles along the Nile.
The basis for this policy was the Mahdi's concept of hijrah ("flight" or "emigration"), which, from his manifestation in 1881 until his death, urged Sudanese to renounce the world, embrace an ascetic life, and join him in his jihad against the unbelievers.5 Evoking the experience of the original Muslim community under the Prophet Muhammad, and consistent with the Sudanic African practice of seeking refuge with a holy man in the face of oppression, the Mahdi's use of hijrah recast the Sudanese as Ansar ("Helpers," following the precedent of the Prophet) as well as muhajirun (emigrants) and mujahidun (soldiers on behalf of the faith): in essence, implying privilege and conferring protection with the fulfillment of a religious obligation.
As applied by the Khalifah, the concept of hijrah was evoked on behalf of a broad and detailed program to mobilize and relocate many Sudanese. This in turn was linked to his goals of promoting the spiritual and economic primacy of Omdurman, encouraging the notion of Mahdist exclusivity and the avoidance of unbelievers, and deemphasizing the religious duty of pilgrimage to Mecca. Not incidentally, it also bolstered the Khalifah's authority in times of political stress, most especially when facing the resistance of the Mahdi's kinsmen who opposed his leadership.
The policy of hijrah was not all encompassing, since practicality required that the policy be tempered to fit the circumstances. For instance, the Khalifah's own Ta'aysha tribe and other western Sudanese pastoralists (the so-called Baqqara) were expected to relocate to Omdurman, with their cattle and possessions, on behalf of waging the jihad: this gave the Khalifah greater supervision over a potentially unreliable population, while also strengthening his hand against his rivals. Meanwhile, farmers from the fertile Jazirah region and Kordofan were often released from military campaigns at the start of the cultivation season, while some villagers along the Nile were exempt from the jihad entirely after the capture of Khartoum.6 Merchants were likewise able to minimize (or escape altogether) the obligation to fight, while at least some Sudanese were entitled to pay an indemnity to the Mahdist treasury to avoid the obligation of hijrah.
A variety of circumstances seem to have determined who was required to make the hijrah and who was not. Some important religious figures were left to their pious pursuits in the provinces, while others (e.g., the holy men of El Obeid in 1886) were called to Omdurman to teach in its schools. Former employees of the Turco-Egyptian regime were always in demand for their skills and so were relocated to the capital. Some pastoralist tribes of the Jazirah were initially required to make the hijrah, although after convincing the Khalifah of their loyalty, they were allowed to return home. Criminals and offenders of various sorts were often brought from the provinces to the capital for punishment or rehabilitation. Likewise, unmarried women and widows from the provinces were usually brought to Omdurman to be settled among members of their ethnic or tribal community: a measure intended to protect vulnerable members of society and uphold the moral order. Alternatively, women captured during the jihad, whether within or without Sudan, could be classified as "spoils of war" and distributed to the Khalifah's followers as wives or concubines, or else sold as property of the state. All these and more played a role in the peopling of Omdurman, although the population of the city was primarily the result of emigration for the purpose of jihad.
The Khalifah's first call for hijrah in 1885 was answered by thousands of loyal Ansar in the belief that refusal constituted disobedience to God. Others, however, were more reluctant. A few recalcitrant tribal leaders were punished with imprisonment and seizure of their cattle as an object lesson, but such measures ultimately proved ineffective. As with the evacuation of Khartoum, the Khalifah was forced to relent. A second series of letters summoning people to Omdurman was issued from late 1886–1887, directed mainly at the pastoralist Arab tribes of Darfur and Kordofan. These letters outlined in greater detail the penalties for disobedience and made an individual, usually a tribal shaykh, responsible for bringing in the group. Simultaneously, the chief judge at Omdurman ruled that the goods of all tribes resisting emigration were liable to seizure and sale by the government, with the proceeds left in trust for the tribe in the state treasury. This had the desired effect, and by late 1887 the bulk of the Kordofan tribes had settled in Omdurman, although a section of each was allowed to remain under the supervision of a local Mahdist official (amir) to watch over a portion of the tribal herds.
The years 1888–1890 saw the completion of the great period of emigration to Omdurman, including most notably the Ta'aysha and other pastoralist tribes of Darfur. These were met at the Nile by Mahdist officials and transported by government steamers to the capital (their cattle being brought separately), where they were settled on vacant land in the southern sector of the city. Throughout the period of the Mahdiyyah, however, Sudanese continued to migrate to Omdurman for the jihad, as numerous letters addressed to the Khalifah indicate: for example, "1,819 mujahidun" in 1892, "1,101 mujahidun from the deserts" in 1893. With the approach of the invading Anglo-Egyptian army in 1897, the Khalifah issued a final and urgent summons for all Ansar to relocate to the capital, although in the final two years of his reign this call went largely unanswered.
Omdurman in Mahdist Belief
Apart from waging jihad, other considerations led people to migrate to Omdurman during the Mahdiyyah. Given the unsettled conditions of the time, it is not surprising that the annual pilgrimage (hajj) to Mecca was disrupted, though not entirely stopped. The Mahdi had earlier declared that hijrah and jihad are more important than pilgrimage, and according to Sudanese popular belief, emigration to Omdurman was equal to 70 pilgrimages. Those Sudanese who made the hijrah in fulfillment of their hajj commitment were joined by a stream of pilgrims from western and central Sudanic Africa, who reached Omdurman following the centuries-old pilgrimage route. Some of these pilgrims continued on to Mecca, although a great many remained in Omdurman as Ansar, settled in a distinct West African ("Fellata") quarter of the city.7
Omdurman's allure as a holy place was a major factor in the steady migration of noncombatant Sudanese throughout the period (Figures 2 and 3).
Untold numbers flocked to the city, often traveling great distances, to visit family members and partake of the tangible holiness (barakah) emanating from the Mahdi's tomb, the central mosque, and the homes of the Mahdi's and Khalifah's families.
Usually, visits to the city coincided with two annual events, the Rajabiyyah festival (27 Rajab) and the feast of 'Id al-Adha (10 Dhu'l-Hijjah), although such occasions as the Prophet's birthday (5 Rabi' al-Awwal) and 'Id al-Fitr (at the end of Ramadan) might also draw visitors. For the most part, this was a transient population, though not always. Their letters to the Khalifah and his brother Ya'qub requesting permission to travel are noteworthy in that they cross ethnic, tribal and regional lines and reveal a profound reverence for the city.
Rarely was the name "Omdurman" used by Sudanese at this time. Rather, a variety of honorifics were employed, such as al-Buq'a al-Tahirah ("The Pure Place"), al-Buq'a al-Mubarakah ("The Blessed Place"), and Markaz al-Falah ("The Center of Prosperity"). Three names in particular stand out: al-Buq'a al-Musharrafah ("The Noble Place," a designation typically associated with the Ka'bah in Mecca); al-Madinah al-Munawwarah ("The Radiant City," a name usually applied to Medina); and al-Haram al-Sharif ("The Noble Sanctuary," used here in reference to the Mahdi's tomb but most commonly applied to either the mosque of the Ka'bah or the Temple Mount in Jerusalem). Such designations were not, and could not, have been imposed upon the Ansar by the Khalifah, and they indicate the central and unrivaled spiritual importance of Omdurman during this messianic era.
Also reflecting the spiritual importance of Omdurman was the manner in which emigrants prepared to enter the city. Mahdist officials attached great importance to the condition of emigrants, who were instructed to clean themselves and don fresh clothing before treading upon the soil of the Mahdi's city. When necessary, the state supplied emigrants with clean clothing. In at least one instance, a visiting Ansari removed his shoes before entering the city, out of respect for the Mahdi's remains.
The spiritual center of Omdurman—and by extension, the Mahdist Sudan—was the Mahdi's tomb in the middle of town (Figure 4). Popularly known as the "Qubbah," it was the repository of his barakah and occupied an important place in the hearts and minds of the Sudanese, as well as figured largely in their poetry. Located just east of the prayer niche of the central mosque, it was directly before the Ansar as they prayed. Looming over the city with its whitewashed dome, it was Omdurman's most visible feature from a distance and hence served as a beacon to approaching travelers.
In the tradition of a visitation (ziyarah) to a saint's tomb, visitors approached the Qubbah with a mixture of awe and reverence, often seeking the Mahdi's blessing for improved fortunes, restored health, or protection from calamity (Figure 5).8
The central mosque, popularly known as "the Khalifah's mosque," was also an object of considerable devotion. The Ansar named it "the Fourth Mosque," after those in Mecca, Medina, and Jerusalem, and as with the Mahdi's tomb, poetry was composed and recited in praise of it throughout the period. An additional source of barakah for many of the Ansar was the family of the Mahdi—his wives and children especially—as well as the family of the Khalifah. Visits to Omdurman generally included stops at their homes, and if this was impossible, the central quarter of town where their homes were located and the barakah was concentrated. The Khalifah was believed by many Ansar to have the power to intercede with God and direct their prayers to success: a belief with clear precedent in both Sufi and Sudanic African tradition.
The Functioning of the City
The Omdurman Economy
Omdurman thus came to fulfill the functions of both military command center and embarkation point for the jihad, as well as a place of pilgrimage for those Sudanese who believed in the mission of the Mahdi and understood themselves to be living in a messianic age. As the capital of a sprawling territorial state, it also assumed the role of both administrative and market center. In this respect, it followed more closely the precedent of Khartoum, capital of the "unbeliever" Turks, than the earlier Sudanic states of Sinnar and Darfur, whose administrative and economic facilities had been separately situated.
If the spiritual hub of Omdurman was the central district where the Qubbah, main mosque, and homes of the Mahdi's and Khalifah's families were located, the economic center and nexus of daily activity was unquestionably the marketplace (suq). Located in the northwest corner of town, on the fringe of the settled area, the suq was reorganized by order of the Khalifah in 1888 to concentrate each type of merchant in a specific area and increase competition. This arrangement had the benefit of not only driving down prices for consumers, but also allowing the state's treasury greater control over the marketplace and increasing its revenues from rental plots. State control was further assured by the presence of market inspectors, whose duties combined the conventional functions of police (providing security and apprehending criminals) with the classical Islamic office of muhtasib (upholding public morality, ensuring correct weights and measures, and punishing users of alcohol and tobacco). A market court functioned throughout the period, its authority emphasized by a nearby gallows.
By design, Omdurman was the chief marketplace of the Mahdist Sudan. Early in his reign, the Khalifah suspended all trade with Egypt, seemingly to ward off spiritual contamination and dangerous influences, but also to prevent the outflow of capital. Although this policy was eventually relaxed in 1890 in an attempt to resuscitate the economy, other policies were enacted to weaken the power of the provincial markets as well as compel foreign merchants to bring their goods directly to Omdurman. Such policies were only partially successful: some Sudanese merchants continued to trade intermittently in the markets of the Jazirah and to the north in Dongola, as well as beyond the state's borders in British-controlled Suakin on the Red Sea coast. Despite the state's limited control and its porous borders, Mahdist policy induced most merchants to converge on the capital, where regional produce and imported goods were bartered for items monopolized by the state and purchased by local retailers.
The economic activities within the Omdurman suq were quite diverse. As befit a state motivated by jihad, most industries were devoted to items of warfare and transport: spears, swords, knives and sheaths, stirrup irons, saddles, reins, horse and donkey bits; but also agricultural implements, bed frames, doors and window fittings, boxes and clay pots, shoes and clothing, and so on (Figure 6).
The wholesale and retail sections of the suq were vast, consisting of separate markets offering the above manufactures as well as various food items (e.g., meat, fish, dairy, grains, produce, spices, cooking oils), textiles, leather goods, baskets and mats, building materials, livestock, feed and forage, pharmaceuticals, jewelry, and perfume. A separate women's market existed to serve the needs of widowed or elderly women, while a services area included stalls for barbers, tailors, cooked food vendors, coffee houses, and a common laundry area. The layout of the suq conformed to a pattern familiar in Sudanic Africa, with warehouses, wholesalers, and craftsmen on the peripheries, and retailers and services in the interior. A large open area in the center was reserved for the selling of livestock, with individual markets grouped around it. The market court with its prison and gallows was prominently situated adjacent to the open area, facing into the major portion of the suq, while the women's market was placed on the far northwest corner, allowing women some measure of privacy while entering and exiting the public area.
Apart from the activities confined to the suq, an informal economy flourished in Omdurman based on household production and barter. Many free women spent their time sewing and weaving items, or else raising animals for slaughter, to be exchanged in their neighborhoods at informal markets for other goods. In a reversion to the earlier practice of Sinnar and Darfur, this exchange was often practiced with strips of cloth (dammur) rather than currency, especially since Mahdist coinage was often in short supply or in danger of depreciation. Otherwise, women were also represented in the formal economy, whether as slave women selling handicrafts in the suq on behalf of their mistresses or as widowed and elderly women buying and selling goods in the women's market.
Another aspect of Omdurman's informal economy involved the varied services provided to the households of the Mahdi and Khalifah by devoted Ansar. It was not uncommon for Sudanese to attach themselves to these households in the hope of sharing in the Mahdi's barakah. Some were daughters of the Ansar, known as Ansariyyat, brought by their fathers to work in Omdurman. Although they neither received nor expected remuneration for their labor, they lived within the Mahdi's and Khalifah's families' compounds and received food and other necessities, including instruction in the Qur'an. Allegedly, these Ansariyyat were virtually unique among the servants of Omdurman in their literacy. In similar fashion, some Sudanese offered their daughters to the Mahdi and Khalifah as "gifts," hoping that they would be taken as concubines (or preferably, wives). This offer accorded with an older Sudanic practice of honoring holy men and endowing their settlements with land, slaves, livestock, shares of produce, and voluntary labor. Moreover, people often requested that holy men marry their daughters so that they might benefit from the barakah of any offspring. In Mahdist Omdurman, such marriages (or relations of concubinage) conferred not only spiritual benefits, but also obvious social advancement; and in some cases, it may be assumed, they brought financial gain through preferential trade opportunities, access to information, and the like.
Much of the affluence (and perhaps some of the influence) of the Mahdist elite was dependent on the labor of their slaves; indeed, most of the labor performed within Omdurman (and the Mahdist state as a whole) was slave labor. Identified by the Ansar as "blacks," these slaves were drawn from the non-Arabic speaking and non-Muslim peoples of the Nuba Mountains, upper White Nile or upper Blue Nile, Bahr al-Ghazal, and Equatorial regions. Consistent with Sudanic tradition, their labor, often taken by force, formed the productive base of society. While written evidence is scant, it seems likely that Omdurman's population was at least half slave, including both the poorer households with perhaps a solitary female slave and the larger households with several specialized slaves. Families of the Mahdist elite could possess upward of 100 slaves, whether employed in agriculture outside the city or providing services within.9
A specialized category of slave within Omdurman was the jihadiyya: slave soldiers who were recent converts to Islam, taken over from the Turco-Egyptian regime and charged with both military and nonmilitary responsibilities. Housed in a distinct quarter of the city, these soldiers performed a wide variety of functions. Jihadiyya were utilized by the state as guards and laborers at the Khalifah's house, the soap factory, market court, central prison, the ports and boatyards, the arsenal, the treasury, and the state storehouses. They could also be pressed into service as herders of livestock, gatherers of straw and wood, builders of fortifications, tax collectors, and even military tailors. Trained in the use of gunpowder weapons, they served as an essential fighting unit outside the city and an elite bodyguard (mulazimin) to the Khalifah within the city. While their numbers tended to vary, at any one time there were usually 3,000 garrisoned in their quarter of Omdurman, although others were settled adjacent to the Khalifah's home. Taken as a distinct social group—and certainly they were viewed this way by the other Ansar—the jihadiyya constituted the largest single category within the public labor force. While the actual legal status of the jihadiyya was uncertain, as was often the case historically with "slaves of the state," their diminished social status within Omdurman was not. Perhaps not surprisingly, their military professionalism outlasted, and sometimes transcended, their Mahdist loyalty.10
Issues of Governance
The political and social conditions faced by the Khalifah and his Ansar were hardly conducive to stable governance. Moreover, in a messianic environment charged with the anticipation of an imminent Judgment Day, it was unclear exactly what degree of governance was desired. The closest model of urban administration was Khartoum across the Nile, but the spiritually contaminated "City of the Turks" was not supposed to be an example to be emulated. Ultimately, in the absence of any specific municipal offices or officials, Omdurman's governance depended on a variety of institutions and practices, whether formal or informal, obligatory or voluntary, individual or collective.
At the top of Mahdist administration, and hence ultimately responsible for conditions within "the Mahdi's city," was of course the Khalifah. Of necessity, he often delegated authority to his brother, known as "Amir Ya'qub," who also commanded the largest division within the Mahdist army, the Black Standard. Since Omdurman was designed to be the mobilization site and command center of a state defined by jihad, and since all men of Omdurman who were not members of the jihadiyya or Khalifah's bodyguard were attached to the Black Standard, Amir Ya'qub was not only their military commander but essentially the city's chief executive. Put differently, the military organization of the Mahdiyyah assumed the role of civic organization: each of the four divisions of the Black Standard was led by a chief officer (amir), who in turn, oversaw a number of smaller units organized by tribal, clan, ethnic, or other affiliation. These units were then divided into groups of 100, which were further divided into groups of 25.
At every level of command (with some few exceptions), authority derived from the preexisting social hierarchies: tribal, clan, or family leaders who understood the needs and ability of their followers, and who lived with them in their particular part of town. Every military unit thus acquired a spatial dimension within the settlement pattern of Omdurman, while every military leader was also a neighborhood leader, directly accountable to Ya'qub for the well-being of his soldiers. Moreover, the responsibilities of these leaders extended beyond the material needs of their people to other, particularly civic, matters: mediating disputes that did not require the involvement of the courts; overseeing matters of public health and sanitation; mobilizing the Ansar for communal labor projects, such as building the Qubba or city walls; and explaining (and enforcing) the directives of the Khalifah contained in his published proclamations or expressed in his Friday sermons.
To a certain degree, the governance of Omdurman also relied on the Sudanese people's pervasive ties to various Sufi organizations. Early in his uprising, the Mahdi had officially abolished the Sufi brotherhoods and prohibited their devotional activities, along with use of the term "dervishes" (darawish). At the same time, much of the ideology and organizational strength of the Mahdiyyah had its origins in Sufism.11 Thus, while public practices such as collective chanting (dhikr) ceased, the Khalifah was compelled to recognize, at least tacitly, the practical benefits of Sufi affiliation and authority. This was especially the case with regard to conflict resolution among the rapidly urbanizing population.
The two chief institutions of the Mahdist state, the public treasury and the main court, played important roles in governing the city. The public treasury (Bayt al-Mal) was the state's most important institution and employed a considerable number of people in Omdurman. Ultimately responsible for directing the economy of the Mahdist state and maintaining the material well-being of the Ansar, its staff comprised the largest overall number of employees in the Mahdist government. Under its chief officer, the Amin Bayt al-Mal, were administrative clerks, camel post workers, artisans and weapons manufacturers, as well as the actual treasury employees. Additionally, the Bayt al-Mal supervised the city's soap factory, pharmacy, hospital, telegraph stations, armory, mint, and lithograph press, as well as conducting the only slave market in Omdurman. In a purely economic sense, it was responsible for revenues and expenditures; policies of land ownership, manufacturing, foreign trade, agriculture and taxes; the city's food supply; and supervision of the state's economic policies. By the end of the Mahdiyyah, the Bayt al-Mal had split into several specialized treasuries, each concerned with a particular function within the city (e.g., treasuries for the Khalifah's bodyguard, the military workshop and dockyard, and the market inspectors.) Many, if not most, of its administrative and clerical staffs were skilled workers who had previously served the Turco-Egyptian regime, including Egyptian Coptic Christians (who were captives of the Mahdiyyah) and northern riverain Sudanese Muslims (who were loyal Ansar.)
The Mahdist courts exhibited a similar degree of specialization. The main court (Mahkamat al-Islam), located at the mosque in the center of town, heard all serious criminal cases and served as the court of appeal for cases heard in the provinces. Headed by a chief judge (Qadi al-Islam), it consisted of approximately 20 judges whose judgments were based on the Qur'an, Sunna (the example of the Prophet), and the proclamations (Manshurat) of the Mahdi. When these sources were deemed insufficient, judges referred to the practices of Sudan's dominant legal school, the Maliki rite. Additionally, a number of smaller courts existed to treat particular matters: a court at the Bayt al-Mal heard cases involving inheritance, taxation, the spoils of war, and slave ownership; two other courts mediated disputes involving the Khalifah's bodyguard and the jihadiyya soldiers; another court heard cases related to the operations of the port involving boat owners, port officials, and merchants. At all times, however, the Ansar could take these and other legal matters directly to the Khalifah or Amir Ya'qub, whose authority was paramount.
The court at the marketplace (Mahkamat al-Suq) represents the most deliberate attempt at urban governance by the Mahdist administration. Operating in conjunction with the aforementioned market inspectors, it helped maintain order in the city's only truly "public" space. For most of the Mahdist period, responsibility for this court—and indeed, for the market as a whole—was vested in a former police official of the Turco-Egyptian regime, a Sudanese named Muhammad Wahbi Husayn. The breadth of Muhammad Wahbi's authority reveals how closely the Mahdist ideal of urban governance approximated the classical Islamic office of muhtasib: his titles speak to his duties as police chief, market supervisor, tax collector, and judge. Accompanied by a force of approximately 25 inspectors, he patrolled the market inspecting the quality of food; supervised the regularity of weights, measures, and prices; guarded against the use of counterfeit currency and the smuggling of goods; enforced the separation of the sexes and safeguarded public morality; attended to problems of traffic, antisocial behavior, and public sanitation; enacted the judgments of the Qadi al-Islam; and urged regular attendance at prayer.
Some distinction between the duties of the market court and the market inspectors apparently did exist, although it was an unclear one. Ideally, the market inspectors acted to supervise "correct" behavior and uphold the law in the marketplace, while the market court passed judgment upon offenders. And while their personnel did not overlap, the broad authority of Muhammad Wahbi, as judge and police chief, certainly did.
Outside the market area, that is, in the residential quarters of the city, matters of public health and safety were the immediate responsibility of the local inhabitants. While the government provided some medical services at the Bayt al-Mal (most especially, inoculation against smallpox) and treated the indigent population for free, traditional medical practitioners were to be found in most of the districts. These physicians provided herbal remedies, set broken bones, delivered babies, and so on, although serious wounds required the attention of the government's physician, Dr. Hasan Zaki, an Egyptian taken captive in Khartoum. Public sanitation meanwhile was a matter of communal responsibility: by the Khalifah's order, every district was made responsible for its own proper sanitary arrangements, an order that was enforced through the military command structure. In similar fashion, each district was responsible for its own local security. The Mahdi had ruled that anyone who failed to expose a crime was deserving of the same punishment as the criminal, and this ruling was strenuously upheld. As conditions warranted, jihadiyya might patrol the city districts at night, sometimes accompanied by the market inspectors; but as a matter of Mahdist belief as well as legal practice, all of the Ansar were essentially deemed "police."
The Population of Omdurman
For a 19th-century Sudanic African town, Omdurman was an extraordinarily huge and diverse place. While there are insufficient data from Mahdist and Anglo-Egyptian sources to establish the city's exact population at any one time, it is possible to estimate its average minimum population, as well as its sustained core population, from 1885 to 1898.12
At the time of Khartoum's capture in 1885, there were approximately 30,000 people in the city. The Mahdists made no official count of the casualties suffered by their enemy, although Egyptian Military Intelligence estimated it to be at least 4,000 soldiers and civilians. As already mentioned, the survivors were relocated to Omdurman. Soon thereafter, the Khalifah's call to hijrah went out and many thousands of Sudanese poured into the new city, joining those Ansar already present. Just how many thousands arrived and then remained, however, is unclear. Many of these were soldiers, mujahidun, and they were called to join the jihad soon after their arrival; thus, their family members either remained at home in the provinces or settled in a city district specific to their clan or tribe. Estimates of Omdurman's population for the late 1880s and early 1890s vary widely—from 120,000 to half a million—although these estimates were at best guesses, and the higher numbers reflect times of major military mobilization.
It is clear that Omdurman's population fluctuated wildly, responding to a variety of factors: the Khalifah's periodic summons to hijrah; Sudanese traveling to the city annually for the Rajabiyyah festival, 'Id al-Adha, or the Prophet's birthday; others coming to the city in fulfillment of the pilgrimage obligation or to partake of the Mahdi's and Khalifah's barakah; and merchants bringing their goods from the provinces or abroad to trade in the country's chief marketplace. Against these population shifts must be figured the constant outflow of Ansar embarking on jihad to the north, the Red Sea coast, and the Ethiopian borderlands; others who were allowed to return to their farmlands in the Jazirah or Kordofan to cultivate each winter; as well as the steady population losses due to natural or battle-related mortality. Certainly, a major influence on Omdurman's population was the devastating famine of 1306/1888–1889: Many thousands of Sudanese converged on the capital in search of food at this time, while the government simultaneously transported thousands of newly arrived western pastoralists upriver to Fashoda to relieve the burden of feeding them. While the precise effect of the famine on the city's population is unknown, it is clear that many thousands died. Most of these, however, were the new arrivals from the countryside rather than the city's settled population, who had managed to store grain and who assisted one another until the famine passed.
Women and children appear to have constituted the largest portion of Omdurman's population at any one time. Moreover, evidence suggests that women outnumbered men by a ratio of about three to one. Added to these would be the slave population—separate from the "family members" enumerated in Mahdist documents—who, as stated earlier, may have accounted for as much as half of the city's population. Others who could be considered core residents—that is, those who were generally not required to leave the city for jihad—represented a reserve of the jihadiyya soldiers garrisoned in Omdurman, who typically numbered 3,000 but at times reached 8,000; a Muslim-convert community of Syrians, Armenians, Italians, Cypriots, and Greek Orthodox Christians, as well as Egyptian Copts and Jews, who originally numbered in the several hundreds but diminished considerably by the end of the period; former Turco-Egyptian officials and soldiers (some of whom were Copts), as well as their dependents, who in 1898 numbered some 8,676 persons; the administrators and officials of the treasuries, courts, and other offices, who at the end of the Mahdiyyah numbered almost 250; and the households of the Mahdist elite. This last category included the spouses and children of the Mahdi and his brothers and the Khalifah and his brothers; the families of the Mahdi's and Khalifah's relatives; and the families of the two junior khalifas, Muhammad Sharif and 'Ali al-Hilu. Available data suggest that these totaled—at an absolute minimum and exclusive of slaves and concubines—somewhere in the vicinity of 500 individuals.
Based on Mahdist records of troop strengths and mortality rates, as well as surviving treasury documents and government memoranda, together with the reports of Omdurman residents and informants to the Egyptian Military Intelligence, it seems likely that Omdurman's average minimum population was approximately 240,000. This figure, whether or not it is inclusive of slaves, represents an extremely large average urban population for its time and place, and indeed it was unprecedented in Sudanic history. Moreover, the broad diversity of Omdurman's inhabitants, in terms of tribal identity, geographic origin, and ethnicity, sets it apart from earlier Sudanic towns and helps explain Omdurman's significance as the crucible of a broader Sudanese national identity.
Omdurman and Sudanese History
The history of Mahdist Omdurman, and particularly its social history, suggests the continuation of several earlier practices as well as some interesting new developments. The settlement of the city, for example, follows the earlier Sudanic pattern of spatially distinct tribal and ethnic quarters with a centrally located, enclosed "royal quarter." At the same time, across the southern, central, and northern zones of the city appear multiple examples of a more dynamic settlement mixture that quickly created new affiliations. Likewise, the economic activities in Omdurman confirm the historical dominance of Sudan's northern riverain and Red Sea populations, especially in long-distance trade; and yet a variety of other peoples—central Sudanic, Fur, and, most surprisingly, the western pastoralist "Baqqara"—became involved in the activities of the suq, with the Baqqara gaining a particular reputation for their proficiency in retail business.
The marriage alliances made in Omdurman reveal the formation of a multitribal, multiethnic ruling class. To some degree, this followed precedent: the distribution of daughters between family groups to form strategic alliances was well established among the earlier states of Sinnar and Darfur. At the same time, the conditions of the Mahdiyyah, with political authority in the hands of the Khalifah and his Ta'aysha relations, and spiritual authority emanating from the family of the Mahdi, favored new marriage alliances between the otherwise-estranged northern and western Sudanese communities. Added to these were the marriages conducted between the above two families and the family of the junior khalifah 'Ali al-Hilu, whose White Nile relations from the Kinana and Dighaym Arabs became part of a broader Sudanese elite.
There is little evidence that such an admixture was a common practice among the rest of the Ansar, and yet a more subtle socialization process was underway in the culture of Omdurman. One indication of this process is the above-mentioned incorporation of the western pastoralists into the northern riverain mercantile economy. Another indication is linguistic. Many of the Baqqara, as a result of their settlement, began to adopt the riverain dialect of Arabic that was prevalent in Omdurman. The Khalifah's son and heir apparent, 'Uthman Shaykh al-Din, spoke this form of Arabic exclusively and was hence dubbed "Ibn al-Madina" ("son of the city"). To further Shaykh al-Din's education, the Khalifah assigned his secretary (al-Tayyib Hashim, from a prominent riverain family) to teach him classical Arabic. Additionally, the poetry of the Mahdiyyah—an important instrument of Mahdist indoctrination as well as an expression of popular culture—was recited mainly in the riverain Arabic vernacular. Even outside the city, Arabic was replacing other languages (e.g., Nubian Kenzi) as a consequence of the Mahdiyyah, while polygamous marriages encouraged by the Mahdi and Khalifah were replacing monogamy among Nubian Sudanese communities.
In short, the experience of Mahdist Omdurman, with its ideological rigor and processes of acculturation and urbanization, accelerated many of the changes introduced in the earlier Funj and Turco-Egyptian periods, while contributing to the growth of a new type of Sudanese Arab-Muslim culture. And while never the intention of the Mahdi and Khalifah, this eventually led to the rise of a more particular Sudanese, and especially northern Sudanese, identity in the context of the 20th century.
The Literature on Omdurman
The present author's study of Omdurman during the Mahdiyyah is the only scholarly work on the subject: Holy City on the Nile, Omdurman During the Mahdiyya.13. Otherwise, there is some historical literature on the Sudan that treats Mahdist Omdurman in a tangential way. All serious consideration of the Mahdiyyah begins with the authoritative work of P. M. Holt, The Mahdist State in the Sudan.14 Holt's book was the first historical study of the period based on the voluminous archives of the Mahdist state, and it remains unsurpassed. Among the scholarship produced by Sudanese scholars, the contributions of Muhammad Ibrahim Abu Salim stand out prominently. Three of Abu Salim's books in particular contribute to our understanding of Omdurman: Al-'Arḍ fī'l-Mahdiyyah Ta'rīkh al-Kharṭūm; and Al-Ḥarakah al-Fikriyyah fī'l-Mahdiyyah.15 Specialized works on the Mahdiyyah that refer to Omdurman in important ways include Husayn Sid Ahmad al-Mufti, Taṭawwur Niẓām al-Qaḍā' fī'l-Mahdiyyah; 'Ismat Hasan Zulfo, Kararī; and Al-Siyāsah al-Iqtiṣādiyyah li'l-Dawlah al-Mahdiyyah.16
Omdurman and the period of the Mahdiyyah cannot be fully understood without reference to the prior history of state formation and urbanization in the Sudan. The starting point is the coauthored volume by R. S. O'Fahey and Jay Spaulding, Kingdoms of the Sudan.17 In addition, one should refer to their individual works: R. S. O'Fahey, State and Society in Dar Fur (London: 1980); and Jay Spaulding The Heroic Age in Sinnar.18 For the period of Turco-Egyptian rule in the Sudan, Richard Hill's Egypt in the Sudan (London: 1959) remains the most important work, complemented by Anders Bjorkelo, Prelude to the Mahdiyya: Peasants and Traders in the Shendi Region.19 To these may be added two scholarly articles on urbanization: F. Rehfisch, "A Sketch of the Early History of Omdurman," and R. C. Stevenson, "Old Khartoum, 1821–1885," 20
Primary Sources
The archive of the Mahdist state is preserved in the National Records Office in Khartoum, and contains most of the surviving records and documents produced by the government of the Khalifah, as well as other materials gathered in Omdurman by Egyptian Military Intelligence after the Anglo-Egyptian conquest in September 1898. Of direct importance to the study of Omdurman is its complete collection of Egyptian Military Intelligence reports from 1885 to 1898. The collection is not digitized and cannot be accessed remotely. Otherwise, a considerable amount of material relating to the Mahdiyyah and some material relating to conditions in Omdurman may be found in the Sudan Archive at the University of Durham (U.K.). Durham's extensive and wide-ranging collection was built upon the papers of former British officials who served in the Sudan Political Service during Anglo-Egyptian rule (1899–1955). The collection is well catalogued, and much of it is searchable online.
Some primary source material from the Mahdiyyah has been published. The collected proclamations and pronouncements of the Mahdi are available in seven volumes edited by Muhammad Ibrahim Abu Salim: Al-Āthār al-Kāmilah li'l-Imām al-Mahdī.21 Additionally, Abu Salim collected a great deal of polemical material, both pro- and anti-Mahdi, that sheds interesting light on the intellectual debates of the period: Al-Khuṣūmah fī Mahdiyyat al-Sūdān.22 For an understanding of conditions in Omdurman, the memoir of Babikr Bedri, a former Ansari, is invaluable: Memoirs.23 Likewise, the account of an Egyptian military officer who spent the Mahdiyyah as a captive in Omdurman sheds much interesting light on the period: Ibrahim Fawzi, Al-Sūdān Bayna Yadāy Ghurdūn wa Kitshanir.24 A history of the Sudan written by a former officer of the Egyptian Military Intelligence, Na'um Shuqayr, contains some important information about Omdurman and may be considered authoritative, given Shuqayr's access to and familiarity with intelligence data; Shuqayr was also charged with discovering and collecting all written materials in Omdurman after the conquest: Tarīkh al-Sūdān al-Qadīm wa'l-Ḥadīth wa Jughrāfīyatuhu.25
Finally, the published accounts of the European prisoners of the Mahdi and Khalifah, who spent long, unhappy years of captivity in Omdurman, are important sources. These works, however, must be read carefully (see P. M. Holt, "The Source Materials of the Sudanese Mahdiya."26 Among these memoirs, the most informative on conditions in the city is the account of Father Paolo Rosignoli: "Omdurman during the Mahdiya."27 The self-serving account of the German prisoner Charles Neufeld has some useful information: A Prisoner of the Khaleefa.28 The two most frequently cited accounts, those of Rudolf Slatin and Father Joseph Ohrwalder, were both coauthored and "edited" by Colonel F. R. Wingate, the director of Egyptian Military Intelligence. (The latter was in fact published under Wingate's name.) These works served the important propaganda purpose of keeping the matter of Sudan alive in British public attention. Nonetheless, their observations of conditions in the city are relevant: see Rudolf C. Slatin and F. R. Wingate, Fire and Sword in the Sudan, and F. R. Wingate, Ten Years' Captivity in the Mahdi's Camp.29
Further Reading
Abu Salim, Muhammad Ibrahim. Ta'rīkh al-Kharṭūm. Beirut: 1979.Find this resource:
Holt, P. M. The Mahdist State in the Sudan. 2d ed. Oxford: Oxford University Press, 1970.Find this resource:
Kramer, Robert S. Holy City on the Nile: Omdurman during the Mahdiyya, 1885–1898. Princeton, NJ: Princeton University Press, 2010.Find this resource:
(1.) "Durman" may be a proper name, or it may refer to an earlier word for "hill." An equally inscrutable name for the site, "Washal," survived into the Mahdiyyah: Robert S. Kramer, Holy City on the Nile: Omdurman during the Mahdiyya, 1885–1898 (Princeton, NJ: Markus Wiener Publishers, 2010), 21–22.
(2.) For the history of the Mahdist period as well as the religious claims of Muhammad Ahmad al-Mahdi, see P. M. Holt, The Mahdist State in the Sudan, 2d ed. (Oxford: Oxford University Press, 1970).
(3.) Each of the Mahdi's three chief followers was given the title of "Khalifah," in the sense that they had inherited the authority of the Prophet Muhammad's first three successors. All initially assumed positions of military leadership: 'Abdallahi al-Ta'ayshi over the western pastoralist tribes, 'Ali al-Hilu over the White Nile Arabs, and Muhammad Sharif (the Mahdi's kinsman) over the northern riverain Sudanese. All retained some measure of moral authority throughout the Mahdiyyah, although 'Abdallahi, known simply as "the Khalifah," wielded supreme authority in all matters.
(4.) The title "Ashraf" (sing: Sharif) implies noble descent from the Prophet Muhammad's clan, the Hashimites. The Mahdi's extended family, known as the "Dongola Ashraf" for their place of origin, was one of several families in the Sudan to make such a claim in the 19th century. Resentful of the Khalifah's authority, they were frequent adversaries during the period.
(5.) See John O. Voll, "The Mahdi's Concept and Use of Hijra," Islamic Studies 26.1(1987): 31–42.
(6.) The Jazirah is the expanse of fertile land between the White and Blue Niles, and as with portions of the Kordofan region, it was crucial to the Sudan's food supply.
(7.) The term "Fellata" was usually pejorative and referred to emigrants of Fulani origin (in particular) and West African origin (in general). For Sudan's importance to the pilgrimage route, see 'Umar 'Abd al-Raziq al-Naqar, The Pilgrimage Tradition in West Africa (Khartoum: Khartoum University Press, 1972).
(8.) For the Sufi tradition in Sudanese Islam, see Ali Salih Karrar, The Sufi Brotherhoods in the Sudan (Evanston, IL: Northwestern University Press, 1992); and Neil McHugh, Holymen of the Blue Nile (Evanston, IL: Northwestern University Press, 1994).
(9.) Two important works on slavery in the Sudan are Jay Spaulding, "Slavery, Land Tenure and Social Class in the Northern Turkish Sudan," International Journal of African Historical Studies 15.1(1982): 1–20; and Gabriel Warburg, "Ideological and Practical Considerations Regarding Slavery in the Mahdist State and Anglo-Egyptian Sudan," in The Ideology of Slavery, ed. Paul Lovejoy (Beverly Hills, CA: SAGE, 1981), 245–69.
(10.) See Douglas Johnson, "Sudanese Military Slavery from the Eighteenth to the Twentieth Century," in Slavery and Other Forms of Unfree Labour, ed. Leonie Archer (London: Routledge, 1988), 142–56.
(11.) Lidwien Kapteijns, "The Religious Background of the Mahdi," African Perspectives 2 (1976): 61–79.
(12.) A good survey of Sudanese urbanization prior to the Mahdiyyah is El-Sayed al-Bushra, "Towns in the Sudan in the Eighteenth and Early Nineteenth Centuries," Sudan Notes and Records 52(1971): 63–70.
(13.) Robert S. Kramer, Holy City on the Nile, Omdurman During the Mahdiyya, 2010.
(14.) P. M. Holt, The Mahdist State in the Sudan, 1970.
(15.) Muhammad Ibrahim Abu Salim, Al-'Arḍ fī'l-Mahdiyyah (Khartoum: 1970); Ta'rīkh al-Kharṭūm (Beirut: 1979); and Al-Ḥarakah al-Fikriyyah fī'l-Mahdiyyah (Khartoum: 1989).
(16.) Husayn Sid Ahmad al-Mufti, Taṭawwur Niẓām al-Qaḍā' fī'l-Mahdiyyah (Khartoum: 1959); 'Ismat Hasan Zulfo, Kararī (Khartoum: 1973); and Muhammad Sa'id al-Qaddal, Al-Siyāsah al-Iqtiṣādiyyah li'l-Dawlah al-Mahdiyyah (Khartoum: 1986).
(17.) R. S. O'Fahey and Jay Spaulding, Kingdoms of the Sudan (London: 1974).
(18.) R. S. O'Fahey, State and Society in Dar Fur (London: 1980); and Jay Spaulding The Heroic Age in Sinnar (East Lansing, MI: 1985).
(19.) Anders Bjorkelo, Prelude to the Mahdiyya: Peasants and Traders in the Shendi Region (Cambridge, U.K.: 1989).
(20.) F. Rehfisch, "A Sketch of the Early History of Omdurman," Sudan Notes and Records 45(1964): 35–47; and R. C. Stevenson, "Old Khartoum, 1821–1885," Sudan Notes and Records 47(1966): 1–38.
(21.) Muhammad Ibrahim Abu Salim (ed.), Al-Āthār al-Kāmilah li'l-Imām al-Mahdī, 7 vols. (Khartoum: 1990–1994).
(22.) Muhammad Ibrahim Abu Salim Al-Khuṣūmah fī Mahdiyyat al-Sūdān (Khartoum: 2004).
(23.) Babikr Bedri, Memoirs, trans. Y. Bedri and G. Scott (London: 1969).
(24.) Ibrahim Fawzi, Al-Sūdān Bayna Yadāy Ghurdūn wa Kitshanir, 2 vols. (Cairo: 1901).
(25.) Na'um Shuqayr, Tarīkh al-Sūdān al-Qadīm wa'l-Ḥadīth wa Jughrāfīyatuhu, 3 vols. (Cairo: 1903).
(26.) P. M. Holt, "The Source Materials of the Sudanese Mahdiya,"Middle Eastern Affairs 1(1958).
(27.) Father Paolo Rosignoli: "Omdurman during the Mahdiya," ed. and trans. F. Rehfisch, Sudan Notes and Records 48(1967): 33–61.
(28.) Charles Neufeld, A Prisoner of the Khaleefa (London: 1899).
(29.) Rudolf C. Slatin and F. R. Wingate, Fire and Sword in the Sudan (London: 1896) and F. R. Wingate, Ten Years' Captivity in the Mahdi's Camp (London: 1892).


text:
2013 HumanaFest: The Big Picture
More Voices
Rise, Shine, Repeat: A Day in the Life of an Acting Apprentice
Sarah Grace Welbourn needs sleep. It's 5 o'clock on the final Friday of Actors Theatre of Louisville's Humana Festival of New American Plays. The acting apprentice is curled up in an office chair … [Read More...]
In Previews: ATL's Apprentice Actors
By Jenny Lawton
The Actors Theatre apprentice program is known nationally for its rigorous training and strong performances. This year it's expressed in the sleep-themed triptych Sleep Rock Thy … [Read More...]
The Dramaturg's Success
By Suzi Steffen
During the Humana Fest's industry weekend - the final one - it's not just normal audience members, critics, other actors, directors and agents in the audience. There are also dramaturgs and literary … [Read More...]
ATL's Les Waters: To Hell with the Good Old Days
As a young director in London, Les Waters read about the plays coming out of Kentucky's HumanaFest. A generation later he's running it, along with Actors Theatre of Louisville. The festival made its … [Read More...]
Still Waters: An Interview with Actors Theatre of Lousville Artistic Director Les Waters
By Chris Arnott
Les Waters was named Artistic Director of Actors Theatre of Louisville in 2011. But the first full season that he has programmed for the theater -- and that means not just the Humana Festival but a … [Read More...]
See Me After Class: Paula Vogel on Playwrights as Teachers
By Chris Arnott
The weekend shouldn't have to feel like school. But a Humana panel discussion Saturday morning stayed safely within ivy towers, even though its most revered participant has taken her work to the … [Read More...]
Weight of History: The Playwright Confronts
By Suzi Steffen
Waves whoosh in and out, and seabirds cry over the speakers. Sand piles up and spills over corners and floor the floor of the set. A young man looks around in terror as he collects branches to build a … [Read More...]
Influenced: Playwrights and directors recall the one who got them here
By Chris Klimek
"I learned it by watching you!" a 1980s anti-drug PSA once accused. Why artists make the work they do is an existential query no amount of bloviation could ever fully answer -- no tolerable amount … [Read More...]
Read The Stage: Going Forward
By Suzi Steffen
Peter Gnit: A whiny, dorky narcissist who somehow has women, from his long-suffering mother to the sweet Solvei, ruining their lives for him. Old story, right? Yes, really old story. Gnit (guh-NIT) … [Read More...]
Q&A with David J. Loehr of 2amt
By Suzi Steffen
David J. Loehr is a playwright, co-founder and artist in residence of Riverrun Theatre and the online theatre site 2amtheatre (full disclosure: 2amt is a site for which I have written several … [Read More...]
Shopping for talent at HumanaFest
The new talent's gotta come from somewhere. Among hundreds of visitors to this year's HumanaFest is veteran New York talent agent Doug Kesten. He's scouting the apprentice company, he says, "hopefully … [Read More...]
e31 Features
Local Impact: Where's The Local Flavor In HumanaFest?
April 7, 2013 By Elizabeth Kramer
A notice for auditions for local actors posted by the Actors Theatre of Louisville appeared Sunday in The Courier-Journal. The timing was odd, in part because it was also the last day of the theatre's 2013 Humana Festival of New American … [Read More...]
Appropriate in Six Words
April 6, 2013 By By Sasha Anawalt and Jenny Lawton
Some plays generate a lot of talk. Branden Jacobs-Jensen's Appropriate is about family and legacy and secrets and shame. And even though the word is only used twice in the script, it's also about lynching. Difficult subjects all. How do you tell … [Read More...]
We Can Get Down: Artist and Critic Talk Hip Hop and Theatre
April 6, 2013 By Rebecca Haithcoat
Humana is down with hip hop. In 2008, Marc Bamuthi Joseph's solo piece the break/s: a mixtape for the stage had its co-premiere in Louisville. Joseph dances through stories he collected as a "hip-hop educator," and in my review, I compared him to … [Read More...]
The ATL Apprentice Company: Niceness Counts
March 31, 2013 By Chris Arnott
"We're probably the country's only practical training program," boasts Michael Legg, the director of the Actors Theatre of Louisville's Apprentice Company for the past six years. This troupe of young actors helps keep the Humana Festival—and, indeed, … [Read More...]
Critical Debate: To Read or Not Read The Play First
March 29, 2013 By Christopher Arnott & Lou Harry
Chris: Okay, I've got homework tonight. Lou: No, you don't. You don't have to read plays before you see them. Chris: I do, you know. I've always done it. Lou: I would suggest that, in most cases, especially at a new play festival, it's … [Read More...]
Backstory: What happens after Humana?
March 29, 2013 By Lou Harry
"I saw it at Humana." Sure, but did you see it anywhere else after that? How quickly do plays launch out of the Humana Festival into the wider theatrical world? How high do they fly? How often do they stay put on the Louisville launch … [Read More...]
Best of The Reviews
Critics' Round-up: O Guru Guru Guru…
O Guru Guru Guru, or why I don't want to go to yoga class with you By Mallery Avidon Directed by Lila Neuberger This subversive assessment of the craze for spiritual enlightenment has an odd structure. The first part is basically a lecture … [Read More...]
Aggregated Humanafest Around The Web
- Review: 'Appropriate' Opens Windows Into History
- Reviews: Strengths And Stumbles In Six Plays
- Review: 'Gnit' Plays Well With A Classic Tale
- Training Up (Or Up And Away) The Apprentices
- Reviews: Coming To A Theatre Near You (Maybe?)
- Robert Schenkkan Wins ATCA's Top New Play Award
- 'Gnit' Goes High-Concept For Jokes, But Some Fall Flat
- 'Delling Shore' Disappoints; 'Appropriate' Thrills
- Swollen Egos Stride the Stage
- Flying In Your 'Sleep' [VIDEO]
- Review: 'O Guru Guru' Is Creative and Maybe A Little Profound
- Teching 'Sleep Rock Thy Brain'
- Almost Everything You Ever Wanted To Know About Engine 31
- Review: Which Play Should You See This Final Weekend?
- 'The Delling Shore' Is *That* Play
- 'Sleep Rock Thy Brain' Uses Science As An Inspiration [AUDIO]
- Review: In 'Appropriate,' the first act overshadows everything
- Review: 'Cry Old Kingdom' is profound on many levels
- Review: 'O Guru Guru Guru' an emotional onstage pilgrimage
- Review: 'Sleep Rock Thy Brain' combines inventive one-acts
Recent Comments
- Vogelspiel | New Haven Theater Jerk on See Me After Class: Paula Vogel on Playwrights as Teachers
- Erin Merritt on Director: Why do audiences resist?
- David J. Loehr on Portrait of an Artist: New Meaning At HumanaFest
- Hmmmmph on Portrait of an Artist: New Meaning At HumanaFest
- Aaron on Lou's bourbon-fueled review: Drink rocks my brain
- Austin on Rise, Shine, Repeat: A Day in the Life of an Acting Apprentice

subset: commoncrawl


text:
Servicios Personalizados
Links relacionados
- Citado por Google
- Similares en Google
SAMJ: South African Medical Journal
versión On-line ISSN 2078-5135
versión impresa ISSN 0256-9574
SAMJ, S. Afr. med. j. vol.100 no.10 Cape Town oct. 2010
Home self-testing for HIV: AIDS exceptionalism gone wrong
Marlise Richter; W D Francois Venter; Andy Gray
Self-tests for HIV in South Africa are currently unregulated. Gaps in law and policy have created a legal loophole where such tests could effectively be sold in supermarkets, but not in pharmacies. At the same time, South Africa lacks an effective regulating mechanism for diagnostic tests, which brings the quality and reliability of all self-tests into question. The authors argue for greater access to, and availability of, quality HIV self-tests. This strategy will encourage regular HIV testing, allay fears about stigma and confidentiality when testing in public facilities, and decrease the costs associated with traditional voluntary counselling and testing, and is likely to lead to earlier diagnosis and treatment of HIV.
The South African Medical Association (SAMA) recently warned the public against using HIV self-testing kits. SAMA chairman Norman Mabasa noted that it was 'risky' for individuals to test themselves 'unmonitored' and that it might lead to devastated patients or suicide.1-3 These warnings were subsequently echoed by members of the national Department of Health and the Treatment Action Campaign.4 Objections included questions about the accuracy of the tests, lack of support systems and pre-and post-test counselling, the inability to always be able to confirm the results by a second test, and the dangers of misinterpretation of the results.1,2,4 SAMA expressed similar objections in 2005 when the supermarket chain store Pick 'n Pay explored selling self-testing kits for HIV at its outlets.5 The Pick 'n Pay launch was subsequently cancelled.6 Yet, during that time, HIV self-tests were available over the counter (OTC) from a number of pharmacies at prices that ranged from R40 to R60 per test.
A number of other OTC self-tests are available from the Dis-Chem pharmacy chain (Table I), while some of these were also available at the Clicks pharmacy chain and other local pharmacies. Neither Clicks nor Dis-Chem pharmacy chains stocked HIV self-tests at the time of writing, but the extent to which these are currently provided by community pharmacies is unknown. The objections that SAMA raised against HIV self-tests could apply equally to other self-tests, yet the distribution of such tests is not regulated. Other diagnoses may be as devastating, or might have been in the past. A diagnosis of type 1 diabetes, for instance, was a certain death sentence before there was widespread access to insulin. Such access is not yet universal. Pregnancy testing might also be considered to pose risks, in the absence of access to suitable professional advice. Cancer remains a dreaded diagnosis, and there are serious ethical concerns surrounding testing for 'recreational' drugs.
What is it about HIV/AIDS in 2010 that encourages medical, ethics and activist bodies to respond to HIV self-diagnosis with such alarm and conservatism?
HIV testing models
The term 'AIDS exceptionalism' was coined in the early 1990s to describe an approach to the AIDS epidemic that was explicitly located within a human rights and bioethics framework.7-11 This approach to HIV/AIDS led to a novel methodology in the diagnosis of HIV: voluntary counselling and testing (VCT). VCT includes pre-and post-test counselling, express and informed consent that an HIV test would be conducted on the patient, and assurances of the confidentiality of the test result.12
With the advent of highly active antiretroviral treatment and subsequent increased access to such treatment, a number of authors started questioning the ongoing relevance and appropriateness of 'AIDS exceptionalism'. Proponents of the 'normalisation of AIDS' argue that it will decrease the stigma associated with the epidemic, remove barriers to testing, increase access to treatment, and change societal perceptions of HIV/AIDS.11,13-15 There was a call for the rapid scale-up of HIV testing after the WHO/UNAIDS 3x5 initiative (treating 3 million people by 2005) was launched in 2003.16-18 After substantial controversy and debate, the WHO/UNAIDS-endorsed 'provider-initiated testing and counselling' (PITC) model was introduced to scale up the number of people who know their HIV status. The PITC approach moves away from VCT by emphasising the health care provider's role in recommending an HIV test to patients and providing 'pre-test information' (not counselling). An HIV test would generally be performed unless the patient declines.19 South Africa's National Strategic Plan and various authors recommend this approach.20,21 A change to current testing practices, that has been termed HIV counselling and testing (HCT), was introduced in the 2010 guidelines, but no policy has been passed.22,23
New or alternative approaches to HIV testing include: (i) models that make subtle changes to the traditional VCT model, such as mobile VCT centres, routine offer of VCT,24 home-based VCT;25 (ii) providing monetary or other incentives to individuals to test;26 (iii) home-based HIV testing where the individual sends a dry-spot test to a laboratory and the results are relayed telephonically and anonymously;27 (iv) self-testing;27,28 and (v) mandatory testing during pregnancy29 or for deployment of soldiers to conflict areas.30 The majority of these testing models involve a third party (a counsellor, nurse or physician) and make it near-impossible for a person to test for HIV without counselling.
State of HIV testing in South Africa
HIV testing has escalated dramatically in South Africa over the last few years, this escalation driven by the Department of Health, non-governmental and donor programmes, and the insurance industry. The 2008 HSRC Household Survey showed a significant increase in the number of people who knew their HIV status.31 In the 2002 HSRC survey, only 21.4% of people over the age of 15 years had had an HIV test in their lifetime, compared with 30.5% in 2005, and 50.8% in 2008. Almost a quarter (24.7%) of people aged 15 -49 years had had an HIV test in the preceding 12 months in 2008. The 2008 survey highlighted once again the important gender differences in HIV testing: significantly more women (28.7%) received an HIV test in the last 12 months and knew their results than men (19.8%).31 The survey encouraged further initiatives to increase uptake of testing.
Current legal and policy analysis
It is clear that HIV testing needs to be expanded in South Africa, and that people should regularly retest. Self-testing for HIV could aid this process. Would HIV self-tests be possible under current South African law and policy?
Legal considerations
Self-tests for HIV should fall under the definition of a 'medical device' in the Medicines and Related Substances Control Act (Act 101 of 1965, as amended) and should be regulated by this Act. However, no mechanism for the registration of medical devices currently exists. Some medicated devices (such as drug-impregnated stents) have been registered as 'medicines', but diagnostic tests remain unregulated. The Medicines and Related Substances Amendment Act (Act 72 of 2008) attempted to remedy this situation by simply replacing the term 'medicine' throughout the Act with the term 'product, medical device or IVD (in vitro diagnostic)'. This Act has not yet been promulgated. The practicality of applying the same registration process for medicines to all medical devices, which range from large-scale imaging systems to disposable test kits, is questionable. There is currently no restriction on where such diagnostic tests may be sold or to whom. The only legally binding restriction on the distribution of self-testing HIV kits is provided by the Good Pharmacy Practice (GPP) standards issued by the South African Pharmacy Council. These are discussed below.
The National Health Act (Act 61 of 2003) will replace the Human Tissue Act (Act 65 of 1983) but has not yet been brought into effect in its entirety. Section 68(1)(h) of the Act makes provision for the Minister of Health to enact regulations on 'the withdrawal of blood from living persons and the preservation, testing, processing, supply or disposal of withdrawn or imported blood'. Section 68 was brought into effect on 17 May 2010;32 the accompanying regulations33 enabled persons who are not health care providers, but who had received at least three hours of training at a health establishment, to withdraw a 'small quantity of capillary blood sufficient for testing'. Although this enables lay counsellors to be used in HIV testing, it does not preclude patients, such as diabetics, from withdrawing their own capillary blood using suitable equipment.
The Department of Health published the National Policy on Testing for HIV in 2000,34 which provides for the conditions under which HIV tests can be conducted in health care facilities, and is based on the traditional VCT model. It is silent on self-tests. South Africa's national AIDS policy - the National Strategic Plan 2007 -2011 - provides new directions for HIV testing in South Africa; it tasks the Department of Health with development of 'new strategies for the provision of counselling and testing outside of health facilities'. 21 Although the 2010 clinical guidelines make reference to an 'HCT policy', no such policy has been issued. A new guideline currently before the South African National AIDS Council (SANAC) is intended to guide practitioners on HIV testing, but current drafts suggest conventional approaches to testing and counselling processes and have also not been finalised.35
The minimum conditions for screening and testing by pharmacies are provided in the GPP standards issued by the South African Pharmacy Council.36 Section18.104.22.168(h)of the GPP is nequivocal that' [p]harmacists must not sell HIV tests for patients to perform at home'. 36 This injunction does not apply to any other monitoring tests. The GPP notes that the Medicines Control Council does not register HIV tests, and it recommends that these tests should only be purchased from 'reputable companies' and when such tests had been registered 'in the country of origin'.
The Health Professions Council of South Africa guidelines on 'The management of patients with HIV infection or AIDS' mention self-testing in relation to potential abuse of such tests. This document advises that people who want to utilise self-tests should enquire from their doctor on their reliability and safety. The guidelines make it clear that new forms of testing 'should only be adopted if it conforms with the guidelines' - thus effectively endorsing existing health care professional-controlled methods such as VCT.
Arguments against self-testing for HIV
A number of arguments have been levelled against self-testing; they are briefly discussed below.
There is increased risk of unmanaged anxiety, with potential for suicide
The risk certainly exists that the user of a self-test may be traumatised by the test result; yet the same holds true for other conditions, such as pregnancy and cancer, that can be diagnosed by currently available self-tests. Pregnancy is a sexually transmitted condition with profound and lifelong implications that may lead to stigma and suicide. There is no move to halt the distribution of these tests (widely available in supermarkets), as weighing the benefits of knowing one's pregnancy status against possible social harms seems relatively easy. Merson and colleagues point out that, although suicide and suicidal ideation can occur after a positive HIV diagnosis, the available evidence shows that suicide only really becomes a concern when AIDS-related symptoms develop.27
Counselling is a vital component of HIV tests and is bypassed by self-testing
Our own experience - from undergoing counselling personally, providing it and/or running programmes that provide this service - is that the quality and applicability of counselling in South Africa is extremely variable. At its best, counselling provides information, manages anxiety, and refers people to appropriate care. At worst, it is culturally inappropriate, increases anxiety and misinformation, and leaves patients devastated and disempowered, with no link to health or other follow-up systems. While the potential benefits of counselling are acknowledged, it should never constitute a barrier to people who want to ascertain their HIV status, but do not want to be counselled.
Testing could be coerced in a home environment
Risk of coercion (forced testing) arises with a number of self-tests, including pregnancy and drug tests. We are not aware of any available data on the incidence of such coercive testing in South Africa. HIV self-tests might have been available from some outlets, and no reports of abuse of these tests have appeared. South Africa has an extensive HIV-related legal framework in place. Legislation such as the Employment Equity Act and the National Health Act, as well as common law, should provide ample protection against potential abuse. Indeed, various authors have pointed out that potentially beneficial technology should not be prohibited because there is a chance that it could be abused.14,37
Accuracy of test
Opposition against self-testing has relied heavily on the claim that self-tests could be inaccurate and should therefore not be available to the public. The Food and Drug Administration (FDA) in the USA approved the first HIV self-testing kit in 1996.25 Diagnostic testing technology has improved since the late 1990s. Nonetheless, South Africa lacks an effective regulating mechanism for all diagnostic tests - not just HIV tests. This legal loophole is one more reason to ensure that the appropriate frameworks be put into place so that all diagnostic tests, including self-tests, are thoroughly tested, approved and appropriately regulated.
In summary, the arguments against self-testing are largely based on vague fears with little or no evidence to support them. It would seem sensible to provide increased access to HIV testing in a facilitatory way, encouraging people to access care in a way that suits them, rather than based on a model that encourages unnecessary 'AIDS exceptionalism'38 and fear-mongering. Indeed, self-testing may reach groups that have been traditionally hard to reach with general public health campaigns,39 and would be in line with the spirit of the Patients Rights Charter and the National Health Act, that both encourage people to take responsibility for their own health.
We believe that self-testing should be made widely available in South Africa, and offer the following recommendations to this end:
The current legal and policy framework should be amended to include specific provisions on self-testing kits and to remove all provisions that would prohibit their distribution. Once the South African Health Products Regulatory Authority is in place, a suitable regulatory system for all diagnostic tests, including self-tests for HIV, needs to be created.
The information sheet in a self-testing kit should contain detailed but simple information on HIV testing with an emphasis on explaining the window period and the importance of confirming a positive HIV result at a clinic or hospital where appropriate HIV management could be offered.
Self-testing kits should clearly display the accuracy of the test and emphasise the importance, in unambiguous language, of the need for a confirmatory test of a positive result.
The information sheet in the testing kits should recommend that the user contact a toll-free helpline for counselling and assistance when taking the test. Existing telephone helplines (such as the National AIDS Helpline and LifeLine) should expand their services to include counsellors who have been trained to counsel people who conduct home tests, and can make the necessary referrals.
Clear warnings should be displayed on the pack that it is illegal to test other people for HIV, while providing links to legal support and advice organisations.
The sentiments expressed by the medical establishment, activists and the Department of Health seem poorly thought through, especially when measured against existing practice in areas other than HIV. At present, it would seem that there is no legal impediment to supermarkets selling HIV self-testing kits, but that the GPP prohibits the sale of such tests only in pharmacies, notwithstanding which there is no mechanism in place to regulate the quality and reliability of self-tests; this situation should be addressed urgently.
We believe that the availability of accurate home-based tests will increase access to HIV testing - especially for individuals who have fears about stigma and confidentiality when testing in public facilities - will remove some of the burden of the 'worried well' from the public and private health system, and will encourage regular testing within the general population. It is foreseeable that self-testing would lead to earlier diagnosis of HIV status and earlier enrolment into treatment, and decrease the costs associated with traditional VCT.38 South Africa has reached a point in its AIDS epidemic where individuals should be able to decide when and where they would like to test for HIV, and do so without having to involve anyone else.
1. SAPA. Home Aids tests 'too risky'. IOL 21 January 2010. http://www.iol.co.za/index.php?set_id=1&click_id=125&art_id=nw20100121082307560C274082 (accessed 18 April 2010). [ Links ]
2. Corporate Communication Unit SAMA. SAMA cautions against promotion or use of HIV hometesting kits. Media release 20 January 2010. Pretoria: SAMA, 2010. [ Links ]
3. Mabasa N. SAMA does not endorse HIV home testing kits. SAMA Insider. March 2010:4-5. [ Links ]
4. Maposa S. HIV home tests: more warnings. IOL 22 January 2010. http://www.iol.co.za/index.php?set_id=1&click_id=125&art_id=vn20100122122715218C496722 (accessed 18 April 2010). [ Links ]
5. South African Medical Association. Doctors concerned about Home HIV/AIDS Test Kits. Media release 24 May 2005. Pretoria: SAMA, 2005. [ Links ]
6. National Consumer Forum. Launch of HIV home testing kit delayed by outcry. http://www.ncf.org.za/docs/publications/consumerfair/vol3/launch.htm (accessed 18 April 2010). [ Links ]
7. Office of the United Nations High Commissioner for Human Rights and the Joint United Nations Programme on HIV/AIDS. International Guidelines on HIV/AIDS and Human Rights 2006 Consolidated Version. Geneva: World Health Organization, 2006. [ Links ]
8. Kirby M. The never-ending paradoxes of HIV/AIDS and human rights. African Journal of Human Rights 2004;4(2):163-180. [ Links ]
9. Kirby M. AIDS and the Law. South African Journal on Human Rights 1993; 9(1):1-21. [ Links ]
10. United Nations. The Declaration of Commitment on HIV/AIDS: United Nations General Assembly Special Session on HIV/AIDS; 25-27 June 2001. [ Links ]
11. De Cock KM, Johnson AM. From exceptionalism to normalisation: a reappraisal of attitudes and practice around HIV testing. BMJ (Clinical research ed.) 1998; 316:290-293. [ Links ]
12. UNAIDS. Voluntary Counselling and Testing (VCT). Report No.: UNAIDS Technical update WC 503.6. Geneva: UNAIDS, May 2000. [ Links ]
13. Cameron E. Normalising testing - normalising AIDS. Forum Lecture, Ronald Louw Memorial Campaign: 'Get tested, get treated'. University of KwaZulu-Natal, Durban, 4 May 2006. [ Links ]
14. Bayer R, Fairchild A. Changing the paradigm for HIV testing - the end of exceptionalism. N Engl J Med 2006;355:647-649. [ Links ]
15. Frieden T, Das-Douglas M, Kellerman S, Henning K. Applying public health principles to the HIV epidemic. N Engl J Med 2005;353(22):2397-2402. [ Links ]
16. Macklin R. Scaling up HIV testing: Ethical issues. Health and Human Rights 2005;8(2):27-30. [ Links ]
17. Bayer R, Edington C. HIV testing, human rights, and global AIDS policy: exceptionalism and its discontents. J Health Polit Pol Law 2009;34(3):301-323. [ Links ]
18. WHO. Treat 3 Million by 2005 Initiative. Geneva: World Health Organization, 2003. [ Links ]
19. UNAIDS. Guidance on Provider-initiated HIV Testing and Counselling in Health Facilities. Geneva: World Health Organization, 2007. [ Links ]
20. Leon NH, Colvin CJ, Lewin S, Mathews C, Jennings K. Provider-initiated testing and counselling for HIV - from debate to implementation. S Afr Med J 2010;100(4):220-221. [ Links ]
21. Department of Health. HIV & AIDS and STI Strategic Plan for South Africa 2007-2011. Pretoria: Department of Health, 2007. [ Links ]
22. Department of Health. Clinical Guidelines for the Management of HIV & AIDS in Adults and Adolescents 2010. http://www.doh.gov.za/docs/factsheets/guidelines/adult_art.pdf (accessed 11 April 2010). [ Links ]
23. South African National AIDS Council. Change in Policy Guidelines. April 2010. http://www.sanac.org.za/press-room/in-the-news/change-in-policy-guidelines (accessed 11 April 2010). [ Links ]
24. Matovu JK, Makumbi FE. Expanding access to voluntary HIV counselling and testing in sub-Saharan Africa: alternative approaches for improving uptake, 2001-2007. Trop Med Int Health 2007;12(11):1315-1322. [ Links ]
25. Ganguli I, Bassett IV, Dong KL, Walensky RP. Home testing for HIV infection in resource-limited settings. Current HIV/AIDS Rep 2009;6(4):217-223. [ Links ]
26. Smetherham J. Unemployed Cape Town men paid to take HIV tests. Cape Times 21 April 2009. [ Links ]
27. Merson MH, Feldman EA, Bayer R, Stryker J. Rapid self testing for HIV infection. Lancet 1997;349(9048):352-353. [ Links ]
28. Hicks JM. Home testing: to do or not to do? Clin Chem 1993;39(1):7-8. [ Links ]
29. Schuklenk U, Kleinsmidt A. Rethinking mandatory HIV testing during pregnancy in areas with high HIV prevalence rates: ethical and policy issues. Am J Public Health 2007;97(7):1179-1183. [ Links ]
30. Fleshman M. AIDS prevention in the ranks - UN targets peacekeepers, combatants in war against the disease. Africa Recovery 2001;15(1-2):16-18. [ Links ]
31. Shisana O, Rehle T, Simbayi L, et al. South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2008 -A Turning Tide Among Teenagers? Cape Town: HSRC Press, 2009. [ Links ]
32. President of the Republic of South Africa. Commencement of certain sections of the National Health Act, 2003 (Act No. 61 of 2003). Proclamation notice No. R.20, 2010. Pretoria: Government Gazette No. 33187, 14 May 2010. [ Links ]
33. Minister of Health. National Health Act (61/2003) regulations: Withdrawal of blood from a living person for testing. Government Notice No. R.401. Pretoria: Government Gazette No. 33187, 14 May 2010. [ Links ]
34. Department of Health. National Policy on Testing for HIV. Pretoria: Department of Health, August 2000. [ Links ]
35. La Greca AM, Bearman KJ. Commentary: If 'An apple a day keeps the doctor away,' Why is adherence so darn hard? J Pediatr Psychol 2001;26(5):279-282. [ Links ]
36. The South African Pharmacy Council. Good Pharmacy Practice in South Africa. 3rd ed. Pretoria: The South African Pharmacy Council, 2008. [ Links ]
37. Palles M, Jürgens R. Home testing for HIV: Potential benefits and pitfalls. Canadian HIV/AIDS Policy & Law Newsletter 1996;3(1):19-20. [ Links ]
38. Cameron E. Stigma, human rights, testing and treatment - Time for Action. SA HIV Clinicians' Society Ruben Sher Memorial Lecture 2009. Johannesburg: 26 November 2009. [ Links ]
39. Walensky RP, Paltiel AD. Rapid HIV testing at home: Does it solve a problem or create one? Ann Intern Med 2006;145:459-462. [ Links ]
Marlise Richter is a researcher at the International Centre for Reproductive Health, Department of Obstetrics and Gynaecology, Ghent University, Belgium, and the Forced Migration Studies Programme, University of the Witwatersrand, Johannesburg.
W D Francois Venter is Senior Director of the HIV Management Cluster, Reproductive Health and HIV Research Unit, and Associate Professor of the Department of Medicine, at the University of the Witwatersrand, Johannesburg.
Andy Gray is a senior lecturer in the Department of Therapeutics and Medicines Management at the Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban.
Corresponding author: M Richter (firstname.lastname@example.com)


text:
We can put this knowledge to work for you by creating user interfaces and software tools to automate your process workflow
Workflow Automation
MAYA offers over 25 years of software development experience to help leverage your investment in engineering software tools. As a developer of core products within the Siemens PLM Software family of tools, we're extremely familiar with NX™, Teamcenter®, Solid Edge®, Femap™, and other environments. We can put this knowledge to work for you by creating user interfaces and software tools to automate your process workflow.
Our customers have found that customization of NX™ has helped them:
- Convert CATIA macros to NX Open applications, so you can still benefit from your CATIA customizations when migrating to NX
- Reduce the time spent on individual tasks by more than 50%
- Save up to 70% of time spent on processes
- Standardize global engineering processes by adopting best practices worldwide
We help you automate repetitive tasks and capture, re-use, and apply best practices in your engineering processes. We do this using our skills and experience in software development, support and training.


text:
A Minuet of Galaxies
This troupe of four galaxies, known as Hickson Compact Group 87 (HCG 87), is performing an intricate dance orchestrated by the mutual gravitational forces acting between them. The dance is a slow, graceful minuet, occurring over a time span of hundreds of millions of years.
This Hubble telescope image reveals complex details in the dust lanes of the group's largest galaxy member (HCG 87a), which is actually disk-shaped, but tilted so that we see it nearly edge-on. Both 87a and its elliptically shaped nearest neighbor (87b) have active galactic nuclei, which are believed to harbor black holes that are consuming gas. A third group member, the nearby spiral galaxy 87c, may be undergoing a burst of active star formation. The three galaxies are so close to each other that gravitational forces disrupt their structure and alter their evolution.
Hickson Compact Group 87: A Minuet of Four Galaxies
Image Credit: The Hubble Heritage Team (STScI/AURA/NASA)


text:
Camilo José Vergara: Tracking Time
Harlem/The Book
Harlem/65 East 125th St
Los Angeles/2113 S Central Ave LA
Newark/By Night in Newark
South Bronx/Vyse Avenue
Curriculum Vitae
Camden/Former Camden Free Public Library
Chicago/1117 N Cleveland St
Los Angeles/7316 Broadway
Chicago/4337 West Madison St
South Bronx/Morris Ave S Bronx
South Bronx/E 149th St at Prospect Ave
Los Angeles/10828 S Avalon Blvd L A
Gary/Four Brothers
Chicago/5134 W Madison St
Newark/15th Ave at 7th St
Newark/253 Bergen St
Detroit/Former Michigan Central Station
Camden/North Camden Panorama
Detroit/Former Packard PLant
South Bronx/3339 Third Ave
Camden/Paired Houses
Gary/Former City Methodist Church
About This Project
Harlem/Former Corn Exchange Bank
Detroit/Former Metropolitan Building
Brooklyn/The Other Brooklyn
Los Angeles/By Night in LA
Detroit/Detroit New Architecture
Chicago/4344 West Madison St
Detroit/Former Ransom Gillis Mansion
Detroit/Detroit By Night
MLK Folk Murals
Los Angeles/Skid Row LA
Newark/New at Newark Sts
Camden/Camden by Night
South Bronx/By Night in the Bronx
Los Angeles/7301 S Broadway
Los Angeles/9006 S Compton Ave
Los Angeles/6003 Compton Ave
Los Angeles/4119 Hoover St
Brooklyn/By Night in Brooklyn
Chicago/Robert Taylor Homes, Dearborn St
Newark/Kea's Ark
Gary/Former Train Station
Chicago/By Night In Chicagoland
Newark/View NW from 673 Broad St
Harlem/SW corner of W 125th St at Malcolm X Blvd
By Night In Philadelphia
Old New York 1970-1973
By Night In Baltimore
Crossroads, Selection
Los Angeles/1435 S. Vermont Ave., LA
Los Angeles/1917 S. Central Ave.
World Trade Center 1970-2018:/WTC view along Madison St Manhattan
World Trade Center 1970-2018:/WTC from Exchange Place
World Trade Center 1970-2018:/WTC from Staten Island Ferry
World Trade Center 1970-2018:/WTC from Manhattan Bridge
World Trade Center 1970-2018:/WTC from Williamsburg, Brooklyn
World Trade Center 1970-2018:/WTC from Sumpter St. Brooklyn
World Trade Center 1970-2018:/WTC From Tomkins Houses Roof
Chicago/Cabrini Green, 660 Division St.
Chicago/2700 West Taylor St.
Newark/Woodland Cemetery Entrance
Detroit/6407 Gratiot Ave.
Chicago/1556 S. Pulaski Rd.
Camden/Fern St 1979-2019
Hip Hop Fish and Chicken, 2912 Hartford Rd. by Hugo, Baltimore, 2017
15 of 25


text:
The following crime is from the week of May 19 to May 25, 2013.
May 22. 8400 block Germantown Avenue. Complainant states she put her purse down on seat next to her on bus and a black male grabbed purse and got off bus with her belongings. Someone returned her purse with the following items missing: one HTC cell phone, Kindle notepad and money. Offender, black male, wearing a blue shirt and blue pants.
Summary – One crime for week.
Town Watch.
If you have been the victim of a crime and would like information, service or support, call Northwest Victim Services, 6301 Germantown Ave., Second Floor, Suite One, 215-438-4410. The service is free.


text:
The Band Perry to Pay for Burial of Family Killed in House Fire
The Band Perry are stepping forward to pay for the burial of a mom and eight children who tragically passed away in a house fire in Greenville, Ken. on Thursday (Jan. 30).
The mother, LaRae Watson, and eight of her children, ages 4 to 15, died Thursday, while the father, Chad Watson, and his daughter, 11, survived the fire and are being treated at Vanderbilt University Medical Center. They are in stable condition, according to CNN.
"I don't know why the Band Perry reached out to the family other than they are just very gracious," a friend of the family, Pam Burden, shares. "The family doesn't have any personal connection to the band before now."
Kimberly, Neil and Reid Perry are strangers -- paying for the family's funeral is simply a compassionate act in a deeply sorrowful time.
The country trio's representatives contacted the Watson family, offering to cover all the expenses, including hotel costs for family members staying near Vanderbilt. The Band Perry's publicist, Brian Bumbery, confirmed the band's offer.
The cause of the fire appears to be accidental, as an electric baseboard heater in the bedroom seems to have ignited nearby combustibles.


text:
Alert 2007-36
Subject: Counterfeit Cashier's Checks
Date: June 12, 2007
Description: Sonabank, N.A.
Counterfeit Cashier's Checks of Sonabank, N.A., Clifton Forge, VA
To: Chief Executive Officers of All National Banks; All State Banking Authorities; Chairman, Board of Governors of the Federal Reserve System; Chairman, Federal Deposit Insurance Corporation; Director, Office of Thrift Supervision; Conference of State Bank Supervisors; Deputy Comptrollers (districts); Assistant Deputy Comptrollers; District Counsel; and All Examining Personnel
The above-named bank has reported that counterfeit cashier's checks issued in the bank's name and using a correct routing number of 051409278 are being presented for payment nationwide in connection with a lottery scam.
The counterfeit checks do not resemble the authentic items and may be identified by the following: the instruments are of unknown color, include the bank's name and address under the bank logo in the upper-left corner of the instrument, and contain a 4-digit serial number in the upper-right corner. The words "CASHIER'S CHECK" are located in the top center portion of the check and are enclosed in a box. Similarly, the date information and numerical dollar amount are also enclosed in boxes.
Items presented to date have been made payable in the amount of $2,500.00 and have been dated 05/29/2007. Due to possible variations of appearance, it is suggested that officials of Sonabank, N.A. be contacted to verify authenticity of the bank's cashier's checks if received from an unknown or questionable source.
Correspondence accompanying the counterfeit checks may contain the letterhead of "Heritage Lottery Fund, 28 Vincent Close, Westminster, London, SW1 10BT, UK, Tel: 011447788431299." The letter alerts the recipient that he or she is the winner of an unclaimed prize and instructs the recipient to contact agent Mr. Anthony Wright at 011-44-7908848115 within 14 days to remain eligible to claim the winnings. The letter further states that the enclosed check is to be used "for the payment of tax clearance fees" and that the recipient is to keep all winning information confidential. The letter may be signed by Dame Liz Forgan (Chairperson Heritage Lottery Fund).
For additional information and guidance and to verify the authenticity of Sonabank, N.A.'s cashier's checks, please contact Diane Wilcher, Compliance Officer, 511 Main Street, Clifton Forge, VA 24422, by telephone at (540) 862-4782, by fax at (540) 862-4255, or via e-mail at [email@example.com].
Consumers who receive a counterfeit or fictitious item and associated material should file complaints with the following agencies, as appropriate:
Additional information concerning this matter that you believe should be brought to the attention of the OCC may be forwarded to:
E-mail: firstname.lastname@example.com
For additional information regarding other types of financial fraud, please visit the OCC's anti-fraud resource at: https://www.occ.gov/topics/consumer-protection/fraud-resources/index-fraud-resources.html.
Richard C. Stearns
Related Links


text:
Many of you know me as Captain Smack, that guy who drops acid, sees UFOs, and jerks off with toothpaste (although not usually at the same time). But did you know that I have other talents as well? Oh, yes I do. Hey, I'm not just a pretty face, you know.
In lieu of one of my zany stories or wacky observations, I thought I'd switch it up a little this week and toss out an original Captain Smack recording. That's right, you're about to hear my actual voice, so let's all pause for a moment, take a deep breath, and try not to freak out.
Are you in your happy place yet? Good.
This here's one of my satanic country songs about drugs (actually, all of my songs are satanic country songs about drugs), so get ready for some good 'ol down-home, knee-slappin', deep-fried pickin & grinnin.
And listen up, ladies: now might be a good time to check and make sure the batteries in your vibrators are fully charged, because after hearing The Captain kick out the mother fucking jams, you might need a little something to take the edge off. Sorry, but my music just has that effect on certain women. It's beyond my control.
Oh, and the song is called "I Got High" (what a freaking surprise).
(if the media player isn't working for you, try this)
Have a great weekend, y'all. See ya on the flippity-flop.
Peace out.


text:
Storage Adapters, Controllers, and ICs
The broadest portfolio of highly reliable server storage products in the industry offers the connectivity, performance, and protection to support critical applications. Our SATA and SAS RAID controllers and host bus adapters are in the majority of the world's storage server platforms. Our product portfolio also includes SAS I/O controllers, ROC ICs, and SAS expander ICs delivering high performance, scalability, and high reliability.