He played a major role in the country's struggle for independence from British colonial rule, and was the transitional president of Sudan after the Sudanese October 1964 Revolution.

[9][5][10] During that meeting el-Mahi stated:[10][11] In African psychiatry, one can follow the early start, transformation, maturity and spread of psychiatric knowledge around the world today.

(...) in light of this great continent, will lead us to new perspectives of understanding, where historical, social, economic and cultural factors merge, interact and emerge as an integral part of the concept of mental health.

[1] el-Mahi was a prominent figure in Sudanese literary and intellectual circles who was also deeply involved in promoting education and cultural development in Sudan.

[1] He was deeply influenced by the ideas of pan-Arabism and pan-Africanism, and saw Sudan's future as part of a larger movement for political and cultural liberation across the continent.

[18] el-Mahi was also a collector of historical artefacts, including a large collection of General Gordon's correspondences and personal notes, which he presented to Queen Elizabeth II during the 1965 visit to Sudan.

[22][4] He collected 20 000 items including coins date back to the Alexander the Great era,[1] and 6000 historical documents that now part of the University of Khartoum library.

[10][4][23] el-Mahi was one of the leading figures in this struggle, and his ideas and activism played an important role in shaping the direction of Sudanese nationalism and the broader independence movement.

el-Mahi was critical of the SCP's tactics and ideology, but he also recognised the important role that the party played in the broader struggle for independence.

[24] During the year when his country gained independence, el-Mahi joined the Egyptian Medical Corps as a chief psychiatrist to support the resistance against the 1956 tripartite invasion of Egypt.

[25] During this time, professionals and workers demanded deep socio-economic reforms to strengthen democracy, which led to the victory over the military regime.

[5][28][29] On 8 February 1965, Elizabeth II visited Sudan and met with El Tigani El-Mahi, the President of the Supreme Council at the time.

[31] The Queen and Prince Philip also visited El Obeid, where they were greeted by the province high commissioner, Sayed Suleeman Wagieallah.

The Second Democracy in Sudan refers to a period of time from 1965 to 1969 when political parties returned and competed in elections, which were held by the transitional government in April and May 1965.

During this period, radical professionals and workers demanded socio-economic reforms to strengthen democracy and succeeded in defeating the military regime that had ruled Sudan before.

[37] However, this democratic era was short-lived as a successful coup d'état took place in 1969, led by Colonel Gaafar Nimeiry against the government of President Ismail al-Azhari and Prime Minister.

[37] During that period, el-Mahi remained committed to his vision of Sudanese nationalism and cultural identity, and was critical of many of the policies and practices of the post-independence governments.

He was particularly concerned about issues of regional inequality and the marginalisation of certain groups within Sudanese society, and advocated for a more inclusive and egalitarian approach to governance.