Abdel is a graphic designer at the University of Khartoum and suffers from a most 21st century aliment: an aching back, due to hours spent hunched over his computer.

Yet to cure his pains, he opts for a technique that has not changed much since the 9th century: Hijama, the traditional cupping technique practiced throughout the Muslim world.

During a visit to Sudan, I had the chance to spend an afternoon with Ahmed and his Hijama healers.

I was in Khartoum to learn about mycetoma, a terrible flesh-eating fungal infection that is endemic in Sudan and for which there is no safe, affordable treatment. In the absence of a cure, patients often go to traditional healers to treat the massive tumor-like infections caused by mycetoma.

Hijama is used therapeutically as a pain reliever for aches.

Healers use herbs and roots but some also cut and burn the affected area. Stories exist of healers crushing battery acid and rubbing it on mycetoma tumors, causing excruciating pain while doing nothing to halt the infection spread up the body.

What I saw was completely different. Hijama is used therapeutically as a pain reliever for aches, pains, migraines. While bloodless ‘cupping’ is well-known around the world, Hijama takes it a step further by draining blood. Yet it is not bloodletting per se – no veins are opened.

Hijama Healers Ahmed (l) and Souma (Moussa) with their cupping tools.

Abdel had kindly invited me to his monthly Hijama session. Instead of holding the session in a marketplace, where my presence would attract too much attention, Abdel had the healers come to us. The healers, brothers Ahmed and Souma Moussa, set up in a traditional Darfur tea hut in a courtyard of the Soba University Campus in Khartoum.

The process starts with a cow horn. Ahmed creates a vacuum on the site of Abdel’s back pain with the horn, drawing the blood to the area.

He swears the technique is the only solution.

As the process starts, a few of Abdel’s colleagues from the University walk by and grimace – one woman shrieks. Abdel is an employee of the medical university and many of his colleagues are not on board with Hijama. He swears the technique is the only solution for his chronic back pain after long work days.

‘This isn’t magic or witchcraft,’ Ahmed Moussa assures me. ‘We’re just removing bad blood.’ The brothers learned their craft from family members in Gezira state, south of Khartoum.

Once he is satisfied with the cupping, Souma then makes several small incisions with a razor blade. Over the next 15 or so minutes, he drains the ‘bad’ blood using the suction cups.

Ahmed demonstrating how to cup with a cow horn.

Professor Ahmed Fahal, a famed surgeon who heads up the Mycetoma Research Centre in Khartoum – the only clinic for mycetoma worldwide – accompanied us as we watched Abdel get his treatment

‘This practice is dangerous,’ Professor Fahal insisted. ‘It can be a very important medium for transmission of infections both for the healer and the patient. Healers really need to wear gloves.’
The healers did not wear gloves though and did not use any chemical disinfectant. They did however use a hunk of rock salt to clean the wounds and Abdel grimaced as it was rubbed against the wound.

He felt a hundred times better.

As the healers start to pack up, I notice Abdel – shirt back on and ready to return to work – is helping to put away suctions cups in a special kit. I take a closer look at the design of the box, which he said was ordered from Saudi Arabia.

Curious packaging.

Lining the box are copies of what seems to be an 18th Century engraving of cupping in Europe. I mention to Abdel that I found it odd that a Hijama kit had European engravings but as he put his shirt on and walked out of the tea hut he didn’t see any irony. He felt a hundred times better. As he had told me a few minutes earlier when the process was over: