Scarce medical care in Karachi drives return of old healing practices

By Tehmina Qureshi

KARACHI, Pakistan, July 1 (News Lens Pakistan) -- Wet cupping, an old healing method using cups to create suction on the skin and an incision to drain the accumulated blood, is becoming popular in Karachi, where medical treatment is expensive and difficult to obtain.

The practice aims to relieve ailments ranging from allergies to migraines to back pain. But improper use of the procedure, also known as "hijama," can spread infection and compound untreated health problems, some say.


Karachi, a city of 20 million, has only four government hospitals -- which serve poorer patients -- and medical staff strikes over late pay and staff and funding shortages are routine. Patients wait for hours for doctors and medicines, if they are available.

As a result, proliferating alternative healing methods are becoming popular because they are cheaper and more widely available.

But untrained practitioners have become a huge problem, said Dr. Hakeem Hannan, vice chancellor of Hamdard University, the only certified institution for practitioners of traditional medicine.


"People with no knowledge of medicine have begun to perform the procedure, which is invasive and, if not performed properly, it can spread worse infections," he said.

For the past year, Hamdard has been offering a monthlong course on hijama for qualified medical doctors. Homeopathic practitioners are not allowed. Hannan said that although the university issues certificates to doctors who complete the hijama course, it does not register their practices.

The course's coordinator, Dr. Asif Iqbal, said seven classes of 5 to 10 hijama practitioners had been certified.

Hannan agreed that during the past few years there has been a mushrooming growth of hijama practitioners, and in the absence of reliable data about them and the procedure, prospective patients could easily fall into the wrong hands

Sheraz Khan is an uncertified hijama practitioner who, after having been cured of migraine attacks with hijama, learned to practice the technique.

He has a diploma in physiotherapy and runs a small clinic in his house. Khan said he did not spend much time learning how to perform hijama.

"I already had basic knowledge of important points of the body. I spent about a week learning how to make cuts properly," he told News Lens Pakistan.


Sheraz now treats about eight patients every day. He said most come for back problems and cervical pain.

A hijama kit, Hannan said, includes six cups of various sizes and a suction pump.

"It is easily available in shops and can also be delivered at home. There are many people openly practicing hijama in their homes without any training. This is dangerous," he said.

Operating an unlicensed health practice is not uncommon in Pakistan, especially Karachi. According Dr. Ali Farhan Razi, chairman of the anti-quackery committee of the Pakistan Medical and Dental Council, about 600,000 unlicensed practitioners operate across Pakistan, and one-third are in Sindh. Between 70,000 and 80,000 practice in Karachi alone.

Dr. Tipu Sultan, president of the Pakistan Medical Association, said there is no scientific evidence to support hijama. Yet, the practice is growing in popularity among practitioners of medicine.

Neurosurgeon Mohammad Imad works at the Civil Hospital Karachi and uses his knowledge of medicine when performing hijama on patients.

"I ask my patients to bring the results of any medical tests such as MRIs or blood profiles they have had done. It gives me a better picture of the nature of disease," he said. "I specifically ask heart patients to have all their test results ready. It makes my job easier because I know where the disease stands."


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