BAGHDAD, Iraq -- Conventional medicine is a mess in Iraq, but business is booming for the Hijamma man.
Doctors have fled the country, and others have been assassinated - a U.N. report says at least 102 have been killed, with 250 more kidnapped. Sunnis are afraid to go to hospitals in Shiite neighborhoods. There hasn't been a new hospital built in Baghdad since 1986.
But in the Inbaryeen district of northern Baghdad, Ammar Mohammed Shubbar's office is crammed with people seeking his help. Shubbar practices the ancient craft of Hijamma, or cupping. In 21st-century Baghdad, this ancient medical skill, long tied to Islamic tradition with a history in Africa and ancient Egypt, has grown more popular out of necessity.
Using small glass-like jars and a surgical knife, Shubbar makes small cuts in one of 123 areas of the body, depending on his patients' complaints: high blood pressure; blood sugar; migraines; back, hand or leg pain; and even some conditions of sterility.
His patients swear by him. "Honestly, all the doctors and their medicine didn't help me much," said Ghazi Salmamn, 51, who suffers from high blood pressure. "I came here. I did the Hijamma, and the second day I really felt better, and there was a great change."
Unlike the practitioners of more traditional medical treatments, Hijamma men like Shubbar aren't heavy on academics. His training has been on the job, starting when he was 15 in the shop that used to be his father's.
Now at the grand age of 23, Shubbar is known to his patients as the sayyed, an honorific reserved for the grandsons of the prophet Muhammad.
He can tell how to begin simply by looking at a person's back. He works from 8 a.m. until 1 p.m. and from 3 p.m. until 7 p.m. One treatment costs the equivalent of about $1.50.
Shubbar's tools are simple: two glasses and a medical knife. When he chooses a spot, he burns a small piece of paper inside one of the glasses and puts it on the man's back (women are permitted to have Hijamma performed on them, but only by other women).
The burning uses up the oxygen in the glass and creates a small vacuum that pulls blood near the skin's surface. After several minutes, he takes off the glasses and uses the knife to slice six to eight small cuts in each spot. The blood, which he calls "spoiled," starts to ooze, and he moves around to other places on the back. He cleans the wounds with an antiseptic and bandages them.
Shubbar said 10 places on the human body offer the best places to work: the head, either side of the neck, two spots in the middle of the back, the lower back and other positions on the legs.
"The man doesn't feel any pain; in fact, he feels better the next day," Shubbar said.
In the United States, his brand of medicine would be considered alternative. But in Baghdad, the threat to medical workers and their patients is so great that modern treatment isn't much of an alternative anymore.
Iraq's Ministry of Health recently reported that the country has lost 720 doctors and health employees since April 9, 2003. Informal statistics estimated that more than 2,000 doctors have left the country. Recognizing the problem, the ministry recently announced that it would allow doctors to open private clinics in state hospitals without paying rent as a way of protecting them.
In addition to the 102 doctors that the U.N. found had been murdered in Iraq from April 2003 to May 31, 2006, 164 nurses have been killed and 77 wounded.
Lack of consistent electricity hampers medical services, as does corruption. Militias and other security forces intimidate medical staff into prioritizing patients who are their members.
The decline in medical care is readily evident on Al Saddon Street in the center of Baghdad. It was once known as Doctors' Street and was filled with doctors' offices and clinics. Iraqis from throughout the country's 18 provinces used to go there to find specialists, many of whom had degrees from Western universities.
After the fall of Saddam Hussein, however, it became an easy venue for kidnappings and assassinations, and now there are few doctors working there.
The rise in sectarian violence has taken its toll as well. People in the Ghazaliya neighborhood in west Baghdad, for instance, no longer go to Al Hakeem hospital in nearby Shula. Ghazaliya is mainly a Sunni neighborhood, and its residents are afraid of being killed or kidnapped if they go to Al Hakeem in Shiite Shula.
"Some armed militia members check IDs and they kidnap any Sunni people," said a 35-year-old man who didn't want his name used because of security reasons. The closest safe hospital is 18 miles away.
So into the void come men such as Shubbar, who's familiar not only with where best to bleed a patient but also when in the month to do it.
The second half of the month is better, especially during what's known as "the white nights" when the moon is full. It's believed that the ebb and flow of the blood is strongly affected by the moon. The best days to do Hijamma are Sundays, Tuesdays and Thursdays. Hijamma isn't done on Wednesdays or on Fridays after midday.
By Mark Brunswick and Laith Hammudi
Hammudi is a special correspondent for McClatchy Newspapers.