I’ve compiled a list of physical (medical) states and symptoms for you to review. Don’t worry if you don't know what everything on the list means. In most cases, if you have some-thing to take care of, you'll know it. But do try to familiarize yourself with the kinds of things that might be exposed to or come down with while your on pilgrimage. I've kept in mind your physician while compiling this list. You can show it to him or her on a consultation and together form an appropriate medical strategy for your upcoming Hajj, God willing.
High risk group
People with the following existing problems are at high risks when under-taking Hajj. At the same time these are the people who emotionally and spiritually feel more inclined to make the pilgrimage. Therefore it is imperative that these pilgrims prepare themselves to the utmost while undertaking this sacred but difficult task. Some of them may be at a higher risk than others depending on the severity of their conditions.
For the purpose of risk management the following conditions will be included in the list:
1. Cardiovascular diseases: Coronary artery disease, congestive heart failure, hypertension, peripheral vascular disease.
2. Respiratory diseases: Bronchial asthma, chronic obstructive pulmonary disease and emphysema.
3. Metabolic diseases: Uncontrolled diabetes mellitus, diabetes insipidus and patients with history of thyroid storm and Addisonian crisis.
4. Renal diseases: Chronic renal failure, particularly patients on dialysis.
5. Neurological diseases: History of seizure disorder and cerebrovascular accidents.
2. Heat Exhaustion: Secondary to non-acclimatization, strenuous exercise associated with water depletion (with or without salt depletion)
3. Heat Stroke: Secondary to body's inability to dissipate heat from the body secondary to failure to produce enough sweat. (Heat is lost through evaporation of sweat).
1. Meningococcal Meningitis with W135 strain
2. Hepatitis A and Malaria
3. Hepatitis B and HIV—from use of infected razors or scissors
4. Pneumonia and Tuberculosis
Upper respiratory infections
1. Pharyngitis, Sinusitis
2. Flu-like Illness: Very common and highly contagious but fortunately short lived; need simple measures to treat and prevent the spread
1. Travelers Diarrhea
3. Bacterial or Parasitic Infection: Salmonellosis, shigellosis and amoebiasis
Precautions, prevention and treatment
Preparation and precautions:
Self assessment of financial and physical abilities
Detailed knowledge of medical conditions
Self education about Hajj and participation in group activities
Preparation of a will
List everyday necessities
Last needed over-the-counter medicines for cold, diarrhea, constipation, headache, nausea, and vomiting
List persons or physicians for emergency contacts
Knowing adequate amounts of prescribed medications for existing conditions
Attend or initiate pre-departure mini-camp to teach prospective pilgrims about the rules of Hajj, First Aid, and preventive measures. Education in symptoms of serious conditions, such as dehydration, hypotension, high fever and jaundice
This may vary according to the country departure. Here are the common commendations:
At the country of Departure
1. Flu Vaccine
2. Meningococcal Vaccine
3. Prophylaxis for Malaria
4. Hepatitis A Vaccine
5. Compliance with the health regulations of Saudi Arabia (Your public health specialist can look these up for you)
6. After Reaching Makkah:
7. Maintain strict personal hygiene, good hand washing and wearing mask in anticipated areas of overcrowding (preferred)
8. Avoid unnecessary sun exposure.
9. Use umbrella when possible
10. Avoid strenuous physical activity long walks in sun
11. Wear sun glasses
12. Carry sufficient supply of liquid (preferably water) outside of Haram
Conditions needing urgent professional help
Some things you can self-treat, and some you can't. If you recognize one or more of these six symptoms in yourself or companions, get proper medical attention without delay.
1. High fever with or without rigors and chills
2. Change in mental status
3. Seizure activity
4. Shortness of breath—not responding to simple measure or prescribed medications
5. Chest pain—not responding to nitroglycerine (in case of known heart condition)
6. Vomiting of blood or passing of blood from the rectum or excessive menstrual bleeding
Religion is advice
Hajj is a physical and collective migration of Muslims from all over the globe to visit the Sacred House of Allah, the Ka`bah, in the city of Makkah. But spiritually, it is an emigration to Allah en masse in response to His ancient call. What an august honor for the chosen ones.
Hajj might sound rather difficult and complex. Yet once the intention is made Allah makes it easy on everyone, regard-less of age and physical health.
I know from personal experience (and many of your own friends and colleagues will attest to this), the memory of all the hardship is entirely wiped away with Hajj's completion—along with all your sins. The body will likely be exhausted, but the innocent mind is left with the everlasting memory of the Ka'bah, the Haramain, the refreshing and invigorating effect of Zamzam water, the Sa’y, the sweetness of the recited Qur'an, the ocean of believers, an endless vision of it all before your mind's eye (especially the Ka`bah in Salah), and an innumerable list of the most subtle personal blessings.
You might be surprised at the immense planning, preparation, and coordination by national and international establishments and health organizations to address Hajj health issues and the Hajj experience. Allah knows it and shall reward it according to its intention. But you and I, the individual pilgrims that make up these very special annual Hajj communities—Allah's specially invited guests to His Ancient House-we, most of all, need to do our parts to perform our personal pilgrimage with complete success, to make our Hajj that dream of a lifetime at last come true. Ameen!