The Hajj is an annual pilgrimage to Mecca in Saudia Arabia, the holiest place on earth for Muslims. This year, it runs from 9 to 14 August. More than two million pilgrims are expected to congregate, making it one of the largest gatherings of humans in the world. Scientific health advice is thin on the ground, so A&E doctor and BBC presenter Saleyha Ahsan offers her views.
How physically fit do you need to be?
To really embrace the journey and help you complete Hajj safely, preparation is key. Spend as much time on physical preparation as you do on spiritual preparation. The former will support the latter.
As soon as you know you are going on Hajj, start spending time on your feet. Being ‘walking fit’ is important. Take the stairs instead of the lift, walk to work or at least some of the way, and do the school run by foot. But don’t worry, there’s no need to embark on marathon-like training.
What about people with pre-existing medical conditions?
Dr Imran Zia, an emergency medicine consultant from London who has worked as a Hajj doctor for 11 years and advises for the Council of British Hajjis UK CBHUK, recommends those with existing health problems carry a document detailing their hospital, consultant, contact information, the name of their conditions, any medication they take, and their NHS number.
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Do I need to wear any special clothing?
Having the right footwear for long days walking in hot, dusty terrain is essential. Sensible walking shoes with socks are a good place to start. Some people opt for rugged terrain sandals which also work. The important thing is to buy them in advance and break them in. Don’t wait until you are in Mecca to take them out of the box. You are just inviting blisters!
All the best prep in the world might still not prevent you getting blisters and walking long distances in the heat will leave you susceptible. Although it is better to leave blisters intact in their own sterile fluid bubble, if walking is painful, speak to a medic. They may opt remove the top layer of skin from a blister, clean and dress the area. Change the dressing daily to avoid infection. If it’s a small blister, cover it with gauze and apply a firm plaster on top. Don’t forget to take oral painkillers to help with the pain.
Heat, moisture, sweat and friction can lead to chafing of the skin on the inner thighs. To prevent it, avoid walking in midday heat and apply petroleum jelly or anti-chafing cream between the upper thighs. If chafed, apply lubrication, take painkillers, and rest. If the area becomes blistered, hot, painful and swollen, seek medical help.
How about vaccinations?
Every pilgrim must have received the meningococcal ACWY vaccine, complete with certificate of immunisation. No one gets into Saudi Arabia for Hajj without it. You can either get this from your GP or a pharmacy. Zia recommends pilgrims should get several other vaccinations. Chances are you may already have some of these, so get an update from your GP. All pilgrims aged 65 or over and those suffering from asthma, COPD, heart, liver or kidney disease, diabetes and HIV, should also be immunised against influenza and pneumococcus.
Are there any special considerations for women?
One of the predominate worries on Hajj for women centres on their period. Certain stages of the pilgrimage require a woman to be period-free. There are several safe, short-term interventions that female pilgrims should discuss with their GP early in their prep.
How do I protect myself against infections?
There’s nothing worse than diarrhoea and vomiting, especially when travelling. Ensure you always eat freshly prepared food and make sure any meat is cooked thoroughly. Avoid street food, salads and uncooked vegetables which may have been washed in contaminated water. Only drink sealed bottled water – ZamZam water is safe to drink. (ZamZam water comes from a holy well in Mecca.)
Overcrowded facilities contribute to the spread of infectious diseases, including the infamous Hajj cough. It affects over 60 per cent of pilgrims and the sound of coughing soon becomes part of the soundtrack of Hajj. Get the flu and pneumonia jabs before you travel and follow simple hygiene measures – wash your hands regularly with hand-cleansing gel, throw tissues in bins after use, and don’t share towels, cutlery or cups.
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What should I do if I get dehydrated?
Despite signage with plenty of water stops, pilgrims still fail to keep hydrated. We need between two to three litres of fluids daily in normal conditions. Walking in high temperatures can lead to significant fluid loss in sweat, which means we need to replace that. Keep a water bottle close at hand and drink small amounts regularly, and always wear plenty of sunscreen. Don’t wait to become thirsty before you drink. Fruit juices can help as they provide fluid, nutrients and sugar.
If you experience headaches, thirst, dizziness, nausea, vomiting or muscle cramps you may be dehydrated. Get into shade, drink water with diluted rehydration salts or diluted fruit juice, and get some rest.
If you are suffering from confusion and agitation, you stop sweating, you have hot and dry skin, and you experience a loss of consciousness, you may be suffering from heat stroke. This is a life-threatening medical emergency and needs immediate hospital attention.
What should I do when I return home?
Most people have nothing more than the Hajj cough to recover from on their return home, but it can take a couple of weeks for the virus to clear.
Some may have aching muscles and feet. If you’ve been on a flight with long periods of immobility, make sure you don’t confuse a swollen, tender, red leg for simple muscular pain. If you notice pain in your calf and the affected leg is bigger than the other, seek immediate medical help as this might be a blood clot. To protect yourself when flying, walk regularly in the plane aisles and do leg exercises when sitting.
A few days of post Hajj recovery will likely mean catching up on sleep, reflecting on what you’ve just achieved, and letting it sink in that you are now officially a Hajji.