Health Challenges for Pilgrims

1. Hygiene And General Cleanliness Tips:
   • Maintaining personal hygiene, bathing regularly, and washing hands well by using water and soap, or other disinfectants used for handwashing, especially after coughing and sneezing.
   • Using handkerchiefs when coughing or sneezing by covering the nose and mouth, and then eliminating them in the trash. In case there are no handkerchiefs at hand, use the upper arms rather than hands.
   • Using a face-mask, especially in crowded places, and changing it every now and then.
   • In case there are no handkerchiefs at hand, use the upper arms, rather than hands, for covering the nose and mouth when coughing or sneezing.
   • Wash your hands well, using water and soap, or the hand-sterilizing gel, especially after bathing, after coughing and sneezing, before eating, and when coming back to your residence.
   • Paying close attention to the oral and dental cleanliness.
   • Eliminating wastes in the trash.
   • Changing cloths with new ones every now and then.
   • Paying close attention to the cleanliness of your residence, on a daily basis.
   • Avoiding spitting on the floor, since it is a hazardous source of infection.
   • Don’t spit on the floor. It is a hazardous source of infection transmission.
   • Face-masks are recommended at crowded and congested places, especially during circumambulation of the Ka’ba (Tawaf), stoning (Rajm), and walking between Safa and Marwa (Sa’i). They should be changed regularly (every six hours), or when dirty, in accordance with the guidelines provided by the manufacturer, along with washing hands with water and soap when taking them off.

2. Shaving And Haircutting Tips: When shaving or haircutting, be sure to follow certain health tips and instructions to protect yourself against such infectious diseases as hepatitis (B) and (C) and AIDS. Such tips include,

• Choose a suitable barber, and never go to street barbers,
• Once-use shavers are recommended. Keep away from all other kinds of shavers, including the ones which have their razors changed after every shave.
• Never share others with such personal tools as the brushes used to remove hair, sponges, etc.
• Ask the barber to wash his hands well (by using water and soap) before shaving or haircutting.
• Remember that using your own shavers, and not sharing others with theirs, is the best way to protect yourself against the infection of hepatitis (B) and (C), and maybe AIDS

3. Protection Against Food Poisoning During Hajj:

• Wash fruits and vegetables well before eating.
  • Verify of the expiry date when buying canned foods and drinks.
  • Keep away from the uncovered food, since it is exposed to insects and pollution.
  • Wash your hands well before and after preparing food.
  • Wash your hands well before and after eating.
  • Cooked food should be eaten immediately after cooking, and, when need to be, it could be kept in the fridge.
  • Avoid storing cooked food in buses for long when moving from on Hajj site to another. This is one of the major triggers of food poisoning during Hajj.
• Remember that storing cooked food for more than two hours in the room/bus temperature may lead to the growing of bacteria causing food poisoning

4. Tips For Protection Against Heat Exhaustion and Sun Strokes:

• Drink enough liquids (water, juices, etc.) regularly.
  • Avoid exposure to the sun for long, and use an umbrella when necessary. Light colored umbrellas are recommended.
  • Avoid making excessive effort, and keep to take sufficient sleep after performing each of the Hajj rituals, so as to restore your energy.
  • Loose, light colored cloths are recommended. Don’t use heavy cloths

Areas of Frequent Heat Injuries: Heat injuries are frequent in these areas:

• Tawaf (circumambulation of the Ka’ba), especially at midday times.
• Sa’i (walking between Safa and Marwa), especially in cases of crowding and high temperature.
• Arafat at midday time.
• Mina (places of slaughtering the sacrificial animals and stoning), due to the long distance and congestion.

On the onset of the signs and symptoms of heat exhaustion or sun strokes (high body temperature, headache, dizziness, nausea, fatigue, thirst, and/or cramping of the abdominal and leg muscles), you should:

– Getting away from the sunny to a shady place.

– Cooling the body by cold water.

– Taking enough sleep.

– Taking antipyretics and painkillers when necessary.

– Heading for the nearest health centers in severe cases

5. Tips For Patients with Chronic Diseases: When performing the Hajj and Umrah rites, pilgrims are vulnerable to the diseases commonly associated with the Hajj season, including:
   • Respiratory diseases.
   • Gastrointestinal (digestive) diseases.
   • Food poisoning.
   • Dermatology (skin diseases)
   • Dry eye.
   • Sun strokes and heat exhaustion
   • Coryza (cold), seasonal influenza and bronchitis. They are transmitted through the droplets of coughing, sneezing or speaking.

Consult with a Doctor before setting out for Hajj, to assess your health situation.

• Take sufficient medications with yourself.
• Take medicines on time.
• Adhere to the doctor’s instructions, such as following a certain diet.
• Put on the wrist strap (or the information card), which shows your name, age, disease, the kind of treatment, address and contact information.
• You’d better tell your fellow pilgrims about your disease and proper medications, so that they can help you when necessity be.
• Avoid making too much effort, and use the Hajj legal concessions (like assigning someone to do the stoning ritual on your behalf), when the conditions of such concessions are true.
• Head for the nearest health center when necessity be.

6. Prevention and Reduction of Spread:

• Putting on face-masks, especially in crowded and congested places, and changing them every now and then, in accordance with the manufacturer’s instructions.
• Using handkerchiefs to cover the nose and mouth when coughing or sneezing, and disposing them in the trash. In case there aren’t handkerchiefs at hand, use, instead, the upper arms rather than the hands.
• Don’t touch your eyes, nose or hands with the hands until after washing them well.
• Greeting others by shaking hands only.
• Don’t drink ice water.
• Keep away from the air conditioner when sweated.
• Take enough sleep, and drink much liquids containing Vitamin C, such as lemonade and orange juice.
• Take antipyretics and painkillers.
• See a doctor on the onset of acute symptoms

7. Tuberculosis : Tuberculosis is one of the diseases that could be easily transmitted during Hajj, because of the overcrowding, and because some pilgrims hail from places stricken by this disease. It is transmitted through the droplets of coughing, sneezing or speaking. Therefore, the Saudi Ministry of Health calls upon tuberculosis patients to put their Hajj off for later years, except in these cases:

• The result of spitting is negative, which indicates the diseases is unlikely to be transmitted.
  • Tuberculosis is unable to resist antibiotics
  • The patient is a strict adherent to the medicine schedule.
• In case you’re suffering from continuing cough for more than two weeks, you have to undergo the necessary tests before traveling for Hajj, to be sure you don’t have tuberculosis.
• Prevention and Reduction of Spread of Tuberculosis during Hajj:
  • Put on a face-mask, especially in crowded and congested places.
  • Keep, as much as possible, away from overcrowded places.
  • Use handkerchiefs to cover the nose and mouth when coughing or sneezing, and disposing them in the trash.
  • Wash your hands well every now and then.
  • Keep your residence always well ventilated.
  • In case there is a fellow Hajj coughing all the time, tell the doctor of your Hajj Mission.
  • In case you have tuberculosis, tell the doctor of you Hajj Mission to follow you up during Hajj.
  • When getting back home, after Hajj, it is advisable to see your doctor to undergo the necessary tests, to ensure that you haven’t been infected with tuberculosis during Hajj.
• Using face-masks, especially in overcrowded places, and changing them every now and then (in accordance with the manufacturer’s instructions) helps protect you from the infectious diseases transmitted through coughing or sneezing.

8. Digestive Diseases: There is a set of diseases affecting the digestive system commonly associated with Hajj, such as diarrhea, constipation, nausea and vomiting. In order to avoid complications, you’d better adhere to the following tips and instructions,

Diarrhea:

• Keep away from fatty foods.
• Verify of the cleanliness of food, and cook it well, and don’t buy foods from street vendors (See the Prevention of Food Poisoning).
• Drink much liquid to avoid dehydration.
• Head for the nearest health center if diarrhea persists

Constipation:

• Eat much fresh fruit and vegetables.
• Drink much liquid.

Nausea and Vomiting:

• Don’t eat and drink too much, especially fatty foods, until nausea and vomiting stop.
• Drink frequently to avoid dehydration.
• See a doctor in case vomiting is severe or persisting.

Food Poisoning during Hajj: Many pilgrims are prone to food poisoning, especially the kind of poisoning caused by salmonella, which leads to acute inflammation in the intestine and colon, and entails such symptoms as stomach ache, headache, high temperature, diarrhea and vomiting

Infection can be transmitted through:

• Negligence of cleaning vegetables before having them.
• Negligence of washing hands before preparing (or having) food.
• Negligence of cooking meat well.
• Drinking unpasteurized milk.
• Eating some foods uncooked (such as eggs), or some foods which contain uncooked eggs as an ingredient (such as mayonnaise), when kept in improper temperature.
• Eating “shawarma” without taking the necessary health precautions. It has been proven as the cause of many injuries

Prevention:

• Wash your hands well before and after eating.
• Wash fruits and vegetables well before having them.
• Avoid keeping cooked food in buses when moving from one Hajj site to another. It is regarded as one of the major causes of food poisoning during Hajj.
• Keep in mind that keeping uncooked food in the room temperature for more than two hours leads to the growing of bacteria causing food poisoning.
• Cooked food should be eaten directly, or kept in the fridge when need be.
• Using pure water for drinking and cooking, and canned mineral water is preferred. In case you’re unsure whether or not the water is pure enough, it should be boiled before use.
• Don’t drink water from taps, or unclean ice cubes.
• Make sure that the milk you’re having is pasteurized. Canned juices are preferred also.
• Verify of the expiry date of products, and be sure that the contents don’t leak.
• Keep damageable foods (such as milk products and tuna) in the fridge, before and after opening cans
• It is advisable to buy automatically packaged foods, and keep away from uncovered foods, or those prepared long time ago.
• Make sure that food is well cooked, to kill bacteria.
• Don’t by foods from street vendors.
• You’d better eat fruits with thick crust, such as bananas and oranges, to be certain that they are clean and uncontaminated.
• Use clean utensils and plates. Paper plates and cups are preferred.
• Remember that when food has a different color or smell, this indicates that the food is spoilt and poisoned

9. Health Tips for Asthma Patients: During Hajj or Umrah, the asthma patient usually encounters an increase in asthma symptoms and dyspnea; and this is due to several reasons of which: being in crowded places fraught with dust and polluted with smoke emitting from vehicle exhausts pipes, excessive strain and continuous movement, and pneumonia which could increase because of the crowd.

Asthma patients are recommended to do the following: 

• Put a bracelet around the wrist with your name and age, and a diagnosis or your disease and prescribed medicines.
• See the respiratory diseases doctor to make sure of the stabilization of your condition and your ability to travel and the steps to take in asthma attacks.
• Take enough quantities of medicines, particularly inhalers
• Before making any physical effort, it is recommended to use a bronchodilator, especially during Tawaf (circumambulation of the Ka’ba) and throwing stones. • Take a great deal of rest repeatedly.
• Avoid overcrowded places in order to prevent any asthma attack.
• Hasten to use an inhaler when you feel symptoms of an asthma attack and head for the nearest health facility or hospital if you encounter a severe asthma attack

10. Health tips for Allergy Patients: In some cases, allergy symptoms may increase due to some materials in the surroundings, such as smokes, dust, foods, chemicals, etc), and affect the skin, eyes, nose, chest (asthma). During the Hajj and Umrah such symptoms may increase because of the congestion, dust and dirt, temperature, car smokes, etc.

Health tips for reducing such health problems:

• Avoid places and times causing allergy, such as direct exposure to the sun and congestion.
• In case of skin/nose and eye allergy: A patient should bring with him proper anti-allergic agents (pills, nasal sprays, or eye drops) in accordance with medical instructions. Allergy is not a serious threat to the pilgrim except in cases of asthma attacks.
• In case of food allergy: In case of an allergic reaction to specific foods, the proper treatment is avoiding such foods

11. Health Tips for Kidney Patients: Recommendations for patients with renal failure, impaired kidney function, and kidney stones:

• See urologist to make sure you are able to perform the Hajj and give you the proper health tips.
• Hold the prescribed medicines and store them in a proper, easily reachable place.
• Adhere to taking the medicines regularly and on time.
• Have fluids and salts according to what is determined by the urologist previously.
• Avoid exposure to the scorching sunlight for long periods to prevent losing the body’s fluids and salts.
• Avoid eating meat to excess in order not to affect the kidney function.
• See the convoy’s doctor or the nearest health center/hospital when any disturbances occur to the body such as gastroenteritis and urinary tract infections.
• Head for the nearest health center or hospital when needed.

Patients with renal failure: Hajj or Umrah could be extremely difficult or even a threat to you unless you are accompanied with a medical convoy, and you previously made arrangements with a hospital to do a renal dialysis.

Patients with kidney stones: It is recommended to drink much fluids and to avoid direct exposure to the sun. You should also perform some rituals after sunset or deputize another person to do it on your behalf as per Islamic legitimate license

12. Nutrition Guidelines: Hajj and Umrah are profound spiritual journeys requiring immense physical energy and mental strength. These pilgrimages involve long hours of worship, walking, and exposure to extreme heat, making it vital to follow a proper nutrition plan during Hajj and Umrahto maintain health, energy, and endurance. A well-balanced diet is crucial to:

• Sustain Energy: Long-lasting energy is essential for completing daily rituals.
• Prevent Dehydration: High temperatures can lead to heat exhaustion and dehydration.
• Boost Immunity: Crowded environments increase the risk of illness, so a strong immune system is essential.
• Support Endurance: A balanced diet enhances stamina and reduces fatigue

Essential Nutrients for Pilgrims:

• Complex Carbohydrates: Whole grains like brown rice, oats, and whole-wheat bread provide sustained energy.
• Proteins: Lean meats, eggs, fish, and legumes help repair muscles and maintain satiety.
• Healthy Fats: Nuts, seeds, and olive oil provide essential fatty acids and promote brain function.
• Water-Rich Fruits: Watermelon, oranges, cucumbers, and apples help maintain hydration.
• Electrolyte Drinks: Coconut water and sports drinks replenish lost salts.
• Yogurt and Lassi: These contain probiotics, aiding digestion and hydration.
• Vitamin C-rich foods: Oranges, strawberries, and bell peppers enhance immunity.
• Ginger and Garlic: Known for their anti-inflammatory properties, they support overall health.
• Dates and Honey: Traditional Islamic foods rich in antioxidants and quick-digesting sugars

Foods to Avoid During Hajj and Umrah:

• Sugary and Processed Foods
• Sodas and candy lead to energy crashes and add no nutritional value.
• Fried and Heavy Foods
• These can cause indigestion and bloating.
• Caffeinated Drinks
• Coffee and tea can dehydrate the body, so limit consumption.

Health and Safety Tips:

• Stay Hydrated: Carry a refillable water bottle and sip water frequently.
• Small, Frequent Meals: Opt for smaller daily portions to maintain energy.
• Personal Hygiene: Wash your hands regularly and avoid uncovered food.
• Prepare Ahead: Pack snacks like nuts and dried fruits for convenience.
• Rest and Recharge: Take breaks between rituals to conserve energy

13. Hajj General Tip:
    • Not to kindle fires inside the tents and to use the places designated for cooking.
    • Not to sleep on the pavements and roadsides for the pilgrims’ safety.
    • Not to get on top of the buses and vehicles.
    • Not to jostle and shove during rush times, as this expose all especially the elderly and women for danger.
    • To adhere to the directives issued by the Ministry of Health and other governmental bodies.
    • To head to the nearest health facility when needed.
    • To use toilet to defecate and urinate in order for the infectious epidemics not to spread.
    • Not to slaughter the sacrifice in places not prepare for that such as the roads and by the tents. Hence, this exposes all for the diseases and odor and slaughtering should be in the designated places

14. Women and Children during Hajj: The Hajj is a hard journey and requires great effort. And woman has their own status during the hajj; they could be pregnant, experience the menstrual period, or suffer because of their physical configuration from excessive hardship.

• MENSTRUAL PERIOD: If the woman to go on the hajj would like to use pms pills in order to perform the hajj rites properly, they should follow the following tips:
  • To consult a gyncaecologist before going on the Hajj with enough time space (7 days at minimum or according to the gyncaecologist’s tips), to make sure of how to take the pills and the proper dose.
  • The goal of these medicines is to stop the blood from coming down; hence woman must make a point of having them at their specific time according to the gyncaecologist’s tips.
  • There are some side effects for such pills of which there are nausea, headache, pains in the breast areas, mood swings, and nervousness.
  • Each woman has their own nature, so they must consult the gyncaecologist to recognize suitable medicines, helping them perform the Hajj rites smoothly and easily.
• PREGNANT WOMEN AND HAJJ: It is recommended postponing the Hajj for the pregnant woman for the following reasons:
  • They could experience some complications such as inflammations or be vulnerable to any infection due to immunodeficiency and overcrowding.
  • They are likely to sustain sun strokes.
  • They are likely be vulnerable to physical exhaustion as a result of walking for long distances, which could lead to the sustaining of contractions in the lower area of the abdomen and backaches.
  • They are likely to sustain physical injuries as a result of the overcrowding, which could lead to complications affecting the pregnancy safety and fetus life.
  • They are likely to sustain severe drought because of not having enough amount of fluids.
• The pregnant should postpone Hajj in the following cases:
  • Preterm birth disease history
  • Early miscarriage cases.
  • Suffering from pregnancy diabetes.
  • Heart and hypertension diseases or kidney patients and others

Health Tips for the Pregnant Woman:

• To consult an obedtrician in order to know if you could go on the Hajj without sustaining any health complications.
• To make sure of consulting the obedtrician if they could be vaccinated against the meningitis and influenza before at least ten days of the Hajj.
• To make sure of bringing all the necessary medicines as enough as all the Hajj period along.
• To make a point of wearing the proper, snug clothes and shoes.
• To have an enough amount of fluids.
• To walk for little period every an hour or two to avoid the venous thrombosis of legs
• To avoid crowding and to choose the proper times to perform the rites.
• When you feel bleeding, abdominal contractions, migraine, or high temperature, you should head to the nearest health center or hospital.
• To avoid any excessive physical effort and apply the legitimate license according to its conditions when necessary such as using the wheel chair during Tawaf (circumambulation) and Sa’i (walking) when feeling strain.

• Infants and Children during the Hajj: It is recommended not to be accompanied by children who are not at puberty during the Hajj for the following reason:
  • Children are more vulnerable to get infected with diseases such as respiratory tract and digestive tract infections, or gastroenteritis.
  • Children are more vulnerable to lose fluids than adults either because of the high temperature or the little water they consume.
  • Exhaustion tires children during the Hajj and could suppress their appetite; hence leading to the loss of the body’s fluids.
  • Children are more vulnerable to get lost because of the overcrowding during the hajj.

Tips the Parents must know when brining their children along: Generally speaking, patents must be interested in making their children adhere to the general health tips during the Hajj and they must specifically be interested in the following:

• Making a point of putting a bracelet around the child’s wrist showing their full name. residence place, telephone number, and the name of the convoy.
• Making sure that the child has taken the main vaccinations.
• It is recommended that the child take Escherichia coli bacterium (Haemophilus influenza) ten days before travelling if it were among the main vaccinations.
• Having fluids to excess to avoid drought.
• Washing hands continuously.
• Making sure of the cleanliness and dryness of the in-between thighs’ area to prevent exfoliations.
• Making sure of the food cleanliness.
• Not bringing children along to overcrowded places as much as possible.
• Wearing face-masks in the overcrowded places.
• It is recommended to see a doctor when any health problems occur such as diarrhea, vomit, and high temperature.

15. Health Tips After Hajj: A considerable number of pilgrims undergo some of the common symptoms after the Hajj such as: strain, muscle pains and aches, headache, cold, laziness, irregular sleep, and complexion-darkening. And such symptoms result from exposure to sunlight beams, excessive movement without adequate fitness, and getting infected with cold and influenza. Here are some advices for pilgrim after returning to their country safely.

• Using handkerchiefs to cover the nose and mouth when sneezing or coughing, then throw them away in the wastepaper basket.
  • Making a point of washing hands repeatedly in a correct way.
  • Taking a great deal of rest and drinking fluids, as this helps you recover, God willing.
  • Taking analgesics when needed.
  • Seeing a doctor when necessary.
  • If you found out during the Hajj that you would suffer from a specific disease such as diabetes or hypertension, make a point of seeing a doctor and taking the necessary steps after returning from the Hajj.