Stay fit during HAJJ

Hajj is an essential part of Muslim’s faith and all pilgrims should aim to be fit throughout this journey. Although  medical missions of respective countries take care of pilgrims health problems Kingdom of Saudi Arabia also  provides free healthcare services to all pilgrims’ at all holy sites round the clock . It  is highly recommended, a general health check-up should  be done for  risk stratification, medication adjustments before traveling.  To stay fit  during this  journey should actually  begin at least two to three months before the actual date of departure as during this journey your chronic or subclinical health problems  may  get precipitated or  unmasked  deprive or delay  a pilgrim from actually  performing certain Hajj rituals  resulting in great inconvenience  to other group members  and organizers.  Following health tips for commonly encountered health problems during Hajj  can  help a great deal  but in no way replacement for seeking proper Medical consultation or following  advisory on health recommendations for visitors traveling to Saudi Arabia for the purposes of  Hajj. Persons suffering from chronic diseases like diabetes, high blood pressure, heart, kidney, respiratory, musculoskeletal (spinal, arthritis) etc., disorders should get thorough  check up done by their treating doctors to follow  their instructions on medications and life style modifications during this journey. Vaccinations not limited to meningitis differ from region to region should be followed as per  Haj committee instructions. Pilgrims are required to submit a valid certificate indicating that prophylaxis was applied in accordance with methods recommended by WHO at least few weeks before travel. Some people only obtain certificates and skip actual vaccination ,which is not  a good practice and can prove fatal. Due to the nature of physical activity, change in dietary habits sometimes simple surgically correctable  problems like Hernia, piles if not  tackled  appropriately before departure  could pose greater problems later during Haj journey  so let   your doctor assess you  at least 4-6 weeks before whether any  sort of intervention is needed or not  to  perform hassle free Hajj.If your doctor feels the problem  is of trivial in nature, or  due to time constraint can’t be operated  now   people  with hernia should avoid  excessive bending, lifting  heavy weight, cough etc or  may  use truss after consultation with your Doctor. In case pilgrim at any stage  of  journey experiences  sever  pain or prominence at  hernia site he or she should  take rest immediately, preferably lie down  restrict oral intake, and try to seek urgent medical attention. People suffering from piles should follow strict dietary regulation in addition to prescribed medicines. Retention of urine during hajj rituals can pose a problem  for elderly people suffering from  prostatic enlargement symptoms  if not treated properly one  may have to pray or complete  Hajj rituals with catheter, seek Urologist advice before travel. Pain /colic due to stones in, Gall bladder, kidney and ureter are very painful conditions and can get   precipitated, take care about  adequate hydration, diet and  keep pain killers handy. Symptomatic gall bladder diseases in the laparoscopic era are easy to tackle before travel while people with asymptomatic  stones may travel with some dietary advices  to prevent an attack  during the journey. Sisters who want to delay their periods to complete hajj rituals should consult gynecologists for usage of such medication without harmful side effects. Beware KSA pharmacopeia differs from ours in many respects, does not allow many medications  or combinations of medicine used here and  without  local authorized prescription’s pharmacy may not give you medicines so you should carry enough stock to cover the duration of journey along with Medical prescription preferably in generic names and  few common medicines  like antidiarrheal,antiemetics, antipyretics,  carrying medication more than required amount  for personal use may not be allowed at customs and drug trafficking is a serious offense in the Kingdom  carries capital punishment .Since temperature at various holy sites differ follow manufacturer’s instructions to store your medications especially hormones like  Insulin etc. Those on dialysis should carry medical report with latest serology status at least for Hepatitis B, C and HIV to have hemo-dialysis on infection free machines provided to Haj pilgrims free of cost at all Holy cities. People with diabetes should be extra cautious of many health hazards during the Hajj, including but not limited to the ‘killer triad’: hypoglycemia, foot injury and infections, and should  take care not to walk bare foot on hot  roads due to impaired sensation of feet.

Hajis with acid dyspepsia  problems should take antiulcer medications regularly and avoid spicy or  fast  food so as not to suffer from the complications of disease. Upper respiratory tract infection (Cough,fever, sore throat ,aches and pains  )during Hajj pilgrimage due to influenza virus is a common occurrence, face-masks are recommended at crowded and congested places, use disposable tissues when coughing or sneezing and dispose of used tissues in a wastebasket. Avoid close contact with people who appear ill and avoid sharing their personal belongings. Vaccination against seasonal influenza is good preventive measure particularly important for pregnant women, children under 5 years, the elderly, individuals with chronic medical and immunosuppressive conditions.  All pilgrims are advised to  wash hands with soap and water or a disinfectant, especially after coughing and sneezing,  after using toilets, before handling and consuming food. Don’t spit on the floor. It is a hazardous source of infection transmission, avoid  unnecessary exposure to sun or exerting strenuous physical muscle activity in hot weather, drink lot of water and use umbrella so as not to suffer from heat exhaustion symptoms. Food should be kept at safe temperature fresh vegetables and fruit  thoroughly cleaned  and washed before eating. Wearing  health information strap (or the information card),  showing disease, the kind of treatment, contact information is good practice  and one may inform fellow pilgrims in group about your disease and proper medications, so that they can help you when necessity arises. Moreover, we request all pilgrims to read and follow the health advisory and take all the precautions announced through the Hajj missions by Ministry Of Health and Hajj of Kingdom of Saudi Arabia, adhere to their treating  doctor’s instructions on life style modifications, such as following a certain physical activities  and dietary  regulations. The address, contact information of the Haj health mission  or your tour operator   should be  readily available with every  pilgrim  for  contact if you have any questions or health issues . Wishing you healthy and acceptable Hajj.

(Dr Fiaz Fazili is a Consultant Surgeon and  Hospital policy planner   for Quality Improvement)