Keep yourself physically fit

Hajj 2023 has begun. The first flight of pilgrims for the Hajj-2023 from Jammu and Kashmir left for Saudi Arabia on June 7. Hajj is an essential part of Muslim’s faith, and all pilgrims should aim to be fit throughout this journey.

When in Makkah or Medina, the pilgrims are required to perform specific rituals at locations in and around the holy city, and maintaining energy and bodily strength during Hajj necessitates that certain safety precautions be taken till all Haj rituals are performed healthily.

   

From walking around the Holy Kaaba – circumambulation seven times – to running between Safa and Marwa, travelling between Mina and Arafat is tiresome, and spending a night under the open sky in Muzdalifah, and crowded Tawaf Al-Ifadah and Tawaf wida, and then travel between Medina and Makkah or vice versa, you need to be physically fit in order to perform the rituals of Hajj in a prescribed righteous way.

Although medical missions of respective countries take care of pilgrim’s health problems, the 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 weeks/ 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.

Good news that Covid threat as pandemic has ended, despite that the Saudi mitigation plan ensured the safety of pilgrims and healthcare workers for Hajj, successfully limited the risk of COVID-19 transmission inside or outside holy sites during previous Haj pilgrimages.

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 Hajj 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 trivial, 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 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’s advice before travel. Pain /colic due to stones in gall bladder, kidney and ureter can get precipitated; take care of the diet and keep pain killers handy.

Heat is a threat to the health and well-being of all pilgrims, take care about adequate hydration. Symptomatic gallbladder diseases in the laparoscopic era are easy to tackle before travel while people with asymptomatic stones may travel with some dietary advice to prevent an attack during the journey.

Sisters who want to delay their periods to complete hajj rituals should consult gynaecologists 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 locally authorized prescription 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’: hypoglycaemia, 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 anti-ulcer 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 lifestyle 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 served as a Consultant Surgeon & have experience of treating Hajis for three decades at King Fahd Hospital, Medina Munawarah, KSA)

Disclaimer: The views and opinions expressed in this article are the personal opinions of the author.

The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.

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