Hajj is an essential part of Muslim's faith and all pilgrimsshould aim to be fit throughout this journey. Although medical missions of respective countries takecare of pilgrims health problems Kingdom of Saudi Arabia also provides free healthcare services to allpilgrims' at all holy sites round the clock . It is highly recommended, a general health check-upshould be done for risk stratification, medication adjustmentsbefore traveling. To stay fit during this journey should actually begin atleast two to three months before the actual date of departure as during thisjourney 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 commonlyencountered health problems during Hajj can help a great deal but in no way replacement for seeking properMedical consultation or following advisory on health recommendations for visitors traveling to SaudiArabia for the purposes of Hajj. Personssuffering from chronic diseases like diabetes, high blood pressure, heart,kidney, respiratory, musculoskeletal (spinal, arthritis) etc., disorders shouldget thorough check up done by theirtreating doctors to follow theirinstructions on medications and life style modifications during this journey.Vaccinations not limited to meningitis differ from region to region should befollowed as per Haj committeeinstructions. Pilgrims are required to submit a valid certificate indicatingthat prophylaxis was applied in accordance with methods recommended by WHO atleast few weeks before travel. Some people only obtain certificates and skipactual vaccination ,which is not a goodpractice and can prove fatal. Due to the nature of physical activity, change indietary 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 least4-6 weeks before whether any sort ofintervention is needed or not to perform hassle free Hajj.If your doctor feelsthe 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 usetruss 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 liedown restrict oral intake, and try toseek urgent medical attention. People suffering from piles should follow strictdietary regulation in addition to prescribed medicines. Retention of urineduring hajj rituals can pose a problem for elderly people suffering from prostatic enlargement symptoms ifnot treated properly one may have topray or complete Hajj rituals withcatheter, 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 gallbladder diseases in the laparoscopic era are easy to tackle before travel whilepeople with asymptomatic stones maytravel with some dietary advices toprevent an attack during the journey.Sisters who want to delay their periods to complete hajj rituals should consultgynecologists for usage of such medication without harmful side effects. BewareKSA pharmacopeia differs from ours in many respects, does not allow manymedications or combinations of medicineused here and without local authorized prescription's pharmacy maynot give you medicines so you should carry enough stock to cover the durationof journey along with Medical prescription preferably in generic names and few common medicines like antidiarrheal,antiemetics,antipyretics, carrying medication morethan required amount for personal usemay not be allowed at customs and drug trafficking is a serious offense in theKingdom carries capital punishment.Since temperature at various holy sites differ follow manufacturer'sinstructions to store your medications especially hormones like Insulin etc. Those on dialysis should carrymedical report with latest serology status at least for Hepatitis B, C and HIVto have hemo-dialysis on infection free machines provided to Haj pilgrims freeof cost at all Holy cities. People with diabetes should be extra cautious ofmany health hazards during the Hajj, including but not limited to the 'killertriad': 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 spicyor fast food so as not to suffer from the complications of disease. Upperrespiratory tract infection (Cough,fever, sore throat ,aches and pains )during Hajj pilgrimage due to influenzavirus is a common occurrence, face-masks are recommended at crowded andcongested places, use disposable tissues when coughing or sneezing and disposeof used tissues in a wastebasket. Avoid close contact with people who appearill and avoid sharing their personal belongings. Vaccination against seasonalinfluenza is good preventive measure particularly important for pregnant women,children under 5 years, the elderly, individuals with chronic medical andimmunosuppressive conditions. Allpilgrims are advised to wash hands withsoap and water or a disinfectant, especially after coughing and sneezing, after using toilets, before handling andconsuming food. Don't spit on the floor. It is a hazardous source of infectiontransmission, avoid unnecessary exposureto sun or exerting strenuous physical muscle activity in hot weather, drink lotof 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 informationcard), showing disease, the kind oftreatment, contact information is good practice and one may inform fellow pilgrims in group about your disease andproper 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 theprecautions announced through the Hajj missions by Ministry Of Health and Hajjof Kingdom of Saudi Arabia, adhere to their treating doctor's instructions on life stylemodifications, such as following a certain physical activities and dietary regulations. The address, contact information of the Haj healthmission or your tour operator should be readily available with every pilgrim for contact if you have any questions or healthissues . Wishing you healthy and acceptable Hajj.
(Dr Fiaz Fazili is a Consultant Surgeon and Hospital policy planner for Quality Improvement)
