What Should You Do Before Traveling to Makkah?
Hajj is one of the five pillars of Islam. Approximately 2 million Muslims go for the Hajj journey each year most of whom come from the belt which stretches from Morocco to Indonesia in the east, and extends north into Kazakhstan and south to Madagascar. A great part of this belt is endemic with communicable and parasitic diseases that affect the health of the Hujjaaj or the pilgrim and those who serve them at the time of Hajj at Makkah and Madinah. As it is known, all of these Hujjaaj gather in certain places at specified times. This can present major health challenges to the Hujjaaj and those in charge of organizing it. In this article, we will shed light on some health issues and present prevention tips anyone going for Hajj should find useful. Only those items pertaining to the Muslims living in the west will be dealt with here.
People who are traveling to Makkah to perform Hajj can be divided into two groups: Healthy People and Chronically ill people.
FIRST CATEGORY: HEALTHY PEOPLE
If you are apparently healthy - you are not currently on any medication for chronic illnesses or you don't have acute medical problem - then, you should observe the following:
A. Immunisation Requirements
Pertinent requirement for the forthcoming Hajj season as issued by the Saudi Arabian Ministry of Health (World Health Organization, Weekly Epidemiological Record, No. 1/2, 2/9 January 1998) are as follows:
MENINGOCOCCAL MENINGITIS
All Hujjaaj, from every country of the world, are requested to produce a certificate of vaccination against meningitis issued not more that 3 years and not less than 10 days before arrival in Jeddah or Madinah. Vaccination has to be carried out as follows:
o Adults and children over the age of 2 years must be given 1 dose of the A/C vaccine; Children between 3 months and 2 years of age must be given 2 doses of the A vaccine with a 3-month interval between the 2 doses.
o There are special requirements for those who are coming from certain countries, like countries in the African meningitis belt. If you are coming directly from these countries or have recently been to them, make sure you comply with the requirements specific to them.
o If the authenticity of the vaccination certificate is felt to be questionable, re-vaccination is to be carried out. Cheek your documents before leaving the health organization that administered your shots.
B. Routine General Health Check-Up
You will be exerting considerable physical effort during Hajj. All Hajj rites (Tawaf, Sa'i, etc.) require a great deal of strength and endurance. The constant crush with hundreds of thousands of other Hujjaj, each trying to perform the same rites at the same time in limited spaces and very hot weather, compounds the demands on your physical conditioning and mental toughness. Although you may be apparently normal, some asymptomatic diseases, might become apparent only with vigorous physical effort. So it is worth visiting your doctor at least one month before traveling to Makkah.
C. You Should Also Know Epidemiological Surveillance
Tight control is usually exercised at entry points and thorough surveillance will be made for those arriving from countries known to have diseases subject to the International Health Regulations, in addition to isolation of suspect cases and surveillance of their contacts. Your doctor will have the necessary information or will be able to access it readily. He may recommend additional immunizations in the light of his knowledge and experience. Be sure to get an official immunization record from your health department. Have your physician fill it out, sign it, and stamp it.
SECOND CATEGORY: CRONICALLY ILL PEOPLE
Hajj is a very stressful endeavor and a worship that requires strenuous physical effort, especially for the diabetic, the elderly and persons with other chronic illnesses.
A. Diabetic Patients
Any diabetic persons traveling for Hajj should: Learn about symptoms and signs of low blood sugar and how it should be treated. They should visit their physician to make sure that their diabetes is under control, bring the necessary medication in proper containers, wear protective diabetic shoes and wear identifying wrist bands. They should also carry a brief medical record and a signed statement from their doctor indicating that they are taking insulin.
Always keep one or more extra bottles of insulin handy, and syringes with you, at all times. A pocket or purse will do, but never leave insulin where it is very hot or below freezing. You can use a thermos-type jar, or you may want to buy a special storage container. Keep unopened insulin in the refrigerator, but do not freeze.
Once opened, insulin may be stored in the refrigerator, for longer life, or at room temperature. If in doubt, check with your doctor about how best to store insulin.
B. High Blood Pressure
Have your blood pressure measured by your health care provider. If your blood pressure is under control (systolic pressure less than 130 and diastolic pressure less than 85) by medicines, then take all medication exactly as prescribed. Be aware that blood pressure rises again if medication is stopped.
C. Other Chronic Diseases
Neither chronic disease nor advanced age is an absolute contra-indication for travel. People suffering from chronic diseases or taking immuno-suppressive medication should seek the advice of their doctors. Drugs and medicines should be kept at hand so as to avoid the risk of an accidental break in medication.
Hot climates can exacerbate diseases of the cardiovascular and digestive systems but may alleviate rheumatic pain and chronic infections of the upper respiratory tract. If you are an asthmatic patient, always keep your inhaler and rescue medicines with you. A person with asthma needs a special plan for overseas travel. Make a checklist to be sure you are ready before you leave.
Contraindications for air travel include cardiac failure, recent strokes, chest pain at rest, rhythm disorders like atrial fibrillation, severe anemia, sickle-cell anemia, acute mental disorders, epilepsy and any serious and acute contagious disease. Passengers with a pacemaker should be made aware of the possibility of induction currents on board (from radar and electronic devices) and should take appropriate precautions. Passengers with rheumatism, arthritis, varicose veins and swollen legs are likely to experience discomfort on long-haul flights. It is particularly important that travelers with a chronic illness obtain information on the medical facilities available in the country to be visited (Saudi Arabia).
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