MEDICAL INFORMATION FOR THE PILGRIMS

VACCINATION

Consult Your Doctor 6-8 Weeks Before Departure

He will advise you and arrange vaccinations (some of these can take time to become effective). He can also issue the certificate you need.

Tell your doctor if you are taking your children with you. This is particularly important if they have not had their full course of childhood immunization. Special consideration may have to be given to children who have not been vaccinated against tuberculosis.

Get your doctor’s advice if you have any illness. Take enough supply of your medicine with you.

Four Weeks Before Departure:

• Typhoid Injection – if you have not had it in the last three years. (You can have capsules if you prefer).
• Tetanus Injection – if you have not had it in the last 10 years. If your have never had them, you will need a full course of three.
• Polio Drops – if you have not had them in the last 10 years. If you have never had them, you will need a full course of three.
• Hepatitis A Injection – first dose will give immunity for 1 year. Second dose 6-12 months after the first dose will give immunity for 10 years. In children under 16 years, a junior Injection is available. Dosage – same as adults.
• Meningitis quadrivalent ACWY Vax – if you have not had it in the last 3 years – 5 years.
• Hepatitis B – if your work will involve health care of people.

One Week Before Departure:
• Start taking Malaria tablets if necessary, while abroad and for four weeks after travel.

VERY IMPORTANT
In past years, there were outbreaks of Meningococcal Meningitis W135 infection among the hujjaj. Numerous people had infection and many died. It is now a requirement that the Quadrivalent Meningococcal Polysaccharide Vaccine, which provides protection against A, C, W135, and Y strains, is administered. Saudi authorities have made this a compulsory requirement for HAJJ and UMRAH and you will need a certificate.
 

You can get malaria, if bitten by an infected mosquito, during Haj or Ziarat.

Even if you lived in Africa or Asia you can lose any immunity after a few years. And if your children were born in non-Malarial countries they have no immunity at all. So here’s what to do if you visit a malarial country or even stopover there:

• Ask your doctor about anti-malarial tablets. The dosage and drugs change from time to time according to the strains of mosquitoes present in the country you are visiting.
• Be aware of risks.
• Avoid mosquito bites and carry standby treatment if going to be far from medical facilities.
• Keep arms and legs covered when outdoors after sunset.
• Sleep in screened accommodation or use mosquito nets.

Following this advice could prevent serious illness – particularly in children.
 

HAVE A DENTAL CHECK-UP

See your dentist if you will be away for more than a short time and you have any doubts about your teeth. It may be difficult and expensive to get treatment where you are going.

GENERAL ADVICE
Hujjaj should bear in mind that although Saudi authorities have done and are still doing as much as possible to prevent illness during Haj, it is simply impossible to do it adequately because of the sheer number of people. Mecca is a city of 200,000 people and during Haj, it swells to over a million. Sanitation, water supply and food supply is stretched over the limit. The city appears to be bursting at the seams. The heat is extreme. There is intense overcrowding and a lot of dust. People come from all walks and cultures. Not all of them can or do get appropriate accommodation. In Arafat and Mina, people have to spend time in tents in the deserts. Consequently, hygiene and sanitation becomes Non-Existent. It is therefore very important that people try to maintain the highest possible standard of hygiene. It can NOT be substituted for any amount of injections, immunisations, medicines, vitamins or hospitalisations. It is also very important to take the following precautions and not lax on it even if you have taken immunisation injections or medicines.

WARNING

• For next few years Haj will be during winter months. It can be very cold especially at night. Remember to keep warm. There is a risk of Pneumonia.

• Try and avoid direct heat of the sun by covering yourself adequately, walking in the shade, doing Ahkaams during the evening or night, etc. This way you will prevent heat exhaustion, heat stroke or sunburn.

• Drink plenty of ‘clear’ water. This will prevent you from getting dehydrated (dry), heat stroke or kidney stones. Try and avoid sweet drinks (canned or bottled drinks, and locally brewed fruit juices). Try to drink clean water only, preferably bottled mineral water.

• Do not eat ‘exposed’ foods. This includes foodstuff left exposed, fruits which cannot be peeled and meat on the counter. Try and eat simple food which is self cooked. If food has to be eaten from shops, restrict yourself to food which has been prepared (preferably roasted or fried) in front of you and fruits which look fresh and which can be peeled (bananas, oranges, etc.). Avoid grapes, peaches, plums, exposed dates, fresh dates, etc.

REMEMBER VACCINATIONS ARE NOT ENOUGH TO PREVENT DISEASES
Besides them:

• Take plenty of salt tablets and start taking them as soon as you arrive in Jeddah. If you cannot get these tablets, common salt (two tea spoonfuls) is adequate per day. This will prevent you from losing too much salt through your sweat and making you feel very weak.

• Take something to soothe your throat since sore throats are very common.

• Take something to help your cough, constipation or diarrhoea.

• Get small supplies of medicines from your doctor for your own use while you are away. Ask your doctor for details.
 

GUIDANCE FOR WOMEN IN PREPARATION FOR HAJ & ZIARAT

If you feel that you are going to menstruate during Haj, then is it better to postpone your menstrual period. To achieve this you must plan to control your menstrual cycle one month in advance. Please follow these instructions carefully:

• On the first day of your last menstrual period commence a contraceptive pill. You may choose from the following – Microgynon 30, Brevinor, Ovysmen, Marvelon and Ovranette. (If for medical reasons you can not take the contraceptive pill, then start taking Norethesteron 5mg tablets three times a days 2 days before expected period, continue taking them for as long as you want to postpone your period. Menstruation will resume 2 days after stopping).

You must consult your doctor (General Practitioner) before commencing the pill.

• Continue with the pill throughout the duration of the pilgrimage.

• Consult your doctor (GP) and ask for a supply of Norethesteron (Primolet N) 5 mg tablets. Take one tablet three times a day if bleeding commences.

• Other drugs such as Provera, Danazol (Danol), etc. may be prescribed by your doctor and may be effective in stopping bleeding.

IMPORTANT: On completion of the pilgrimage STOP your contraceptive pill and you will experience a normal period. Your normal cycle will resume.
 

• Sore Throat: Avoid cold drinks, over-crowding, dust, contact with other people with sore throats or cough.

• Chest Infection: Avoid dust, overcrowding and contact with other people with sore throats or coughs.

• Heat Exhaustion: (Muscle weakness due to loss of body salt) – Avoid direct heat from the sun. Drink plenty of water and take salt tablets.

• Heat Stroke: Avoid direct heat from the sun. Get medical help immediately. THIS IS AN EMERGENCY.

• Cholera: Caught by contaminated water or food. Vaccination does not give protection. Take scrupulous care over food and drink.

• Infectious Hepatitis (Jaundice): There is a high risk of this disease in Haj and Ziarat because of poor sanitation. It is caught by consuming contaminated food or water or contact with an infected person. Take scrupulous care over food, drink and hygiene. Get yourself vaccinated. (Vaccine lasts 1 year or 10 years depending on dose taken).

• Malaria: Caught by a bite from an infected mosquito. Take anti-malaria tablets. Avoid mosquito bites.

• Polio: Caught by direct contact with infected person. Take scrupulous care over food and drink. Get yourself vaccinated.
• Tetanus: Risk areas are places where medical facilities are not available. It is caught by open injury. Wash any wound thoroughly. Get yourself vaccinated.

• Typhoid: Caught by contaminated food, water or milk. Take scrupulous care over food and drink. Get yourself vaccinated. (Vaccine lasts three years).

• Meningitis: Caught by contact with an infected person. This is a very serious condition and potentially fatal. Get yourself vaccinated. (Vaccine lasts 3-5 years).
 

Other Useful Information

• Haj is at times difficult and quite taxing to the human body. Therefore, try and fulfil it while you are young. Do not take children, frail old people or ill people to Haj.

• Hospitals (there are five to six small hospitals in Mecca) are overcrowded. Take health precautions rigidly since the treatment in the hospitals is not up to standard because of extreme overcrowding.

• Have a small first aid kit with you, containing adhesive dressings, some insect repellent and antiseptic creams and water sterilisation tablets.

• Make sure drinking water, and the water you use for cleaning your teeth and washing your mouth is clean. Unless you know it is safe, (bottled water usually is) sterilise your drinking water. You can do this by boiling your water or by using sterilisation tablets. Milk should be boiled, before use unless it is pasteurised or sterilised.

• Be careful with these foods:- raw vegetables, salads and unpeeled fruits, raw shellfish, cream, ice-cream, ice cubes, underdone meat or fish, uncooked, cold or reheated food. They are best avoided.

• Personal hygiene is vital. Always wash your hands before eating or handling food.

• When you return home, if you become ill, tell your doctor where you have been.

• If in doubt, get in touch with the doctors at Medical Advisory Board of World Federation in Birmingham.

REMEMBER for Hujjaj from the West: To avoid heat exhaustion (muscle weakness) please take salt tablets daily.
 

Economy Class Syndrome or Travellers’ Thrombosis

Recent studies show that long-distance travel may increase the risk of developing deep vein thrombosis (DVT) in travellers.

Most people with existing medical conditions can fly without concern. However, passengers who suffer from heart disease, lung disease, cancer, or have previous or a family history of DVT, are recommended to seek advice from their GP prior to flying. Other risk factors include hormone treatment, recent surgery, recent trauma involving lower limbs and any abnormalities of blood clotting factors.

Please be assured that most people who fly will experience a degree of swelling in the feet and ankles, but the more you move your feet up and down the less is the swelling. Research indicates that DVT stems from sitting immobile for long periods, whether in a plane, bus or car. Although the real risk of DVT remains low, the medical profession believes that by following a few simple guidelines you will almost certainly prevent the development of even minor blood clots.

DVT Guidelines
• Purchase a pair of elastic compression stockings to wear for the duration of the flight.
• Wear loose and baggy clothing during the flight.
• Drink plenty of non-alcoholic fluids to prevent dehydration.
• Stand up in the seat area and stretch arms and legs every couple of hours.
• Avoid crossing legs when seated.
• Carry out foot and leg exercises frequently.
• Walk around the cabin as often as possible.
• Carry-on luggage should not be kept in a position that would interfere with the mobility of your legs. As well, a cushion should be used on the seat if it is very hard.
• If you can take aspirin, have one tablet on the morning of travel. Please consult your GP first.
 

HEAT STROKE IS A KILLER!

Between March and August, the weather in Saudi Arabia is extremely hot. Temperatures can go up to 55 degrees centigrade. There is a serious risk of heat stroke. The signs and symptoms to look for:
• Feeling of extreme heat.
• Body temperature rising rapidly.
• Feeling of drowsiness.
• Unconsciousness.
• Epileptic fits.

What To Do:
• Take the person into the shade.
• Take their clothes off.
• Spray body with cool water and fan it.
• Get medical help urgently.

How To Avoid Heat Stroke:
• As far as possible, avoid direct heat from the sun.
• Remain in the shade.
• Go out during evenings and nights.
• Keep your body cool by drinking plenty of water.
• When you have to go out in the sun cover your body completely with clothes. Cover your head so that only your eyes and nose are exposed.
 

Essentials of First Aid

• Act quickly, quietly and methodically, giving priority to the most urgent conditions.

• If breathing has stopped, clear the throat and mouth. If necessary, start emergency resuscitation.

• Control bleeding.

• Give reassurance and encouragement to the patient.

• Position the patient correctly - in coma position.

• Do not allow people to crowd round.

• Do not give anything by mouth to a casualty who is unconscious, who has internal injury or who may shortly need an anaesthetic for an operation.

• As soon as possible arrange to call for an ambulance or doctor.

• Reduce any further danger to the casualty or to yourself. e.g.
Road Accident: Instruct someone to control the traffic.
Electrocution (Electric Shock): Switch of the current; take necessary precautions against further electric shock.
Fire and collapsing building: Move the casualty to safety away from the building or tent.
Gas and Poisonous fumes: Turn off at source. Remove casualty to fresh air.

• Go with the casualty or give written or verbal message to the ambulance driver or doctor regarding the circumstances of the accident or illness and the treatment given.
 

Some Common Emergencies

Essential Tips

• Bleeding Wounds:
1. Apply direct pressure to the bleeding wound point or points for 10 - 15
minutes.
2. Lower the head position if possible.
3. Apply a dressing and firm bandage, but not too tight.

• Bone Fracture:
Steady and support the injured part at once to prevent further damage. Do not allow any movement - use bandages or sticks for this purpose.

• Fainting:
     1. Lay the patient on the floor or bed in fresh air or if not possible then sit him down and lower his head between his knees.
     2. Loosen clothing at the neck, chest and waist.
     3. Reassure and urge to breathe deeply, to move the muscles of the legs thighs and buttocks to help the circulation of the blood.
     4. On recovery, sips of water may be given.
 

Useful Contact Details