Health Guidelines For Hajj And Umrah - (to be continued )

As a prophylaxis and also as treatment in some cases, a cheap
anti-fungal in the form of a generic anti-fungal can be useful. More
expensive preparations, which are cosmetically better, are available
and may be in a spray or powder form. The spray and powder form can be
used inside shoes and sandles where the fungus may still be present.
Treatment must start well before departure so that the infection can
be treated adequately.
Only prophylactic treatment may then be needed. Treat fungal
infections well before departure to prevent complications.
Diabetics
Tea ordered from a take-away place may have sugar added to it.
Fruit juices that are made in take-away places have large amounts of
sugar added to them to make the juice taste sweet. It is not wise to
assume that the fruit juice that is available has not had sugar added
to it. Please read labels of fruit juice containers to make sure
whether sugar is added or not.
Diabetics must make sure that no sugar is added. Fruit juices are
plentiful and extremely tempting.
Please make sure that diabetic control is at its optimum. Together
with a Doctor's help optimal diabetic control should start at least
two months before departure to make sure that control is good and the
correct medication is taken. Take your glucose monitor (glucometer)
with you and enough strips to last you for the duration of your stay.
Test your glucose level regularly and write down the results. This
becomes important if a Doctor needs to be consulted.
A proper diabetic diet is very important. Some people would have their
food included in their accommodation package. The hotels provide food
for many people who do not have special dietary requirements.
Diabetics should make their own arrangements where possible, e.g., use
brown bread which can be bought easily instead of the tempting
white-flour rolls or bread that may be on offer, or the abundant white
rice that may be prepared.
Diabetics must take extra care of their feet. Treat scratches and even
tiny cuts and fungal infections promptly with an antibiotic cream like
Bactroban until they heal.
Apply extra moisturiser to keep the skin supple and elastic.
Urea-based moisturizers are the best.
Care of nails on feet is also important. Remember that open sandals
will be worn for the duration of Hajj. Nails should be well trimmed
and not "catch" on clothes.
When walking, allow enough space in front so that feet are not
trampled. If a fidgety or panicky person is in front of you, move to
another place.
Complications from wounds can easily arise in diabetics resulting in
unnecessary pain and discomfort and a possibility of missing Hajj.
Following a diabetic diet is very important always but especially
before and during Hajj. Correct medication and good control must be
maintained throughout your stay. Take your glucose monitor with you
with enough test strips to last you for the duration of your stay.
High Blood Pressure
High blood pressure must be well controlled. Start at least three
months before departure. Visit your Doctor regularly so that if a
change in medication is necessary, it can be introduced and
established before your departure. It is not enough to have your blood
pressure checked at a Pharmacy or a nursing sister. Your whole body
would need to be checked.
Have your blood pressure checked regularly whilst you are there.
Gout
Those who suffer from gout must make sure that they continue their
preventative medication. They should also take with them a supply of
medicines that usually helps them during an attack of gout. Gout
usually affects the feet causing swelling and severe pain.
Asthma
Those who suffer from asthma must ensure that their asthma is well
controlled with preventative medications. Good control must be
achieved before departure. Adequate supplies of medications must be
taken, especially preventative medications, broncho-dilator inhalers
and tablets.
If well controlled, asthma should not pose a problem during Hajj and Umrah.
Both Makkah and Medinahhave a dry climate. There is very little pollen
in the air. Due to the dry climate, house dust mite population is also
low. Cockroach allergy may cause a problem for those who are allergic
to cockroach droppings. Those with hyper-reactive airways sensitive to
other pollutants should ensure that they control their asthma well.
Asthmatics must seek medical attention as soon as their normal
medication stops helping them.
Good asthma control is essential for a hassle-free Hajj and Umrah.
Itchy conditions of the skin
People who suffer from skin conditions which cause intense itching,
e.g., eczema, lichen planus, psoriasis, etc., are advised to visit
their doctor to bring their condition under control to their best
ability well before departure. Medications, both tablets and creams
can be taken to stop the itching for the duration of the state of
Ihraam.
Moisturizers must be used liberally throughout the stay in the Holy
land, especially during Hajj. Make sure that the moisturizers do not
contain perfumes as perfumes are not allowed whilst in the state of
Ihraam.
Moisturizers have different strengths of oil in them. This affects
their ability to moisturize. The more the oil content, the more the
ability to moisturize. If a moisturizer is not moisturizing
adequately, then a "stronger" one is necessary.
Going from weak to strong, the following is a guide:
Aqueous cream – Cream E45 – Vaseline – Nutraderm – Nutraderm Plus – Heal balm.
For itchy conditions of the skin, moisturize, moisturize, moisturize.
Dental Care
There is nothing worse than having pain during Hajj. It can take all
your energy and concentration away. A toothache is one such condition
that can cause intense pain. To find a dentist during the Hajj period
will be very difficult. A dental check is essential well before
departure to make sure that all the teeth and gums are normal. If you
are unfortunate enough to suffer a toothache whilst you are there, a
course of a broad spectrum antibiotic will help the pain until you can
have it attended to after Hajj, Insha-Allah.
Have a dental check before departure to make sure that your teeth and
gums are all in order.
Eye care
People who have an eye problem, e.g., glaucoma, must make sure that
they take enough medication with them.
Those people who need reading glasses and those that cannot see well
without glasses should take a spare set of spectacles with them. If
your glasses break for some reason or is lost, it will not be possible
to find another suitable pair.
The white marble around the Haramain shine brilliantly in sunshine. It
can be over-whelming. Sun glasses can be used for those with sensitive
eyes.
PROBLEMS THAT MAY ARISE
The Prevention of Infections
In situations where there are crowds of people, infections are bound
to spread. Germs spread by droplets from our mouth as we speak or when
we cough or sneeze especially if phlegm is present, or by direct
contact as in kissing or sharing a cup, spoon, fork, etc.
Germs also spread via the faecal-oral route, as in the case of
diarrhoea or gastro-enteritis and hepatitis A. Protect children, as
they are the ones who come closest to us. Cover your mouth before you
cough so as not to spread the infection further. The unhygienic act of
spitting phlegm onto the pavement is a sure way of spreading germs!
Signs that show that spitting on floors is prohibited are stuck on
walls in all Muassasah's offices. Large open bins are situated in
strategic places for those that want to spit. Rather there than on the
floor.
Thorough washing of hands with soap helps tremendously in preventing
the spread of infections.
Avoid close contact with people who are ill. Visit them by all means
but keep your distance. Spend as little time as possible with the ill
person.
Use a mask if necessary.
If you are ill and are fortunate enough to have a visitor, protect
your visitor by staying a fair distance away. Avoid close contact and
tell visitors that the illness may be contagious.
People who are ill should try not to mix with people who are well. In
this way, the illness can be contained.
If you suffer from any condition which results in decreased immunity,
e.g., following chemo-therapy, please use a mask. Avoid people who are
ill. Avoid crowded conditions.
If you need an antibiotic, please consult a Doctor there to get the
most appropriate antibiotic at the correct dose.
Diarrhoea and vomiting
If one has diarrhoea, one must drink extra fluids, preferably oral
re-hydrating fluids, like hydrol or rehidrate, which are easily
available there. Try not to take any medication to stop the diarrhoea
unless one is having very frequent diarrhoea (more than 6 times in 12
hours for an adult is a reasonable guide). In this case, one may take
either lomotil or Imodium or their generic equivalents as directed in
the package insert. These are easily available in Saudi Arabia.
Diarrhoea is a method by which the body is trying to get rid of the
germs. By stopping it, one may be helping the germs to stay in the
body causing one to become more ill. Stomach cramps can occur.
Anti-spasmodic agents such as buscopan can be used for pain relief. If
there is appetite loss, the forced intake of food may cause the person
to become more ill. If an appetite is present, one may eat food, but
take in carbohydrates, fruit and vegetables only. Avoid protein foods
such as meat, chicken, fish, eggs, dairy products and fried and fatty
foods for the first 48 hours. Then, a normal diet may be resumed.
The fruit bought may have insecticides or pesticides sprayed on them.
Thorough washing of the fruit before eating must be done to minimize
infection. Peel the fruit to be safer. Fruit that need to be peeled
are safer e.g., oranges, mandarins, bananas, etc.
When diarrhoea and vomiting are present, drink extra fluids preferably
with electrolytes.
Constipation
Due to a change in the diet and the hot weather resulting in water
depletion, constipation can be a real problem. Constipation may result
in haemorrhoids and fissures. These may result in bleeding.
Constipation, haemorrhoids and fissures can be very distressing. It
can affect normal activities resulting in loss of valuable time in
Makkah and Medinah.
Maintaining a high fibre diet, e.g., a high fibre breakfast cereal,
wholemeal bread, dried fruit like prunes and apricots, drinking
adequate amounts of water can avoid constipation.
To avoid constipation, eat a high fibre diet and drink adequate
amounts of liquids.
Skin Care
Because of the harsh, dry conditions that can be encountered, dryness
of the skin can become a problem.
Saudi Arabia, being in the Northern Hemisphere has its winter when the
southern hemisphere is having its summer. Hence, those people
travelling from the southern hemisphere are confronted by a big change
in the external environment.
Going from a humid climate to dry conditions will have a major effect
on the skin. The skin will not have the time necessary to acclimatise.
Cracking of the skin is common. If this happens on the feet, it can
cause deep fissures resulting in pain and discomfort with the
possibility of infection developing. This is especially important for
diabetics.
A good moisturizer applied two or three times a day starting as soon
as possible after arrival in Saudi Arabia will help the skin retain
moisture and slowly acclimatise. The moisturizer need not be
expensive. A good heel balm would be ideal. To allow the feet to
retain the moisture in the skin, it may be necessary to wear a pair of
socks to avoid the evaporation of water. Extra care should be paid to
the feet, as performing Hajj with painful feet would add an
unnecessary burden. A suitable heel balm will also help to smoothen
out the thick skin around the heels.
Good care must be taken of the skin, especially the skin on the feet.
Scafing or scuffing of the inner thigh and scrotum
As men are not allowed to wear underwear, inflammation of the skin on
the inner side of the thigh and scrotum can occur especially if the
person is over-weight. The sweat and the rubbing of the thighs and
scrotum during walking can cause a very painful rash and excoriation
of the skin in this area.
To prevent this condition, men are advised to use vaseline or any
other non-perfumed moisturiser liberally to the inner side of the
thighs frequently throughout the state of Ihraam. If this problem does
occur, a mild steroid cream will help in soothing the area until
healing takes place, Insha-Allah.
Prevention is better than cure.
Swelling of feet
Due to the intense heat, it is not uncommon for the feet to swell. In
healthy people, this is transient and is due to the dilatation of
blood vessels in the lower limbs from the heat. As the body
acclimatises to the hot conditions, the swelling should subside, Insha
Allah. If one suffers from any illness, especially heart disease,
diabetes or high blood pressure, then one should seek the advice of a
Doctor. Acclimatisation usually takes about 5 to 7 days. Those that
spend a short time in Saudi Arabia before Hajj may find their feet
swollen during Hajj. Not much can be done about this as the body needs
time to adjust.
It would help to elevate the legs at every opportunity so that the
dependent fluid in the feet can go back into the circulation.
Medicines
Most medicines that we find here are obtainable in Saudi Arabia. Take
adequate and extra amounts of the usual medicines that you need in
case departure from Saudi Arabia is for some reason delayed. These
would include medications for High blood pressure, Diabetes, Heart
Disease, Glaucoma, raised cholesterol, etc. Besides the usual
medicines taken, one may take small quantities of a pain killer such
as panado or suncodin and whatever else one may feel is needed.
Codiene-containing preparations are not available in Saudi Arabia as
codeine is addictive. Pharmacies in Saudi Arabia do not require
prescriptions for medications that usually require control here. This
is done to make medication easily accessible to the millions of people
that come there without the need to look for a doctor. The pharmacists
are usually very helpful and will give you whatever you need. Take a
presctription of your medications from your Doctor to make it easier
for the Pharmacist there. Do not hesitate to take the advise of a
Doctor or a Pharmacist who may be traveling with you.
The Holy Mosques in Makkah and Medina have extensive marble floors
inside and outside. When the smooth marble is wet, as after rain or
after washing, it becomes very slippery. Walking on slippery floors
must be done with extra care as slipping and falling hard onto the
marble can cause some serious injury to the back, hips, elbows and
wrists.
Fractures usually result from these falls.
Take extra care when walking on wet marble floors in and around the Haramain.
THE FIVE DAYS OF HAJJ
We must not lose sight of the primary aim of our journey and that is
to perform Hajj. We can become engrossed in daily activities in Makkah
and Medinah without realising the closeness of Hajj. The whole purpose
of our journey is to perform Hajj. We must therefore be physically and
spiritually ready to undertake the Pilgrimage.
If you are ill, get adequate treatment so that you can recover well
before Hajj actually starts. If you are not ill, make sure that you
look after yourself so that you do not become ill, e.g., avoid coming
too close to people who are ill, dress adequately so that you do not
get cold or wet if it rains. exercise your body to keep well in peak
condition. Take special care of your skin and your feet. Try out your
footwear to make sure they fit. Walk with them for a few days or all
the time to "break" them in and allow your feet to become accustomed
to the footwear.
Have a positive attitude during this time. You are a guest of Allah
Ta'ala. Look forward to going out of Makkah to show Allah Ta'ala that
you would prove to Him that you are worthy of returning to Makkah for
Tawaful Ziyarah, that you reject Shaitaan with enthusiasm and contempt
and not return to the ways of Shaitaan. It would be more productive to
go out there and perform the rituals with enthusiasm. A positive
attitude towards helping other pilgrims in whichever way possible can
help you to have a very fulfilling Hajj, Insha-Allah. Please help out
in which ever way you can and don't expect things to be done for you
by others.
DURING HAJJ
Spend ALL your time in Ibadaat. The time in Mina is mainly for
reflection, on your life so far and on Allah Ta'ala, on Zikr and
reading appropriate parts of the Quran.
The Day of Arafat is the most important day of Hajj. Use it to the
maximum. You may not get another chance. Take full advantage of
standing outside during Waquf to tell Allah Ta'ala how Great He is and
to thank Him for all that He has done for you and your family and
friends.
Ask Him for whatever your needs are with humility and confidence. If
you have prepared well, standing in the hot sun for two to three hours
would not be a difficult task Insha Allah.
Please remember to take your medications on time. If you are on a
diet, stay strictly on the diet. This is not the time to get sick
because you did not take your medication or follow your diet. Besides
compromising your own Hajj, you may inconvenience other Hajees.
Do not over eat. Eat small meals, take adequate liquids
Do not rush to stone the Shaitaan. This must be done deliberately with
a lot of emotion. Wait for a suitable opportunity. Stand at a safe
spot and observe the scene. Do not rush into the crowd. Insha-Allah, a
suitable opportunity will present itself. Women should be protected
from the pushing. There can be a lot of pushing. Please do not push as
it worsens the situation. If you lose your footwear and if it is very
crowded with people pushing and shoving, leave your footwear. Do not
try looking for your footwear in the crowd. A little push can throw
you to the ground. People can get trampled in this rush.
If an injury is sustained on the feet, treat it well with an
antiseptic such as savlon regularly and apply Mercurochrome or a
suitable antiseptic cream if the wound is deeper until medical help is
available. Do not ignore it as Hajj is yet incomplete. There is still
Tawaful Ziyarah to be done sometimes under very trying conditions.
There is no need to rush. Insha-Allah, there will be plenty of time to
complete Hajj.
Pharmacies are available at Mina during Hajj.
IMMUNISATIONS
Yellow Fever Immunisation is recommended only for people traveling
through Africa. South Africa is not regarded as a yellow fever endemic
area. Therefore, South Africans traveling straight to Saudi Arabia
need not take yellow fever immunization. However, some airlines
travelling from South Africa to Saudi Arabia make an unscheduled stop
in Central Africa, usually Nairobi. If this happens, then Yellow Fever
Immunisation becomes necessary. Therefore, it would be advisable to
take the Yellow Fever Immunisation. This vaccine lasts 10 years.
Menningo-coccal meningitis vaccine (4 strain – A,C,W135,L- only) is
also recommended and required by the Saudi authorities as this
infection can be picked up from fellow travelers. This is compulsory
for everyone above 2 years old.
This vaccine lasts for 3 years.
Menningo-coccal meningitis can be carried by people who have been
vaccinated. To prevent pilgrims from taking the germ home where it can
infect other people, all pilgrims are required to take one dose of
CIPROBAY 500mg before departure (GENERIC AVAILABLE). This can be
obtained from a pharmacy. The tablets are purchased in packs of ten
tablets.
Hepatitis A is an infection of the liver resulting in jaundice. It is
transmitted via the faecal-oral route by infected food from infected
food handlers. The incubation period is 2 to 3 weeks from the time of
contact. It can be a serious illness. Hepatitis A vaccine can be taken
at least two weeks before departure. Immunity derived from this
vaccine can last up to two years. If a booster vaccine is taken after
six months, the immunity to hepatitis A will last 10 years. This
vaccine is optional.
It is recommended that the Influenza vaccine be taken by all pilgrims
before departure for Hajj. Influenza spreads very fast in the crowded
situations. This is most important for the elderly, and for people who
have chronic illnesses like asthma, diabetes, etc.
Immunisations can have side effects. For this reason, it is better to
take the injections well before departure. This will allow for good
immunity to develop as well as for the injection site to heal.
CONCLUSION
Adequate preparations to keep your health in good condition will,
Insha Allah make the performance of Hajj and Umrah a spiritually
uplifting and memorable experience. Invoking Allah Ta'ala's help, in
duas, in keeping illness and injury away and in protection from
ill-health cannot be over-emphasised.