Hajj and Umrah

Hajj

During the 8th – 13th days of the Dhu al-Hijjah (the 12th month of the Islamic calendar), thousands upon thousands take the annual Hajj pilgrimage to Mecca. The Hajj is one of the biggest annual pilgrimages in the world, with around 3.7 million pilgrims participating, and culminates in the beautiful and holy lands of the Makkah Province in Saudi Arabia.

Because the Islamic calendar is 11 days shorter than the Gregorian calendar, the calendar most commonly used in western countries, the date of Hajj is 11 days earlier from year to year in a British diary. In 2019, Hajj fell between approximately the 9th-14th August. In 2020, Hajj will occur between 28th July and 2nd August.

Umrah

Unlike Hajj, Umrah is a pilgrimage to Mecca that can be taken at
any date through the year. This pilgrimage is highly recommended
for those of the Islamic faith, but isn’t compulsory like
Hajj.

There are two types of Umrah:

1. Umrat al-tammatu. This is the Umrah taken alongside Hajj
2. al-Umrat al mufradah. This is Umrah that is taken on its own,
   without Hajj

Health Regulations for Pilgrimage

Whichever type of pilgrimage you are planning to make, there are a number of health regulations to follow that are published by the Saudi Arabia Ministry of Health (MoH). These recommendations for travellers contain all the vaccine requirements for your entry into the country. Make sure you’re clued up on what you need to do before you make pilgrimage this year.

Respiratory Disease

Since its outbreak in 2012, the Saudi Arabian Ministry of Health have been trying to raise awareness of Middle Eastern Respiratory Syndrome (MERS-CoV): a viral respiratory infection that can initially cause a fever, cough, nose and throat congestion, diarrhoea and shortness of breath. If you have any of these symptoms after travelling to Saudi Arabia, seek medical advice as soon as possible. Those infected with MERS-CoV can also carry the infection to countries outside of the Middle East, so please take precaution when around those who have been on a recent pilgrimage.

For your own safety, Saudi Arabia’s Ministry of Health
recommend that the following people should delay taking Hajj or
Umrah:

• Those with severe medical conditions like heart, kidney or
  respiratory diseases
• Diabetics
• Those with immune deficiencies, terminal or malignant
  illnesses
• Those over 65 or under 12 years of age
• Pregnant women

Hajj can be incredibly tiring and taxing on your health because of the high temperatures, long walking distances, and the large numbers of pilgrims, so it’s important you’re certain that you and your body can take it before you go. Umrah is not as taxing on your health as Hajj as there are fewer pilgrims. However during busy periods, such as the month when Ramadan is being observed, there are significantly more pilgrims visiting the Grand Mosque. If you’re going this year, the Ministry of Health has published a list of helpful tips and guidelines for pilgrims to follow in order to help reduce the risk of respiratory infection. Here’s a quick round-up of what they say:

• Personal hygiene is crucial: make sure to wash your hands with soap, water or antibacterial gel regularly. If you’re coughing or sneezing, or are around people who are, then this is extra important.
• Always use disposable tissues if you need them. Make sure you get rid of these appropriately so as not to pass on infection. It is also advised that pilgrims should wear masks to reduce the spread of infections.
• Try not to touch your eyes, nose and mouth with your hands, as this is an easy way for infection to spread.
• Don’t get too close to anyone showing signs of infection.
• However cute they look, try not to come into direct contact with animals, and always wash your hands properly afterwards if you do.
• Take proper care with anything you eat or drink while you’re on pilgrimage: avoid any food that’s been made in unsanitary conditions, and make sure that any cooked food is piping hot before you eat it, especially if the dish contains meat. Wash all fresh fruit and vegetables with clean drinking water before you eat them, and avoid anything with unpasteurised milk in it like camel’s milk. Take a look at our page on food and water precautions for more info.

Vaccinations

There are a number of different vaccines you could need before taking a trip to Saudi Arabia. Why not arrange a consultation with one of our expert nurses or pharmacists at your local Superdrug Health Clinic to discuss your individual vaccination requirements?

If you’re coming from within the UK, then you’ll need the vaccine against Meningococcal Meningitis ACWY. Anyone over the age of 2 making an Umrah or Hajj pilgrimage, or even anyone planning on a work trip to the Hajj area, will need to bring a certificate of vaccination. You’ll have to bring one that’s been issued no longer than 3-5 years ago (depending on which vaccine you received) and no less than 10 days before the flight. If you’re coming from the UK, you won’t even be able to get a visa for your trip unless you’ve got the certificate proving this while you apply.

Vaccination against meningococcal ACWY is also required for domestic pilgrims, residents of the two holy cities Mecca and Medina and any person who may be in contact with pilgrims including personnel in healthcare settings.

Coming from outside the UK? There are a few other vaccination
requirements depending on where you’re coming from:

• Anyone coming from a country that the World Health Organisation (WHO) lists as having known infections of Yellow Fever must bring a valid yellow fever certificate with them when they come. Here’s a link to the list of countries at risk of yellow fever
• If you’re travelling from a country that has a high risk of the Polio virus (poliomyelitis), you’ll have to take a dose of the oral polio vaccine. This is for everyone, regardless of how old you are or which other vaccines you’ve had. Here’s the list of countries affected

As well as these, the Saudi Arabian MoH recommends that pilgrims have had all the usual immunisations you need for living in the UK (i.e. 5 doses of the tetanus vaccine and 5 doses of the polio vaccine). You’ll need to get a booster vaccine for polio if it’s been more than 10 years since your last one.

This is also a great chance to check that you are protected against measles, seasonal influenza and rubella. These are all diseases that are easy to prevent with the right vaccine. We’d recommend that you get the seasonal influenza vaccine if you’re planning on making Hajj, especially if you’re in a higher risk group for example, you’re under 5 or over 65, have chronic heart or lung disease, diabetes or are on immunosuppressive medication. Because there have been more cases of measles and rubella recently, you should be extra careful to make sure you’re immune to them before you go. You’ll know if you are or not by checking with your GP whether you’ve had 2 doses of the MMR vaccine, or if you’ve had measles naturally before.

Malaria

There is a low risk risk of malaria for pilgrims travelling around the South West region of Saudi Arabia. It’s higher in the winter months between September and January, but malaria is no longer considered a risk in higher-altitude cities in the Asir Province like Mecca, Medina, Jeddah and Taif. While in cities like Mecca and Medina pilgrims wouldn’t be at risk,  there is a low risk for the journey in-between. During the 6 hour trip, pilgrims pass through an area of low risk where antimalarial medicine may be required for higher risk travellers, such as infants, pregnant women, and those aged over 70 or with other medical problems. We’d recommend you talk about this with your travel nurse or pharmacist. If you’re travelling by daylight, in a car or bus with air-conditioning, the risk is a lot lower, but it’s still important to practice good insect and mosquito bite avoidance. Read our page on insect bite avoidance.

Zika and Dengue Fever

If you are travelling to Saudi Arabia from a country affected with the Zika virus and/or dengue fever, the Saudi Arabian Ministry of Health will require a certificate confirming that disinfection measures have been taken.

Travellers’ Diarrhoea

Unluckily, travellers’ diarrhoea is a common enough disease, and all travellers during Hajj will be at risk. This is especially true for those eating food prepared in contaminated or unsanitary conditions. Even if you’re on a low budget, try to avoid anything that seems too risky: steer clear of unpasteurised dairy products, unpeeled fruit and veg, and make sure you have clean, treated drinking water at all times. If you’re travelling over with young children, people over 65 or with a pre-existing medical condition, then they could become more seriously dehydrated and ill if they catch travellers’ diarrhoea. You can get antibiotics to treat travellers’ diarrhoea at a Superdrug Health Clinic.

Climate Related Health Risks

It probably won’t come as a surprise to you that, even in the winter months, Saudi Arabia will be very, very hot… In the coolest months it’s common for temperatures during the day to reach up to 30°C! Because it is so warm, all pilgrims are at risk of heat-related illnesses like sunstroke, sunburn, dehydration and heat stroke or exhaustion. Here are our top tips for staying healthy even in extreme climates during Hajj:

• Try to make your way there in good time before the pilgrimage so that you’ve got enough time to acclimatise to the hot weather.
• Rest-up whenever you can. Try to take regular pit-stops in shady areas along the way. Recently, the Saudi government has tried a lot harder to provide shady spots for pilgrims, but just in case you can’t find anywhere why not create your own with an umbrella or parasol?
• The Saudi Ministry has also decreed that all pilgrims can perform the Stoning the Devil at any point between sunrise and sunset. So if you’re really suffering from the heat, try to perform as many rituals as possible in the early evening or earlier in the morning when it’s cool.
• Wear plenty of suncream during the day and keep hydrated with safe drinking water.
• Because you’ll be walking most of the time, often across
  a hot sandy desert, you must bring sturdy walking sandals or
  good-quality shoes with you. This is especially important for
  anyone suffering from diabetes. Stow your shoes away in a small
  tote bag when you remove them for prayer.

It’s very hot most of the year in Saudi Arabia, but it can
also get cold at night during the winter months, so make sure
you’ve got suitable clothing and bedding with you for all
year round.

Blood-Borne Viruses

For male pilgrims, one of the biggest health risks is the ritual head shaving that happens at the end of Hajj. Only go to the official shaving centres, and steer clear of any unlicensed barbers or shavers you’ll see on the roadside. Non-sterile or shared razor blades can pass on blood-borne infections like hepatitis B, C, and HIV. If you can’t be shaved with your own razor, only ever use a licensed barber who has already been tested for these infections and is required by law to use one blade per person.

Rabies

Pilgrims should steer clear of wild and domestic animals as there may be a risk of rabies. If you are bitten or scratched, seek medical advice immediately. While the rabies vaccination is not required for travel to Saudi Arabia, it is recommended.

Accidents

Because Hajj is the biggest and busiest pilgrimage of its kind in the world, it’s hardly surprising that accidents and injuries happen. It’s essential that you are up-to-date and fully covered for repatriation with a comprehensive travel and medical insurance certificate well before you set off.

Since the stampede of 2006, in which more than 365 pilgrims tragically died, the Saudi government has been working hard to make improvements to the buildings at Jamaraat and the bridges around it. Try to avoid the fullest crowds and take care while crossing busy roads during the pilgrimage.

It’s common for pilgrims to get minor leg or foot injuries after walking such a long way, so you must bring supportive footwear with you for the trip. If you have diabetes or bad circulation then you’ll need to take special care during the walk and wear the appropriate socks and footwear. If you do hurt yourself from walking and you’ve been diagnosed with diabetes, then go get checked out by a medical professional as soon as you can.

Before you go

The best advice we can give you before undertaking Hajj is to see your GP or one of our expert nurses or pharmacists at a Superdrug Health Clinic. They’ll be able to assess you properly to make sure you’re up-to-date with all the above vaccines, and that you’re fit enough to make the pilgrimage itself. Have a general check-up before you go, especially if you’re over 65, pregnant, diabetic, have hypertension or an underlying heart, kidney or lung condition.

Your GP will also be able to make sure you’ve got enough of any prescription medicines for the whole trip. Ask them for a print-out of your prescription and a letter explaining that these are for private, medical use so that you don’t have any problems at the airport. Keep these medicines in their original packaging in your hand luggage so that they’re easy to access. If you’re due to have a period during Hajj, you might also want to talk to your GP about the types of hormonal therapy you can take in order to delay menstruation until afterwards to save the hassle and to make sure you’re eligible to perform the Tawaf al-Ziyarah and Tawaf al-Wida.

All pilgrims should aim to be active and mobile before they go because it will be too tiring if you’re not properly prepared. If you’ve got a chronic condition like diabetes, asthma or epilepsy, or you’re on an anticoagulant therapy with warfarin, then you must have these at a manageable level of control before you go.

Finally, every pilgrim should bring their own personal first aid kit with them so that they’re fully prepared for what the trip will throw at them. In a small bag, pack:

• Fabric plasters, bandages and dressings
• Scissors, safety pins and tape
• Antiseptic cream, antihistamine and sunburn lotion
• Rehydration salts
• Analgesics and paracetamol for pain
• Antidiarrhoeal tablets