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Hajj & Umra
and
Your Health
 
Dr. Mohammad Azhar Sheikh
 
   

In The Name of Allah The Most Gracious, The Most Merciful

All the praises to Allah, The Sustainer of all universes. Peace and blessings to Muhammad, The   Servant and Messenger of Allah.

The Hajj is a one-in-a-lifetime obligation upon adult Muslims whose health and means permit it. It brings together Muslims of all races and tongues for one of life's most moving spiritual experiences.   

On the authority of Abu Huraira (may Allah be pleased with him) who reported that the Messenger of Allah (may the peace and blessing of Allah be upon him) had said: Who perform the pilgrimage for Allah (SWT) without talking indecently and committing any default, returns from the pilgrimage, as the day on which his mother gave birth to him (Agreed upon).  

What a great reward? It is of utmost importance that one prepares oneself spiritually and physically for this rewarding but hugely demanding holy journey. One must be in good health, not only to enjoy Hajj and Umrah but also to make maximum use of the opportunity to make as much ibadat as possible and share the bounties of Allah, the Most Generous, the Most Kind. Travel on Hajj or Umrah carries special risks because:

Take some extra medications of common ailments.   Keep one or two days supplies in a hand baggage to avoid missing your dosage during travel.

The weather is likely to be hotter than you are used to
You will be in very large crowds
You may have to walk long distances
Clean water and sanitation are difficult to maintain in these circumstances

However, if you follow simple following steps, you and your family will reduce the risk of falling ill at Hajj or Umrah. This must be accompanied by your own Doctor's advice pertaining to your own health needs.

 

Pre-Hajj Preparation

Health status and Medication:   If you suffer from any ailment such as a heart or chest condition or diabetes, tell your doctor or specialist well in advance of your intention to undertake this journey and ask their advice on how to reduce your chances of becoming ill.   Get your condition under optimal control.   Also ask them for a report to carry with you, with a list of your usual medications. Please take enough medications for your journey and properly label them for the ease of taking.

Take some extra medications of common ailments.   Keep one or two days supplies in a hand baggage to avoid missing your dosage during travel.

Dental & Eye Check-up: Have your oral and eye health check ups before this enduring life time journey.   Keep an extra pair of glasses in case you loose it or break it.

Sisters:   If they feel their days are likely to fall during Hajj then they need to seek advice from their doctor at least 6-8 weeks before Hajj to adjust or delay their periods. This is a controversial issue with two schools of thought.   Please be guided by your Ulemah and your own conscience.

Walking: One would require walking a few miles every day during Umrah and Hajj. Therefore, please practice walking, starting about 4 to 6 weeks before departure, and walking greater and greater distances as the time of departure arrives. Rasulallah Sallallahu Alaihi Wasallum often spoke of the importance of physical fitness in general. This preparation will help you tremendously. Hajj is a preparation for strong faith, patience and cultural harmony.   

Immunisations: Meningitis vaccine is discussed in detail in other chapter. For advice on other vaccinations like Hepatitis A and malaria tablets consult you doctor.

A proper diabetic diet is very important. Most 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.

Luggage and travel (DVT): Please keep the luggage as light as possible. Suite cases should be small and with wheels to avoid stress to back. On long journey blood clot can be formed in leg veins, called deep vein thrombosis. This can be serious risk to health.   Keep doing legs and feet exercises and should wear elastic compression stockings.   One can take mini aspirin with the doctor's advice.  

During Hajj

Next few years the Hajj is going to be in winter. At night it can be cold so please make sure you have appropriate Ihram to keep you warm during night especially in an open sky night of Muzdalifa.   There is risk of pneumonia.  

Sanitation: Try to maintain high standards of personal and surroundings cleanliness to minimize the diseases. Messenger of Allah (PBUH) said: "Cleanliness is half of the faith". By following this Hadith, one can earn reward in addition to prevention of diseases spread.   Always wash hands before eating or handling food.

Water and Food: Drink plenty of water. Use bottle water or boil it before drinking. Avoid ice as it is not sure about the quality of water from which it is made. Zam Zam is available freely in Makkah and in Madinah and one should try to benefit from it as much as possible. Although the authorities provide disposable cups for drinking Zam Zam in the Haram, people unfamiliar with this practice often mix the used cups with the unused ones resulting in confusion. If one is unsure, rinse out the cup well before use. It is through the sharing of cups that infections can spread from one pilgrim to another. People come from all parts of the world with different hygienic control. Please avoid picking up infections from this source.

In hot weather salts can get depleted. Salt tablets or lemon & honey in water can be taken, if medical condition does not prohibit its use.   Oral Re-hydration Salt (ORS) packets are widely available in pharmacies on the counter.

Maintain a high fibre diet, like a bran or wheat cereal, wholemeal bread, vegetables. Laban is freely available and highly nutritious. Take small meals and avoid fried or fatty meal, exposed food, salads and uncooked vegetables.   Please eat from good restaurants where hygienic principles are observed. Only eat fruits, which can be peeled like banana, oranges, etc.  

The time is for reflection, on your life so far. Use this opportunity to the maximum; you may not get another chance. Seek forgiveness with humility and belief. Special care is required during stoning of Shaitaan. Be careful of other people. If you lose your footwear, do not bend to find it. A little push can throw you to the ground and that can be disastrous.

Constipation: Change in the diet and the hot weather resulting in water depletion, leading to constipation, which can be a real problem. It can affect normal activities resulting in loss of valuable time in Makkah and Madinah. By sticking to above diet and drinking lot of water or Zam Zam should avoid this problem.  

Asthma & chest infections: If well controlled, asthma should not pose a problem during Hajj and Umrah. Avoid crowds and dust wherever possible. Take inhalers regularly as advised.

Acute upper respiratory infection is very common. Epidemics of flu-like illnesses are also very common. Vast majority of these are viral. Paracetamol should be enough, but seek medical advice if not sure.

Smoking: Avoid smoking during whole Hajj or Umrah especially when in Ihram. Take this opportunity to give up this habit that causes loss of health and wealth.  

Skin Care: Because of the harsh, dry conditions that can be encountered, our bodies are confronted by a big change in the external environment. A good moisturizer applied two or three times a day will help the skin retain moisture and slowly acclimatize. Extra care should be paid to the feet, as performing Hajj with painful feet would add an unnecessary burden.

Men are not allowed to wear underwear. The sweat and the rubbing of the thighs together during walking cause the problem and can be a real trouble in walking. To prevent this, men are advised to use Vaseline or any other non-perfumed moisturizer liberally to the inner side of the thighs frequently throughout the state of Ihram.

Take an umbrella and sun cream to protect against the sun and heat. Even in winter sun can be very hot and cause heat stroke.  

Fungal Infections of the feet: If a fungal infection is present, this must be attended to especially if diabetes is present. Treatment must start well before departure so that the infection can be treated adequately.

Fungal infections of the feet resulting in cracks or maceration of the skin can get secondarily infected and can take up to a week to resolve with antibiotics. This is something that one does not need during Umrah or Hajj.

Diabetics must take extra care of their feet. Treat scratches and even tiny cuts promptly until they heal. When walking, avoid crowds and allow enough space in front so that feet are not trampled. If a panicky person is in front of you, move to another place. Remember that open sandals will be worn for the duration of Hajj, so nails should be well trimmed and do not "catch".

Complications from wounds can easily arise in diabetics resulting in unnecessary pain and discomfort and a possibility of missing Hajj.

Diabetes: 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.

A proper diabetic diet is very important. Most 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. Avoid juices, which may contain lot of sugar.   

High Blood Pressure: Please visit your Doctor regularly for few months so that if a change in medication is necessary, it can be introduced and blood pressure is stabilized, well before departure. If you are on diuretics ("water tablets"), you may need to adjust the dose due to hot weather. Please be guided by your blood pressure and seek advice if in doubt.

Diarrhea and vomiting: In situations where there are crowds of people, infections are bound to spread. Remember, germs spread by droplets from our mouth as we speak or when we cough especially if phlegm is present, or by direct contact as in sharing a cup, spoon, fork, etc.

Avoid close contact with people who are ill. Visit them by all means but keep your distance. If you are ill and are fortunate enough to have a visitor, protect your visitor by staying a fair distance away and politely explain to them.

If one has Diarrhea, should drink extra fluids, preferably oral re-hydration salt which is easily available there. If it is more than 6 times in 12 hours and prolonged, please seek medical attention.

Allah's Blessing may be with you all during this holy journey of life.

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Meningitis & Hajj Pilgrims
 
   

Meningitis is one of the most notorious killer diseases known to the mankind. I would call it a dreadful, deadly disabling disease - with a very high risk of mortality and disabilities. Those few who manage to survive, end up with an extremely tragic and pitiable quality of life - if you can call it quality at all- with brain damage, behavior problems, learning difficulties, seizures, deafness, blindness, amputated limbs at times and heavily scared and disfigured skin.

All these tragic consequences are preventable and I shall endeavor to highlight some of the most important and significant points to create public awareness - especially amongst those who intend to perform Hajj and Umrah.

1. What is Meningitis?
The human brain is well protected within the skull from day to day injuries. However, mother nature has provided additional protection through layers of certain tissues, which surround the brain and these are called Meningies. If and when they become inflamed or infected the person becomes a victim of meningitis.

2.   Is 'Septicaemia' also relevant?
Yes, very much. Indeed, in simple words, if and when the germs causing meningitis enter the blood stream, they create a state of ''blood poisoning'' and this is technically labeled as Septicemia. A person can suffer from either or both of these conditions simultaneously.   In any case, the consequences are equally disastrous in terms of mortality and morbidity, as above mentioned.

An official certificate of vaccination must be obtained from the vaccinator, clearly indicating your full name as it appears in your passport, date of vaccination, signature and official stamp of the vaccinator for the following two very important reasons:

a) This certificate is mandatory legal requirement without which your Hajj and Umra visa application will be rejected by the Saudi Embassy.

b) You are protected against this disease for 3 years from the time of vaccination. Should you wish to perform Hajj and Umrah again within those 3 years, revaccination will be un-necessary.

3.   What is the cause of this condition?
To simplify the highly technical background, a large variety of germs can cause these conditions, interestingly enough, some of these ''enemies'' normally live as ''friends'' in the back of our nose and throat, in some 10 percent of the community. Such '' carriers'' normally lead a perfectly happy and healthy life. However, under certain circumstances these bacteria enter into the blood stream and cause septicaemia, meningitis   or both.

I would like to focus here only on those notorious germs, which are most relevant from the point of view of the Hajj and Umrah pilgrims. These germs are known as ''Meningoccocci A and C''

4. What are the main symptoms and signs of the disease and recommended action?
Kindly make a special note of the important fact that the time between the onset of the symptoms and death - if undiagnosed or inadequately treated - is a matter of ONLY HOURS- not days! So

PLEASE BEWARE

The initial symptoms can be as simple as those of flu, common cold and cough but with rapidly rising fever yet cold hands and feet, rapid breathing, dislike for food especially amongst babies, vomiting, diarrhea and stomach pains, muscle and joint pains, head and neck pains with neck stiffness, dislike for bright light as it intensifies the head and neck pain, rapidly increasing drowsiness- leading to coma and eventually - death!

I would particularly highlight here a pink, non-itchy, spotty rash- especially amongst children- which may be generalized or confined only to a part of the body. This is highly diagnostic of this disease. The peculiarity of this spotty rash is that for example, you can detect it by a simple homely test. Take a glass tumbler used for drinking water and press it against the spots. The red spots will not disappear under pressure and will remain visible through the glass. Almost all other types of skin spots either fade off or totally disappear under pressure.

Please note that these symptoms and signs may not appear in the same order as above mentioned and indeed, the victim may not experience all of these either.

Most importantly, even if you remotely suspect meningitis/septicaemia- please immediately seek the expert opinion of your family doctor take the patient to the nearest hospital.

Either way, the patient must be hospitalized as quickly as possible where the specialists shall carry out the comprehensive examination and investigations and if the diagnosis is confirmed, immediate intensive treatment can be initiated to save the precious life.

The key message therefore is - the timely intervention is most crucial because there is only a few hours gap between the bed and the grave! Seek early help- to be safe rather than sorry!

5. Is meningitis preventable?
Yes indeed, it is! All the miserable suffering and death can be prevented by a simple vaccination obtainable from your family doctor or vaccination centres. It is called 'Quadrivalent Vaccine' or 'ACW 135 Y vaccine'

It is imperative to get yourself vaccinated at least 3 weeks before you apply for Hajj and Umrah visa to the Saudi Embassy. It takes at least that long to create adequate immunity in your body against this killer disease.

An official certificate of vaccination must be obtained from the vaccinator, clearly indicating your full name as it appears in your passport, date of vaccination, signature and official stamp of the vaccinator for the following two very important reasons:

a) This certificate is mandatory legal requirement without which your Hajj and Umra visa application will be rejected by the Saudi Embassy.

b) You are protected against this disease for 3 years from the time of vaccination. Should you wish to perform Hajj and Umrah again within those 3 years, revaccination will be un-necessary.

Please make a special note that any accompanying children under 2 years, will need two vaccinations 3 months apart to obtain adequate protection against the disease and their vaccination certificates must be accordingly endorsed.

The good old saying - 'To be forewarned is to be forearmed'- is the most appropriate food for thought in this context here. Indeed, this is sole purpose behind this humble and modest effort on the writer's part.

The good old saying - 'To be forewarned is to be forearmed'- is the most appropriate food for thought in this context here. Indeed, this is sole purpose behind this humble and modest effort on the writer's part.

Most unfortunately, there was an international outbreak of meningitis amongst the returning Hajj Pilgrims in the year 2000, in spite of the compulsory vaccination Sadly, the death toll was heavy. An immediate investigation was launched spearheaded by the WHO as a result of which, a hitherto unknown germ of meningitis was identified and labeled as 'W135'. This was held responsible for the deaths amongst the returning Hajj Pilgrims and their immediate family members.

Through extensive research, the new meningitis vaccine (Quadrivalent) was mass-produced and very rapidly internationally distributed for the use by the Hajj & Umrah Pilgrims from the year 2001.

The Key message therefore is that those pilgrims who had the meningitis vaccination for and before Hajj 2000, must get revaccinated with the new 'Quadrivalent Vaccine' if they wish to perform the pilgrimage now or in future for fuller protection.

6. Conclusion: Beware of the killer disease - meningitis!
he good old saying - 'To be forewarned is to be forearmed'- is the most appropriate food for thought in this context here. Indeed, this is sole purpose behind this humble and modest effort on the writer's part, to impart maximum possible up-to-date information to lay public in particular, in the simplest possible and non technical format. All that remains now to be added are my most sincere and heart felt prayers for you and yours! May Allah Be and Remain your Provider and Protector throughout your sacred pilgrimage and through all your life there after Amen!!

by: Dr Syed Raza Hussain

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IMPORTANT ANNOUNCEMENT FOR
HAJJ & UMRA PILGRIMS:

If you are planning to perform Hajj & Umra this year, then please protect yourself and your family to ensure that your doctor give you the 'quadrivalent' meningococcal vaccine (ACWY vac).

Over 20 Hajjis died in Britain after contracting Meningitis during the Hajj in recent years.

A valid certificate of vaccination against Meningitis is required by the Saudi embassy in London before they issue a visa for Hajj and Umra.

WARNING:
To tour operators and travel agents

Please do not issue a forged certificate of meningitis to your clients.
You are not only putting their lives, but the lives of their family members and friends at risk as well. This is an extremely serious crime.

ABH is the only Hajj specific national organisation and registered charity working for the welfare and well being Hajj and Umra Pilgrims In the UK.

For further Information please contact:
Association of British Hujjaj (Pilgrims) U.K. (ABH)
21/22, Southside Centre
Ladypool Road
Birmingham, B12 8LF
Tel: 0121 440 1700 / 07752 721 546
E-mail: abh12@btconnect.com & mail@abhuk.com
Url: www.abhuk.com


MENINGITIS AWARENESS CAMPAIGN
Association of British Hujjaj (Pilgrims) U.K

Registered Charity No: 1087426


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Going to Hajj or Umra?
Guard against Meningitis and save lives.

Meningitis

Meningitis is a very real and serious risk for you and your family. You could also bring the meningitis germs back to your family and friends at home. A dangerous strain of meningitis has affected travellers to the Hajj in the previous years, and some people have died after contracting it.

Pilgrims going to Hajj or Umrah are required by the Government of Saudi Arabia to have a valid certificate of vaccination every two years against meningitis before they are issued with a visa. If you were vaccinated more than two years ago, you will need to get re-vaccinated otherwise your visa application will be turned down.

Please make sure that:
· you get the right vaccine. You need to make sure your doctor gives you the ' quadrivalent ' meningococcal vaccine (ACWY Vac) which protects against four different strains of meningitis: A, C, W135 and Y.
· if you are planning to take children under the age of two years to Hajj or Umrah you will need to get them vaccinated with two doses of ACWY vaccine, ideally three months apart .
· you and your family get this vaccine even if you have had a different meningitis vaccine in the past. Neither the meningitis vaccine your child(ren) will have had as part of their routine vaccinations (called Men C), nor the vaccine previously recommended for travel will give you the protection you need.
· you get a certificate after having had the vaccination providing it's given within the last two years.

Talk to your doctor if you are in any doubt or phone NHS Direct on 0845 46 47*
*Calls charged at local rates.

NHS Direct can provide confidential interpreters, in many languages including Urdu, Bengali, Punjabi, Gujarati, Arabic,Turkish and Somali, within minutes of your call. All you need to do is state in English the language you would prefer to use.

Why do I need this quadrivalent immunisation for Hajj?

The W135 strain of meningitis is deadly and differs from other meningitis strains usually caught in the UK. Previous vaccination against meningitis A and C does not protect you against the W135 strain. Receiving the quadrivalent meningitis vaccination will not only protect you, but will substantially reduce the risk of infecting your friends, family and community on your return.

The Saudi Arabian Government has made vaccination against the ACWY strains a visa entry requirement, so you may be refused entry if you do not have a valid certificate showing that you have received the quadrivalent meningitis vaccination within the last two years.

Pilgrims are strongly advised to book an appointment with their GP three or more weeks before travel to allow time for the practice to order the ACWY vaccine, and to allow sufficient time for it to become fully effective. And if you are planning to take children under the age of two years, you should book about four months in advance. Please take a copy of this leaflet with you to your GP.

Health tips

Travelling anywhere in the world brings with it some risk to health.Travel on Hajj or Umrah carries additional risks because:

· The weather is likely to be hotter than you are used to.
· You will be in very large crowds.
· You may have to walk long distances.
· Clean water and sanitation are difficult to maintain in these circumstances.

However, by taking certain - often simple - steps, you can minimise your exposure to almost any health hazard. Please take time to read these simple tips, and you and your family will reduce the risk of falling ill at Hajj or Umrah.

· Don't leave your preparations too late - start them in good time.
· Ask your doctor about other vaccinations you should have before you go.
· If you suffer from any ailment such as a heart or chest condition or diabetes, tell your doctor or specialist that you are planning to undertake this journey and ask their advice on how to reduce your chances of becoming ill. Also ask them for a report to carry with you, with a list of your usual medications.
· If you are on any medication from your doctor, make sure you have enough for the whole trip and carry it with you.
· Take an umbrella and sun cream to protect against the sun.
· Make sure you carry with you plenty of clean drinking water.
· Try to get plenty of rest.
· Keep all your belongings and surroundings as clean as possible at all times.

For more information on immunisation visit the website at
www.immunisation.nhs.uk


Information about Meningitis in detail can be obtained from
Meningitis Research Foundation

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Meningitis Warning For Returnee Hajj Pilgrims

Association of British Hujjaj (Pilgrims) UK (ABH) together with the Meningitis Research Foundation is reminding returnee Hajj pilgrims and their families of the symptoms of meningitis and septicaemia, as over the last few years there have been about 20 deaths in UK from these diseases following the Hajj.

Although there are vaccines which give excellent protection against meningitis and septicaemia (blood poisoning) they cannot protect against all forms. Therefore it is important that if someone becomes ill, symptoms are recognised quickly and medical help obtained immediately.

These diseases often start with flu-like symptoms - fever, vomiting, cold hands and feet, shivering and limb, joint and muscle pain. Severe headache, stiff neck and dislike of bright lights may also be present as well as a rash which could appear anywhere on the body.

Mr Khalid Pervez, General Secretary of the ABH said: Meningitis and septicaemia are killer diseases which need to be treated immediately. The ABH would urge all returnee pilgrims and their families to be aware of the symptoms of meningitis and septicaemia and know what to do if these diseases are suspected.”

Denise Vaughan, Meningitis Research Foundation's Chief Executive, commented: “In view of the outbreaks of meningitis and septicaemia over the past few years associated with the Hajj, it is important that returning pilgrims and their families are aware of the symptoms. With these diseases, the quicker they are diagnosed and treated, the better the chances for a good recovery.”

Further information about meningitis and septicaemia can be obtained from Association of British Hujjaj (pilgrims) UK Dr. S. R. Hussain 07866 719 381 or website http://www.abhuk.com or Julia Warren of Meningitis Research Foundation- 01454 281 811 or 07711 057 875 or website: http://www.meningitis.org.

Association of British Hujjaj (Pilgrims) UK
www.abhuk.com
Southside Business Centre
249, Ladypool Road
Birmingham B12 8 LF
UK

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