Introduction
Every year Hajj season makes more than two million hajjis gather in Mina, a relatively small area with temporary cooking, storage, and serving facilities, which makes Hajj a suitable environment for occurrence of food poisoning outbreaks. One of Hamla management major responsibilities is assuring the quality of food services provided for hajjis. Also they're responsible for the availability of medical facilities and reporting mechanism of incidents to authorities and one of these is food poisoning episodes. Food poisoning is a chain of events and if this chain can be broken, outbreaks can be prevented. This study is aiming to identify the role of Hamla management in prevention and control of food poisoning outbreaks by trying to know the factors responsible for these outbreaks, type of medical management provided by Hamla to food poisoning cases, emergency transportation, and availability of a reporting mechanism.
Methodology
A cross-sectional interview-based survey was conducted, by interviewing Hamla managers and observing food preparation and dining services provided in their camps in Mina. Stratified random sampling technique was used to identify the sampling units. Stratification was based on grouping of domestic (33%) and international (67%) Hamlas, proportionate to the number of hajjis in these Hamlas. Using an Arabic interview schedule and an English observation checklist, data was collected on 7th, 8th, 10th and 11th of Dhul hijja.
Results
A total of 91 camps were surveyed, 33 (36.3%) were domestic camps and 58 (63.7%) were international. The mean of Hamlas experience in Hajj was 12.8 years (SD 7.4 years). A total of 54 camps (59.3%) had contracts with a caterer; it was more common in domestic (P-value= 0.016). About 20 camps (22.0%) did not have any supervisory staff, 19 (95%) were International camps (P-value= 0.027), and the remaining 71 camps (78.0%) had from one to five staff for supervision. About frequency of food services supervision, 32 (35.2%) were supervising more than once daily and 45 (49.4%) were supervising each meal, it was more frequent in domestic (P-value= 0.014). Gas stoves were the most frequent heating appliances used in 79 (86.8%) which were used more in international camps (P-value <0.001). A separate dining area was available in 23 (25.3%) which was more in domestic camps (P-value <0.001). Hamla was the most frequently responsible for cleanliness. Cooking area cleanliness was good in 23 (25.3%), more in domestic (P-value= 0.020). Storage area cleanliness was good in 22 (24.2%) (P-value <0.001). Mechanism to lodge complaints by hajjis was available in 55 (61.1%), it was more frequent in domestic (P-value= 0.008), and discarding of whole food complained was the most frequent response to complaints in 66 (72.5%). Medical facilities were available in 44 (48.4%) and they were more in domestic (P-value <0.001). physician was available in 45 (49.5%) more in domestic (P-value <0.001). A reporting mechanism existed in 63 (69.2%) which was more frequent in domestic camps (P-value= 0.042), and managers were responsible for reporting in (96.8%) of all camps.
Conclusion
In this study general food services provided by Hamla management; like the availability of supervisory staff, contract with a caterer, etc., were acceptable although for better food safety and higher food quality these services should be improved. More attention is needed for cleanliness in general and the actions that should be taken by Hamla management or the supervisory staff towards any defect in food services. It was also noticed that domestic camps were providing better food services compared to the international camps.