Multitudes of diverse nationalities perform the annual Islamic pilgrimage (Hajj) to Makkah every year. Hajjees vary in age, nutritional status, underlying chronic diseases, and economic and educational levels. During the Hajj season, the Ministry of Health (MOH) in collaboration with the Islamic countries and the World Health Organization (WHO) carries out health education. This education is conducted in more than 10 languages and is focused on food and personal hygiene, heat-related illness, use of identifying wristbands, avoidance of crowds, and hygienic head shaving.
Methodology
Mina, a holy place where all pilgrims camp for at least 3 days, was divided into 4 zones. All zones where subdivided into 476 equal areas. Sixty-six clusters were randomly selected proportionate to the number of areas in each zone. Selected behaviors predisposing to major Hajj-related illnesses, and the sociodemographic factors that influence them were probed using a self-administered questionnaire that was translated into 16 different languages.
Results
Out of 1707 Hajjees, 79% were performing Hajj for the first time and 2% were residents of Saudi Arabia. Fifty seven percent wore identifying wristbands (44% of whom were advised to do so). Of the total, 24% used face masks (28% of whom were advised to do so), 67.2% washed their hands frequently (54.3% of Hajjees were advised to do so). Eighty-seven percent received the acquired vaccination against meningococcal meningitis (84% of who were advised to do so). Risky behaviors for food poisoning included: bringing food from home country 35% (23.4% were advised to do so), and eating food from street vendors 43% (31% were advised to do so). Heat stroke prevention included 73% who used an umbrella (67% were advised to do so), 90% who drank plenty of water (72% were advised to do so), and 76.3% who used transportation on moving between the holy places (41.3% were advised to do so). After completing the Hajj rites, 99.7% had their heads shaved with razor blades and 7% put themselves at risk of bloodborne disease by using a previously-used blade.
Conclusion
There was inadequate advice regarding healthy behaviors among Hajjees; accordingly, high-risk behaviors are widely prevalent. Health education significantly affects the practices of Hajjees.