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Utilization of Primary Health Care Services during Hajj, Mina, 1418H (1998).*


The annual pilgrimage to Makkah (Hajj) is a unique gathering of Muslims from around the world. Pilgrims (Hajjees) vary considerably in their socio-demographic characteristics, health-related behaviors and their underlying health status. As a result, they vary in their medical needs. The objectives of this study are to identify the pattern of workloads at the primary health centers (PHCCs) in Mina (where Hajjees camp for about 5 days) and to identify the age-, sex-, and nationality-distribution of the common illnesses among Hajjees treated at these PHCCs.


A systematic random sampling was done from the records of patients who visited 15 of the 22 PHCCs and 1 of 3 hospitals serving Hajjees in Mina. The nationalities of Hajjees were divided into eight groups according to the administrative organization of the Ministry of Hajj. Illnesses were also divided into eight groups according to the systems affected.


Of 1,323 records reviewed of more than 44 nationalities, the overall sex ratio was about 2:1. About 10-12% of all patients across different nationalities were 65 years or older except Hajjees from the Gulf Cooperation Countries (GCC) (1.8%) and Iran (17.3%). The workload varied considerably between PHCCs. The workload at the PHCCs in Mina increased steadily and progressively, reaching its peak on the 12th of Dhul Hijjah (April 9). The workload showed consistent daily bimodal pattern; the busiest periods being 6-10 A.M. and 7-10 P.M. These PHCCs were located close to Al-Jamarat area, serving Hajjees from Southeast Asia and Africa. The leading causes of morbidity among Hajjees diagnosed at the PHCCs in Mina were: respiratory diseases (48.6%), gastrointestinal illnesses (10.7%), skin diseases (7.6%), and diseases of the muscles and joints (7.4%). Heat exhaustion, cut wounds, and chronic illnesses such as diabetes mellitus and hypertension constituted less than 2% each.


The variations in the workload at the PHCCs could help decision makers redistribute health manpower between and within PHCCs to design a more efficient schedule for GPs and other medical staff within PHCCs. The remarkable physical effort a Hajjee undergoes could explain the increased utilization of PHCC services by females. Occurrence of illnesses could reflect some undesirable risk behaviours among certain nationality groups.