Health
Guidelines for Haj and Umra
Haj is one of the fundamental pillars of Islam. Fard Haj can only be
performed once by those who can afford it. It is therefore very
important for those performing Haj to be both physically and spiritually
prepared to perform this once in a lifetime ibadat. Here are some health
guidelines to make the performance of Haj and Umra such that more time
can be devoted to ibadat.
Physical Fitness
Haj and Umra are easier for physically fit people. One should
improve physical fitness about six to eight weeks before departure.
Brisk walks for about 30-45 minutes 2 – 3 times a week going up to 5
km. at a time would be ideal. Start slow and increase. Walk in your
“Ihraam” footwear to break them in so that the footwear becomes
user-friendly. If you are over-weight, go on a strict diet and
exercise to lose weight. Wheel chairs are available free of charge
in Makkah and Medina.
Fluid Intake
Because of the harsh weather conditions (very hot, dry weather), one
must drink water in abundance. Tap water is not safe to drink. One
can brush teeth or gargle and make wudu with tap water. Zam Zam is
freely available. Drink as much Zam Zam as possible. Bottled water
is also available and distributed free on the days of Haj. Fruit
juices are also available. Diabetics should make sure that no sugar
is added to the fruit juices. Fluid intake should be about 8 -12
large glasses a day. If your urine is concentrated, your fluid
levels are down. Ensure that you pass at least 1 litre of urine a
day. Restricting water intake to avoid going to the toilet can lead
to heat exhaustion. Drinking very cold water in hot conditions can
cause a sore throat.
Food Intake
One should continue to eat a healthy, well balanced diet and should
be weary of unusual foods. One should be cautious about food
purchased from street vendors. Make sure that your fibre intake is
high to avoid constipation.
Constipation
Constipation is usually caused by inadequate fibre and/or fluid
intake. The fear of using “unknown” toilets can lead one to postpone
the use of the toilet. Familiarise yourself with the toilets, take
in adequate fibre (bran cereals, dried fruit, fruit and vegetables)
and insist on adequate fluid intake. Constipation leads to Piles and
anal fissures, which are unpleasant and painful.
Diarrhoea and Vomiting
A common occurance during travels, it is usually spread by viruses
or by infected foods. Make sure that the food source is clean, wash
all raw fruit and vegetables thoroughly, peel fruit before eating,
make sure food is well cooked as cooking kills the viruses and
bacteria. Viral gastro-enteritis is usually spread by contact with
an infected person. Keep away from people who have the virus (diarrhoea
usually associated with a fever). If this is not possible, wash
hands regularly after touching the infected person. Do not kiss or
hug an infected person until the virus is gone. If you are infected,
keep away from people for a few days until the virus is gone. Stop
vomiting by using anti-emetics like contromet, maxolon, valoid, etc.
Do not stop the diarrhoea as the body is trying to get rid of the
virus. If diarrhoea occurs more than 6 times in 12 hours, then an
anti-diarrhoeal agent like lomotil or Imodium may be used to slow
the diarrhoea. Drink extra fluids especially, Zam Zam, rehydrating
fluids and fruit juices.
Diabetes
Optimal diabetic control is important and should be attained before
departure. Make sure that you have enough of your medicine needs to
last you for at least a week after your expected return just in case
your flight is delayed. Keep on a strict diet during your stay.
Monitor your glucose levels frequently. Beware of fruit juices that
have sugar added to them. Take extra precautions not to injure
yourself, especially on your feet. Leave enough space in front of
you when walking in crowded situations.
High Blood Pressure
Make sure that your blood pressure is well controlled before
departure. Make sure that you take your medication on time. Those on
diuretics may need their medication adjusted in view of the climatic
conditions there. This should be done on the advice of a doctor.
Consult a doctor if you experience blurred vision, unexplained
headaches, dizziness, disorientation or swelling of the ankles and
feet.
Skin Care
The dry weather conditions in Saudi Arabia can cause cracking of the
skin, especially on the feet in the heel area. Deep fissures can
develop with a possibility of infection. Cellulitis can occur
requiring the person to keep the feet elevated for 3-4 days. If this
occurs before Haj starts, it can make it very difficult. This is
especially important for diabetics. Moisturise regularly with a good
moisturizer like Vaseline, heel balms and urea-containing
moisturizers. Glycosol cream available in Saudi Arabia is very
useful. Use socks, ordinary or leather to protect the feet on the
marble floors. Because of the rubbing of the scrotum against the
upper thigh whilst walking, a painful rash can develop. Avoid this
by applying large amounts of Vaseline on the inside of the upper
thigh throughout the first 3 days of Haj. This applies more so to
people who are going to walk throughout Haj. If you are unfortunate
enough to get this painful condition, a steroid cream helps very
quickly.
Fungal Infections
Fungal infections especially of the feet should be treated before
departure. Dry the areas between the toes after wudhu. Use an
anti-fungal cream regularly. Fungal infections can also lead to
cellulitis.
Back Care
Avoid back strain as healing can take anything from 2 – 6 weeks.
Travel with light bags preferably with wheels. Avoid lifting heavy
items. If you have to lift, ask for help or lift with a straight
back by bending your knees. At the first sign of back pain, stop
whatever activity is causing the pain to prevent it from becoming
worse. Seek medical attention early.
Arthritis
Those people who suffer from arthritis of the back, hips, knees or
ankles should lose weight as fast as possible prior to departure if
they are overweight. Start treatment before departure to get the
arthritis under control. Be guided by your doctor or physiotherapist
on the exercises you can do to strengthen your muscles. Stronger
muscles take the pressure off the joints. Carry your medications
with you.
Gout
Continue your preventative medication diligently and continuously.
Take the medication for controlling an attack of gout from your
doctor just in case of an attack. Be strict with your diet, avoiding
purine-containing foods like red meat, canned sardines or anchovies,
veal, etc.
Medicines
Most medicines are easily available in Saudi Arabia. Because there
is a possibility that your chronic medication (medicines you take
daily for whatever reason) may not be available in Saudi Arabia,
please ensure that you have adequate supplies of your medication,
taking an extra weeks’ supply just in case your flight is delayed.
Also, keep some money in reserve just in case you have to purchase
some medications. It is essential that you take a letter from your
doctor specifying your illness/illnesses, the chronic medication you
are on and the dosage. Medicines that may be helpful to take include
pain-killers, tablets for nausea (maxolon, contromet, valoid), for
stomach cramps (buscopan, scopex), for diarrhoea (Imodium, lomotil),
for runny nose (allergex, sinu-med, Actifed), for infections (amoxycillin,
erymycin if allergic to penicillin), phenergan for allergies and any
other medication that you may need on an intermittent basis. Avoid
carrying liquid medicines in bottles.
Delaying Menses
It is preferable to adjust your periods 3-4 months before Haj using
hormones so that no adjustment is needed during the Haj period. It
is possible and permissible to delay periods for convenience by
taking appropriate hormone tablets. Your doctor/gynaecologist can
guide you.
The Marble Floors in the Haramain
The marble can be very slippery when wet. Please take extra care to
avoid slipping. Leather socks is available and allowed. Severe
injuries can occur on the elbows, wrists or hips from a fall. In
bright sunshine, the marble shines brilliantly. Those people who
have sensitive eyes should wear sun glasses. Walking on the marble
bare feet can cause the feet to dry out, e.g., during Tawaf. Wear
leather socks if this becomes a problem. Use moisturizers, e. g.,
Heal balms, Glycosol cream.
Before Haj
From the 4th of Zulhaj, ensure that you are physically and
spiritually fit for the 5 days of Haj. Treat any conditions that
require attention. Do not over-exert yourself. Have adequate rest.
Try to connect with Allah Subahanahu Watha’ala. The main purpose of
your visit is close. You need to be in peak condition.
The Five Days of Haj
Be as helpful as possible to all around you. Do not push under any
circumstance. Keep a space in front of you so that your feet are not
injured. Protect the vulnerable in your company. Remain focused on
your mission. Do not get side-tracked with worldly matters. Avoid
people who distract you from your purpose. Carry your medication in
a safe, dry place. Insulin must be kept in a cold pack. Do not carry
unnecessary items of baggage. The lighter your bag, the better. By
taking care of your health, you will not compromise someone else’s
Haj. Please take your medications on time. Watch your diet if you
are diabetic. Do not over-eat. Eat small meals, have adequate fluid
intake and keep out of the sun unless necessary. Do not deliberately
avoid fluids to prevent you from using the toilets. This can have
disastrous consequences (heat exhaustion and dehydration). Do not
rush to stone the Jamarat. Wait for a suitable opportunity and enjoy
rejecting Shaitan. Avoid bending to look for lost footwear in
crowded situations. You may get pushed to the ground. If an injury
is sustained, clean it well with an antiseptic solution or water,
use an antibiotic or antiseptic cream if available. Seek medical
help for deep wounds or severe sprains. Items that you may need to
take with you include
Immunisations
Yellow Fever and Meningo-coccal (4 strain) vaccines are essential
for all pilgrims from Sub-Saharan Africa. Outside sub-Saharan
Africa, only meningo-coccal vaccine is necessary. A visa will not be
issued without these immunizations. Take the vaccines at least 2
weeks or earlier before departure. If you are unable to take any of
the vaccines, e.g., pregnancy, a letter from your doctor to verify
the pregnancy is required for the visa.
Hepatitis
A vaccine and Influenza vaccine should also be taken. These vaccines
are not compulsory.
Conclusion
Adequate preparation for one of the most important journeys will,
Insha Allah make the performance of Haj a successful and memorable
experience. May Allah Subahanahu Watha’la take you safely and bring
you back safely. May you have a successful and acceptable Haj, Ameen. |
Dr. Farouk Haffejee
drh@rrmc.co.za for further information.
Islamic Medical Association of South Africa
P O Box 48786,
Qualbert,
Durban,
4078
SOUTH AFRICA
031 – 207 2250
Fax: 031 – 207 2260
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