|Year : 2000 | Volume
| Issue : 1 | Page : 13-14
Development of health services in Hajj seasons
Abdel Hadi Hassan Eltahir
Assistant Professor, Health Science College, P.O. Box 3761, Dammam 31481, Saudi Arabia
|Date of Web Publication||31-Jul-2012|
Abdel Hadi Hassan Eltahir
Assistant Professor, Health Science College, P.O. Box 3761, Dammam 31481
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Eltahir AH. Development of health services in Hajj seasons. J Fam Community Med 2000;7:13-4
Over the years, Hajj has been a major public health challenge that required an undivided attention from a number of governmental and non-governmental sectors in Saudi Arabia. Chief among the government sectors is the Ministry of Health (MOH). The MOH has a fundamental mission during the Hajj season stating: provision of the best health care for pilgrims, continuous expansion of health facilities, assignment of qualified health personnel, making effort to avoid bottle neck at health facilities, and setting "Emergency or disaster Plans" in coordination with other relevant sectors. In addition, protection of the people resident in Saudi Arabia against the potential risk factors or diseases is another concern. These risk factors or diseases may accompany the short -term influx of about two millions pilgrims coming from various countries.
The sectors that collaborate with the MOH include the National Guard, Red Crescent, Civil Defense, Medical Department at Ministry of Interior and others. All sectors work in a multidisciplinary team approach to cover the preventive, curative and promotion of health needs of the pilgrims and to achieve stated objectives.
In the past, pilgrims used to suffer from a number of major health problems and mass casualties with high rates of morbidity and mortality. These include cholera, meningitis, respiratory diseases, food poisoning, traffic accidents and fire.  In addition, the environmental health problems such as heat exhaustion and sun or heatstroke with high case fatality rate comprised a major challenge. 
The historical health-related landmark for pilgrimage was on the first of January 1957 when the Makkah pilgrimage became a subject to the International Health Regulations set by the World Health Organization (WHO) and the pilgrims were recognized as international travelers for the first time.  This historic date has been a turning point for improvement of health care and sanitation during Hajj seasons.
Each year multidisciplinary teams composed of Saudi Officials conduct frequent meetings start immediately after Hay to evaluate the situation and identify problems and areas that require more attention. Through such strategy the Saudi hosts have accumulated a great deal of experience in facing and solving the various problems and emergencies.  In this issue, Al-Harbi has highlighted one aspect of the complexity of health care delivered to pilgrims. 
In this decade a remarkable advancement has been made in the development of health services during Hajj seasons. The Saudi government has allocated a lot of resources including health facilities, qualified personnel, materials and logistics to serve the pilgrims. For instance, many permanent and seasonal health facilities are distributed in Makkah and the sacred places. These include 14 permanent and seasonal hospitals, 80 seasonal health centers, 34 permanent health centers, and 96 cooling units for management of heat exhaustion and stroke. A total of 1778 of emergency beds and 4624 hospital beds were prepared in Makkah, sacred places and Medinah for regular and emergency cases during the Hay seasons. Also, a total of 9177 health manpower from the MOH alone was devoted to provide services to pilgrims in 1418H. These figures are subject to annual increase as needed based on the predicted number of pilgrims and the high-risk groups. 
A number of health measures are taken care of at national and international levels to ensure the safety of pilgrims and people resident in Saudi Arabia. The main areas for these measures are preventive, curative and promotion of health care. For instance, the preventive measures require vaccination against cerebrospinal meningitis for all the pilgrims and vaccination against yellow fever as recommended by the WHO for those coming from endemic countries. Also, prophylactic therapy was given to pilgrims coming from areas with certain endemic disease. For example, injections of benzathine penicillin (or erythromycin tablets or capsules for those who are allergic) are given to pilgrims from Soviet Union as a prophylaxis against diphtheria; and immunization services are provided at the sea, air and land ports of Saudi Arabia.
Other services provided and managed by the Saudi officials include: transportation, accommodation in tents built of fire-resistant coated fiberglass material, provision of safe water, supervision of sanitation and proper refuse and waste disposal, slaughter house under close observation for proper sanitation, health education and organization to ensure smooth and safe moving of all pilgrims through the systematic steps of Hajj.
Certainly, the Saudi government spends a lot of money to establish comprehensive and integrated services to the pilgrims during their stay in and movement between the sacred places. For example, a total of SR 3.242 billion (about $800 million) was spent on constructing an efficient network of paved roads for buses and cars and shaded pathways for pedestrians.
As a result of all the efforts and prompt response to epidemics and disasters morbidity and mortality among pilgrims were kept to a minimum. However, plans for providing better health services are set with forward shift of goals and objectives. Indeed, there are many lessons that we can learn from the challenges that Saudi Arabia face in hosting such a short-term influx of unacclimatized people with different backgrounds coming from all over the world.
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