Hajj is a lifetime journey for which the faithful hearts are longing. Indeed, it is a great favor Almighty Allah has bestowed upon His servants so that they can draw closer to Him and have their sins forgiven. As the performance of Hajj requires physical, psychological and financial ability, it’s highly important for all the would-be pilgrims to be aware of all the health aspects of Hajj..
What is the best age for performing Hajj? What are the health aspects necessary to bear in mind during this season? What is the best nutrition that would aid our bodies during Hajj rituals? How to avoid dehydration and other health problems outdoors?To tackle this important topic, Dr. Amira Ayad, a pharmacist, nutrition specialist and natural health consultant provides answers to all these questions in an email-based live clinic session, held on Wednesday, October 10, 2012.
Read below all the questions and Dr. Amira's kind replies:
- Shall we be afraid from an outbreak of that newly discovered SARS-like virus during current Hajj season?
Fear and panic are the number one enemy of your immune system. It is highly important not to panic or worry. Stress and worry are proven to greatly undermine our immunity. Enjoy the moment and cherish your spiritual journey with a deep belief that: "Never will we be struck except by what Allah has decreed for us; He is our protector." And upon Allah let the believers rely." (At-Taubah 9: 51). This of course does not mean neglecting to take our precautions and follow the worldly means for prophylaxis and/or healing. For more on those, please refer to question 3 below.
And, remember, as long as you are fit, the viruses won't stand a chance in shaa Allah, so start taking care of your health early on before departure. Eat healthy, exercise, get enough sleep and rest. and follow the prevention methods to the best of your ability.
- What are the vaccinations required for 2012’s Hajj?
There is one mandatory vaccine for all Hajj travelers, the Meningococcal Vaccine, you can't take your KSA visa for hajj without proof of vaccination.
Some physicians recommend additional other vaccines like Pneumococcal Vaccine, which is recommended for adults above 65 years and other vulnerable groups like people with chronic diseases like diabetes, heart diseases (except high blood pressure), lung diseases (including asthma), and compromised immunity individuals. You should also make sure that you are up-to-date with your polio vaccination (check with your physician if a booster dose is needed). The US CDC (Center of Disease Control) further recommend a seasonal Influenza vaccine to reduce the risk of flu. But, this remains a personal choice. It is essential to take the vaccines at least 2 weeks before travelling.
- I’ve heard about the spreading Coronavirus in KSA recently. How can we immunise ourselves against it?
Coronaviruses are large group of viruses related to the one causing the common cold. Some of them, however could cause serious illnesses like SARS virus spread in 2003.
Scientists do not know much about the new virus species that appeared in KSA and Qartar last September. We do not know yet how it spreads or how it is transmitted. And thus, no cure or vaccine are yet available. But, do not panic! This is not a bad thing after all!
WHO (World Health Oranization) and CDC recommend general measure of self-care and hygiene as a protective measure. Same as all flu and common cold viruses, a healthy, body with a healthy immune system can easily deal with them. I believe that our body has the tremendous ability of self healing and regeneration.
During the season of Hajj, due to large crowd, spread of respiratory diseases is very common. Most of these are common known viruses that our body either already has the immunity from or can take care of like a common bout of cold or flu. Still, prevention is better than cure, so when you are in crowded area put a face mask, take good care of personal hygiene. Wash your hands often, use disposable tissue papers, and avoid touching your eyes and nose. And of course, whenever you can, keep your distance from people who look sick.
Eat healthy food rich in fresh fruits and vegetables. You can take vitamin C supplements (500-1000 mg) for further protection, start at least a week before you leave and continue taking it while there. Vitamin C fights cold viruses, protects mucus membrane, and promotes the production of interferon, the body’s own natural anti-viral protein.
Raw honey with freshly squeezed lemon is great for sore throats and cough or even as prophylactic every morning.
Zinc strengthens immunity and its lozenges are reported to relieve symptoms and reduce duration of common cold and sore throat.
Take echinacea extract to boost your body’s natural defense mechanism (It is available at most health food stores and pharmacies - make sure to get the alcohol-free extract not the tincture).
Finally, you can ask your physician to prescribe an antibiotic for you to carry along in case of need. A broad spectrum antibiotic like ciprofloxacin or amoxicillin will do the job. I do not recommend taking it as prophylactic, just keep it with you to take it if respiratory infection symptoms start to surface. If the symptoms are severe, though, you might consider seeing a physician. But as I said earlier, It is highly important not to panic. Stress and worry are proven to greatly undermine our immunity.
- Every time I go to Hajj or Umrah I return to my homeland extremely sick with a very harsh case of flu, although I always take the influenza vaccination before traveling. Shall I stop taking vaccinations? And what makes it ineffective that way?
Taking the vaccination is totally a personal choice and its effectiveness is also a personal reaction no one can predict. You have to weigh the advantages and disadvantages and decide for yourself.
Common cold and influenza are caused by more than 200 different viruses that cause various degrees of upper respiratory tract infections. These viruses have the ability to readily mutate (i.e. alter their genetic makeup) constantly creating new strains that pose new challenge on our immune system and make permanent immunity against flu impossible.
Influenza vaccines deliver inactivated (i.e. containing dead viruses) or attenuated (i.e. containing weakened viruses) dose of influenza viruses. The shot is aimed at boosting our body’s immune system to synthesize the required antibodies for fighting against the upcoming flu. The problem is, among those hundreds of strains of flu viruses, only three could be included in the vaccine shot. Pharmaceutical companies have to take a calculated ‘guess’ on the most possible ones to appear in the flu season. And, since the vaccines need around 11 months from development till they reach the consumers, and given the fact that the flu viruses have a tremendous ability to readily mutate into new strains, we cannot be certain that these are the right three strains any more.
Again, as I told you, vaccination remains your personal choice although, I have to mention that it is highly recommended by the WHO and CDC.
Personally, I did not take the vaccine when I performed hajj, neither did my husband on his 2 pilgrimages or any of his Omra trips. In some of those, we caught bad flu that managed to take its course and heal alhamdullah but did not stop us from continuing our rituals, and in other cases, we did not fall ill, alhamdullah.
So, it is totally up to you to decide which course to take. Just in any case follow all preventive and immune boosting measures you can (refer to question 3). And remember our Prophet's saying: ""No fatigue, no disease, no sorrow, no sadness, no hurt, no distress befalls a Muslim, even if it was the prick he received from a thorn, but that Allah expiates some of his sins for it" (Bukhari & Muslim). So, even your flu bout, if any, won't go in vain in shaa Allah.
- What is the suitable age to perform Hajj rituals?
As Allah told us, performing hajj starts to be an obligation on every Muslim at the age of puberty if he/she is capable (financially, physically and psychologically). So, due to its physically demanding rituals, it is best to perform it when we are still young and fit. There is no specific age of course, but I guess the age of twenties and thirties seem to be the best choice as during that time we are grown up yet young enough to withstand the physical and emotional stress and of course understand, heed, enjoy and cherish the spiritual benefits.
Still, I have to say here that I have met many people in their forties and fifties healthier and more fit than their younger counterparts. So, in the end, the health and vitality is the best determinant rather than the age.
- What is the maximum number of hours or minutes I could stay outdoor under the direct sun?
This largely varies according to the temperature and according to your body's personal ability. My advice is to stay in the shade whenever possible, wear a sun block (I prefer a physical sun block not a chemical one), sunglasses, and carry an umbrella in the area where shade is not an option. Most importantly, listen to your body, and don't ignore any early signs of dizziness, headache, drowsiness or fatigue. Drink plenty of fluid, water is the best hydrating liquid of course, so carry with you a small bottle of water at all time. And, avoid prolong exposure to the sun.
- Thank god I took the meningitis vaccine. But I need to know what could cause its infection for me during rituals and what are the side effects of its vaccine as my friends made me afraid of it.
Meningitis is a bacterial infection of the membranes covering the brain and spinal cord (meninges). It is a very serious disease, yet it is not highly contagious, alhamdullelah. Both viral meningitis and bacterial meningitis can be spread through direct contact with nose and throat secretions that's why personal hygiene is extremely important especially in crowded places like during hajj.
Meningococcal vaccine has been there for a long time now, and has proven to be relatively safe. Like any medicine, of course, it may have some side effects, but has not shown to cause any serious harm. The rare side effects include symptoms appearing directly following the vaccination like jerking or seizure-like movements. These usually subside by rest for 15-20 minutes after the shot. Some people getting the vaccine could show redness or pain at the injection area which usually disappear within 1 or 2 days. In very rare cases, allergic reaction has been reported directly after the shot and this should be dealt with by the physician giving the vaccination.
- What are the health precautions necessary to bear in mind while eating or drinking in Mecca and Medinah?
Unfortunately diarrhea is one of the common diseases encountered during hajj. The most important precaution is to drink only bottled water (or of course Zamzam water from the mosque) and do not eat food that has been exposed to sun or heat for long time. You can eat packaged food like biscuits and crackers, fresh fruits or vegetables after thorough washing and cooked food if it is freshly cooked and served hot.
Follow all regular hygiene measures: washing hands very well, washing your fresh vegetables or fruits thoroughly, cover all your food...
If you contacted diarrhea, note that the most essential measure is proper hydration. If the diarrhea is severe, consult a physician, meanwhile take a rehydrating salt (available over the counter in all pharmacies) to avoid dehydration.
- Which one is more hygiene and safer to use during Hajj, the flush toilet or the squat one?
Usually the squat one is safer especially in crowded areas. It is less in contact with the person using it so it is less likely to transmit diseases.
In both case, though, it is good to carry a sanitizer and your own toilet paper. Try to get the least possible contact with the toilet and needless to say wash your hands thoroughly after use.
- I performed Hajj 4 times so far Elhamdulillah, yet when I return home, I always go into a very bad psychological condition and depression that lasts for two months or so. What can I do?
Hajj is a highly spiritual journey. It touches the heart and soul much more than it affects the body and this of course is the main purpose. I am not sure of the reason behind your depression, though. Is it the feeling of homesickness to that holy place? or is it because you are back to the usual life stresses and challenges you were temporarily relieved from? or maybe it is because you worry if your hajj had been accepted by Allah SWT? You need to sit and reflect on the origin of your depression. Knowing the source is essential for us to deal with the problem. You may want to sit with a friend or consult a trusted scholar or psychologist to clear up some issues. Most importantly, don't surrender to your depression, seek repentance and ask Allah forgiveness, adjust your intention and He SWT will help you through your challenging times.
On the physical level, mild depression could be resulting from deficiency in essential fatty acids and the neurotransmitter serotonin. You can take fish oil supplements (or DHA or flaxseeds- all are good source of essential fatty acids) and 5HTP (5-hydroxytreptophan) a natural supplement that helps restoring serotonin level and boosting the mood.
Vitamin D deficiency could also have a hand in this. Go outdoors, get exposed to the sun whenever you can and eat lots of fatty fish.
- Why doesn’t Saudi Arabia require a Hepatitis C vaccination?
I can't answer for them. But, what I know is that hepatitis C is mainly transmitted through contaminated blood. So, no wide risk like in case of the disease transmitted through the respiratory tract. The only risk you should be aware of during hajj is when men shave their heads, they need to make sure that the blades used are disposable, clean ones or better yet, take your own shaving kit along.
- Can I take my baby with me to Hajj or this could be unsafe for her immunity?
I do not recommend it. The highly crowded place is a high risk of transmitting disease especially for a baby with still-to-develop immune system. And, another real risk is the pushing around during many of the rituals and the unavoidable human stampede that you sometimes encounter.
- Is the chemical composition of Zamzam water different from other well waters?
Yes, many researches show the high quality and purity of zamzam water compared to other waters, but, personally, I think there is much more into it than chemistry and much more than what we can explain with our current technological and scientific instruments. As I studied energy medicine for years, I see the instant shift in water energy when we simply say a prayer or mention Allah's name while holding the cup. This energy had been recorded under the electron microscope by the Japanese researcher Masaru Emoto who saw water molecules as carrier of information. So imagine how would be the energy of the water that our Prophet PBUH told us about it: “Zamzam water is for whatever is intended in drinking it" (Ibn Majah, Ahmed & Hakim).
- My old mum is going to Hajj with me this year, what are the health prerequisites for her? How to take care of her properly during Hajj?
Same general precautions as all of us regarding food selection, hygiene and sun exposure, but with special stress on some important points for old age:
- Hydration is very important in advanced age as old people get dehydrated very quickly and usually without noticing it. And especially avoid un-necessary sun exposure.
- Avoid crowded places. Try not to perform the rituals in the peak hour. And, whenever possible for you to do it in her place, it will be better (like in rajm-throwing the stones- for instance).
- You can ask for wheel chair for tawaf... if needed, just ask her not to over stress herself.
- I’m on medication for high blood pressures, what are the things to avoid during the pilgrimage?
First you should bring sufficient (or even some reserve) quantity of your medication and remember to take them on time. If your medication involve diuretics like thiazide and thiazid-like medication, it is important to remember to hydrate well as you are at more risk of losing body water. As per usual anti-hypertension recommendations reduce salt in your food and if possible bring along your meter to monitor your blood pressure during your travel. if this is not possible, you can usually measure it at local pharmacies or medical centers upon any sign of disturbance.
Avoid stress and overexertion and avoid too much sun exposure. Eat plenty of leafy green vegetable (thoroughly washed) and fresh fruits and vegetables.
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