Hajj is one of the five pillars of Islam and is a must-do for all adult affording Muslims once in their life. This year, Hajj will be in the month of August and the expected temperatures in these days will range between 30oC to 43oC in and around Makkah. The exertive outdoor rituals of Hajj are already physically challenging in such hot weather for an average healthy adult pilgrim. 8.8% of global human population is estimated to be diabetic. The year, the expected number of pilgrim is expected to be 2.5 million. Around 20% of these pilgrims might be diabetic or cardiac patients. This year, around 200, 000 pilgrims from Pakistan are going to perform Hajj and many of them are over the age of 50. During Hajj, patterns of diet, fluid intake, rest and physical activity are vastly different from the regular daily life routine. A large number of pilgrims from Pakistan might have some diseases like diabetes, hypertension, cardiac diseases, artrithis etc. So the preventive measures are strongly recommended for the patients and their accompained pilgrims especially for the persons over the age of 50. Electrocardiogram (ECG) may be of help before traveling for Hajj with clear instructions to attend health facilities as soon as possible if symptoms like chest pain, shortness of breath or palpitation are felt. However, Hajjis with diabetes and cardiac problems may face some major medical challenge. It may include hypoglycemia, foot injury, infections and fluctuations in blood pressure. It is necessary to take the precautions in the prevention and treatment of possible complications.
Diabetics or cardiac patients while planning for hajj are advice to keep certain recommendations in their mind. Prepare a checklist for mandatory requirements. One should try to have a good control over their blood glucose and blood pressure. Inadequate nutrition, poor intake of drinking water, hot weather and physical exertion and hot weather can lead to various health problems. Patients are advised to complete recommended vaccinations, including influenza and pneumococcal vaccines before leaving for hajj. One should prepare their required medicines and keep them in separate containers. Prepare a cool pack or insulin keeping pouch with ice pack for keeping one’s insulin in. Keep glucometer and blood pressure apparatus in one’s bag pack.
During travel, one should always keep some carbohydrates to be used in hypoglycemic states. Try to adhere to a healthy and well balanced diet containing adequate, but not excess carbohydrates, with appropriate proteins and fiber but minimal (monounsaturated) fat. Use more of vegetables and 2 units of fresh fruits per day. One should drink at least 8-11 glasses of water daily and carry enough water bottles. Before Tawaf (ØæÇÝ)(circumambulation around Ka’bah) and Saaye(ÓÚí) (walking between Safa and Marwah), consume some extra carbohydrate (bread is preferred). Walk slowly during Tawaf and saaye, and try to protect feet from damage by the ground tiles or other pilgrims.
Diabetic and cardiac patients are advised NOT to skip meals and one should adjust their physical activity in such a way that they are able to get rest in between as long walks and increased physical activity leads to fatigue. It is essential to increase fluid intake during the Hajj walking. Reduce medication doses and get snacks if one has hypoglycemia. One should always keep records of the blood glucose measurements to identify patterns that contribute to hypoglycemia. It is important to eat simple food during the hajj days and avoid fast foods, diabetic and cardiac patients are strictly advised consume the foods that are good for their health conditions. Fast food is often very salty which can increase one’s blood pressure. Increased sweat can also lead to dehydration in high temperature. One is advised to carry a dark colored umbrella in order to prevent dehydration due to direct sunlight exposure.
There are very good medical facilities provided by the Saudi Government for Hajjis. Therefore, one should not delay in getting a medical advise or consultation in case one feel any sort of symptom, especially those patients who are known cases of diabetes or cardiac diseases. Moreover, there are many Pakistani restaurants in Makkah and Medina, serving Pakistani food. Cardiac and Diabetic patients are advised to eat simple, less oily, less spicy and nutritious food. It is also advised to eat food which is based on vegetables and fruits. Hajj is a holy activity and if one take care of their diet, they can perform it in a better way.
—The writer, a Gold medallist, holds Master’s Degree in Food and Nutrition from University of Peshawar.