This year’s announcement that Hajj will be limited to only those living in the region has brought mixed emotions. Hajj is a wonderful spiritual experience for so many practising Muslims – a pilgrimage to Mecca attended annually by 2.5 million people with religious activities lasting a week. Denying so many people this unique opportunity is heartbreaking. But as a frontline NHS doctor and regular Hajj medic, not only have I seen the devastation Covid-19 has brought, I can see how a Hajj outbreak could be catastrophic.
Despite having been blessed with the opportunity to attend regularly, I still eagerly look forward to returning the following year. The Hajj is always an uplifting spiritual experience, meeting fellow pilgrims from around the world, dressing in white robes of humility and performing the same rituals in a grand demonstration of unity. But therein lies the problem: with attendees from all corners of the world in attendance, side by side and breathing the same air in tightly confined places, a single pilgrim carrying Covid-19 would be a recipe for disaster.
Moreover, whilst exhilarating and uplifting, Hajj is also challenging. The exhausting schedule, sleep deprivation and close proximity of so many pilgrims from around the world provides the perfect storm to transmit viral infections. The “Hajj cough” – a lingering dry upper respiratory tract infection born out of the spread of multiple viruses from different locations around the world, is a real phenomenon – if not a rite of passage for pilgrims! I often need to prescribe a few doses of strong antibiotics and strict bed rest, and even these are not enough sometimes, with some patients needing hospitalisation, ventilation and monitoring.
For medics like myself, Hajj is busy at the best of times and whilst the Saudis have made extraordinary efforts to support the influx of pilgrims, it is still incredibly challenging. Waiting for ambulances to arrive is often futile, and on more than one occasion I have had to navigate crowds of tens of thousands to take a critically ill person to nearby emergency facilities. These facilities are often overwhelmed too; many groups don’t have medical support, and rely heavily on the local services to assist elderly or chronically unwell pilgrims who fall ill. Of course, outside of the Holy Precincts, Hajj is also a huge social affair, an opportunity to meet and spend time with brothers and sisters in faith from across the world. Introducing Covid-19 to this scenario doesn’t bear thinking about.
That’s why, after almost a decade as a volunteer doctor looking after groups of 150 and participating in camps for 50,000 to 60,000 pilgrims during the busiest times, it pains me to say this year’s downscaling is the right decision.
For the 2.5 million attendees, the pilgrimage is more than an obligation, it is an intensely emotional, uplifting and transformative experience, representing the spiritual pinnacle of their faith. Many will sadly miss out on that this year, but with Saudi Arabia currently suffering from one of the largest coronavirus outbreaks in the Middle East, with 161,000 declared infections and more than 1,300 deaths, tempting a potential global spread by opening its doors is unthinkable.