Protect Your Health During Hajj & Ziyarat

Protect Your Health During Hajj & Ziyarat October 31, 2006 Vancouver, Canada And proclaim the Hajj to people: They shall come to you on foot and on lean camels – coming from distant places…” (Surat Al-Hajj 22:27)

Part 1 – Ladies & Gents “A person seeing (visiting) my grave deserves my intercession. And a person who visits me after my death is like a person who visited me during my lifetime.” (Holy Prophet, saw)

Vaccination • Consult your doctor 6-8 weeks before departure • Vaccination requirements • Meningococcal Vaccine • Other Vaccines

Vaccinations Continued... Four Weeks Before Departure: ♦ Typhoid Injection - if you have not had it in the last three years. (You can have capsules if you prefer). ♦ Tetanus Injection - if you have not had it in the last 10 years. If your have never had them, you will need a full course of three. ♦ Polio Drops - if you have not had them in the last 10 years. If you have never had them, you will need a full course of three. ♦ Hepatitis A & B Injection – 3 doses (start, 1 month and 6 months) ♦ Meningitisquadrivalent ACWY - if you have not had it in the last 3 years.

Economy Class Syndrome • DVT GUIDELINES ♦ Wear loose and baggy clothing during the flight ♦ Drink plenty of non-alcoholic fluids to prevent dehydration ♦ Stand up in the seat area and stretch arms and legs every couple of hours. ♦ Avoid crossing legs when seated. ♦ Carry out foot and leg exercises frequently. ♦ Walk around the cabin as often as possible.

♦ Carry-on luggage should not be kept in a position that would interfere with the mobility of your legs. As well, a cushion should be used on the seat if it is very hard. ♦ If you can take aspirin, have one tablet on the morning of travel. Please consult your GP first

General Advice • Malaria • Dental Check-up • General Hygiene • Cold Weather Protection • Avoid Direct Heat • Drink plenty of clear water • Eat Safe foods Remember… vaccinations are not enough to prevent diseases

Colds & Coughs • Salt Tablets • Sore Throat • Cough, constipation and diarrhea medication • Other medications

Disease & Precautions • Sore Throat • Chest Infection • Heat Exhaustion • Heat Stroke • Cholera • Infectious Hepatitis • (Jaundice) • Malaria • Polio • Tetanus • Typhoid • Meningitis

Diseases and Precautions ♦ Sore Throat: Avoid cold drinks, over-crowding, dust, contact with other people with sore throats or cough. ♦ Chest Infection: Avoid dust, overcrowding and contact with other people with sore throats or coughs. ♦ Heat Exhaustion: (Muscle weakness due to loss of body salt) - Avoid direct heat from the sun. Drink plenty of water and take salt tablets. ♦ Heat Stroke: Avoid direct heat from the sun. Get medical help immediately. THIS IS AN EMERGENCY.

♦ Cholera: Caught by contaminated water or food. Vaccination does not give protection. Take scrupulous care over food and drink. ♦Infectious Hepatitis (Jaundice): There is a high risk of this disease in Haj and Ziarat because of poor sanitation. It is caught by consuming contaminated food or water or contact with an infected person. Take scrupulous care over food, drink and hygiene. Get yourself vaccinated. (Vaccine lasts 1 year or 10 years depending on dose taken).

Diseases and Precautions cont... ♦ Malaria: Caught by a bite from an infected mosquito. Take anti-malaria tablets. Avoid mosquito bites. ♦ Polio: Caught by direct contact with infected person. Take scrupulous care over food and drink. Get yourself vaccinated. ♦ Tetanus: Risk areas are places where medical facilities are not available. It is caught by open injury. Wash any wound thoroughly. Get yourself vaccinated. ♦Typhoid: Caught by contaminated food, water or milk. Take scrupulous care over food and drink. Get yourself vaccinated. (Vaccine lasts three years). ♦Meningitis: Caught by contact with an infected person. This is a very serious condition and potentially fatal. Get yourself vaccinated. (Vaccine lasts 3 years).

WASH YOUR HANDS WITH SOAP AND WATER FREQUENTLY Proven in research to be the most effective method of preventing infections

Special Precautions • Asthma • Avoid dust, perfume, car fumes etc • Ventolin, Advair • Diabetes and Heart Disease • Nitrospray • ASA • Glucose monitoring • Water spray bottles or AVIAN SPRAY • Umbrella, caps • Halak – Beware of used blades – can transmit HIV, Hep B, C, E

Special Precautions cont...… • Waajibaat First • Hajre Aswad – Only after Waajibaats are over! Avoid fractured ribs • Night/day reversal as much as possible • Adequate sleep – Not enough sleep affects the immune system • “glucose tablets” not very useful • Avoiding fungal infections by using creams

Special Precautions during Rituals • Arafat • Avoid dehydration – use the toilets • Heat exhaustion and pneumonia at night • Mina • Hitting Shaytan – special precautions such as glasses etc • Take your time to carry out the rituals – don’t worry…organizers will ensure you get everything done – its not a competition.

First Aid • Act quickly, quietly and methodically • Give priority to the most urgent patient • Control bleeding • Reassure and encourage patient • Do not allow people to crowd patient • Do not give anything by mouth to patient who is unconscious, who has internal injury or who may need an operation • Call for an ambulance or doctor asap

First Aid- Common Emergencies - • Bleeding Wounds • Apply direct pressure to the wound for 10 – 15 minutes • Lower head if possible • Apply a dressing and firm band aid - but not too tight • Fainting • Lay patient flat on floor or bed (if not possible then lower his/her head between his/her knees) • Loosen clothing at the neck, chest and waist • Reassure and urge patient to breath deeply, help him/her to move the muscles of the legs, thighs and buttocks to help the circulation of blood. • On recover, sips of water may be given

Suggested Medications • Prescribed medications … do not forget them • Antibiotics – 2 courses (Cipro, Z pack) • Anti diarrhoea such as Immodium • Vitamins (particularly Vitamin C) • HC with Canesten creams or other creams • Analgesics such as Tyelenol, Motrin, Advil • OCP/Primolut N

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O Allah! Bless the pilgrims and zuwwar with travel provision and sustenance and let them fulfuill what you have regulated in Hajj and ‘Umrah. (Imam Al-Mahdi, as)

Part 2 – Ladies Only “The following things are not necessary for women to perform in the Hajj: • Pronounce the Talbiyyah (Labbayk Allahumma Labbayk) out loud; • Perform the Harwalah (act of briefly running) between the mountains of al-Safa and al-Marwah; • Rubbing of the hand on the Hajral Aswad; entering into the Ka’bah; • Shaving of the head; instead, they only cut some of their hair.” Imam Muhammad Baqir (as)

Part 2 – Ladies Only Menstruation during Hajj: • Introduction • Planning Ahead • Bleeding during Hajj

Ensuring Waajibaat • On the first day of your last menstrual period commence a contraceptive pill. • You may choose from the following - Microgynon 30, Brevinor, Ovysmen, Marvelon and Ovranette. (If for medical reasons you can not take the contraceptive pill, then start taking Norethesteron 5mg tablets three times a days 2 days before expected period, continue taking them for as long as you want to postpone your period.) NO BREAK AFTER 21 DAYS. You must consult your doctor (General Practitioner) before commencing the pill.

♦ Continue with the pill throughout the duration of the pilgrimage. ♦ Consult your doctor (GP) and ask for a supply of Norethesterone (Primolet N) 5 mg tablets. Take one tablet three times a day if bleeding commences.Use as a contingency. • Other drugs such as Provera, Danazol (Danol), etc. may be prescribed by your doctor and may be effective in stopping bleeding.

What do I do if I am on the OCP and then start spotting or bleeding during Hajj? Consult an expert doctor in one of the groups Primolut N 5 mg three times a day Sometimes the dose may need to be higher

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May Allah (swt) accept your Hajj. Please remember us in your duas.Thank you

Protect Your Health During Hajj & Ziyarat