Hajj 2021: How epidemics impacted Hajj over time

The Hijaz region saw its share of epidemics, particularly cholera, which repeatedly hit the area and threatened Hajj pilgrimage routes. (Getty Images)
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The Hijaz region saw its share of epidemics, particularly cholera, which repeatedly hit the area and threatened Hajj pilgrimage routes. (Getty Images)
An Indian health worker (R) administers a meningococcal polysaccharide vaccine to a Hajj pilgrim in Hyderabad, 2010. (Getty Images/AFP)
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An Indian health worker (R) administers a meningococcal polysaccharide vaccine to a Hajj pilgrim in Hyderabad, 2010. (Getty Images/AFP)
Egyptian Hajj pilgrims receive vaccine injections from Saudi medics before leaving the ship upon their arrival in Jeddah in 2002. Getty Images/AFP)
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Egyptian Hajj pilgrims receive vaccine injections from Saudi medics before leaving the ship upon their arrival in Jeddah in 2002. Getty Images/AFP)
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Updated 20 July 2021

Hajj 2021: How epidemics impacted Hajj over time

Hajj 2021: How epidemics impacted Hajj over time
  • One of the earliest recorded epidemics in Makkah was known as Al-Mashri, which killed many people as well as travelers’ camels in 968, as recorded by the renowned historian Ibn Kathir
  • In 1831, a cholera epidemic that started in India killed 20,000 people in Makkah; subsequent epidemics came to the region of the holy cities in 1841, 1847, 1851, 1856–57, and 1859

JEDDAH: Hajj, the annual pilgrimage to the holy shrines in Makkah, is one of the oldest regular movements of people over long distances and one of the largest reoccurring religious mass gatherings globally.

Prior to the current coronavirus disease (COVID-19) pandemic, Hajj was affected by various infectious diseases throughout history, which at times suspended the pilgrimage, limited pilgrims’ travel to the holy city, and claimed victims from among the pilgrims as well as from Makkah’s population. 

One of the first historically recorded plagues in Makkah was mentioned by prominent Muslim scholar and historian Ibn Kathir. In his book, “Al-Bidāya wa-n-Nihāya” (“The Beginning and the End”), he said that an epidemic known as Al-Mashri hit the city of Makkah in 968, killing many people as well as travelers’ camels, while pilgrims who were able to complete their pilgrimage died soon thereafter. 

Several historians indicated that convoys of pilgrims witnessed a significant decline during that period, especially from regions hit by the epidemic, due to the deteriorating social and economic circumstances caused by the disease or other diseases in later periods.

Hajj was later transformed by a global revolution in transportation in the 19th century. New means of transportation facilitated movements of larger groups of people worldwide, making the transmission of diseases faster and severely unmanageable. 

That same century was plagued with epidemics, and global life expectancy declined to just 29 years of age as different diseases spread and killed millions throughout the world. The Hijaz region saw its share of these epidemics, particularly cholera, which repeatedly hit the area through India’s pilgrims.

Muslims have long known about the efficacy of quarantine, since the Prophet Muhammad said in the hadith, “If you get wind of the outbreak of plague in a land, do not enter it; and if it breaks out in a land in which you are, do not leave it.” Pilgrims were often quarantined upon their return in some countries during epidemics, such as in Egypt during the Ottoman Empire. 

Quarantine measures were not yet part of a widespread public health policy back then, however, and the world was not familiar with global disease breakouts. Unlike the plague, cholera was a completely new disease, of which humanity only had very limited knowledge.




An Indian health worker (R) administers a meningococcal polysaccharide vaccine to a Hajj pilgrim in Hyderabad, 2010. (Getty Images/AFP)

Cholera threatened Islamic pilgrimage routes, especially after the opening of the Suez Canal, which facilitated the spread of diseases through ships and railways and forced pilgrims to stay in quarantine for 15 days in the canal or in the Red Sea before heading to Hijaz. 

The disease first appeared in the Arabian Peninsula in 1821. Yet, it did not reach Hijaz until 1831, when it broke out for the first time in Makkah, causing the death of at least three-quarters of the pilgrims arriving at the time. It was called the “Indian epidemic,” and it moved with astonishing swiftness.

According to the book “Histories of Health in South Asia” published by Indiana University Press, cholera killed 20,000 people in Makkah in 1831, and subsequent epidemics came to the region of the holy cities in 1841, 1847, 1851, 1856–57, and 1859. 

In 1840, the Ottoman Empire enforced quarantine, organizing stops at border crossings and in cities near the holy shrines. 

Politics was never too far from the medical policies of Hajj in Hijaz. The massive outbreak of the disease forced British and European colonial powers to pay attention to this crisis and include it in their international politics agenda — not so much to protect the pilgrims as to safeguard their colonies and geopolitical and economic interests. This continued throughout the colonial period, from the late 19th into the early 20th century. 

Colonial powers pushed for a series of large-scale international meetings to deal with the threat of cholera. The first was held at Constantinople in 1866, and it eventually became known simply as the Cholera Conference. 

British policy, however, contradicted the scientific findings of the Cholera Conference. For a long time, the British held that Indian cholera was not a contagious disease, denying the efficacy of cordons and the quarantine of ships following the opening of the Suez Canal, which resulted in a huge loss of life that could have been avoided.

FASTFACT

20,000 people were killed by cholera in Makkah in 1831.

Therefore, although pilgrims were often blamed for being the source of cholera, the worldwide spread of the disease was caused by colonialism, capitalism and new technologies, with pilgrims unwittingly carrying the disease and falling victim to it.

In 1895, the first directorate of health was established in Makkah. Gradually, with the development first of sanitation and then of countermeasures like vaccines and antibiotics, the way the world interfaced with epidemics drastically changed.

In the early 1950s, the Kingdom of Saudi Arabia built a quarry for pilgrims outside the city of Jeddah, the location of what would later come to be the King Abdul Aziz Hospital.

Between Saudi Arabia’s internationally recognized success in handling the COVID-19 health crisis and the death of tens of thousands due to cholera in 1865, the Kingdom has earned over 95 years of experience in managing disease. 

“Saudi Arabia has acquired extensive experience in public health, especially as it has been hosting large numbers of pilgrims during Hajj and Umrah seasons over the years,” Dr. Wael Bajahmoom, consultant in infectious diseases and head of the internal medicine departments at King Fahd Hospital in Jeddah, told Arab News.   

The Kingdom’s history has equipped modern Saudi authorities with significant experience in managing crowds and controlling diseases.

A recently issued report by the Hajj and Umrah Research Institute indicated that infectious diseases still represent a real threat to the current Hajj seasons. 

It showed that between 26-60.5 percent of reported cases in previous Hajj seasons were respiratory diseases such as colds and pneumonia, while the rest were digestive diseases such as intestinal flu, diarrhea and meningitis. The death rate due to infectious diseases during Hajj ranged from 1.08-13.67 percent, with an average of 7.1 percent.

Bajahmoom noted that Saudi Arabia favors the policy of “prevention is better than cure,” which was especially highlighted in its exemplary handling of the COVID-19 pandemic, during which the government limited Hajj to immune local pilgrims.  

“The Kingdom is keen on maintaining the safety of worshipers and visitors to the holy sites, and one of the basics of safety is prevention, which is vaccination. The important role vaccines have played in light of many medical crises over the decades is undeniable,” Bajahmoom added.

One such crisis was meningitis, which is highly transmissible in gatherings such as those at the holy sites in Makkah. Vaccines were essential in curbing its spread.

According to the UK-based Meningitis Research Foundation, epidemics of meningitis have been linked to the Hajj pilgrimage, with cases of the disease also occurring worldwide after pilgrims returned to their own countries. Since then, Saudi Arabia has made vaccination against the disease compulsory for entry into the Kingdom during Hajj and Umrah since 2002. No Hajj-related outbreaks of the disease have been reported ever since.

The Public Health Concerns 2019 report by the Saudi Ministry of Health, the year in which the Kingdom received international pilgrims for the last time before the current COVID-19 pandemic, indicated that the meningitis vaccine was mandatory for everyone in the Hajj area; that polio and yellow fever vaccines were required for pilgrims from certain countries; and that the seasonal influenza vaccine was optional but highly recommended. 

Other viruses and diseases that the Ministry of Health warned of included dengue fever, polio, pulmonary tuberculosis, hemorrhagic fevers including Ebola and Lassa fever, measles, Zika virus, blood-borne viruses, and food and water-borne diseases.

Bajahmoom explained that the vaccine lists for pilgrims were determined by specific factors, such as the widespread nature of an epidemic in a given region or its presence in the world as a whole, and environmental factors that would facilitate the spread of certain diseases such as a particular season or weather changes.




An Indian health worker (R) administers a meningococcal polysaccharide vaccine to a Hajj pilgrim in Hyderabad, 2010. (Getty Images/AFP)

“With the outbreak of COVID-19 this year, the primary vaccine for this Hajj season was the one against this disease,” he noted. 

Saudi Arabia has faced various epidemics and virus outbreaks since meningitis. In 2009, with the spread of the swine flu, Saudi Arabia decided to prevent the elderly, children and pilgrims with chronic diseases from performing Hajj that year.

Moreover, with the escalation of the Middle East respiratory syndrome coronavirus in 2013, Saudi Arabia urged elderly and chronically ill Muslims to refrain from performing Hajj, as the disease had already killed dozens of people in the Kingdom.

Furthermore, during the Ebola outbreak in Africa between 2014 and 2016, in which 11,300 people died, Saudi Arabia made specific contingency plans that included deploying medical staff at airports and setting up isolation units as nearly 3 million Muslims from across the world flocked to perform Hajj. It also suspended pilgrimage visas for Guinea, Sierra Leone, and Liberia — the three worst-affected countries.

With the spread of COVID-19 in early 2020, which claimed thousands of lives worldwide, dozens of workers began sterilizing the floors of the Grand Mosque in Makkah. Saudi Arabia also decided to suspend the entry of pilgrims to the country and enforced health measures for performing Umrah and Hajj — a decision that was welcomed by the World Health Organization (WHO).

“Saudi Arabia played a major role in combating epidemics both locally and internationally,” said Bajahmoom. “Its cooperation with the rest of the world did not stop with the exchange of research but also included medical and financial support to neighboring countries, as well as those farther away.” 

One of the most important contributors to international scientific research is the Ministry of Health’s Global Center for Mass Gatherings Medicine, which works hand-in-hand with the WHO in the health management of mass gatherings and is considered one of the world’s few centers specialized in this area. 

“Having almost two years of experience of controlling COVID-19 in addition to the Kingdom’s accumulated experience gives us extraordinary capabilities to combat any future health issues,” Bajahmoom said. 

As Saudi Arabia approaches herd immunity within months, Bajahmoom hopes that the Kingdom will soon welcome international pilgrims again.

“This pandemic is only one of many crises that we have faced, and it will pass in time. We will look to it as a memory that will equip us with strength in the future.”


Saudi Arabia’s Riyadh Season gets more than 4.5 million visits

Saudi Arabia’s Riyadh Season gets more than 4.5 million visits
Updated 02 December 2021

Saudi Arabia’s Riyadh Season gets more than 4.5 million visits

Saudi Arabia’s Riyadh Season gets more than 4.5 million visits
  • More than 122,000 jobs were offered by the season
  • The Groves, one of the season’s 14 zones, opened its doors on Monday for visitors

DUBAI: Saudi Arabia’s Riyadh Season has recorded over 4.5 million visits in a month, state news agency SPA reported.
More than 122,000 jobs were also offered by the season, SPA added.
The Groves, one of the season’s 14 zones, opened its doors on Monday for visitors to experience the site’s spa, restaurants, shops and shows.
The Groves has combined work and relaxation through an area called The House, which offers business meeting rooms in a luxurious environment.
The Riyadh Season 2021 was launched on Oct. 20 and includes 14 areas: Boulevard Riyadh City, Via Riyadh, Combat Field, Al-Athriyah, Riyadh Oasis, The Groves, Riyadh Winter Wonderland, Riyadh Front, Al-Murabba, Riyadh Pulse, Riyadh Safari, Al-Salam Tree, Khalouha and Zaman Village.


Nabd Al-Riyadh shows the present Kingdom on the walls of past

Nabd Al-Riyadh shows the present Kingdom on the walls of past
Updated 02 December 2021

Nabd Al-Riyadh shows the present Kingdom on the walls of past

Nabd Al-Riyadh shows the present Kingdom on the walls of past
  • Nabd Al-Riyadh, which means the pulse of the capital, presents the rich past of the Kingdom since its foundation through more than 400 storytelling visual presentations

RIYADH: Nabd Al-Riyadh, one of Riyadh Season’s 14 zones, opened its doors for visitors this week to take them on a visually enhanced journey to explore the history, heritage and culture of Saudi Arabia.

The zone, which is free, was a popular feature of Riyadh Season when it first appeared in 2019. This year it has been given an extra touch of music and shows from all around the world to accompany the Saudi folklore and keep the visitors entertained.

Nabd Al-Riyadh, which means the pulse of the capital, presents the rich past of the Kingdom since its foundation through more than 400 storytelling visual presentations. The zone perfectly embodies Saudi cultural traditions and heritage with an artistic simulation of its history projected on the walls of Masmak Palace.

Abdulhameed Fouzi, a visitor from Tabuk, said that Masmak Palace “is one of the places I really wanted to visit and see in person.”

“Masmak Palace is often where the people pledged allegiance to their kings. This is where everything used to happen in the past,” said Rana Al-Wakeel, another visitor.

The zone offers entertainment for individuals, families, and children with musical performances and art shows that will continue until mid-January 2022.

The events at Nabd Al-Riyadh include the Safat Square, which has sand painting, Rubik’s square painting, “3D” street art, glitter art and theatrical and musical performances, as well as the Safat Caffe, which serves traditional drinks and sweets.

The Al-Masmak Square area includes artistic, theatrical, and interactive performances, while the Nabd Al-Riyadh theatre features more than 30 Saudi and international bands, orchestras and singers.


Probe launched after Saudi Arabia records first omicron variant case

Probe launched after Saudi Arabia records first omicron variant case
Updated 02 December 2021

Probe launched after Saudi Arabia records first omicron variant case

Probe launched after Saudi Arabia records first omicron variant case
  • At this stage, prevention is better than cure and standard precautions must continue to be practiced, says Health Ministry spokesman

JEDDAH: Saudi Arabia has launched a health probe after reporting the country’s first positive case of the omicron COVID-19 variant.

The Kingdom joined more than 21 other nations in recording an omicron infection after a Saudi national who flew in on a passenger plane from a north African country tested positive.

The individual was placed in isolation, along with a number of other people they had been in contact with, according to the Saudi Press Agency.

“An epidemiological investigation has started, and the case was sent to quarantine, where accredited health procedures were followed,” the SPA report said.

During a specially convened Saudi Ministry of Health press conference, ministry spokesman Dr. Mohammed Al-Abd Al-Aly said there was still much to learn about the new variant and warned against spreading false information about it.

“Health experts across the world and the Kingdom are closely monitoring the situation and more research needs to be done to determine its lethality. At this stage, prevention is better than the cure and standard precautions must continue to be practiced,” he added.

Dr. Abdullah Algaissi, a virologist and assistant professor at Jazan University’s college of medical sciences, recently told Arab News: “Based on what we know from the genetic sequencing, we don’t have information that could tell us if these mutations will make the virus more lethal, more transmissible, if it will impact the immune response either after infection or vaccination. As of now, we don’t know.”

Al-Aly pointed out the importance of people completing vaccination programs and recommended that anyone who had gone six months since having their second jab should receive a booster, especially those aged over 65.

HIGHLIGHT

Health Ministry spokesman Dr. Mohammed Al-Abd Al-Aly urged people to keep a check on their health status via the ministry approved Tawakkalna app, to self-isolate where necessary, and continue to follow precautionary measures brought in at the start of the pandemic.

Health officials have said that third doses offer increased protection against COVID-19 and can prevent infection or milder illness with symptoms.

According to the US CDC, data from clinical trials showed that a booster shot increased the immune response in trial participants who finished a Pfizer-BioNTech or Moderna primary series six months earlier or who received a Johnson and Johnson/Janssen single-dose vaccine two months earlier.

With an increased immune response, people should have improved protection against COVID-19, including the delta variant. For Pfizer-BioNTech and Johnson and Johnson/Janssen, clinical trials also revealed that a booster jab helped prevent COVID-19 with symptoms.

To date, more than 47.4 million vaccine doses have been administered in Saudi Arabia.

Al-Aly urged people to keep a check on their health status via the ministry-approved Tawakkalna app, to self-isolate where necessary, and continue to follow precautionary measures brought in at the start of the pandemic.

“Masks continue to be a very important protective measure against any infection,” he added.

Health officials are stationed at the Kingdom’s ports to check the temperatures of arriving passengers.

News of the omicron case came as Saudi Arabia lifted a ban on direct travel from India, Egypt, Pakistan, Brazil, Vietnam, and Indonesia although arrivals would need to enter institutional quarantine for five days.

On Wednesday, the Kingdom reported 34 new COVID-19 cases and 26 recoveries. One death was recorded, and 39 patients remained in critical condition.


Who’s Who: Turki Abdulaziz Al-Turki, assistant deputy for technical affairs at Riyadh municipality

Who’s Who: Turki Abdulaziz Al-Turki, assistant deputy for technical affairs at Riyadh municipality
Updated 02 December 2021

Who’s Who: Turki Abdulaziz Al-Turki, assistant deputy for technical affairs at Riyadh municipality

Who’s Who: Turki Abdulaziz Al-Turki, assistant deputy for technical affairs at Riyadh municipality

Turki Abdulaziz Al-Turki has been assistant deputy for technical affairs at Riyadh municipality since November.

Al-Turki, who has also been a consultant to Riyadh’s mayor since February last year, served as a lecturer at King Saud University from 2012 to 2020.

He assisted in the preoperatory year at the university’s architecture and building science department and helped in evaluating and grading the work of students, including in design studios. He also integrated student design with regulations, policy, sustainability, renewable energy, and ecosystems.

In addition, he prepared and delivered lectures to undergraduate students on topics such as architectural design methods, aesthetics and design, and structure and materials.

For 22 months, starting from March 2017, Al-Turki worked as an architect in Al-Rajhi Holding Co.’s development and construction department, assisting on renovation projects for historical buildings using mud, wood, and sustainable materials.

Between June 2011 and May 2012, he acted as an architect engineer at Goot Resorts, helping in the project management office on the building of new chalets, production of schematic design, design development and construction documents, and valuating contractors, suppliers, and vendors.

From June 2011 to January 2014, he served as a part-time design manager with Zaahib estates development where he designed the company’s projects and organized real estate offers.

Al-Turki gained a bachelor’s degree in architecture and building science from King Saud University in 2011 and four years later attended a master’s preparation and ESL program at the University of Southern California, in the US.

In 2017, he obtained a master’s degree in design research and urban design from the Southern California Institute of Architecture and this year took part in an executive leadership program at Harvard Business School.


OIC chief holds talks in Jeddah with envoys to Saudi Arabia

OIC chief holds talks in Jeddah with envoys to Saudi Arabia
Updated 02 December 2021

OIC chief holds talks in Jeddah with envoys to Saudi Arabia

OIC chief holds talks in Jeddah with envoys to Saudi Arabia
  • Hissein Brahim Taha, the Organization of Islamic Cooperation’s new secretary-general, met ambassadors from Norway, Chad, Sudan and Nigeria

JEDDAH: Hissein Brahim Taha, the secretary-general of the Organization of Islamic Cooperation, met a number of foreign ambassadors to Saudi Arabia at the organization's General Secretariat in Jeddah this week.

On Wednesday, Norwegian Ambassador Thomas Lid Ball discussed with the OIC chief ways in which cooperation between his country and the organization can be enhanced, and they reviewed international issues of common interest.

Taha expressed his appreciation for Norway’s role in promoting international peace and security and its support for development efforts in OIC member states. Lid Ball praised the OIC for its stature and positive role in the international arena.

Also on Wednesday, Taha welcomed Ambassador Zakaria Fadoul Kitir of Chad. They discussed bilateral relations how they might be developed, in addition to ways of strengthening Islamic solidarity and joint Islamic action.

On Tuesday, Taha held talks with Sudanese Ambassador Adel Bashir and Nigerian Ambassador Yahaya Lawal. They congratulated the new OIC chief on taking office last month and discussed their countries’ relations with the OIC.