However, those managing the Haj arrangements say adequate precautions are taken, as the prospects of heat stroke and severe dehydration loom large over the pilgrims. Aside from providing umbrellas, water sprinklers and drinking water, the authorities make adequate provision for treatment of heat stroke cases at various medical facilities across the holy sites.
Saudi television also changes its focus from entertainment to edutainment. Its programs are focused on educating the pilgrims about safety in general and protection from heat and infections in particular, as well as heat stroke prevention.
The natural climatic condition is a major contributing factor to the overall heat load, accentuated by automobile exhausts. This situation is further synergized by some pilgrims living in open sunny areas, using vehicles without roofs and lack of awareness of the seriousness of heat exposure among them.
Heat stroke is due to an environmental exposure to heat, resulting in an abnormally high body temperature, says an internist at United Doctors. In severe cases, temperatures can exceed 40 degrees Celsius. Heat stroke may be exertional or non-exertional depending on whether the person has been exposed to the heat.
Significant physical exertion on a very hot day can generate heat beyond a healthy body’s ability to cool itself, because the heat and humidity of the environment reduces the efficiency of the body’s normal cooling mechanisms. Other factors, such as drinking too little water, can exacerbate the condition.
Non-exertional heat stroke is typically precipitated by medications that reduce vasodilatation, sweating, and other heat-loss mechanisms, such as anticholinergic drugs, antihistamines, and diuretics. In this situation, the body’s tolerance for the excessive environmental temperatures can be too limited to cope with the heat, even while resting, says a senior doctor at King Fahd Hospital.
Heat stroke, also referred to as heat stroke, is a life-threatening medical condition. The person’s cooling system, which is controlled by the brain stops working and the internal body temperature rises to the point where brain damage or damage to other internal organs may result.
“Heat stroke is a form of hyperthermia, an abnormally elevated body temperature with accompanying physical and neurological symptoms. Unlike heat cramps and heat exhaustion, two other forms of hyperthermia that are less severe, heat stroke is a true medical emergency that can be fatal if not properly and promptly treated,” he added.
The body normally generates heat as a result of metabolism, and is usually able to dissipate the heat by either radiation of heat through the skin or by evaporation of sweat. However, in extreme heat, high humidity, or vigorous physical exertion under the sun, the body may not be able to dissipate the heat and the body temperature rises, sometimes up to 41.1 C or higher. Another cause of heat stroke is dehydration. A dehydrated person may not be able to sweat fast enough to dissipate heat, which causes the body temperature to rise, a senior physician at King Khaled Specialist Hospital & Research Center, explains.
Those most susceptible individuals to heart strokes include infants, the elderly — often with associated heart diseases, lung diseases, kidney diseases, or who are taking medications that make them vulnerable to dehydration and heat strokes — as well as athletes and individuals who work outside and physically exert themselves under the sun. “Symptoms of heat stroke can sometimes mimic those of heart attack or other conditions. Sometimes a person experiences symptoms of heat exhaustion before progressing to heat strokes,” he says.
Different people may have different symptoms and signs of heat stroke. But common symptoms and signs of heat stroke include high body temperature, the absence of sweating, with hot red or flushed dry skin, rapid pulse, difficulty in breathing, strange behavior, hallucinations, confusion, agitation, disorientation, seizure, and/or coma. The signs and symptoms to look for include feeling of extreme heat, body temperature rising rapidly, feeling of drowsiness, unconsciousness and epileptic fits.
• Move the person out of the sun and into a shady or air-conditioned space
• Take the person’s clothes off
• Cool the person by covering the person with damp sheets or by spraying cool water and fan it.
• Have the person drink cool water or any beverage without caffeine.
• Home care is appropriate for mild forms of heat exhaustion. Heat stroke is a medical emergency, and an ambulance should be called immediately.
Heat stroke often occurs in people who are unable to modify their environments like infants, the elderly and bed-ridden people. Those taking many types of blood pressure, allergy or depression medication may also be particularly at risk and should avoid hot environments. “Those in supervisory positions at the Haj sites or coaches, trainers and lifeguards should be trained to specifically recognize signs of heat illness and what preventive measures to take,” a physician at Dr. Fakeeh Hospital says.
“The prognosis is related to the severity of the heat exposure and the patient’s general medical condition. The very young and the very old have the worst outcomes,” he says. “In general the prognosis with heat exhaustion is excellent, with full recovery expected. However, with heat stroke, permanent nerve, heart, liver or kidney problems, or even death can occur.”
Haj pilgrims who are diabetic have been advised to avoid over exertion during the journey to prevent medical complications. The pilgrims are also advised to guard against dehydration. Those suffering from hyperglycemia or high blood sugar should be aware of the signs and symptoms of their condition. If they feel too thirsty, dryness of mouth, itching of skin, fatigue or blurring of vision, they should immediately check their blood sugar level, says Dr. Amin Ahmed A-Jayyousi, senior consultant at the endocrine-diabetes division of Hamad General Hospital.
Diabetics should take their medicines regularly and avoid foods high in fat. They should also ensure the insulin they are carrying is stored in cold and hygienic conditions and is fit for use.
As for patients suffering from low blood sugar or hypoglycemia, doctors have advised reduction in the insulin dose due to the physical exertion involved during the rituals.
Patients suffering from low sugar have also been advised to carry some sweets and biscuits, apart from ensuring that they take their medicines at the correct time and eat proper meals.
“Hypoglycemia or low blood sugar patients can suffer from excessive sweating, trembling of hands, hunger pangs, weakness, palpitation, loss of concentration and, in extreme cases, bouts of convulsions if they do not take adequate medical care during the pilgrimage,” said Al Jayyousi.
As diabetic patients are at high risk of having foot infections and injuries, doctors have advised them to wear proper footwear, including using special shoes.
Such patients should not walk barefoot and have been instructed to clean their feet and toes regularly to avoid fungal infections and dryness.
• As far as possible, avoid direct heat from the sun
• Remain in the shade
• Go out during evenings and nights
• Keep your body cool by drinking plenty of water
• When you have to go out in the sun cover your body completely with clothes.
