The Government of Saudi Arabia has taken upon itself the responsibility of offering a safe Hajj for pilgrims. All services shall be available for all pilgrims and visitors of the Prophet's city (PBUH). The Kingdom strives to provide pilgrims with means of security and comfort out of a sense of responsibility and holy duty, for which all capabilities and efforts shall be employed.
Following the directions of the Custodian of the Two Holy Mosques, HRH the Crown Prince, and HRH the Deputy Crown Prince, may Allah protect them, which stressed the provision of the best healthcare services to pilgrims and visitors, the Ministry of Health (MOH) is ready with all technical preparations and human resources to offer a healthy, safe and easy Hajj experience. Health facilities are widely spread across KSA, from main entry points, and Hajj zones all the way to the Holy Sites and Madinah. Every facility is well-equipped for all purposes, be it preventive, diagnostic, therapeutic, ambulatory care or even awareness.
First: Preventive Medicine and Public Health Services
MOH pays a special attention to the preventive aspect in Hajj season, where masses gather in a limited space for a period of time, and there is a high risk of exposure to outbreaks, epidemics, and in particular diseases transmitted through droplets in the air, water, or food, and vector-borne diseases.
MOH keeps abreast of the latest developments and changes in health around the world, in cooperation with World Health Organization (WHO) and international health authorities, such as the international Centers for Diseases Control and Prevention (CDC).
Relying on its huge accumulated experience in mass gathering medicine, and successful management of Hajj and Umrah seasons, MOH took several actions, most notably:
1. Issuing of Health Requirements to be Circulated to all Pilgrims' Originating Countries
MOH conducts an annual review of the health requirements for pilgrims in Hajj season, and issues new requirements based on world changing epidemiological map, then circulates them to all Islamic originating countries through KSA embassies and consulates to be referred to when issuing Hajj and Umrah visas for 2015. Health requirements for Hajj can also be found on MOH's website. Those requirements are sent out to the WHO, which adopts them on a yearly basis, and publishes them on its website and on the Weekly Epidemiological Record (WER) ahead of Hajj season, and also circulates them through its regional offices across the world.
2. Operating Centers for Disease Control at Pilgrims Entry Points
MOH has prepared 15 centers for disease control at land, air, and maritime entry points to serve this year as a preventive measure; as well as providing therapeutic and ambulatory services. The centers are supported the required with human resources and medical supplies (vaccines and preventive drugs, etc.) to operate around the clock during the Hajj season. In addition, there are well-equipped ambulances to take patients to the hospitals participating in providing Hajj health services.
These centers apply technical control and quarantine measures to various means of transportation, incoming pilgrims, and imported foods to protect the Kingdom from any outbreak of epidemic and quarantine diseases.
Serving as a shield against infectious disease causative agents, health control centers at pilgrims' entry points set precautionary measures for incoming pilgrims, and means of transportation. All health requirements for Hajj are made sure to be fulfilled by incoming pilgrims, especially those from highly vulnerable countries to epidemics; to prevent any imported infectious disease. Measures include:
Verification of international travel documents which indicate vaccination of pilgrims in their countries (international certificates of vaccination).
Health inspection of all means of transportation (aircraft, ships, cars, buses), and ensuring health requirements are met.
Coordination with related authorities at ports (Saudi Food and Drug Authority and the customs) to check foods brought by pilgrims.
Recording the number of incoming pilgrims and reporting the preventive measures applied to pilgrims in their countries and at ports.
3. Increasing Specialized Quarantine Rooms:
More quarantine rooms are made available in the Holy City of Makkah, and the Holy Sites to ensure treatment of all infection cases: 174 quarantine rooms were furnished in Makkah's hospitals, in addition to 11 quarantine rooms in Khulais Hospital and Al Kamil Hospital, 47 quarantine rooms were furnished in the Holy Sites, eventually totaling 232 quarantine rooms.
4. Activation of role of the Command and Control Center
The Ministry of Health, as represented by the Command Control center (CCC), aims to increase rates of engagement and response rates to health emergency. It helps intensify health concerns monitoring systems by reporting potential epidemic cases in health facilities across the Hajj zones; assessment of all health facilities and their preparations for infectious diseases control in general, and MERS-CoV and Ebola virus in particular.
CCC further monitors social behaviors during Hajj season and attempts to reform those behaviors which may result in an epidemic outbreak. The center seeks to control any epidemic outbreak that may take place (Allah forbid) and also isolates the infected, making sure to prevent spread of the disease in cooperation with other health sectors and related authorities.
CCC includes 14 platforms specialized in various areas as: Epidemiological Surveillance, Control Tower, Public Health, Labs, and other supporting departments such as, IT and Purchasing, etc.
On the event of emergence of a world health concern, outbreaks of diseases that are subject to international health regulations in the countries of Hajj and Umrah pilgrims, KSA health authorities may take additional precautions against the pilgrims coming from those countries, in coordination with WHO in a timely fashion, in order to prevent the spread of the infection among the pilgrims of Hajj and Umrah, or to transport the infection to their countries.
5. Participation of Advisory Scientific Board:
The board members include representatives of National Guards, King Faisal Specialist Hospital, Faculty of Applied Medical Sciences at King Abdulaziz University, private health sector, Ministry of Agriculture, Ministry of Interior, King Saud University, King Fahd Medical City, WHO, USA Centers for Disease Control and Prevention (CDC), and MOH.
It supervises guidelines, policies, measures with regard to public health-related diseases; and sets strategies for scientific research required for combating public health-related diseases.
In coordination with Research and Studies General Department, the board takes the necessary actions to ensure maintaining scientific research ethics, and find the mechanism required for that purpose. Furthermore, the board looks into ways to make the most of current committees in and out MOH.
6. Participation of Global Center of Mass Gathering Medicine in KSA
MOH is to make the most of its Global Center of Mass Gathering Medicine, which was accredited by the WHO as a collaborating center, based on high health standards, with regard to international research and scientific exchange, mass gathering medicine training, and public health. The Global center of Mass Gathering Medicine in KSA is approved by WHO as a world reference for mass gathering medicine.
The center is tasked with setting standards, measures and policies that define mass gathering medicine areas and methodologies, numbers of human masses that constitute mass gathering event, carrying out scientific researches and studies relying on KSA wide accumulated experience in that area, especially in training and scientific research.
7. Health Education and Best Practices:
MOH's plan focuses on spreading health awareness among pilgrims, prior to coming to KSA and throughout their visit. All aids, roads, targeted spots in Hajj zones are to be employed to help carry out the plan in phases as follows:
Prior to Heading to KSA (in the originating countries): Health awareness programs are prepared to include the health requirements and guidelines in different languages, with emphasis on Hajj season common diseases and food poisoning, showing how to prevent them. Programs are submitted to Ministry of Foreign Affairs, which in turn circulates them to KSA embassies and consulates in pilgrims' countries, in an effort to spread awareness in those countries prior to Hajj.
On Arrival to KSA Ports: Educational brochures are circulated to pilgrims, or shown on displays at ports. Even means of transportations that carry pilgrims are employed to communicate health awareness programs during traveling time.
During Hajj Season: MOH utilizes different awareness tools (displays, animated billboards at health facilities' entryways, TVs, tapes in various languages, prints, newsletters, posters, etc.)
8. Launching Preventive Vaccination Campaign:
Every year before Hajj season, MOH launches vaccination campaigns for inhabitants of Makkah and Madinah, as well as the manpower participating in the Hajj program from all sectors. The vaccinations are against meningitis and seasonal flu.
Second: Therapeutic Medicine Services
Seeking to ensure comprehensive, high-quality health services for the Hajj and Umrah pilgrims, and the visitors of the Prophet's Mosque in Madinah, the Ministry of Health (MOH) has founded, furnished and equipped several hospitals and primary health care centers, as well as health care preventive centers at the Kingdom's points of entry, and at the places where pilgrims reside. Following are the medical utilities dedicated for serving pilgrims:
A) Hospitals:
The Ministry has prepared 25 hospitals (4 in Arafat, 4 in Mina, 7 in the Holy City of Makkah, and 9 in Madinah, to be added to King Abdullah Medical City). The total number of inpatient beds in the Hajj sites amounts to 5000, including 500 IC beds, and 550 ER beds.
B) Health Centers:
The above-mentioned hospitals are further supported by 155 permanent and seasonal health centers, disseminated throughout the Hajj sites as follows: 43 in Makkah, 80 in the Holy Sites (46 in Arafat, 6 in Muzdalifah, and 26 in Mina), aside from 18 health centers in Madinah.
C) Emergency Centers (ER)
The MOH has established 16 emergency health centers along the Jamarat Bridge and three ambulatory centers in the Holy Mosque in Makkah.
D) Medical Points:
The MOH has operated 18 medical points alongside the stations of the Holy Sites’ train, in addition to six medical points in Arafat, six medical points in Muzdalifah and six medical points in Mina.
E) Visiting Medical Teams:
The MOH has hired over 800 physicians and nurses in some rare medical specialties from inside the Kingdom to boost the performance in the health facilities of the Holy Sites, Makkah and Madinah during the 1436H Hajj season. They are consultants in the following specialties: intensive care, cardiology, nephrology, endoscopy, emergency and infectious diseases.
F) Health Centers in the Central Area around the Holy Mosque and the Prophet’s Mosque:
In anticipation of any emergency situation due to the gathering of a large number of pilgrims in the central area around the Holy Mosque and the Prophet’s Mosque, field medical teams have been deployed to cover all areas surrounding the two mosques to deal with any emergency cases along both axes of the central area. Also, eight ambulances have been allocated for the emergency medical points stationed at the central area of the Holy Mosque in Makkah.
G) Heat Exhaustion and Sun Stroke:
This year's Hajj season is expected to witness high temperature. So MOH has equipped a number of facilities in the Holy City of Makkah, the Holy Sites, and Madinah to handle heat exhaustion and sun stroke cases. 208 additional water sprinkling fans have been installed for better ventilation in Makkah and the Holy Sites. Madinah has been also provided with a number of those fans.
H) Advanced Health Services and Specialized Life Saving Programs:
MOH continues to run "Life Saving" program that offers free specialized health services, including: open-heart surgery, cardiac catheterization, dialysis (peritoneal and hemodialysis), endoscopy, in addition to childbirth surgeries, and other specialized services that pilgrims may need.
I) Participation of King Abdullah Medical City:
King Abdullah Medical City (KAMC) is once again part of MOH's plan to provide full health services to pilgrims this year, such as: specialized reference tier 4 services.
KAMC has expanded its cardiac catheterization program and heart surgeries. Several developments have been introduced to ICU services. A heliport is set to receive patients, and large amounts of blood were secured through blood donation campaigns.
J) Partnership and Cooperation with Think Tanks and Int’l Organizations:
The MOH is coordinating and cooperating with the government health bodies, international organizations and think tanks, such as the American and European disease control centers. In this regard, coordination was made with the governmental health sectors represented by the Ministry of Defense, the National Guard, the Ministry of Interior, the Ministry of Education, the Ministry of Higher Education and King Faisal Specialist Hospital and Research Center.
The MOH has also hosted experts from the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) in the USA. In addition, the MOH depends on full networking and coordination in the disease control efforts to highlight the leading role carried out by the Government of the Custodian of the Tow Holy Mosques in harnessing all potentials towards its noble objective of achieving the highest levels of safety and security for the pilgrims in a pioneering and distinctive manner.
K) Field Medicine Services (rapid intervention and effective presence):
Emergency and field medical services are varied, including:
100 small-sized ambulances: They are operating as mobile intensive care units to deal with urgent cases in the field.
80 highly-equipped big-sized ambulances: They are distributed as follows: 32 ambulances to the hospitals of the Holy Sites to evacuate cases, 10 ambulances to the health centers located at crossing points, 13 supportive ambulances to the hospitals and health centers in the capital city and Holy Sites, and 25 big-sized ambulances in Madinah.
Eight ambulances were allocated for the emergency medical points stationed at the central area of the Grand Mosque in Makkah.
Third: Supportive Services:
1. Labs and blood banks:
The MOH has prepared an integrated plan for the laboratories and blood banks as it operated the virus lab at Jeddah Regional Laboratory to work around the clock, in addition to the virus lab in Madinah. It also prepared a mobile lab at East Arafat Hospital to deal with all patients, especially the infectious cases. Meanwhile, the ministry has provided these labs with cadres and necessary preparations to do tests for all disease-causing viruses, particularly those transmitted from animals and birds to humans, including the Middle East Respiratory Syndrome (Coronavirus).
The plan targets raising the level of readiness at the laboratories of Makkah hospitals, including the hospitals located in the Holy Capital, Holy Sites and Madinah. Some 19,000 units of blood and its products with all blood groups will be provided as part of the plan.
2. Emergency Medicine Services:
Urgent medical services are part of a package of medical services provided by the Ministry of Health to serve pilgrims, who gather in large numbers within a specific geographic and time scope, making it necessary to be fully prepared to provide medical services. In doing so, the MOH cooperates with all relevant bodies to develop and implement the general emergency plan to deal with urgent cases that may be reported in the Hajj season, Allah forbids, after having it approved by His Royal Highness the Interior Minister, who also presides over the Hajj Higher Committee, in order to ensure the unification and integration of efforts of all bodies providing health services in the Hajj season.
The MOH has an all-out strategic plan to deal with all ambulatory and urgent cases, meanwhile seeking to activate tools to monitor and handle the risk factors in light of the unstoppable developments at the domestic and international levels after assessing all needed requirements to deal with potential risks. Furthermore, the Ministry seeks to implement detailed plans to respectively deal with urgent cases and disasters, given that efforts are underway to prepare a procedural manual expounding how to receive reports and deliver information to all health facilities in the vicinity of the event so that no conflicts occur during the implementation of the emergency plan.
The plans implemented by the ministry to treat urgent cases include an emergency plan for health facilities, a preparedness plan for the Jamarat Bridge (Jisr al-Jamart) and the main roads leading to it, and an emergency plan for the Muzdalifah walkway. Such plans are based on dispatching field medical teams and highly-equipped ambulances to the both sides of the Jamarat Bridge to deal with urgent cases.
3. Medical Supplies (medication, medical supplies and vaccines):
In implementation of directives of the Custodian of the Two Holy Mosques, May Allah protect him, to provide free medical services for all those arriving in Saudi Arabia to perform Hajj, the MOH annually allocates a part of its annual budget to provide enough amounts of medication to meet the medical needs of pilgrims throughout the Hajj season. It also equips its health facilities serving pilgrims in the Hajj season with all medical supplies.
In doing so, the MOH has supplied eight hospitals and 94 health centers in the Holy Sites with all their needs of drugs and medical supplies. Also, it offered large amounts of vaccines to immunize both foreign and domestic pilgrims and all those participating in the Hajj season. The MOH also prepares six airstrips to transport medical cases in need of urgent medical intervention to Al Noor Hospital, Arafat General Hospital, Mina Emergency Hospital, Heraa General Hospital and King Abdullah Medical City in the Holy Capital.
4. Hiring Well-Trained Manpower:
Out of its strong will to provide distinguished medical services in the Hajj season, the MOH has harnessed all its human potentials to achieve this goal, including:
a) Highly-qualified medical staff:
Approximately 25,000 health practitioners of different medical, technical and administrative categories have been assigned to serve the pilgrims in the 1436H Hajj season. All of them are enrolled in the manpower program. In addition, the ministry has supported Madinah province with 770 staff of different categories and specialties to serve as additional manpower.
b) Voluntary work and scouts:
Over 300 scouts will participate in the 1436H Hajj season to secure health facilities, arrange the rows of pilgrims willing to receive medical services, help the pilgrims, especially the elderly, to reach clinics and pharmacies and guide them if lost.