Health Guidelines For Hajj And Umrah

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Islamic Medicine
Staff member

by Dr. Farouk Haffejee (MBChB MCFP)

In the Name of Almighty Allah, Most Gracious Most Merciful.
Assalamualaykum Warahmatullahi Wabarakatuhu

The performance of Hajj is obligatory on all adult Muslims who have the means to make the trip to the Holy City of Makkah. Umrah is regarded as a minor pilgrimage with only part of the required rituals performed.

Whosoever enters the Mi'qaat (boundary of the Holy Land) has to perform Umrah which includes seven circuits around the Holy Kabah.

One must be in good health, not only to enjoy Hajj and Umrah but also tom make maximum use of the opportunity to make as much ibadat as possible, that is, extra Salaah and extra Nafl Tawaaf's. We are guests of Allah Subahanahu Wata 'ala whilst we are in Makkah and guests of Rasulullah Salallahu Alaihi Wassalum whilst we are in Madinah. We must, therefore show enthusiasm whilst we are there and perform Ibadah enthusiastically.

The following is a guideline and must be accompanied by your own Doctor's advice pertaining to your own health needs.

Physical fitness:

The more physically fit one is, the easier it would become to perform the many rituals associated with a complete Hajj. If one has decided to perform a walking Hajj, then it would be very important for one to be as fit as possible. This will require one to walk as much as one can, starting about 4 to 6 weeks before departure, walking greater and greater distances as the
time of departure arrives.

One should be able to walk briskly for about an hour continuously, taking a few hills into one's walk. During Hajj, one will not be walking in one's designer walking shoes but in thongs or a slipper, which is not sewn, or which does not cover the high arch on the top of one's foot in the case of men. These can be quite uncomfortable. For this reason, one should practice
one's walking in similar footwear so that one's feet can get used to the slippers and form calluses where they are required. Men are not allowed to cover their heads during Hajj. Furthermore, the heads of men would have been shaved recently from the performance of Umrah. It would therefore become necessary for one to expose one's head to the sun whilst exercising so that one's head may become used to the sun.

The sooner exercise is started, the better. If one is young and can jog, then this will do fine. Even if one is not performing a walking Hajj, the exercise will help tremendously. Rasulullah Sallallahu Alaihi Wasallum often spoke of the importance of physical fitness in general.

Physical fitness is therefore very important.

Climate in Arabia:

Jeddah is on the coast of the Red Sea and therefore enjoys a slightly humid climate in summer. It becomes less humid in winter.

Makkah is about 70 kilometres inland. It has an escarpment around it. The only natural source of drinking water is from the well of Zam Zam and the well of Abu Dawwod. The rest of the water from bore holes and wells is brackish, unfit for human consumption. Because of the escarpment, the climate is dry and harsh. There is very little vegetation in and around Makkah due to the low rainfall. The Great Arabian Desert is all around Makkah. The climate is dry. Temperatures are extremely high, usually in the forty degree Celsius range and sometimes going into the fifties. It becomes so hot that even the buildings do not get a chance to cool down overnight. Even in winter, it is hot! It is sometimes referred to as the hottest place on earth!

Medinah is situated about 500 kilometres north and is about 100 kilometres from the coast. It is a large oasis with the Great Arabian Desert all around it. Because of the numerous wells providing excellent drinking water, it has date orchards spreading out on to the outskirts of the city.

The climate is dry and hot, the temperatures not reaching as high as in Makkah. In winter, it can become cool to cold especially around Tahadjud and Fajr times. Since the climate of Medinah is less hot and dry than that of Makkah, spending 8-10 days in Medinah before coming to Makkah helps to allow our bodies to acclimatise.

Drinking Water:

Tap water is not safe to drink anywhere in Arabia. Drinking water has to be bought in the form of bottled water. However, Zam Zam is available freely in Makkah and in Medinah. Since this is an opportunity to drink as much Zam Zam water as possible, one can fill containers with Zam Zam water and bring it to one's room. One can make tea and coffee with the Zam Zam water. Zam Zam water is only for drinking. Please respect it.

Because of the hot weather conditions, it becomes necessary to drink water in abundance. Less urine is passed due to the hot conditions. The body conserves water by concentrating the urine. It is not good to pass very concentrated urine for a variety of reasons. Drink enough water so that the urine is clear. Passing clear urine indicates good hydration.

Ice that is available to cool the Zam Zam water is not always of good quality. Unscrupulous people may make the ice with only brackish water or mix the brackish water with drinking water to save on costs. This results in the brackish water contaminating bottled water or Zam Zam water. Drinking Brackish water causes a sore throat, abdominal pains and a cough from the irritation in the throat. People may use antibiotics thinking that the cause of the sore throat is an infection. It is better to drink Zam Zam water directly from the well in the Haram Shareef or taking the water from the numerous taps available outside the Harram Shareef. Zam Zam water that is available in storage containers in the Harram Shareef are cooled by adding ice. This ice may not always be of good quality.

Although the authorities provide disposable cups for drinking Zam Zam in the Haram, people unfamiliar with this practice often mix the used cups with the unused ones resulting in confusion. If one is unsure, rinse out the cup well before use. It is through the sharing of cups that infections can spread from one pilgrim to another. People come from all parts of the world with
different hygienic control. What one may find offensive may be quite normal for another. The important thing to do is to avoid picking up infections from this source.

Please make sure that drinking water is safe. Drink adequate amounts of fluids especially water throughout your stay.


Islamic Medicine
Staff member

Those people who suffer from arthritis of their hips or knees or ankles should lose weight if they are overweight. They must have treatment for their arthritis long before the departure date so that the inflammation has time to settle.

Your Doctor is the best person to ask for guidance on Medication. Please do not take advice from people who are not properly qualified. Once the inflammation has settled, then light exercises to strengthen the muscles around the affected joint would help tremendously. Again be guided by a Doctor with the help of a Physiotherapist.

Care of the back:

Most people would travel with heavy suitcases when going overseas. Going to Makkah is no exception. In most cases, it will be found that most of the clothes taken will not be used, but they were taken just in case they were needed. It is not necessary to travel with heavy luggage but if it is necessary, then care must be taken to lift the bags correctly. Back strain is a common problem that occurs. Bags have to be taken out of the house and into the trunk of a car. At the airport, they must be taken out of the trunk and hopefully put onto a trolley to be wheeled to the departure counter. If no trolleys are available, these bags will need to be carried.

The same process occurs on arrival, the difference being that now the bags will have to be carried into the place of accommodation, e.g., a hotel. If it is necessary to buy new luggage, then it would be better to spend a little more and acquire bags with wheels. These can be pulled along without being carried.

Proper lifting of heavy articles involves not bending the back but bending the knees and lifting with a straight back. It will be better to allow others who are not going to Haj to do the lifting, e.g., relatives who are not going, hotel staff, etc.

If a back problem already exists, extra care needs to be taken not only in lifting but also in sitting in awkward positions or on very low chairs, bending down and twisting awkwardly, etc.

A back injury or aggravation of a back injury takes two to three weeks to settle. Sustaining a back injury on the way to the Holy Land or in the Holy Land may compromise your Umrah and Haj. Please be extra careful.


Due to a change in the diet and the hot weather resulting in water depletion, constipation can be a real problem. Constipation may result in haemorrhoids and bleeding both of which can be very distressing. It can affect normal activities resulting in loss of valuable time in Makkah and Medinah. Maintaining a high fibre diet, like a bran or wheat cereal, wholemeal bread, dried fruit, not eating an abundance of fried or fatty foods, drinking adequate amounts of water can avoid constipation.


Asthma suffers must ensure that their asthma is well controlled with preventative medications. They must ensure that they take an adequate supply of their medications with them including preventative medication, broncho-dilator inhalers and tablets. If well controlled, asthma does not pose a problem during Hajj and Umrah.

Both Makkah and Medinah have a dry climate. There is no pollen in the air. Due to the dry climate, house dust mite population is also less. Those with hyper-reactive airways sensitive to other pollutants should ensure that they control their asthma well.

Skin Care:

Because of the harsh, dry conditions that can be encountered, it would help to prepare one's self. Arabia, being in the Northern Hemisphere has it's winter when we have our summer. Hence, our bodies are confronted by a big change in the external environment. If one lives in a humid climate, the dry conditions will have a major effect on one's skin. One's skin will not have the time necessary to acclimatise. Cracking of the skin is common. If this happens on the feet, it can cause deep fissures resulting in pain and discomfort with the possibility of infection developing. This is especially important for diabetics.

A good moisturiser applied two or three times a day starting as soon as possible after arrival in Arabia will help the skin retain moisture and slowly acclimatise. The moisturiser need not be expensive. Aqueous Cream or Vaseline, which is cheap, applied frequently, will do. To allow the feet to retain the moisture in the skin, it may be necessary to wear a pair of socks to avoid the evaporation of water. Extra care should be paid to the feet, as performing Hajj with painful feet would add an unnecessary burden. A suitable heel balm will also help to smoothen out the thick skin around the heels. Good care must be taken of the skin, especially the skin on the feet.

Swelling of feet:

Due to the intense heat, it is not uncommon for the feet to swell. In healthy people, this is transient. As the body acclimatises to the hot conditions, the swelling should subside. If one suffers from any illness,especially heart disease, diabetes or high blood pressure, then one should seek the advice of a Doctor. Acclimatisation usually takes about 7 to 10 days. Those that spend a short time in Arabia before Haj may find their feet swollen during Haj. Not much can be done about this, as the body needs time to adjust. It would help to elevate the legs at every opportunity so that the dependent fluid in the feet can go back into the circulation. Avoid standing for long periods. Walking would help settle the swelling.

Fungal Infections of the feet:

Fungal infections of the feet present as either a dry scaly very itchy rash or little fluid-filled blisters between the toes or under the feet or around the heel. Fungal infections thrive in moist conditions, as between the toes or under the feet after wudhu. The fungi cannot grow without moisture. It is therefore a good habit to dry the feet and the areas between the toes and to wear open sandals were possible so the feet may dry out. If a fungal infection is present, this must be attended to especially if diabetes is present. Fungal infections of the feet resulting in cracks or maceration of the skin can get secondarily infected with other bacteria causing a spreading cellulitis. This can take up to a week to resolve with antibiotics and leg elevation. This is something that one does not need during Umrah or Haj! Fungal infections can be treated with an anti-fungal agent until cured.

Please consult a Doctor for the most appropriate one to use. As a prophylaxis and also as treatment in some cases, a cheap anti-fungal in the form of Whitfield's Ointment (Fungistatin ointment) can be useful. More expensive preparations, which are cosmetically better, are available and may be used not only on the feet but also inside shoes and sandals where the fungus may still be present.

Treatment must start well before departure so that the infection can be treated adequately. Only prophylactic treatment may then be needed. However, due to the dry, hot conditions in Arabia, the custom of wearing open sandals and the lack of moist carpets in the Mosques, fungal infections are not very common.

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