After at least 1,300 people died during this year’s Hajj pilgrimage in Saudi Arabia, witnesses and experts say a combination of scorching temperatures and difficulties with crowd control made the sacred event disorienting and dangerous.
At Islamic holy sites in Mecca during the annual five-day pilgrimage, temperatures soared as high as 50C.
Witnesses described people vomiting and fainting in the extreme conditions as they attempted to perform the Hajj rituals around the city.
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“People were falling on the streets,” said Muhammed Adnan Chishti, a 37-year-old teacher of Islam based in Hong Kong.
He said street closures near Mina, where pilgrims perform a ritual symbolising the stoning of the devil, meant that people had to walk for hours in “searing heat.”
“What was supposed to take 10 minutes by walk was taking three to four hours,” Chishti said, adding that many pilgrims were not aware of the route closures, which authorities had implemented to manage crowds.
The rush of people along the alternative detour left many baking in the sun for hours, he said.
“I saw there was a woman next to me,” Chishti said. “She fainted from the intense heat. We started pouring water to cool her down and fed her vitamins, but she fainted. She then vomited on my leg. The situation was horrible.”
Chishti, who travelled alone, said he felt the effects of heat-related illness himself on June 11.
“I was so dizzy I didn’t know what was going on with me,” he said, adding that he still feels some lingering symptoms, including weakness and dizziness.
More than 1.8 million Muslims performed the pilgrimage this year, according to The Associated Press.
Deaths during the Hajj have been reported in past years, though not always as a result of extreme heat.
In 2015, a stampede in Mina killed more than 2,400 people, the AP reported. In other years, pilgrims were killed in accidents or disease outbreaks, according to the AP.
This month’s unusually high death toll, however, has increased scrutiny over whether authorities took proper precautions as throngs gathered amid soaring temperatures.
In a statement, Saudi authorities said they had responded quickly and provided “effective support of the Hajj security forces in managing and reducing the effects of heat stress.”
The Ministry of Health said “significant efforts” were taken before the Hajj to “raise awareness on the dangers of heat stress and the importance of preventive measures.”
Saudi authorities also said that healthcare providers had treated people for heat stress and performed emergency care, including dialysis, cardiac catheterization and open-heart surgeries.
More than 30,000 ambulance and 95 air ambulance services were provided, the Ministry of Health said.
Saudi Health Minister Fahd bin Abdurrahman Al-Jalajel said that 83 per cent of the deaths were unauthorised pilgrims who had walked long distances in the heat.
Official Hajj permits typically include dorm or hotel accommodations and transportation around Mecca, but many people cannot afford them, which can cost up to $10,000. As a result, scores of unauthorised pilgrims often make their way without the proper visas or registration.
“The health system provided over 465,000 specialised treatment services for free, including 141,000 services to those who didn’t obtain official authorisation to perform Hajj,” the Ministry of Health said.
Chishti agreed that unauthorised pilgrims were disproportionately affected by the heat because they did not have official travel arrangements or proper accommodations.
‘Unique situation’
“All hotels and dorms had air conditioners and fans. But those who didn’t have reservations or could not find their allotted hotels were forced to sleep on the streets,” he said.
“They didn’t have umbrellas or water bottles. There were some people who arrived themselves without any bookings — they were affected the most.”
Shakoor Hajat, a professor of global environmental health at the London School of Hygiene and Tropical Medicine, said risk mitigation for the Hajj is particularly difficult.
“The Hajj is a unique situation in that pilgrims are often elderly and walking for long periods in very extreme temperatures,” Hajat said.
Extreme heat can be deadly because it affects the body’s ability to regulate its internal temperature. When conditions are too hot and humid, sweat cannot evaporate and the body can no longer cool itself. Heat can also exacerbate pre-existing health conditions, raising the risk of heart attacks, respiratory problems and kidney disease.
Groups at heightened risk include young children, pregnant women and older people.
The recent deaths highlight the difficulties of maintaining some cultural practices and mass gatherings as climate change increases the frequency, intensity and duration of heat waves.
The nature and scale of the Hajj makes it a tough event to manage, even if authorities do their best to prepare, said Milad Haghani, a senior lecturer of urban mobility, public safety and disaster risk at the University of NSW in Australia.
“When it’s an entertainment event, we quickly take action to cancel the event,” Haghani said. “But none of these are an option when it comes to the Hajj. It has to be done in a specific location and city, in a very specific time.”
As the intensity of extreme heat increases, Haghani added, Saudi Arabia will need to rethink how to keep people safe during the sacred pilgrimage. Pilgrims will also need to be better informed about the risks.
“The biggest mass gatherings of all times happen in Mecca,” he said, “and there are more Muslims every year going.”
