Satan gets stoned @ Hajj - YouTube Satan gets stoned @ Hajj Want to watch this again later? Sign in to add this video to a playlist. Need to report the video? Sign in to report inappropriate content. Rating is available when the video has been rented. This feature is not available right now. Please try again later. Uploaded on Dec 11, 2008 Throwing stones at Shaytan When autoplay is enabled, a suggested video will automatically play next. Up next World's Largest Pilgrimage - Hajj Documentary - Duration: 14:20. VICE 997,174 views 14:20 Stoning the Devil, Jamarat, Pillars, Obelisks, not a Wall الكثير يعبدون الدجال وهم لايعلمون - Duration: 6:25. Dave Abdellah 38,979 views 6:25 Stampede kills hundreds at Hajj pilgrimage in Mecca - CNN.com MUST WATCH Hajj: The pilgrimage to Mecca 01:39 "I saw the ambulances, I saw bodies. ...

At least 20, 30 ambulances passed me by," she told CNN by phone. Hundreds have been killed in past years during the same ceremony, and it comes only 13 days after a crane collapse killed more than 100 people at another major Islamic holy site, the Grand Mosque in Mecca. The incident is the deadliest disaster at Mina since 1990, when 1,426 people died. Civil defense authorities said the latest death toll is 717, with 863 people injured, but the numbers have been climbing steadily. Officials deployed 4,000 workers, along with 220 ambulances and other vehicles, to Mina in response to the disaster. In the ritual, crowds of pilgrims throw stones at three pillars in a re-enactment of when the Prophet Abraham stoned the devil and rejected his temptations, according to Muslim traditions. Crown Prince Mohammad bin Nayef bin Abdulaziz held an emergency meeting to discuss the stampede, according to the Saudi Press Agency.

فيديو: خطة عاجلة تطبقها مستشفيات المشاعر المقدسة لفرز الحالات المصابة بتدافع منى #الإخبارية #تدافع_مشعر_مني pic.twitter.com/nnaDNUrIO9 — قناة الإخبارية (@alekhbariyatv) September 24, 2015 He ordered an inquiry. Saudi King Salman bin Abdulaziz Al Saud later ordered a review of the country's plans during Hajj. "Regardless of the investigation results, the improvement of the methods and mechanisms of the Hajj season will not stop. We have instructed the concerned entities to re-evaluate the current policy and the distribution of responsibilities," he said. In Thursday's stampede, pilgrims were walking toward the largest of the pillars when there was a sudden surge in the crowd about 9 a.m., causing a large number of people to fall, the Saudi Press Agency said, citing civil defense officials. Information on what led to the surge wasn't immediately available.

Photos: Hundreds killed in Hajj stampede Hide Caption 14 of 14 A risky pilgrimage The ceremony was the scene of stampedes and hundreds of deaths in the 1980s and 1990s as pilgrims passed a crowded bottleneck area leading to the small pillars on the ground. In 2006, a stampede there killed at least 363 people. After that, the Saudi government erected three massive pillars and completed a $1.2 billion, five-story bridge nearby where pilgrims can toss stones. It was meant to be a roomier atmosphere and a more efficient way to accommodate the faithful. Speaking at St. Patrick's Cathedral in New York, Pope Francis offered words of comfort during evening prayers. "I have two feelings for my Islamic brothers. First my greeting for being today the day of the sacrifice. I would have liked that my greetings would have been warmer," he said. "A second feeling is my closeness, my closeness with the tragedy that its people have suffered today in Mecca. In this moment of prayers, I join and we join them." 5 things to know about the Hajj stampede The ritual The stoning ritual is done over at least two days.

Pilgrims stone the three pillars at Mina -- believed to be where the devil was stoned when he tried to dissuade Abraham from obeying God's orders to slaughter his son. According to tradition, the event was a test from God, who gave Abraham a ram to slaughter instead. Thursday was the third day of the Hajj. On September 11, just days before this year's Hajj started, a construction crane crashed through the roof of another Hajj destination, the Grand Mosque in Mecca, killing 107 people. At least 238 others suffered injuries when a powerful storm toppled the crane. Losing one's life during the Hajj season is considered by many devout Muslims as an entry to heaven. A spiritual climax More than 2 million Muslims from around the world are attending the annual Hajj pilgrimage this year. Photos: The Hajj: Muslims gather for annual pilgrimage Photos: The Hajj: Muslims gather for annual pilgrimage Muslim pilgrims make their way to cast stones at a pillar in the "stoning the devil" ritual Thursday, September 24, in Mina near Mecca, Saudi Arabia.

At some point during this last rite of the annual Hajj, a stampede occurred, killing and injuring hundreds . More than 2 million Muslims have been making the pilgrimage to the holy city of Mecca. The Hajj is one of the most celebrated events in the Islamic calendar. Hide Caption 7 of 8 Photos: The Hajj: Muslims gather for annual pilgrimage Muslim pilgrims circle counterclockwise the Kaaba at the Grand Mosque in Mecca on Monday. The pilgrimage, conducted over five days, includes detailed rituals including wearing a special garment that symbolizes human equality and unity before God, a procession around the Kaaba and the symbolic stoning of evil. Hide Caption 8 of 8 Known as the fifth pillar of Islam, the Hajj is an obligation upon every Muslim who has the financial means and the physical ability to perform it. For most, it is the spiritual climax of their lives, with many saving for decades to make the journey. The pilgrimage, conducted over five days, includes detailed rituals such as wearing a special white garment that symbolizes human equality and unity before God; a circular procession around the Kaaba , Islam's holiest shrine, surrounded by Mecca's Grand Mosque; and the symbolic stoning.

It was also a tragic day for Muslims in Yemen on Thursday, where at least 29 people attending Eid prayers died when a bomb went off inside a crowded mosque in Sanaa. Stampede kills 717 at Hajj pilgrimage near Mecca | myfox8.com Stampede kills 717 at Hajj pilgrimage near Mecca Posted 5:37 am, September 24, 2015, by CNN Wire , Updated at 08:49AM, September 24, 2015 Email This is an archived article and the information in the article may be outdated. Please look at the time stamp on the story to see when it was last updated. More than 2 million Muslims from around the world are spending Wednesday in prayer near Mecca in Saudi Arabia as the most important day of the annual Hajj pilgrimage gets underway. × Stampede kills 717 at Hajj pilgrimage near Mecca More than 2 million Muslims from around the world are spending Wednesday in prayer near Mecca in Saudi Arabia as the most important day of the annual Hajj pilgrimage gets underway.

A stampede during one of the last rituals of the Hajj season has killed 717 people and left 719 others wounded. The stampede occurred during the ritual known as “stoning the devil” in the tent city of Mina, about two miles from Mecca. Hundreds have been killed in past years during the same ceremony. “We have a stampede accident in Mina and civil defense is dealing with it,” Interior Ministry spokesman Brig. Gen. Mansour al-Turki said. Officials deployed 4,000 workers and 220 ambulances and other vehicles to Mina to help with the disaster. In the ritual, crowds of pilgrims throw stones at three pillars, in a re-enactment of an event when Prophet Abraham stoned the devil and rejected his temptations, according to Muslim traditions. The ceremony was the scene of stampedes and hundreds of deaths in the 1980s and 1990s as pilgrims passed a crowded bottleneck area leading to the small pillars on the ground. In 2006, a stampede there killed at least 363 people.

After that, the Saudi government erected three massive pillars and completed a $1.2 billion, five-story bridge nearby where pilgrims can toss stones. It was meant to be a roomier atmosphere and more efficient way to accommodate the faithful. The ritual The stoning ritual is done over at least two days, where pilgrims stone three pillars at Mina — believed to be where the Prophet Abraham stoned the devil when he tried to dissuade him from obeying God’s orders to slaughter his son. According to tradition, the event was a test from God, who gave Abraham a ram to slaughter instead. Thursday was the third day of the Hajj. Ten days before the start of Hajj this year, a construction crane crashed through the roof of the Grand Mosque in Mecca, killing 107 people. At least 238 others suffered injuries when a powerful storm toppled the crane. Losing one’s life during the Hajj season is considered by many devout Muslims as an entry to heaven. A spiritual climax More than 2 million Muslims from around the world are attending the annual Hajj pilgrimage this year.

Known as the fifth pillar of Islam, the Hajj is an obligation upon every Muslim who has the financial means and the physical ability to perform it. For most, it is the spiritual climax of their lives, with many saving for decades to make the journey. The pilgrimage, conducted over five days, includes detailed rituals such as wearing a special white garment that symbolizes human equality and unity before God; a circular procession around the Kaaba, Islam’s holiest shrine; and the symbolic stoning. It was also a tragic day for Muslims in Yemen on Thursday, where at least 29 people attending Eid prayers died when a bomb went off inside a crowded mosque in Sanaa. 21.389082 39.857912 Muslims stone 'devil' at hajj as Eid feast begins Muslims stone 'devil' at hajj as Eid feast begins Lynne Al-Nahhas Pin it Share Mina (Saudi Arabia) (AFP) - Two million Muslims ritually stoned the devil Saturday in the last major rite of this year's hajj in Saudi Arabia, while fellow believers around the world celebrated Eid al-Adha, the feast of sacrifice.

The stoning occurred in Mina, about five kilometres (three miles) east of the Grand Mosque in the holy city of Mecca. All roads leading to Mina, a city that only comes to life during the days of hajj, were blocked as the crowds dressed in white flowed into the area. They crowded into a five-storey structure that resembles a parking garage, and from there tossed pebbles at one of three walls representing Satan. As pilgrims tried to push forward, security officers formed a human chain around part of the wall where space had been left for the elderly and disabled. The heat and the crowds only added to "the joy of carrying out the rites", Mohsen al-Omar, a Jordanian resident of Saudi Arabia, said with sweat running down his face. The pilgrims, who collected the pebbles at Muzdalifah on the way to Mina, will stone two other sites on Sunday and Monday as the hajj concludes. The ritual emulates the prophet Abraham, who is said to have stoned the devil at three locations when he tried to dissuade Abraham from God's order to sacrifice his son.

At the last moment, God spares the boy, sending a sheep to be sacrificed in his place. Pilgrims reached Mina overnight following a day of prayer on Mount Arafat, where the Prophet Mohammed is believed to have given his final sermon 14 centuries ago. After their day on the vast plain of Arafat and the hill that bears its name, the believers' white costumes bore brown dirt stains. Male pilgrims wear a seamless two-piece white "ihram," while women also generally wear white. With the hajj concluding, men shaved their heads before taking off their ihrams, leaving locks scattered on the ground. Women cut off small strands of their hair. In conjunction with the stoning, the hajj faithful offer sacrifices by slaughtering a sheep, whose meat goes to the needy. - A worldwide celebration - Nowadays pilgrims do not carry out this rite themselves, but pay agencies that distribute the meat to Muslims in many countries. A total of about 1.5 billion Muslims around the world were also celebrating Eid al-Adha. From Lagos to Kabul, Manila to Moscow, Muslims took part in events to commemorate Abraham's readiness to sacrifice his son.

Goats, sheep and cows were slaughtered and prayers were said at mosques and in parks. In the Palestinian territories and Israel, Muslims and Jews marked holy days within a short distance of each other. Eid coincides for the first time in three decades with the solemn Jewish fast of Yom Kippur. Hundreds gathered for prayers in front of the flashpoint Al-Aqsa mosque compound in east Jerusalem, amid a security lockdown. This year's hajj attracted just over two million domestic and foreign believers, including almost 1.4 million from abroad, according to the official Saudi Press Agency (SPA). These numbers are roughly the same as last year. The hajj has drawn a cross-section of humanity from presidents -- Sudanese leader Omar al-Bashir was among them -- to commoners including a wounded Syrian rebel war veteran. The world's largest Muslim gathering officially ends on Tuesday. It is one of the five pillars of Islam, and every capable Muslim must perform it at least once in what is the high-point of his or her spiritual life. Despite improved organisation, Pakistani engineer Mohammed Khan, 29, complained that there is still a lack of basics such as "water and shaded areas" to protect people from the desert sun.

Saudi authorities have spent billions of dollars on safety projects for the hajj, which has been almost incident-free in recent years after earlier stampedes and fires. They have invested in everything from cooling water sprays to a train for moving the pilgrims, and Hajj Minister Bandar bin Mohammed Hajjar said the kingdom aims to ensure pilgrims perform their rituals "in ease and comfort". No cases of the deadly MERS or Ebola viruses have been recorded among the pilgrims, a health ministry official was quoted by SPA Saturday as saying. Reblog BBC - Religions - Islam: Hajj: pilgrimage to Mecca Women must not cover their faces, even if they would do so in their home country. Men may not wear clothes with stitching. Bathing is allowed but scented soaps are frowned upon. Umra The Hajj is a real pilgrimage - a journey, with rites and rituals to be done along the way. You begin at a place just outside Mecca called the Miqat, or entry station to the Hajj. There you bathe, put on the Ihram (the special white clothes), make the intention for Umra and begin reciting the Talbiya Du'a (prayer).

Here I am at Your service, O Allah, here I am at your service! You have no partner. Here I am at your service. All praise and blessings belong to you. All dominion is yours and You have no partner. Talbiya Du'a Then you go to the Masjid al Haram and walk around the Ka'ba seven times repeating du'as and prayers. This is called the Tawaf. Afterwards you should sip some Zam Zam water. Zam Zam water is water from the Zam Zam well, the sacred well which opened in the desert to save Hajira and Is'mail from dying of thirst. Next you go to the walkway between the hills of Safa and Marwa and walk back and forth between them seven times. This completes the Umra portion of the Hajj rituals and some of the Ihram restrictions are relaxed. Hajj Now make your intention for the Hajj and put on the Ihram garments again. Travel to Mina on the 8th of Dhul Hijjah (a date in the Islamic calendar) and remain there until Fajr (dawn) next morning. Then you travel to the valley of Arafat and stand in the open praising Allah.

The heat of Arabia at midday provides a hint as to what the Day of Judgement will be like. At the end of the day, travel to Muzdalifa for the night. Gather together 49 or 70 small stones together to use the next day. One of the pillars of Jamraat © In the morning you return to Mina and throw the stones at pillars called Jamraat. These represent the devil. Then a sacrifice called a Qurbani should be made in which a lamb or sheep is slaughtered and the meat distributed among the poor. After this, men's heads are shaved and women cut a lock of their hair. Then return to Mecca and make a Tawaf (this is the ritual of walking around the Ka'aba seven times). Then it's back to Mina for 3 or 4 days, stoning the pillars each day. Finally do a farewell Tawaf in Masjid-al Haram on the twelfth day of the month of Dhul Hijjah, ask Allah's forgiveness, make du'a and the Hajj is finished. Many people then go to the Prophet's Mosque in Medina, but this is optional.

A man who has completed the Hajj is called a Hajji, a woman who has completed it is called a Hajjah. At the end of the Hajj, Muslims from all over the world celebrate the holiday known as the Eid ul Adha or Festival of the sacrifice. This festival commemorates the obedience of the Prophet Ibrahim when he was ordered to sacrifice his son Is'mail. Ibrahim proved his love and devotion to Allah by showing his willingness to kill his beloved son if Allah wished it. In the end Ibrahim did not have to kill his son as Allah gave him a ram to sacrifice instead. Hajj | Uncyclopedia | Fandom powered by Wikia Muslim excited before going on the Hajj. A pilgrim in the state of Ihram. Traditionally, pilgrims, known as "tourists", travel to the Holy City on their lonesome, or with their gay sex partner, wife, husband, second cousin's uncle's sister's former roommate, or someone from their mosque. If a woman is going to the Hajj, she might need a guy around. Arabs are very picky about women traveling without men. This is because Arabs think women are children.

The guys are required to dress only in an aloha shirt, preferably with lei, complete with camera, along with a pair of shorts or plaid pants; women are required to dress in a muumuu or bathing suit along with hijab, with messy makeup and a silly hat being preferred. This is called Ihram, or touristy clothing, and stems from the original Makkah (otherwise known as "Walt Disney World"). The Ihram symbolizes equality and purity, in recognition of the fact that tourists, whether rich or poor, dress and behave like a buffoon on marijuana. A "miqat", or "bathroom", is where one changes into Ihram, and while wearing the Ihram, a person cannot put on makeup, cut their pigtails, upchuck (unless feeling sick), let their feet go bad, pee on the front lawn, or cut their chest hair. To start the Hajj, a tourist chants the "Tourist's Voodoo Prayer", also known as the "Talbiyah".

(The prayer goes, "There's no place like home, there's no place like home, get me outta this God-awful place!") While in a state of Ihram, or Confusion as some folks know it, one should not fuck (unless on a romantic moonlit beach at night or in the back-seat of a car), murder a living thing (unless it's the fucking bug that keeps annoying everyone by buzzing around), swear (yeah, right, nobody pays any attention to that fucking rule), or fight (unless drunk or stoned). edit Performing the Hajj edit Umrah During the Hajj, Muslim women wear the Hijab to reduce Allah's arousal level. When a pilgrim (locally known as a "Hajji", Arabic for "foreign moron who doesn't know what in heck he's doing") performs numerous rituals symbolizing the lives of Hagar and Abraham, the first tourists. Those acts are the "tawaf" and the "sa'i". The Zamzam Jacuzzi, traditional target of the sa'i. Its contents are blessed with an abundance of hydrogen hydroxide, among other substances.

The Tawaf often consists walking around the hotel and hotel room seven times, in order to look for the bathing suit, the sunscreen, the "Tourist's Guide to Playing with Zamzam Water and Bathing in the Zamzam Spa and Health Club", getting fed up, and going to the hotel clerk to request a new room because you couldn't find anything - a man is supposed to do the first three searches around the hotel at a quick pace, followed by four hunts around the Gideon Bible in the hotel room at a more leisurely pace; however, there are variations of this theme. One variation calls for the person performing Tawaf to go to the amusement park's roller coaster, walk around the roller coaster three times, then stand in line to ride it four times, for example. Others have the same going on with respect to some old cube called the "Ka'aba". However, since that is the most boring attraction at the resort, who wants to do that? The Sa'i consists of a hunt for Zamzam water, which is supposed to be a re-enactment of Hagar's search for decent toiletries and a spa.

People walk from the hill of Safa to the hill of Marwah and back seven times, preferably smelling like shit. Currently, this path is enclosed in the town stadium, which also doubles as the Zamzam Resort and Spa (No Non-Muslims Need Book a Room). The aforementioned rituals make up the Umrah, or "lesser Hajj", and can be done at any time of the year. However, Muslims still have to complete the bigger Hajj during tourist season. It is customary to bathe in the Zamzam Jacuzzi (the world's oldest Jacuzzi, built by Muhammad (PBUH) himself, and consequently clad in more than a thousand years of health-altering bacteria) afterwards. One can also switch to civilian wear (business suits, ties, hippie clothes, Army clothes, whatever you wish) from ihram at this point; this is the mut'ah of the Hajj.

edit Medina Side Tour Option, Cost: $100 (400 Riyals) If a pilgrim (also known as an "Indian") is lucky and actually has money on the side, he or she can take the Medina Side Tour, which features the attractions of Muhammad's Harem (where his 9-year-old wife, A'isha, lived), the Mosque of the Prophet, which is Muhammad's original theme park and religious holiday haven and where he was buried, and the Palace of the Caliphs, where the Muslims who wanted to take over the world did their scheming. They set out on a tour bus and have a guide scream in their ear about what Mr. Pbuh did 1400 years ago when in town, including little trivia such as the fact that he liked to kiss A'isha's feet. edit The Hajj, after the Intermission The journey to the Stoning of the Devil ritual is the most dangerous part of the Hajj. The Greater Hajj (so-called because Muhammad (pbuh) paid a Madison Avenue ad firm to sell the most tacky part of the Hajj to the public and this was what they could come up with) starts on the eighth day of Vacation Month.

The tourists put on their ihram and a hula dress, and it is the custom to dance the hula before leaving for Mina ( Disneyland ). The next morning, the pilgrims leave their Mina hotels at Downtown Disney for the Matterhorn . They then have to spend the afternoon inside the queue area of the Matterhorn roller coaster, or nearby, until after sunset. There are no specific rituals required during this stay, although many meditate (or perhaps medicate). After sunset, they leave for the Rivers of America and Tom Sawyer Island, which is supposedly between Downtown Disney and the Matterhorn, but the Qu'ran author(s) may have gotten the directions wrong. On Tom Sawyer Island, people gather 49 pebbles for the stoning of the Devil (Shaitan). Those rocks are thrown into the Rivers of America while yelling war cries, or less commonly at the nearest tree. This throw happens on the 10th day of Vacation Month, and the first part of the Stoning consists of toking on a bong... err, no, it consists of throwing seven pebbles into the water or at a tree. Then an animal (or Audio-Animatronic) is slaughtered.

While the tradition calls for pilgrims to do the slaughtering themselves, the custom now is to buy a re-entry pass and get your hand stamped so you could have someone else do the slaughtering at the local McDonald's. The end of the Stoning of the Devil ritual. On the 10th of Vacation Month, too, most pilgrims are released from Ihram restrictions and get a haircut - and are allowed to wear the Mickey Mouse ears. They go to Mecca at this point to do a Tawaf of Confusion (a re-enactment of Abraham and Hagar's losing their airplane tickets and having to go back to Mecca to find it). The Tawaf of Confusion is a required part of the Hajj. After this, they return to Mina (Disneyland). At this point, on the afternoon of the 11th, the pilgrims throw rocks into the Rivers of America once, have a pillow-fight once, and throw water balloons at each other once. The first event involves seven pebbles. Then, seven pebbles are exchanged for pillows, and each person is supposed to throw seven pillows at each other.

Finally, seven pebbles are exchanged for balloons full of Zamzam or Rivers of America water (the Qu'ran isn't picky on this point) and people throw the balloons at each other. After this, they go back to Mecca to do a farewell Tawaf (the Tawaf of the Packing of the Luggage and the Waiting for the Plane). edit Incidents during the Hajj Muslims sometimes see the Dark Lord appear. This is one of his photos as he sat in Mecca . There have been incidents during the throwing of rocks into the Rivers of America and during the sa'i: people have overcrowded the Huckleberry Finn rafts, leading to numerous sinkings and drownings; folks have also overcrowded the banks of the Rivers and pushed one another into the river, and stampedes during the sa'i have ensued because too many idiots bumped into one another. The Saudi Government, being a bunch of wankers, has not kept up with the infrastructure. The problem is that a bridge to Tom Sawyer Island would spoil the scenery.

Nonetheless, there are other measures put into effect in response to catastrophes, such as holding the stoning for several pilgrims in the parking lot rather than on Tom Sawyer Island (or, at the very least, on Main Street USA). It is customary for people to leave Mecca drenched and/or wet. The Saudi security forces, entrusted with overseeing the Hajj, have been known to shoot and kill hundreds of pilgrims, in order to maintain order and prevent injuries. Their current record is 421 Iranian pilgrims in one day following a conflict in 1987. The big money in Vegas is looking for the Iranians to top this record in the near future. Saudi Arabia: Hajj Pilgrimage - Chapter 4 - 2016 Yellow Book | Travelers' Health | CDC Saudi Arabia: Hajj Pilgrimage Christopher S. Bowron, Salahudin M. Maalim DESTINATION OVERVIEW They will come to thee on foot and (mounted) on every kind of camel, lean on account of journeys through deep and distant mountain highways . . .

(Quran 22:27) The Hajj is the annual pilgrimage to Mecca, Saudi Arabia, and the largest mass gathering in the world. Every able-bodied adult Muslim who can afford to do so is required to make Hajj at least once in his or her lifetime. Hajj takes place from the 8th through the 12th days of Dhu al-Hijja, the last month of the Islamic year. Because the Islamic calendar is lunar, the timing of Hajj varies with respect to the Gregorian calendar (for example, it was October 1–6 in 2014 and September 20–25 in 2015). More than 2 million Muslims from >183 countries make Hajj each year (approximately 2.8 million in 2010), >11,000 of whom travel from the United States. Most international pilgrims fly into Jeddah and take a bus to Mecca. By foot or by bus, the pilgrim then travels 8 km to the massive tent city of Mina, where most pilgrims are housed in air-conditioned tents.

At dawn on the 9th day of Dhu al-Hijja, pilgrims begin a 14.4-km walk to the plain of Arafat, passing Muzdalifah along the way ( Map 4-16 ). The route is littered with cool mist sprinklers to counteract the oppressive daytime temperatures, but the risk of heat-related illnesses during this part of the journey is high. Hajj ambulances and medical stations along the route are available for medical assistance. Hajj culminates on the Plain of Arafat, a few miles east of Mecca, where the Prophet Muhammad delivered his final sermon. Pilgrims spend the day in supplication, praying and reading the Quran; it is the pinnacle of most pilgrims’ spiritual lives. After sunset, pilgrims begin the 9-km walk back to Muzdalifah, where they sleep in the open air. At sunrise on the 10th day of Dhu al-Hijja, pilgrims collect small pebbles at Muzdalifah and carry them to Mina. This day’s ritual is called the Stoning of the Devil at Jamaraat.

During this ritual, pilgrims throw 7 tiny pebbles (specifically, no larger than a chickpea) at each of 3 white pillars. The crowded conditions at this site pose potential hazards; multiple deadly stampedes occurred from 1994 to 2004. In 2004, after 251 pilgrims were killed and another 244 injured, the Saudi government replaced the round pillars with wide, elliptical columns to reduce crowd densities. However, after another stampede in 2006 that killed 380 pilgrims and injured 289, the single-tiered Jamaraat pedestrian bridge was demolished and replaced with a wider, multilevel bridge. Subsequently, no further incidents have occurred at Jamaraat. Traditionally after Jamaraat, pilgrims sacrifice an animal to symbolize the ram that Abraham sacrificed instead of his son. More recently, pilgrims are required to purchase a “sacrifice voucher” in Mecca and have this sacrifice performed by proxy. Centralized, licensed abattoirs perform the sacrifice on behalf of the pilgrim.

After returning to Mecca, pilgrims go immediately to the Grand Mosque, which contains the Ka’aba, the most sacred site in Islam, and perform a tawaf, circling the Ka’aba 7 times counterclockwise. Because of the vast number of people (each floor of the 3-level mosque has a capacity of 750,000), a single tawaf can take hours. In addition to tawaf, pilgrims may perform sa’i, walking or running 7 times between the hills of Safa and Marwah and then drinking water from the Well of Zamzam. Previously performed in open air, this route is now enclosed by the Grand Mosque and can be traversed via air-conditioned tunnels, with separate sections for walkers, runners, and disabled pilgrims. After a final tawaf, pilgrims leave Mecca, ending Hajj. Although it is not required as part of Hajj, many pilgrims extend their trips to travel to Medina. In Medina, pilgrims visit the Mosque of the Prophet, which contains the tomb of Mohammed and is the second holiest site in Islam. Map 4-16.

Hajj destination map HEALTH ISSUES Immunizations All pilgrims should be up-to-date with routine immunizations. In addition, hepatitis A and B and typhoid vaccines are recommended. Although a requirement for polio vaccine does not include adult pilgrims from the United States, it is best to ensure full vaccination against polio before travel. Children up to 15 years of age must show proof of vaccination with quadrivalent meningococcal vaccine and polio vaccine. Children older than 15 years of age have the same vaccination requirements as adults. Meningococcal Vaccine Because of the intensely crowded conditions of the Hajj and high carrier rates of Neisseria meningitidis among pilgrims, outbreaks of meningococcal disease have historically been a problem during Hajj. In the aftermath of outbreaks in 2000 and 2001 that affected 1,300 and 1,109 people, respectively, the Saudi Ministry of Health began requiring all pilgrims and local at-risk populations to receive the meningococcal vaccine. Hajj visas cannot be issued without proof of meningococcal vaccination.

All adults and children >2 years of age must have received a single dose of quadrivalent A/C/Y/W-135 vaccine and must show proof of vaccination on a valid International Certificate of Vaccination or Prophylaxis. Children between 3 months and 2 years of age must show proof of vaccination with 2 doses of meningococcal A monovalent vaccine with a 3-month interval between the doses. Hajj pilgrims must have had the meningococcal vaccine ≤3 years and ≥10 days before arriving in Saudi Arabia. Current Hajj vaccination requirements are available from the following sources: Saudi Arabian Ministry of Health ( ) Saudi Arabian Embassy ( ) Respiratory Infections Respiratory tract infections are common during Hajj; the most common cause of hospital admission is pneumonia. These risks underscore the need to follow the Advisory Committee on Immunization Practices’ recommendations for pneumococcal polysaccharide vaccine for pilgrims aged ≥65 years and for younger pilgrims with comorbidities. Seasonal influenza vaccine, including H1N1, is strongly recommended for all pilgrims.

Behavioral interventions such as hand hygiene, wearing a face mask, cough etiquette, social distancing, and contact avoidance can be effective at mitigating respiratory illness among Hajj pilgrims. Pre-Hajj travel advice about common respiratory conditions should include a general assessment for respiratory fitness, necessary vaccinations, and prescription of adequate supplies of portable respiratory medications (prefer inhalers over nebulizers). The crowded conditions during Hajj increase the probability of tuberculosis transmission. Pilgrims are advised to see their doctors if they develop signs of active tuberculosis: cough with sputum and blood at times, chest pains, weakness, weight loss, fever, and night sweats. Middle East respiratory syndrome (MERS) was first identified in Saudi Arabia in 2012. The illness is caused by a novel coronavirus that is similar to the virus responsible for the 2003 global outbreak of severe acute respiratory syndrome (SARS). Cases have been identified in and around the Arabian Peninsula, but cases have also been exported to other countries, including the United States. The most common symptoms include fever, cough, and shortness of breath. However, myalgias, diarrhea, vomiting, abdominal pain, thrombocytopenia, and leukopenia have also been reported.

The severity of illness has ranged from mild to severe, and approximately 35% of reported cases have been fatal. The role of animal-to-human transmission is unclear, but the virus has been found in camels in this region. The diagnosis can be suspected on clinical grounds and confirmed by PCR testing. More information is available in Chapter 3, MERS . Other Health and Safety Risks Communicable Diseases Diarrheal disease is common during Hajj, and travelers should be educated on usual prevention measures and self-treatment. A pre-travel visit should include discussions about prevention, oral rehydration strategies, antimotility agents, and emergency antibiotic use for treatment of traveler’s diarrhea. Chafing caused by long rituals of standing and walking in the heat can lead to fungal or bacterial skin infections. Clothing should be light, not restrictive, and changed often to maintain hygiene. Travelers should be advised to keep skin dry, use talcum powder, and be aware of any pain or soreness caused by garments. Any sores or blisters that develop should be disinfected and kept covered. Special attention should be paid to protect the feet, which are bare when inside the Grand Mosque.

Nasal ablution, called istinshaaq, is the practice of rinsing your nose with water before performing some rituals during the Hajj. Medical literature has identified rare cases of primary amebic meningoencephalitis (PAM) caused by Naegleria fowleri. Even though no cases of Hajj-related PAM have been reported, nasal ablution is common during Hajj, and pilgrims are advised to use safe water to protect themselves from this potential risk. When in doubt, they should use bottled water. Boiling or filtering the water are other ways to decrease the risk of PAM. At the end of Hajj, Muslim men must shave their heads. The use of unclean blades can transmit bloodborne pathogens, such as hepatitis B, hepatitis C, and HIV. Licensed barbers are tested for these bloodborne pathogens and are required to use disposable, single-use blades. Unfortunately, unlicensed barbers continue to operate by the roadside, where they use nonsterile blades on multiple men. Male travelers should be advised to be shaved only at officially designated centers, which are clearly marked.

Noncommunicable Diseases and Other Hazards Hajj is arduous even for young, healthy pilgrims, and many Muslims wait until they are older before making Hajj. Pilgrims who are caught up in the spiritual experience of Hajj may forget to take their usual medications. Travelers with chronic medical conditions should undergo a functional assessment before leaving for Hajj. The medical provider should identify each traveler’s unique risks and tailor a plan on how to reduce them. The provider should make any adjustments to the usual medical regimen, ensure that the traveler has an adequate supply of medications, and educate the traveler about symptoms that should prompt urgent medical attention. Heat exhaustion and heatstroke are leading causes of death, particularly when Hajj occurs during the summer months. Pilgrims should stay hydrated, wear sunscreen, and seek shade when possible. Umbrellas are frequently used to provide portable sun protection. Travelers should be counseled on minimizing the risk of heat-related injuries as well as sun avoidance. Some rituals may also be performed at night to avoid daytime heat. Pilgrims can be reassured that night rituals have been advocated as legitimate by religious clerics. Fire is a potential risk at Hajj.

In 1997, open stoves set tents on fire, and the resulting blaze killed 343 pilgrims and injured >1,500. As a result, makeshift tents were replaced with permanent fiberglass structures; no pilgrim is allowed to set up his own tent or prepare his own food. Cooking in the tents is also prohibited. Trauma Trauma is a major cause of injury and death during Hajj. Pilgrims may walk long distances through or near dense traffic, and motor vehicle accidents are inevitable. The most feared trauma hazard, however, is stampede. In such dense crowds, little can be done to avoid or escape a stampede once it has begun, but the physical environment of the Hajj has been engineered specifically to minimize this risk. Past stampedes have often begun as minor incidents; the 2006 Hajj stampede, for example, began when some pilgrims tripped over fallen luggage, but it resulted in hundreds of injuries and deaths. Death usually results from asphyxiation or head trauma, and providing prompt treatment is next to impossible in large crowds.

Special Health Considerations Menstruation Women are not permitted to perform tawaf around the Ka’aba stone if they are menstruating. The remainder of the rituals may be performed during menstruation if the tawaf was performed before the menstrual period began. Thus, a female Hajj pilgrim who suspects that she may be menstruating during the Hajj may request hormonal suppression of menstrual bleeding. Diabetes Mellitus Muslims with diabetes planning to make Hajj should make a pre-Hajj travel clinic visit with enough advanced notice to carefully construct a diabetes management plan tailored to the health challenges of the Hajj. Diabetic patients should ensure adequate prescriptions for all medications, including syringes and needles. A diabetes emergency kit should include easily accessible carbohydrate sources to counter hypoglycemia, glucometer and test strips, urine ketone sticks to evaluate for ketoacidosis, a list of medications and care plans, and glucagon as indicated. Lastly, durable and protective footwear are necessary to avoid minor foot trauma that can lead to infections. Epilepsy Before making Hajj, a pilgrim’s seizure disorder must be controlled on stable doses of medications.

Before departure, Hajj travelers should ensure they have adequate supplies of routine medications, as well as a buccal or rectal formulation of antiseizure medications. SAUDI GOVERNMENT SAFETY MEASURES The Saudi government has created a Ministry of Hajj that collaborates with the Ministry of Health to improve pilgrims’ experience, including mitigating health risks during Hajj. The hospitals and health centers in and around the holy sites are adequately staffed and equipped for the large gathering. The medical facilities offer high quality of care, and services are offered free to Hajj pilgrims. To ensure efficient transport through the King Abdulaziz International Airport in Jeddah, the Saudi government has built a modern airport terminal solely dedicated to Hajj pilgrims. Furthermore, modern modes of transportation (light rail, 15,000 Hajj dedicated buses, and even high-speed rail lines) have been developed to safely transport pilgrims to the city of Mecca and other holy sites. To mitigate the risk of heat exposure during this journey, the government provides complimentary water distributed from refrigerated trucks, more air conditioned sites (tents at Mina), large sun-blocking canopies, and thousands of fine mist sprinklers.

To further protect themselves, travelers are urged to avoid the most densely crowded areas during Hajj. When the option exists, performance of rituals at nonpeak hours is encouraged. For example, most pilgrims prefer to perform the Stoning of the Devil at midday, but Saudi authorities have decreed that it may be performed anytime between sunrise and sunset or even by proxy, if the pilgrim cannot access the Jamaraat bridge. BIBLIOGRAPHY Ahmed QA, Arabi YM, Memish ZA. Health risks at the Hajj. Lancet. 2006 Mar 25;367(9515):1008–15. Alsafadi H, Goodwin W, Syed A. Diabetes care during Hajj. Clin Med. 2011 Jun;11(3):218–21. Alzahrani AG, Choudhry AJ, Al Mazroa MA, Turkistani AH, Nouman GS, Memish ZA. Pattern of diseases among visitors to Mina health centers during the Hajj season, 1429 H (2008 G). J Infect Public Health.

2012 Mar;5(1):22–34. Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, Al-Rabiah FA, Al-Hajjar S, Al-Barrak A, et al. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect Dis. 2013 Sep;13(9):752–61. Balaban V, Stauffer WM, Hammad A, Afgarshe M, Abd-Alla M, Ahmed Q, et al. Protective practices and respiratory illness among US travelers to the 2009 Hajj. J Travel Med. 2012 May–Jun;19(3):163–8. Khan NA, Ishag AM, Ahmad MS, El-Sayed FM, Bachal ZA, Abbas TG. Pattern of medical diseases and determinants of prognosis of hospitalization during 2005 Muslim pilgrimage Hajj in a tertiary care hospital. A prospective cohort study. Saudi Med J.

2006 Sep;27(9):1373–80. Memish ZA. The Hajj: communicable and non-communicable health hazards and current guidance for pilgrims. Euro Surveill. 2010 Sep 30;15(39):19671. Memish ZA. Saudi Arabia has several strategies to care for pilgrims on the Hajj. BMJ. 2011;343:d7731. Memish ZA, Al-Rabeeah AA. Health conditions of travellers to Saudi Arabia for the pilgrimage to Mecca (Hajj and Umra) for 1434 (2013). J Epidemiol Glob Health. 2013 Jun;3(2):59–61. World Health Organization. Health conditions for travellers to Saudi Arabia pilgrimage to Mecca (Hajj). Wkly Epidemiol Rec. 2005 Dec 9;80(49–50):431–2.

Question: Who gets stoned during Hajj?
Answer: The Devil