Pilgrims at the Holy House of God, Kabah
Today, the Hajj is a safe spiritual journey because Muslims have learned and applied public health best practices.
As a child, when the time for the annual Hajj would approach, I would often hear the same story from my father. He would tell me about Syed Yussef, a relative of my great-grandfather who travelled to Mecca to perform the Hajj at the turn of the 20th century
At that time, the journey from our homeland in northern Kenya to Islam’s holy places was an arduous one and many pilgrims did not make it back, falling victim to disease, exhaustion or attacks by bandits.
Knowing full well these dangers, Syed Yussef set out for Mecca overjoyed that he would be fulfilling his religious obligation, experiencing a journey of spiritual purification and feeling the cool marble flooring around the Holy Kaaba. It would take him four months – traveling on foot, by boat and camel – to reach the holy site.
More than a century after my distant relative crossed seas and deserts to get to Mecca, I also made the journey – which took me just a few hours by plane. It was 2019, a year before the COVID-19 pandemic. I was appointed to a World Health Organization team which was dispatched to Saudi Arabia to support the Ministry of Health in health crisis preparedness and disease outbreak prevention during the Hajj season.
I was impressed by the public health measures that the Saudi authorities already had in place to keep safe the millions of people who poured in. They had made sure that pilgrims had access to clean water and sanitation facilities, food, transportation and medical care. The elderly, the sick and people with disabilities were also accommodated so they to could participate fully in the Hajj. The holy sites were kept clean and there was constant monitoring for disease outbreaks.
The Hajj I saw was not only a wondrous unforgettable spiritual journey for the pilgrims, but also a safe one where people did not have to risk their lives to undertake it – as my legendary relative and many others had to in the past. And that was not only because the Saudi health ministry was doing its job well, but also because Muslims had learned from past disasters. In fact, one could argue that the Hajj has shaped global public health practices used today around the world.
As a mass gathering of people, the Hajj has had a history of public health crises. For example, in 1865, during the Hajj season, a cholera epidemic broke out, killing 15,000 of the 90,000 pilgrims that undertook it. Once the pilgrimage was over, people went back to their homes, carrying with them the deadly disease and causing various outbreaks in Africa, Asia and Europe. The total death toll from the epidemic was estimated at 200,000 people.
As cholera spread to Europe, the French government was alarmed. Under its initiative, in 1866, the Ottoman authorities hosted in Istanbul the International Sanitary Conference held, which was exclusively devoted to the disease outbreak.
At the summit, which was dominated by European nations, the cholera epidemic in Europe was linked to the Hajj. The measures that were discussed focused on ways to prevent the spread towards European countries, including by closing ports to arrivals from the Arabian Peninsula and imposing maritime quarantine. However, tackling the epicentre of the outbreak in the East was hardly discussed, which was a mistake.
Quarantine centres were set up in al-Tur in the Gulf of Suez, the Kamaran Island in the Red Sea, and in Izmir, Trabzon and on the Bosphorus in the Ottoman Empire. They targeted specifically Muslim pilgrims who were hoarded into camps and kept there for at least 15 days to ensure they were not carrying the disease.
Unsurprisingly, the quarantine stations were deeply unpopular and pilgrims resented being detained and overseen by people of another faith. The result was that many would travel longer distances so that they would not have to go through these ports and experience such humiliation.
Many Muslims avoided the quarantine despite them knowing the public health teaching of Prophet Muhammad: “If you hear of an outbreak of plague in a land, do not enter it; but if the plague breaks out in a place while you are in it, do not go out escaping from it.”
There would have been more compliance had Muslim communities been properly consulted and included in developing the quarantine measures, instead of being coerced. These policies were clearly designed to serve the interests of rich and powerful European nations and that provoked distrust and rejection. This is a recipe for disaster in any public health strategy.
Meanwhile, Muslims learned the lessons of the 1865 outbreak and put in place policies to prevent another one in their holy sites. In Mecca, various sanitation measures were implemented to reduce the risk of cholera, which proved successful. Outbreaks of cholera dwindled afterwards.
Fast-forward to today, the public health knowledge and traditions accumulated over centuries have been embedded in Saudi Arabia’s modern policies, which ensure that the Hajj is carried out in a safe manner.
When the COVID-19 pandemic broke out in the 2020, the kingdom immediately took measures to prevent the Hajj from becoming a superspreader event. The number of pilgrims was dramatically reduced to just 1,000 and the rituals were carried out under strict social distancing and masking mandates.
The COVID-19 pandemic was tough on all of us, not only physically but psychologically and socially as well. This year, we will have the first Hajj without strict pandemic measures in place, enabling more than 2.5 million Muslims to embark on this spiritual journey. This is great news.
In 2019, I witnessed the impact the Hajj has on Muslims from all over the world, of all races, of all walks of life. I observed what American psychologist Abraham Maslow calls transcendence and defines as: “the very highest and most inclusive or holistic levels of human consciousness, behaving and relating, as ends rather than means, to oneself, to significant others, to human beings in general, to other species, to nature, and to the cosmos.”
But with the end of the COVID-19 pandemic, we should not let our guard down. In an increasingly hotter and interconnected world, the next global public health emergency may be just around the corner; we know it is a question of when not if.
That is why, we should learn from past mistakes. The cholera outbreak of 1865 demonstrates how measures that lack a public buy-in and trust can undermine efforts to curb the spread of a disease. We need to keep in mind these lessons as world leaders discuss a new pandemic accord that can help improve how pandemics are detected and responded to.
In a time of heightened mis- and dis-information, amplified by social media, reflecting on the facts and working with communities on pandemic preparedness and response will determine our success and failure.
In all this, the Hajj can be a beacon of hope. It can offer not just a religious and spiritual path but also a public health one. It stands as an example where science supports transcendence, spirituality and human solidarity.
Abdirahman Mahamud, Director at WHO's Alert and Response Coordination Department
The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial stance.