ABSTRACT
The annual pilgrimage to Makkah [Hajj] is a unique gathering of Muslims from all over the world. Pilgrims [Hajjees] vary considerably in their socio-demographic characteristics, health-related behaviors and their underlying health status. As a result, they vary in their medical needs. The objectives of this study were to identify the pattern of workload at the primary health care centers in Mina, where Hajjees camp for about 5 days, and the age, sex and nationality distribution of the common illnesses among Hajjees treated at these primary health care centers. A systematic random sample was selected from the records of patients who visited 15 out of the 22 primary health care centers and one of 3 hospitals serving Hajjees in Mina. The nationalities of Hajjees were divided into 8 groups according to the administrative organization of the Ministry of Hajj. Illnesses were also regrouped into 8 groups according to the systems affected. Out of 1,323 records reviewed of more than 44 nationalities, the overall sex ratio was about 2:1. About 10-12% of all patients across different nationalities were 65 years or older except Hajjees from GCC [2%] and Iran [17%]. The workload varied considerably between primary health care centers. The workload at the primary health care centers in Mina increased steadily and progressively, reaching its peak on the 12th of Dhul Hijja. The workload showed consistent daily bimodal pattern; the busiest periods were between 6-10 am and 7-10 pm. These primary health care centers were located close to Al-Jamarat area, serving Hajjees from southeast Asia and Africa. The leading causes of morbidity among Hajjees diagnosed at the primary health care centers in Mina were respiratory diseases [49% of all illnesses], gastrointestinal illnesses [11%], skin diseases [8%] and diseases of the muscles and joints [7%]. Heat exhaustion cut wounds and chronic illnesses such as diabetes mellitus and hypertension constituted less than 2% each. The variations in the workload at the primary health care centers could help decision makers in redistribution of the health manpower between and within primary health care centers to design a more efficient schedule for General Practitioners and other medical staff within primary health care centers. The remarkably wearisome physical effort a Hajjee would undergo could probably explain the increased utilization of primary health care centers services by females. Occurrence of illnesses could reflect some undesirable risk behaviors among certain nationality groups