PEOPLE coming for the annual pilgrimiage can be divided into two categories: Healthy people If you are apparently healthy i.e you are not currently on any medication for chronic illnesses then: u Make sure you are vaccinated against meningitis. u Undergo a general health check-up. You will be exerting considerable physical effort during Haj. All Haj rites (Tawaf, Sa'ee, etc.) require a great deal of strength and endurance. The constant crush with hundreds of thousands of other pilgrims, each trying to perform the same rites at the same time in limited spaces and in very hot weather, compounds the demands on your physical conditioning and mental toughness. Although you may be apparently normal, some asymptomatic diseases, might appear only with vigorous physical effort. So it is worth visiting your doctor at least a month before traveling to Makkah. Chronically ill people Haj is a very stressful endeavor and an act of worship that requires strenuous physical effort, especially for the diabetic, the elderly and persons with other chronic illnesses. A. Diabetic patients A diabetic person traveling for Haj should: Learn about symptoms and signs of low blood sugar and how it should be treated. Such people should visit their physician to make sure that their diabetes is under control, bring the necessary medication in proper containers, wear protective diabetic shoes and wear identifying wrist bands. They should also carry a brief medical record and a signed statement from their doctors indicating that they are taking insulin. Always keep one or more extra bottles of insulin handy, and syringes with you, at all times. A pocket or purse will do, but never leave insulin at a place where it is very hot or the temperature is below freezing. You can use a thermos-type jar, or you may buy a special storage container. Check with your doctor about how best to store insulin. B. High blood pressure Have your blood pressure measured by your healthcare provider. If your blood pressure is under control with medication, then take all medication exactly as prescribed. Beware that blood pressure rises again if medication is stopped. C. Other chronic diseases Neither chronic disease nor old age is an absolute contraindication for travel. People suffering from chronic diseases or taking immuno-suppressive medication should seek the advice of their doctors. Drugs and medicines should be kept at hand so as to avoid the risk of an accidental break in medication. Hot climates can exacerbate diseases of the cardiovascular and digestive systems but may alleviate rheumatic pain and chronic infections of the upper respiratory tract. If you are an asthmatic patient, always keep your inhaler and alleviating medicines with you. A person with asthma needs a special plan. Make a checklist to be sure you are ready before you leave. Contraindications for air travel include cardiac failure, recent strokes, chest pain while at rest, rhythm disorders like atrial fibrillation, severe anemia, sickle-cell anemia, acute mental disorders, epilepsy and any serious and acute contagious disease. __