The Kingdom of Saudi Arabia receives approximately 3 million pilgrims during the Hajj season, and annually hosts around 15 million Umrah pilgrims from 184 countries. This requires advanced skills and techniques to manage crowds safely, prevent infections, and treat any injuries that may result from stampedes, high temperatures, or other factors. The Kingdom takes a leading role in health and safety management for crowds and is globally recognized in this field. The concept of this healthcare sector originated from the seasons of Hajj and Umrah, and for years, artificial intelligence technology has been introduced to enhance service quality during the Hajj season and provide better care for the pilgrims of the Holy Kaaba, given their simultaneous gathering and specific spatial area.
This branch of medicine was established by Saudi physician Dr. Ziad Memish, who obtained his specialization from the University of Ottawa in Canada, as well as fellowships from the American College of Infectious Diseases and the Royal College of Physicians, and an honorary professorship in infectious diseases from the Liverpool School of Tropical Medicine. This extensive academic background granted him the ability to establish the Global Center for Mass Gatherings Medicine (GCMGM) in collaboration with the World Health Organization. To share these scientific experiences in Crowd Medicine, Dr. Memish organized the world’s first conferences on mass gatherings medicine in Jeddah, establishing Saudi Arabia as a global reference in Crowd Medicine and managing public assemblies. An electronic disease surveillance system has also been implemented across the Kingdom, the first of its kind in the region.
Today, the GCMGM, established in 2014, is considered a significant milestone in this field. It is one of three global centers specializing in crowd and human assembly management in various domains. The center plays a pioneering role in organizing and hosting the International Conference on Mass Gatherings Medicine, building collaborations with other public assembly organizations and World Health Organization subsidiaries, coordinating policies and procedures, and managing awareness campaigns related to this field.
Smart Technologies for Optimal Safety
In the current Hajj season of 2023, there has been a greater reliance on artificial intelligence technologies through the launch of the Virtual Health Hospital. The Saudi Ministry of Health announced its participation in this year’s Hajj season by providing a range of virtual healthcare services remotely, using the latest medical technologies that have proven their efficiency and effectiveness in rapid medical intervention and accurate disease diagnosis. This enables timely and appropriate medical decision making and the provision of therapeutic services to the guests of Allah.
The hospital is equipped with integrated medical teams supervised by a number of consultants in various specialized fields. It operates 24/7 across six main tracks, including virtual stroke care, virtual critical care, cardiac services, virtual radiology, virtual medical consultations, virtual clinic consultations, and finally, virtual kidney dialysis services.
What stands out this year is that the Hajj season of 2023 marks the first complete return of pilgrims since the COVID-19 pandemic. In the previous season, the number of pilgrims was 899,353, while the Hajj season in 2021 was limited to only 60,000 participants from within the Kingdom. The 2020 season witnessed around 10,000 participants from within Saudi Arabia alone, compared to approximately 2.5 million pilgrims from around the world in 2019.
This prompted the relevant authorities in the Kingdom, especially in the public and private sectors, to prepare for the current season with full readiness, modern technologies, and advanced plans to prevent pilgrims from infections or stampede-related injuries. Particularly, they focused on protecting pilgrims from heat stroke as temperatures reached 48 degrees Celsius during the Hajj period. The Field Services and Affairs Agency introduced “Smart Sanitization Sweepers” as part of its plans to enhance operations this year. These sweepers work manually and electronically through their dedicated smart application, equipped with artificial intelligence mapping technology. Additionally, the General Authority of Roads announced the use of drones to inspect and evaluate the road network in the holy sites for the first time in this year’s Hajj season. This initiative aims to ensure the safety and quality of roads leading to the holy sites. The thermal technology used by these drones allows for observations and automated, rapid, and accurate examination of bridges and ferries.
Saudi Arabia has also innovated new and creative tools to ensure the safety of crowds. The “Jeddah Tool” was developed to enhance preparedness, response, and recovery from health emergencies based on the H-EDRM framework. It serves as a risk assessment tool and has proven effective in mitigating disease risks. The “Salem Tool” was introduced in March 2020 during the peak of the COVID-19 pandemic. It assesses health risks in gatherings and public places and provides recommendations to enhance health safety and prevent virus spread. The “Salem Tool” evaluates 17 factors that could pose health risks. Based on the evaluation, events are classified as high, medium, or low-risk. Decision-makers and planners receive recommendations based on this classification to ensure effective implementation.
Based on these technologies and others, Saudi Arabia has demonstrated great proficiency in Crowd Medicine, which has been exemplified in the current season through the optimal use of artificial intelligence. This has greatly contributed to monitoring and organizing the movement of crowds, effectively protecting the masses’ health, and facilitating the description and provision of necessary treatment in case of health conditions requiring medical attention and follow-up.
Successful efforts and global acclaim
The Saudi Ministry of Health continued its warnings to the pilgrims of the Holy Kaaba, urging them not to abandon the use of sunshades throughout the day, to drink sufficient amounts of water and fluids, to avoid excessive physical exertion without necessity, and to avoid standing for long periods in queues, to prevent the risk of heat stress and heat stroke.
Saudi Minister of Health, Fahd bin Abdulrahman Al-Jalajel, also announced the success of the health plans for the Hajj season of the year 1444 AH (2023), emphasizing that there have been no outbreaks or threats to public health. From the Command and Control Center in Mina, he stated, “Thanks to Allah and with the great support of the Custodian of the Two Holy Mosques and the follow-up of the Crown Prince, Chairman of the Council of Ministers, I am pleased to announce the success of this year’s health plans for Hajj, along with the return of pilgrim numbers to pre-pandemic levels.”
He added, “Based on the commitment of the Custodian of the Two Holy Mosques to prioritizing human health, the healthcare system has prepared over 354 healthcare facilities across all sectors to provide services to the guests of Allah. More than 36,000 healthcare professionals from various sectors have contributed to delivering these services, supported by over 7,600 volunteers.”
He revealed that the number of pilgrims who received healthcare services exceeded 400,000, including over 50 open-heart surgeries, more than 800 cardiac catheterizations, and over 1,600 dialysis sessions. Virtual services were also provided through the Virtual Health Hospital to over 4,000 pilgrims, and more than 8,000 cases related to sunburn and high temperatures were handled. The proactive awareness efforts played a role in reducing the increase in the number of cases.
Due to the successful organization and satisfactory results, the World Health Organization praised the efforts of the Kingdom of Saudi Arabia during this year’s Hajj season, noting that no incidents or disease outbreaks were reported. The organization commended the exceptional efforts made by the Saudi authorities in providing healthcare services to millions of pilgrims and their continuous collaboration with the organization to enhance various areas of healthcare work.
Dr. Ahmed Al-Mandhari, the Regional Director of the World Health Organization for the Eastern Mediterranean, stated, “We appreciate the extraordinary efforts made by the Saudi authorities to organize and provide healthcare services to millions of pilgrims.” He affirmed that the organization is confident that the Ministry of Health and all relevant bodies involved in Hajj spare no effort in this regard. The preventive measures ensuring the safety of the pilgrims of the Holy Kaaba were implemented in accordance with the requirements of the International Health Regulations (2005). These measures include effective surveillance to detect any outbreaks of infectious diseases among the pilgrims and promptly respond to them, infection prevention and control, proper sanitation, food safety, vaccination, risk communication, and timely response.