Indian Medical Mission at Hajj-2016: Mass-Gathering Medicine Perspectives, Challenges, and Opportunities in a Mission Posture

Hajj is an annual mass gathering of over 3.5 million pilgrims congregating from 200 countries in the desert climate of Saudi Arabia. Mass gathering medicine at Hajj is challenged by issues of healthcare accessibility, infection control, on-site treatment, referral, evacuation, and response to disasters and public health emergencies. The Indian Medical Mission at Hajj 2016 established, operated, and coordinated a strategic network of mass gathering medical operations, the proceeds of which are discussed herein. The mission was designed to provide holistic health security through health intelligence for pre-existing chronic diseases, epidemic intelligence for endemic and exotic diseases, public-health and disaster-health preparedness, and tiered healthcare through mobile medical task forces, static clinics, tent clinics, secondary care hospitals, and evacuation capabilities. Primary care, secondary care, and tertiary care treated 374 475, 930, and 523 patients, respectively. Patients exhibited limited compliance with pre-instituted treatments and precautionary protocols. Respiratory and gastrointestinal infections, cardiorespiratory, trauma, and heat illnesses were seen. Epidemic intelligence revealed an outbreak of food poisoning. Respiratory infections were reported by 90% of the healthcare personnel. Surge capacity was overwhelmed with patient throughput and ambulance transfers. Crude unadjusted mortality was 11.99/10 000. The Indian Medical Mission at Hajj 2016 yielded solutions to the challenges faced during the 2016 Hajj pilgrimage. The mission posture of the Indian Medical Mission in Hajj presents a modus operandi for handling crisis scenarios in mass gathering. The situational analysis of the Hajj health mission calls for dynamic interventions in preparedness, clientele, and health systems.