Avoid new shoes and look after your mental health. How to be well at the Hajj

ISLAMABAD — Hajj is the annual Islamic pilgrimage to Mecca that is required once in a lifetime of every Muslim who can afford it and is physically able to do it.

It is a spiritual highlight for those fortunate enough to go, but it is also grueling and stressful.

Pilgrims conduct their rituals outdoors, among huge crowds, walking up to 25 kilometers (15 miles) a day. There is often no privacy or personal space. Languages, routines and surroundings can feel unfamiliar, and the emotional impact of doing the Hajj can also take its toll.

Here are some ways to be well at the Hajj.

Preparation, preparation, preparation

Pilgrims work on their spiritual readiness to undertake the Hajj, but equally important is their physical preparation.

Saudi authorities have published a 45-page safety kit in eight languages. It encourages people to do aerobic exercises for 30 minutes daily and to ''make movement activities'' like using the stairs instead of the elevator, before they travel to Saudi Arabia.

There's a lot of walking at the Hajj, even when pilgrims are not performing rituals. Too much traffic, or not enough transport, means people end up walking up to 25 kilometers (15 miles) every day. All the rituals are on foot.

High temperatures, adrenaline, and physical exertion will elevate the heart rate.

If pilgrims are not used to working out, they should have at least prepared their bodies for the long periods that will be spent outdoors and upright, as going from an inactive or sedentary lifestyle straight to the Hajj will be a shock to the system.

Keep cool and carry or wear a UV umbrella

This year, temperatures at the Hajj are expected to reach 45 degrees Celsius (113 degrees Fahrenheit).

The body's resting core temperature is typically about 37 degrees Celsius (98.6 degrees Fahrenheit), just 4 degrees Celsius (7 degrees Fahrenheit) away from catastrophe in the form of heatstroke.

The bigger killer in the heat is the strain on the heart, especially for people who have cardiovascular disease. Blood rushes to the skin to help shed core heat, causing blood pressure to drop. The heart responds by trying to pump more blood to keep someone from passing out.

Avoid going out during the day unless necessary. Seek shade and rest often, despite the temptation to go at top speed. The Hajj is a marathon not a sprint.

White or pale-colored clothing and UV umbrellas reflect the sunlight, meaning your body and clothing won't get as hot. Oral rehydration sachets can help replenish electrolytes lost through sweating and physical exertion.

There are also hands-free ''Hajj'' umbrellas that are worn on the head, allowing pilgrims to pray and carry out their rituals unencumbered.

Put your best foot forward with comfy shoes

Avoid new shoes, says Dr. Hina Shahid, the London-based chair of the Muslim Doctors Association. ''If you have new shoes, break them in beforehand. Make sure your footwear is comfortable. You don't want to get blisters.''

Well-fitting sandals or sliders are fine for Mecca, which has well-paved roads and sidewalks. It is common to see Muslims streaming into the city by foot.

There is smooth tiling on the outer courtyard of the Grand Mosque that is washed by an army of cleaners at regular intervals. But pilgrims go barefoot when circling the Kaaba, where the marble flooring is cool to the skin whatever the weather.

But the terrain changes in Muzdalifah, where people collect pebbles to use in the symbolic stoning of pillars representing the devil.

They also spend the night in the open air so it's better to wear a sturdier, closed-toe shoe and also at Mount Arafat, where people clamber over rocks to reach the hill's 70-meter-high (230 feet) summit to spend hours in prayer.

Adopt pandemic-style personal hygiene

Cough? Runny nose? Sore throat? Fever? That's ''Hajj flu,'' a nickname for the respiratory infection that people develop during the crowded conditions of the pilgrimage.

It's common to see people wearing face masks during the Hajj, even though face coverings are not a religious requirement, because they are in close proximity to each other, making droplet infections inevitable.

Pilgrims are exposed to new germs, new environments and new routines. These are tough on the immune system when combined.

To minimize the chances of developing the Hajj flu or giving it to others, pilgrims should wash their hands well, especially before eating and after sneezing, coughing or using the bathroom.

Coughing or sneezing into the arm or elbow can help prevent the spread of germs when a tissue isn't available. It's worth sanitizing frequently touched objects and surfaces in the camps at Mina and opening windows for ventilation.

It's important to stay on top of mandatory and recommended vaccinations before traveling to Saudi Arabia.

Take care of your mental health at the Hajj

The Hajj can be daunting because of its scale, religious significance, practical difficulties, the expense, the physical exertion and the pressure to get it right.

It is one of the Five Pillars of Islam, the core beliefs and acts of worship that Muslims must practice.

It can feel tough to fulfill this obligation when you're away from home comforts. Not following your normal routine, sleep deprivation, vast cultural and linguistic differences, and being surrounded by upward of 1.5 million strangers add to the challenges. You can't even wear your regular clothes.

These factors can rattle your calm, kindness and patience.

Prioritizing your health, and resting whenever needed, can alleviate some of the stress. Focusing on what you are doing, rather than comparing yourself to others, can also relieve the pressure.

Being grateful for the opportunity to be at the Hajj will help remind you why you are there. Talking to friends and family back home will ground you.

Hajj is about endurance, humility, mindfulness and struggle. A willingness to let go of negative emotions.

It's a test of your spiritual connection with God, even when everything around you is testing that connection.

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Associated Press religion coverage receives support through the AP's collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.