Meningococcal outbreak (1987): The Saudi government, from 1988 onwards, required applicants for Hajj and Umrah visas to have themselves vaccinated against meningococcal infection before submitting their visa applications. We in Peshawar were the initiators of this inconvenience in 1988. Here is the story behind this Saudi demand.
ALAF KHAN
On January 2, 1988, we received into our medical ward a patient with meningococcal meningitis. The number of cases rose to 18 by 21 January. The two neighboring medical units had a similar experience. At least one meningitic patient entering one of the three medical units each day was something unheard of. The patient inflow continued over the ensuing few weeks. All the victims had one thing in common: they had all just returned from their Hajj pilgrimage at the end of 1987. It transpired that a large number of pilgrims with the same illness had been hospitalized in Makkah and Madina during the Hajj period. Some had died, some had recovered, and some had left the hospital against medical advice. I called Dr. Barlas who worked in King Fahd Hospital in Madina. He confirmed that there had been an outbreak of meningococcal meningitis during that Hajj season.
We treated half of our patients with a combination of intravenous penicillin and chloramphenicol 8-hourly, and the other half with intravenous Rocephin (ceftriaxone) daily in standard doses. Both groups made an uneventful recovery. The outcome of this small open trial was published in the fortnightly Pulse International, Karachi. Relying on common empirical knowledge, we did not vaccinate any member of our medical and nursing staff. Surprisingly, no health caregivers had been known to have contracted the disease from their patients.
I telephoned the Saudi Embassy in Islamabad and talked to the Ambassador’s Secretary, Mrs. Barlas Haideri. A memorandum was sent to the Ambassador on 30 May 1988 recommending vaccination against meningococcus A and C for persons who were planning to perform the Pilgrimages during the ensuing few years. Why just a ‘few years’? Because meningococcal outbreaks had been known to occur cyclically every 8-10 years in places of mass gatherings like the Hajj.
Bringing an issue to the notice of the Saudi authorities is a mistake at times. They are the proverbial automatons (لکیر کے فقیر) whom you launch on a track for some short-term purpose, and they will keep treading it till well beyond eternity. I don’t know if foreign diplomats or officials of oil companies were ever required to get vaccinated before entering the Kingdom. Laborers, office workers, and Muslim pilgrims from anywhere in the world have remained subject to this rule for decades.
Intending pilgrims from the USA, UK, and some other countries faced problems getting vaccinated. The disease is almost nonexistent in those countries and pharmacies don’t generally stock the vaccine.
Meddling in Saudi affairs proved taxing for us. The Ambassador’s Secretary, Mrs. Haideri, phoned that all persons from our Frontier Province applying for a Saudi visa for any purpose would be referred to me for vaccination and certification. Using a special pink paper, I got columns printed for the Applicant’s Name, Passport Number, National Identity Card Number, Date of Vaccination, Brand Name of the vaccine, Batch Number, and Expiry Date. For almost two years my Medical Registrar, Dr. Manzoor Ahmad, and I vaccinated 12 -15 applicants every working day from 11.30 a.m. to 1.30 p.m. and issued them the certificates. We had vaccinated, and documented, 379 visa applicants by 20 September 1988.
Pakistani politicians and bureaucrats are not accustomed to presenting themselves in person for such formalities. One of our provincial cabinet ministers, Mian Iqbal, and his secretary, Sanaullah Babar, had planned to perform Umrah and were referred to us for vaccination. One of their office clerks brought their passports for vaccination certificates in absentia. The two VIPs looked visibly displeased when they came in person for the jabs the next day. A Maulana was so famous that the road in Gulberg (Peshawar) he lived at was named after him. His son came with the passports of his parents for the vaccination certificates. The frown on the Maulana’s forehead was writ large when he and his spouse came for their shots the next day.
His strengths, however, outweighed his weaknesses. One could not help admiring My late friend Dr. Mahboob Ali from Wales (UK) and I decided to perform Umrah together. I flew to Britain and from there together by British Airways to Jeddah. I had injected myself with the meningococcal vaccine before leaving home and had filled out the same certificate that I had been issuing to visa applicants for the preceding two years. I did not expect any special hospitality from the Saudi officials. I did, however, assume that my vaccination certificate for myself was as good as the hundreds I had issued to pilgrims and laborers. The Immigration Officer at Jedda looked at my Passport and the certificate. He tossed the certificate back at me. No good; you make it yourself, he said. Almost every second person in the airport seemed to be an Abdallah. One such Abdallah took me to a paramedic for a repeat shot in the arm. The same Immigration Official must have seen and accepted scores of such certificates under my signature and seal.
I had in my handbag a VHS cassette of the movie Mary Poppins for my sons. The cassette and I landed in a scrutiny room where a guy played a few scenes on his VCR. Julie Andrews in her graceful Victorian robes was dancing with cartoons and the two little kids. Bad, very bad; woman dancing, the guy mumbled. I thanked Allah for being let out of that room, even though the video was confiscated.
I faxed the Saudi Ambassador’s secretary on my return to inform her that I won’t be vaccinating visa applicants anymore. She asked for the reason. If my certificate is not good enough for myself, it can’t be any good for others, I told her. Her response was brief: OK; thank you, doctor.
The Saudis earn a fortune through the Hajj and Umrah every year. The number of Umrah pilgrims during Ramadhan alone is colossal. Some may consider it blasphemous to suggest that the Muslim Umma, by consensus, forgo just the optional Umrah for only two years. The Rulers will feel the pinch of losing their billions of dollars. The Saudi annual GDP can’t be a small sum. Three percent of that sum comes from these pilgrimages. The kingdom’s income from Hajj and Umrah in 2013, according to the Arab News of 5 January 2013, was 16.5 billion US dollars. The expected income from the 2014 annual Hajj alone was 8.5 billion US dollars (Saudi Gazette, 25 Aug 2014; Al Arabiya, 26 Aug 2014). Many pilgrims from around the globe travel by Saudi Airlines for their pilgrimages. That is an additional source of the Kingdom’s inflow of dollars. The pilgrims also spend billions of dollars on food, hotels, transport, and shopping in the Kingdom every year.
Despite the Kingdom’s massive earnings from the oil and the pilgrimages, some sources report an overall unemployment rate of 12%. At least 30% of the jobless are said to be young people. It is a case of scarcity amidst plenty (Middle East Eye; 28 September 2015).
Thousands of laborers from Asian and African countries were stranded in the Kingdom for months during 2015-16 without receiving any wages. They were camped in poor conditions on inadequate food and scant health facilities. Their repatriation in itself was a problem of some magnitude. Some of the workers were promised delayed payment of their arrears through their national embassies. The plummeting oil prices and the reduction in earnings from the annual pilgrimage put a squeeze on the monarchy. The New York Times of 27 September 2016 reported an unprecedented fall in wages as well as in the services. Salaries of Ministers were trimmed by 20%. Salaries and allowances of civil servants are expected to hit a record low. The Saudi government is about to sign a 10 billion dollar loan with international banks in order to shore up its sagging economy (BBC Urdu Service; 27 October 2016).
The large drop in the Kingdom’s annual revenue got the rulers worried. Fees for different categories of Saudi visas have been raised by several hundred percent. Two types of visas that used to cost 500 Saudi riyals each will now cost 3000 and 8000 riyals. The first Hajj and Umrah visa fees, however, remained unchanged (BBC Urdu Service; 2 October 2016). Visa fees for second and subsequent pilgrimages have gone up from 350 Saudi riyals to 2,000 S.R. Multiple Entry Visas for business purposes have also jumped up several hundred percent. This increase applies to all countries except the USA and the European Union (BBC Urdu Service, 21 October 2016)!
South African Muslims launched a protest campaign against these Saudi steps. Egypt’s Travel Agents Association and Morocco’s Federation of Travel Agencies suspended Umrah and Hajj booking in 2016. Turkey and Jordan have expressed their disgust at these measures (International Business Times, October 17, 2016).
The Kingdom decided that, as of 1st October 2016, it will pay salaries and wages according to the Gregorian calendar, i.e. a year of 365 days instead of the Islamic Hijri year of about 354 days. An employee thus loses eleven days’ earnings each year (Dawn, Karachi, 4 October 2016).
The increase in Hajj and Umrah visa fees has probably affected the Kingdom’s earnings adversely. A great percentage of intending pilgrims cannot afford the new fees. A second thought might have become a compulsion for the Kingdom. The Arab News of 9 September 2019 published the withdrawal of the additional fees to get 30 million Umrah pilgrims per year by 2030 CE.
The lifestyle of the Saudi Royals and of the Gulf Emirs in some ways verges on the vulgar. A diamond-crusted car is as comfortable as any other sedan automobile. Kids of the rich were metaphorically said to be born with silver spoons in their mouths. Feeding bottles of babies in the Saudi Kingdom and the Gulf States are said to be encrusted with 18-21 carat gold and cost 400 to 1333 US dollars each (Al-Arabiya — English; 4 November 2016). A private luxury yacht costing billions of dollars and a sword made of several kilograms of pure gold and encrusted with diamonds were given as personal gifts to President Donald Trump. Watches made of gold and diamonds were presented to the members of Trump’s entourage.
Let us pray such extravagances are not the beginning of the end.
