Preface. IndonesiaHajProfile

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1 Preface HajithefifthpilarofIlam ithaan obligation foronce in a lifetime to conductit epecialyforeverymulim whoiabletofulfil. RepublicIndoneiaLawNo.3year008onHaj Managementtatedthattheorganizationofthe Hajaim to provide guidance,ervice and protectionawelapoibletothepilgrimo theycanperform theworhipinaccordancewith the teaching of Ilam.Coaching,care and protection given to pilgrim,notonly forthe generalthingbutaloforhealthpreparedne. So the health management of Haj i comprehenive guidance, care and health protectiontopilgriminceinthecountry,and duringtheirtayinsaudiarabia. Motof the Hajrituali a phyical activitie,othatthepilgrimdemandedtobe phyicalyfitandmentalyinordertocaryouta erieofpilgrimageactivitiemoothly.oneof the activitie which are very important and trategicefortiaerieofactivitiethrough creeningprogramandhealthcoachinghajin orderto fulfilthe condition itithaah health (healthcapabilitiepilgrimtoperform aerieof activitie in harmony and obligatory Haj).In general,pilgrimhealthhajitithaahidefineda theabilityoftheapectofhealth,whichinclude phyicaland mentalmeaured byexamination andguidancethatcanbeaccountedforothat pilgrim can perform the guidance ofworhip accordingtoilam.tomeetthecriteriahealth itithaah,earlypreparationinthecountryhould be caried outa the government' efort in bringinghealthypilgrimfrom Indoneia,during thetrip,andinsaudiarabia. Screening and coaching efort ofhaj healthinordertoachievehealthitithaahforthe pilgrim i the criteria ofhajhealth itithaah throughchecklitandhealthcoachinginorderto prepare the condition through a tandard mechanim ontandardizedhealthcarefacilitie, thiactivitieheldcontinuou(coveringthewhole period ofpilgrimageand levelofhealth care ervice ranging from primary health care, pecialit,andreferalineverytrataofhealth ervice),and comprehenive (comprehenive management by approaching five level of prevention)thatincludehealthpromotion,the pecificprotection,earlydiagnoiandprompt treatment(earlydiagnoiandtreatmentifat and precie), diability limitation, and rehabilitation. Ingeneral,thehealthconditionofpilgrim afectedbytheinternalandexternalrikfactor. Internalrikfactorincludingage,education(the majorityofindoneianpilgrimaregraduateof primary and econdary chool), chronic degenerativedieae,andthebehaviorofthe pilgrim.theexternalrikfactor,whichafect theincidenceofthedieaeandcanaggravate health condition, thee including phyical environment(temperature,humidity,dut),ocial, pychological,and otherconditionthatafect the immune ytem ofthe pilgrim.the rik factor particularly internal rik factor i aociated with characteritic or profile of Indoneianpilgrim. Degenerative dieae, metabolic and chronictildominateathedieaeuferedby thepilgrim,epecialytheelderly.eachyear,the IndoneianpilgrimpaedawayinSaudiArabia aremotlycauedbyheartdieae,repiratory, renal,metabolic,andhypertenion.ontheother hand the threatofilnee in SaudiArabia (externalrik)uchaheattroke,middleeat repiratoryyndromecoronaviru,ebola,zikaand meningiti are need to be wary,due to a potentialoutbreakandalohaahighfatality. HajiHealth Profile decribe brieflythe managementofthehealthofthehajin06. Data obtained from Integrated Computerized Haj Health Sytem or Sikohatke and implementationreportofhajhealthervice06. IndoneiaHajProfile Thenumberofpilgrimwhoperform the pilgrimagein06were68800people.baed on the numberofworhiper,female pilgrim morethanmalepilgrim.formoredetailcanbe eeninthefolowinggraph: Source: Integrated Computerized Haj HealthSytem Sikohatke,06. Figure.Graph ofindoneian pilgrim proportionbyex Baedontheagecompoitionmotofthe

2 pilgrimwereaged560year(34%),folowedby theagegroup 6year(8%). Source: IntegratedComputerizedHaj HealthSytem Sikohatke,06. Figure. Graph proportion of Indoneianpilgrimbaedonagegroup The magnitude ofthe elderly age group wa a chalenge forhealth ervice, becauethiagegrouphaavulnerabilityto phyicaland pychologicalcondition to a particulardieae. Baed on the level of formal education,elementary education wa the highet(3%)folowedbyuniveritybachelor (6%)andhighchoollevel(4%). Sytem Sikohatke,06. Figure4.ThegraphtypeofworkIndoneian pilgrim ImplementationofHajHealth HajHealthExaminationandHealth Coaching Pilgrimpreparationbeforedeparture to SaudiArabiaito conducthajmedical examination. The reult of the medical examinationwilbehealthtatuofpilgrim thatwilbe ued a the baeline forthe implementationofhealthcoachinginorderto achievehajhealthitithaahofpilgrimbefore dipatchedtosaudiarabia. Source: IntegratedComputerizedHaj HealthSytem Sikohatke,06. Figure3.Graphproportionbaedon thelevelofformaleducation From thetypeofwork,themajorityof Indoneianpilgrimarehouewife.Folowed privateemployeeandcivilervant.more canbeeeninthefolowingchart. Healthcreeningandcoachingofthe pilgrimageheldincontinuou)covering the entireperiodofthepilgrimageandlevelof health care ervice ranging from primary healthcare,pecialit,and referalinevery trataofhealthervice),andcomprehenive management by approaching five level preventionthatincludehealthpromotion,the pecific protection, early diagnoi and prompttreatment,diability limitation and rehabilitation. The inpection proce and health coaching to achieve Hajhealth itithaah beginwhenpilgrimenrolment.inpection anduperviionofhealthhajimplementation tartedinhealthcenter/clinic/hopital intheditrict/citierangingfrom thefirt tageexamination(determinationofthelevel

3 ofhealthrik),healthcoachinginthewaiting period (coaching toward health itithaah), econd tage examination (determination health itithaah) and coaching before departure(coachingtotrengthenthehealth itithaah). While the third tage medical examination i to determination of travel qulafication)heldatembarkation. Stage ofhajmedicalexamination andguidancetowardhealthitithaah Pilgrimtageuntildeparturecanbe eeninthefolowingfigure Source:MinitryofHealthRegulationno.5year 06 Figure5.StageofHajmedicalexaminationand coachingtoachievehajhealthitithaah ReultofHajexaminationandhealthcoaching recorded in : Integrated Computerized Haj HealthSytem orsikohatkeathebaelinefor iuance of Jemaah Haji Health Handbook (BKJH). ServiceandhealthprotectionofHaj pilgrim ImplementationofHajhealthervice 06facedchalengingituation () behavior of pilgrim who lack undertandingabouthealthitithaah, ()weatherfactorthataloafectthe healthmanagementofthehajpilgrim, (3)infectioudieaeduringpilgrim traveling and conducting ritual of the pilgrimage. Activitie to upport haj health itithaahtobemabrur(achievetheidealtate) withgoodhealth,tayfitandinjuryfreeby applyingthefivetageofprevention,there were: ()HealthPromotion, ()SpecialProtection, (3)EarlyDiagnoioftheDieae, (4)RetrictiononDiabilityand (5)Rehabilitation. Allevelofpreventionarecariedout ateverylevelofexaminationbyconducting theeactivitie: ()Themedicalexaminationaearly apoible; ()StrengtheningPPIH(hajorganizing commitee)andtkhi(hajmedical team) to be able to provide promotiveandpreventiveactivitie apartofacompreheniveervice; (3)Cooperation among program to improve communitybaed health developmentactivitie; (4)croectorcooperationtoupport increaed acce to pilgrim in health ervice by trengthening promotionandprevention; (5)To maintain good communication with the government of Saudi Arabia to have a common perceptionofthehajorganization andtoprovidebetfacilitationfor Indoneiapilgrim. Haj health ervice in Indoneia were divided in embarkation, diembarkation and referalhopital.pilgrimrikfactorprevention beforedeparturetosaudiarabiawereincluding: MeningococcalMeningitivaccination,anitation hygienemonitoringinhajdormitoryandcatering, andhighrikpilgrimidentificationbracelet. HajhealtherviceinSaudiArabiawere dividedinerviceintheflightgroup(kloter), ector,airport,indoneiahajhealthclinic (KKHI)andreferaltotheHopitalofSaudi Arabia(RSAS). In06,healthcareinSaudiArabiaformedinto threeteam,therewere: a.promotiveandpreventiveteam aigned toconducthealthpromotionefort,

4 protectionandearlydiagnoiofthe dieaeinhelter,hotelandotherplace thatalow. b.emergencyteam tofindemergencyand perform emergencyerviceonindoneian pilgrimearlyapoibleinthehelter, airport,arafat,mudalifah,minaand otherplaceofpotentialemergency condition. c. Healthcareclinicteam inchargefor curativeandrehabilitative,conduct viitationervicetotheectorandrsas, anitationandurveilanceervice, nutritionervice,computerized monitoringervice,awela pharmaceuticalervice. PilgrimhealthrikfactorprotectioninSaudi Arabiainclude,monitoringofhygieneand anitationhelterandcatering,temperature monitoring,humidity,windpeedanddut. IndoneianHajHealthProfile JemaahHajiHighRik(Riti) To controlrik factor,before the pilgrim departedtosaudiarabiaamedicalexamination conducted.theinformationthehealthtatuof thepilgrimproducedabaeline.government ue thi baeline to grouped pilgrim health tatuinto4categorie:.healthypilgrim.highrik elderly pilgrim (age 60 year) 3.highrikelderlypilgrimwithdieae ( 60yearofageandhadthedieae) 4.highrik pilgrim with dieae (age <60yearandhavehighrikdieae) 06,thenumberofpilgrimidentifiedahighrik were pilgrim (67% ofthe total pilgrim).thedetailareafolow: highrikelderlypilgrimwithdieae 4569pilgrim highrikpilgrimwithdieae503 pilgrim highrik elderly pilgrim 8,530 Jemaahage HajhealthItithaahtatu The reult of medicalexamination Hajin addition to provide health tatu information (highrik / nonhighrik) alo provide informationonhajhealthitithaahtatu,which wagroupedintofourcategorie: a.qualifiedforhajhealthitithaah; b.qualified forhajhealth itithaah with coaching; c. Temporarynotqualified forhajhealth itithaah; d.notqualifiedforhajhealthitithaah. In06,thetatuofQualifiedforhajhealth itithaahwa7.45%andqualifiedforhajhealth itithaahwithcoachingwa8.5%.thetatu helped to draft the coaching approach and trategy and alo to identify the need for appropriateandbenefitedreource. HajPilgrimMorbidityandMortality )Themorbidityandmortalityof pilgriminembarkation Table.Morbidityandmortalitypilgrimin embarkation Embarkatio n Aceh Medan Batam Padang Palembang (Bekai) Solo Surabaya Ujung Pandang Balikpapan Banjarmai n Lombok Healthcare ervice Out In Refe red Died 3 Total

5 Sytem Sikohatke,06. Kode ICDX J00 J06 I0 Baedonikohatkedata,thehighetpilgrim morbidity in embarkation wa at Solo embarkation,whilehighetmortalityratewaat Bekaiembarkation.. Debarkation Aceh Medan Batam Padang Palembang (Bekai) Solo Surabaya Ujung Pandang Balikpapan Banjarmai n Lombok Namapenyakit Acutenaopharyngiti [commoncold] Acuteupperrepiratory infectionofmultipleand unpecifiedite Eential(primary) hypertenion Healthcare ervice Out In Jumlah Kau %rawat jalan Refere d % 3% % M79. Myalgia 346 7% J0 Influenzaduetoother 075 identifiedinfluenzaviru 6% J0 Acutepharyngiti % R05 Cough % K30 Dypepia % E Noninulindependent 978 diabetemelitu 3% R5 Headache 7764 % Die d Total Sytem Sikohatke,06. The highetpilgrimmorbiditypilgrim wainsolodebarkation. )Themorbidityandmortalityof pilgriminsaudiarabia a)morbidityinflightgroup Numberofflightgroupoutervice wa348785withdetailoferviceperiod..prearmina:97899pilgrim.armina:5070pilgrimage 3.PotArmina:9986 Pilgrimage Sytem Sikohatke,06. Table3.Thedieaemotflightgroup outinsaudiarabia,06 Mottypeofdieaeuferedbythe pilgrim provided by health ervice and treatmentintheflightgroupintheperiodof PreArmina,ArminaandPotwereanacute repiratorydieaefolowedbyhypertenion dieae. b)pilgrim refered in Saudi Arabia. Number of pilgrim need medical atention and refered to healtherviceinsaudiarabiaarea folow: Table 4.Numberofpilgrim needmedicalatentionandreferedto healtherviceinsaudiarabia Sytem Sikohatke,06. c) Themortalityrateofpilgrim insaudiarabia. Until the end of the implementationofhajhealthervice insaudiarabiathenumberofpilgrim died were 38 from regular worhiper and 4 from pecial worhiper.totalhajpilgrimdiedin SaudiArabiawa34people.

6 The caue of death motly were cardiovaculardieaewith80pilgrim(53%), folowedbyrepiratorydieae94(7%). Table5.Caueofdeathofpilgrimdiedin SaudiArabiain06 Sytem Sikohatke,06. Theachievementofthehealth organizationofthehaj06 (3) EarlyRecruitmentOficer; (4) Thefulfilmentofthetandard of health clinic in embarkation; (5) Strengthening Curative and Rehabilitative in the area of Nuring,MedicalRehabilitation, andclinicalnutrition. Inadditiontotheactivitieabove,CenterforHaj Health conducted activitie that upport the implementationofotherunitincluding: () Participated in mentoring NuantaraSehat team; () Conductedmonitoringoftate owned fixed aet and adminitrativeupplie; (3) Supportedtheactivitieofthe National Haj Health Expert Commitee; (4) Program activitie planning baedhealthparadigm. Achievementfor06activitiewere () Etablihment of health itithaah guideline a the bai for implementing the healthcoachingandprotection, () Themedicalexaminationha met the national coverage targetwhichwa65% or09 70examinationconducted, (3) the qualified haj health itithaah tatu wa 7.45% and qualified with coaching wa8.5%, (4) Implement couneling and fitnetetto,396pilgrim in6location, (5) Hajhealthreourcedocument developed, (6) Aignment of,458 health worker for health care aitance preventive, promotiveandcurative, (7) Procurement of equipment health clinic in four hajdormitory a a minimum ervicetandardofhajmain clinic. From the 06 activity implementation, policyfor07activitywadeveloped,therewere: () Application of Haj Health Itithaah () Healthy Haj Pilgrim Socialization; Concluion

7 Theincreaingnumberofhighrik pilgrimiachalengefortheorganizationof HajHealthServicein06.Otherchalenge ucha () thebehaviorofthepilgrim whodonotundertandthe meaninghealthitithaah () weatherfactorthatalo afecttheorganizationofthe HajHealth, (3) infectioudieaeduringthe tripandpeforminghajritual arechalengethatneedtobe conidered. Variouefortervice,health coachingandprotectionhajhabeencaried outtothemaximum.activitietoupporthaj healthitithaahwhichreferingtothefive levelofpreventiveandpromotive implementedthroughthefolowingtep (a) Themedicalexaminationa earlyapoible, (b) StrengtheningPPIHandTKHI toableprovidehealth promotionandpreventiona partofacomprehenive ervice, (c) colaborationofcroprogram toimprovethecommunitybaedhealthcoaching (d) colaborationacroector toimprovehajpilgrim acceabilitytoreceivehealth ervicebytrengthening promotionandprevention, (e) Etablihingcommunication withthegovernmentofsaudi Arabiatoacommon perceptionoftheorganization ofhajandtogainacceto upporterviceandfacilitie forpilgrimindoneia. CurativeandRehabilitativeinthearea ofnuring,medicalrehabilitation,and ClinicalNutritionneedtobetrengthened. Includingthehumanreource,health facilitieandinfratructureforhajhealth ervicetobeimproved.