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Approximately two million people attend the Hajj pilgrimage in Saudi Arabia every year. The journey is obligatory for those who have the physical and financial means, once in a lifetime. The pilgrimage lasts five days and is based in and around the city of Makkah.

The climate is one of a hot desert with day temperatures regularly exceeding 45ºC (113ºF) during the summer. This is made all the tougher with average relative humidity reaching 33%. Pilgrims travel from around the world. They include all ages and backgrounds, and individuals with complex medical conditions.

I was lucky enough to be given the opportunity to attend this year. My journey began like any other pilgrim’s, initially solely focusing on the religious events ahead. The first few days went as planned, with challenging walks, but nothing more than I had physically and mentally prepared for. Things however changed as the days went on and as the weather deteriorated. I cannot emphasise enough the combined effects of extreme heat and huge crowds. Despite an umbrella to keep one out of direct sunlight and copious amounts of water consumption, heat exhaustion is relatively common. I was also soon to learn that heat stroke was becoming dangerously frequent during my time there. As anaesthetists, our challenge is often to keep patients undergoing major surgery warm. As I entered my hotel lobby, my job was to do the opposite and help cool my fellow pilgrims down!