With a focus on the Arbaeen procession, this study sought to investigate the difficulties associated with providing health services in mass gatherings. Experts, managers, legislators, healthcare professionals, and individuals with disabilities attending mass gatherings were taken into consideration. The study's conclusions show that there are substantial obstacles that both service providers and service recipients must overcome. We categorized the challenges faced by managers and policymakers into four areas about service provision, logistics, coordination, and planning. In addition, the viewpoints of individuals with disabilities were taken into account in the following areas: logistics and infrastructure provision, care-support services, and health service management.
Developing procedures and programs, communicating with others, providing training, and evaluating the current situation were among the planning challenges. Mass gatherings require advance planning and preparation in order to ensure a suitable reaction to any emergencies and to assist initiatives aimed at averting future mishaps (11). Consistent with the current research, Koksi et al. The importance of preparation and planning for coordinating mass gatherings in conjunction with representatives from multiple sectors was emphasized in 2021 (12). Event planners should start by learning about the factors that are related to mass gatherings. Once these factors are taken into account, a thorough needs analysis can be carried out and resource allocation can be decided upon using factual data (13). The results of this study indicate that an evaluation of the venue's current condition is required for mass gatherings. Given the vulnerability of individuals with disabilities, it's also critical to create suitable procedures and give health care providers enough training prior to and during the event.
The subcategories of providing infrastructure, financial resources, medicine and equipment, and human resources were among the other difficulties that emerged from the statements of experts and managers. The studies that have been conducted have identified several risks related to health management and education. These risks include inadequate medical resources, a shortage of trained personnel, inadequate medical infrastructure, the need to educate pilgrims, and the requirement to take into account their medical histories (14–16). The results of this study are supported by another study, which recommends that medical services at the gathering site should be supplied by professionals rather than by a greater number of employees (12).
According to a retrospective study by Locoh-Donou et al., the quantity of complaints from medical services came in second. evaluated a range of occurrences that take place in mass gatherings. This result validates the issue with insufficient infrastructure and resource availability for service delivery that we pointed out (17). Prior to, during, and following events, inclusive evaluations of individuals with disabilities form the basis for planning service access. Making sure money is set aside for activities pertaining to disabilities is crucial. Funding should also be allocated for the transportation of disabled individuals to medical facilities, referral services to specialized clinics and specialists, and rehabilitation services.
Three subcategories of insufficient coordination were identified in terms of management: intra-organizational, inter-organizational, and international coordination. Communicable diseases, illnesses linked to the heat or cold, food- and water-borne illnesses, and mass casualty incidents are among the potential public health risks that can arise during mass gatherings. As a result, cooperation between local, regional, nonprofit, and federal health-related service providers is necessary for public health planning for such events (18–20). Comprehensive planning, inter-organizational cooperation and communication, and readiness for medical requirements are necessary for effectively preparing for events (21). Research has also shown how important it is to set up strong systems of coordination, leadership, and cooperation. These systems should be strengthened by inter-organizational agreements. This is required to guarantee that all pertinent parties are aware of their specific responsibilities (22, 23). These investigations bolster the notion that the results of the present study are vital to the management of mass gatherings and the provision of services to individuals with disabilities.
Effective incident preparation requires creating an integrated response plan that outlines the roles and responsibilities of stakeholders, communication procedures, and the chain of command (24). The length and nature of the event, the climate, the population's size and behavior, and other factors all affect the demand for additional medical resources (10, 25). As a result, it is crucial to actively address participant safety, devise plans to improve resource and medical personnel availability, and address safety concerns.
Mass gatherings raise the demand for medical emergencies and strain daily emergency medical service systems because of the temporary concentration of people in the area (15). In Iraq, the absence of pre-hospital and ambulance emergency services can pose a risk for pilgrims (26). Research has indicated that mass gatherings lead to an increase in the workload for pre-hospital emergency personnel (11, 14). To effectively address the needs of this population, governments must have a thorough understanding of the health needs of people with disabilities and the barriers they face in accessing healthcare services (27). Unmet healthcare needs occur when people with disabilities encounter obstacles when trying to access healthcare services (28). According to data, compared to those without disabilities, people with disabilities encounter more unmet needs and services (29). People with disabilities run a serious risk of receiving a delayed diagnosis and developing secondary diseases if they do not have equal access to healthcare (30). People with disabilities should have improved access to healthcare through the implementation of appropriate needs-based strategies (27).
At the Hajj ceremony, the risk and strain on the nation's healthcare system are reduced through efficient communication and widespread public education (31). 2018 brought attention to the significance of providing healthcare professionals with in-service training to improve their communication skills when working with individuals who have a range of disabilities (32). Crucial measures include pre-participation screening, immunization of at-risk individuals, and health risk education for pilgrims and officials (33). These results are consistent with the current study's findings. When it comes to providing people with disabilities with timely and high-quality services during large-scale events, policymakers should invest a great deal of time and energy in identifying the gaps and barriers.