Document Type : Research articles


1 Critical Care Quality Improvement Research Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Department of Nursing, Sabzevar Branch, Islamic Azad University, Sabzevar, Iran

3 Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Iran Helal Institute of Applied-science and Technology, Red Crescent Society of Iran, Tehran, Iran

5 Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran


Background: The Arbaeen foot-pilgrimage in the Holy City of Karbala is one of the world's most significant religious events, attracting millions of pilgrims yearly. Health and hygienic issues in this gathering have always been a cause of concern for the communities involved.
Objectives: The study aimed to examine the challenges Ehsan Field Hospital faced in the Arbaeen of 2022 and its approach to providing services to referring pilgrims.
Methods: The present study was a cross-sectional study with a 10-day interval conducted on 19,800 patients referred to Ehsan Field Hospital between the 9th and 19th of September, 2022. The research tool was a two-part checklist; the first part included the patients demographic information, and the second part included information about the disease (e.g., laboratory information, the disease symptoms, and the disease diagnosis). The SPSS software (version 26) was used for data analysis. Moreover, a brief qualitative investigation based on the experiences of the personnel working on-site was conducted to assess the challenges and their solutions in this foot-pilgrimage.Results: A total of 13,860 (70%) patients were male, 5,940 (30%) were female, and the majority of them were between the ages of 25-55 (63.8%). Most hospitalizations (58.5%) were related to problems caused by gastroenteritis.
Conclusion: Considering the importance of people's health and hygiene in gatherings similar to Arbaeen, the necessity of building and operating field hospitals and mobile treatment camps for serving people is crucial, starting a few days before and continuing after the gathering. Furthermore, universities of medical sciences can provide a platform to facilitate and carry out valid research projects and studies to clarify the health and treatment problems dealt with during the Arbaeen foot-pilgrimage. Furthermore, they can provide practical and efficient solutions to improve the level of health and hygiene.


  1. Farahani AJ, Zijoud SR. Research and researchers of hygiene, medicine and health field in the service of Arbaeen walk. Journal of Military Medicine. 2019;21(6):547-8.
  2. Al-Ansari F, Mirzaei M, Al-Ansari B, Al-Ansari MB, Abdulzahra MS, et al. Health risks, preventive behaviours and respiratory illnesses at the 2019 arbaeen: Implications for covid-19 and other pandemics. Int J Environ Res Public Health. 2021;18(6):3287. doi: 10.3390/ijerph18063287. [PubMed: 33810092].
  3. Hashjin, Zahed Ghaffari, and Mohsen Mohammadi Khanghahi. "Messages of “Arba'een Walking” as “Media”."International Journal of Multicultural and Multireligious Understanding 6.6 (2020): 924-35.
  4. Karampourian A, Ghomian Z, Khorasani Zavareh D. Exploring challenges of health system preparedness for communicable diseases in Arbaeen mass gathering: a qualitative study. F1000Res. 2018;7:1448. doi: 10.12688/f1000research.15290.1. [PubMed: 30473777].
  5. Abdulredha M, Kot P, Al Khaddar R, Jordan D, Abdulridha A. Investigating municipal solid waste management system performance during the Arba’een event in the city of Kerbala, Iraq. Environment, Development and Sustainability. 2020;22(2):1431-54. doi: 10.1007/s10668-018-0256-2.
  6. Yamin M. Managing crowds with technology: cases of Hajj and Kumbh Mela. Int J Inf Technol. 2019;11(2):229-37. doi: 10.1007/s41870-018-0266-1. [PubMed: 32289103]
  7. Khankeh H, Kolivand PH, Beyrami Jam M, Rajabi E. Kermanshah health care services: A lesson learned from Iran’s recent earthquake. Health in Emergencies and Disasters Quarterly. 2018;3(4):221-33. doi: 10.32598/hdq.3.4.221.
  8. Al-Ansari F, Al Ansari M, Hill-Cawthorne GA, Abdulzahra MS, Al-Ansari MB, et al. Arbaeen public health concerns: A pilot cross-sectional survey. Travel Med Infect Dis. 2020;35:101546. doi: 10.1016/j.tmaid.2019.101546. [PubMed: 31838209].
  9. Saberian P, Kolivand PH, Hasani-Sharamin P, Dadashi F, Farhoud AR. Iranian emergency medical service response in disaster; report of three earthquakes. Adv J Emerg Med. 2019;3(2):e13. doi: 10.22114/AJEM.v0i0.121. [PubMed: 31172124].
  10. Farahmand F, Hayati F, Mousavi-Roknabadi RS, Safaei-Firouzabadi H, Hosseini-Marvast SR, Mohsenian L. Treatment camp and patients in arbaeen pilgrimage in 2019. Int J Travel Med Glob Health. 2022;10(1):24-31. doi: 10.34172/ijtmgh.2022.05.
  11. Ajam M, Sadeghifar J, Anjomshoa M, Mahmoudi S, Honarvar H, Mousavi SM. Assessing quality of healthcare service by the SERVQUAL model: A case study of a field hospital. Journal of Military Medicine. 2014;15(4):273-9.
  12. Nuno-Gonzalez A, Martin-Carrillo P, Magaletsky K, Martin Rios MD, Herranz Mañas C, Artigas Almazan J, et al. Prevalence of mucocutaneous manifestations in 666 patients with COVID-19 in a field hospital in Spain: oral and palmoplantar findings. Br J Dermatol. 2021 ;184(1):184-5. doi: 10.1111/bjd.19564. [PubMed: 32969503].
  13. Wallis N, Gust C, Porter E, Gilchrist N, Amaral A. Implementation of field hospital pharmacy services during the COVID-19 pandemic. Am J Health Syst Pharm. 2020;77(19):1547-51. doi: 10.1093/ajhp/zxaa211. [PubMed: 32539128].
  14. Sweileh WM. Health-related research publications on religious mass gatherings of Muslims: a bibliometric analysis (1980-2020). Trop Dis Travel Med Vaccines. 2022;8(1):1. doi: 10.1186/s40794-021-00158-y. [PubMed: 34980277].
  15. DURING FH. Caring for patients at a COVID-19 field hospital. J Hosp Med. 2021;16(2):117-9. doi: 10.12788/jhm.3551. [PubMed: 33496666]