In Mina, a temporary tent city near Mecca, teams at a Saudi hospital are ready to treat a tidal wave of pilgrims on the eve of the hajj, the great Muslim pilgrimage, which will once again take place this year in extreme heat.

Mina Emergency Hospital is one of 15 health facilities that operate only a few weeks a year, when more than a million worshippers from around the world converge on Mecca.

In 2024, the thermometer reached 51.8 degrees Celsius, and more than 1,300 pilgrims died, according to authorities. This week, the weather forecast does not predict such peaks, but temperatures are still expected to exceed 40 degrees Celsius.

On Monday, the Ministry of Health announced that it had already treated 44 cases of heatstroke, as more than 1.4 million worshippers have already arrived in the kingdom for the hajj, which officially begins Wednesday.

Although patients at Mina hospital are still rare, the country has nonetheless prepared for the "worst-case scenario," Abdullah Asiri, Deputy Minister of Health, emphasized from the hospital.

"The focus is on heat-related illnesses because the hajj coincides with extreme temperatures," he told AFP.

The Grand Mosque, which houses the Kaaba, the black structure toward which Muslims face to pray, is cooled by one of the most powerful air conditioning systems in the world, according to Saudi state television, while huge fans and floor cooling systems help keep it cool.

But outdoors, protecting yourself from the effects of heat can be difficult.

Increased capacity

Some pilgrims carry caps or umbrellas, but many have no protection from the sun, like Rabah Mansour, a 70-year-old Palestinian, who says he "is not bothered by the heat."

"I've been working in the fields since I was a child," he explains, his face streaming with sweat.

Carried away by religious fervor, many pilgrims expose themselves unnecessarily to extreme conditions, warns Mr. Asiri.

Among them is Badr Chreïté, another Palestinian. "As you can see, we are drenched in sweat," he told AFP, but "the more we endure, the greater the reward."

According to Mr. Asiri, a total of 50,000 medical and administrative staff were mobilized for the hajj, far more than in previous years.

More than 700 hospital beds are ready, equipped with ventilators for serious cases.

"This year, capacity has increased by more than 60%," he says.

Last year, medical personnel treated 2,764 pilgrims suffering from heatstroke or other illnesses related to high temperatures, according to the Ministry of Health.

"In full sun"

To prevent hospitalizations, 71 mobile emergency units have also been deployed around holy sites, to "treat patients on site before their condition deteriorates," explains Mr. Asiri.

It already anticipates the second day of the hajj, when pilgrims go to Mount Arafat, which they climb before reciting prayers until nightfall.

"Most of the heat-related problems in Arafat arise because people think they absolutely have to be in direct sunlight," he says.

However, he emphasizes, "it is not necessary to leave one's tent in Arafat." And "it is not obligatory to climb the mountain either," which "carries a great risk."

Hajj Minister Tawfiq al-Rabiah told AFP that thousands of misters and more than 400 fresh water points had been deployed to welcome the crowds.

Authorities have also built shaded walkways and a new four-kilometer-long road covered with cooling paving stones leading to Arafat.

Last year's deaths illustrate the vulnerability of worshippers to climate extremes, with 2024 being the hottest year on record, according to the European climate observatory Copernicus.

"It's extremely hot, but sometimes it's very cold inside the Grand Mosque because of the tiles and the air conditioning," Asiri notes.

But "we experience this as a trial, a test of our moral strength."