Identification of potential health risks in mass gatherings: A study from Sabarimala pilgrimage, Kerala, India

In India mass gatherings are especially common in religious congregations. Sabarimala is one of the most crowded sacred places in India and the most crowded in the state of Kerala, in southern India. This pilgrim destination attracts over 30 million pilgrims in a short period of 41 days (during which the temple is open to the devotees). Such mass gatherings pose special challenges for the community's existing health system. The present study aims to identify the potential health risk and the main difficulties faced by health care professionals in this world famous mass gathering destination. A total number of 46 doctors were interviewed with a structured questionnaire. The data thus obtained was analyzed with a modified health risk ranking method developed for this study based on literature survey and Microsoft Excel spread sheet. Risk prioritization index (RPI), likelihood level index (LLI) and corresponding consequences level index (CLI) were determined for the risk ranking. Human stampedes and person-to-person communicable disease have the highest rank in the risk identification. Lack of coordination, difficulty in access to medical facilities and shortage of paramedical staff are the main issues faced by doctors. The tools developed in this study can be effectively used in any mass gathering destination for identifying key health risks.