MASS GATHERINGS: PUBLIC HEALTH IMPLICATIONS AND OPPORTUNITIES

Mass gatherings (MG) are public events of limited duration, planned in advance and attended by more than 25000 people. According to World Health Organization (WHO), mass gathering, in the context of public health, is “any occasion, either organized or spontaneous, that attracts sufficient number of people to strain the planning and response resources of the community, city or nation hosting the event”. Any mass gathering spontaneous or organized presents significant challenges to the public health mechanism owing to shifting populations and an increase in the demand on existing infrastructure of health and other essential services. These challenges are more pronounced in developing countries with limited resources. Unlike developed countries where sports and cultural events account for majority of mass gatherings, traditional and religious mass gatherings predominate in developing countries. The major mass gatherings of traditional nature include fairs and festivals and pilgrimages to holy places such as Hajj pilgrimage, Maha Kumbh Mela and Haridwar-Rishikesh Yatra followed by political meetings, conferences and protests, funeral processions of religious and political heads followed by sports events and other celebrations. The Kumbh Mela is one of the largest mass gatherings and is suspected to have contributed to the 181724 Asiatic Cholera pandemic. Several occurrences of stampedes and clashes with resulting deaths have been reported. The common public health risks associated with MGs in both developed and developing countries include extreme weather-related illness, food-borne and water-borne diseases, outbreak of epidemic-prone infections, imported diseases, aggravation of pre-existing chronic illness, unhealthy behaviours such as drug and alcohol abuse and risky sexual behaviour, crowd behaviour, accidents and injuries, intentional threats, environmental risks of air, water and noise pollution and unexpected natural calamities.