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MENA, Saudi Arabia (Reuters) - Every year hundreds of part-time, unlicensed barbers flock to the holy city of Mena to shave the heads of pilgrims observing the last step in performing the haj as desired by the Prophet Mohammad.
"I'm shaving my head because this is what the Prophet asked us to do, and it's really hot now, so having a shaved head isn't a bad idea," said Yemeni Mohamed Hassan, as he crouched on the ground under a barber's razor.
"We are on haj, so God will cause no harm to us," he said, wiping dripping blood from his head with his hands.
The barbers wield the same razor on dozens of men, exponentially increasing the chances of spreading sickness and disease among this year's estimated two million pilgrims on haj, which started on Monday.
It's a practice the Saudi health ministry has been trying to stamp out for years. The barbers avoid arrest by maintaining they are relatives of their clients, and claiming not to receive compensation for their service.
This year, in addition to bringing in licensed barbers from around the country and putting up posters as usual, the authorities have flooded television and radio with warnings of the potential health hazards.
It's a tough sell. The owner of a licensed shop in Mena said with many of the pilgrims on a tight budget, at least 60 percent go to the unofficial barbers or shave themselves.
"I can't afford to pay anything over 10 riyals ($2.7) and the barbers that the government approves here are expensive," said Salam Assem, a factory worker from Egypt.
Saudi health ministry officials say it is difficult to know how many pilgrims contract diseases because of razor-sharing because they return to their home countries after their visits, complicating data collection and coordination. But the concerns are very real.
"Sharing razors can be incredibly dangerous," said Amin al-Mahdi, physician manager of a hospital in Mena during haj.
"Through open wounds, viruses like HIV, hepatitis C and B in addition to malaria can be transferred from one person to another. And even through dirty hands there's a risk of getting mange and other skin infections," he said.
Such infections are only part of the health risks associated with the physically demanding haj.
A 2008 study by the Journal of Infection and Public Health detailed a long list of what it called "extreme stressors" during the haj - heat, sun exposure, thirst, crowding, traf�c congestion, steep inclines and rough ground underfoot.
Health experts say countries that send large numbers of pilgrims can help by warning their citizens of the dangers before they visit.
Abdel Rahman Rajab, a student from Jeddah, said taking the risk of shaving on the streets was not worth it.
"I came to a licensed barber because at least I know the razor he's using is new, and he took it out of the packet in front of my eyes," he said. "I paid 50 riyals for a shave: It's a lot of money but it's better than getting a dangerous virus." (Reporting by Amena Bakr; Editing by Maha El Dahan, William Maclean and Sonya Hepinstall)