What Hari Raya reveals about the health risks we often ignore

IN Sabah, Hari Raya begins long before the morning prayers. The roads come alive first. Headlights stretch across the highway from Kota Kinabalu to Tawau, from Sandakan to Keningau, from the city back to villages where parents are waiting at the door. Inside homes, kitchens remain warm deep into the night. Lemang is turned carefully over open flame. Rendang simmers slowly, filling the air with a smell that belongs only to this time of year. Hari Raya is more than a date on the calendar. It is the journey back to where we are known, forgiven, and loved.

Yet across Sabah, another preparation is happening quietly. In emergency departments, primary clinics, and pre-hospital care, healthcare workers prepare for a pattern they have learned to expect. Every year, throughout and after Hari Raya, the same stories begin to appear. A road accident on a rural stretch of highway. A patient whose blood sugar was stable for months is now suddenly uncontrolled. An elderly parent with a cough that was ignored during celebration, now struggling to breathe. These are not failures of celebration. They are the consequences of disrupted rhythm in a population already living with silent vulnerability.

This pattern becomes most visible through individual lives. One elderly patient from a rural district arrived at a clinic days after Hari Raya, breathless and exhausted. He had travelled hours to celebrate with family and delayed seeking care because he did not want to disrupt the occasion. His blood pressure had already reached dangerous levels when he finally presented. His intention was to protect the celebration. Instead, he required hospital admission.

Malaysia’s health data tells the truth clearly. The National Health and Morbidity Survey 2023 found that 15.6% of Malaysian adults live with diabetes and 29.2% with hypertension. More than half of adults, 54.4%, are overweight or obese. These are not distant statistics. They are fathers, mothers, uncles, and grandparents, sitting at the dining table this Hari Raya. Their health depends on stability. Medication taken consistently, sleep that restores the body, and meals that do not overwhelm it. Hari Raya, by its nature, interrupts these protections.

The transition from Ramadan to Syawal is especially delicate. During Ramadan, the body adapts to structure. Meals are predictable. Many individuals become more disciplined, and some even see improvements in glucose control. Then Hari Raya arrives, and the rhythm shifts overnight. Open houses begin early and continue throughout the day. Sweet drinks, kuih, ketupat, and festive meals are offered with love at every home. No one wants to refuse. But the body experiences this not as celebration, but as sudden metabolic stress. Blood sugar rises. Blood pressure becomes unstable. Weight lost during Ramadan often returns quickly. The danger is silent. People feel fine, until weeks later when complications begin to surface.

Clinics across the state often hear the same sentence after Hari Raya. “Saya tunggu sampai habis Raya dulu.” I waited until Raya finished. What began as mild chest discomfort or breathlessness becomes something far more serious. What was manageable days earlier becomes an emergency requiring urgent medical attention.

Some patients discover the consequences only after returning home. Medication left behind in another district. Insulin doses delayed during visits and antihypertensive tablets missed for several days. Such interruptions feel small in the moment, but clinics regularly see the aftermath. Blood sugar levels rise rapidly; blood pressure becomes unstable; what was controlled becomes unpredictable.

There is another risk that develops more quietly and is often overlooked during celebration. As of epidemiological week 6 of 2026, Sabah recorded 755 tuberculosis cases, the highest in Malaysia. Tuberculosis does not announce itself loudly. It begins with a cough that lingers. Fatigue that feels ordinary. Weight loss that is easily explained away. During Hari Raya, when families gather closely and elders are surrounded by grandchildren, symptoms are often ignored out of politeness or hope; care is delayed. Exposure continues; what could have been treated early becomes harder to control.

The journey home itself carries danger. During Op Selamat in conjunction with Hari Raya 2024, Royal Malaysia Police reported 8,862 road accidents and 119 deaths within just days. Behind every number is a family that began a journey with joy and never completed it. Fatigue is often the invisible cause. Sabah’s geography makes this risk real. Long interdistrict travel, night driving, and road fatigue slowly erode reaction time. Drivers often do not realise how impaired they are until the moment they need to react, and cannot.

There is also a quieter danger that lives inside the home. Hari Raya is built around fire. Lemang cooks slowly over open flame. Dodol requires hours of constant heat. Kitchens are crowded, electrical outlets overloaded, and cooking sometimes continues while families step away briefly. JBPM Sabah recorded 2,490 fire related incidents and emergency calls in 2023. Nationally, the Malaysian Fire and Rescue Department recorded 1,303 fire incidents during the Aidilfitri festive period in 2024 alone, reflecting the increased risk associated with unattended cooking, electrical overload, and prolonged festive preparations. Firefighters describe the same scene: a celebration interrupted by smoke, a home reduced to ash, and families left standing outside with nothing but the clothes they were wearing.

Firecrackers add another dimension of harm. Hospitals in Malaysia continue to treat severe festive injuries each year, including burns, amputations, and permanent disability. Official reports from the 2025 Aidilfitri season show how quickly firecracker injuries can turn serious. In Kelantan alone, the state health director reported 47 firecracker related injury cases during the festive season, including severe injuries with possible long-term effects, and many victims were children. These injuries happen in seconds, but their consequences can last a lifetime.

I spoke to Ismail bin Edi, Head of Program for the Diploma in Medical and Health Sciences at Institut Latihan Kementerian Kesihatan Malaysia Kota Kinabalu (ILKKM KK), who has trained generations of Assistant Medical Officers (AMO) and healthcare personnel now serving across Malaysia. He shared that festive periods often become defining moments for young healthcare workers encountering the realities of emergency care for the first time. “Many of our former trainees later tell us that their Raya duty is something they never forget,” he said. “They expect celebration, but instead they see accident victims who were travelling home, patients whose conditions worsened after medication was missed, and families facing emergencies that could have been prevented. These experiences remind them that healthcare continues even during celebration, and that small preventive actions taken before and during Hari Raya can protect lives.”

These risks exist not because celebration is harmful, but because it changes behaviour. People travel further. Sleep becomes shorter and less restorative. Medication routines are interrupted. Attention shifts outward toward family and tradition, and inward signals from the body are easier to ignore. But the solution is not to celebrate less. It is to celebrate with awareness.

Bringing enough medication during travel protects stability. Resting before long journeys protects life. Watching cooking fires protects homes built over decades. Paying attention to a persistent cough protects the people we love. These are small acts, invisible to others, but powerful in their effect.

For healthcare workers, Hari Raya reveals both the resilience and fragility of the communities they serve. They treat accident victims who were travelling home. They stabilise patients whose chronic illness worsened during celebration. They care for families whose festive preparations ended in emergency.

Across Sabah, healthcare workers continue serving throughout Hari Raya. Assistant Medical Officers, nurses, doctors, and emergency responders remain on duty while others return home. They witness both sides of Hari Raya. They see the joy. They also see the cost when prevention is forgotten.

Prevention throughout Hari Raya is not about restriction. It is about protecting the people waiting for us at home. It reminds us of what matters most. Protecting health during this time is not about fear. It is about love. It ensures that the same roads we travel this year will continue to carry us home safely for many years to come.

Melvin Ebin Bondi is a PhD candidate in Public Health at Universiti Malaysia Sabah. He writes a weekly public health column for The Borneo Post.