Archaeological Research in Asia 21 (2020) 100174

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Archaeological Research in Asia

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The impact of Ming and Qing dynasty maritime bans on trade ceramics T
recovered from coastal settlements in northern Sumatra, Indonesia
Yew Seng Taia, Patrick Dalyb,⁎, E. Edwards Mckinnona, Andrew Parnellc, R. Michael Feenerd,
Jedrzej Majewskib, Nazli Ismaile, Kerry Siehb
a
Institute for Southeast Asian Studies, 30 Heng Mui Keng Terrance, Singapore 119614, Singapore
b
Earth Observatory of Singapore, Nanyang Technological University, 50 Nanyang Ave. Block N2-01a-15, Singapore 639798, Singapore
c
Insight Centre for Data Analytics, Hamilton Institute, Eolas Building, 3rd Floor, Maynooth University, Co., Kildare, Ireland
d
Centre for Islamic Studies, University of Oxford, Marston Rd, Oxford OX3 0EE, United Kingdom
e
Dept. of Geophysics, Syiah Kuala University, Banda Aceh, Indonesia

ARTICLE INFO ABSTRACT

Keywords: We review published literature and historical texts to propose that three periods of official Chinese maritime
Aceh bans impacted the composition and circulation of trade ceramics along Asian trade routes: Ming Ban 1 (1371 –
Trade ceramics 1509), Ming Ban 2 (1521 – 1529), and Qing Ban (1654 – 1684). We use ceramics collected during a landscape
Maritime trade archaeology survey along 40km of coast in Aceh, Indonesia to show how the three ban periods manifest in the
Straits of Melaka
ceramic record of settlements along an important stretch of the maritime silkroad. All three ban periods overlap
with reductions in the quantity of Chinese ceramics. Within several decades of the start of Ming Ban 1, people in
Aceh began importing ceramics from production centers in Burma and Thailand as a substitute for Chinese
ceramics. Following Ming Ban 2, there is an increase in imports from Chinese production centers, albeit from
new kilns sites. While brief, the Qing ban resulted in an almost immediate influx of ceramics from Japan and
Vietnam, which maintained some market share until the mid-17th century, after which Chinese ceramics
dominate the record until the end of the Qing dynasty. Our data show both the importance of Chinese ceramics
within regional trade networks and how those networks and local patterns of consumption adapted to disrup-
tions of supply.

1. Introduction
For over a thousand years, Chinese ceramics were an important
component in Asian trade networks (Brown and Sjostrand, 2004; Krahl
and Effeny, 2010; Zhu, 2007). Historical and archaeological evidence
show that Chinese ceramics had spread around the Indian Ocean by the
Tang dynasty (Fig. 1). A combination of the technological innovations
and artistic virtuosity needed to produce delicate fine ware porcelain
made Chinese ceramics highly prized commodities that were traded
throughout Asia, Europe and Africa through networks that returned
incense, precious stones and metals, fabric, wood, etc. back to China
(Christie, 1998; Edwards McKinnon, 1977; Finlay, 2010; Flecker, 2001;
Gerritsen and McDowall, 2012; Guy, 2004; Hall, 1985, 2010; Heng,
2012; Morgan, 1991; Oka et al., 2009; Pierson, 2012; Prinsloo et al.,
2005; Schottenhammer, 2017; Stargardt, 2014; Takahito, 1988; Wade,
2008; Zhao, 2012). During the Ming (1368–1644) and Qing
(1644–1911) dynasties, a combination of security issues, internal
political tensions and a series of Imperial maritime bans affected the
production and export of Chinese ceramics.
Scholars have long noted the impact of the Ming sea ban on mar-
itime trade (Cao, 2005; Hiroshi, 2004). In 1958 Tom Harrisson, Curator
of the Sarawak Museum, pointed out that he could not find any Chinese
ceramics dated to the Ming dynasty along over a hundred miles of the
southwest coast of Borneo (Harrisson, 1958). Given the presence of
earlier and later Chinese ceramics, he named this phenomenon the
“Ming Gap”. While his discovery was challenged by Chin (Chin, 1977),
Brown’s subsequent analysis of trade ceramics recovered from ship-
wrecks in Southeast Asia established that the Ming Gap was real and
occurred in stages between 1350 and 1567. Brown proposed that there
was a brief rebound in trade between 1488 and 1505 (Brown, 2004;
Evans, 2004).
Brown also showed that the limited availability of Chinese ceramics
starting in the late 14th century occurred around the same time as an
increase in the percentage of ceramics from Southeast Asian production

⁎
Corresponding author.
E-mail address: patrickdaly@ntu.edu.sg (P. Daly).

https://doi.org/10.1016/j.ara.2019.100174
Received 13 March 2019; Received in revised form 9 November 2019; Accepted 20 November 2019
Available online 26 December 2019
2352-2267/ © 2019 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/BY-NC-ND/4.0/).
Y.S. Tai, et al.
Fig. 1. Map of the Indian Ocean showing location of ceramic production sites [1 – 10], shipwrecks with Chinese trade ceramics in the cargo [11 – 40] and selected
excavation sites with medieval (Tang – Qing) Chinese trade ceramics [41 – 78]. See Appendix C for a list of supporting selected references. The map insert is the study
zone in Aceh, Indonesia showing all sites where surface material was recovered.
centers found within ship cargoes (Brown, 2009). In particular, cera-
mics made in Thailand and Vietnam comprise at least half of the
ceramic cargo in shipwrecks between 1380 and 1430; followed by a
“golden age of Thailand celadon” between 1430 and 1487 (Ibid.).
Champa ceramics from central Vietnam were exported in 1450-1475,
and Burmese ware has been found on shipwrecks dating between 1470
and 1505 (Ibid.). (Fig. 1)
The work of Brown and others has done much to illustrate the
changing patterns of ceramic trade in Southeast Asia during the Ming
dynasty. However, some scholars have suggested that official trade
prohibitions could have been circumvented by trade networks and
smugglers, mitigating the impact of the bans on the quantity of Chinese
ceramics in circulation (Oka et al., 2009). There are three issues that
need to be further resolved related to the impact of Chinese maritime
bans upon ceramic supply and consumption, which we address in this
paper. 1) Most of Brown’s research on the Ming Gap ceramics is based
upon data from shipwrecks. This does not allow for a more nuanced
examination of how Chinese maritime bans changed patterns of
ceramic consumption and use in settlement sites connected to maritime
trade routes. 2) Brown’s chronology for the Ming Gap did not include a
rigorous review of historical sources. 3) There has been no explicit re-
search on the possible impacts of a Qing dynasty trade ban on ceramic
trade and consumption between 1654 and 1684.
In this paper, we analyze over 50,000 ceramic sherds collected as
part of a large landscape survey along 40 km of the coast of Aceh,
Indonesia to comment on the chronology and trade implications of
disruptions in Chinese ceramic exports in the Ming and Qing dynasties.
Aceh, strategically located at the confluence of the Melaka Straits and
the Indian Ocean, was an important node in maritime trade since at
least the 9th century and thus an ideal site to study the composition of
trade ceramics over time (Feener et al., 2011). We first present a de-
tailed discussion of the timing and justifications for the prohibitions on
maritime trade during the Ming and Qing dynasties based upon official
2
Archaeological Research in Asia 21 (2020) 100174
Chinese records. We then present analysis of imported trade ceramics
recovered along the Aceh coast to show how the composition of local
assemblages changed as a result of the Chinese trade bans.
1.1. Historic records of the disruption of ceramic production and maritime
trade in the Ming and Qing Dynasties
1.1.1. Chinese ceramic production and Maritime trade during the Ming
Dynasty
There is extensive archaeological evidence that that ceramics, and
in particular fine porcelain wares, were produced in China in large
quantities for export markets starting in the Tang dynasty (618–907 CE)
dynasty (Christie, 1998; Finlay, 2010; Flecker, 2001; Guy, 2004;
Pierson, 2012; Schottenhammer, 2017; Stargardt, 2014) (Fig. 1). The
popularity and value of Chinese ceramics reached new levels with the
production of blue-and-white fine porcelain wares, coloured by cobalt,
during the late Yuan dynasty in the 1330s in Jingdezhen (Carswell,
2000). However, a combination of conflict, imperial regulations on
ceramic production, and restrictions on maritime trade disrupted the
circulation of Chinese ceramics in the early Ming dynasty (Heng, 2012;
Ptak, 1999; Wade, 2008). Conflict in Jingdezhen in 1352 between
various parties of rebels and the Mongol army likely caused the Por-
celain Bureau of Fuliang (Jingdezhen) to close down briefly and re-
duced the production of ceramics (Tai, 2011). The war ended in 1361
with Jingdezhen under the control of Emperor Taizu (1328–1398), the
founder of the Ming dynasty, with ceramic production resuming, albeit
under a new set of regulations.
The newly established Ming Court enacted a number of policies that
limited the production of blue-and-white porcelain (Wade, 2008). Ac-
cording to Ming law, Imperial kilns were located in Jingdezhen, Jiangxi
province, and Longquan, Zhejiang province [Appendix A.1] (see Fig. 1).
These kilns produced blue-and-white porcelain during the early and
middle Ming period almost exclusively for Imperial use, commissioned
Y.S. Tai, et al.
by the Taizu (1368 –1398), Chengzu (1402 – 1424), and Xuanzong (1426
– 1435) emperors. By 1431, the Imperial court exerted tight control over
cobalt imported from both the Middle East and Chinese sources, effec-
tively giving the court exclusive control over the production of blue-and-
white porcelain. The kilns sent their products to the Imperial palace,
where the court selected items for Imperial use and gifts. All ceramics not
selected for Imperial use were smashed and buried to ensure they did not
end up in circulation outside officially sanctioned purposes. This limited
the availability of blue-and-white porcelain within China and abroad
starting at the end of the 14th century.
The Imperial court allowed commercial kilns to obtain cobalt after
1435. This led to a rapid increase in the commercial production of blue-
and-white porcelain for markets within China. However, the Emperor
Yingzong (reigned 1436–1449, 1457–1464) issued ordinances in 1439
and 1449 that limited the commercial production of blue-and-white
porcelain and punished violators with death, confiscation or banish-
ment [Appendices A.2–A.4]. These controls were put in place because
of Imperial concerns that commercial mass production was devaluing
the blue-and-white porcelain associated with the royal court (Tai,
2011). There is no indication that Imperial kiln production was affected
(Tai, 2012). The Emperor Wuzong of the Ming dynasty did not enforce
the ban of producing blue-and-white ware in commercial kilns, leading
to a surge of blue-and-white export between 1509 and 1521, as dis-
cussed more below.
A number of Imperial ordinances that limited and/or banned mar-
itime trade further disrupted ceramic export. The first emperor of the
Ming dynasty, the Emperor Taizu (1368–1398), imposed a ban on
maritime trade starting around 1371 [Appendix A.5]. This ban was a
response to the predation of Japanese pirates that had been harassing
Chinese and neighboring kingdoms’ coastal regions for several centuries
along shipping lanes stretching from Korea to Vietnam. According to
the edict, communities living along coastal regions were not allowed to
set sail in any capacity whatsoever. The ban on seafaring was so strict
that even fishing boats were not allowed to venture out to sea. This ban
was codified into formal law in 1393 [Appendix A.6].
During the early Ming period, the Imperial court used porcelain as
part of a system of ‘ceramic diplomacy’. The Court sent selected types of
ceramics and other valued materials overseas with diplomatic missions
to be distributed as Imperial gifts to vassals. According to official
Chinese records, the Emperor Taizu started to send ceramics to rulers as
state gifts soon after 1376 [Appendix A.7]. There are at least two ad-
ditional records of Ming missions in 1383 and 1386 to Siam, Champa
and Chenla that presented ceramics to the rulers of foreign polities
during the Hongwu reign (1368-1398) [Appendices A.8–A.9]. During
the Yongle (1403–1424) and Xuande (1426–1435) reigns, the Chinese
emperors sent Admiral Zheng He with a large fleet on a number of
voyages through Southeast Asia and the wider Indian Ocean world
(Dreyer, 2006; Finlay, 2008; Levathes, 1997; Wade, 2005). He brought
along sets of highly distinctive ceramics, as well as other presents, for
rulers of the polities he visited during his missions.
While restrictions on maritime trade spanned much of the early and
mid-Ming dynasty, some scholars have suggested that trade restrictions
were relaxed during the late 15th century (Brown, 2009; Wade, 2008).
Our review of historic sources suggests the sea ban was temporarily
lifted between 1509 to 1521 by the Emperor Wuzong (reigned
1506–1521). There are reports of foreign ships coming into Chinese
ports during this period and of a growing realization amongst some civil
servants that the maritime ban was limiting access to imported products
desired by the Emperor, such as incense [Appendices A.10–A.12]. Of-
ficials saw taxes on cargo as a way to shore up the treasury and help
support the military. This is the first time in the Ming dynasty that the
sea ban on trade was lifted. In a memorial to the throne, Censor He Ao
described ships trailing endlessly at sea, indicating that trade flourished
during this period. [Appendices A.13]
The Portuguese established contact with the Ming court in 1518
after their conquest of Melaka in 1511. This brief period of access to
3
Archaeological Research in Asia 21 (2020) 100174
Chinese ports led to an increase in ceramic export – in particular blue-
and-white porcelain from Jingdezhen. In 1521, Investigating Censor
Qiu Daolong stated in a memorial to the new emperor that the
Portuguese had attacked Melaka, which was a vassal state of the Ming
dynasty, and therefore China should not trade with or accept tribute
from the Portuguese until they withdrew from Melaka [Appendix
A.13]. There was a strict ban on trade for eight years. The Imperial
court ended the ban on 7 November 1529 and opened the port at
Guangdong for trade [Appendix A.14]. In Fujian Province, officials
advocated re-opening ports for trade. The Ming Emperor Jiajing (1522
– 1567) supported this, ordering court officials to eliminate piracy and
restart trade. Once piracy was reduced in Fujian province, the
Zhangzhou Yuegang (Moon Port) was opened to trade in 1567, re-
sulting in a surge of export of ceramics from the Zhangzhou kilns
(Zhang, 2000) [Appendix A.15–A.16].
1.2. Chinese ceramic production and export during the Qing Dynasty
While the Ming bans on maritime trade and resultant ceramic gap
has gotten significant attention from scholars, historical records show
that there were also sea bans during the Qing dynasty that limited the
export of Chinese ceramics (Schottenhammer, 2010). The Qing trade
bans resulted in part from the Manchurian conquest of China in 1644.
This led to a period of turmoil and involved retaliation by Han Chinese
during which time armed merchant ships that had formerly been con-
sidered ‘pirates’ became a vanguard against the Manchurian forces. In
March 1654, Supervising Secretary of the Ministry of Rites, Ji Kaisheng
proposed a sea ban to defend against Ming resistance forces. The fol-
lowing year, the Ministry of Defense decided “not even a single sail is
allowed to enter the sea”. In 1656, the sea ban was formalized [Ap-
pendix A.17]. The Emperor Qing Shizu (Shunzhi) imposed a ban on all
maritime activity to cut the supply and communication lines of the
resistance forces. The Imperial court ordered officials to erect barriers
at all possible landing locations and not allow any ship to sail or land
along the Chinese coast. Those who supplied or traded with the re-
sistance were executed, with their cargo and property confiscated.
Those who failed to report offences were executed. Any officials who
failed to conduct their duties were severely punished.
When the resistance leader Zheng Chenggong (1624–1662) expelled
the Dutch from Taiwan in 1661 and made it his base, the Manchurian
emperor imposed the strictest sea ban order in Chinese history, referred
to as the ‘Great Clearance’ [Appendix A.18] (Hayes, 1974; Po, 2018;
Shi, 2006). The policy forced all residents living in coastal areas of
China to move approximately 25 km inland to prevent any form of
maritime activity or interaction with resistance forces in Taiwan.
During this period, major ceramic manufacturing centers shifted from
Pinghe to Hua’an and Nanjing counties, both about 100 km from the
sea.
On 17th March 1681, the resistance leader Zheng Jing (1642-1681),
son of Zheng Chenggong, passed away in Taiwan. The Governor-gen-
eral of Fujian, Yao Qisheng (1624–1683), and Grand Coordinator, Wu
Xingzuo, suggested they should open the border and allow people to
return to the coast. In 1683, the 12 year-old Zheng Keshuang
(1670–1707) surrendered to the Qing dynasty, effectively ending the
need for the ban. On 6th December of that year, Wu Xingzuo, Governor-
general of Guangdong and Guangxi provinces, started to repopulate the
coast. With the surrender of resistance forces and the end of the ‘Great
Clearance’ policy in 1683, the Qing dynasty sea ban was lifted in 1684
[Appendix A.19].
Given the almost total monopoly on the ceramic trade enjoyed by
the Chinese before the Ming dynasty in Southeast Asia, these periods of
maritime bans impacted regional trade. Below we analyze ceramics
collected from our survey zone along Aceh coast of Sumatra to in-
vestigate whether the disruptions in Chinese ceramic export can be seen
in the archaeological record of an important center of Southeast Asian
maritime trade.
Y.S. Tai, et al.
2. Methods
We collected the data presented in this paper through a systematic
landscape archaeological survey conducted by Acehnese researchers at
the International Centre for Aceh and Indian Ocean Studies between
2015 and 2017. Our study area covered 40 km of coast near the city of
Banda Aceh, Indonesia (Fig. 1). We selected the study zone to in-
vestigate the coastal areas on either side of what became the center of
the Acehnese Sultanate in the 16th century and because ad-hoc field
walking had previously found clusters of historic grave markers and
scatters of imported trade ceramics on the ground surface. The field
team worked with village elders to identify known archaeological sites.
They then walked transects through each of the villages, marking all
sites where archaeological material was visible on the ground surface.
We located over 1000 sites, most of which contained ceramic material.
We define ‘sites’ as any discrete concentration of archaeological mate-
rial visible on the surface, such as clusters of grave stones, scatters of
ceramics, and structural remains.
For each site containing ceramics, the team measured the extent of
the surface scatter, took GPS coordinates and photos, and collected all
sherds found on the surface large enough to be identified. We collected,
cleaned, tagged, weighted, photographed and analysed 52,939 ceramic
sherds. We were able to identify the date range and provenance (man-
ufacture center) for 40,850 pieces of imported trade ceramics which form
the basis of this study. We collected over 8,000 sherds of non-descript
earthenware ceramics, many presumably manufactured locally.
However, the lack of dated, comparable material prevents us from in-
cluding this in our analysis. Our ceramic identification was informed by
comparing the forms, styles, and decoration of the sherds recovered
during our survey with dated material from shipwrecks, excavated kiln
sites, and museum collections (see references associated with Fig. 1).
We created a spreadsheet for each site containing ceramics, listing
the site code, unique ID number for each sherd, weight, fabric, dec-
oration, provenance, vessel type, chronology, and comments. Date
ranges vary considerably by the type of ceramic vessel - some types
were only produced in a specific year, while other types were produced
for decades or even centuries. To manage the date ranges and constrain
human activity to multi-decadal precision we applied a statistical model
to the ceramic dataset to calculate probable activity levels for each
year, using the BchronDensityFast function in Bchron (Haslett and
Parnell, 2008; Parnell et al., 2008). This function considers the date
ranges for each sherd and provides a statistical estimate for when dif-
ferent kinds of ceramics found in Aceh were most likely in use. We
provide a more detailed technical overview of the TheBchronDensity-
Fast function in Appendix B. Furthermore, acknowledging the problems
posed by the ceramic date ranges, we present both the minimum and
maximum potential totals for the ceramics for each time period under
investigation (Table 1, Table S1).
3. Results
The bulk of the trade ceramics recovered from our survey area date
between the early 13th to 19th centuries C.E. The Aceh assemblage
contains a wide range of material from East Asian, Southeast Asian,
South Asian, Middle Eastern and European production centers, re-
flecting Aceh’s connections to global trading networks (Fig. 2; Tables 1
& S1). The overall quantity of ceramics increased over time, with most
dating from after the mid-16th century. As discussed in detail below, we
found decreases in the quantity of Chinese ceramics and increases in
non-Chinese material recovered in our study area that date to the Ming
and Qing ban periods.
3.1. Ceramics in Aceh before the Ming Bans (Pre-1371)
Before the Ming Bans, the Aceh assemblage consists almost ex-
clusively of Chinese ceramics produced in Guangdong, Fujian, Zhejiang
4
Archaeological Research in Asia 21 (2020) 100174
and Jiangxi provinces (Table 1 & Table S1). More than half the sherds are
fragments of large jars and basins applied with a layer of yellowish-
brown glaze that were produced in Guangdong. These jars were used as
storage containers on merchant ships exporting material from China.
(Fig. 3a & b) The Fujian wares were made in specialized production
centers in Tong’an, Cizao, and Dehua. The Tong’an ceramics are mainly
green ware rice bowls used for food preparation and consumption.
(Fig. 4a & b) The Cizao material are ubiquitous small-mouth jars, fired at
high temperatures, which were commonly used as containers for liquids
such as mercury, condiments and alcohol. (Fig. 5a & b) The Dehua ma-
terial are mainly covered boxes often used as incense containers.
We recovered significant quantities of high quality fine ware from
Zhejiang (Longquan) and Jiangxi (Jingdezhen) respectively. The
Longquan material mainly consists of monochrome celadon bowls and
dishes. Longquan celadon fine wares were a major export product
during the later Southern Song and Yuan dynasties and are found
throughout Southeast Asia (Chin, 1977; Edwards McKinnon, 1977;
Evans, 2004; Flecker, 2001, 2013, 2015; Ho, 1994; Li, 2014; Lim, 2018;
Miksic, 2006, 2009; Stargardt, 2001). The Jingdezhen fine ware in-
cludes shufu ware, qingbai ware, and blue-and-white ware.
3.2. Ceramics dating to Ming Bans 1 & 2 (1371 - 1506 & 1521 - 1529)
Our data shows that during the Ming Ban periods there was a major
reduction in the quantity of Chinese coarse ware ceramics in the Aceh
assemblage. In our study area we recovered only five sherds each of Fujian
and Guangdong coarse ware vessels, indicating the two most common
types of pre-ban ceramics were not imported during the Ming Bans.
However, we found a continued but greatly reduced presence of Chinese
fine ware. We recovered 48 sherds of Longquan fine ware that we can date
to within the period of Ming Ban 1. We suspect that one interesting sherd
of underglaze copper-red, part of a large bowl with a band of “lotus petal”
pattern border just above the ring foot, dates to between 1380 and 1398
based upon comparison with ceramics in the Palace Museum, Beijing,
dated to the reign of Ming Dynasty founder, Taizu (Fig. 6a & b). A sherd
with a ‘diaper’ pattern similar to celadon from the Chinese Imperial col-
lection in the National Palace Museum, Taipei (Fig. 7a & b) was most
likely produced in the early 15th century (Tsai, 2009 p. 76 - 77). Although
only a small sample, we believe that these ceramics were gifted by the
Imperial court to elites within our study area as part of formal diplomatic
connections during the first Ming Ban period; possibly even brought to the
Aceh coast during visits by Zheng He’s fleet, which historical records show
passed the Aceh coast five times in 1405, 1408, 1413, 1417 and 1430
(Dreyer, 2006; Wade, 2005).
The reduced quantity of Chinese ceramics is partially offset by an
increase in ceramics from production centers in Burma, Thailand and
Vietnam (Fig. 2; Table 1 & Table S1; Fig. S1 - 5). The Burmese material
is mainly from relatively crudely-potted celadon bowls and dishes for
serving food and large coarse ware Martaban storage jars. The Thai
ceramics are mainly bowls and dishes for serving food from the Sa-
wankhalok kilns in Sukhothai. The Thai bowls and dishes are mostly
high quality celadon, coated with a greenish glossy glaze and decorated
with carved feather-like patterns. We recovered a small quantity of high
quality Vietnamese bowls decorated with underglaze iron black, cobalt
blue, or in some cases both colors.
Interestingly, there is a spike in the quantity of Chinese fine ware
that we date between 1506 and 1521, which falls between Ming Bans 1
& 2 (Fig. 2, Fig. S2). We recovered at least 254 sherds of Jingdezhen
blue-and-white wares that we believe date between 1506 and 1521,
mainly dishes and bowls for serving food, some covered boxes and
fragments from a bottle (Fig. 8 a & b). Some of this material is similar in
style and decoration to a vessel from the Hutian kiln with an inscription
on the bottom that reads “Made in the Great Ming Zhengde Reign
Autumn Auspicious Day” (Liu, 1980), and from a small jar excavated
from a tomb in Boyang dated to 1520 currently found in the collection
of the Jiangxi Museum.
Y.S. Tai, et al. Archaeological Research in Asia 21 (2020) 100174

Table 1
Sherd counts by location of production for the key time periods in the study. This table only includes material that we can definitely date within the time periods,
removing all sherds that overlap multiple periods. The maximum count for all material from each production center that could possibly date within that time period is
shown in Table S1. We applied a statistical model to control for sherds that have date ranges that overlap with the time periods listed in the table. (see Fig. 2 and
Supplementary Figs. 1 – 5).
Country Region Sub-region Pre 1371 count 1371 – 1529 count 1529 – 1654 count 1654 – 1684 count 1684 – 1850 count Total by country

Burma Karen Kaw Don 2 10

Mon Martaban 247 326
Yangon Twante 9
Unknown Unknown 53 54 701
China Fujian Anxi 15
Cizao 123
Dehua 9 20 3289
Minnan 55 1
Quanzhou 16
Tongan 381
Shaowu 5
Zhangzhou (Swatow) 1 4481
Zhangzhou (Dongxi) 8 6602
Unknown 212 4 503 4,089
Guangdong Guangzhou 21
Unknown 1246 6 5 10
Hebei Cizhou 2
Quyang 1
Jiangsu Yixing 14
Jiangxi Jingdezhen 52 254 876 1 766
Zhejiang Longquan 225 48
Unknown Unknown 51 3 3 16 23,411
Japan Hizen 1 13 149 377 540
Thailand Ayutthaya Unknown 2
Singburi Unknown 1
Sukhothai Sawankhalok 186 2
Sukhothai 15
Unknown Unknown 1 20 247
Vietnam Hai Duong Hop Le 4 1 3
Unknown 35 43
Totals 2400 888 6298 158 15,181 24,925

Fig 2. The plot shows estimated probability densities over time based upon statistical analysis of the quantity of sherds and their individual date ranges. The peaks
represent the probable density of ceramics that date to every given year, relative to the total count and date ranges for each country respectively. We use these
densities as a proxy for the timing of when the different types of ceramics were most likely present and in use by people along the Aceh coast. The red bars indicate
the Ming and Qing export bans.

5
Y.S. Tai, et al. Archaeological Research in Asia 21 (2020) 100174

Table 2
Changes in the dominant production centers for the main types of ceramics within the study area, showing change over time.
Pre 1371 1371 – 1529 Ming Bans 1529 - 1654 1654 – 1684 Qing Ban 1684 - 1850

Coarse ware jars Guangdong (China) Martaban (Burma) Martaban (Burma)

Coarse table wares (bowls, dishes, Tong’an (China) Martaban (Burma) Pinghe, Zhangzhou Hua’an and Nanjing, Hua’an and Nanjing,
etc.) Cizao (China) Twante (Burma) (China) Zhangzhou (China) Zhangzhou (China)
Minnan (China) Twante (Burma)
Quanzhou (China)
Fine table wares (bowls, dishes, Longquan (China) Jingdezhen (China) Jingdezhen (China) Hizen (Japan) Dehua (China)
bottles, boxes, vases, etc.) Jingdezhen (China) Sawankhalok Sawankhalok (Thailand) Hop Le (Vietnam) Hizen (Japan)
(Thailand) Dehua (China) Dehua (China) Jingdezhen (China)
Longquan (China) Jingdezhen (China) Hop Le (Vietnam)

Fig. 3. a & b. Example of base of a pre-1400 Guangdong jar.

Fig. 4. a & b. Sherd from a small pre-1400 Tong’an ware bowl.

3.3. Ceramics after the Ming Ban 1529 - 1650
Between the Ming Bans and the Qing Ban there was a major increase in
the quantity of Chinese export ceramics recovered in Aceh, mainly coarse
ware bowls and dishes from kilns in the Zhangzhou region. This material,
often known as Swatow ware, which was produced in Pinghe county, is a
form of mass-produced domestic ceramic that flooded regional trade
markets in the second half of the 16th century following the opening of the
Moon Port (Zhangzhou Yuegang) in 1567. There is also an increase of fine
ware bowls, dishes and boxes from Dehua and Jingdezhen.
While we recovered small amounts of Thai and Japanese ceramics
that we can date between 1529 and 1650, the main non-Chinese ceramic
import during this period were large, coarse ware Martaban jars from
southern Burma. This suggests that Burmese production centers retained
market share for large storage vessels and also that Chinese traders were
either using Burmese jars for shipping, or may have developed alter-
native shipping practices after the Ming Bans. Before the Ming Bans were
lifted, Martaban jars typically had black-brown glaze and were decorated
with vertical and horizontal lines in relief, which divide the body into
two panels (Goddio et al., 2002). Early Martaban jars also had three
horizontal lugs and saddle straps with distinct ‘dot’ decoration (OCSHK,
1979). Later Martaban jars do not have applied lines and strap decora-
tion (Fig. 9a & b). There is a gradual decrease in Thai ceramics by the
mid-16th century (Fig. 2, Table 1 & Table S1).

6
Y.S. Tai, et al.
Fig. 5. a & b. Rim sherd from a pre-1400 small mouth jar from Cizao.
Fig 6. A & B. Underglaze copper-red bowl found in Aceh with a band of lotus-petal pattern. Examples of similar underglaze copper-red bottle and bowl dated to the
Hongwu reign (1368-1398) from the collection of the Palace Museum, Beijing.
3.4. Ceramics dating to the Qing Ban period 1654 - 1684
The Qing Ban period is characterised by 1) a slight decrease in the
quantity of Chinese ceramics, 2) a lack of Thai ceramics, 3) an increase in
the quantity of Burmese ceramics, and 4) the entrance of Japanese and
Vietnamese ceramics1 (Fig. 2, Table 1 & Table S1). We recovered at least
149 sherds of Japanese Hizen porcelain bowls and dishes dated between
1650 and 1700.2 These Japanese ceramics are relatively fine blue-and-
white ware and have some similarities with ceramics produced in
Zhangzhou, such as a slightly underfired off-white paste and use of dull
1
It is difficult to provide a precise analysis of the impact of the three-decade
Qing ban as some styles of Chinese and other southeast Asian ceramics have
possible date ranges of 50 to 100 years, overlapping with, or including the
decades of the Qing ban. However, our statistical analysis clearly shows on
aggregate that there are shifts in the counts of ceramics found in our survey
zone during and after the Qing ban period.
2 such as yu (玉jade), jia (佳excellence) or ya (雅elegant) painted on the center
Japanese potters started making porcelain in 1616 with their main manu-
facturing center in Hizen, which includes important kiln sites in Arita (Kyushu).
The Japanese ceramic industry developed rapidly over the next 50 years. Japan
began commercially exporting ceramics after the Dutch established a trading
post at Dejima, Nagasaki, in 1641, that hosted a range of Japanese, Chinese,
and other international merchants. By 1660, Japan was exporting large quan-
tities of high quality ceramics.
7
Archaeological Research in Asia 21 (2020) 100174
blue pigment for the decoration. Some of this material is decorated with
dragon or phoenix motifs, with other examples having the Kanji char-
acter ni (日sun), which is also found on some Zhangzhou ceramics.
3.5. Ceramics dating after the Qing Ban period 1684 - 1850
Following the Qing Ban there was a significant increase in the quantity of
Chinese ceramics, with a pronounced spike in the early 19th century. The
Chinese ceramics from this period are dominated by coarse ware bowls and
dishes from Zhangzhou. We found a sherd of a Zhangzhou magnolia leaf and
poem dish with a sexagenary cycle calendar date of Jia Zi Nian (1684), the
year the Qing Ban ended (Fig. 10a & b). We are confident that the inscribed
date is 1684 (rather than another date in the cycle) because this ceramic
style was not in production either 60 years before or after the date. We
recovered numerous sherds from Zhangzhou cursive shou (longevity) char-
acter bowls (Fig. 11a & b). These vessels are decorated with cursive char-
acters "shou" (寿longevity), with some fragments displaying other characters
of the interior. The Zhangzhou material before the Qing Ban was produced in
Pinghe county and fired in saggers on coarse sand, which leaves traces of
sand on the running glaze along the base of the vessels. Following the Qing
Ban there is a shift to manufacturing centers in Hua’an and Nanjing counties,
where the ceramics were stack fired. These different manufacturing techni-
ques leave distinct signatures on the vessels, making it relatively easy to
Y.S. Tai, et al. Archaeological Research in Asia 21 (2020) 100174

Fig 7. A. Longquan celadon with diaper pattern, found in Aceh. B. Example of similar ceramics from the Chinese imperial collection at the National Palace Museum,
Taipei. (With kind permission from the National Palace Museum, Taiwan).

Fig. 8. A & B. Sherd of Jingdezhen blue-and-white dish decorated with a mythical creature galloping on a wave. We date this sherd between Ming Ban 1 and Ming
Ban 2, 1506 and 1521.

Fig. 9. a & b. Rim sherd from a large Martaban jar most likely dating after the Ming Ban period.

identify. The ceramics produced in Hua’an and Nanjing counties are also We also found a persistence of Burmese, Japanese and Vietnamese
known as Dongxi ware. We recovered large quantities of fine ware bowls, ceramics until the mid-18th century. The Burmese material consists of
dishes, bottles, boxes, and vases from Jingdezhen and Dehua. coarse ware Martaban bowls and jars. The Japanese ceramics are high

8
Y.S. Tai, et al.
Fig. 10. A & B. Sherd from a Zhangzhou magnolia leaf and poem dish with a sexagenary cycle calendar data of Jia Zi Nian (1684) from Aceh.
Fig. 11. A & B. Sherd from a Zhangzhou cursive ‘longevity’ character bowl dating after the Qing gap from Aceh. The character ‘yu’ is on the inside of the bowl, while
‘shou’ is written in cursive along the outside of the bowl.
quality fine ware vessels. Most of the Japanese sherds came from Kraak
ware vessels, with painted decorations including flowers, insects, birds,
and landscape scenes (Fig. 12a & b). All of the Vietnamese ceramics are
‘sunburst’ bowls produced in Hop Le (Hai Duong), with many decorated
with a block-printed sunburst (chrysanthemum) pattern (Fig. 13a & b).
Burmese, Japanese and Vietnamese ceramics all disappear from Aceh’s
archaeological record around the same time in the mid-18th century.
4. Discussion
Our review of historical Chinese records shows that the Ming Gap
(1371 – 1529) consisted of three stages: Ming Ban 1 (1371 – 1509),
followed by a brief resumption of trade (1509 – 1521), and then Ming
Ban 2 (1521 – 1529). Historical records from the Qing dynasty report a
number of ordinances that limited export between 1654 and 1684,
which we identify as the Qing Gap.
Our analysis of trade ceramics recovered from the Aceh coast shows
that both the Ming and Qing Bans, as well as changes in production centers
in China, impacted the import and use of ceramics along the Straits of
Melaka (Table 2). Before the Ming Bans almost all imported ceramics were
produced in China. The Ming Bans significantly reduced the import of
Chinese ceramics. However, within several decades of the ban, the main
forms of Chinese ceramics used in Aceh had been partially replaced by
similar material produced in Burma and Thailand. Burmese coarse wares
from Martaban and Twante substituted for coarse ware jars and table
9
Archaeological Research in Asia 21 (2020) 100174
wares from Guangdong and Fujian (Table 2). The high-quality celadon and
porcelain from Longquan and Jingdezhen that most likely were used by
affluent elites in Aceh were replaced by fine wares from the Sawankhalok
production centers in Thailand.3
Following the end of the Ming Bans, our data show a gradual in-
crease in Chinese ceramics through the mid-16th century in Aceh. This
was followed by a major influx of coarse table wares from Zhangzhou
and increased imports of fine wares from Jingdezhen and Dehua. Large
storage jars continued to be imported from Burma. Imports of Thai fine
ware decreased steadily and ended by the mid-16th century, after
which Thai material is absent from our study area.
While brief, the Qing Ban resulted in major changes in the ceramic re-
cord. The date ranges of Chinese ceramics make it difficult to evaluate the
extent of the decrease in Chinese material, but our statistical analysis shows
some reduction. However, there is a clear spike in the quantity of Burmese
ceramics, and the import of fine wares from production centers in Japan
and Vietnam occurs within years of the Qing Ban. In fact, the styles of the
Japanese and Vietnamese wares closely mimic some of the characteristics of
3
The Thai wares were rarely as well fired as the Longquan material in our
survey zone. The Thai examples are commonly discolored, greens with grey or
brown patches. As such, while we feel the Thai material was used as a substitute
for the fine ware from Longquan, we do not feel that they matched the quality
of the earlier Longquan ceramics.
Y.S. Tai, et al.
Fig. 12. A & B. Sherds from a Japanese Kraak dish (reconstructed) recovered in Aceh.
Fig. 13. A & B. Sherd from a Vietnamese sunburst bowl produced in Hop Le, Hai Duong.
Chinese fine ware from Jingdezhen. Following the Qing Ban, Burmese,
Japanese and Vietnamese fine wares are present in Aceh until they all
disappear around the same time in the mid-18th century, after which time
almost all trade ceramics were imported from China until the entrance of
European ceramics in the 19th century.
Our findings are in general agreement with Brown’s timeline for the
Ming Gap, with one notable exception. Brown proposes that there is a
brief rebound of trade during the Hongzhi reign (1488 – 1505), sup-
ported by the dating of ceramics from the Brunei and Lena Shoal
shipwrecks (Brown, 2004; Goddio et al., 2000a, 2002). Our review of
Chinese historical sources suggest that the Ming trade ban was relaxed
during the Zhengde reign (1506 – 1521), but we found no indication
that it was also relaxed during the Hongzhi reign. Second, we have been
able to date some of the Jingdezhen ceramics from our study area with
confidence to the Zhengde reign. Interestingly, we noticed that some of
the material we can date to the Zhengde reign is very similar to material
recovered from the Lena Shoal wreck and currently dated to the Hon-
gzhi reign. Additional research is needed to test whether similar styles
of Jingdezhen ceramics could have spanned both the Hongzhi and
Zhengde reigns (thus accounting for the overlap), or if the dating of the
cargos of the Lena Shoal and Brunei wrecks needs to be reconsidered in
light of similar types of ceramics from dated contexts in China.
5. Conclusion
For over 600 years, settlements along the Aceh coast at the northern tip
10
Archaeological Research in Asia 21 (2020) 100174
of Sumatra were deeply connected to regional trading networks, verified by
the rich collection of trade ceramics we collected. We have reason to believe
that some of the changes we can see in the ceramic assemblage in Aceh
were the result of economic and political changes caused when a large
tsunami destroyed all low-lying coastal settlements in our survey area at the
end of the 14th century and disrupted society for at least several decades
thereafter (Daly et al., 2019; Sieh et al., 2015). However, the historic trading
site of Lamri, positioned on an elevated headland within our study area,
continued to import trade ceramics from Thailand and received diplomatic
gifts of Imperial ceramics from China during the 15th century. Furthermore,
by the end of the 15th century, we start to see an increase of imported
ceramics in the area that emerged as the center of the Aceh Sultanate.
Therefore, we suggest the changing patterns of ceramic import along
the Aceh coast are representative of broader regional trends. What
emerges from our analysis is a picture of how producers, consumers, and
traders adjusted fluidly to the massive shocks caused by the Chinese
maritime bans. While informal trade might well have circulated limited
amounts of Chinese ceramics during the ban periods, the official prohi-
bitions had a major impact on the quantity of Chinese trade ceramics
along the Aceh coast and led to stimulating other regional production
centers. While there are indications from both our data and shipwreck
cargos that Southeast Asian ceramics started be exported prior to the
disruption of Chinese ceramics, our analysis shows that it might have
taken up to several decades for other producers to accelerate ceramic
manufacturing technology and scale up production, and for new trading
networks to emerge. However, during the Qing gap, producers and
Y.S. Tai, et al. Archaeological Research in Asia 21 (2020) 100174

markets responded more rapidly, and production centers in Japan and
Vietnam deliberately produced ceramics with many of the characteristics
and decorative motifs found on Chinese ceramics. Looking at the trade
ceramics imported over an extended period reveals the ability of Chinese
ceramics to regain market hare and quickly return to dominate regional
markets, most likely because of a combination of technological super-
iority and economies of scale enjoyed by Chinese production centers
through the end of the Qing dynasty.
Declaration of Competing Interest
None
Acknowledgements
We thank colleagues at the International Centre for Aceh and Indian
Ocean Studies (ICAIOS) and Syiah Kuala University in Banda Aceh for
their continued partnership and support for this research. Authority for
locating and documenting the surface archaeology was provided by the
Aceh governor’s office and by the heads of all the villages in our survey
area. The documentation of the archaeological sites was carried out
over 2 years by an Acehnese field team based at ICAIOS. The team
consisted of the following persons: M. Irwani (project manager);
Hayatullah (field team leader); D. Satria, S. Wahyuni, M. Zahara, A.
Gapi, A. Muziburrahmi, and M. Ikhsanuddin (heritage survey team);
Jihan, P. Arafat, Muksalmina, A. Yamani, S. Novita, and R. Zahara
(artefact and data processing); and Safrida, H. Adnin, and Evan (ad-
ministrative and logistical support). Their incredible efforts under dif-
ficult conditions were essential to collect the data used in this paper,
and we, and the people of Aceh, owe them a debt of gratitude. We
especially thank Professor E. Srimulyani, Dr. S. Ihsan, Dr. Arfiansyah,
Dr. A. Widyanto, Dr. S. Mahdi, and Dr. T. Zulfikar for their advide and
support. Y. Descatoire at the Earth Observatory of Singapore provided
extensive support in drafting the figures used in this paper. This re-
search was supported by the National Research Foundation Singapore
and the Singapore Ministry of Education under the Research Centres of
Excellence Initiative. This work comprises Earth Observatory of
Singapore contribution no. 257.

Appendix A. Chinese imperial ordinances related to the manufacture and export of ceramics

A.1. 洪武二十六年定:凡烧造供用器皿等物，须要定夺样制，计算人工物料。如果数多，起取人匠赴京，置窑兴工，或数少，行移饶、处等府烧造。
(《大明会典》卷一百九十四“陶器”)

Implemented in 1393: Whenever (there is a need to) fire Imperial wares, [you] must design the pattern and calculate the cost of manpower and
materials. If the quantity is large, send the potters to the capital and set up kilns to do the job. If the quantity is small, fire it in the Raozhou (today’s
Jingdezhen) and Chuzhou (today’s Longquan) kilns.
[Shen Shixing, Collected Statutes of the Ming (《明会典》), 1587 A.D. juan 194. Beijing: Zhong Hua Publishing, 2007, p. 980.]

A.2. (正统三年十二月丙寅)命都察院出榜，禁江西瓷器窰场，烧造官样青花白地瓷器，于各处货卖及馈送官员之家。违者正犯处死，全家谪戍口外。

(1 Jan 1439, the Emperor) ordered the Censorate to post a notice banning the production, sale and gifting to officials of naval blue-on-white
ground porcelain from the kilns of Jiangxi. Offenders will be sentenced to death and their families will be banished to a frontier post.
[Sun Jizong ed., Veritable Records of Ming Dynasty Emperor Yingzong (《大明英宗实录》), 1467 A.D., juan 49, p. 4a. Taipei: Institute of History and
Philology, Academia Sinica, 1964, vol. 24, p. 946.]

A.3. (正统十二年九月戊戌)禁约两京并陕西、河南、湖广、甘肃、大同、辽东沿途驿递镇店军民客商人等，不许私将白地青花瓷器皿卖与外夷使臣。

(18 Oct 1447) Soldiers, civilians, visitors and businessmen at postal relay stations, transport offices, defence commands and shops/inns along the
roads of northern and southern Capitals, Shanxi, Henan, Huguang, Gansu, Datong and Liaodong are not allowed to sell naval blue-on-white ground
wares to foreign emissaries.
[Sun Jizong ed., Veritable Records of Ming Dynasty Emperor Yingzong (《大明英宗实录》), 1467 A.D., juan 158, p. 3b. Taipei: Institute of History
and Philology, Academia Sinica, 1964, vol. 29, p. 3074.]

A.4. (正统十二年十二月甲戌)禁江西饶州府私造黄、紫、红、绿、青、蓝、白地青花等瓷器。命都察院榜谕其处，有敢仍冒前禁者，首犯淩迟处死，
籍其家赀，丁男充军边卫。知而不以告者，连坐。

(On the 22nd Jan 1448, the Emperor) banned the private production of yellow, purple, pink, green, naval blue, light blue and naval blue-on-white
ground coloured ceramics in Raozhou (now Jingdezhen), Jiangxi. [The Emperor] ordered the office of the Censorate to post notice there. Offenders
will be sentenced to death by the slow process of slicing, their property will be confiscated and male family members will be sent to a frontier post as
a soldier. Any who fails to report this offence will be prosecuted as well.
[Sun Jizong ed., Veritable Records of Ming Dynasty Emperor Yingzong (《明英宗实录》), 1467 A.D., juan 161, p. 4b. Taipei: Institute of History and
Philology, Academia Sinica, 1964, vol. 29, p. 3132.]

A.5. (洪武四年)仍禁濒海民不得私出海。(《明太祖实录》)

(1371) Do not allow people living along coastal regions to set sail.
[Yao, Guangxiao (1335-1418) eds., Veritable Records of Ming Dynasty Emperor Taizu (《明太祖实录》), 1418 A.D., juan. 70, p. 3b. Taipei: Institute
of History and Philology, Academia Sinica, 1964, Vol. 3, p. 1300.]

A.6. 充军按律充军凡四十六款、而诸司职掌内二十二款、则洪武年间例、皆律所不载者。其嘉靖二十九年、奏定条例内充军凡二百十三款、与今所
奏定、大略相同、诸例已附载各律之下、永為遵守。今仍类次于后。其职掌所载、仍列于前、以备参考。

洪武二十六年定:贩卖私盐、诡寄田粮、私充牙行、私自下海、閒吏、土豪、应合抄札家属、积年民害官吏、诬告人充军、无籍户、揽纳户、旧日
山寨头目、更名易姓家属、不务生理、游食、断指诽谤、小书生、主文、野牢子、帮虎、伴当、直司。

11
Y.S. Tai, et al. Archaeological Research in Asia 21 (2020) 100174

嘉靖二十九年定:…… (《大明会典》)
According to the law, there are 46 articles on crimes that can be punished by banishment to an army post. The 22 listed in Zhu Si Zhi Zhang were
regulations of Hongwu reign (1368-1398) and were not listed in the law book. Laws approved in 29th year of Jiajing reign (1550) have 213 articles
on banishment to an army post… Now all [of these laws] are included and listed accordingly as follows, with those (laws) in the (Zhu Si) Zhi Zhang
listed first for consideration: (Those laws) drafted in the 26th year of Hongwu reign (1393): Smuggling salt, evading grain tax, acting as agent in
private, putting to sea without permission…… (Those laws) drafted in the 29th year of Jiajing reign (1550): ……
[Shen Shixing, Collected Statutes of the Great Ming《大明会典》, 1587 A.D. juan 175, p. 1, in Continuation Series of the Complete Collection of the
Imperial Library《续修四库全书》, Vol. 792, Shanghai: Shanghai Guji 1995, p. 129.]

A.7. 洪武九年……夏四月甲申朔，刑部侍郎李浩还自琉球……浩因言其国俗市易，不贵纨绮，但贵磁器、铁釜等物。自是赐予及市马，多用磁器、
铁釜云。(《明太祖实录》卷一百五)

On 19 April 1376…… The Deputy Minister of Law, Li Hao, returned from Ryukyu…… He reported that when they trade, they highly value Chinese
ceramics and iron cauldrons, but not silk. From then on, presents for foreign rulers and the trading of horses will be ceramics and iron cauldrons.
[Yao Guangxiao ed., Veritable Records of Ming Dynasty Emperor Taizu (《明太祖实录》), 1418 A.D., juan 105, p. 3b-4a. Taipei: Institute of History
and Philology, Academia Sinica, 1964, Vol. 4, p. 1754-1755.]

A.8. 洪武十六年八月……遣使赐占城、暹罗、真腊国王织金文绮各三十二匹、磁器一万九千事。(《明太祖实录》卷一百五十六)

In the 8th month of 1383, a mission was sent to Siam, Champa, and Chenla, and presented each king 32 pieces of gold thread woven damasks and
19,000 pieces of ceramics.
[Yao Guangxiao eds., Veritable Records of Ming Dynasty Emperor Taizu (《明太祖实录》), 1418 A.D., juan 156, p. 2b-3a. Taipei: Institute of History
and Philology, Academia Sinica, 1964, Vol. 6, p. 2426-2427.]

A.9. 洪武十九年九月……癸未，遣行人刘敏、唐敬偕内使赍磁器，往赐真腊等国。(《明太祖实录》卷一百七十九)

On the 23rd Oct 1386... Sent Liu Min, Tang Jing and eunuch(s) to bring ceramics to present to Chenla and other kingdoms.
[Yao Guangxiao eds., Veritable Records of Ming Dynasty Emperor Taizu (《明太祖实录》), 1418 A.D., juan 179, p. 5a. Taipei: Institute of History
and Philology, Academia Sinica, 1964, Vol. 6, p. 2711.]

A.10. (正德四年三月乙未)暹罗国船有为风飘泊至广东境者，镇巡官会议税其货，以备军需。市舶司太监熊宣计得预其事以要利，乃奏请于上。礼部
议:阻之。诏:以宣妄揽事权，令回南京管事。以内官监太监毕真代之。(《明武宗实录》卷四十八)

(23rd March 1509) A Siamese ship drifted into Guangdong territory due to a storm. The Grand Defender and Grand Coordinator held a meeting
and decided to tax the cargo in order to subsidize the army. The Superintendent, Eunuch Xiong Xuan, wanted to be involved so as to profit from it. He
sent his request to the emperor, but was blocked by the Ministry of Rites after the ministry meeting. (The Emperor) proclaimed: Xiong Xuan acted
beyond his authority, he is ordered to return to Nanjing, Eunuch Bi Zhen will take over his post.
[Xu Guangzuo (?-1526) eds., Veritable Records of Ming Dynasty Emperor Wuzong (《明武宗实录》), 1525 A.D., juan 48, pp. 1b-2a. Taipei: Institute
of History and Philology, Academia Sinica, 1964, Vol. 63, pp. 1082-1083.]

A.11. (正德十二年五月辛丑)命:番国进贡并装货舶船，榷十之二。解京及存留饷军者，俱如旧例，勿执近例阻遏。先是:两广奸民，私通番货，勾引外
夷，与进贡者混以图利，招诱亡命，略买子女，出没纵横，民受其害。参议陈伯献请禁治之:其应供番夷，不依年分亦行阻回。至是，右布政使吴廷
举，巧辩兴利，请立一切之法。抚按官及户部，皆惑而从之。不数年间，遂启佛朗机之衅，副使汪鋐尽力剿捕，仅能胜之。于是，每岁造船、铸铳，
为守御计，所费不赀。而应供番夷，皆以佛朗机故，一概阻绝，舶货不通矣。利源一启，为患无穷，廷举之罪也。(《明武宗实录》卷一百四十九)

(15th June 1517) Ordered: Imposes 20% tax on foreign tributary mission and cargo on ships. Those (who) need to be escorted to the capital or
those meant for military expenditure will stick to the original regulations. Do not cite the new regulations to obstruct the procedure. Prior to this, the
people in Guangdong lured foreigners and tributary missions for profit. (They) attracted the outlaws, buying sons and daughters (of the locals for
slavery), haunted the region and became a problem for the people. The Assistant Administration Commissioner Chen Boxian requested a ban on
trade. He demanded any visiting foreign tributary mission visiting anytime other than on the designated dates be turned back. But the Provincial
Administration Commissioner, Wu Tingju (吴廷举1462-1527), suggested to increase the revenue and to draft new regulations (for trade). The Grand
Coordinator and Surveillance Commissioner (of Guangdong Province) and Ministry of Revenue (of the central government) accepted his suggestions.
In a few years, the Portuguese intruded. Vice Censor Wang Hong (汪鋐1466-1536) only managed to withhold their aggression.
[Xu Guangzuo (?-1526) ed., Veritable Records of Ming Dynasty Emperor Wuzong (《武宗实录》), 1525 A.D., juan 149, p. 9a. Taipei: Institute of
History and Philology, Academia Sinica, 1964, Vol. 68, p. 2911.]

A.12. 先是，暹罗、占城、爪哇、琉球、浡泥诸国互市，俱在广州，设市舶司领之。正德时，移于高州之电白县。嘉靖十四年，指挥黄庆纳贿，请于
上官，移之壕镜，岁输课二万金，佛郎机遂得混入。(《明史》)

Prior [to the arrival of Portuguese], Siam, Champa, Java, Ryukyu and Boneo traded with the supervision of the Superintendent in Guangzhou
(Canton). During the reign of Zhengde (1506-1521), the office moved to Dianbai. In 14th year of the reign of Jiajing (1535), the Military Officer
Huang Qing accepted bribes and requested his superior to set up the Office of the Superintendent at Macau. The Portuguese pay 20,000,000 bronze
coins yearly as rental and have thus managed to stay in China.
[Zhang Tingyu eds., Ming History (《明史》), 1739 A.D. Beijing: Zhonghua Publishing, 1999, p. 5649.]

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Y.S. Tai, et al. Archaeological Research in Asia 21 (2020) 100174

A.13. (正德十五年十二月己丑)海外佛朗机，前此未通中国，近岁吞并满剌加，逐其国王，遣使进贡。因请封，诏许来京，其留候怀远驿者，遂略买
人口、盖房立寨，为久居计。满剌加亦尝具奏求捄朝廷，未有处也。会监察御史丘道隆言:满剌加，朝贡诏封之国，而佛朗机并之，且啖我以利，邀
求封赏，于义决不可听。请却其贡献，明示顺逆，使归还满剌加疆土之后，方许朝贡，脱或执迷不悛，虽外夷不烦兵力，亦必檄召诸夷声罪致讨，庶
几大义以明。御史何鳌亦言:佛朗机最号凶诈，兵器比诸夷独精。前年驾大舶，突进广平省下，铳炮之声震动城郭。留驿者，违禁交通，至京者桀骜
争长。今听其私舶往来交易，势必至于争斗而杀伤。南方之祸，殆无极矣。且祖宗时，四夷来贡，皆有年限，备倭官军，防截甚严。间有番舶诡称遭
风飘泊欲图贸易者，亦必核实具奏，抽分如例。夷人获利不多故其来有数。近因布政使吴廷举首倡缺少上供香料及军门取给之议，不拘年分，至即抽
货，以致番舶不绝于海澳，蛮夷杂沓于州城。法防既疏，道路益熟，此佛郎机所以乘机而突至也。乞查复旧例，悉驱在澳番舶及夷人潜住者，禁私
通，严守备，则一方得其所矣。礼部覆议:道隆先为顺德令，鳌顺德人，故备知其情。宜俟满剌加使臣到日，会官译诘佛朗机番使侵夺邻国扰害地方
之故。奏请:处置广东三司掌印并守巡、巡视备倭官不能呈详防御，宜行镇巡官逮问。以后严加禁约，夷人留驿者，不许往来私通贸易。番舶非当贡
年，驱逐远去，勿与抽盘。廷举倡开事端，仍行户部查例停革。诏:悉如议，行之。(《明武宗实录》卷一百四十九)

(13th Jan 1521) Prior to this, the overseas’ Portuguese never contacted China. In recent years, [the Portuguese] conquered Melaka, expelled its
King, and sent a mission to the Ming Court to pay tribute. Because they asked for a title to be conferred upon them, they were allowed to visit the
capital. Those in the Huai Yuan Station started to buy slaves and build houses and a fortress for staying long-term. Although Melaka asked for help, no
action was taken. Now, the Investigating Censor Qiu Daolong requested [in his memorial]: Melaka is our vassal state, the Portuguese attacked it and
wanted to trade with us and requested to be conferred a title. Morally it is not acceptable. Please reject their tribute to show [the difference between]
submission and defiance [of them]. Only if [the Portuguese] return the land of Melaka, will they be allowed to pay tribute. If they refuse, even though
they are foreigners which we need not use military force, we will still request the kingdoms in the region to condemn them, thus delivering a
righteousness message. Censor He Ao (1497–1559) also said [in his memorial]: the Portuguese are famous as the most malicious and cunning (people).
Their weapons are the best among the foreigners. The year before last year, they sailed large boat(s) and intruded into Quang Binh Province (now part
of Vietnam). The sound of cannons shook the city walls. Those who stay at the station break the law by engaging with locals, and those who came to the
capital did not observe social norms and acted in their own arrogant manner. Now if we allow their private ships to trade, it will inevitably lead to
conflict and injury. The problems in the south will be endless. Furthermore, the foreigners pay tribute according to an allocated schedule and the navy
has intercepted and guarded them very closely. Sometimes there are ships that claim to have been struck by a storm, which drift [into the port] and
want to trade, [we will] verify that and report [to the Emperor], imposing a tax as required by the regulations. Because the foreigners have not profited
from it thus they did not come regularly. Recently, due to the lack of incense for the emperor and military expenses, Guangdong Provincial
Administration Commissioner Wu Tingju suggested to tax the cargoes [of ships], regardless of the designated date [of the tributary mission]. It caused
the foreign ships to come endlessly at sea, and large numbers of foreigners appeared in the capital of the province. The laws and defences are slack, and
[the foreigners are] familiar with the routes. This is the reason behind the intrusion of Portuguese. Requests: Check and return back to the original
regulation, and expel the foreign ships at Macau and all foreigners who stay illegally. Do not allow any to engage foreigners, strengthen the defences,
and the region will be all right. The Ministry of Rites replied after discussion: Daolong once was the Magistrate of Shunde County and Ao is a native of
Shunde, therefore they know the details. It is appropriate that when the envoy from Melaka is here, gather the officials and translators to question the
Portuguese envoy about their reason for invading a neighbouring country. Suggestion to the Emperor: Punish the person in charge of the Guangdong
Three Provincial Offices [note: (they are the) Provincial Administration Commissions, Provincial Surveillance Commissions and Regional Military
Commissions], Governor, Grand Coordinator and the Censor Inspecting the Readiness Against Japanese pirates for their inability to mount a proper
defence. Have them arrested and sent to the judge for interrogation. From now on, strictly prohibit foreigners in the station to trade with locals. Foreign
ships [that come to China] outside the designated seasons of the tribute year will be turned back and not taxed. Tingju caused this problem, the Ministry
of Revenue removed [him] from the office in accordance with the regulation. [The Emperor] ordered: As requested, implement.
[Xu Guangzuo (?-1526) eds., Veritable Records of Ming Dynasty Emperor Wuzong (《武宗实录》), 1525 A.D., juan 194, p. 2b-3a. Taipei: Institute of
History and Philology, Academia Sinica, 1964, Vol. 69, p. 3630-3631.]

A.14. (嘉靖八年十月己巳)初，佛朗机火者亚三等既诛，广东有司乃并绝安南、满剌加。诸番舶皆潜泊漳州，私与为市。至是，提督两广侍郎林富疏
其事，下兵部。议言:安南、满剌加，自昔内属，例得通市，载在祖训会典。佛朗机，正德中始入，而亚三等以不法诛，故驱绝之，岂得以此尽绝番
舶?且广东设市舶司，而漳州无之，是广东不当阻而阻，漳州当禁而不禁也。请令:广东番舶，例许通市者，毋得禁绝；漳州则驱之，毋得停舶。从
之。(《明世宗实录》卷一百六)

(7th Nov 1529) After the Portuguese [interpreter] Huo-Zhe-Ya-San (Khoja Hassan) was executed (in 1521), the officials in Guangdong stopped all
trading with Annan and Melaka. Foreign ships secretly berthed at Zhangzhou (in order) to conduct illegal trade. Now, the Supreme Commander of
Guangdong and Guangxi Provinces cum Vice Minister of the Ministry of War Lin Fu file in the case in his memorial to the throne, and it was sent to
the Ministry of War for discussion. It is decided that: Annan and Melaka are vassal states, they are allowed to trade, as stated in the Code of Great
Ming Dynasty. The Portuguese came to China during the Zhengde (1506-1521) reign, and Ya-San was executed for breaking the law, therefore they
were expelled. This should not be used as a reason to block all foreign ships. Furthermore, Guangdong has a Shipping Superintendent Office but
Zhangzhou does not have one. Guangdong is a port which should not ban foreign ships but has banned them, whereas Zhangzhou should ban foreign
ships but has not done so. Please issue an edict: The foreign ships allowed to trade at Guangdong should not be banned. Send them off at Zhangzhou,
do not allow them to berth there. Approved [by the Emperor].
[Zhang Rong, Veritable Records of Ming Dynasty Emperor Shizong (《明世宗实录》), 1577 A.D. juan 106, p. 5a. Taipei: Institute of History and
Philology, Academia Sinica, 1964, Vol. 76, p. 2507.]

A.15. 四十四年，奏设海澄县治，其明年隆庆改元，福建巡抚都御史涂泽民请开海禁，准贩东西二洋。

In 44th year (1565 CE), a memorial to the throne requested to set up the county of Chenghai. The following year (note: early 1567, not 1566
because the Chinese calendar and the Gregorian calendar are not fully overlapping each other), Emperor Muzong (1537-1572) was enthroned. Grand
Coordinator of Fujian Province Tu Zemin requested to lift the sea ban and allow trade in the East Ocean (note: East China Sea and east of South China
Sea eg. Borneo and the Philippines) and the Western Ocean (note: West of the South China Sea eg. Vietnam, Thailand, and Indian Ocean).
[Zhang Xue, An Investigation of Western and Eastern Ocean (《东西洋考》). Beijing: Zhong Hua, 2000, p. 131.]

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Y.S. Tai, et al. Archaeological Research in Asia 21 (2020) 100174

A.16. 凡沿海去处下海船只，除有号票文引许令出洋外，若奸豪势要及军民人等，擅造二桅以上违式大船，将带违禁货物下海前往番国买卖，潜通海
贼、同谋结聚及为向导劫掠良民者，正犯比照谋叛已行律处斩，仍枭首示众，全家发边卫充军。(《大明律集解附例》)

Along the coastal region, ships are allowed to go overseas only if they have a permit. If influential persons, military or civilian, build ships [with
or more than] two masts, bring along banned items to foreign countries to trade, cooperate with pirates to rob or guide them to rob civilians, those
responsible will be prosecuted as traitors and will be decapitated publicly. His whole family will be banished to the outpost as soldiers.
[Anon., The Great Ming Code (《大明律集解附例》), 16th Century, juan 15, p.15a. Taipei: Student Bookstore, 1970, p. Vol.3, p. 1203.]

A.17. (顺治十三年六月癸巳)严禁商民船只私自出海。有将一切粮食、货物等项，与逆贼贸易者……皆论死。凡沿海地方，大小贼船，可容湾泊登岸
口子，各该督抚镇，俱严饬防守……不许片帆入口，一贼登岸。(《清世祖实录》)

(6th Aug 1656) Do not allow traders or civilians to sail on the sea. Anybody caught supplying food and goods to the pirates……will be exe-
cuted…… Every Governor, Grand Coordinator and Grand Defender should setup defences in coastal areas where the pirates may dock……Do not
allow a single sail to enter (the bay], or a single pirate to land.
[Ba Tai ed., Veritable Records of Qing Dynasty Emperor Shunzhi (《清世祖实录》), 1672 A.D., juan 102, p. 7a. Beijing: Zhonghua Publishing 1985,
vol. 3, p. 789.]

A.18. (顺治)十八年，郑成功攻台湾，逐和兰而取其地。诏徙沿海居民，严海禁。(《清史稿》)

Eighteenth year [of the reign of Shunzhi, 1661], Zheng Chenggong attacked Taiwan, expelled the Dutch, and occupied their land. [The Emperor]
ordered: Relocate the coastal residents, enforce the sea ban. [Zao Erxun, Qing History Draft (《清史稿》), 1927, juan 159. Beijing: Zhonghua
Publishing, 1976, Vol. 16, p. 4650.]

A.19. (康熙二十三年)是时始开江、浙、闽、广海禁，于云山、宁波、漳州、澳门设四海关，关设监督，满、汉各一笔帖式，期年而代。……免外国
贡船税，减洋船丈抽例十之三。(《清史稿》)

Since then (1684), the sea ban in Jiangsu, Zhejiang, Fujian and Guangdong was lifted. Four customs posts were set up in Yunshan, Ningbo,
Zhangzhou and Macau. Han and Manchurian Superintendents were appointed [at each customs post], rotating every year……The tributary mission
levy was waived and the foreign ship tax [calculated by length of yard] was reduced by 30%.
[Zao Erxun, Qing History Draft (《清史稿》), 1927, juan 125. Beijing: Zhonghua Publishing, 1976, Vol. 13, p. 3675-3676.]

Appendix B. The BchronDensityFast function

The BchronDensityFast function estimates activity levels for a large set of dates by first drawing a large number of samples (default 2000) from
the probability distribution of each date, and then using the Mclust density estimation procedure (Fraley and Raftery, 2002; Scrucca et al., 2016) to
fit a mixture of univariate normal distributions to the samples. The mclust procedure fits the model via the EM algorithm and so does not produce
estimates of uncertainty in the parameters. It further requires as input the number of individual mixture components; we set this at 30. Some
informal exploration showed that the results were insensitive to this value. The output of the BchronDensityFast model is an estimate, for each age
value, of the activity level measured as a probability density and so summing to 1. This can subsequently be interpreted as showing periods of high
and low relative activity, especially when compared across different groups. By default Bchron only accepts either radiocarbon or normally dis-
tributed dates whereas the present data set contained dates only defined on a uniform interval. For that reason all dates were converted so that the
uniform range was re-expressed as a 99% confidence interval for a normally distributed date. In general, the BchronDensityFast function can be seen
as a more sophisticated density estimation method to that of the SUM functions currently implemented in OxCal (Bronk Ramsey, 1995).

Appendix C. References of excavated sites and shipwrecks shown in Fig. 1

Site name Date range References

1 Jingdezhen (Jiangxi Provincial Institute of Cultural Relics and Archaeology, 2007; Peking University, 2009a)
2 Longquan (Provincial Institute of Cultural Relics and Archaeology, 2005; Peking University, 2009b)
3 Dehua (Fung Ping Shan Museum, 1990; Dehua Kiln Excavation Team, 1979)
4 Tong’an (Du, 2017)
5 Zhangzhou (Fujian Museum, 1998; Yang, 2016)
6 Guangzhou (City University of Hong Kong, 1987)
7 Hai Duong (Aoyagi et al., 2000)
8 Sawankhalok (Hein, 1980; Hein et al., 1981)
Sukhothai
9 Martaban More clues to Martaban jar mystery, 26 Nov 2012. Myanmar Times. Accessed on 25 March 2019.
https://www.mmtimes.com/national-news/3359-more-clues-to-martaban-jar-mystery.html
Possible kiln site for Martaban Jars discovered, November 28, 2012. Southeast Asian Archaeology. Accessed on 25 March
2019.
http://www.southeastasianarchaeology.com/2012/11/28/possible-kiln-site-for-martaban-jars-discovered/
Japan and Myanmar conduct research on ancient pottery kilns in Mon and Kayin States, February 25, 2016. Myitmakha
News Agency website. Accessed on 25 March 2019.
http://www.globalnewlightofmyanmar.com/japan-and-myanmar-conduct-research-on-ancient-pottery-kilns-in-mon-and-
kayin-states/
10 Yangon (Myo and U, 2003)
11 Vung Tau Late 17th century (Christie’s, 1992; Flecker, 1992; Jorg and Flecker, 2001; Nguyen, 1992)

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Y.S. Tai, et al. Archaeological Research in Asia 21 (2020) 100174

12 Binh Thuan Late 16th to early 17th (Pierre Bergé and Associés, 2008; Flecker, 2002b, 2004a, b)
century
13 Hoi An Late 15th to early 16th (Pope, 2007; Ysaguirre et al., 2000)
century
14 Nanhai I c. 12th century (SACH Center of Underwater Cultural Heritage, 2018a, 2018b)
15 Nan’ao I c. 16th century (Guangdong Provincial Institute of Cultural Relics and Archaeology, 2014)
16 San Isidro Late 16th century (Crick, 1997; Cuevas, 1997, 2002; Tan, 2007; Goddio, 1997)
17 San Diego Early 17th century (Crick, 1997, 2000; Cuevas, 1997, 2002; Destoches et al., 1996; Dizon, 2016; Tan, 2007; Goddio, 1994, 1997; Orillaneda,
2002; Valdes and Diem, 1993)
18 Lena Shoal Early 16th century (Goddio et al., 2000a, 2000b, 2002)
19 Royal Captain Shoal Late 18th century (Goddio et al, 2000)
20 Breaker Reef Shoal c. 13th century (Dupoizat, 1995)
21 Pandanan 15th century (Diem, 1997, 1998 - 2001; Loviny, 1998)
22 Investigator Shoal 13th century (Dupoizat, 2007)
23 Tanjong Simpang 11th – 12th century (Sjostrand et al., 2006)
Mengayau
24 Brunei Early 16th century (L’Hour, 2001; Osman, 2015; Perrin, 2000; Pirazzoli-t’Serstevens, 2011; Richards, 2003)
25 Jepara 12th century (Djuana and Edwards McKinnon, 2005)
26 Cirebon Late 10th century (Chiew, 2010; Harkantiningsih et al., 2010; Liebner, 2014)
27 Karawang 10th century (Liebner, 2014)
28 Intan 10th century (Flecker, 2002, 2005)
29 Bakau 15th century (Flecker, 2001)
30 Belitung Late 9th century (Chong, 2017; Flecker, 2000; Krahl and Effeny, 2010)
31 Tek Sing Early 19th century (Nagel Auctions, 2000; Pickford, 2002)
32 Pulau Buaya 12th century (Ridho and Edwards McKinnon, 1998)
33 Hatcher Junk Early 17th century (Christie’s, 1984, 1985; Sheaf and Kilburn, 1988)
34 Desaru Early 19th century (Brown and Sjostrand, 2004; Sjostrand et al., 2006)
35 Turiang Late 14th century (Brown and Sjostrand, 2000; Sjostrand and Barnes, 2001)
36 Nanyang Mid 15th century (Brown and Sjostrand, 2004; Sjostrand et al., 2006)
37 Royal Nanhai Mid to late 16th cen- (Brown and Sjostrand, 2004; Sjostrand et al., 2006)
tury
38 Longquan Mid 15th century (Brown and Sjostrand, 2004; Sjostrand et al., 2006)
39 Singtai 16th century (Brown and Sjostrand, 2004; Sjostrand et al., 2006)
40 Diana Early 19th century (Ball, 1995; Christie’s, 1995)
41 Trowulan (Mundardjito, 1986)
42 Borobudur (Miksic, 1990)
43 Palembang (Edwards McKinnon, 1979; Taim, 1992)
44 Padang Lawas (Perret and Surachman, 2014)
45 Barus (Dupoizat, 1998, 2003)
46 Kota Cina (Edwards McKinnon, 1975, 1976, 1977; Milner et al., 1978)
47 Kedah (Peacock, 1958)
48 Takuapa (Lamb, 1961, 1964)
49 Andhra Pradesh (Karashima, 2004)
50 Periyapattinam (Karashima, 1989, 2004)
51 Mantai (Karashima, 2004)
52 Yapahuwa (Carswell, 1978)
53 Quilon (Karashima, 1989)
54 Hormuz (Morgan, 1991)
55 Qais (Kish) (Shih, 2001; Whitehouse, 1976)
56 Siraf (Tampoe, 1989; Whitehouse, 1971, 1972, 1973, 1974)
57 Samarra (Gyllensvard, 1973)
58 Karbabad (Bahrain (Kervran et al., 1982)
Fort) Zhao, B. 2011. 16th–17th centuries Chinese and Southeast Asian ceramics from Qal'at al-Bahrain.
https://www.researchgate.net/publication/279253372_16_th_-17_th_centuries_Chinese_and_Southeast_Asian_ceramics_from_
Qal%27at_al-Bahrain
59 Julfar (Hansman, 1985)
60 Sohar (Kervran, 1994; Pirazzoli-t’Serstevens, 1988)
61 Abyan (Hardy-Guilbert and Axelle, 1997)
62 Al Qarawi (Hardy-Guilbert and Axelle, 2016; Lane and Serjeant, 1948)
63 Fustat (Mikami, 1980 - 1981)
64 Aydhab (Hobson, 1928)
65 Sa’ad ad-Din (Curle, 1937)
66 Berbera (Chittick, 1976)
67 Mogadishu (Murdoch, 1959; Zhao, 2015)
68 Kismayo (Elliot, 1925; Wilson, 1984)
69 Coiama (Chittick, 1969; Elliot, 1926; Sanseverino, 1983)
70 Lamu, Pate, Manda (Chittick, 1984; Horton, 1996; Wilson and Omar, 1997)
71 Mambrui, Malindi, (Kirkman, 1958; Pradines, 2004, 2006, 2009, 2010; Pradines and Blanchard, 2005; Qin et al., 2012)
Gede
72 Kilifi, Mnarani, (Kirkman, 1959; Sassoon, 1980)
Mombasa
73 Unguja Ukuu (Chittick, 1966; Horton and Clark, 1985)
74 Dembeni (Pradines, 2013; Pradines and Brial, 2012)
75 Vohemar (Gaudebout and Vernier, 1941a, 1941b; Molet, 1974; Schreurs et al., 2011; Vernier and Mulot, 1971)
76 Sofala (Dickinson, 1975)
77 Great Zimbabwe (Duffey, 2008; Garlake, 1973)
78 Mapungubwe Hill (Gardner, 1963; Prinsloo et al., 2005)
79 Cape Town (Klose, 1997;)

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 The Asian Journal of Shipping and Logistics 35(4) (2019) 172-180

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The Asian Journal of Shipping and Logistics

Journal homepage: www.elsevier.com/locate/ajsl

Port Maritime Connectivity in South-East Indonesia: A New Strategic Positioning for

Transhipment Port of Tenau Kupang

RUMAJIa, Ana ADILIYAb

a
Airlangga University, Indonesia, Email: wjrrumaji@gmail.com (Corresponding Author)
b
Senior Port Officer , PT. Pelindo III, Indonesia, Email: ana.adeliya@pelindo.co.id

ARTICLE INFO ABSTRACT

Article history: Indonesia faces a number of crucial issues regarding cargo distribution in terms of the availability
Received 13 November 2018
of infrastructure, shipping patterns, supply and demand of maritime transport including port
Received in revised form 11 November 2019
Accepted 30 November 2019 connectivity. The aim of the present article is to examine and explore the scenarios for maritime
access through the Eastern-Indonesia. In this study, we address the issue of high logistics costs and
Keywords: price disparity between the Western and Eastern regions of Indonesia. There are three scenarios has
Strategic Position been constructed, in which Scenarios I and II apply a multi-port-calling networks based on the
Tenau Kupang implementation of the Sea Toll Programme in Indonesia, while scenario III uses a hub-and-spoke
Multi-port-calling Networks
network by involving the port of Tenau Kupang-East Timor Province as a transhipment port of
Hub-and-Spoke Network
Indonesia container distribution from the port of Tanjung Perak to the South-East of Indonesia. As the result,
scenario III generates the lowest total shipping costs. In other words, involving the port of Tenau
Kupang as a transhipment port can help to reduce total shipping costs. Finally, the selected scenario
become a recommendation for shipping practices to find the best solutions to improve the eastern
connectivity in Indonesia. Moreover, the result also will encourage the government and port
authority to take a consideration in re-configure Tenau-Kupang port infrastructure to become
transhipment port thus can attract the cargo volume.

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1. Introduction

Indonesia is an archipelagic country with an abundance of natural
resources, located strategically between the Indian and the Pacific oceans,
with approximately two-thirds of its area being the seas. Currently,
Indonesia faces a number of crucial issues regarding cargo distribution in
terms of the availability of infrastructure, shipping patterns, supply and
demand of maritime transport including port connectivities, which
requires an advanced and reliable maritime transport system.
In addition, Indonesia also faces an imbalanced economic situation
between its Western and Eastern regions which is proved by the share of
GDP. More than 80 percent of GDP is produced by the Western regions

http://dx.doi.org/10.1016/j.ajsl.2019.12.004

2092-5212/© 2019 The Korean Association of Shipping and Logistics, Inc. Production and hosting by Elsevier B.V.
Peer review under responsibility of the Korean Association of Shipping and Logistics, Inc.
 Port Maritime Connectivity in South-East Indonesia: A New Strategic Positioning for Transhipment Port of Tenau Kupang
while Eastern regions contribute only less than 20 percent (Central
Statistical Bureau of Indonesia, 2016). Cargo distribution is one of the
major problems that held back some regions especially in the East region
of Indonesia from economic development. This issue creates the price
disparity between both of the regions where price in the Eastern regions is
higher than in the Western regions.
Nowadays, the Indonesian government is trying to implement the
design of sea toll road programme in order to address several issues
related to the distribution of cargo and to decrease price disparities. The
design involves 24 strategic ports spread out from the west to the east of
Indonesia.
Fig. 1. Sea toll road in the medium-term development plan 2015-2019
Source: Ministry of National Development Planning (BAPPENAS), 2015
During 2015-2019, the Indonesian government has been focused on
developing 24 strategic ports for the new facilities and upgrading their
capacity. However, the price disparity problem as a result of the higher
logistics costs in Indonesia has to be solved as soon as possible. Therefore,
the government of Indonesia took initiative to implement the sea toll
programme in 2016 and 2017.
The Sea toll road programme of 2016 and 2017 used the concept of
direct network connecting the hub port to sub-feeder ports or multi-port-
calling network. The port of Tanjung Perak was appointed as one of the
main ports in the western part of the country to serve as an origin port for
distributing cargo to the eastern regions of Indonesia. Referring to the
master plan of sea toll road programme to be implemented in 2019, the
concept that should be operated is a hub-and-spoke network where the
feeder port has a major role of connecting port between the hub port and
the sub-feeder ports. This concept allows the use of larger sized vessels
that are expected to reduce operating costs because of the ability to create
economies of scale.
In line with the issues described, this article will analyse the efficiency
in terms of the shipping costs for distributing cargo under the
implementation of sea toll road programme of 2016 and 2017. This thesis
will be focused on the routes starting from the Tanjung Perak port since
this port has an important role of the gateway to the eastern regions of
Indonesia. Furthermore, this paper also suggests another potential route by
involving the Port of Tenau Kupang as a feeder port using the hub-and-
spoke network. Since the feeder port in Indonesia acts as a connecting
port between the hub port and the sub-feeder port, Tenau Kupang port will
have a function of a transhipment port in this study. The main idea behind
this consideration is that Tenau Kupang port as one of the 24 national
strategic ports involved in the master plan of the 2019 sea toll road
programme. In other words, through implementation this research, it will
be possible to quickly align between the current sea toll routes and the
master plan of the 2019 sea toll road programme. Furthermore, as this
study is in line with the National Development Planning, it may be
possible to accelerate and expand the economic development in Indonesia
by strengthening domestic connectivity.
173
2. Literature Review
2.1. Hub-and-Spoke vs. Multi-Port-Calling Network
Imai et al. (2006) noted an interesting phenomenon - rapid growth in
ship size leads to changes in the service network from multi-port-calling
to the hub-and-spoke network. Over the past few years, there has been an
unprecedented increase in the number of container ships serving the
world's most densely packed maritime routes. This can be attributed to the
fact that a more flexible and widespread form of cooperation has emerged
in the maritime industry, 'The global alliances', which are so dominant on
the main routes, have proven to be very successful in gaining the
economies of scale achieved through the use of larger vessels. The hub-
and-spoke (H&S) network entails using a mega-containership and the
multi-port-calling system (MPC) is operated using smaller containerships
(Imai et al., 2009).
Fig. 2. Service networks
Source: Imai et al., 2009
A port might have a function of a regional port for one liner shipping
operator or a function of a feeder port for another one (Notteboom &
Rodrigue, 2008). Driven by economic factors, the port developed into two
port types namely the hub port that serves the mother vessels, and the
secondary port or commonly called the port 'spoke' (Mourao, et al., 2002).
When the hub and spoke system was created, the feeder or land
transportation mode moved the cargo to and from the hub port and used
the port to consolidation transport flows. The low volume of goods
transported between certain ports and the high fixed costs incurred by the
vessels encouraged more intense use of this hub and spoke system
(Mourao, et al., 2002). Mulder & Dekker (2014) made a distinction
between the main services and the feeder services. The feeder services are
used to ship the cargo from the cluster centre in one cluster to the other
ports in the same cluster.
Fig. 3. The fundamental hub and spoke maritime network
Source: Hsu & Hsieh, 2007
A hub-and-spoke network is a network pattern that has one or more
ports that serve as a hub port in the destination area based on the
geographical location and demand for shipping items (Hsu & Hsieh,
2007). Major ports are frequently selected as hub ports, and the other ports
act as feeder ports or spoke ports. The cargo transported is consolidated at
the port hub and then delivered by the larger vessels that provide inter-hub
174 Port Maritime Connectivity in South-East Indonesia: A New Strategic Positioning for Transhipment Port of Tenau Kupang
port services in both areas. Meanwhile, to provide services between port
hubs and small ports small vessels (feeder vessels) are used. Figure 3
illustrates the fundamental hub-and-spoke maritime network. In their
study, Hsu & Hsieh (2007) explained that each region has one or more
hub ports (p3, p4, p5 and p6) and other ports act as feeder ports (p1 and
p2). A container can be shipped directly from a feeder port in the region
of origin to a hub port in the region of destination directly or have it
transported through the hub port at the region of origin by routing the
feeder line and then the main line.
2.2. Sea toll road programme 2016
In 2016, the Indonesian government adopted a strategy defining six
routes connecting the main ports with sub-feeder ports located on the
small islands of the country. These routes started in early 2016 and were
operated by PELNI, a state-owned enterprise. The six predefined routes
mentioned in the Decree of the General of Sea Transportation Number:
Al.108/7/8/DJPL-2015 as follow.
Fig. 4. Sea toll road programme of 2016
Source: Ministry of Transportation, 2016
2.3. Sea toll road programme 2017
In the beginning of 2017, the Indonesian government decided to change
the routes after evaluating the implementation of Sea Toll Road
Programme in 2016. Several routes were added so the total number of the
routes increased to 13. Four of the routes were a change from the previous
route. The government found on the routes established in 2016, the ships
had to sail over very long distances for a very long time so that had to
change.
Fig. 5. Sea toll road programme of 2017
Source: Modified from Ministry of Transportation, 2017
In 2017, the Indonesian government also stipulated the type of the ships,
the route involving the main ports and sub-feeder ports, the sailing
frequency and the maximum time required by a ship to sail. Besides the
number of routes, the main item that distinguishes the programme from
the previous year is that the Indonesian government allowed the private
shipping companies to participate by serving some certain routes which
cannot be handled by PELNI because they do not have the facilities. The
government opened bidding process to assess the private shipping
company that has capability to serve the certain routes.
3. Methodology
A fundamental hub-and-spoke and multi-port-calling network are taken
into account in this study. Container shipping services are provided by the
carrier between two regions separated by the ocean. Since the design of
the hub-and-spoke model in Indonesia is slightly different from the
common model introduced by several researchers in earlier work, we
adapted the model by involving sub-feeder ports as part of the hub-and-
spoke network. If the distribution of goods is conducted from hub to hub
and then will be distributed to the feeder port, in this study we will
analyse the distribution of goods from the hub port to the feeder port and
then to the sub-feeder port. In that case the function of the feeder port in
this study is one of a transhipment port. In section 3.1, a mathematical
model for shipping cost functions is defined. Shipping costs consist of
operating costs that are based on time charter rates, fuel consumption
costs, port dues and cargo-handling fees on the route being served.
Section 3.1.1 further determines shipping cost functions for multi-port-
calling networks, followed by the hub-and-spoke network in section 3.1.2.
The assumptions are explained in section 3.2.
3.1. Shipping cost function
Based on Stopford (2009), shipping costs can be calculated as a sum of
capital costs, operating costs, periodic maintenance costs, voyage costs
and cargo handling costs. In this research, we consider that the ship is
hired by using a time charter arrangement with the charter rate in Dollar
per day (US$/day). Further, we change capital costs, operating costs and
periodic maintenance costs by applying the time charter rate in unit
dollars per day (US$/day), thus shipping costs is a sum of time charter
rate, fuel costs, port dues and cargo handling costs as shown in the
following formula:
ை ி ை೟
‫ܥ‬ௌ௠ ൌ  σ௜ ቂߙ௜௧ ൅  ܱ௧ ܹ௜ ൅  ‫ܨ‬௜௧ ൅ ‫ܦ‬௜௠ ቀ ೟ ൅ ೟ ቁቃ ൅ σ௜ σ௝ ቂቀߚ௜ ൅ ቁ ܲ௜௝ ቃ [1]
௏೟ ௏೟ ோ೔
Subject to
ߙ௜௧ ൌ  σ௜ ݈ܲ௜௧ ൅ ܶ‫݋‬௜௧ ൅  ‫ܮ‬௜௧ ൅  ‫ܤ‬௜௧ 
Where:
m route
i port of origin on route m
j port of destination on route m
t type of ship
ߙ௜௧ fixed portion of port i charge for a ship of type t (US$)
ܱ௧ average daily charter rate for a ship of type t (US$/day)
ܹ௜ time a ship spends on the arrival and departure process in port i
‫ܨ‬௜௧ fuel cost in port i by a ship of type t (US$)
‫ܦ‬௜௠ shipping distance between port i and port i + 1 on route m
ܸ௧ service speed for a ship of type t (knot)
‫ܨ‬௧ fuel cost at sea for a ship of type t (US$)
ߚ௜ average handling fee per TEU in port i (US$ per TEU)
ܴ௜ average gross handling rate in port i (TEU per day)
ܲ௜௝ the number of containers shipped between port i and port
 Port Maritime Connectivity in South-East Indonesia: A New Strategic Positioning for Transhipment Port of Tenau Kupang 175

݈ܲ௜௧ pilotage for a ship of type t (US$) We construct three constraints in order to gain the objective of this
ܶ‫݋‬௜௧ towage for a ship of type t (US$) study. Firstly, we develop connectivity constraint, equation [8] depicts
‫ܮ‬௜௧ anchoring fee for a ship of type t (US$) that ship sails from port i to port j (1) or not (0). Equations [9] and [10]
‫ܤ‬௜௧ berth occupancy charge for a ship of type t (US$) indicate that the sum of travelling routes should be equal or more than 1,
‫ܩ‬௜ loading and unloading fee (US$/box)
since this multi-port-calling model is used to capture the shipping costs in
The objective of the proposed model is to minimise shipping costs. The the implementation of the sea toll road programme of 2016 and 2017
fixed component (Ȧ௠ ௧ ሻand the variable shipping cost (߶௧ ሻfor ship type t
௠
where a vessel is allowed to visit port more than once in one route
on route m can further be denoted by simplifying the variables as: (pendulum service).
Due to the fact that the number of the container discharged at
ை ி
Ȧ௠ ௠ ೟ ೟
௧ ൌ σ௜ ቂߙ௜௧ ൅  ܱ௧ ܹ௜ ൅  ‫ܨ‬௜௧ ൅ ‫ܦ‬௜ ቀ ൅ ቁቃ ௏೟ ௏೟
[2] destination ports are from the port of Tanjung Perak as a port of origin, we
formulate the equation [11] that illustrates that the number of containers
ఉ೔೟ ை
߶௧௠ ൌ  σ௜ σ௝ ቂቀ‫ܩ‬௜ ൅
ோ೔
൅ ೟ ቁ ܲ௜௝ ቃ
ோ೔
[3] discharged at the destination port should be equal to the total demand in
Furthermore, the shipping cost equation can be simplified as this port. The similar way is applied to equation [12], the total number of
containers loaded at the port of origin should be equal to the total supply
‫ܥ‬ௌ௠ ൌ  Ȧ௠ ௠
௧ ൅  ߶௧ [4] in this port. The last constraint of cargo allocation is shown in equation
[13], where the number of containers should be equal or more than zero
The shipping cost function as denoted in equation [1] and simplified in
and must be an integer. It means that the number of containers should
equation [4] is a basic formula to calculate the total shipping costs in the
excel sheet. Moreover, we use unit cost (Cij) as the variable cost of one- have a positive value.
unit container (TEU). Unit cost for every route within arc (i, j) derived by Ship capacity constraint delineates that the number of containers
dividing the total variable shipping cost ሺ߶௧௠ ሻ by the number of containers carried from the port of origin to the destination port should be less than
carried from origin to destination (Pij). While, the fixed cost or equal to the maximum ship capacity (TEU).
௧ ሻdependent on the type of ship and route (Xij). Hence, we formulate
(Ȧ௠
the objective function [5] to determine the minimum shipping costs of 3.1.1 Shipping Cost Function for Hub-and-Spoke Network
distributing cargo on a certain route, as follows:
In order to formulate the hub-and-spoke network, we consider
‫ ݊݅ܯ‬σ௜ǡ௝‫א‬ே σ௖‫א‬஼ σௗ‫א‬஽ൣܲ௜௝ ‫ܥ כ‬௜௝ ൧ ൅  σ௜ǡ௝‫א‬ே Ȧ௠
௧ ‫ܺ  כ‬௜௝ [5] combining the costs in two lines, i.e. main line (h) and feeder line (s).
Moreover, the minimum shipping costs are derived from the minimum
3.1.1 Shipping Cost Functions for Multi-Port-Calling Network sailing frequency, indicating the use of the bigger vessel capacity. Since
the number of containers carried on a ship cannot exceed its capacity on
In order to figure out the total shipping cost for a multi-port-calling any route, the sailing frequency must be equal to the maximum network
network, we construct the formula that refers to equation [4] and flow (Maxk). The minimum sailing frequency (f) can be formulated as:
substitutes the number of sailing frequencies on a certain route (f) per year
௠௔௫
‫ܥ‬ௌௗ = Ȧ௠ ௠
௧ ൅ ߶௧ ೖ σ೔ σೕ ഃ೓ ೓
೔ೕೖ ೂ೔ೕ
݂ ൌ ݂௧௛ି௠௜௡ ൌ  [15]
= ˆȦ௠
௧ ൅ ߶௧௠ [6] ௎೟

ை ி ை
= ݂ σ௜‫א‬ே ቂߙ௜௧ ൅ ܱ௧ ܹ௜ ൅  ‫ܨ‬௜௧ ൅ ‫ܦ‬௜௠ ቀ௏೟ ൅ ௏೟ ቁቃ ൅ σ௜‫א‬ே σ௝‫א‬ே ቂቀߚ௜ ൅ ோ೟ ቁ ܲ௜௝ ቃ [7] Where:
೟ ೟ ೔

The objective function refers to equation [3] and substitute the number of ݂௧௛ି௠௜௡ the minimum sailing frequency w.r.t. to a ship type t on the
sailing frequency (f), subject to: main line
݉ܽ‫ݔ‬௞ maximum network flow
Connectivity constraint ௛
ߜ௜௝௞ the binary variable
௛
݆ܺ݅ ‫  א‬ሼͲǡͳሽ [8] ߜ௜௝௞ =1, if route from port i to j contains a link between port k
σ௜‫א‬ே ܺ௜௝ ൒ ͳ‫ܰ א ݆׊‬ [9] and k+1
௛
σ௝‫א‬ே ܺ௜௝ ൒ ͳ‫ܰ א ݅׊‬ [10] ߜ௜௝௞ =0, otherwise
௛
Cargo allocation constraint: ܳ௜௝ Flow from port i to j on the main line per season (TEU)
σ௜‫א‬ே ܲ௜௝ ൌ ‫ܦ‬௝ ‫ܰ א ݆׊‬ [11] ܷ௧ Ship’s capacity (TEU) given by the Indonesian government
σ௝‫א‬ே ܲ௜௝ ൌ ܵ௜ ‫ܰ א ݅׊‬ [12]
Then the minimum shipping cost on the main line can be represented as
ܲ௜௝ ൒ Ͳܽ݊݀݅݊‫݅׊ݎ݁݃݁ݐ‬ǡ ݆ ‫ܰ א‬ [13] ௛
‫ܥ‬ௌǡ௧ . Substituting formula [15] into formula [4] leads to the following
Ship capacity constraint equation.
σ௜ǡ௝‫א‬ே ܲ௜௝ ൑ σ௧‫ܷ ்א‬௧ ܺ௜௝ [14]
௠௔௫ ೓ ೂ೓
ೖ σ೔ σೕ ഃ೔ೕೖ
௛ ೔ೕ
‫ܥ‬ௌǡ௧ ൌ Ȧ௠ ௠
௧ ൅  ߶௧
Where: ௎೟
௠௔௫
ೖ σ೔ σೕ ഃ೓ ೓
೔ೕೖ ೂ೔ೕ
Xij binary variable ൌ ௎೟
ை
௏
೟
ி
௏೟ ோ
ை
σ௜‫א‬ே ቂߙ௜௧ ൅ ܱ௧ ܹ௜ ൅  ‫ܨ‬௜௧ ൅ ‫ܦ‬௜௠ ቀ ೟ ൅ ೟ ቁቃ ൅ σ௜‫א‬ே σ௝‫א‬ே ቂቀߚ௜ ൅ ೟ ቁ ܲ௜௝ ቃ
೔
[16]
1 = if ship sails from port i to port j using ship of type t
We denote total shipping costs as TCs of the main line (h) and feeder line
0 = otherwise
(s).
N all nodes on route m ௛ ௦
ܶ‫ܥ‬௦ ൌ ‫ܥ‬ௌǡ௧ ൅  ‫ܥ‬ௌǡ௧ [17]
D_j total demand of the container (TEU) at port j
S_i total supply of the container (TEU) from port i
U_t maximum TEU capacity of ship type t per voyage
176 Port Maritime Connectivity in South-East Indonesia: A New Strategic Positioning for Transhipment Port of Tenau Kupang
3.2. Assumption
In this section, we introduce several assumptions used in this research to
simplify the calculation and derive the goal of this study. These
assumptions can be explained as follows:
1. The demand and supply come from 16 domestic ports based on the
average total container loading and unloading for each port over the
last five years. The ports that are involved in the sea toll road
programme of 2016 and 2017 include such ports as Tanjung Perak,
Wanci, Namlea, Fak-Fak, Kaimana, Timika, Kalabahi, Saumlaki,
Moa, Dobo, Merauke, Larantuka, Loweloba, Sabu, Rote and
Waingapu.
2. The port of Tenau Kupang is proposed to be a transhipment port that
can handle the total number of containers from the Port of Tanjung
Perak before being deployed to the destination ports.
3. We consider using time charter vessels with the daily charter rate in
Dollar per day (US$/day) to cover the capital costs, operating costs
and periodic maintenance costs. Hence, shipping costs in this study is
a sum of time charter rate, fuel costs, port dues and cargo handling
costs.
4. This study only takes into account the containers that carry staple and
essential goods.
3.3. Research Methodology Scheme
We develop three scenarios, two of them being based on the Sea Toll
Road Programme of 2016 and 2017, while the last scenario is based on
the proposed network which assumes involving the port of Tenau Kupang
as a port pairing of Tanjung Perak port that serves as a transhipment port.
a. Scenario I based on the 2016 sea toll road programme
1) Tanjung Perak – Wanci – Namlea – Fak-Fak – Kaimana – Timika
– Kaimana – Fak-Fak – Namlea – Wanci – Tanjung Perak
2) Tanjung Perak – Kalabahi – Moa – Saumlaki – Dobo – Merauke –
Dobo – Saumlaki – Moa- Kalabahi – Tanjung Perak
3) Tanjung Perak – Larantuka – Lewoleba – Rote – Sabu – Waingapu
– Sabu – Rote – Lewoleba – Larantuka – Tanjung Perak
b. Scenario II based on the 2017 sea toll road programme
1) Tanjung Perak – Wanci – Namlea – Wanci – Namlea - Tanjg Perak
2) Tanjung Perak – Fak-Fak – Kaimana – Timika – Kaimana – Fak-
Fak – Tanjung Perak
3) Tanjung Perak – Kalabahi – Moa – Saumlaki – Moa - Kalabahi –
Tanjung Perak
4) Tanjung Perak – Dobo – Merauke – Dobo –Tanjung Perak
c. Scenario III is based on the proposed network to involve the port of
Tenau Kupang as a transhipment port.
At the next step of the research we construct two fundamental networks,
namely, the multi-port-calling (MPC) and the hub-and-spoke (H&S)
networks. The scenario I and II apply multi-port-calling network and the
scenario III using hub-and-spoke network. At this step, we calculate the
total shipping costs per each route by using the equation [1]. The shipping
costs are the sum of time charter rates, fuel costs, port charges and
container handling costs. Moreover, we divide the shipping cost into two
types of forms which are cost fixed cost and variable cost. Afterwards, we
determine the objective function by minimising the total shipping costs.
The following data are required as inputs in this research:
1. To analyse the implementation of the Sea Toll Road Programme of
2016 and 2017, the following data from the government regulation
Number: AL.108/1/9/DJPL-17 is required:
a. The routes
b. The number of ports involved on the route
c. The number of sailing frequency
d. The maximum travel time
e. The type of vessel and maximum capacity (TEU)
2. The demand and supply are reflected in the number of the containers
loaded and unloaded at the ports is derived from the Tanjung Perak
port report over the last five years.
3. To determine the components of total shipping costs, we obtain data
from the Ministry of Transportation and Pelindo III corporation as our
respondents, the type of data is mentioned below:
a. Port facilities
b. Port classification
c. Port operation performance
d. Port dues
e. Terminal handling charge
4. Additional data required are obtained from:
a. The government Regulation (for the data on the distance between
the ports in scenarios I and II);
b. Websites http://www.searoutes.com and http://ports.com (for the
data on the distance between the ports in scenario III);
c. Indonesian Classification Agency (BKI register). The data
necessary for the regression formula to determine the
classification of the ship was collected from the list of
specifications of container ships registered by this agency;
d. The Maersk Broker 2015 (for the data on the time charter);
e. Shell Indonesia (which provided information on the fuel price);
f. Central statistical bureau of Indonesia;
g. Ministry of National Development Planning
4. Profile of Tenau Kupang Port
4.1. Tenau Kupang Port
The port of Tenau Kupang is located in the East of Nusa Island. It is
considered to be the main class port under the management of Pelindo III
Corporation (Ministry of transportation Regulation, 2016). The Tenau
Kupang port also manages three regional ports: Waingapu, Kalabahi and
Ende/Ippi. Two of these ports, Waingapu and Kalabahi, are involved in
the route of the Sea Toll Road Programme.
The Tenau Kupang port consists of four terminals: the Multiguna
terminal, the Nusantara terminal, the Local terminal and the multipurpose
terminal. In addition, the local port authority has just developed new
berthing facility in the area of the port of Tenau Kupang with the length of
125 meter, and it is currently under approval from the Ministry of
Transportation to be operated by Pelindo III Corporation. It means that the
port of Tenau Kupang has an additional capacity to serve the loading and
unloading activities.
Figure 6. Layout of Tenau Kupang port
Source: Google earth, 2017
The port of Tenau Kupang is the main port in the Eastern region of
Indonesia as its container flows continues to grow over the past eight
years
 Port Maritime Connectivity in South-East Indonesia: A New Strategic Positioning for Transhipment Port of Tenau Kupang 177

variable cost. Starting with the fixed cost, we manually input 1 or 0

into the Table of connectivity (Xij). 1 (one) indicates that there is
connectivity between a port and the next port. If there is no
connectivity, we input 0. The connectivity is followed the routes as
stipulated by the government of Indonesia. The fixed costs ሺȦ௠ ௧ ) is
based on the type of the ship used. Afterward, we multiply the Table
of connectivity (Xij) and the Table of fixed cost ሺȦ௠
௧ ).

Table 1.
The type of the ship used in the sea toll road programme
Name of DWT GT Capacity ME AE Vt Type of
Vessel (Ton) (Ton) (TEU) (HP) (HP) (Knot) ship
Figure 7. Container traffic at the port of Tenau Kupang MV Mentari
5,314 4,303 192 4,168 1,331 11 t1
Source: Annual report of the port of Tenau Kupang, 2017 Freedom
MV Mentari
4,985 4,180 199 3,940 1,313 11 t2
Perdana
MV Caraka
3,650 3,258 135 3,013 1,16 11 t3
5. Result Jaya NI II-22
MV Nusantara
3,106 2,997 115 2,635 1,137 11 t4
This section describes the results of the model analysis used in this Pelangi
research paper. Calling to the previous explanation, we construct three MV Mentari
6,207 4,258 200 4,788 1,324 11 t5
scenarios where Scenario I and Scenario II use the multi-port-calling Perkasa
networks based on the implementation of the sea toll road program in Source: Compiled by Author
2016 and 2017, while Scenario III uses the hub-and-spoke network as
described in the master plan of sea toll road program. The routes in Moreover, since in this study we propose a new route in Scenario III by
Scenario I – sea toll road programme of 2016 and Scenario II – sea toll involving the port of Tenau Kupang as a feeder port that serves as a
road programme of 2017 have been stipulated by the Indonesian transhipment hub connecting the main port (i.e. the port of Tanjung Perak)
government, so we follow these routes in order to calculate total shipping with the many sub-feeder ports, we need to determine the ship size used to
costs. Meanwhile, we build the routes in Scenario III by involving the port carry the number of containers from Tanjung Perak port to the port of
of Tenau Kupang as a transhipment port. As described before, the port of Tenau Kupang. To address with this problem, we use a regression formula
Tenau Kupang is set up as a feeder port and is connected with the main as can be seen in Appendix 1, where we can use the range of DWT to
port (i.e. the Port of Tanjung Perak) according to the master plan of the express the size of the ship including the gross tonnage (GT), TEU
sea toll road program (Ministry of development planning, 2015). Because capacity, speed, engine power for Main Engine (ME) and Auxiliary
the network in Indonesia recognises the main port, feeder ports and sub- Engine (AE), this calculation is based on the list of the ships and their
feeder ports, Tenau Kupang port as a feeder port has the function of a specifications that already registered with the Indonesia Classification
transhipment port to connect the main port and the sub-feeder ports. We Bureau (BKI).
will compare the results of these three scenarios, and look at which one of
the scenario generates the lowest total shipping costs. Table 2.
In the implementation, all of the containers come from Tanjung Perak Ship specification by ship size
and will be distributed to the several destination ports involved on the Type of DWT Payload GT ME AE Vt
Range of DWT
routes in the different Scenarios. Likewise, containers from the destination Ship (Ton) (TE Us) (Ton) (HP) (HP) (knot)
ports will be carried back merely to the port of Tanjung Perak. This means
ta < 2,000 2,000 80 1,800 1,900 1,000 11
that the vessel will visit all ports selected on the route. However, the
tb 2,000 - 3,000 3,000 160 2,700 2,600 1,100 11
container can merely be uploaded in the destination port. Therefore, in
order to simplify the calculation, we divide the costs into two different tc 3,000 - 5,000 5,000 320 4,500 4,000 1,400 12
types of cost: fixed costs related to the type of ship used and the route, td 5,000 - 7,500 7,500 520 6,800 5,700 1,800 14
while variable costs related to the number of containers. The fixed costs te 7,500 - 10,000 10,000 720 9,000 7,400 2,200 15
cover all the ports visited by the ship (using connectivity between the tf 10,001 - 12,500 12,500 920 11,300 9,200 2,500 t5
ports), while the variable costs merely connect the port of Tanjung Perak Source: Modified from Indonesia Classification Bureau (BKI)
and the destination port.
All scenarios constructed in this research paper use the same demand We require the number of Gross Tonnage (GT) to calculate port dues
and supply data based on container flow projections in 2019. We divide including pilotage services, tugging services, anchoring fees and berth
the total demand and supply by 12 months as we would like to present the occupancy charges, while information on engine power is needed to figure
number of containers transported per voyage. If one ship is not allowed to out fuel consumption both at sea and in the port, allowing us to estimate
carry all the containers demanded by the destination port on one route fuel costs
within a month due to constraints on the type of the ship used, we need 3. We will add this output with the variable cost. We obtain this cost by
more than one ship, whereby the total number of ships used should cover determining the number of container that will be loaded and unloaded
the total number of containers that needs to be transported. Next, we at the ports involved on this route (∑Pij) and multiplying the number
multiply the total number of ships used a month by 12 to find out the of containers with the unit cost (Cij)
annual sailing frequencies. 4. Further, total shipping cost derived by adding the fixed cost and
In order to get a more detailed explanation of our calculation, we will variable cost. Moreover, we also calculate the time travel required for
explain step by step. a ship to sail from the port of Tanjung Perak to the ports of
1. We have to capture the distance among the ports on this route as well destination and returns to the origin port. The total travel time is sum
as the type of the ship where we follow the Indonesian government. of the time at the sea (days) and the port
2. As explained before, we divided the cost into two different type of 5. We also determine the number of vessels are needed per month in
cost: fixed cost (USD) and unit cost (USD/TEU/Nmile) based on order to generate the number of sailing frequencies per year. The
178 Port Maritime Connectivity in South-East Indonesia: A New Strategic Positioning for Transhipment Port of Tenau Kupang

result is one of the factors in determining the total shipping cost per Table 4.
route. As explained before, we divide the total demand and supply by The result of Scenario II
Number of Number of
12 months as we would like to present the number of containers The
Ship's
ships Sailing
Traveling Utilization Total Shipping
Capacity time of Cost per route
transported per voyage. If one ship is not allowed to carry all the Route
(TEU)
needed Frequency
(days) vessel ($)
containers demanded by the destination port on one route within a per month per year

month due to constraints on the type of the ship used, we need more N-1 115 1 12 12 28% 1.347.655
N-13 192 4 48 20 91% 15.122.991
than one ship, whereby the total number of ships used should cover
N-2 200 1 12 16 57% 2.963.685
the total number of containers that needs to be transported N-11 199 4 48 20 84% 16.486.649
6. In addition, we also calculate the utilization of vessel as one of the N-3 135 2 24 14 79% 2.179.808
key factor in determining the effectiveness and efficiency of a vessel Total Shipping Cost 38.090.788
use. We calculate the utilization rate by dividing the total containers
Source: Authors
carried per voyage and the total capacity of a ship used
According to the result in table 2, the level of vessel utilization on the
5.1. Scenario I
route N-1 and N-2 are very low. Moreover, this ineffectiveness potentially
leads to an increase in total shipping costs as we found that the total
We analyse three routes in the first scenario based on the shipping cost in scenario II which reflects to the implementation of the sea
implementation of the sea toll road programme 2016. In scenario I, we toll road programme of 2017 has increased compared to the
have three pendulum routes to be evaluated: implementation in 2016. As mentioned before, the implementation of sea
1. Tanjung Perak - Wanci - Namlea - Fak-Fak - Kaimana - Timika - toll road programme in 2017 is a remedial step executed by the Indonesian
government in improving the implementation of the previous programme.
Kaimana - Fak-Fak - Namlea - Wanci - Tanjung Perak (N1)
2. Tanjung Perak - Kalabahi - Moa - Saumlaki - Dobo - Merauke -
5.3. Scenario III
Dobo - Saumlaki - Moa - Kalabahi - Tanjung Perak (N2)
3. Tanjung Perak - Larantuka - Loweloba - Rote - Sabu - Waingapu - We develop Scenario III on the basis of a hub-and-spoke network. As
Sabu - Rote - Lewoleba - Larantuka - Tanjung Perak (N3) explained before, the Port of Tenau Kupang is part of this scenario. Since
this port, as a feeder port to connect the port of Tanjung Perak to sub-
After calculating all of these networks in scenario I by applying those feeder ports, it has a main function as a transhipment port. The
steps as explain before, we generate the result as follows. calculations made are slightly different from those in Scenarios I and II,
because in this Scenario we have to determine the type of ships used to
Table 3.
carry containers from the port of Tanjung Perak to Tenau Kupang Port
The result of Scenario I
Number Number Moreover, we have to multiply the container handling charges of
Total
Ship's of of Traveling loading and unloading at the port of Tenau Kupang by two. We assume
The Utilization Shipping
Capacity ships Sailing time that the stacking time for the container to be loaded and unloaded at the
Route of vessel Cost per
(Teu) needed Frequency (days)
per month per year
route ($) port of Tenau Kupang is five days. This means that there will be an
N-1 192 4 48 26 95% 15.798.267 additional ten days on a round time. We construct 15 networks in this
N-2 199 4 48 26 98% 16.995.622 Scenario based on the number of sub-feeder ports selected in this study.
N-3 135 2 24 14 79% 2.179.808 The container will be carried from the port of Tanjung Perak and
Total Shipping Cost 34.973.697 transhipped via the port of Tenau Kupang before being delivered to the
sub-feeder ports. The use of a bigger vessel to transport the number of
Source: Authors
containers from Tanjung Perak to Tenau Kupang leads to the achievement
of economies of scale.
5.2. Scenario II
The Table 5 depicts the result of the total shipping cost per network in
scenario III.
Scenario II is constructed, based on the implementation of the sea toll
road program 2017. The number of ports involved in this scenario is the Table 5.
same compared to Scenario I. However, the total networks in this scenario The result of Scenario III
increases to five networks as Networks 1 and 2, that were used in Scenario Ship's Number of ships
Number of
Travelling Utilization
Total
The Name of sailing Shipping
I, are divided into two different networks, while the Network 3 remains Route the Port
Capacity needed per
frequency
time of
Cost per
(Teu) month (days) vessel
the same as it was in Scenario I. The Indonesian government decided to per year route ($)
H&S 1 Wanci 115 1 12 16 18% 1.052.916
change the routes since Networks 1 and 2 involved to many ports in one H&S 2 Namlea 115 1 12 16 10% 1.066.398
network. Scenario II therefore consists of the following five networks: H&S 3 Fak-Fak 115 1 12 18 92% 1.709.060
H&S 4 Kaimana 135 1 12 18 84% 1.705.864
1. Tanjung Perak - Wanci - Namlea - Wanci - Tanjung Perak (N1) H&S 5 Timika 200 3 36 20 79% 8.074.694
2. Tanjung Perak - Fak-Fak - Kaimana - Timika - Kaimana - Fak-Fak - H&S 6 Saumlaki 115 1 12 16 10% 1.075.838
H&S 7 Kalabahi 135 1 12 14 68% 856.503
Tanjung Perak (N13) H&S 8 Moa 115 1 12 16 10% 1.074.570
H&S 9 Dobo 115 1 12 16 88% 1.396.072
3. Tanjung Perak - Kalabahi - Moa - Saumlaki - Moa - Kalabahi - H&S 10 Merauke 200 3 36 20 96% 9.878.574
Tanjung Perak (N2) H&S 11 Larantuka 115 1 12 12 30% 615.557
H&S 12 Lewoleba 115 1 12 12 17% 558.138
4. Tanjung Perak - Dobo - Merauke - Dobo -Tanjung Perak (N11) H&S 13 Rote 115 1 12 12 2% 511.451
H&S 14 Sabu 115 1 12 12 10% 538.235
5. Tanjung Perak - Larantuka - Loweloba - Rote - Sabu - Waingapu -
H&S 15 Waingapu 192 1 12 16 76% 1.144.394
Sabu - Rote - Lewoleba - Larantuka - Tanjung Perak (N3) Total Shipping cost 31.168.264
Our calculations follow the same methodological steps as under Source: Authors
Scenario I. Table 4 shows the results of the total shipping cost in each
Based on the Table 3, the calculation of Scenario III generates the
network in Scenario II. lowest total shipping cost. However, since there are some ports with a low
 Port Maritime Connectivity in South-East Indonesia: A New Strategic Positioning for Transhipment Port of Tenau Kupang 179

number of containers, we consider to create a hub-and-spoke network Scenario II. In contrast, scenario I produces a high level of sailing
with indirect shipments. The main thinking behind this consideration is frequencies compared to other scenarios. The reason for this is that the
that we have to optimise the use of the vessel. We combine these ports in ship has a maximum capacity and should carry the container to several
one route while the other ports which have enough demand remains the ports. While, combining direct and indirect hub-and-spoke network in
same using the direct hub-and-spoke, as follows: Scenario III shows the best result of this study. The hub-and-spoke model
1. Tanjung Perak – Tenau Kupang – Larantuka – Lewoleba – Wanci – allows the use of the bigger sized vessels for container demand from the
Namlea – Wanci – Lewoleba – Larantuka – Tenau Kupang – Tanjung port of Tanjung Perak to the port of Tenau Kupang to achieve economies
Perak (defined as H&S indirect 1) of scale. So, the proposed model by involving the port of Tenau Kupang,
2. Tanjung Perak – Tenau Kupang – Kalabahi – Moa – Saumlaki – Moa
contributes to reduce total shipping costs of container distribution from
– Kalabahi – Tenau Kupang – Tanjung Perak (defined as H&S
the western regions of Indonesia that are represented by the port of
indirect 2)
Tanjung Perak to South-Eastern part of Indonesia.
3. Tanjung Perak – Tenau Kupang – Rote – Sabu – Waingapu – Sabu –
Rote – Tenau Kupang – Tanjung Perak (defined as H&S indirect)
After changing the network by combining these ports that have low References
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Appendix 1. The demand and Supply

Table 8
Total number of containers in TEU (Full)
Name of 2012 2013 2014 2015 2016
the port Supply Demand Supply Demand Supply Demand Supply Demand Supply Demand
DOBO - - - - - - - - 756 2.788
FAK-FAK 203 869 224 908 220 951 120 1.029 254 2.046
KAIMANA 60 2.370 106 2.541 157 2.942 214 3.506 134 3.492
KALABAHI - - - - - - - 1.520 326 2.835
LARANTUKA - - 194 465 145 627 140 638 207 856
LEWOLEBA - - - - - - - - 207 638
MERAUKE 1.236 7.284 1.358 10.442 1.622 10.351 2.055 10.414 2.770 14.022
NAMLEA - - - - - - - - 102 344
ROTE - - - - - - - - 12 66
SAUMLAKI - - - - - - - - 44 344
TIMIKA 824 5.645 694 4.451 1.054 7.481 1.022 6.210 865 10.268
WAINGAPU - - 302 1.546 270 2.184 508 2.378 544 3.300
WANCI - - - - - - - - 207 638
SABU - - - - - - - - 44 344
MOA - - - - - - - - 44 344

Table 9.
Total number of containers contain of staple goods in TEU (Full)
Name of the 2012 2013 2014 2015 2016
port Supply Demand Supply Demand Supply Demand Supply Demand Supply Demand
DOBO - - - - - - - - 219 807
FAK-FAK 59 252 65 263 64 275 35 298 74 592
KAIMANA 17 686 31 736 45 852 62 1.015 39 1.011
KALABAHI - - - - - - - 440 94 821
LARANTUKA - - 56 135 42 182 41 185 60 248
LEWOLEBA - - - - - - - - 60 185
MERAUKE 358 2.109 393 3.024 470 2.997 595 3.015 802 4.060
NAMLEA - - - - - - - - 30 100
ROTE - - - - - - - - 3 19
SAUMLAKI - - - - - - - - 13 100
TIMIKA 239 1.635 201 1.289 305 2.166 296 1.798 250 2.973
WAINGAPU - - 87 448 78 632 147 689 158 956
WANCI - - - - - - - - 60 185
SABU - - - - - - - - 13 100
MOA - - - - - - - - 13 100

 International Journal of Infectious Diseases 47 (2016) 79–82

Contents lists available at ScienceDirect

International Journal of Infectious Diseases

journal homepage: www.elsevier.com/locate/ijid

The annual Hajj pilgrimage—minimizing the risk of ill health in

pilgrims from Europe and opportunity for driving the best prevention
and health promotion guidelines
Shuja Shafi a,*, Osman Dar b,c, Mishal Khan d,e, Minal Khan f, Esam I. Azhar g,
Brian McCloskey h, Alimuddin Zumla i, Eskild Petersen j,k
a
Muslim Council of Great Britain, London, UK
b
Public Health England, London, UK
c
Chatham House Centre on Global Health Security, Royal Institute of International Affairs, London, UK
d
London School of Hygiene and Tropical Medicine, London, UK
e
Saw Swee Hock School of Public Health, National University of Singapore, Singapore
f
Imperial College London, London, UK
g
Special Infectious Agents Unit, King Fahd Medical Research Centre, and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences,
King Abdulaziz University, Jeddah, Saudi Arabia
h
Global Health Department, Public Health England, London, UK
i
Division of Infection and Immunity, University College London, and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
j
Institute of Clinical Medicine, University of Aarhus, Denmark
k
The Royal Hospital, Muscat, Oman

A R T I C L E I N F O S U M M A R Y

Article history: Mass gatherings at religious events can pose major public health challenges, particularly the
Received 8 June 2016 transmission of infectious diseases. Every year the Kingdom of Saudi Arabia (KSA) hosts the Hajj
Accepted 8 June 2016 pilgrimage, the largest gathering held on an annual basis where over 2 million people come to KSA from
over 180 countries. Living together in crowded conditions exposes the pilgrims and the local population
Keywords: to a range infectious diseases. Respiratory and gastrointestinal tract bacterial and viral infections can
Mass agthering spread rapidly and affect attendees of mass gatherings. Lethal infectious disease outbreaks were
Hajj common during Hajj in the 19th and 20th centuries although they have now been controlled to a great
public health
extent by the huge investments made by the KSA into public health prevention and surveillance
prevention
programs. The KSA provides regular updated Hajj travel advice and health regulations through
international public health agencies such as the WHO, Public Health England, the Centers for Disease
Control and Prevention, and Hajj travel agencies. During the Hajj, an additional 25 000 health workers are
deployed; there are eight hospitals in Makkah and Mina complete with state-of-the-art surgical wards
and intensive care units made specifically available for pilgrims. All medical facilities offer high quality of
care, and services are offered free to Hajj pilgrims to ensure the risks of ill health to all pilgrims and KSA
residents are minimal. A summary of the key health issues that arise in pilgrims from Europe during Hajj
and of the KSA Hajj guidelines, together with other factors that may play a role in reducing the risks to
pilgrims and to wider global health security, is provided herein.
ß 2016 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open
access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

1. Introduction disorders related to climate change.1–5 Every year, the Kingdom

Mass gathering sporting and religious events pose important
public health challenges, including the transmission of infec-
tious diseases, exacerbation of non-communicable diseases, and
* Corresponding author.
E-mail address: msshafi12@gmail.com (S. Shafi).
of Saudi Arabia (KSA) hosts the Hajj pilgrimage, which is the
largest mass gathering in the world held on a recurrent annual
basis.3 The Hajj occurs annually from the eighth to the 12th of
Dhul al-Hijah, the last (12th) month of the Islamic calendar,
and two to three million people perform the pilgrimage during
this period.3 A further seven million complete a ‘mini’ pilgrim-
age, known as Umrah, outside the Hajj period throughout
the year.

http://dx.doi.org/10.1016/j.ijid.2016.06.013
1201-9712/ß 2016 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://
creativecommons.org/licenses/by-nc-nd/4.0/).
80 S. Shafi et al. / International Journal of Infectious Diseases 47 (2016) 79–82
In light of the huge number of pilgrims from all around the world –
of which thousands come from low-income countries with minimal
access to healthcare – mixing closely for several days in a difficult
terrain, it is remarkable that the majority of pilgrims complete the
Hajj without experiencing any major health issues. Infectious disease
outbreaks were common during Hajj in the 19th and 20th centuries
and have been controlled to a great extent, although proactive
surveillance of the transmission of potential epidemic threats at Hajj
is critical to preserving global health security.3,5 Crush injuries and
stampedes, which can pose major risks at mass gatherings, are
infrequent during the Hajj relative to its size and logistical
complexity. A summary of the key health issues that arise in pilgrims
from Europe during Hajj and of the KSA Hajj guidelines, together with
other factors that may play a role in reducing the risks to pilgrims and
to wider global health security, is provided herein.
2. Health risks during the Hajj
2.1. Communicable diseases
Respiratory and gastrointestinal tract bacterial and viral
infections spread rapidly and affect almost all pilgrims during
Hajj.6–13 Respiratory tract infections – whose spread through
coughing and sneezing is exacerbated by the crowded Hajj
conditions – include community-acquired pneumonia, influenza,
and tuberculosis (TB). While bacterial and viral pneumonia are
well-documented causes of hospital admission in pilgrims,13
quantifying the increase in risk of TB transmission is more
challenging owing to the longer time period between infection and
the development of symptoms. The elderly and those with
comorbid diseases such as diabetes are particularly vulnerable
to morbidity from respiratory illnesses.
2.2. Gastrointestinal disorders
Acute food poisoning is common during the Hajj and is caused
by toxins produced by Staphylococcus aureus and Bacillus cereus.
Gastroenteritis due to Salmonella spp and viruses such as rotavirus
and norovirus are common during Hajj.3,12 Factors responsible for
increasing the spread of gastrointestinal diseases during Hajj
include contamination of food through unhygienic preparation,
prolonged storage of food, drinking from contaminated water
sources, and a shortage of water for hand washing. The risks of
dehydration are heightened when Hajj occurs during summer
months, owing to the extremely hot climate in Saudi Arabia.14
Other infectious disease risks include meningococcal disease,
which caused outbreaks during Hajj in the early 2000s owing to
overcrowding and high carrier rates of Neisseria meningitidis among
pilgrims.3,15–17 Mosquito species responsible for the transmission of
malaria and the arbovirus that causes dengue are present in the KSA,
although the country has been classified by the World Health
Organization (WHO) as a low, geographically restricted malaria
transmission area since 2008.3
2.3. Non-communicable diseases
Historically, infectious diseases were the largest cause of
morbidity and mortality during Hajj, but non-communicable
diseases are now a major burden.3 Many pilgrims both elderly and
young have existing non-communicable diseases such as diabetes,
hypertension, arthritis, epilepsy, liver and kidney disease, which
can be worsened by strenuous Hajj conditions or if regular
medications are neglected during the spiritual activities. In
addition to cardiovascular disease, heat exhaustion and heatstroke
are important causes of death; again health-related morbidity is
exacerbated when Hajj occurs during the summer months.
2.4. Fire and trauma
The risk of injury from fires has been reduced since tents were
replaced with fibreglass and cooking in tents was prohibited
following a fire in 1997. However, risks from stampedes and crush
injuries remain due to the overcrowding. As the events of the
falling cranes and the stampede in the 2015 Hajj illustrate, trauma
can be a major cause of injury and death during Hajj. Furthermore,
many pilgrims who walk long distances as part of the rituals
invariably are injured by motor vehicles.
3. Factors reducing health risks (Table 1)
Table 1
3.1. Pre-Hajj preparations
The KSA Government employs a well-coordinated, inter-
sectoral approach to the planning, communication, public health,
and safety issues of the Hajj.3 Planning for Hajj starts soon after the
end of the current Hajj and the KSA Ministry of Hajj and Ministry of
Health liaise with the governments of all countries from which
pilgrims come to the KSA. Recommendations discussed are pre-
travel health regulations and advice about vaccinations, health
checks, and specific immunizations at the port of entry. Well before
each Hajj, the Saudi Ministry of Health generates the health
requirements for the issue of travel visas. It also provides health
education campaigns through the provision of reading materials
and through travel agents, pilgrim group leaders, websites, and the
media, both before and during the Hajj.
The KSA Government also provides regular updated Hajj travel
advice and health regulations through international public health
agencies such as the WHO, Public Health England, the Centers for
Disease Control and Prevention (CDC), and Hajj travel agencies.
For the 2015 Hajj, for example, alerts were raised for the prevailing
global threats from Middle East respiratory syndrome coronavirus
(MERS-CoV), influenza and other respiratory tract viruses,
multidrug-resistant TB, multi-antibiotic-resistant bacteria, and
Ebola.18–21,6,22,23
3.2. Measures taken during Hajj
During the Hajj, an additional 25 000 health workers are
deployed; there are eight hospitals in Makkah and Mina complete
with state-of-the-art surgical wards and intensive care units made
specifically available for pilgrims.3 All medical facilities offer high
quality of care, and services are offered free to Hajj pilgrims to
ensure the risks of ill health to all pilgrims and KSA residents are
minimal.
In terms of preventative measures, in addition to the vaccina-
tion requirements described below, measures are put in place to
ensure food safety and the Ministry of Health ensures strict
enforcement of the regulation that pilgrims are not allowed to
bring fresh food or agricultural products into the country. Other
coordinated activities include targeted insecticide spraying to
control mosquito populations, the distribution of health promotion
materials to pilgrims, and electronic surveillance of infectious
diseases.3
3.3. Hajj regulations for incoming pilgrims
The health requirements for pilgrimage to Mecca (Hajj and
Umrah) are published annually by the KSA Government. Informa-
tion for pilgrims is made available on the Saudi Arabia Ministry of
Health website.24–26
 S. Shafi et al. / International Journal of Infectious Diseases 47 (2016) 79–82 81

Table 1
Factors contributing to reducing the health risks from Hajj

Hajj preparation activities, guidelines, and recommendations

Hajj norms and rules
Extensive pre-Hajj activities
undertaken by the KSA
KSA Hajj activities
Areas under development
The elderly, sick, and disabled are exempted from the obligation of performing Hajj
Crime is strictly forbidden during the pilgrimage, reducing the risk of violent altercations
The environment is weapon-free, drug-free, and alcohol-free
Tobacco intake is banned, curtailing the risk of inadvertent fire hazards
Sexual relations are not allowed, and male and female pilgrims are accommodated separately
The Ministry of Health liaises closely with the KSA Ministry of Hajj to ensure entry requirements and Hajj health regulations are
fulfilled
Extensive preparations by the KSA include lessons learned from the previous Hajj; preparations for the Hajj start as soon as
possible after Hajj
Sophisticated command and control centre in place
Free healthcare through numerous hospitals and clinics at all points of the Hajj ritual journeys
The KSA Ministry of Health liaises with and updates all international public health agencies including the WHO, Public Health
England, ECDC, and CDC
Close collaboration with relevant stakeholders (travel agents, Muslim councils, and tour organizers) in the countries where the
pilgrims come from to develop appropriate material for health education
Issuing of vaccination and other health precautions guidelines well before the Hajj and vaccination certificates required prior to
visa approval
Border controls to ensure fresh or unprocessed food is not imported by pilgrims
Ministry of Hajj, Ministry of Public Health, and the Ministry of Agriculture coordinate regular pesticide spraying
An additional 25 000 health workers are deployed specifically for pilgrims
Public health teams stationed through the Hajj site supervise key public health and preventive matters
Screening at port of entry for vaccinations; arrangements for one dose of oral polio vaccine for travellers arriving from polio-
endemic countries and children under 15 years
Proactive command and control centre for Hajj
Use of the electronic health surveillance systems
Strategies to encourage personal hygiene behaviour (beyond educational messaging) for pilgrims and those handling food
Improving guidelines for non-communicable disease control (existing guidelines focus on communicable disease control)

KSA, Kingdom of Saudi Arabia; WHO, World Health Organization; ECDC, European Centre for Disease Prevention and Control; CDC, US Centers for Disease Control and
Prevention.

Meningococcal vaccine is a prerequisite for all pilgrims; Hajj
visas cannot be issued without proof of meningococcal vaccina-
tion. All adults and children aged >2 years must have received a
single dose of quadrivalent A/C/Y/W-135 vaccine and must show
proof of vaccination on a valid International Certificate of
Vaccination or Prophylaxis. Children between 3 months and
2 years of age must show proof of vaccination with two doses of
meningococcal A monovalent vaccine with a 3-month interval
between the doses. Hajj pilgrims need to have had the
meningococcal vaccine 3 years and 10 days before arriving
in Saudi Arabia.
Other vaccination requirements for Hajj pilgrims entering
from specific countries include yellow fever and polio vaccines.
The yellow fever vaccine is mandatory for all travellers arriving
from countries listed by the WHO as being a yellow fever risk.
Polio vaccine is required for travellers arriving from countries that
have polio virus circulating, or from countries at high risk of re-
importation of polio virus, regardless of age and vaccination
status. Those who do not have evidence certificates are immu-
nized at the port of entry.3 The Saudi Ministry of Health
recommends seasonal influenza vaccine for those at increased
risk, such as the elderly and those with chronic comorbidities.24
However, there is conflicting evidence about the efficacy of
influenza vaccine in protecting Hajj pilgrims.27,28 Pneumonia is
among the most common causes of hospital admission during
Hajj,14 and thus the prevention of pneumococcal infection is
crucial. Pneumococcal polysaccharide vaccine is recommended
for pilgrims aged 65 years and for younger pilgrims with
comorbidities.29 Finally, with regard to measles and rubella
vaccines, updating immunization against vaccine-preventable
diseases in all travellers is strongly recommended.
4. Lessons for and beyond mass gatherings
The prevention and management of threats to global health
security and protecting the health and lives of pilgrims requires
effective cooperation between numerous agencies within and
outside the KSA.30 The Hajj can therefore provide important
lessons for setting up and maintaining inter-sectoral collabora-
tions, for example between agencies responsible for health,
transport, border control, and environmental health. The value
of the Hajj experience to planners of mass gatherings in sharing
best practices is evident, but lessons can go beyond mass
gatherings to inform other areas of public health that require
inter-sectoral engagement, such as One Health and the control of
antimicrobial resistance. The Hajj also provides an opportunity for
research, not only into all aspects of mass gatherings, but also into
faith-based health promotion and electronic disease surveillance
capacity building.
Conflict of interest: All authors have an interest in infectious
diseases transmission at mass gatherings.
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Journal of Infection and Public Health (2012) 5, 22—34

Pattern of diseases among visitors to Mina health

centers during the Hajj season, 1429 H (2008 G)
Abdullah G. Alzahrani a,∗, Abdul Jamil Choudhry a,
Mohammad A. Al Mazroa a, Abdul Hafiz M. Turkistani b,
Ghassan S. Nouman c, Ziad A. Memish d

a Field Epidemiology Training Program (FETP), Ministry of Health, Riyadh, Saudi Arabia
b General Directorate Assistant of PHC and Preventive Medicine, Makkah Region, Saudi Arabia
c Faculty of Medicine and Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
d Assistant Agency for Preventive Medicine, Ministry of Health, Riyadh, Saudi Arabia

Received 17 August 2011 ; received in revised form 3 October 2011; accepted 4 October 2011

KEYWORDS Abstract
Hajj; Background: While performing the Hajj, hajjis face different risks related to the
Saudi Arabia; environment, their behaviors and their health conditions that can result in a variety
Disease pattern; of diseases. The objective of this study was to determine the pattern of diseases
Primary health centers among pilgrims seeking medical services in Mina primary health care centers (PHCCs)
during the Hajj season in 1429 (2008).
Methods: This is a descriptive study based on the medical records of a random
sample of 4136 patients who attended 13 randomly selected Mina PHCCs from 8 to
12 Dhu-Alhijja, 1429 H (6—10 December 2008).
Results: The majority of the patients were men (70.7%), and most of the patients
were between 45 and 64 years of age (42.8%). One-fifth (20.2%) of the patients suf-
fered from multiple diseases. Respiratory diseases were the most common (60.8%),
followed by musculoskeletal (17.6%), skin (15.0%) and gastrointestinal (13.1%) dis-
eases. Diabetes, asthma and hypertension each constituted less than 3% of the total
diseases. Respiratory diseases were the most common independent of nationality or
the day of visit, while the frequency of the other diseases varied according to nation-
ality and the day of visit. The most frequently prescribed drugs were analgesics,
antipyretics, antibiotics and cough syrups.
Conclusion: This study describes the pattern of diseases among pilgrims attending
Mina PHCCs, which may aid in providing the best possible health care services to
pilgrims.
© 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier
Ltd. All rights reserved.

∗
Corresponding author at: Field Epidemiology Training Program, Ministry of Health, Al Rawdah District, P.O. Box 6344,
Riyadh 11442, Saudi Arabia. Tel.: +966 1 4960163; fax: +966 1 4939675.
E-mail address: abdullahgz@gmail.com (A.G. Alzahrani).

1876-0341/$ — see front matter © 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.jiph.2011.10.003
Pattern of diseases among visitors to Mina health centers during the Hajj season, 1429 H (2008 G)
Introduction
The Hajj is the largest annual Islamic pilgrim-
age to Mecca. While performing the Hajj, pilgrims
face different risks related to the environment,
their behaviors and their underlying health con-
ditions that can result in a variety of diseases.
For these reasons, pilgrims are vulnerable and
require focused medical support. The Saudi author-
ities spare no effort to ensure a safe and healthy
environment during the Hajj period by providing
guidance on pre-departure vaccination in the pil-
grims’ countries of origin, providing free health
services in-Kingdom throughout the Hajj premises,
improving housing and crowding conditions and
educating and supervising all pilgrims and local
support staff operating on the Hajj premises.
Understanding the pattern of disease that occurs
during the Hajj provides health policy makers with
important information for the optimal provision of
health services during the Hajj.
Although several studies have been conducted
in the past few years to determine the pattern of
diseases occurring among pilgrims, most of these
were among pilgrims registered in hospitals, who
constitute the minority of those seeking medical
services and are usually have more advanced or
severe diseases [1—4]. Compared to hospitals, pri-
mary health care centers (PHCCs), which are also
open 24 h a day, receive more pilgrims (accord-
ing to data from the Hajj in 1428 H data, 287,756
hajjis visited PHCCs, but only 78,762 visited hospi-
tals), are considered first-level care facilities, and
are more accessible and better distributed through-
out the Mina area (there are only five hospitals
but 25 PHCCs serving pilgrims in Mina, as shown in
Appendix A). However, no studies have been con-
ducted to determine the pattern of diseases in Mina
PHCCs since 1998, and no pattern of diseases in
Mina PHCCs has been reported by the Ministry of
Health (MoH) statistical department [5,6].
This study aims to determine the pattern of dis-
eases among pilgrims seeking medical services at
Mina PHCCs to provide evidence-based information
to guide the optimal allocation of health resources
during future Hajj seasons.
Materials and methods
A descriptive study was carried out among pilgrims
seeking medical services in Mina PHCCs during the
period from 8 to 12 Dhu al Hijjah 1429 H (6—10
December 2008). A sample size of 3732 was used to
determine which diseases probably affected 2.5%
or more of the study population with a precision of
23
0.5% at a 95% confidence level. The sample size was
then increased to 5000 to compensate for the antic-
ipated incompleteness of the forms. A two-stage,
stratified, systematic sampling technique was used
to select cases randomly. In the first stage, 13 out
of the 25 centers were chosen using a simple ran-
dom sampling technique (Appendix A). The sample
was stratified according to the participating PHCC
and the date of the patient visit. The size of the
sample allocated to each center was based on the
proportion of patients attending each participating
health facility on a given date during the last Hajj
season. In the second stage, a systematic technique
was used to randomly select patient forms from the
available forms in accordance with both the sam-
ple size allocated to each center on a given date
and the actual number of patients who attended
the health facility on a given date.
Upon entering a PHCC, each pilgrim is assigned
a standard form (Appendix B) that documents the
date, duty shift, demographic data (name, age,
gender and nationality), diagnosis, treatment and
type of intervention (referral to hospital, dressing
or observation). Each form is completed by a doc-
tor according to the pilgrim’s condition and is then
sent to the pharmacy so that medications can be
dispensed and the form can be reported and stored.
Each center sends a summary report on the demo-
graphic characteristics of its patients (total number
of visitors, Saudis or non-Saudis, pilgrims or non-
pilgrims, gender and age) three times daily to the
statistical department of the Mina health center’s
administration, which in turn compiles these data
to prepare summarized reports for Mina. However,
at no stage are the data on diseases transmitted or
analyzed.
Based on the prescription form, an electronic
form was designed using the ‘‘make view’’ module
of Epi info statistical software version 3.5.3 (cen-
ters for disease control and prevention), and all
collected data were entered into the database.
For administrative purposes and according to the
guidelines of the Ministry of Hajj, global nation-
alities were categorized into eight groups: Saudi
Arabia; other Arab countries; non-Arab African
countries; Iran; Turkey and developed countries
(Europe, America and Australia); South Asian coun-
tries; Southeast Asian countries; and other or
non-specified nationalities. Diseases were cate-
gorized, as on the prescription form, into five
subgroups according to the anatomical system
involved (cardiovascular, respiratory, gastrointesti-
nal, skin and ‘‘eye and ear’’ diseases). The category
‘‘others’’ includes four types of disease that can-
not be classified under the main anatomical systems
(diabetes, urinary tract infections, musculoskeletal
24 A.G. Alzahrani et al.

Table 1 Demographic characteristics of patients

attending PHCCs in Mina during Hajj season 1429 H.
N % 95%CI
Gender
Male 2925 70.7 69.3—72.1
Female 1211 29.3 27.9—30.7
Total 4136 100.0

Age groups
Fig. 1 Hourly distribution of patients to Mina PHCCs dur- 0—14 years 69 2.9 2.2—3.6
ing Hajj season 1429 H. 15—24 years 179 7.6 6.5—8.6
25—44 years 928 39.2 37.3—41.2
diseases and ‘‘obstetric and gynecological’’ dis- 45—64 years 1013 42.8 40.8—44.8
eases). In addition, dental problems and injuries 65+ years 177 7.5 6.4—8.5
were documented manually by the physicians, cre- Total 2366 100.0
ating another group of unspecified diseases. In
patients with more than one disease, each disease Hajj status
was assessed as a separate case. Hajj 3696 94.9 94.3—95.6
The proportion of the forms assigned to each Non Hajj 197 5.1 4.4—5.7
PHCC was based on the Mina PHCCs’ statistics for Total 3893 100.0
the Hajj season of 1428 H, under the assump-
tion that a similar pattern of patient presentation Residency status
existed in 1429 H. However, to adjust for the Domestic 679 17.6 16.4—18.8
actual patient presentation pattern at each PHCC International 3170 82.4 81.2—83.6
on a given date during the current year, data were Total 3849 100.0
obtained from the general directorate of statistics
in the MoH after the Hajj (in 1429 H, 232,384 pre- Nationality
scription forms were registered), and weights were Saudi Arabia 316 8.3 7.4—9.2
calculated to adjust for the differences between Other Arab 1691 44.4 42.8—46
1428 H and 1429 H. countries
Data were analyzed using Statistical Package for Non-Arab 422 11.1 10.1—12.1
African
Social Sciences (SPSS) version 18.0 based on the
countries
adjusted, weighted values of the variables. Descrip- Iran 148 3.9 3.3—4.5
tive statistics, including frequencies for variables, Turkey and 122 3.2 2.6—3.8
means, standard deviations and cross tabulations, developed
were performed as appropriate. Confidence inter- countriesa
vals (95%) were calculated for the differences in South Asian 1030 27.0 25.6—28.5
proportions. The chi squared test was used to countries
evaluate the distribution of categorical data, and Southeast Asian 30 0.8 0.5—1.1
statistical significance was set at less than 0.05 countries
throughout the analysis. Others 50 1.3 1.0—1.7
Because the objective of the study was to assess Total 3809 100.0
the pattern of diseases, forms with missing diag- CI: confidence interval.
noses were excluded, leaving 4136 records (83%) in a Turkey, Europe, American countries and Australia.

the final sample.

The demographic characteristics of the patients

Results
Of the 4136 included patients who attended the sur-
veyed centers during the study period, the number
of patients seeking medical care was lowest on day
9 and highest on day 11. Most of the patients pre-
sented during the morning shift (58.2%), and there
was a bimodal pattern of attendance (at 8:00 am
and at 8:00 pm) (Fig. 1).
whose records were reviewed in this study are sum-
marized in Table 1. Of the patients whose age and
sex are known, men were predominant in all groups
except those under 15 years of age, and there was a
relatively higher proportion of women in the 45—64
age group (M:F ratio of 1.7:1) when compared to
the 15—24 (M:F ratio of 2.6:1), 25—44 (M:F ratio of
2.8:1) and 65+ (M:F ratio of 2.8:1) age groups. The
patients represented more than 82 nationalities;
Pattern of diseases among visitors to Mina health centers during the Hajj season, 1429 H (2008 G)
Egyptians (720; 18.9%) and Pakistanis (666; 17.5%)
were the most frequent attendees at the surveyed
centers, followed by Saudis (316; 8.3%), Nigerians
(254; 6.7%) and Indians (216; 5.7%). Among nation-
ality groups, males also predominated in all of the
groups except the non-Arab Africans (M:F ratio of
0.9:1) and the Southeast Asians (M:F ratio of 1:1).
In the Saudi and other Arab nationalities groups, the
ratios of males to females were much higher than
for the other nationalities, with M:F ratios of 5.6:1
and 3.7:1, respectively.
Among the 3606 patients whose nationality and
residency status were known, most patients from
domestic group were Saudis (48.1%), followed by
other Arabs (38.9%).
During the study period, 4136 patients were diag-
nosed with 5025 diseases, with an average number
of diseases per patient of 1.21 (±0.44). The major-
ity of the patients (79.8%) suffered from a single
disease, but 20.2% had multiple diseases.
The most frequently occurring diseases (Table 2)
were those pertaining to the respiratory system
(2516; 60.8%), followed by musculoskeletal dis-
eases (727; 17.6%), skin diseases (620; 15.0%) and
gastrointestinal diseases (540; 13.1%).
Pharyngitis and the common cold were the most
common diseases—–982 cases (23.7%) and 850 cases
(20.6%), respectively—–followed by musculoskele-
tal diseases (727; 17.6%) and allergic skin diseases
(426; 10.3%) (Table 2).
Among the chronic diseases, diabetes and
asthma were the most common—–106 cases (2.6%)
and 104 cases (2.5%), respectively—–followed by
hypertension (81; 2.0%) (Table 2).
As shown in Table 3, apart from the respiratory
diseases that made up the majority of cases during
the study period, most of the patients who attended
on days 8, 11 and 12 had musculoskeletal diseases;
most of those who attended on day 9 had gastroin-
testinal diseases and most of those who attended
on day 10 had skin diseases.
Compared to female patients, male patients
had a higher percentage of skin diseases (17.6%
of men compared to 8.4% of women; p value
<0.0001). In contrast, the percentage of women
with musculoskeletal diseases was higher (22.8% of
women compared to 15.4% of men; p value <0.0001)
(Table 4).
Table 5 shows the prevalence of the registered
diseases among the different age groups. Cardio-
vascular diseases were more frequently observed
in the older age groups, ranging from 0.6% among
those aged 15—24 years to 4.5% among those aged
65 years and older (p value = 0.0017). A similar
trend was observed for musculoskeletal diseases,
where the percentage ranged from 8.7% among
25
those under 15 years of age to 22.6% among those
aged 65 years and older (p value <0.0001). In
contrast, respiratory diseases were more common
among children under 15 years of age (78.3%; p
value <0.0062). Moreover, there was a bimodal dis-
tribution of injuries within the age groups; the cases
were clustered among those 65 years of age and
older (4.4%) and among the younger age groups
(2.9% among those under 15 years of age and 3.4%
among those 15—24 years of age). Furthermore,
some diseases were more common among differ-
ent age groups. Gastrointestinal and liver diseases
were most common among children under 15 years
of age (10.1%). Musculoskeletal diseases were most
common among those 15—24 years of age, 45—64
and 65 or older (12.3%, 20.8% and 22.6%, respec-
tively). Skin diseases were most common among
adults 24—45 years of age (19.8%).
Regarding the proportional frequencies of the
different diseases according to nationality, res-
piratory diseases were most common among all
nationalities (59.3% of the total diseases). The
next most common diseases among specific nation-
alities included gastrointestinal diseases among
Saudis (19.3%); skin diseases among other Arabs
(21.5%) and those from Turkey and developed coun-
tries (13.9%); and musculoskeletal diseases among
non-Arab Africans (28.9%), South Asians (21.6%),
Iranians (19.6%) and Southeast Asians (6.0%)
(Table 6). Respiratory diseases, musculoskeletal
diseases, skin diseases and gastrointestinal diseases
all showed statistically significant differences (p
values <0.05).
A total of 9704 drugs were prescribed to the
4136 patients, with an average number of drugs per
patient of 2.35 ± 0.97. Of the patients included in
this study, 19.0% received monotherapy and 80.2%
received multiple therapies; only 0.8% received no
medication. The most frequently prescribed drugs
were analgesics and antipyretics (79.4%), followed
by antibiotics (53.9%) and cough syrups (37.1%).
A review of the collected prescription forms
showed that only one patient was referred to a hos-
pital. There were 205 patients (4.96%) who were
referred from the clinics to the dressing room and
25 patients (0.60%) who were referred to the obser-
vation room.
Discussion
The Hajj is a special event that attracts a large num-
ber of people from different cultures. It is a major
challenge for the Saudi Ministry of Health to provide
health services, especially preventive services, for
this event. This study provides information that will
26 A.G. Alzahrani et al.

Table 2 Distribution of diseases among patients attending PHCCs in Mina during Hajj season 1429 H.
Diseases groupsa Disease Patients (n = 4136)b %c
Cardiovascular diseases Hypertension 81 2.0
Others 6 0.2
Total 87 2.1

Respiratory diseases Common cold 850 20.6

Pharyngitis 982 23.7
Tonsillitis 172 4.2
Bronchitis 401 9.6
Bronchial asthma 104 2.5
Pneumonia 7 0.2
Total 2516 60.8

GIT diseases Gastritis 233 5.6

Gastroenteritis 155 3.8
Diarrhea 51 1.2
Cholecystitis 3 0.1
Hepatitis 10 0.2
Others 83 2.0
Piles 5 0.1
Total 540 13.1

Skin diseases Allergic 426 10.3

Infectious 193 4.7
Nail diseases 1 0.0
Total 620 15.0

Eye and ear diseases Conjunctivitis 124 2.8

Trachoma 2 0.1
Blephritis 2 0.1
Otitis externa 5 0.1
Otitis media 7 0.2
Others 2 0.1
Total 142 3.4

Diabetes mellitus Diabetes 106 2.6

Urinary tract infections UTI 61 1.5
Musculoskeletal diseases Musculoskeletal 727 17.6
OBs & Gyn diseases OBsG 7 0.2

Injuries Burns 12 0.3

Trauma 8 0.2
Wounds 46 1.1
Insect bites 1 0.0
Total 67 1.6

Dental diseases Dental diseases 40 1.0

Other diseases Others 112 2.7
a GIT (gastrointestinal, liver and gall bladder) disease; OBs & Gyn (obstetric and gynecological) diseases.
b More than one disease may be recorded per patient. Total number of diseases = 5025.
c Percentage according to the number of patients (n = 4136).
Pattern of diseases among visitors to Mina health centers during the Hajj season, 1429 H (2008 G) 27

Table 3 Distribution of disease groups according to the date of visit for patients attending PHCCs in Mina during
Hajj season 1429 H.
Diseases groupsa Day Total (n = 4196)b P**
8 (n = 484) 9 (n = 184) 10 (n = 1046) 11 (n = 1432) 12 (n = 1050)
Cardiovascular 6 5 19 30 26 86 0.1525
diseases
% within disease 7.0 5.8 22.1 34.9 30.2 100.0
% within day 1.4 2.7 1.8 2.1 2.5 1.7
Respiratory 243 89 524 926 733 2515 <0.0001
diseases
% within disease 9.7 3.5 20.8 36.8 29.1 100.0
% within day 57.3 48.4 50.1 64.7 69.8 50.1
GIT diseases 57 39 145 177 121 539 0.1379
% within disease 10.6 7.2 26.9 32.8 22.4 100.0
% within day 13.4 21.2 13.9 12.4 11.5 10.7
Skin diseases 57 34 228 202 99 620 0.0004
% within disease 9.2 5.5 36.8 32.6 16.0 100.0
% within day 13.4 18.5 21.8 14.1 9.4 12.4
Eye and ear 12 4 44 50 31 141 0.7802
diseases
% within disease 8.5 2.8 31.2 35.5 22.0 100.0
% within day 2.8 2.2 4.2 3.5 3.0 2.8
Diabetes 8 3 25 45 25 106 0.2061
mellitus
% within disease 7.5 2.8 23.6 42.5 23.6 100.0
% within day 1.9 1.6 2.4 3.1 2.4 2.1
Urinary tract 6 7 20 17 12 62 0.1726
infections
% within disease 9.7 11.3 32.3 27.4 19.4 100.0
% within day 1.4 3.8 1.9 1.2 1.1 1.2
Musculoskeletal 78 29 206 254 159 726 0.4127
diseases
% within disease 10.7 4.0 28.4 35.0 21.9 100.0
% within day 18.4 15.8 19.7 17.7 15.1 14.5
OBs & Gyn 0 1 0 4 2 7 0.3535
diseases
% within disease 0.0 14.3 0.0 57.1 28.6 100.0
% within day 0.0 0.5 0.0 0.3 0.2 0.1
Injuries 7 4 30 14 12 67 0.0727
% within disease 10.4 6.0 44.8 20.9 17.9 100.0
% within day 1.7 2.2 2.9 1.0 1.1 1.3
Dental diseases 6 1 9 9 15 40 0.6701
% within disease 15.0 2.5 22.5 22.5 37.5 100.0
% within day 1.4 0.5 0.9 0.6 1.4 0.8
Other diseases 15 15 36 28 17 111 0.0003
% within disease 13.5 13.5 32.4 25.2 15.3 100.0
% within day 3.5 8.2 3.4 2.0 1.6 2.2
a GIT (gastrointestinal, liver and gall bladder) disease; OBs & Gyn (obstetric and gynecological) diseases.
b More than one disease may be recorded per patient. Total number of diseases = 5020.
** p value based on chi squared for the trend.
28 A.G. Alzahrani et al.

Table 4 Distribution of disease groups according to gender for patients attending PHCCs in Mina during Hajj season
1429 H.
Diseases groupsa Male (n = 2925) Female (n = 1211) p***

Nb %c Nb %c
Cardiovascular diseases 44 1.5 42 3.5 <0.0001
Respiratory diseases 1718 58.7 750 61.9 0.0565
GIT diseases 337 11.5 193 15.9 0.0001
Skin diseases 516 17.6 102 8.4 <0.0001
Eye and ear diseases 78 2.7 64 5.3 <0.0001
Diabetes mellitus 77 2.6 29 2.4 0.6597
Urinary tract infections 39 1.3 22 1.8 0.2406
Musculoskeletal diseases 451 15.4 276 22.8 <0.0001
OBs & Gyn diseases — — 7 0.6 —
Injuries 52 1.8 14 1.2 0.1465
Dental diseases 32 1.1 8 0.7 0.1950
Other diseases 86 2.9 26 2.1 0.1527
a GIT (gastrointestinal, liver and gall bladder) disease; OBs & Gyn (obstetric and gynecological) diseases.
b More than one disease may be recorded per patient. Total number of diseases = 4963.
c Percentage according to gender.
*** p value based on chi squared.

be useful in planning the health care services pro-
vided by the Saudi Arabian government during the
Hajj.
To our knowledge, this is the first study to deter-
mine the health problems diagnosed in Mina PHCCs
since Abodahish et al. conducted a similar study in
1998, in which the main objective was to assess the
utilization of primary health care services and one
hospital was included in addition to 15 PHCCs [5].
Another similar study was conducted in Al-Madinah
Al-Munawwarah by Al-Quwaidhi et al. in the second
half of Dhul Qidah (the 11th month of the lunar cal-
endar, just 15—20 days before the Hajj) in 1428 H
(2007); this was the first station for some pilgrims,
while others visited Al-Madinah after performing
the Hajj [7]. It is also well known that pilgrims
spend shorter periods there than in the Mina area
(about 2 days), and that area has a different envi-
ronment and different places to visit. For these
reasons, comparisons with our study may not be
entirely accurate.
The observed changes in the caseload at the
clinics during the study period coincided with the
frequent movements of the pilgrims during the per-
formance of their rituals. On day 8, which saw a
major influx of pilgrims into Mina, the pilgrims were
often more fit than on the following days, so the
number of patients who attended the health facil-
ities at Mina was lower than the number attending
later (10.3%). By the end of day 8, some pilgrims
were traveling to Arafat, and the rest would fol-
low them in the early morning of day 9. Therefore,
the number of patients who attended the health
centers in Mina reached its minimum on day 9
(4.5%). The pilgrims were most likely to suffer from
health problems that caused them to attend PHCCs
during the first hours of day 10, while traveling from
Arafat towards Mina and passing by Muzdalifa after
a full day of activities, which explains the stepwise
increase in the number of cases over the following
two days.
Patients primarily attended PHCCs during the
morning shift, which reflects the normal daily activ-
ities of the pilgrims. Our results suggest that there
was an accumulation of patients between the two
working shifts, as indicated by the bimodal pattern
of the caseload during the day. This is similar to
results published ten years ago by Abodahish et al.
[5].
Men and physically fit pilgrims are usually
responsible for taking care of their families, and it
is common for women and elderly pilgrims to assign
men and younger pilgrims to perform Jamarat rit-
uals in their stead. All these factors could explain
the higher proportions of males (70.7%) and those
25—64 years of age (82.0%) who attended the health
centers in Mina. Moreover, a woman cannot go on
the Hajj without a male to accompany her (usu-
ally her husband or an eternally mahram relative
whom she can never marry), which also explains
the higher percentage of males.
Respiratory diseases (60.8%), musculoskeletal
diseases (17.6%), skin diseases (15.0%) and gastroin-
testinal diseases (13.1%) represent the greatest
burdens. These were also among the most com-
mon diseases evident in previous studies, which
 Pattern of diseases among visitors to Mina health centers during the Hajj season, 1429 H (2008 G)
Table 5 Distribution of disease groups according to age for patients attending PHCCs in Mina during Hajj season 1429 H.
Diseases groupsa 0—14 years 15—24 years 25—44 years 45—64 years 65+ years Total* p***
(n = 69) (n = 179) (n = 928) (n = 1013) (n = 177) (n = 2366)
Nb %c Nb %c Nb %c Nb %c Nb %c
Cardiovascular 0 0.0 1 0.6 14 1.5 24 2.4 8 4.5 47 0.0017
diseases
Respiratory 54 78.3 115 64.2 537 57.9 590 58.2 98 55.4 1394 0.0062
diseases
GIT diseases 7 10.1 19 10.6 121 13.0 133 13.1 20 11.3 300 0.6179
Skin diseases 3 4.3 15 8.4 184 19.8 148 14.6 17 9.6 367 0.9006
Eye and ear 2 2.9 5 2.8 26 2.8 45 4.4 7 4.0 85 0.1106
diseases
Diabetes mellitus 0 0.0 0 0.0 9 1.0 30 3.0 8 4.5 47 <0.0001
Urinary tract 4 5.8 4 2.2 13 1.4 19 1.9 2 1.1 42 0.1618
infections
Musculoskeletal 6 8.7 22 12.3 155 16.7 211 20.8 40 22.6 434 <0.0001
diseases
OBs & Gyn 0 0.0 0 0.0 1 0.1 0 0.0 0 0.0 1 0.6016
diseases
Injuries 2 2.9 6 3.4 9 1.0 11 1.1 7 4.0 35 0.915
Dental diseases 0 0.0 5 2.8 14 1.5 5 0.5 2 1.1 26 0.0804
Other diseases 2 2.9 3 1.7 32 3.4 19 1.9 4 2.3 60 0.308
a GIT (gastrointestinal, liver and gall bladder) disease; OBs & Gyn (obstetric and gynecological) diseases.
b More than one disease may be recorded per patient. Total number of diseases = 2838.
c Percentage according to age groups.
*** p value based on chi squared for trend.

29
 30
Table 6 Distribution of disease groups according to nationality for patients attending PHCCs in Mina during Hajj season 1429 H.
Diseases groupsa Saudi Arabia Arab Non-Arab Iran Turkey and South Asia Southeast Others Total p***
(n = 316) (n = 1691) Africa (n = 148) developed (n = 1030) Asia (n = 50) (n = 30) (n = 3809)
(n = 422) countries
(n = 122)
Nb %c Nb %c Nb %c Nb %c Nb %c Nb %c Nb %c Nb %c Nb %c
Cardiovascular 5 1.6 33 2.0 7 1.7 0 0.0 6 4.9 26 2.5 2 4.0 0 0.0 79 2.1 0.1210
disease
Respiratory 182 57.6 918 54.3 273 64.7 110 74.3 79 64.8 640 62.1 22 44.0 35 116.7 2259 59.3 0.0001
disease
GIT diseases 61 19.3 224 13.2 56 13.3 11 7.4 12 9.8 128 12.4 2 4.0 4 13.3 498 13.1 0.0053
Skin diseases 32 10.1 364 21.5 43 10.2 14 9.5 17 13.9 119 11.6 1 2.0 9 30.0 599 15.7 0.0001
Eye and ear 6 1.9 54 3.2 22 5.2 9 6.1 4 3.3 31 3.0 1 2.0 3 10.0 130 3.4 0.0421
disease
Diabetes mellitus 7 2.2 61 3.6 1 0.2 3 2.0 2 1.6 19 1.8 0 0.0 0 0.0 93 2.4 0.0022
UTI 5 1.6 28 1.7 4 0.9 1 0.7 0 0.0 9 0.9 0 0.0 1 3.3 48 1.3 0.3696
Musculoskeletal 44 13.9 238 14.1 122 28.9 29 19.6 10 8.2 222 21.6 3 6.0 4 13.3 672 17.6 0.0001
disease
OBs & Gyn 0 0.0 4 0.2 0 0.0 0 0.0 0 0.0 1 0.1 0 0.0 0 0.0 5 0.1 0.8894
diseases
Injuries 6 1.9 27 1.6 3 0.7 0 0.0 0 0.0 27 2.6 1 2.0 1 3.3 65 1.7 0.0718
Dental diseases 1 0.3 15 0.9 2 0.5 0 0.0 1 0.8 10 1.0 0 0.0 0 0.0 29 0.8 0.7802
Other diseases 11 3.5 49 2.9 7 1.7 0 0.0 7 5.7 22 2.1 0 0.0 3 10.0 99 2.6 0.0047
a GIT (gastrointestinal, liver and gall bladder) disease; OBs & Gyn (obstetric and gynecological) diseases.
b More than one disease may be recorded per patient. Total number of diseases = 4567.
c Percentage according to nationality groups.

A.G. Alzahrani et al.

*** p value based on chi squared for trend.
Pattern of diseases among visitors to Mina health centers during the Hajj season, 1429 H (2008 G)
demonstrates that they are the main diagnoses of
PHCC physicians [5,8].
Although the above mentioned diseases have
been found in other studies in different orders,
respiratory diseases are always at the top of
the list, even in some studies conducted on hos-
pitals [1,2,5,8]. This can be attributed to the
Hajj environment, which includes crowds, cramped
accommodations and adverse weather [9,10]. In
this Hajj season, which took place in December,
the highest temperature was 38 ◦ C. The Abodahish
et al. study conducted in April 1998 (high tem-
perature of 55 ◦ C) reported a lower prevalence of
respiratory diseases than that reported in our study
(49% and 60.8%, respectively), which might suggest
the impact of ambient temperature on respiratory
diseases [6,11,12]. In the Abdulkareem et al. study,
respiratory diseases were observed in outpatients
at a rate similar to that reported by Abodahish et al.
(46.2%), but when grouped according to hajji sta-
tus, it was found that respiratory diseases were
reported more often in non-pilgrims than in pilgrims
(62.2% and 43.9%, respectively) [7]. This high pro-
portion among non-pilgrims, which was similar to
the proportion of respiratory diseases among the
sample in our study, might suggest that the length
of stay in this environment could be a risk factor
for developing respiratory diseases (as pilgrims in
Al Madinah usually spend only 2 days there). Two
questionnaire-based studies conducted among pil-
grims assigned to camps and muftaresheen pilgrims
(unofficial, internal pilgrims who have not been
granted permission to undertake the Hajj and do
not have official accommodations provided by a
Hajj company, necessitating that they sleep in the
streets) showed that respiratory diseases were their
main complaints (67.3% and 70.8%, respectively),
which is similar to the results of our study [13,14].
The extra physical effort expended during the
performance of rituals (long-distance walking,
uncomfortable sleeping conditions and carrying
heavy weights) may explain the high percentage
of musculoskeletal diseases (17.6%). This is much
higher than the proportion reported in 1998 by Abo-
dahish et al. (7.0%), which can be explained partly
by the subsequent restriction of buses with fewer
than 15 passengers from entering the sacred places
[5]. Musculoskeletal diseases were also more preva-
lent in women than in men and displayed an upward
trend as age increased, which has been reported in
other studies [15—17]. Furthermore, the high pro-
portion of women among non-Arab Africans may
partially explain the increased percentage of mus-
culoskeletal diseases among these nationalities.
The high incidence of skin diseases correlates
well with other studies that reported skin diseases
31
as one of the common causes to seek care from
a health provider [18,19]. Long distance walking
and overcrowding may also contribute to the devel-
opment of skin diseases, which may explain why
men, who are responsible for their families’ needs,
developed skin diseases more than women (15.0%,
compared with 6.7%, respectively) [20]. Among
non-Saudi Arabs, skin diseases were more common
than any other disease except respiratory diseases,
especially on day 10, which was similar to the find-
ings of Abodahish et al. [5].
The high occurrence of gastrointestinal diseases
(13.1%) could reflect the low standard of food sani-
tation during the Hajj (e.g., illegal street vendors),
irregular meals, or poor storage of leftover foods
in Mina or Arafat [21]. The outbreaks of food poi-
soning that occurred in some domestic pilgrims’
camps explains the substantial increase in the pro-
portion of patients with gastrointestinal problems
among Saudis, who constituted most of the domes-
tic hajjis.
The movement of pilgrims on day 9 followed by
the rush for stoning Jamarat on day 10 increases
the likelihood of injuries on day 10 (45% of injury
cases were presented on day 10). The elderly and
younger age groups were more prone to injury than
the age groups in between, which are composed
of more physically fit people. Contrary to previous
studies, which reported high numbers of trauma
cases, the low incidence of injuries in our study
(1.6%) could be due to the improved regulation of
traffic, the new expansion of the Jamarat area, and
the absence of any disaster this year [3,22].
The upward trend of cardiovascular diseases and
diabetes with increasing age fits with the natural
history of the diseases. Our results were lower than
those found in questionnaire-based studies, which
might be because not all patients with chronic dis-
eases seek medical advice unless they are out of
their medications, their condition deteriorates or
they have a new complaint [14,23].
The medications prescribed were consistent with
the pattern of the diseases.
In our study, there was only one patient who was
transferred to a hospital, and we later found that
the forms were transferred along with the patients
who were referred to a hospital and were never sent
back to the PHCCs.
There are a few limitations in our study. The
major limitation is the incompleteness of the forms.
Some missing data could result in bias, but we
assume that the missing data were random in nature
and unlikely to have distorted the results of the
survey. Another limitation is that we used data col-
lected from governmental centers only, while some
country-specific medical missions (more than 59%)
32
provide health services to their registered pilgrims,
as revealed by some studies, and therefore, our
results may not be an exact representation of the
disease pattern for all pilgrims [23,24]. However,
this is a valid assessment of the diseases of patients
who attended PHCCs, which was the objective of
the study. Furthermore, the disease pattern also
agrees with those reported in studies conducted
in camps, indicating the absence of any major dif-
ference in patterns of illness between PHCCs and
camps. An additional limitation was the absence
of the forms that are marked with hospital refer-
rals, which could lead to an underestimation of the
number of severe diseases diagnosed in Mina health
centers.
In conclusion, respiratory, musculoskeletal, skin
and gastrointestinal diseases were the most com-
mon complaints among all patients visiting the
primary health care centers in Mina during the Hajj
season.
Our recommendations include three major
areas: (1) strengthening the supervision efforts to
ensure the completeness of prescription forms by
the centers’ reception staff and physicians to allow
for the accurate assessment of patterns of illnesses;
(2) distributing the statistical results of last year’s
patient data to policy makers and each centers’
A.G. Alzahrani et al.
administrator to allow for better management of
the PHCCs in Mina; and (3) reporting the patient
disease patterns and medications along with the
demographic data to the MoH to produce the opti-
mal information about the health services delivered
during the Hajj seasons.
Conflict of interest
We have no conflict of interest to declare.
Acknowledgements
We would like to thank the health authorities in
the Makkah general directorate for their support
for this project. We would like to thank Dr. Essam
Hammo, the Director of Mina PHCC administration,
whose cooperation was highly appreciated, as well
as all the staff in the centers for their assistance
with the data collection.
Appendix A. Map of Mina area showing
the distribution of PHCCs, hospitals, and
hajji’s camps, Mina, Hajj season 1429 H
Pattern of diseases among visitors to Mina health centers during the Hajj season, 1429 H (2008 G) 33

Appendix B. Prescription form used in

Mina PHCCs during Hajj season 1429 H

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