(JTA) — One person died and several hundred required medical treatment during the annual pilgrimage in Uman, a Ukrainian city where tens of thousands of Jews gather on Rosh Hashanah, the Jewish new year.

The deceased was a 23-year-old who died of heart failure caused by medical complications, according to a statement Tuesday by the United Hatzalah emergency services group, which is based in Israel but runs a clinic in Uman during the holiday.

Of the 34,000 people estimated to have participated in the pilgrimage this year, about 2,700 people were treated by Hatzalah for various issues, ranging from mild headaches to injuries sustained by people who stumbled while walking the city’s pothole-filled streets.

The clinic that United Hatzalah runs in Uman with cooperation of other groups has 20 staff and works 24 hours a day throughout the holiday. The clinic will extend its activities until Yom Kippur next week, the statement said.

Among the complications faced by the clinic’s staff are pilgrims who ignore medical advice and travel after major surgeries to Uman, which is about 150 miles from the nearest international airport. Some of these pilgrims believe visiting the city on Rosh Hashanah has healing powers.

The visitors come to Uman to be near what many believe is the burial site of Rabbi Nachman, an 18th-century luminary whose supposed gravesite is the focal point of the celebration.

As in previous years, Israeli police sent officers to Uman for the duration of the holiday to help local authorities maintain order.

Authorities in Ukraine have improved access to Uman in recent years, and plans are underway for reopening an unused military airport near the city for direct flights.

Last year, a record 40,000 pilgrims made the trek to Uman.

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