First in the region
for medical tourism
Following a recent report by the World Bank that ranks Jordan in the top five in the world and number one in the
region with regards medical tourism Middle East Health visited the Kingdom to speak to some of the leading
hospitals in Amman to gauge why the country is so successful in attracting foreign patients for treatment.
The Hashemite Kingdom of Jordan is an
attractive country for foreign medical
patients for many reasons. The Kingdom
has a long history, relative to other countries
in the region, of sound medical practice
by highly qualified physicians. It has
remained politically stable and secure,
while many of its neighbours have been or
are currently in turmoil. Its
geographical location makes it easy to
access – it’s just a short flight from all
countries in the Middle East, as well as
from North Africa and the ‘Stans’, the
former Soviet Union countries to the
north and east. The country has a well developed
infrastructure – its road network
is first class and there is a bigger more
modern airport being built outside
Amman, the capital. From a healthcare
point of view, most of the leading hospitals
in Amman are accredited by the robust
and rigorous Joint Commission
International, putting them on a par with the top hospitals in the United
Arabic is the language of choice, but
English is also fairly widely spoken in
For relatives accompanying patients, or
for recuperating patients, the Kingdom has
some of the world’s most remarkable
tourist sites, such as the well-preserved
Roman ruins of the city of Jerash, the Dead
Sea and the incredible rose-red city of
Petra carved into the mountains around
300BC. These are all easily accessible from
Amman, which itself is a fascinating city
and reputedly one of the oldest permanently
inhabited cities on Earth. A further
attraction is the climate in Amman which,
due to it elevation, remains pleasantly cool
in summer while much of the rest of the
Middle East is uncomfortably hot.
Medical tourism to Jordan has been
increasing year on year. When Middle East Health last visited Jordan in 2009,
country was already well-established to
receive medical patients from overseas.
Key hospitals in Amman such as the King
Hussein Cancer Center (KHCC), the
Specialty Hospital, the Arab Medical
Centre and Al Khalidi Medical Center,
had established foreign patient departments
and concierge services to smooth
the process for patients seeking treatment
at these facilities. When we spoke to Dr
Fawzi Al Hammouri, then chairman of the
Jordanian Private Hospitals Association,
he explained that these hospitals were
receiving patients from northern Saudi
Arabia (Amman being closer to these
people than Riyadh), Sudan (a few
wealthy individuals) and many patients
from Iraq (as a consequence of the war in
that country at the time).
This time around we spoke to Dr Awni
Al-Bashir, the new president of Jordan’s
Private Hospitals Association. He pointed out that Jordan is experiencing a
10% growth in foreign medical tourist
numbers year on year. In 2010 patients
came from 102 countries to seek treatment
in Jordan, he said. However, he
pointed out in a recent interview with
the Jordan Times that the potential for
growth in this sector was limited by the
number of hospitals available.
“There are 61 private hospitals in the
country and a further two are under
construction,” Dr Bashir said, adding that
the available hospitals were struggling to
cope with the rising number of patients
seeking treatment in the country. “There is
a need for more investment in the sector.”
Interestingly, several hospitals we
spoke to in Amman on this trip in May
are all in the throes of expansion to cope
with the influx of foreign patients. The
demand is clearly there.
And they are expanding their horizons.
Most of the hospitals treating foreign
patients receive them from neighbouring
countries like Iraq and Palestine, but
several of the hospitals we spoke to said
they are actively targeting countries in
North Africa as well as the former Soviet
Speaking to the Jordan Times, Dr Bashir
noted that one of the drawbacks for medical
tourism in Jordan was that there was no
“medical accountability” law, which
prevented US health insurance companies
referring their patients for treatment in
Jordanian hospitals. In other words there is no legislation to enforce patient
protect them against medical error. The US
is a potentially big market as the costs for
certain medical procedures in Jordan can be
as low as a quarter of that in the US.
According to a Jordan Times report in
February this year, a draft medical accountability
law has been drawn up, but has not
yet been passed to the lower house of
parliament for consideration.
We visited several hospitals in Amman.
Following is a brief overview of three of
these hospitals with a focus on medical
King Hussein Cancer Center
The King Hussein Cancer Center
(KHCC) is one of several hospitals in
Amman that is bursting at the seams in
trying to cope with the fast growing
demand for cancer care. The JCI-accredited
hospital has a high profile in the
region as one of the best cancer referral centres. KHCC has established
programmes that focus on all stages of
cancer care; from prevention and early
detection, through diagnosis and treatment
to palliative care. The centre is also
accreted by the JCI as a disease-specific cancer center, making it the only such
centre in the Arab world with this accreditation.
This has come about through the
KHCC developing local disease-specific
protocols for diagnosis and treatment of
cancer, rather than relying on US or
Speaking to Middle East Health Dr Mahmoud Sarhan, MD, CEO and Director
General of KHCC, explained that the
hospital was constructing a new wing
because of growing demand. He said that
KHCC had completed a new wing in 2008
with the addition of 60 beds. However, the
new expansion currently under construction
will add a further 200 beds to the
hospital. It is and expected to be
completed by the end of 2013.
“We are seeing a growth of about 200
new cases a year,” he said. “In 2010 we saw
about 4,800 new cases and the year before
that around 4,600 new cases. This is higher
than the growth of the population which is
“We think this growth is due to the
aging population and the continuous
exposure to carcinogens, such as smoking.
For example, if you take the whole population
there are about 120 new cases per
100,000. If you look only at the population
over 60 years of age there are about 600
new cases per 100,000 of population.”
Life expectancy in Jordan is increasing
and with more people living into old age
the country is facing an increasing burden
of cancer, as well as other chronic diseases
such as diabetes and cardiovascular disease.
“In 2010 there were 5,000 new cases of
cancer in Jordanians and a further 2,000
new cases of cancer in foreigners in
Jordan,” Dr Sarhan said.
“About 45% of these are treated at KHCC, about 66% of which are Jordanians
and around 34% non-Jordanians.”
Speaking at a King Hussein Cancer
Foundation fund-raising event in Abu
Dhabi in March this year, HRH Princess Ghida Talal, Chairperson of the Board of
Trustees of the King Hussein Cancer
Foundation, explained the attraction of
Jordan for medical tourists saying: “We are
fortunate to have the King Hussein
Cancer Center which provides comprehensive
cancer treatment comparable to
that of the best cancer centres in the West,
with the additional distinction of being
here in our own region, where patients can remain among their families and loved
ones, cared for by doctors and nurses who
speak our Arabic language and who understand
our fears, all at one third the cost of
receiving treatment abroad.”
Country of origin
The non-Jordanians treated at KHCC
come from the following countries,
according to Dr Sarhan: Iraq and Palestine
make up about 50% and the others come
from Syria, Sudan, Libya and Yemen with
a handful from a variety of other countries.
The new expansion will consist of two
towers with a combined area of 83,360 sq m.
It will be attached to the current hospital,
will house a 2,000 sq m cancer research
facility and a public blood stem cell bank.
One tower will have outpatient clinics
across 10 floors. The second tower will be
for inpatients. It will have 11 floors in total
with radiotherapy, radiology, operating
rooms, 24 ICU rooms, 24 paediatric rooms,
24 leukemia rooms and several floors of
general patient rooms.
KHCC collaborates with several key
international centres including: St Jude’s
Children’s Research Hospital in the US;
The Lombardi Cancer Center of
Georgetown, US; Susan G Komen for the
Cure, US; The Sick Children’s Hospital,
Canada; National Cancer Institute, Egypt
and the August Victoria Hospital,
Palestine, among others.
Istishari Hospital is Amman’s newest
private hospital. The current new management
took over the hospital in 2008. In
August 2010 it received JCI accreditation.
It is a 108-bed, high-tech, multi-specialty
hospital using some of the most advanced
medical technology available including a
1.5T MRI and a 64-slice CT scanner.
“We have five Centres of Excellence,” Zahira Haram, chief executive and experience
officer, Istishari Hospital, told Middle
East Health, when we visited the hospital
in May. They are cardiovascular, gastroenterology,
newborn medicine, infertility,
hematology/oncology. The hospital has six
ORs all equipped with (negative pressure)
laminar flow, to cut out airborne infection.
One of these theatres is a dedicated cardiovascular
surgery and includes a cath lab.
Istishari Hospital has a full digital
Hospital Information System in place.
All in all, this is a state-of-the-art
Their doctors are all well qualified. The
cardiac team, for example, are all Harvardtrained
Quality is key to healthcare in the
hospital, explained Haram. The hospital
has established a quality control department
to continually assess quality on all
levels at the hospital.
“We also conduct a continual patient
survey to have an on-going assessment of patient satisfaction and to ensure
services are of the best quality,” she said.
The hospital has initiated several unique
and innovative features. To ensure quality
of service in the hospital they employ
‘patient representatives’, whose exclusive
job it is to visit every patient in the
hospital after admission to check whether
they are happy with the services and to
handle any complaints.
“We have also set up a team to double
check all billing. They will go through each
bill before it is issued to ensure patients are
not being overcharged,” she explained.
The hospital has a range of accommodation,
including three luxurious Royal
Suites, several spacious two-room suites
and large first, second and third class air-conditioned
It is an upmarket private hospital, and
since reducing their reliance on insurance payors, they have seen a 40% increase in
the number of “out-of-pocket” payors.
The hospital has an established
International Patient Services department
to cater to medical tourists. This is also well
placed on their website –
www.IstishariHospital.com – reflecting the
importance this hospital places on this
market. The hospital also has a non-profit
“We’ve seen patients from 57 countries.
Before the conflict [the Arab uprising
currently sweeping parts of the Arab
world] we saw patients mainly from Libya,
Yemen and Saudi Arabia.
“It is the hospital of choice for foreign
embassies based in Jordan. The embassies
recommend this hospital to tourists in the
country who need medical care,” Haram
She pointed out that the hospital is
listed on the Jordan stock exchange. “As a
public company we have to be totally
transparent with our finances. We also try
to reflect this in the culture of the hospital,
with the staffing in particular who are
hired on merit and equal opportunity.”
Even the architecture of the building
reflects this transparency, with a lot of glass
there is openness and a flow of natural light.
Ishtishari is also expanding to cope with
high demand for their services. “Planning
has been approved for a 14-storey tower adjacent to the hospital. The priority
this expansion is to house more outpatient
clinics,” Haram explained.
“Our biggest patient growth is in
oncology, although we are also experiencing
considerable growth in the IVF
unit,” Haram said.
Haran emphasised that the hospital has a
patient-centred approach to the way they
operate and “we make it clear to all patients
on admission that they should know their
‘rights and responsibilities’ as patients.”
The Specialty Hospital is one of Amman’s
leading private hospitals. It has been
honoured with several awards over the
years in testament to its prestigious position
in Jordan, such as the King Abdullah
II Award for Excellence.
“We are the only hospital in Jordan to
have received this award and we have
received it twice,” Dr Fawzi Al-Hammouri
told Middle East Health when we visited
the hospital in May this year.
This multi-specialty facility has JCI
accreditation and it has a long list of firsts:
They were the first to introduce 3T MRI in
Jordan, the first to introduce 64-slice CT
in the country and the first to introduce
hyberbaric oxygen therapy, among other
The hospital treats many foreign
“In 2010 we treated 45,000 non-
Jordanian patients – about 25% of
capacity,” Dr Hammouri pointed out. “At
some points 50% of our patients have been
Like other leading hospitals in Jordan,
Specialty Hospital has a foreign patients
department and concierge service to handle
all necessary arrangements for foreign
patients seeking treatment at this facility.
To cope with growing demand for their
services, this hospital has also expanded.
“We opened a new wing to the hospital
in 2010 with a further 230 patient rooms.
We now have capacity to take another
45,000 patients from abroad,” he said.
The new wing has 10 ORs with laminar
flow and hepa filters.
“We’ve seen a noticeable reduction in
surgical infections with these state-of-theart
operating theatres,” Dr Hammouri
“The air in these rooms is changed 18
times per hour and goes through six filters.”
The new wing also houses 18 royal
Before the Arab uprising Specialty
Hospital received many of their foreign
patients from Libya, which ranked
number two on their list for medical
“But now there are no flights from Libya,
so currently most of our patients come
from Palestine, Iraq, Saudi Arabia, Sudan
and Yemen,” Dr Hammouri said.
“And we’re starting to receive patients
from the former Soviet Union countries,
such as Uzbekistan and Azerbaijan,” he
“We’re also looking at targeting North
and West African countries such as Chad
and Nigeria, as well as Arab-speaking
people in Europe.”
He explained that 2009 to from 2010
they saw a 10% increase in foreign
patients. “We expect this to increase again
this year by another 10-15%,” Dr Hamourri said.
He said there were several reasons why
medical tourism was growing in Jordan and
not only for patients from neighbouring
countries, but also from Europe and the US.
“There are, of course, economic
reasons,” he said, “As the cost of treatment
here compared to Europe and the US is
considerably less expensive, while the
quality remains high, but there are other
reasons as well.
“For example, if we look at IVF: in
Germany you are not allowed to choose
the sex of the baby. In Jordan there is no
legislation prohibiting this so prospective
parents who would like to choose the sex
of their baby come here for IVF treatment.
Also in Germany in vitro testing for
diseases like Thalassaemia is not allowed,
but it can be done here.”
With Jordan’s stability in a sea of Arab
turmoil, its reputation for providing some
of the best quality healthcare in the
region, its modern state-of-the-art
medical facilities and the country’s many
easily accessible tourist attractions, the
Kingdom looks set to keep its status as
the premier destination for medical
tourism in the region for some time to
come, while expanding this prestige
of upload: 15th Aug 2011