Jordan Report

Arab uprising spurs
renewed focus on
patients from the region


Health tourism to the Hashemite Kingdom of Jordan is a significant revenue earner for the kingdom, but the violence in Syria is deterring Western patients from seeking cost-effective healthcare in the country and spurring a renewed focus by Jordan on attracting patients from the region. Shaun Benton reports.

Jordan, whose reputation as a centre of affordable excellence for skilled healthcare, including reconstructive surgery, has been building steadily over the years, is now feeling the impact of Syria's drawnout internal conflict.

The number of so-called health tourists, and not only from its neighbours in the region and Arab north Africa, but also from the United States and Europe have for some years now been steadily increasing, drawn to this relatively stable kingdom by the high quality and cost effectiveness of medical treatments.

Medical tourism has, in fact, become an important part of the kingdom’s economy. By 2010, it was – according to the Oxford Business Group, a think tank – earning about US$1 billion in revenues from foreign patients requiring a range of treatments, some of it using sophisticated technology. In the same year, this contributed 4% to the country’s gross domestic product. The World Bank recently ranked Jordan fifth in the world as a medical tourism destination.

Seen in the context of other contributors to Jordan’s annual GDP of about US$30 billion (US$36.8 billion at purchasing power parity, while US$28 billion at official exchange rates), this is an invaluable contribution to the country’s economy and is more or less equivalent to the entire agriculture sector.

Industry contributes 30% to Jordan’s economy – one of the smallest in the Middle East, with poor supplies of natural resources – while services, which of course includes medical services, contributes by far the biggest share: 65%. (All figures according to estimates made by observers of its economy for 2011.) This is no small achievement for this country of 6.5 million people who have a ratio of 2.45 physicians for every 1,000 people.

However, this was before internal conflict in its troubled neighbour, Syria, which has rapidly escalated to the horrific and tragic proportions we see today. This has forced a revised earnings forecast for Jordan as foreign patients – mainly from the US and Europe – began to weigh in the possible dangers – or at least, perceptions of danger – of travelling to Amman for medical treatment.

Awni Bashir, the president of the Private Hospitals Association (PHA) in Jordan, was recently reported as saying that Jordan saw a sudden drop of about 20,000 health tourists as the ‘Arab Spring’ crept ever nearer.

In 2010, Jordan received about 200,000 health tourists. Due to what he called “uncertainty generated by the so-called Arab Spring”, this number dropped to about 180,000 the following year.

It is now taking pro-active measures to shore up its market share and ensure that its sophisticated medical sector does not take too much damage from the seemingly intractable situation next-door. These include participation at various international medical tourism conferences in the region and the hosting of several medical congresses, among other initiatives.

One shining star that the country is keen to show to the world is its 300-bed multi-specialty hospital in Amman, prosaically named Jordan Hospital, which is increasingly popular with fastidious American patients hoping to save money on exorbitant medical operations and procedures in the United States, while expecting similarly high levels of quality in the treatment they receive.

In a major boost to the hospital and ability to tap into this market, it received an award in 2011 from the American Heart Association/American Stroke Association for the quality of its treatment. American patients now comprise the 10th biggest category of foreign visitors seeking medical treatment, who are now drawn from 58 countries.

And Jordan Hospital is not the only major player – there is the King Hussein Cancer Centre which provides top-of-the-range treatment to cancer sufferers and is now recognised as one of the best in the world for this specialised and difficult treatment.

The Arab Medical Centre is another leader, as is the Specialty Hospital, known to be well-equipped, while the Al Khalidi Medical Centre also offers sophisticated treatments for lower costs than patients would otherwise pay if they received similar treatments at private medical centres in Europe or the United States.

Also sought after by foreign patients is the Farah Hospital. Fitted with the latest technologies, it focuses on assisted reproduction for couples battling fertility problems. This, along with so-called “preimplantation” and genetic manipulation, is a burgeoning and lucrative market in the health sector in industrialised countries.

With fewer Americans willing to come to a region embroiled in violent strife, it makes sense for Jordanians tasked with marketing the country's array of medical services to renew their focus on regional markets – and this is what they are doing, according to reports.

Their efforts seem to be paying off, with reports citing an increase of 26% in medical visitors from the Gulf Cooperation Council (GCC) states in the first eight months of 2011.


In a sign of the country’s relatively advanced state of healthcare development, the industry there is in a position to afford a certain degree of altruism, with sympathetic surgeons providing free, life-restoring reconstructive surgery to children and adults badly wounded in the conflicts in nearby Iraq, and now Syria, as well as other countries caught up in the Arab uprising.

Like the international medical nongovernmental organisation, Médecins Sans Frontières – doing life-saving work in Jordan – there are a number of independent healthcare operations doing good work in the kingdom. One of these is located at a hotel in a suburb in Amman and has been treating the seriously wounded coming from Egypt, Libya, Yemen, Iraq, the Palestinian territories and most recently, Syria. It was set up in 2006 as a temporary programme to help victims of violence in Iraq. However, the continued arrival of victims of violence from the ‘Arab Spring’ made its closure untenable and it has since been expanded by 40%, according to a report broadcast recently by BBC's Newsnight programme.

Patients – the forgotten victims of Middle East violence – are arriving as terrorised casualties of explosions, bullets, rockets, grenades, shrapnel and collapsed buildings and their injuries are so severe that, often, three, four or more operations are performed on each patient.

One surgeon at the centre, Dr Majd el- Raas, a Syrian national, says he works hard to avoid amputations and says he would rather perform several operations to save a patients’ limb or limbs. As a professional, he regards amputation as “like a failure” but acknowledges that the overriding aim is to save a human life.

There is “a huge waiting list”. Among the patients are a man from Dera in Syria who had been tortured, another Syrian shot by a sniper, a young man from Baghdad with a shattered leg, a Yemeni whose wife and two-year-old daughter died when a rocket hit their car. He underwent four operations in Yemen before arriving in Amman for further procedures, involving the transplant of a bone from his leg to his arm. He has attempted suicide three times already and is carefully watched by the centre’s staff, who are keenly aware of the psychological effects on victims of the violence they have experienced.

Another, a child from Baghdad, lost his left leg, left eye and half of his face in a bomb blast, and has undergone 25 operations, with one involving muscle transferred from his back to his mouth – one of the most complicated surgeries in the world.

The centre – one in ten of whose patients are children, who are schooled in a makeshift classroom in a nearby hotel – exposes the reality of the horrors of violence engulfing the region's troubled countries and yet, at the same time, reveals to the world the hope and optimism to be found as compassionate, dedicated individuals do their best to make a difference, one person at a time.

Yet for these doctors, it is not easy, either: “The hardest part,” Dr el-Raas told the programme, “is seeing the patient on arrival … especially children.”

 Date of upload: 26th Jul 2012


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