Regional profile - Jordan
Ancient
land – modern medicine
Jordan sees many visitors who come to savour the country’s historical
sites such as the ancient city of Petra, but it is not only for the
history that they come. More and more are visiting the county to make
use of its first class healthcare facilities. Middle East Health visited
some of the country’s leading hospitals to find out why.
The Hashemite Kingdom of
Jordan has a wealth of
history with many ancient
and well preserved historical
sites. It is a relatively small
country (population 5.6
million) with a good road
network making it easy to
get around.
By far its most wellknown
attraction is the
World Heritage Site of Petra.
This ancient Nabataean
caravan-city was an important
crossroads between
Arabia, Egypt and Syria-
Phoenicia. Petra is halfbuilt,
half-carved into the
rock and is considered one
of the world's most famous
archaeological sites, where
ancient Eastern traditions
blend with Hellenistic architecture.
However, there is much
more to Jordan – from the well preserved Roman ruins
at Jerash in the north to the
spectacular diving at the
Gulf of Aqaba on the Red
Sea in the south. The
country is dotted with
Crusader castles and Arabic
forts, the mesmerising
desert landscape at Wadi
Rum and the rejuvenating
saltwater of the Dead Sea.
But the country does not
attract visitors exclusively to
its cultural and historical
sites. Increasingly visitors,
particularly from the Arab
world, but also as far away
as South Africa, are travelling
to the country to make
use of its first class healthcare
facilities. These are
largely based in Amman, the
ancient capital. Middle East
Health visited some of these
hospitals and clinics to find
out more.
The development of
Jordan’s healthcare infrastructure
has essentially
taken place over the past 40
years following independence
from Britain in 1946
and the establishment of
the Hashemite Kingdom of
Jordan.
In the following years the
Ministry of Health established
many of the important
pillars of the country’s
healthcare infrastructure,
including a nursing college
in 1953, the establishment a
central laboratory for
medical tests in 1955; the
implementation of the country’s first health insurance
system for the Armed
Forces in 1963 and for civilians
in 1965.
During these
years various laws were
implemented to protect
public health.
According to 2001 statistics
from the Ministry of
Health infant mortality is
23.8 infant deaths per 1,000
live births; life expect
ancy at
birth for the kingdom's
population is 68 years for
males and 71 for females;
population growth was estimated
at 2.78%, and the
fertility rate at three children
per woman.
The leading causes of
death according to Dr Abdallah Bashir, Chairman
Board of Directors, Jordan
Hospital, are, as it is in
other developed countries,
cardiac-related diseases and
cancer.
Doctors with whom
Middle East Health spoke
said there were no diseases
peculiar to Jordan. They
said there was relatively
good health education
through-out the country
and noted that the incidence
of AIDS was low.
However, Dr Najeeb
Layyous, a well respected
gynaecologist and obstetrician
and IVF specialist
based in Amman, told
Middle East Health that in
the rural areas there is a
high incidence of genetic
problems, largely due to
intermarriage or consanguinity.
“There is a lack of genetic counselling,” Dr Layyous
pointed out, “and although
the Government has made
progress in pre-marital
genetic testing, it is only for
Thalassaemia.
“This creates a false sense
of security,” he emphasised,
“as there are many other
genetic diseases.” Related couples are being
screened for Thalassaemia
and being cleared and then
think they have nothing to
be concerned about
regarding genetic abnormalities,
he said.
“Even families who have
had genetic problems don’t
talk about.
They hide it
from other family members
because of the stigmas
attached to such diseases.
“There needs to be more
government education about the issue.”
Dr Layyous did, however,
remark that the situation
had improved considerably
over the past 15 to 20 years.
“The media has had a
large effect. More patients
are seeking help although
they want to keep it quiet.”
Health insurance
According to a report in the
Jordan Times in January
regarding health insurance,
within two years 95% of
Jordanians will be covered
by the national health
insurance scheme.
Health minister Saeed
Darwazeh, said currently
80% of the population are
covered by national health
insurance.
The Ministry of Health
(MoH) is planning to
upgrade the agreement
with private hospitals
whereby patients will be
referred for treatment by
the MoH and public hospitals.
According to the newspaper
such patients pay
20% of private healthcare costs and this was expected
to increase under the new
scheme.
The health minister said
the new scheme will enable
patients to choose from 56
private hospitals compared
to only three under the
present scheme. Dawazeh said that beneficiaries
of the current
scheme were largely
government employees and
their dependants and called
on citizens not covered by
any health insurance to
apply for coverage in the
new scheme in the second
half of this year.
Jordan hospital
Jordan Hospital in Amman
is a fully comprehensive
medical facility offering
expert medical and multispecialty
care.
“The hospital receives
referrals for tertiary care
from all Arab countries,” Dr
Abdallah Bashir, consultant
surgeon and chairman of
the Board of Directors,
Jordan Hospital, told
Middle East Health.
He pointed out that the
hospital’s rates are
approved by the Jordanian
Ministry of Health and the
Jordanian Medical
Association.
The hospital has ISO
9002:2000 certification. It is
also well-recognised for its
post-graduate medical
education and training.
“Each specialty is a
medical centre,” Dr Bashir
said.
For example the
endocrinology and
diabetes medical centre
was setup in 1998 when
two well-known specialists
in the field of
endocrinology and diabetes
in Jordan, Dr
Mohamed El-Zaheri, (a
diplomate of the American
Board of Internal Medicine
and the American Board of
Endocrinology and Metabolism)
and Dr Omar Abu-
Hijleh (Member of the
Royal Colleges of United
Kingdom and Masters
Degree in Endocrinology
and Diabetes [UK])
combined their private
practices and efforts to
establish the Jordan Center for Diabetes & Endocrinology
(JCDE).
The
centre treats all types of
diabetes and is equipped to
carry out the following
procedures:
Thyroid Ultrasound and
fine needle aspiration
(FNA); Dynamic testing of
various endocrine functions;
Assessment of
diab
etes control by blood
and urine testing; Electrocardiogram
and Peripheral
Vascular Doppler.
Dr Bashir said that the
hospital was renown for a
number of specialties, in
particular, neurosurgery
with robotic surgery, cardiology
and transplantation
including liver and bone
marrow.
The 300-bed hospital is
equipped with modern technology
for conventional
radiology, interventional
radiology and digital angiography
and fluoroscopy.
Among its range of modern
equipment is a 16-slice CT
scanner, 1.5T MRI and ultrasound
with colour Doppler.
Jordan hospital has four
intensive care units –
neonatal, paediatric, adult and neuro.
“Our coronary care unit comprisses four beds for
angina, myocardial infarction
and post cardiac
catheterization and angioplasty,”
Dr Bashir noted.
Its medical centres
include the JCDE; the
International Medical
Center – affiliated with the
Boston University Medical
Center – specialising in
sexual dysfunction and
prostate diseases; the
Obesity Center for morbid
obesity treatment; and the
Jordan Osteoporosis
Diagnostic and Therapeutic
Center with DEXA (the hitech
bone densitometer).
The hospital has its own
laboratory and pathology
labs, including those for haematology, genetics,
microbiology and
histopathology among
others.
The hospital is kept busy
particularly with a 24-hour
ER. “We received 22,680 ER
cases in 2004,” Dr Bashir
pointed out.
“In 2003 in-patient
admissions numbered
14,604, however, in 2004
the hospital put in 66 extra
beds and admissions
increased to 17,500.”
Asked why Jordan is a
popular destination for
patients from Arab countries
Dr Bashir said: “Visitors
come here because they have
confidence in the doctors, all
of whom are Jordanian and
either US, UK or West
German board certified.”
For more information
visit: www.jordanhospital.com
Jordan University Hospital
Jordan University Hospital
(JUH) in Amman is big. It
covers the whole gamut
from family medicine to
open heart surgery and everything in between.
The 540-bed hospital is
the main teaching hospital
in Jordan.
It was established
in 1971 by the Ministry of
Health to serve as a referral
hospital and was called
Amman Grand Hospital. In
1975 the hospital was transferred
to the University of
Jordan and was affiliated
with the Faculty of
Medicine.
The hospital serves three
core functions – a teaching
facility for the Faculty of
Medicine at the University
of Jordan Medical School, a
research facility and as a
healthcare facility.
As a healthcare facility “it
serves as a referral centre for
the Ministry of Health, the
Royal Corps and the private
sector”, professor, Dr Mahmoud Abu-Khalaf,
director general JUH, told
Middle East Health.
“As such we try to keep
costs down and make it
affordable. In-patients pay
around JD100 (about
US$140) a day.”
Regarding its role as the
main teaching hospital in
the country, Prof Abu- Khalaf commented:
“Currently we have about
300 under-graduate
students and about 200 post-graduate residents.”
“The students are mostly
Jordanian, although among
the undergraduates there are
a number of other nationalities
studying here through
various exchange programmes.
“The hospital covers all
departments of medicine
from family medicine to
cardiology, although the
emphasis is on critical care.
A quarter of the hospital’s
beds are for this.”
The hospital has 18 operating
rooms.
The out patients clinics
(OPD) were built in 1987 to
provide the necessary space
for teaching and for all the
specialised clinics and other
complete services. The OPD
complex contains the
dentistry clinics with 85
dental chairs, the renal
dialysis units with 16
machines, the blood and
the eye bank, as well as the
medical labs.
The diagnostic imaging
facilities include: spiral CT
scanners (Somotom plus 4);
MRI – Magnotom Vision plus
1.5 tesla; Echocardiography;
Sonography; Mammography;
Coloured Doppler
Ultrasound; Interventional
radiology services.
These facilities and the hospital’s nuclear medicine
department, provide
comprehensive diagnostic
services.
The hospital had 56,000
ER patients last year. Inpatients
numbered 27,376
and out-patients 292,000.
At the community level,
the hospital plays a
pioneering role in educating
the local community. This is
in addition to its wellacknowledged
voluntary and
benevolent services it gives to
the underprivileged elderly,
women and children in
remote areas of the kingdom.
For more information
visit: www.ju.edu.jo/resources/hospital.htm
Amman Surgical Hospital
Amman Surgical Hospital
(ASH) is a
leading Jordanian hospital specialising in
aesthetic plastic and reconstructive
surgery, otolaryngology,
ophthalmology,
paediatric and general
surgery.
The hospital opened in
1993 with a capacity of 24
beds as a private hospital
designed and equipped for a
few specialist services such
as aesthetic plastic and
reconstructive surgery and
paediatric surgery.
In 1997, ASH expanded
into a comprehensive
medical centre with a
capacity of 95 beds.
The hospital now has the
following departments:
- gastroenterology –
comprising a fully
equipped endoscopy unit;
- cardiology with the catheterisation lab, cardiac
theatres. The Intensive Care Unit and Cardiac
Care Unit are on the same
floor for patient comfort.
Organ transplants can also
be carried out here;
- NNICU (Neonatal
Intensive Care Unit);
- internal medicine;
- general surgery including
laparoscopic surgery;
- A renal unit with seven of
the most advanced dialysis
machines in the kingdom;
- urology and nephrology;
- plastic surgery and reconstructive
surgery;
- ENT (Ear-Nose and Throat
Surgery);
- ophthalmology;
- orthopaedic surgery;
- obstetrics and gynaecology
comprising fully
equipped delivery suite
and private theatre;
- anaesthesia;
- diagnostic radiology
including general radiography,
digital fluoroscopy, doppler ultrasound and
spiral CT-scanning; laboratory
medicine;
- 24-hour fully equipped ER.
“The hospital is most well
known for its cardiology
services,” Rasha Taher,
director of patient services
told Middle East Health.
“We have all the latest
equipment and can treat all
cardiac problems,” she said.
Taher said the hospital
had a telemedicine facility
offering a direct satellite link
with the Mayo clinic in the
US for patient consultations
and video-conferencing.
Other disciplines for
which the hospital is recognised
include plastic surgery
and obs-gyn.
Taher said they have many
patients and VIPs visiting
from the Arab countries.
For more information visit:
http://clients.johealth.com/ash
Other top healthcare facilities
in Amman include the
Al Khalidi Medical Centre
and the Specialty Hospital.
Speciality Hospital
The Speciality Hospital is a
200-bed private facility
specialising in cardiology,
neonatal intensive care,
nuclear medicine and a wide
range of other specialties.
The hospital has 14 Royal Suites and has a dedicated
patient services department
where medical records can
be sent to be analysed
before a foreign patient
makes the trip to Jordan
and the hospital. The
department takes care of all
visitor formalities and will
meet patients at the airport.
For more information
visit: www.specialtyhospital.com
Al Khalidi Medical Centre
The Al Khalidi Medical
Centre is an Amman-based
upmarket private medical
centre with 243 affiliated
doctors.
Established in 1978 as a
maternity hospital in
Amman, Al Khalidi Medical
Center (KMC) is now a first
class heart and comprehensive
specialty hospital with
more then 15 clinical
departments.
It houses some of the
latest medical technology
including a 32-slice CT
scanner, MRI, 4D ultrasound
and an advanced lithotripsy
unit, among others.
Walid Maaytah, the
director of marketing, told
Middle East Health that KMC would soon be opening a
nuclear medicine centre with
a PET scanner and other hitech
equipment including a
gamma knife.
He said the centre was
most recognised for openheart
surgery; its ICU which
is used by VIPs; IVF; bonemarrow
transplants; radiology;
and its labs.
“Our labs are highly
respected. In fact, several
foreign hospitals send their
samples here to be tested.”
He said that about 40% of
the KMC’s patients were
foreign, “mostly from the
Gulf”.
“As we say here: we offer
1st class medicine and 5-star
service.”
For more information
visit: www.kmc.jo
Dead Sea Medical Centre
The Dead Sea Medical
Centre situated on the Dead
Sea about 45 minutes drive
from Amman is worldrenown
for its treatment of
psoriasis and arthritis.
(Look out for an in depth
report on the Dead Sea and
the Dead Sea Medical Centre
in the September issue of
Middle East Health.)
