history of neurosurgery in jordan

HISTORY OFNEUROSURGERY

IN JORDAN

PROF. WALID MAANI, MD, FRCSEdJordan University Hospital and Medical School

23年 4月 9日 APPLIED SCIENCES UNIVERSITY

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Jordan is a small country with big dreams, and many of its aspirations have become

physical realities in our lifetime.

In order to be worthy of the global respect we currently enjoy, we must aspire to continue

our progress and development


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GENERAL INFORMATION

POPULATION: 6 MILLIONS

50% BELOW 25 YEARS

22 UNIVERSITIES

100 HOSPITALS

AREA : 96,000 SQ. KLMS


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HEALTH STATISTICS

• CRUDE BIRTH RATE: 29.1/1000• CRUDE DEATH RATE: 7/1000• INFANT MORTALITY: 19/1000• MATERNAL MORTALITY: 0.4/1000• EXPECTED AGE AT BIRTH: 73 YEARS• PHYSICIANS: 26.7/10000• DENTISTS: 8.5/10000• NURSES: 33.6/10000• HOSPITAL BEDS: 18/10000


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HEALTH STATISTICS

• SOURCES OF HEALTH CARE FINANCE:• PUBLIC: 36.5%

• PRIVATE: 58.9%

• DONORS: 4.7%

• HEALTH EXPENDITURE AS PERCENTAGE OF GDP 9.6%


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PRELUDE

The progress in medical care in Jordan was a translation of the concept that human power was the main asset of the country since it lacks natural resources.

Therefore emphases were placed on education and health.

Hence, primary health care indices & literacy rates are the best in the Arab world.

25% of the population are students

5% attend university and community colleges


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PRELUDE

To look at just 2 indices of health will tell the story of medical care progress in this country.

In 1950 the infant mortality rate was 63/1000,

today it is 19

In 1950 the expected age at birth was 47 years today it is 73

Not a single case of poliomyelitis was reported since 1993

The immunization rate in infants is above 98%


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PRELUDE

• The progress in medical care was across the board in all care levels; primary, secondary and tertiary.

• The advance in tertiary care covered all fields of medicine, so it was not a surprise that Jordan was the eighth country in the world to perform a cardiac transplant in 1984 at the KHMC by Dr. D. Hanania.

• The advancement in neurosurgery in Jordan is a part of this success story.


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THE BEGINNINGS (1960-1980)

• Jordan population 1,500,000• In 1962 Dr. Anton Tarazi (Canadian trained) practiced

neuro-surgery in Jordan, his base was in Jerusalem at the St. Augusta hospital

• Many patients went to the AUB in Lebanon• Some sought care in Egypt• The wealthy traveled to Europe


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1969

Two more neurosurgeons practiced in Jordan:• Ahmad Hanieh, who later (1976) immigrated to

Australia to practice in Adelaide

• Tawfiq Abu Rob re-located from Kuwait


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1973

Neurosurgery started at the KHMC by the return of Dr. Ishaq Maraqa after training in the UK, this service was to grow until it becomes one of the main neurosurgical facilities in Jordan. He and Dr. Ashraf Kurdi (neurologist), established the 1st. neuroscience center in Jordan with the support of Dr. M. Fayyad a neuro-radiologist and

Dr. I. Ayesh a neuro- ophthalmologist.


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1975

Dr. Sartawi returns to Jordan from Canada and starts practice in the private sector at the Palestine hospital, he also managed patients at the university hospital for a short while. He died in an accident in 1977.


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1977

This year saw the arrival of the first CT to Jordan. It was installed at

the KHMC (the main military hospital in Jordan). This was 4 years after the instalment of the

first CT scanner in the world at the Atkinson Morley’s Hospital in

Wimbledon in London


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1977

Professor Maani returns from Britain and starts the neurosurgical service at the University Hospital, today it is one of the major facilities.

The 1st. Sitting position surgery was performed

The 1st. Intracranial aneurysm was operated


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1982

The second CT scanner (EMI) was introduced to the Jordan University Hospital. Images were reported by neurosurgeons due to the lack on neuroradiology.

The availability of the scanner to the civilian population was given such importance that H.M. Queen Noor was present at the inauguration ceremony


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1978 and 1983

Professor Maani establishes the first Neurosurgical Residency Program in Jordan. It started as a professional program but later in 1983 it became academic ending in a university degree in addition to the Residency.

It graduated 22 out of the 50 neurosurgeons practicing today in Jordan


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1979

The whole of the public sector i.e. The Ministry of Health

Hospitals, the Military Hospital (KHMC) and the University

Hospital were served by one neurosurgical team of one

neurosurgeon and one resident.

The rest of the neurosurgeons (2) worked in the private sector


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1979

Two more neurosurgeons arrive:

Dr. Salah Salah (Austrain trained), who worked at the KHMC.

Dr. Saleh Tawalbeh (German trained).


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1984

The “Jordanian Neurosciences Society” was established through the efforts of Dr. Maraqa,

Prof. Maani and Dr. Kurdi (neurologist). The general assembly consisted of 18 neurosurgeons,

neurologists and allied disciplines’ specialists. Dr. Kurdi was elected as its 1st. President.


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FIRST ACTIVITY

As its inaugural activity it organized the 3rd. Pan Arab neurosciences conference in May 1984 and the combined E.A.N.S - Pan Arab graduate course in neurosurgery


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REGIONAL COOPERATION

Jordanian neurosurgeons were instrumental in establishing the Pan Arab Neurosurgical Society.

Jordanian residency programs had helped through graduating neurosurgeons for countries like Yemen, Palestine and Iraq.


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2005

In February 2005 this society was split into “The Jordanian Neurological Association” and the “Society of Jordanian Neurological Surgeons”. Prof. Maani was elected as its first president.


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2008

October 2008 saw the establishment of the ‘ Jordanian Society for Skull Base Surgery ’. Prof. I. Sbeih becomes its 1st. President.


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1980-2008

• Jordan population grew to 6.000.000• More neurosurgeons were graduated and

many returned after finishing their training abroad.

• The Society of Jordanian Neurological surgeons has a membership of 47

• Five Residency programs are functioning.


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NEUROSURGICAL RESIDENCY PROGRAMS AND DATES OF RECOGNITION BY THE JMC

• The Jordan University Hospital, 1983• The Royal Medical Services, 1987• The University of Science and Technology King

Abdulla Hospital, 1997• The Jordan Hospital, 2004• The Islamic and Ibn Haytham Hospitals 2006


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TYPES OF NEUROSURGERY PERFORMED

• ALL TYPES OF CRANIAL SURGERY• ALL TYPES OF SPINAL SURGERY• FUNCTIONAL NEUROSURGERY• ENDOVASCULAR• EPILEPSY SURGERY• PAIN MANAGEMENT


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INFRASTRUCTURE AVAILABLE

SPECILAIZED OPERATING THEATRES• TRAINED STAFF• ADVANCED MICROSCOPES• ENDOSCOPES• NEURO-NAVIGATION• ROBOTIC ASSISTED SURGERY• INTRA-OPERATIVE ULTRASOUND• INTRA-OPERATIVE PHYSIOLOGICAL MONITORS• SPINAL INSTRUMENTATION

IMAGING• CT• SPIRAL CT• PET-CT• MRI• FLEUROSCOPY


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SUPPORTING FACILITIES

MEDICAL FACILITIES

• THE KING HUSSEIN CANCER CENTER• THE FARAH REHABILITAION CENTER• THE NATIONAL CENTER FOR ENDOCRINOLOGY,

DAIBETES AND METABOLISM• THE GAMMA KNIFE CENTER AT IBN HAYTHAM

HOSPITAL• THE ACCELERATORS AT THE KHCC• THE RADIOTHERAPY UNIT AT AL BASHIR HOSPITAL


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SUPPORTING FACILITIES

EDUCATIONAL FACILITIES

• 4 MEDICAL SCHOOLS• 8 NURSING SCHOOLS• 1 SCHOOL OF REHABILITAION SCIENCES


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RECOGNITION

Jordan bid to host the WFNS 2013 conference was submitted in Nagoya in 2007.

Many believe that the 3rd. position was less than what we deserved.


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RECOGNITION

In 2008 around 100,000 patients from the Arab world came to Jordan for treatment.

Neurosurgery was in the forefront of the subspecialties sought by these patients who came from countries like Syria, Iraq, Yemen, Libya, Algeria, Saudi Arabia, Palestine, Sudan and the Arabian Gulf states.


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RECOGNITION

PUBLIC SECTOR

KING HUSSIEN MEDICAL CENTERJORDAN UNIVERSITY HOSPITALKING ABDULLA THE 1ST. HOSPITALKING HUSSIEN CANCER CENTER

PRIVATE SECTOR

IBN AL HAYTHAM HOSPITALTHE JORDAN HOSPITALTHE PALESTINE HOSPITALTHE KHALIDI HOSPITALTHE ARAB CENTERTHE ISLAMIC HOSPITAL

MAJOR NEUROSURGICAL FACILITIES


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THANK YOU

history of neurosurgery in jordan

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