1. HISTORY OF
NEUROSURGERY
IN JORDAN
PROF. WALID MAANI, MD, FRCSEd
Jordan University Hospital and Medical School

2. 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
12/05/12 APPLIED SCIENCES UNIVERSITY 2

3. GENERAL INFORMATION
POPULATION: 6 MILLIONS
50% BELOW 25 YEARS
22 UNIVERSITIES
100 HOSPITALS
AREA : 96,000 SQ. KLMS
12/05/12 APPLIED SCIENCES UNIVERSITY 3

4. 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
12/05/12 APPLIED SCIENCES UNIVERSITY 4

5. HEALTH STATISTICS
• SOURCES OF HEALTH CARE FINANCE:
• PUBLIC: 36.5%
• PRIVATE: 58.9%
• DONORS: 4.7%
• HEALTH EXPENDITURE AS PERCENTAGE
OF GDP 9.6%
12/05/12 APPLIED SCIENCES UNIVERSITY 5

6. 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
12/05/12 APPLIED SCIENCES UNIVERSITY 6

7. 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%
12/05/12 APPLIED SCIENCES UNIVERSITY 7

8. 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.
12/05/12 APPLIED SCIENCES UNIVERSITY 8

9. 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
12/05/12 APPLIED SCIENCES UNIVERSITY 9

10. 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
12/05/12 APPLIED SCIENCES UNIVERSITY 10

11. 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.
12/05/12 APPLIED SCIENCES UNIVERSITY 11

12. 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.
12/05/12 APPLIED SCIENCES UNIVERSITY 12

13. 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
12/05/12 APPLIED SCIENCES UNIVERSITY 13

14. 1977
Professor Maani returns from Britain and starts the neuro-
surgical 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
12/05/12 APPLIED SCIENCES UNIVERSITY 14

15. 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
12/05/12 APPLIED SCIENCES UNIVERSITY 15

16. 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
12/05/12 APPLIED SCIENCES UNIVERSITY 16

17. 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
12/05/12 APPLIED SCIENCES UNIVERSITY 17

18. 1979
Two more neurosurgeons arrive:
Dr. Salah Salah (Austrain trained), who worked at the
KHMC.
Dr. Saleh Tawalbeh (German trained).
12/05/12 APPLIED SCIENCES UNIVERSITY 18

19. 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 1 st. President.
12/05/12 APPLIED SCIENCES UNIVERSITY 19

20. FIRST ACTIVITY
As its inaugural activity it organized the 3 rd. Pan
Arab neurosciences conference in May 1984 and
the combined E.A.N.S - Pan Arab graduate
course in neurosurgery
12/05/12 APPLIED SCIENCES UNIVERSITY 20

21. 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.
12/05/12 APPLIED SCIENCES UNIVERSITY 21

22. 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.
12/05/12 APPLIED SCIENCES UNIVERSITY 22

23. 2008
October 2008 saw the establishment
of the ‘ Jordanian Society for Skull
Base Surgery ’. Prof. I. Sbeih becomes
its 1st. President.
12/05/12 APPLIED SCIENCES UNIVERSITY 23

24. 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.
12/05/12 APPLIED SCIENCES UNIVERSITY 24

25. 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
12/05/12 APPLIED SCIENCES UNIVERSITY 25

26. TYPES OF NEUROSURGERY PERFORMED
• ALL TYPES OF CRANIAL SURGERY
• ALL TYPES OF SPINAL SURGERY
• FUNCTIONAL NEUROSURGERY
• ENDOVASCULAR
• EPILEPSY SURGERY
• PAIN MANAGEMENT
12/05/12 APPLIED SCIENCES UNIVERSITY 26

27. 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
12/05/12 APPLIED SCIENCES UNIVERSITY 27

28. 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
12/05/12 APPLIED SCIENCES UNIVERSITY 28

29. SUPPORTING FACILITIES
EDUCATIONAL FACILITIES
• 4 MEDICAL SCHOOLS
• 8 NURSING SCHOOLS
• 1 SCHOOL OF REHABILITAION SCIENCES
12/05/12 APPLIED SCIENCES UNIVERSITY 29

30. 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.
12/05/12 APPLIED SCIENCES UNIVERSITY 30

31. 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.
12/05/12 APPLIED SCIENCES UNIVERSITY 31

32. RECOGNITION
MAJOR NEUROSURGICAL
FACILITIES
PUBLIC SECTOR PRIVATE SECTOR
KING HUSSIEN MEDICAL IBN AL HAYTHAM
CENTER HOSPITAL
JORDAN UNIVERSITY THE JORDAN HOSPITAL
HOSPITAL THE PALESTINE
KING ABDULLA THE 1ST. HOSPITAL
HOSPITAL THE KHALIDI HOSPITAL
KING HUSSIEN CANCER THE ARAB CENTER
CENTER THE ISLAMIC HOSPITAL
12/05/12 APPLIED SCIENCES UNIVERSITY 32

33. THANK YOU
12/05/12 APPLIED SCIENCES UNIVERSITY 33