Post on 29-Nov-2014
description
HISTORY OFNEUROSURGERY
IN JORDAN
PROF. WALID MAANI, MD, FRCSEdJordan University Hospital and Medical School
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
3
GENERAL INFORMATION
POPULATION: 6 MILLIONS
50% BELOW 25 YEARS
22 UNIVERSITIES
100 HOSPITALS
AREA : 96,000 SQ. KLMS
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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%
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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%
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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.
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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.
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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.
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
18
1979
Two more neurosurgeons arrive:
Dr. Salah Salah (Austrain trained), who worked at the KHMC.
Dr. Saleh Tawalbeh (German trained).
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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 1st. President.
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
20
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
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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.
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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.
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
23
2008
October 2008 saw the establishment of the ‘ Jordanian Society for Skull Base Surgery ’. Prof. I. Sbeih becomes its 1st. President.
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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.
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
26
TYPES OF NEUROSURGERY PERFORMED
• ALL TYPES OF CRANIAL SURGERY• ALL TYPES OF SPINAL SURGERY• FUNCTIONAL NEUROSURGERY• ENDOVASCULAR• EPILEPSY SURGERY• PAIN MANAGEMENT
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
29
SUPPORTING FACILITIES
EDUCATIONAL FACILITIES
• 4 MEDICAL SCHOOLS• 8 NURSING SCHOOLS• 1 SCHOOL OF REHABILITAION SCIENCES
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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.
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
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.
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
32
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
23年 4月 9日 APPLIED SCIENCES UNIVERSITY
33
THANK YOU