Health & insurance
Prevention and common sense is the key to staying healthy when travelling in Jordan. Infectious diseases occur, but these can be avoided with a few simple precautions. If you need vaccinations, remember to visit the doctor around eight weeks before travelling as some require multiple injections; this will also give time to ensure immunity on arrival as some vaccinations take time to come into effect.
The most common reason for travellers needing medical help is as a result of traffic accidents, which can partly be avoided if you wear a seatbelt, even though no one else in Jordan seems to bother, and stick to the speed limit on Jordan's less than perfect roads.
Medical facilities are generally very good, particularly in Amman where there are some excellent modern hospitals. In case of an emergency, contact your embassy or consulate where you will at least receive sound local advice. Don't forget to take out health insurance before you leave!
Before You Go
You are strongly advised to have insurance before travelling to Jordan. Check it covers the following:
- direct payments to health providers (or reimbursement later) for expenditure while in Jordan
- assistance in locating the nearest source of medical help
- emergency dental treatment
- repatriation home or air transport to better medical facilities elsewhere
The following vaccinations are recommended for most travellers to Jordan:
- diphtheria and tetanus – single booster recommended if you've not had one in the previous 10 years
- hepatitis A – a single dose at least two to four weeks before departure gives protection for up to a year; a booster 12 months later gives another 10 years or more of protection
- hepatitis B – now considered routine for most travellers
- measles, mumps and rubella – two doses of MMR recommended unless you have previously had the diseases; young adults may require a booster
- polio – generally given in childhood and should be boosted every 10 years
- typhoid – recommended if you're travelling for more than a couple of weeks
- yellow fever – vaccination is required for entry into Jordan for all travellers over one year of age if coming from infected areas such as sub-Saharan Africa and parts of South America
Note that some vaccinations should not be given during pregnancy, to people with allergies and to very young children – discuss this with your doctor.
Items you should consider packing:
- acetaminophen/paracetamol (Tylenol) or aspirin
- antibacterial ointment (eg Bactroban) for cuts and abrasions
- antidiarrhoeal drugs (eg loperamide)
- antihistamines (for hay fever and allergic reactions)
- insect repellent containing DEET (for the body)
- insect spray containing Permethrin (for clothing, tents and bed nets)
- iodine tablets or other water-purification tablets
- oral rehydration salts
Travelling with Medication
Bring medications in their original clearly labelled containers. A signed and dated letter from your physician describing your medical conditions and medications, including generic names, is also a good idea. If carrying syringes or needles, be sure to have a physician's letter documenting their medical necessity and keep these handy when entering or exiting any of Jordan's borders.
Consult your government's travel health website before departure:
In addition to government health websites, the following provide useful health information:
Centers for Disease Control (www.cdc.gov) Overview of the health issues facing travellers to Jordan and neighbouring countries.
MD Travel Health (www.mdtravelhealth.com) Complete travel-health recommendations for every country, updated daily, also at no cost.
World Health Organization (www.who.int/ith) Publishes a free, online book, International Travel and Health, revised annually.
International Travel Health Guide (Stuart R Rose, MD)
The Travellers' Good Health Guide (Ted Lankester) An especially useful health guide for volunteers and long-term expatriates working in the Middle East.
Traveller's Health (Dr Richard Dawood)
Travel with Children (Lonely Planet) Includes advice on travel health for younger children.
Travel Problems & Prevention
|Deep Vein Thrombosis (DVT) – formation of blood clots in the legs during long plane flights; some clots may break off and travel through the blood vessels to the lungs, where they may cause life-threatening complications.||Swelling or pain of the foot, ankle or calf, usually but not always on just one side. Chest pain and difficulty in breathing – immediately seek medical attention.||Walk about the cabin. Perform isometric compressions of the leg muscles (ie contract the leg muscles while sitting). Drink plenty of fluids. Avoid alcohol and tobacco.|
|Jet Lag – common when crossing more than five time zones.||Insomnia, fatigue, malaise, nausea||Drink plenty of fluids (nonalcoholic). Eat light meals.Upon arrival, seek exposure to natural sunlight and readjust your schedule (for meals, sleep etc) as soon as possible.|
|Motion Sickness||Nausea||Antihistamines such as dimenhydrinate (Dramamine) and meclizine (Antivert, Bonine). A herbal alternative is ginger.|
Availability & Cost of Health Care
Health-care provision is of a high standard in Jordan and any emergency treatment not requiring hospitalisation is free. The availability of health care can be summarised as follows:
- Modern, well-equipped public and private hospitals in Amman, Irbid, Aqaba and Karak.
- Good regional hospitals in Madaba, Ramtha and Zarqa.
- Basic health centres (all towns).
- Fairly modern and well-equipped dental surgeries in cities.
- Well-stocked pharmacies (most towns) dispensing advice as well as medicines.
- All doctors (and most pharmacists) speak English; many have studied abroad.
- Telephone numbers for pharmacies and hospitals in all cities are listed in the English-language newspapers.
- Ambulance number in Jordan: 911.
Diphtheria & Tetanus
Diphtheria is spread through close respiratory contact. It causes a high temperature and severe sore throat. Sometimes a membrane forms across the throat requiring a tracheostomy to prevent suffocation. Vaccination is recommended for those likely to be in close contact with the local population in infected areas. The vaccine is given as an injection alone, or with tetanus (you may well have had this combined injection as a child), and lasts 10 years.
Hepatitis A is spread through contaminated food (particularly shellfish) and water. It causes jaundice and, although it is rarely fatal, can cause prolonged lethargy and delayed recovery. Symptoms include dark urine, a yellow colour to the whites of the eyes, fever and abdominal pain. Hepatitis A vaccine (Avaxim, VAQTA, Havrix) is given as an injection; hepatitis A and typhoid vaccines can also be given as a single-dose vaccine, hepatyrix or viatim.
Infected blood, contaminated needles and sexual intercourse can all transmit hepatitis B. It can cause jaundice and affects the liver, occasionally causing liver failure. All travellers should make this a routine vaccination. Many countries now give hepatitis B vaccination as part of routine childhood vaccination. The vaccine is given singly, or at the same time as the hepatitis A vaccine (hepatyrix). A course will give protection for at least five years. It can be given over four weeks, or six months.
This is spread via infected blood and blood products, sexual intercourse with an infected partner and from an infected mother to her newborn child. It can be spread through 'blood to blood' contacts, such as contaminated instruments during medical and dental procedures, acupuncture, body-piercing and sharing used intravenous needles.
Reliable figures aren't available about the number of people in Jordan with HIV or AIDS (even the lead UN agency, UNAIDS, lacks data) but given the strict taboos in Jordanian society about drugs, homosexuality and promiscuity, the disease is relatively rare. Contracting HIV through a blood transfusion is about as unlikely as in most Western countries, and anyone needing serious surgery will probably be sent home anyway.
You may need to supply a negative HIV test in order to get a second visa extension for a stay of longer than three months.
Generally spread through either contaminated food or water, polio is one of the vaccines given in childhood and should be boosted every 10 years, either orally (a drop on the tongue), or as an injection. Polio may be carried asymptomatically, although it can cause a transient fever and, in rare cases, potentially permanent muscle weakness or paralysis. Polio is not currently present in Jordan but is prevalent in neighbouring countries.
Spread through bites or licks on broken skin from an infected animal, rabies is fatal. Animal handlers should be vaccinated, as should those travelling to remote areas where a reliable source of post-bite vaccine is not available within 24 hours. Three injections are needed over a month. If you've come into physical contact with an infected animal and haven't been vaccinated, you'll need a course of five injections starting within 24 hours or as soon as possible after the injury. Vaccination does not provide you with immunity, it merely buys you more time to seek appropriate medical help.
Tuberculosis (TB) is spread through close respiratory contact and occasionally through infected milk or milk products. BCG vaccine is recommended for those likely to be mixing closely with the local population. It is more important for those visiting family or planning a long stay, and those employed as teachers and healthcare workers. TB can be asymptomatic, although symptoms can include cough, weight loss or fever, months or even years after exposure. An X-ray is the best way to confirm if you have TB. BCG gives a moderate degree of protection against TB. It causes a small permanent scar at the site of injection, and is usually only given in specialised chest clinics. As it's a live vaccine it should not be given to pregnant women or immunocompromised individuals. The BCG vaccine is not available in all countries.
This is spread through food or water that has been contaminated by infected human faeces. The first symptom is usually fever or a pink rash on the abdomen. Septicaemia (blood poisoning) may also occur. Typhoid vaccine (typhim Vi, typherix) will give protection for three years. In some countries, the oral vaccine Vivotif is also available.
Yellow-fever vaccination is not required for Jordan, but you do need a yellow-fever certificate, from a designated clinic, if arriving from an infected area, or if you've been in an infected area in the two weeks before arriving in Jordan.
Jordan is not a dangerous place to visit, but it does have a few hazards unique to desert environments. Some visitors get themselves into trouble hiking through the desert in the heat of the day, especially around Wadi Rum. While heat-related problems are the most common, don't forget that the desert can be bitterly cold in winter: there is a real risk of hypothermia if camping between December and February without adequate bedding.
If Bitten by a Snake
- Don't panic: half of those bitten by venomous snakes are not actually injected with poison (envenomed).
- Immobilise the bitten limb with a splint (eg a stick).
- Apply a bandage over the site, with firm pressure, similar to bandaging a sprain.
- Do not apply a tourniquet, or cut or suck the bite.
- Get the victim to medical help as soon as possible so that antivenin can be given if necessary.
|Diarrhoea – occurs usually after eating unhygienically prepared food.||Onset of loose stools.||Take oral-rehydration solution containing salt and sugar; sip weak black tea with sugar; drink soft drinks allowed to go flat and diluted 50% with clean water.||Drink plenty of fluids; eat in busy restaurants; wash your hands regularly.|
|More than four or five loose stools.||Antibiotic (usually a quinolone drug); antidiarrhoeal agent (such as loperamide).||As above|
|Bloody diarrhoea persistent for more than 72 hours; accompanied by fever, shaking chills or severe abdominal pain.||Seek medical attention; in an emergency you can make up a solution of six teaspoons of sugar and half a teaspoon of salt to 1L of boiled or bottled water.||As above|
|Heat exhaustion – occurs following heavy sweating and excessive fluid loss with inadequate replacement of fluids and salt.||Headache, dizziness and tiredness; dehydration; dark yellow urine.||Replace fluids with water or fruit juice or both; cool with cold water and fans; take salty fluids through soup or broth; add a little more table salt to foods than usual.||Get fit before planning a long hike; acclimatise to the heat before exercise; wear a hat and cover your neck in the sun; avoid the midday sun in summer; wear sunscreen.|
|Heat stroke – occurs when the body's heat-regulating mechanism breaks down.||Excessive rise in body temperature; cessation of sweating; irrational and hyperactive behaviour; eventually loss of consciousness and death.||Give rapid cooling by spraying the body with water and fanning; seek emergency fluid and electrolyte replacement by intravenous drip.||As above|
|Mosquito bite – can spread dengue fever but not malaria.||Irritation; infection.||Don't scratch the bites; apply antiseptic.||Use DEET-based insect repellents; sleep under mosquito netting.|
|Bed bugs||Very itchy, lumpy bites.||Apply lotion from pharmacy.||Spray mattress or move hotel!|
|Scabies||Itchy rash, often between fingers.||Apply lotion from pharmacy; treat those you are in contact with.||As above|
|Snake bite||Pain; swelling.||Seek medical attention.||Wear boots, socks and long trousers when hiking; avoid holes and crevices; be careful handling wood piles.|
|Scorpion bite||Intense pain.||Seek medical attention.||Check your shoes in the morning, particularly if you are camping near Little Petra.|
Tap water in Jordan is generally safe to drink, but for a short trip it's better to stick to bottled water. This is readily available but check the seal has not been broken. Alternatively, you can boil tap water for 10 minutes, use water purification tablets or a filter.
The tap water in southern Jordan, particularly Wadi Rum, comes from natural springs at Diseh and so is extremely pure. Avoid drinking water from wadis in the wild as pools may have been used as waterholes for livestock. In the Jordan Valley, amoebic dysentery can be a problem.
If you get stuck in the desert without water, remember that you are more likely to be seriously ill (and even die) from dehydration than you are from an upset stomach, however unpleasant it may be. In summary, if water is offered and you need it, worry about its provenance later!
The risk of becoming sick from unhygienic food preparation in Jordan is slim, especially if you follow this advice:
- Avoid tap water unless it has been boiled, filtered or chemically disinfected (iodine tablets).
- Beware of ice cream that may have melted and then been refrozen (eg a power cut in the last day or two).
- Be careful of shellfish, such as mussels, oysters and clams, particularly outside of Aqaba, as well as the raw-meat dishes available in Lebanese restaurants.
- Eat meals only at busy restaurants and be cautious of buffets that may have been standing for more than a day.