Health care and safety in Jordan
From Peace Corps Wiki
|Health care and safety in Jordan|
|The Peace Corps’ highest priority is maintaining the good health and safety of every Volunteer and trainee. Medical programs emphasize the preventive, rather than the curative approach to disease.
Serving as a Volunteer overseas entails certain safety and security risks. Living and traveling in an unfamiliar environment, a limited understanding of the local language and culture, and the perception of being a wealthy American are some of the factors that can put a Volunteer at risk.
The Peace Corps’ highest priority is ensuring the health and safety of every Volunteer. Peace Corps medical programs emphasize the preventive rather than the curative approach to disease. Peace Corps/Jordan maintains a clinic with a full-time medical officer who manages Volunteer and trainee primary healthcare needs. Additional medical services are available at local American-standard hospitals through referral by the medical officer. If you become seriously ill, you may be treated in the capital, Amman, or transferred to the United States for additional testing and/or treatment.
Health Issues in Jordan
Major health problems among Peace Corps Volunteers in Jordan are rare and are often the result of a Volunteer’s failure to take preventive measures to stay healthy. The most common health problems here are the same ones found at home, such as colds, diarrhea, hemorrhoids, constipation, sinus infection, skin infections, headaches, dental problems, minor injuries, sexually transmitted diseases (STDs), adjustment disorders, and emotional problems. These may be more frequent or compounded by life in Jordan because certain environmental factors here raise the risk or exacerbate the severity of the symptoms or illness. Smoking, for example, is not restricted at work or in public buildings. Volunteers are usually unprepared for the amount of cigarette smoke to which they are exposed. Summers are hot and dry. Dust and wind in parts of the country may cause your throat, nose, and eyes to sting and create cold-like symptoms. Winters, on the other hand, are cold and damp and may lead to sinusitis and upper-respiratory infection.
One of the most common health concerns in Jordan is diarrhea, which can be avoided by thoroughly washing fruits and vegetables and by boiling your drinking water.
Hepatitis is always present in the population. You will be vaccinated against hepatitis A and B, meningitis, tetanus, diphtheria, typhoid, MMR (Measles, Mumps, Rubella), and polio, if you have no documentation of previous immunization.
Helping You Stay Healthy
Peace Corps will provide all the necessary immunizations, medications, and information needed to stay healthy and productive during your two years of service.
Shortly after your arrival, you will receive a medical handbook and supplies for basic first aid and treatment of mild illnesses. Before going to your permanent site you will receive a medical kit. The contents of the kit are listed later in this section. You will have access to replenishment of medical supplies through the medical office. However, you will be responsible for bringing with you an initial supply of any prescription medications. Please bring a three-month supply of any prescription medications used daily with you. These will be supplied by the medical office, but if not available in Jordan, they will be ordered from the US and it may take several months for new shipments to arrive.
You will have physical exams at mid-service and at the end of your tour. If you develop a serious medical problem during your service, the medical officer in Jordan will consult with the Office of Medical Services in Washington, D.C. If it is determined that your condition cannot be properly treated in Jordan, you may be sent out of the country for further evaluation and care.
Maintaining Your Health
As a Volunteer, the ultimate responsibility for your health is yours. Proper precautions will significantly reduce risk of serious illness or injury. The old adage, “An ounce of prevention is worth a pound of cure.” should be kept in mind throughout your Peace Corps service.
It is critical to your health that you report promptly to the medical office for scheduled immunizations and that you inform the medical officer immediately of significant illness and injuries.
Many diseases that afflict Volunteers worldwide are entirely preventable if proper food and water precautions are taken. These diseases include food poisoning, amoebas, giardia, hepatitis A, dysentery, tapeworms, and typhoid fever. The medical officer will review Jordan-specific standards for food and water preparation during pre-service training.
HIV/AIDS and other sexually transmitted diseases (STDs) are present in this part of the world, but, because of sexual mores, are not readily discussed. AIDS is an incurable disease. Peace Corps has adopted worldwide medical policies and practices to protect its Volunteers and staff from transmission of the disease, but it is the Volunteer who bears responsibility for avoiding risks of infection. HIV/AIDS is a concern to all sexually active individuals, both heterosexual and homosexual. Abstinence is the only certain choice for prevention of HIV/AIDS and other STDs. You are taking risks if you choose to be sexually active. To lessen risk, use a condom every time you have sex. Whether your partner is a host country citizen, a fellow Volunteer, anyone at all, do not assume the person is free of HIV/AIDS or other STDs. You will receive more information about this important issue during pre-service training medical sessions.
Volunteers are expected to adhere to an effective means of birth control to prevent unplanned pregnancies. Your medical officer can help you decide on the most appropriate method to suit your individual needs. Contraceptive methods are available without charge from the medical office.
Women’s Health Information
Pregnancy is a health condition that is treated in the same manner as other Volunteer health conditions requiring medical attention, but also may have programmatic ramifications. The Peace Corps is responsible for determining medical risk and the availability of appropriate medical care if a pregnant Volunteer remains in-country. Given the circumstances under which Volunteers live and work in Peace Corps countries, it is rare that Peace Corps medical and program standards for continued service can be met. The majority of Volunteers who become pregnant are medically separated.
Feminine hygiene products are readily available for purchase on the local market, and the Peace Corps medical officer will not provide them. If you require a specific feminine hygiene product, please bring a two-year supply with you.
Your Peace Corps Medical Kit
Peace Corps provides Volunteers with a first-aid kit containing basic items necessary to prevent and treat illnesses that might occur during service. These can be restocked periodically at your Peace Corps medical office.
Medical Kit Contents:
- Ace bandage
- Adhesive tape
- Antacid tablets (Tums)
- Antiseptic antimicrobial skin cleaner (Hibiclens)
- Bacitracin/Neomycin/Polymixin B ointment
- Butterfly closures
- Calamine lotion
- Cepacol lozenges
- Dental floss
- Diphenhydramine HCL (Benadryl): 25 mg tablets
- Insect repellant stick (Cutter’s)
- Iodine tablets (Water purification tablets)
- Lip balm (Chapstick)
- Oral rehydration salts
- Oral thermometer (Fahrenheit)
- Pseudephedrine HCL (Sudafed): 30 mg tablets
- Red Cross First Aid and Personal Safety Manual
- Robitussin-DM lozenges (Cough calmers)
- Sterile gauze pads
- Tetrahydrozaline eye drops (Visine)
- Tinactin cream (Tolnaftate)
Before You Leave Home: A Medical Checklist
If there has been any change in your physical, mental, or dental health since the time you submitted your examination reports to the Peace Corps, you must immediately notify the Office of Medical Services. Failure to disclose new illnesses, injuries, allergies, or pregnancy can endanger your health and may jeopardize your eligibility to serve.
If your dental exam was done more than a year ago, or if your physical exam is more than two years old, contact the Office of Medical Services to find out whether you need to update your records.
If your dentist or Peace Corps dental consultant has recommended that you undergo dental treatment or repair, you must complete that work and make sure your dentist sends requested confirmation reports or X-rays to the Office of Medical Services.
If you wish to avoid duplicate vaccinations, obtain a copy of your immunization record from your physician and bring it to your pre-departure orientation. If you have had any immunizations prior to Peace Corps service, the Peace Corps cannot reimburse you for the cost. The Peace Corps will provide all the immunizations necessary for your overseas assignment once you arrive in country. You do not need malaria medication in Jordan.
Bring a three-month supply of any prescription or over-thecounter medication you use on a regular basis, including birth-control pills. Although the Peace Corps cannot reimburse you for this three-month supply, we will order refills during your service. While awaiting delivery, which can take several months, you will be dependent on your own medication supply. The Peace Corps will not pay for herbal or non-prescribed medications, such as St. John’s Wort, glucosamane, Selenium, or anti-oxidant supplements.
You are encouraged to bring copies of medical prescriptions signed by your physician. This is not a requirement, although it might come in handy if you are questioned in transit about your three-month supply of prescription drugs.
If you wear eyeglasses, bring two pairs—a pair and a spare. If a pair breaks, the Peace Corps will replace it, using the information your doctor in the United States provided on the eyeglasses form during your examination. To reduce the risk of developing serious infection or other eye disease, we discourage you from using contact lenses during your service. Most Peace Corps countries do not have appropriate water and sanitation to support eye care with the use of contact lenses. The Peace Corps will not supply or replace contact lenses or associated solutions unless their use has been recommended by an ophthalmologist for a specific medical condition and Peace Corps Office of Medical Services has given approval.
If you are over 50 and eligible for Medicare, or have a medical condition that may restrict your future participation in healthcare plans, you may wish to consult an insurance specialist about your coverage needs before your departure. Peace Corps will provide all necessary healthcare from the time you leave for your pre-departure orientation until you complete your service. When you finish, you will be entitled to the post-service healthcare benefits described in the Peace Corps Volunteer Handbook. You may wish to consider keeping an existing plan in effect during your service if you think age and/or preexisting conditions might prevent you from reenrolling once you return home.
Safety and Security—Our Partnership
Serving as a Volunteer overseas entails certain safety and security risks. Living and traveling in an unfamiliar environment, a limited understanding of the local language and culture, and the perception of being a wealthy American are some of the factors that can put a Volunteer at risk. Property thefts and burglaries are not uncommon. Incidents of physical and sexual assault do occur, although almost all Volunteers complete their two years of service without serious personal safety problems. In addition, more than 84 percent of Volunteers surveyed in the 2004 Peace Corps Volunteer Survey say they would join the Peace Corps again.
The Peace Corps approaches safety and security as a partnership with you. This Welcome Book contains sections on: Living Conditions and Volunteer Lifestyle; Peace Corps Training; and Your Health Care and Safety. All of these sections include important safety and security information.
The Peace Corps makes every effort to give Volunteers the tools they need to function in the safest and most secure way possible, because working to maximize the safety and security of Volunteers is our highest priority. Not only do we provide you with training and tools to prepare for the unexpected, but we teach you to identify and manage the risks you may encounter.
Factors that Contribute to Volunteer Risk
There are several factors that can heighten a Volunteer’s risk, many of which are within the Volunteer’s control.
Based on information gathered from incident reports worldwide in 2004, the following factors stand out as risk characteristics for assaults. Assaults consist of personal crimes committed against Volunteers, and do not include property crimes (such as vandalism or theft).
- Location: Most crimes occurred when Volunteers were in public areas (e.g., street, park, beach, public buildings). Specifically, 43 percent of assaults took place when Volunteers were away from their sites.
- Time of day: Assaults usually took place on the weekend during the evening between 5:00 p.m. and 2:00 a.m.— with most assaults occurring around 1:00 a.m.
- Absence of others: Assaults usually occurred when the Volunteer was unaccompanied. In 82 percent of the sexual assaults the Volunteer was unaccompanied and in 55 percent of physical assaults the Volunteer was unaccompanied.
- Relationship to assailant: In most assaults, the Volunteer did not know the assailant.
- Consumption of alcohol: Forty percent of all assaults involved alcohol consumption by Volunteers and/or assailants.
Summary Strategies to Reduce Risk
Before and during service, your training will address these areas of concern so that you can reduce the risks you face.
For example, here are some strategies Volunteers employ:
Strategies to reduce the risk/impact of theft:
- Know the environment and choose safe routes/times for travel
- Avoid high-crime areas per Peace Corps guidance
- Know the vocabulary to get help in an emergency
- Carry valuables in different pockets/places
- Carry a "dummy" wallet as a decoy Strategies to reduce the risk/impact of burglary:
- Live with a local family or on a family compound
- Put strong locks on doors and keep valuables in a lock box or trunk
- Leave irreplaceable objects at home in the U.S.
- Follow Peace Corps guidelines on maintaining home security
Strategies to reduce the risk/impact of assault:
- Make local friends
- Make sure your appearance is respectful of local customs; don’t draw negative attention to yourself by wearing inappropriate clothing
- Get to know local officials, police, and neighbors
- Travel with someone whenever possible
- Avoid known high crime areas
- Limit alcohol consumption
Support from Staff
In March 2003, the Peace Corps created the Office of Safety and Security with its mission to “foster improved communication, coordination, oversight, and accountability of all Peace Corps’ safety and security efforts.” The new office is led by an Associate Director for Safety and Security who reports to the Peace Corps Director and includes the following divisions: Volunteer Safety and Overseas Security; Information and Personnel Security; Emergency Preparedness, Plans, Training and Exercise; and Crime Statistics and Analysis.
The major responsibilities of the Volunteer Safety and Overseas Security Division are to coordinate the office’s overseas operations and direct the Peace Corps’ safety and security officers who are located in various regions around the world that have Peace Corps programs. The safety and security officers conduct security assessments; review safety trainings; train trainers and managers; train Volunteer safety wardens, local guards, and staff; develop security incident response procedures; and provide crisis management support.
If a trainee or Volunteer is the victim of a safety incident, Peace Corps staff is prepared to provide support. All Peace Corps posts have procedures in place to respond to incidents of crime committed against Volunteers. The first priority for all posts in the aftermath of an incident is to ensure that the Volunteer is safe and receiving medical treatment as needed. After assuring the safety of the Volunteer, Peace Corps staff provides support by reassessing the Volunteer’s work site and housing arrangements and making any adjustments, as needed. In some cases, the nature of the incident may necessitate a site or housing transfer. Peace Corps staff will also assist Volunteers with preserving their rights to pursue legal sanctions against the perpetrators of the crime. It is very important that Volunteers report incidents as they occur, not only to protect their peer Volunteers, but also to preserve the future right to prosecute. Should Volunteers decide later in the process that they want to proceed with the prosecution of their assailant, this option may no longer exist if the evidence of the event has not been preserved at the time of the incident.
The country-specific data chart below shows the incidence rates and the average number of incidents of the major types of safety incidents reported by Peace Corps Volunteers/trainees in Jordan as compared to all other Europe, Mediterranean, and Asia (EMA) region programs as a whole, from 2001–2005. It is presented to you in a somewhat technical manner for statistical accuracy.
To fully appreciate the collected data below, an explanation of the graph is provided as follows:
The incidence rate for each type of crime is the number of crime events relative to the Volunteer/trainee population. It is expressed on the chart as a ratio of crime to Volunteer and trainee years (or V/T years, which is a measure of 12 full months of V/T service) to allow for a statistically valid way to compare crime data across countries. An “incident” is a specific offense, per Peace Corps' classification of offenses, and may involve one or more Volunteer/trainee victims. For example, if two Volunteers are robbed at the same time and place, this is classified as one robbery incident.
The chart is separated into eight crime categories. These include vandalism (malicious defacement or damage of property); theft (taking without force or illegal entry); burglary (forcible entry of a residence); robbery (taking something by force); minor physical assault (attacking without a weapon with minor injuries); minor sexual assault (fondling, groping, etc.); aggravated assault (attacking with a weapon, and/or without a weapon when serious injury results); and rape (sexual intercourse without consent).
When anticipating Peace Corps Volunteer service, you should review all of the safety and security information provided to you, including the strategies to reduce risk. Throughout your training and Volunteer service, you will be expected to successfully complete all training competencies in a variety of areas including safety and security. Once in-country, use the tools and information shared with you to remain as safe and secure as possible.
What if you become a victim of a violent crime?
Few Peace Corps Volunteers are victims of violent crimes. The Peace Corps will give you information and training in how to be safe. But, just as in the U.S., crime happens, and Volunteers can become victims. When this happens, the investigative team of the Office of Inspector General (OIG) is charged with helping pursue prosecution of those who perpetrate a violent crime against a Volunteer. If you become a victim of a violent crime, the decision to prosecute or not to prosecute is entirely yours, and one of the tasks of the OIG is to make sure that you are fully informed of your options and help you through the process and procedures involved in going forward with prosecution should you wish to do so. If you decide to prosecute, we are here to assist you in every way we can.
Crimes that occur overseas, of course, are investigated and prosecuted by local authorities in local courts. Our role is to coordinate the investigation and evidence collection with the regional security officers (RSOs) at the U.S. embassy, local police, and local prosecutors and others to ensure that your rights are protected to the fullest extent possible under the laws of the country. OIG investigative staff has extensive experience in criminal investigation, in working sensitively with victims, and as advocates for victims. We also, may, in certain limited circumstances, arrange for the retention of a local lawyer to assist the local public prosecutor in making the case against the individual who perpetrated the violent crime.
If you do become a victim of a violent crime, first, make sure you are in a safe place and with people you trust and second, contact the country director or the Peace Corps medical officer. Immediate reporting is important to the preservation of evidence and the chances of apprehending the suspect. Country directors and medical officers are required to report all violent crimes to the Inspector General and the RSO. This information is protected from unauthorized further disclosure by the Privacy Act. Reporting the crime also helps prevent your further victimization and protects your fellow Volunteers.
In conjunction with the RSO, the OIG does a preliminary investigation of all violent crimes against Volunteers regardless of whether the crime has been reported to local authorities or of the decision you may ultimately make to prosecute. If you are a victim of a crime, our staff will work with you through final disposition of the case. OIG staff is available 24 hours-aday, 7 days-a-week. We may be contacted through our 24-hour violent crime hotline via telephone at 202.692.2911, or by e-mail at [email protected]
Security Issues in Jordan
When it comes to safety and security in the Peace Corps, you must be willing to adapt your behavior and lifestyle to minimize your potential as a target of crime. As it does anywhere in the world, crime exists in Jordan. You can reduce your risk of becoming a target by avoiding situations that make you uncomfortable and by taking advance precautions. Crime at the village or town level is less frequent than in large cities; people know each other and generally will not steal from their neighbors. Tourist attractions are favorite sites for thieves. Some safety concerns in Jordan follow.
Motor vehicle accidents: This is the single greatest risk to your safety in Jordan. Volunteers are required to wear seat belts when available. Due to high risk of certain modes of transportation, certain countries have placed restrictions on travel. In Jordan, Volunteers are prohibited from traveling after dark, away from their village, except in emergencies. They are encouraged to choose larger buses that appear to be in good repair.
Robbery/burglary: Some Volunteers have been pickpocketed or had their homes broken into in the past, and Volunteers must establish the same precautions and good habits that they would in the U.S. Peace Corps will teach you about proper home safety during training and requires that all Volunteers change the locks (and maintain all keys) before moving into approved accommodations.
Regional conflicts: Jordan borders the West Bank and Israel, and the Palestinian-Israeli conflict continues. More than 60 percent of Jordan’s population is Palestinian, and people in Jordan are very sensitive to events that affect Palestinians. When tension is high between the Arabs and Israelis, which is much of the time, there can be large demonstrations of solidarity from Palestinians in Jordan. You are discouraged from traveling to Israel during your service in Jordan. There is no travel to Iraq! Updates about these political situations will be provided as your departure for Jordan nears and frequently throughout your service.
Harassment: Volunteers report varying levels of harassment, such as having rocks thrown at them by children, being called derogatory names by teenagers, and receiving overt sexual comments. This is less likely to happen at a Volunteer’s site and more likely to happen in larger cities where Volunteers are anonymous. Strategies for coping with harassment appropriately are discussed at length during pre-service training.
Alcohol abuse: Jordan is an Islamic country and alcohol, although available in Amman and some larger towns, is strictly forbidden by the Muslim religion. A Volunteer should not be seen drinking alcohol at any time and should not even discuss or refer to alcohol while at work or in her/his community. Alcohol use can discredit a Volunteer and the Peace Corps.
Sexual Assault: Volunteers have been targets of sexual assault in Jordan. Alcohol consumption and cross-cultural differences in gender relations are associated with these assaults, and the assailant on occasion has been an acquaintance of the Volunteer. Volunteers who take seriously the training provided by Peace Corps/Jordan regarding sexual assaults can minimize their risk. Volunteers are required to report all assaults and threats of assault to Peace Corps staff so that an appropriate response and support can be provided.
Sex outside marriage is judged harshly in Jordan and may jeopardize your safety and/or ability to develop mutually respectful relationships in your community. Promiscuity puts both men and women at risk. Muslim women may be subject to severe retribution, even death, in the name of family honor.
Homosexual behavior is illegal in Jordan, and gay and lesbian rights are not protected under the Jordanian constitution. Jordanian gays may be jailed and beaten by police. Gay and lesbian Volunteers will have to practice discretion. The Peace Corps is committed to providing confidential support to all Volunteers, regardless of sexual orientation.
Staying Safe: Don’t Be a Target for Crime
You must take the primary responsibility for your safety. Only you can make yourself less of a target, ensure that your house is secure, and develop relations in your community that will ensure local acceptance. Do what you would do if you moved to a new city anywhere: be cautious, check things out, ask a lot of questions, learn about your neighborhood, know where the questionable locations are, use common sense, and be aware. You can significantly reduce your vulnerability to crime by integrating into your community, speaking Arabic, acting responsibly, and abiding by Peace Corps policies and procedures. Serving safely and effectively in Jordan will require some restrictions to your preferred lifestyle.
Volunteers attract a lot of attention in large cities and at their sites, but receive far more negative attention in highly populated centers where they are/feel anonymous. In smaller towns, “family,” friends, and colleagues look out for them. While whistles and exclamations are fairly common on the street, this behavior can be reduced if you dress appropriately, avoid eye contact, and do not respond to such negative and unwanted attention. Other methods have helped Volunteers avoid becoming targets for crime. Keep your money out of sight, not in external backpack pockets, in coat pockets, or in fanny packs. Always walk with a companion at night.
Preparing for the Unexpected: Safety Training and Volunteer Support in Jordan
The Peace Corps safety program takes a five-pronged approach to helping you stay safe during your two-year service: information sharing; Volunteer safety training; rigorous site selection; a detailed emergency action plan; and protocols for addressing safety and security incidents. Jordan’s in-country safety program is outlined below.
Peace Corps/Jordan staff will keep Volunteers apprised of issues that may affect Volunteer safety through information sharing. Regular updates will be provided in Volunteer newsletters and in memoranda from the Country Director. In the event of a critical situation, Volunteers will be contacted through the emergency communication network.
Volunteer training will orient and prepare you for specific safety and security concerns in Jordan. Sessions will prepare you to adopt a culturally appropriate lifestyle and to exercise judgment that promotes safety and reduces risk in your home, at work, and while traveling. Safety training is offered at every PC event throughout your two-year service and is integrated into all language, cross culture, and health presentations.
Rigorous site selection criteria are used to identify safe housing for Volunteers before assignment. Peace Corps staff work closely with host communities and counterpart agencies to prepare them for the Volunteer’s arrival and to establish expectations of their respective roles in supporting the Volunteer. Each site is inspected before the Volunteer’s arrival to ensure placement in appropriate, safe, and secure housing and schools or centers. Site selection criteria are based, in part, on relevant site history; access to medical, banking, postal, and other essential services; availability of communications, transportation, and markets; suitable housing options and other support requirements.
You will be trained in Peace Corps/Jordan’s detailed emergency action plan, which provides guidance in the event of civil or political unrest or a natural disaster. Once at your site, you will submit a detailed site locator form with address, contact information, maps and travel routes. If there is a security threat, Volunteers may be gathered at pre-determined locations until the situation is resolved. If the situation warrants, the Peace Corps may decide to evacuate Volunteers. Such a decision is made in close collaboration with the U.S. embassy and Peace Corps headquarters in Washington, D.C.
Finally, to be fully responsive to the needs of Volunteers, the safety and security coordinator must be informed of any incident. Peace Corps has established protocols for addressing safety and security incidents in a timely and appropriate manner. Peace Corps collects and evaluates safety and security data to track trends and develop strategies to minimize current and future risks.