ARIJ Logo
Jordan map

COVID-19 Hotspots in Jordan

Al-Omari Crossing: The Bitter Passage

Ansar Abu Fara

On May 9, 2020, Jordanian truck driver Yasser Qaraba unloaded his truck at the Saudi Arabian border before heading back to Jordan through the Al-Omari crossing which connects Jordan to Saudi Arabia and the Arab Peninsula. There, he joined hundreds of drivers in a waiting room that was hastily preparing PCR tests for those returning to Jordan, which had imposed a travel ban on air and sea travel since March 16, 2020.

Qaraba, along with 300 other drivers (both Jordanian and foreign) camped out on the sidewalk as they waited for their results. Yet after receiving news that he had tested negative for COVID-19, he was surprised to find that he, along with his fellow drivers, were obligated to quarantine at the Prince Faisal Military School in Al-Azraq (49km from Al-Omari). This facility was chosen as a temporary quarantine centre based on an official decree issued on the eve of Qaraba's travel and until caravans were prepared inside the crossing.

corona-img

The government’s confusion in implementing travel restrictions, coupled with their insistence on quarantining drivers (even those testing negative), led to overcrowding at the borders and avoidable interactions. Consequently, the drivers’ health and safety were put at risk, as confirmed by the investigative team through firsthand observations at the border through video calls. The investigators were unable to visit the closed border (154km south of Amman) or the Military School (quarantine facility) due to the security and safety concerns.

The investigation documents the mishandling of the authorities during their attempts at enforcing regulations for testing, housing and quarantining drivers. These regulations were established on May 10, 2020, after a member of the Ministry’s staff visited the crossing. The footage from the two sites demonstrates the negligent handling of the situation given the absence of physical distancing and preventive measures during PCR examinations, as well as prolonged waiting times.

COVID-19 preventative measures stipulate that drivers wait in their trucks, however many of them operate based on a handover/transfer system, where drivers share the same trucks. Consequently, many drivers were left without housing at the border as they waited for their trucks to return. The Land Transport Regulatory Authority has not prevented this practice and has failed to regulate or supervise this gathering of truck drivers.

As of April 15, the government subjected incoming drivers to a self-funded COVID-19 test (paid to the private lab “Med Lab” which costs 45JOD ($ 64)). As a result, dozens of drivers await their results by the borders, on a daily basis, without any sanitary precautions.

On April 17, 2020, the laboratory opened a branch by the crossing under a contract with the Ministry of Health, according to the Ministry’s response to our enquiry.

van

Delayed Responses and Poor Enforcement

Many of the decisions and regulations adopted by the Jordanian government were reactionary instead of preemptive. The decision to implement compulsory tests for those crossing the border, for example, was issued 67 days after the first infection by air was recorded on March 2, 2020. Additionally, the decision was taken 51 days after the closure of air and sea borders following the discovery of a breakout in the village of Johfiya in Irbid on March 13; a result of a wedding which violated Health Ministry recommendations.

Additionally, government measures at the crossing were delayed by 25 days, and only came as a result of two infections confirmed on April 14. Further, government action was taken two days after an outbreak of cases in the village of Al-Khanasiri in Mafraq (a population of almost 60,000), when a driver violated his monitored quarantine period.

As a result of delayed government response, Jordan has seen a rapid increase in the number of casualties labeled “high risk” despite recording zero cases for 11 days (from April 25 to May 5, 2020), according to the National Centre for Security and Crisis Management. This led to a prolonged nationwide quarantine period, which lasted from March 18 to June 4, costing the Kingdom $140 million a day, according to statements made by the Finance Minister on May 8. Tens of thousands lost their jobs and source of livelihood, while thousands of medium and small enterprises became insolvent and bankrupt.

A Timeline of Government Decisions as COVID-19 Reached Jordan
March 2, 2020

The first case of COVID-19 is recorded in Jordan

March 10, 2020

Sea crossings with Egypt are closed

March 13, 2020

Two recorded infections; one from the US and the other from Spain, both of whom attend a wedding in Irbid.
Authorities begin counting infections of wedding attendees.

March 16, 2020

- Suspension of all official institutions and the private sector, with the exception of vital sectors as determined by the prime minister
- No-one is to leave the house unless absolutely necessary
- No movement between governorates is allowed
- Newspaper printing is suspended
- Public transport is suspended
- Commercial complexes, except pharmacies and catering centres, are closed
- Quarantine camps are erected at land crossings for Jordanians returning, and Jordanians abroad are advised to stay put
- Closure of the airport, sea and land crossings, except for the Al-Omari crossing, the Karama crossings with Iraq and Jaber with Syria

April 14, 2020

Two recorded infections of truck drivers at Al-Omari crossing

April 17, 2020

A medical laboratory is opened at Al Omari, requiring drivers to perform a PCR test

May 6, 2020

- A truck driver in the village of Al-Khanasri in the Mafraq governorate is infected.
- Authorities begin tracing the driver’s contact in Mafraq, Irbid, Ramtha, Zarqa and Jerash

May 8, 2020

A decision is taken to quarantine truck drivers in military schools in the Azraq area until caravans are equipped

May 17, 2020

Drivers at Al-Omari begin quarantining in individual caravans

June 18, 2020

Completion of the "handling yard" between trucks at the customs crossing of Al-Omari

Completion of the "handling yard" between trucks at the customs crossing of Al-Omari

Thus, delayed responses, overcrowding in unsanitary conditions, the negligent management of drivers, and poor implementation of preventative measures at the crossing led to counterproductive results, as documented by this investigation.

Following the truck driver’s infection in Al-Khanasiri, the virus spread, with up to 104 cases recorded in several cities across the country, including Irbid, Jerash, Ramtha, Zarqa, and Mafraq, according to Dr. Nazir Obeidat, the spokesperson for the National Epidemiological Committee.

corona-img corona-img

Shock by the Border

“The decision to quarantine was surprising,” says Korbaa, who left his home with the intention of returning quickly, and without providing his family with what they needed to prepare for the long absence. Meanwhile, drivers were arriving at the Al-Omari border after unloading their truckloads in Saudi Arabia (Jordan's largest trading partner).

The new arrivals could not be sheltered as the military school was overcrowded with 320 drivers divided among 24 rooms. Of the 200 drivers who remained homeless, 40-year old Abu Faisal spent eight days at the Omari Borders (from May 11 to May 18, 2020) sleeping on the sidewalk and taking refuge inside the only mosque at the border crossing, which was also crowded with other drivers.

Expensive and Insufficient Caravans

On May 17, the Al-Omari administration prepared 200 “independent” caravans, according to instructions issued by the National Centre for Security and Crisis Management. However, their capacity dropped to 194 caravans after six were converted into offices, storage facilities for testing equipment, and spaces for border agents. On June 12 an additional 47 caravans were prepared based on the Ministry of Health’s response, resulting in a total of 241 units to house quarantining drivers.

Despite their efforts, 241 units are not sufficient based on the average number of 300 drivers arriving daily, according to data collected by the investigator. The crossing receives 4,200 drivers every two weeks, each of whom is required to individually quarantine in a caravan for a period of 14 days. Consequently, the units are overbooked for that period, while about 4,000 drivers accumulate at the crossing as they wait for a free unit. This number effectively doubles after four weeks causing major overcrowding at the crossing, as documented by the investigative team.

This situation forces drivers to wait in the desert for around 8 to 14 days until a unit becomes vacant, according to testimonies by 15 drivers. Before a caravan becomes available for drivers, they are required to pay the full amount due as they wait for their accommodation. The amount comes to 10JOD ($14) per night, coupled with an extra 20JOD ($28) as a transportation tariff. When the drivers were asked for their receipt, Ahmed Al Hayek, Mundhir Al Dawood, Qurba 'and Abu Faisal answered that drivers are not given one.

Furthermore, drivers are also required to pay the cost of the PCR test (45JOD , $64), while some of them complete their quarantine period (having paid for the first round of tests) without having actually completed their shift, and have to undergo a second test before they are allowed to leave. As a result, some drivers are forced to bear the testing costs twice.

corona-img corona-img

Deaths and Suicide Attempts

"A man in a truck and a man in a grave," complains driver Ali Al-Sokhni, who spent 8 days at the border last May before being transported to a caravan, and switched to working a different role to avoid a repeat of this experience.

The media’s coverage of the overcrowding at the borders has led to negative implications on truck drivers returning home. Driver Ahmed Al-Hayek says timidly that drivers' families are being "socially ostracized" in their neighborhoods due to people's fear of catching infection. In an audio recording, he explains how his nine-year-old child was kicked out of a grocery store: "you are the son of a driver? Don't come to buy, but deliver your father!"

On July 21, 2020, a Jordanian driver tried to commit suicide by ingesting a large number of pills in front of the clearance building at the al-Omari crossing. This was in response to security forces displacing drivers who could not find shelter and sought refuge at the entrances to the building to escape the heat. According to an official statement, another driver died that same evening after attempting to escape his mandated quarantine by hiding in the back of an outgoing truck. His colleagues informed us that he had not seen his family since May, and was delaying his return to avoid another round of quarantine before being able to continue his job. However, when he heard news of his child being born he tried to escape. Unfortunately, he was crushed by the body of the truck, which caused outrage amongst the other drivers who were enraged by the situation. Security forces were forced to intervene as hundreds of overcrowded drivers at the crossing were angrily protesting.

A third driver attempted to commit suicide by hanging himself on July 23 in protest of the quarantine measures and the negligent treatment of drivers at the crossing, according to Hayek, who tried to talk him out of it.

In response to the tragic events at the crossing, Jordan’s Prime Minister Omar Al-Razzaz, decided on July 23, 2020 to provide truck drivers at Al-Omari and Jaber crossings an exemption from paying the testing fees, according to the official page of the prime ministry.

corona-img corona-img corona-img corona-img

Confusion at the Quarantine Administration

We followed the transfer of the first batch of drivers on May 9, 2020, to the military school. There, we witnessed a number of health and safety violations, including 14 drivers gathered in one room, with an average of two square meters between each driver, despite social distancing recommendations. Drivers described the whole situation as a "health catastrophe." The rest of the drivers spent seven days outdoors by the border until May 17, when the first group of drivers was quarantined.

According to Alaa Al-Abadi, head of the Goods Transport Directorate at the Land Transport Regulatory Authority, and the testimonies of numerous drivers (including Ahmed Al-Hayek and Saeed Abu Milad and Farhan Al Jarwan), drivers that operate based on a handover systems are allowed to wait at the crossing despite the absence of shelter. Based on the estimates of the Land Transport Regulatory Authority, the number of drivers in this situation is approximately 220 (Jordanian and foreign).

Drivers have the choice between sleeping outdoors at the crossing or sheltering inside the military academy and risk contracting the virus due to interactions with other drivers. Munther Al-Daoud, a driver who passed through the crossing on May 23, chose to wait outside instead of taking shelter at the military academy. After getting tested, he remained in his truck for 5 days before transferring it to another driver that could take the cargo into Jordan. During this time, Al-Daoud was able to avoid paying the caravan fee by seeking refuge in a mosque and wandering around.

"I can’t pay these fees every time I pass through, especially because I can’t work for 4-weeks because I have to quarantine,” said Al-Daoud.

He also stressed that the movement of drivers at the crossing area is not restricted or regulated, nor is there any control over social distancing measures.

For his part, Al-Abadi thinks drivers should be responsible for maintaining the appropriate distance.

Warning Signs

Despite the elevated risk of transmission and the virus’s spread to several towns as a result of returning truck drivers, the government waited until April 14 to implement any preventative measures (such as PCR testing) or procedures governing the truck drivers’ journeys.

The preventative measures were implemented after two infection cases of Jordanian drivers returning from Saudi Arabia were confirmed (on April 12-13, 2020 according to the Ministry of Health). In light of these cases, the Ministry of Health announced (at a press briefing on April 17) that all returning drivers would be required to undergo mandatory examinations in designated hospitals to prevent the spread of the virus. At that time, 1,200 Jordanian drivers underwent a free COVID-19 examination in national hospitals, according to data reported by the Land Transport Regulatory Authority.

van icon
120
Jordanian truck drivers
van icon
152
Non-Jordanian truck drivers
face mask icon
272
Total cases from April 12 to July 25, 2020
Source: Jordanian Ministry of Health
corona-img corona-img

A Domino Effect

On April 15, 2020, Health Minister Saad Jaber confirmed three children had contracted the virus after their father, a truck driver, transmitted it upon his return to Irbid. Two days later, a truck driver that had already crossed the border into Jordan before getting tested was found to also be a carrier of the virus. This is not an uncommon occurrence, as cases started spreading amongst other truck drivers who had been in contact with their families. On April 22 and 24, two new cases were confirmed due to the interactions of truck drivers with other people.

Meanwhile, the number of confirmed cases in Saudi Arabia was doubling daily, starting from May 7, 2020, according to updates on the Saudi Ministry of Health’s website. Meanwhile, Jordan was recording between one and eight cases per day at Al-Omari Centre during the period of this investigation which lasted 25 days, starting from April 14 to May 8, 2020. Only on April 16, 19 and 28 was the crossing free of new cases.

The aforementioned cases were a red flag for the risks associated with truck drivers, according to the statistician, Mutassem Al-Saeedan. Al-Saeedan, criticises the Ministry of Health’s late intervention: "They should have double tested the drivers instead of taking random samples of drivers returning from Saudi Arabia, where the virus was already spreading rapidly.

Procedural Flaws

Before quarantine was imposed in mid-April, driver’s entry was largely dependent on the result of the border check over a period of 23 days. If the result was negative, the driver would be allowed to unload their cargo trucks inside the country, and if it was positive (and the driver was Jordanian), they would be taken to a designated quarantine hospital.

According to Dr. Obeidar, foreign drivers testing positive are asked to return to their starting point at the crossing. According to the Ministry of Health, the hospitals designated to host COVID cases are the “Hamza Governmental Hospital” in Amman, 147 km away from Al-Omari, and the “King Abdullah Hospital” in Irbid, 181 km away from the crossing.

Despite the World Health Organisation’s recommendation that travelers should self-isolate for a period of 14 days, even if test results are negative, the Jordanian Ministry of Health ignored this in their dealing with drivers. According to the testimonies of 15 drivers, drivers were not required to go through a second round of testing. At the time, the ministry was satisfied with a pledge signed by the drivers in which they would commit to self-isolating for 14 days.

corona-img corona-img
corona-img

Unsafe Testing Procedures

Jordanian driver Saeed Abu Milad expressed his fears of infection when he went through the legal and health procedures at Al-Omari Centre. Abu Milad complains of the absence of physical distancing measures while undergoing the mandatory PCR test, as well as at the results waiting rooms. The investigation documents, through various interviews, evidence of close contact between drivers waiting for the results of the examination or their transfer to caravans.

The same concerns were expressed by Al Dawood, especially after it was confirmed that two drivers who were waiting at the border at the same time as his test were carriers of the virus. "Only a few steps separated us from these two drivers while we were waiting for the test results. Nobody cares about the drivers. There was absolutely no physical distancing," says Al-Dawood.

Jordanian driver Ahmed Hayak, describes the testing equipment as a carrier of the virus “in and of themselves”. The tests are conducted in a small room near the customs centre at the crossing. Multiple drivers, both Jordanians and non-Jordanians, crowd in front of this single-seat room during the process. Inside the room, two laboratory technicians (accompanied by military personnel) are tasked with collecting samples.

According to the drivers’ testimonies, doctors do not change gloves after taking a sample from a patient. This is even more concerning because doctors collect the examination fees and identification from one driver to the next without changing their own equipment, increasing the risk of transmission.

Examination procedures at the crossing violate WHO guidelines related to examination rooms which are required to be "well-ventilated, sterile, and free of clutter”, and staff are obligated to use the appropriate attire (including gloves, face shields, masks, and glasses) which should be changed after coming into contact with patients.

corona-img corona-img

Ministry of Health’s Negligence

Jordanian driver Farhan Al-Jarwan accuses the Ministry of Health of negligent behaviour that has placed drivers’ lives at risk. He wonders, "Why does the government not guarantee our protection? Instead, it deals with us as though we were the ones spreading the virus, even though they were clearly disorganised with their quarantine policies."

The Jordanian Ministry of Health indicates that it implemented the procedures recommended by the WHO and in accordance with the International Health Regulations, by “conducting thermal tests (measuring the temperature of the patient’s forehead) for all those arriving by land”. The Ministry adds that they “took initiative” by setting up testing labs at the borders even though it was not yet recommended by the WHO or the United Nations.

According to the Ministry’s written response, “the discovery of a large number of cases recorded amongst truck drivers led to our decision to implement a mandatory quarantine period at the crossing”.

The Land Transport Regulatory Authority seeks to distance itself from assuming responsibility and transfers its authority to the Ministry of Health and the Crisis Management Committee, which includes representatives from both the Ministries of Health and Transport. The transport authority’s spokesperson, Abla Weshah, confirms that the authority’s regulatory role is restricted to land transport, and that health issues are under the jurisdiction of the National Epidemiology Committee and the National Centre for Security and Crisis Management.

For its part, the Epidemiology Committee confirms that it initially recommended quarantining drivers from the start, but logistical difficulties intervened and caused delay.

The National Crisis Management Centre refused to clarify when asked about the nature of logistical difficulties leading to improper quarantining methods and processes.

corona-img corona-img

WHO Recommendations

The WHO confirms in its two manuals on preparedness and response measures for COVID-19 that there is no one-size-fits-all approach to managing the crisis. Therefore, each country must assess its risks and quickly implement the necessary measures on the appropriate scale to limit the transmission of COVID-19 and its economic, public and social impacts.

The organisation calls on all countries to raise their level of preparedness to identify new cases of COVID-19. The contents of the two manuals are consistent with what is stipulated in Article 22 of the 2005 International Health Regulations Law, that “the appropriate authorities must make effective arrangements to deal with emergencies in order to deal with unforeseen public health events.”

As for the recommendations issued on February 11, 2020, regarding the quarantine protocols applicable to travelers, the WHO confirms that the state may, under Article 31 of the International Health Regulations Law, subject travelers to quarantine if it anticipates a risk of spreading infection. The emergency protocols must also include support for quarantine, which places responsibility on the authority managing the crisis.

Al Omari Crossing: A Hotspot

According to daily communication on COVID-19 issued by the Prime Minister and the Ministry of Health in Jordan, cases continue to rise at Al-Omari Crossing. By June 23, 221 infections were recorded, of which 83 were Jordanians and 183 foreigners. (It may be useful here to mention that the number of cases at the crossing (221) represents 21% of the group of cases in Jordan as of June 23 (1047 injuries).) It provides additional evidence that the passage is a hotspot for infection.

Has Al-Omari turned into a breeding ground for the virus? Researcher Saeedan says: “There are many indications that Al-Omari has become a hotspot for infection, as a result of the lack of social distancing and prevention measures, in light of the high number of drivers who cross it daily, both Jordanian and non-Jordanian.”

corona-img corona-img