Improved Medical treatment on board

Seafarers are among the most isolated demographic working groups in the world in relation to access to medical care, both in emergency situations and for primary health care. On a large, slow vessel in the middle of the Pacific, a seafarer may be several days away from quality medical services. But this is set to change soon.

Seafarers can now look forward to maintaining better health while at sea. In this regard the International Maritime Health Association (IMHA) has taken up the cause of Indian seafarers by helping to form the Maritime Health Assn of India which is now headed by Dr. Suresh Idnani, the incumbent president.

Recently, the Chief Medical Advisor to the U.K. Maritime and Coastguard Agency and Mr Tim Carter visited India to coordinate and inspect the facilities available in India. He said, “Some Indian ship owners that I have met are very concerned and active but some of the accounts I have had when meeting trade unions suggest that others may be uncaring. There are additional issues when seafarers are recruited here to work on ships of other flags and employers, agents, P and I clubs that set unrealistically high medical standards to exclude capable seafarers from work.”

According to him many ship owners take advantage of the facilities offered by IMHA. It is all that the seafarer or the union wants. “It is often cheaper and easier for employers to get the tests done,” he says. “If by saying that he does not want the tests he would actually be pushing the seafarer out of a job in case of an accident and often this would be permanently, when they apparently find the seafarer is not fit to work at sea.”

Tim Carter who is also the past president of the International Maritime Health Association (IMHA) met Shipping Today along with Dr. Idnani during his visit to Mumbai to discuss developments in seafarer medical fitness assessment with the maritime sector and to help organize the programme for the 10th International Symposium on Maritime Health to be held in Goa this September.
He indicated that it was now essential to base decisions about seafarers’ fitness at work on the best available evidence on risk rather than just on the medical opinion of the examining doctor. To be fair to seafarers and to employers the reason for fitness decisions needs to be clearly identified in advance. Standards should aim to ensure that health problems arising at sea do not endanger other seafarers, the vessel or the individual’s own prospects of safe and complete recovery.
Tim noted that, while everyone wanted seafarers to be healthy, the seafarers themselves did not want to be denied work unless there was a well defined reason for it. In contrast ship operators were primarily concerned to having their vessels operating efficiently and economically and as a result could all too easily decide to not engage anyone with any form of ill-health even if it was irrelevant to work at sea. At times unscrupulous medical examiners could conspire with this approach in return for the business operators provided to them.
Such problems may be solved by having a fair and transparent system of medical fitness assessment that is regulated and audited by the national maritime authority. Indeed this responsibility is being increasingly placed on authorities by the conventions from international agencies such as IMO and ILO.
Tim related his experience in revising and managing the medical standards system in Britain and also described the work he was doing with IMHA to assist IMO and ILO to develop a fair and consistent set of international standards.
Dr. Idnani informed that the International Committee on Seafarers’ Welfare (ICSW) and the International Maritime Health Association (IMHA) have come together to bridge the gap between seafarers’ welfare and seafarers’ health. Some of the planned initiatives are to ensure that the health and welfare of seafarers are safeguarded and improved and that there is effective dissemination of good practices and high quality information on health aspects for the seafarers’ welfare.

Other areas of work include the availability of the expertise and communication networks of both organisations to help out with the ongoing projects and programmes concerning and related to the health aspects of seafarers’ welfare. Yet another area of joint action is to foster the investigation of solutions to practical problems concerning seafarers’ health and welfare. Efforts are on to ensure that the members of both organisations and those they represent understand and work effectively together to improve the life of seafarers whether at sea or on shore. It is the necessity here to provide the framework for joint project work where this is both beneficial and cost-effective.

“There are absolutely high standards for doing the tests, providing the treatment and getting medical advice,” states Mr. Carter. “But people do get them because they know they don’t want to have their seafarers’ career to end abruptly. “

Before joining the ship all seafarers undergo the fitness medical tests to see that there is no disease. What is being relied on is the training given to officers and what they have to depend on when on the ship viz., proper medicine and equipment that needs to be made available in the medical chest. Besides, in many of countries seafarers can avail of the national radio medical advisory service.

On every ship an officer is trained and he is the second officer. But this also means the master and the chief mate too, have done the training and can provide treatment to the injured or the seafarer who is ill. In India the coast guards have started providing medical cover and medical advice through a designated officer.

“The medical equipment on the ship should be exactly what is used when designated officer was trained to use,” pointed out Mr Carter. “When seeking medical advice the first thing the medical advisor would like to know is what equipment and medicine is available on the ship. It is important to have the medical guide, medical stores and radio medical advise should be properly coordinated.”
The International Committee on Seafarers’ Welfare, aware of the importance of lifestyle aspect in the health of seafarers, has launched a project FIT ONBOARD as one of the topics in the Seafarers’ Health Information Programme, sponsored by the ITF Seafarers' Trust.