THE INTERNATIONAL Chamber of Shipping is calling on governments to do more to ensure seafarers can access healthcare ashore once pandemic circumstances have settled.

The ICS noted port restrictions and reduced shore leave led to an increase in digital healthcare and telemedical services onboard during COVID-19, but there is still concern around future access to in-person and emergency medical care.

Earlier this year it was revealed that crews were still being refused urgent treatment at ports, according to the ICS.

Ismael Cobos Delgado, deputy director of the International Maritime Organization Maritime Safety Division, said the IMO’s seafarer crisis action team received numerous requests for assistance from seafarers during the pandemic who were unable to disembark to receive medical care ashore.

“Receiving such care can be a matter of life and death,” he said.

“While telemedicine and shipboard publications are valuable medical resources, there is also a legal obligation under IMO and ILO conventions to render assistance to seafarers in distress, including medical assistance.”

A problematic new normal

The ICS highlighted publicly reported examples of crew members being denied medical care, such as seafarers with broken limbs being asked to remain on board and take painkillers.

It said in one instance a chief engineer who was vomiting blood was not allowed to disembark, and a ship master’s body was refused repatriation after he had died from a heart attack.

“In lieu of access to medical shore leave, shipowners and seafarers have had to develop strategies to become more self-sufficient,” ICS said.

It said crews have often had to act as first-line responders, relying on telemedical services and onboard medical guides.

“As a result, not only have there been calls to update the guides in question – provided internationally by the World Health Organization or regionally by the flag state – but it has also led to a greater focus on preventative actions and raising awareness of resources available for crews,” it said.

Sandra Welch, CEO of the Seafarers Hospital Society, said many of the issues that began or worsened during COVID are ongoing.

She said the “new normal” includes difficulties accessing shore leave and medical services while on contract.

“This is one of the reasons we’ve extended our services to now not only support seafarers who contact us directly, but also offer information that might assist with preventative measures, such as physiotherapy exercises that can help reduce the risk of musculoskeletal injuries with repetitive physical work,” she said.

The International Labour Organization suggested that denying seafarers medical treatment puts additional stress on the global supply chain.

“[T]he crew change situation remains critical and appears to be deteriorating, which jeopardises the safe and uninterrupted delivery of vital supplies,” it said


Outdated medical material

The ICS also raised the issue of impractical medical advice being kept onboard vessels, a concern which is reportedly shared by seafarers, shipowners and operators.

For instance, the WHO’s International Medical Guide for Ships is perceived as outdated and “too bulky and academic” in nature, which makes it difficult for seafarers to use, particularly those who are less comfortable with reading English.

“The WHO International Medical Guide for Ships (Third Edition, 2007) has not been reviewed by the intended audience – real seafarers – but was reviewed by doctors,” Captain Pradeep Chawla of Anglo Eastern said.

“While this ensures that the medical advice provided is correct, its actual practical use in the field leaves much to be desired.

“If you have an emergency or something like a heart attack onboard, then you do not have time to look for a fat manual and read a whole page of text,” he said.

“What you need is a brief list of steps to follow, ideally in a pictorial format, and these would be best if available as cards rather than a whole book.”

The ICS said it has produced new medical material, the International Medical Guide for Seafarers and Fishers (First edition), to be published in November this year. It was designed to be simpler and more user-friendly.

First aid training for seafarers

In addition to concerns around medical material, Mr Chawla also suggested medical training currently provided to seafarers is not fit for purpose.

“I would strongly advise that the training period be increased and the modelled courses lay down the minimum equipment and medicines required,” Mr Chawla said.

He said there needs to be uniformity in first response training, as different regions and facilities may suggest the seafarer use medicine or equipment that is outdated, unavailable in that region or unknown by the seafarer.

“While an international guide may be the first step to greater uniformity of seafarer medical training, updates to international regulation, such as in the ongoing review of STCW, and an end to governments blocking medical aid ashore must be achieved if seafarer healthcare is to improve,” ICS said.