Posted on 20th October 2016
Working at sea is naturally going to limit options when it comes to healthcare: there’s no ER just down the road, no 24 hour emergency walk-in, no GP to hand for managing chronic conditions. The Maritime Labour Convention 2006 (MLC) demands that seafarers have the right to ‘equivalent’ healthcare as their on-shore counterparts – but is this really possible?
Ship operators face so many challenges when it comes to delivering on-board healthcare that it’s a problem often ignored. Medical care is delivered by partially-trained crew without the knowledge of a fully trained clinician – and management of long-term chronic conditions such as diabetes is non-existent.
Chronic conditions are increasingly common among seafarers with the expanding waistlines of the global nation: obesity is a bigger problem than ever before for ship operators sourcing crew. Increased mechanisation of tasks means a less physical job, while better access to less healthy foods compounds the issue.
While on the surface a mildly obese seafarer may not appear to be troublesome, the long term chronic conditions that are associated with it can significantly impact a seafarer’s risk of medical emergencies and long term co-morbidities such as diabetes. An obese crew member will have a much higher risk of a heart attack or stroke, while problems with the lungs, kidneys, liver, and heart are commonplace. Arthritis and joint problems are prevalent in obese people – increasing the risk of injury on-board.
Whether injury or illness, early assessment, diagnosis, treatment and ongoing management are all essential in order to ensure the best welfare for the patient and the least impact on the vessel’s productivity and efficiency. A seafarer out of action from injury or illness causes a devastating knock-on effect to other crew members who need to take up the slack of the patient’s duties. This results in untrained personnel taking on tasks they shouldn’t really do, over-working long hours resulting in tiredness, and ultimately increased risk to ship and crew safety.
Limited care on-board due to high costs and lack of resources means the impact of injury and illness in seafarers has a massive impact on ship operators’ margins. A study by the International Maritime Health Organisation (2013) found that one in five ships diverts every year – at an average cost of $180,000.
However, Masters will often choose to divert or arrange a costly medevac for a perceived medical emergency in order to avoid liability of exacerbation of an illness – or even death. This comes at a great price: a diversion for medical reasons means a delay in transport of cargo, last-minute changes to routes potentially into dangerous weathers, and possible fines for late delivery.
It is, however, not the only option.
Telemedicine has been around for years for on-shore healthcare: wound management nurses have had great success in the United States with video-based patient care. Clinicians can provide remote care and advice, and give the patient more independence and responsibility to their own health, driving up recovery rates and slashing the time for the restoration of full health.
The troubles with telehealth at sea, however, are multiple:
While every vessel is able to access free public radio telemedical services from the closest shore station, this is incredibly limited and often unreliable. The combination of language barriers, lack of clinical knowledge, and inability for a live read of a patient’s condition all mean diagnosis is shaky at best. Vessels deciding whether to continue with a voyage or arrange a diversion or medevac are often left no better informed than before contacting the medical station.
The alternative, private telemedical systems, has historically been too expensive, too unreliable, and too out of reach for most ship operators’ budgets. The problems with access, language, and response time are often still an issue, too,
Things are changing, however. Improved on-board technology, advances in smart ship innovations, and the delivery of iVital to the market mean telemedical care is now available to any ship operator on any budget.
No capital outlay.
You read that correctly.
A monthly subscription service means any ship will have access 24/7 to a senior NHS-registered clinician – from anywhere in the world – for just a few dollars per day.
Whether to assist in the management of on-board chronic conditions such as asthma and diabetes, or to assist in a medical emergency, iVital is the system that delivers. The clue is in the name: vital signs of the patient can be instantly read and fed back in real time thanks to several wireless monitoring components. A blood glucose monitor, pulse oximeter, ECG reader – these all contribute to increased accuracy in early diagnosis and enable a clinician to provide recommendations and monitor conditions whenever required.
The special tablet included in the kit is encrypted to protect patient confidentiality – without restricting visibility for the clinician. This means a fully informed analysis and diagnosis can be made: what may be a mild problem in one person could be fatal in another with a chronic condition or complex medical history.
It’s ship operators’ responsibility under the MLC 2006 to provide such high level healthcare on-board for all seafarers. Until now, it’s not been possible. iVital is the difference the maritime industry has been waiting for!