Published on 12/04/2017
Gunshot wounds, severed limbs, broken bones, tropical diseases, allergic reactions and sudden cardiac arrest: just some of the emergencies experienced at sea according to results released in a recent seafarers’ survey carried out by maritime professionals’ trade union Nautilus International and global maritime technology innovator Martek Marine.
Results from the seafarers’ survey, which have just been released, indicated that much more needed be done to improve the accessibility and quality of healthcare services onboard seafaring vessels. Shockingly, in the case of one crew member who was shot by a colleague and left with a serious gunshot wound, he was left for four hours until the vessel reached port before receiving professional medical care. “I was left to die with no help until we reached port 4 hours later,” he said.
In terms of crew health, shipowners are obliged under MLC 2006, to ensure that they provide, ‘access to prompt and adequate medical care whilst working on board.’ Seafarers should also be provided, ‘with medical care as comparable as possible to that which is generally available to workers ashore.’
That said, the average merchant vessel is staffed by less than 25 people, meaning it’s not mandatory to have a doctor onboard the vessel and this being the case, the vast majority of ships do not have access to a medical professional when they are offshore. Therefore, when a crew member falls ill, a tough decision often has to be made by the crew.
When asked if seafarers felt that they had the same quality of healthcare at sea as they did onshore, 82% of those surveyed stated “no” and the main reasons given related to the lack of access to a GP. Results of the survey also confirmed how common medical evacuations and diversions are at sea. “We divert, speed up, slow down, whatever is needed to help if there is a serious enough medical issue,” said one seafarer, who explained, “it’s not always clear how urgent a case is.”
In fact, a staggering 68% of those questioned had been on a vessel that was forced to divert due to a medical emergency and 70% had been on a vessel where there had been a medical evacuation.
In the event on an injury or illness at sea, when asked what their main concern would be, nearly half of those questioned specified the lack of adequate healthcare provision offshore. In addition, 66% of people stated that they would be concerned about their own ability to handle a medical emergency.
In contrast, 69% of people surveyed said that they would be confident making a decision on whether an injury, or illness was severe enough to warrant a diversion, or evacuation, if they had a trained medical consultant on the end of the phone. “There should be a means where increasing connectivity can be taken advantage of, like a video chat to enable trained health personnel to see the casualty, or patient and advise,” said one participant. “An instantly advisable system via a video link to a qualified medical practitioner,” would be beneficial according to another.
Many crew rely on a physical copy of the Ship Captain’s Medical Guide for medical guidance when working on board a ship. When asked what would make them feel safer at sea, 82% of those questioned specified the ability to transfer live vital signs to a UK based medical professional who can diagnose patients and offer advice. “In this day and age, it is crazy that I should be flicking through an outdated book to try and diagnose appendicitis, when there is technology available to let an expert diagnose it for me,” said one seafarer.
Telemedicine used on ships offers wide-ranging benefits beyond regulation compliance. Firstly, crew benefit from increased patient engagement and improved patient care quality. Virtual consultations reassure patients that medical professionals are involved in their care when they need them the most and it makes it much easier for them to reach out with questions. In addition, ongoing condition monitoring allows chronic health problems and mental health issues to be monitored effectively. Secondly, telemedicine offers quicker and more convenient clinical access. Through sophisticated diagnostics, potentially serious healthcare issues can be addressed quickly with real-time, urgent care consultations and the best course of action can be discussed within minutes.
Shipping companies using telemedicine on their ships have reported a reduction in lost time through illness and injury, as well as improved crew retention. Medical issues can be addressed via professional consultation before symptoms worsen, resulting in the crew member needing to take time off work to recover. Finally, the use of telemedicine dramatically reduces unnecessary patient evacuations and ship diversions to shore: non-urgent visits to land-based medical facilities are avoided thanks to expert medical assistance given at the right time, leading to more-informed decision making in crisis situations. For these reasons, a recent study by the International Maritime Health IMHA, highlights huge predicted financial benefits to the shipping industry through the deployment of telemedicine, suggesting a 20% saving to shipping companies, equating to an industry saving of $168 million per year (€152 million).