Marine Healthcare: Top 3 Killers at Sea & How Telemedicine Systems Can Save Lives
Seafaring has long been one of the most dangerous occupations in the world. It’s not just the heavy machinery and difficult working conditions that contribute to fatality statistics, mariners are more at risk of certain illnesses and diseases which can be difficult to diagnose and treat with the limited resources found on a ship.
Here, we look at the Top 3 Killers at Sea and how telemedicine systems can help to save lives and make seafaring a safer occupation.
3. Heart Disease
Cardio-vascular disease (CVD), or heart disease is one of the world’s biggest killers, with 17.9 million people dying of a CVD related illness in 2015 alone. It’s no surprise that seafarers are more susceptible to the disease as it is often caused and exacerbated by an unhealthy lifestyle. Smoking, obesity, poor diet and excessive alcohol consumption can all contribute to the progress of cardiovascular disease, as can stress and lack of exercise – all common issues when onboard a ship for weeks or months at a time.
The lack of access to progressive medical treatment is a well-known fact in the marine industry with many vessels only having the basic first-aid equipment and trained personnel. Statistics from the United States show that the survival rate for cardiac arrest is under 6% when it occurs outside of a hospital setting. Strokes, another cardiovascular related disease, have similar fatality rates if not identified and treated rapidly, so in a maritime environment prevention is the most viable option.
It is thought that around 90% of CVD cases could be prevented by avoiding the obvious risk factors. Here are 5 tips for limiting the risk of cardiovascular disease:
- Stopping smoking is thought to reduce the risk of CVD by around 35%. Sign up to a smoking cessation service via your doctor, look at nicotine replacement therapy, or spend your time at sea reading the famous book ‘The Only Way to Stop Smoking Permanently’.
- Exercise is another method of lowing risk of CVD. Taking 2 ½ hours of exercise per week can cut your risk by up to 26%. Exercise should be fun – fitness apps can help you to keep track of your improvements and help you to challenge yourself and your crewmates.
- Diet – it can be tough sticking to a specific diet when you don’t have full control over what you eat but making healthier choices can be a start. A lower sugar, lower fat and higher fibre diet can help to lower cholesterol levels – a leading contributor to heart disease. Start off small – cutting out lots of fizzy drinks, switch to wholemeal bread or make a conscious effort to eat more vegetables.
- Cutting down your alcohol consumption can play a huge part in lowering your risk of CVD. Exercise can help to take your mind off things at times when you would usually have a drink.
- Lower your stress levels – this may seem like an impossible task when dieting, not smoking and limiting alcohol consumption but again, exercise can be the key to lowering stress levels as it releases endorphins into your body to help combat stress.
It’s obviously hugely difficult to change your lifestyle profoundly when on a vessel so it can help to make healthier, life-enhancing choices before deploying to give your body, and mind, time to get used to it.
If you find yourself getting dizzy, short of breath or have any pain in your arms or chest – report your symptoms and get them checked out immediately.
Hypertension is one of the major contributors to fatalities of seafarers. If left untreated, it can cause renal failure, heart attacks and strokes. Caused by excessive stress, fatigue and an unhealthy lifestyle, hypertension is a serious issue.
Realising you have hypertension can be difficult as often there aren’t any specific symptoms that would give you an unusual cause for concern. If your blood pressure is unusually high, you might experience chest pains, difficulty breathing and a severe headache but often symptoms can be masked under the stress of the job.
Without access to regular medical care, it’s imperative that seafarers take charge of their own medical health and hypertension is easy to diagnose with a basic piece of equipment – a blood pressure monitor. Anyone who works under stressful conditions should regularly check their blood pressure for early signs of hypertension and potential organ damage. If you notice that your blood pressure is high it’s time to take action!
Treatment for hypertension can be as simple as improving your diet and taking more exercise (notice a theme developing here?) although medication can also be necessary to combat the worst symptoms and lower your blood pressure. Following the advice for preventing CVD can cut your risk of hypertension dramatically.
Feeling stressed, having difficulty breathing and severe headaches can all be symptoms of hypertension. It can also affect anyone at any age. Don’t wait – report your symptoms and get your blood pressure checked. You can find out more about hypertension and ways to reduce your blood pressure here.
1. Mental Illness & Depression
In 2015, the World Health Organisation released a study which found that seafarers are the second most at-risk of committing suicide. Unsurprisingly, the isolated and remote life onboard a ship can lead to all manner of mental health issues – from loneliness and separation anxiety when away from your family for long periods, to depression and anxiety caused by social isolation, long periods spent at sea can play havoc with your mental stability.
Effects and symptoms of social isolation can range from a lowered immune system, increase in blood pressure and even suicidal thoughts. It’s imperative that each crew member takes an interest in the mental welfare of their colleagues but more importantly, that each individual is aware of their own stress and anxiety levels.
Diet and exercise are often overlooked when you get depressed. The tendency to eat the wrong things combined with the lack of motivation to get moving makes mental and physical symptoms worse. Using the time spent at sea to improve your physical state will have a huge knock-on effect on your mental state so try and stay healthy and get your endorphins flowing to beat the blues. Challenge yourself to lose weight, or just get fitter and keep people back at home up to date with your progress.
Younger seafarers tend to feel the isolation more profoundly, having grown up in constant contact with friends and family via social media and communication apps such as SnapChat and WhatsApp. Connected ships have been a blessing for those in a traditionally disconnected world. Staying in touch with the outside world is now easier which can help prevent loneliness creeping in, as can having access to an almost limitless supply of onboard entertainment via movie subscription services, e-books and music streaming services.
Technology can hold the key to staving off boredom and loneliness yet can also be a contributing factor to depression when away from home for long periods of time. The UK P&I Club recently stated that suicide accounts for 15% of deaths at sea and cited social media as being a major cause of depression amongst younger seafarers. The feeling of missing out on things and seeing friends and family carrying on life in the outside world can lead to greater feelings of isolation.
With such a wide range of risks and hazards onboard a ship, mental health and happiness are easily overlooked. Suicides now account for the more than any other health-related deaths at sea so make sure you, and your crewmates keep your mind and body active when away for long periods.
The Seafarers Hospital Society has joined forces with the Big White Wall to provide confidential advice and support for merchant seafarers based in the UK. Trained counsellors and peer to peer counselling services are available via a support network either online or via an App. Find out more here. For global mental health support, the Samaritans have been working with Befrienders Worldwide – a network of 400 centres in 39 countries. Find a Befrienders centre in your closest country here.
The Saviour at Sea – Telemedicine
As much as prevention of any illness will help to reduce fatalities, it’s not always practical or possible. Survival often depends on fast diagnosis and treatment which is notoriously difficult when medical resources are limited and a vessel is miles from the nearest port. Advanced ‘telemedicine’ can increase survival rates of many conditions, enhancing early diagnosis options and providing critical care for those in dire need.
With 1 in 5 ships a year being forced to divert for medical reasons, telemedicine systems represent a critical advancement in marine healthcare and crew welfare. Telemedicine systems, such as iVital, offer remote access to healthcare services as well as mobile systems to aid immediate diagnosis and monitor patient’s vital functions. From blood pressure monitors to assess and diagnose hypertension, to ECG machines which check a heart’s rhythm and electrical activity (critical when diagnosing a heart attack) telemedicine systems can help to save lives.
iVital is a pay-monthly healthcare package which includes 24/7 access to onshore clinical staff. Packaged in a slimline briefcase, the iVital telemedicine system includes blood pressure and heart monitors and an infrared thermometer, with the option to add a glucometer and LIFEFORCE marine type approved defibrillator. The unique onboard healthcare system uses Skype, or phone, to contact medical professionals to help assess a crew member’s medical status and provide emergency medical support for those treating life-threatening illnesses and injuries onboard.
In a recent survey conducted by ourselves and Nautilus International, 98% of seafarers think that a greater provision of telemedicine on vessels would save lives, but more needs to be done to improve the accessibility and quality of healthcare onboard seafaring vessels. It was also highlighted that “it’s not always clear how urgent a case is” before diversions or emergency evacuations are carried out. With 68% of respondents saying that they had been on a vessel which had been forced to divert due to a medical emergency and the average cost of a diversion running at $180,000, it’s clear that reactive healthcare is costing the industry millions.
Telemedicine systems utilise the best in technological advancement for the good of all onboard a vessel – connected technology gives the ability to have 24 hour a day access to expert medical advice, whilst smaller, lower cost medical equipment is more accessible and easier to use. Ship operators are now obliged to provide high levels of onboard healthcare which are as close to on-shore facilities as possible – telemedicine, specifically iVital, will help to make this possible, saving lives in the process.