What ‘good’ looks like in medical services for seafarers
By Dr Jens Tülsner
The maritime industry is the lifeblood of global trade, with millions of seafarers navigating the world’s oceans to ensure the smooth transportation of goods. Ensuring seafarers have access to quality medical services is not just a regulatory requirement but a moral imperative.
In our experience working with seafarers, whose work environment on seagoing vessels exposes them to unique health risks, we see many challenges that often come down to lack of medical knowledge on board, incomplete delivery of information, and language barriers. We often recommend to seafarers that the best way to maintain their health at sea is to maintain compliance with the medical advice given and the intake of any medication prescribed.
We encourage seafarers to join preventative and follow-up programs especially in cases of any chronic conditions (diabetes, hypertension, obesity) and not wait until it is too late to seek help.
Here, we present our guide to what ‘good’ looks like when it comes to medical services for seafarers.
First is comprehensive pre-employment medical examinations. Before setting sail, seafarers must undergo rigorous pre-employment medical examinations. These assessments ensure they are fit for the demanding conditions at sea and will disclose potential risks for upcoming medical issues while being at sea. While this is often perceived as a burdensome duty we recommend thinking of it as a chance instead – for check-up, follow- up, and potential initiation of further diagnostics or therapeutic adjustments. A thorough examination includes a physical health check – comprehensive physical examinations to assess cardiovascular, respiratory, and musculoskeletal health; a mental health assessment; psychological evaluations to identify potential mental health issues – ensuring seafarers are mentally prepared for long periods away from home; and drug and alcohol testing – ensuring seafarers are free from substance abuse, which could jeopardise safety on board.
Second is continuous access to medical care on board. Once on board, seafarers should have continuous access to medical care. This includes trained medical personnel – ships should have at least one crew member trained in advanced medical care, such as a ship’s doctor or a certified medical officer; medical supplies and equipment – well- stocked medical chests adjusted to current medical standards; basic medical devices such as defibrillators or pulse oximeters, and telemedicine equipment to manage emergencies; and telemedicine services – reliable communication systems that allow seafarers to consult medical professionals remotely, ensuring timely and accurate medical advice.
Emergency care
Third is a prompt and efficient emergency response. In the event of a medical emergency, prompt and efficient response protocols are critical. This involves emergency medical training – regular drills and training for the crew to handle medical emergencies efficiently; evacuation plans – clear protocols for medical evacuations, including communication paths, coordination with MRCC, nearby ships and medical facilities ashore; and access to onshore medical facilities – partnerships with onshore hospitals and clinics to ensure swift medical attention when necessary.
Fourth is mental health support and wellbeing programmes. The isolation and stress of seafaring can take a toll on mental health. Providing robust mental health support is essential and includes mental health awareness – regular workshops and training sessions to promote mental health awareness and reduce stigma; counselling services – access to counselling services, either on board or through telemedicine, to support seafarers dealing with stress, anxiety, or depression; and recreational activities – ensuring seafarers have access to recreational facilities and activities to promote relaxation and mental wellbeing.
Fifth is regular health monitoring and wellness programmes. Continuous health monitoring and wellness programs are vital to maintaining seafarers’ health. This includes periodic health checks – regular health check-ups while on duty to monitor ongoing health conditions and detect any new issues early; health education – programmes to educate seafarers about healthy lifestyle choices, including diet, exercise, and stress management; and vaccination programmes – ensuring seafarers are vaccinated against prevalent diseases, especially when traveling to high-risk areas.
Lastly, there needs to be adherence to international standards and regulations. Compliance with international standards and regulations ensures consistency and quality in medical services. This includes the Maritime Labour Convention (MLC) 2006 standards, which outline comprehensive requirements for health protection and medical care; and the International Health Regulations (IHR) guidelines to manage and prevent the spread of diseases.
These suggestions are in many ways common sense, but you may be surprised at how often these basic guidelines aren’t followed. Overall, when we talk to seafarers, we urge them to find a balance in their everyday life between what they like and what they know is healthiest in terms of diet and exercise as the best way to stay healthy.
Dr Jens Tülsner is managing director, CEO and founder of Marine Medical Solutions.
