With reports pouring from different quarters that seafarers are being denied medical acess at ports and are constantly battling with mental trauma over repeated extension of their term because of crew change problem, the International Chamber of Shipping has issued fresh COVID19 Guidance addressing these issues.
Today, we are going to include those guidelines to help seafarers get their medicines at ports and maintain proper mental health while at sea.
Medical Assistance to Seafarers in Ports
Under the ILO MLC 2006, port States must ensure that any seafarers on board ships in their territory who need immediate medical care are given access to medical facilities on shore.
However, medical assistance to seafarers in ports is now limited and, before sending a seafarer ashore for medical care, the person(s) responsible for on board medical care should be in direct contact with the receiving medical service.
This can be arranged through the ship’s agent or other port intermediaries. This is necessary as hospitals and clinics may not be allowed, or may not want, to receive patients that are at risk of infection, or potentially a risk of causing infection or considered not urgent.
- If a seafarer cannot be brought ashore for medical care, the person(s) responsible for onboard medical care must seek advice from a TMAS or other medical advice service with experience in handling medical issues and to identify possible contacts on land.
- If a seafarer has not had contact with anyone for 14 days with COVID-19 and is not showing any symptoms of COVID-19, they are unlikely to pose a risk and port authorities should use discretion and identify suitable aid and assistance.
- Ship visitors and other intermediaries in ports should be made aware of the seafarer’s situation and try to mediate where possible.
- Some crew members in critical need of medical attention have been prevented from disembarking for urgent treatment.
- There have also been occasions when it has proved difficult to properly manage removal
of seafarers who have died on board. - National and local restrictions are impacting seafarers who require urgent medical care, both for COVID-19 and non-COVID-19 cases.
- The ILO, IMO and WHO have reminded all member States that seafarers are key workers and entitled to medical care and assistance under the IHR, SOLAS, MLC and STCW.
- Shipping companies experiencing such issues should contact their flag State and telemedical services for urgent assistance.
- National shipowners’ associations should be informed, so that they can alert ICS which will take action at an international level.
Mental Health Guidance for Seafarers
The circumstances associated with the ongoing COVID-19 outbreak may pose unique challenges to seafarers and their families.
Seafarers may become bored, frustrated or lonely, and their families may also be
experiencing difficulties.
Everyone reacts differently to events, and changes in thoughts, feelings and behaviour
vary between people and over time. Seafarers must nurture their mind as well as their body and seek further support if required.
Different strategies to enhance mental health and wellbeing are provided in Annex G.
Managing Physical Symptoms Triggered by Stress and Anxiety
The following short-lived symptoms may arise for people with a low mood or anxiety:
- Faster, irregular or more noticeable heartbeat;
- Feeling lightheaded and dizzy;
- Headaches;
- Chest pains or loss of appetite.
It can be difficult to know what causes these symptoms, but they are often experienced due to stress, anxiety or low mood and may worsen when people focus on them.
Seafarers who are concerned about physical symptoms should speak to the person(s) responsible for on board medical care and if necessary seek advice from telemedical services.
Anyone experiencing stress, feelings of anxiety or low mood, should:
• Use the ISWAN mental health practical tools available at seafarerswelfare.org/seafarer-healthinformation-programme/good-mental-health; and
• Watch the video Managing Your Mental Health during the COVID 19 Pandemic, available at seafarerswelfare.org/seafarer-health-information-programme/coronavirus-covid-19/managingyour-mental-health-during-the-covid-19-pandemic.
Handling a Mental Health Crisis and Emergency
Added stress due to COVID-19 may impact mental health and shipping companies should take a mental health emergency as seriously as a physical health emergency. Seafarers may think they are having a mental health crisis and no longer feel able to cope or control their situation and may feel:
• Great emotional distress or anxiety;
• Unable to cope with daily life or work; and
• Like considering self-harm or even suicide, or experience or hear voices (hallucinations).
If this occurs, seek immediate expert assessment and advice for the best course of action from a mental health professional. If under the care of a mental health provider, contact the specific advisor for advice.
Expiry and Renewal of Medical and Ship Sanitation Certificates
ILO, IMO and WHO have encouraged issuing administrations by issuing a joint statement on medical certificates of seafarers, ship sanitation certificates and medical care of seafarers in the context of the COVID-19 pandemic.
Under the STCW Convention and the MLC 2006, the maximum validity of medical certificates is two years. If the period of validity of a medical certificate expires during a voyage, the medical certificate shall continue in force until the next port of call, where a medical practitioner recognised by the state party is available, provided this does not exceed three months.
ILO has recognised that restrictions imposed to contain the pandemic may, under certain circumstances, constitute a situation of force majeure in which it becomes materially impossible to renew a medical certificate within the maximum period of three months foreseen by the STCW Convention and the MLC 2006.
Administrations have been encouraged to take a pragmatic and practical approach regarding the extension of medical certificates, as strictly necessary, and to notify ships, seafarers and relevant administrations accordingly.
Port State control authorities are also encouraged to take a similar approach in relation to medical certificates and their acceptance in the exercise of control procedures in accordance with the MLC 2006.
Medical certificates must be renewed as soon as the situation improves. Maritime administrations should regularly review the evolution of the situation.
For more information see the ILO Information Note on Maritime Labour Issues and Coronavirus (COVID-19) ilo.org/wcmsp5/groups/public/—ed_norm/—normes/documents/briefingnote/wcms_741024.pdf
For further guidance, see the ICS guidance Coronavirus (COVID-19): Managing Ship and Seafarer Certificates during the Pandemic at www.ics-shipping.org/covid19
Renewal of Prescriptions
In view of the present uncertainty and time needed to resolve crew changes, seafarers should request, without delay, access to long-term personal medications on prescription that are running low so that they can be purchased and delivered as essential items.
National legislation differs and it is not always possible to obtain certain types of medicine, to use repeat prescriptions or to validate electronic prescriptions, especially under the current restrictions.
Seafarers whose essential personal medication is running low should:
- Alert the ship’s Master of the need to obtain a repeat prescription, providing accurate details of the medication required, including correct dosage to assist the ship’s request to the port agent and provide information to the port authorities to obtain the medicine;
- Where possible, obtain an electronic prescription from their doctor before arriving in a port or provide a hard copy of the prescription (if available) to allow the port agent to verify that it is accepted to purchase the medicine;
- If privacy and confidentiality is required and seafarers do not wish to notify the ship’s management, they should contact a seafarers’ centre or mission to obtain information, delivery and purchase of medicines, noting that during the current restrictions, the activity of seafarers’ centres and missions has been heavily restricted;
- Request supplies to be sent from their country of residence, if possible. However, this may be difficult under the current restrictions and delivery may be delayed. Parcels containing prescriptions may also be subject to quarantine, depending on national and company policies on COVID-19 contagion prevention.
A table is attached at Annex H outlining the requirements for requesting repeat prescriptions for seafarers whose personal medication is running low.
The list is not exhaustive and it is important to make contact with the port authorities or local welfare workers in advance of arrival to establish how best this can be achieved
on a timely basis.
Did you subscribe to our daily newsletter?
It’s Free! Click here to Subscribe!
Source: International Chamber of Shipping
