Returning Sick and Injured Seafarers Home

• Medical repatriation involves returning an injured or ill seafarer to their home country for treatment, focusing on both the welfare of the crewmember and cost control.
• The process depends on the seafarer’s medical condition, including fitness to travel, the prognosis for care, and the availability of adequate medical facilities in their home country.
• Transportation methods vary from road travel to air ambulances, often accompanied by medical escorts.
• Multiple stakeholders are involved, including the ship’s crew, P&I Clubs, medical professionals, and the seafarer’s family.
• Challenges include medical clearance, logistical complications, and ensuring cost-effective yet adequate care.

Medical repatriation refers to the process of returning a seafarer to their home country following an injury or illness to receive necessary medical care. As highlighted by industry guidelines, this process is often complex and costly, depending on the seafarer’s condition, travel requirements, and the medical facilities in their home country. Addressing both the welfare of the crewmember and controlling costs are critical priorities throughout the process, reports UK P&I Club.

Determining Medical Fitness and Feasibility

The feasibility of repatriation is primarily a medical decision made by treating doctors, who assess whether the seafarer is “fit to travel.” Key factors include the severity of the injury or illness, risks associated with air travel (e.g., changes in air pressure), and the prognosis for short-term or long-term care. Other considerations include the proximity and adequacy of medical facilities in the seafarer’s home country or potential interim destinations.

Modes of Medical Transport

Depending on the seafarer’s condition, various transportation options are available:

• Road travel
• Commercial airline (seated, lie-flat seat, or stretcher arrangements)
• Air ambulance services
• Accompanied travel with medical escorts, which may include nurses or doctors
• Special provisions such as wheelchair assistance or oxygen support

Stakeholders in Medical Repatriation

Numerous parties play critical roles in the repatriation process:

• Ship’s Master and crew
• Crewing department
• Ship’s agent
• P&I Clubs and their local correspondents
• Treating hospitals
• Medical case management companies
• Seafarer’s family
• Receiving medical facilities in the home country

Managing the advice and input from these various stakeholders can be challenging, requiring clear communication and coordination.

Key Considerations for Medical Escorts

The selection of medical escorts involves multiple factors, including the seafarer’s and escort’s nationalities, location, availability, insurance coverage, and cost implications.

Cost Management in Repatriation

The economic aspect of repatriation is significant, particularly when high-cost countries like the U.S. are involved. While medical care in the seafarer’s home country may be more affordable, it is essential to ensure the same level of care is available. Costs vary widely depending on the distance and mode of transport, with air ambulances being the most expensive option.

Challenges in Repatriation

Several hurdles can complicate the repatriation process, including:

• Family involvement affecting treatment and logistics
• Medical conditions preventing travel clearance
• Difficulty securing suitable airline seats for the seafarer and escort
• Airline refusals due to the seafarer’s medical condition
• Deterioration of the seafarer’s condition during transit

Conclusion

Medical repatriation involves numerous variables, making each case unique in complexity and cost. Some cases are straightforward, while others require significant coordination and resources. Early involvement of P&I Clubs and their correspondents is strongly recommended to streamline the process and ensure the best outcomes for the seafarer.