Seafarers are the lifeblood of the shipping industry and are critical to its future sustainability. That said, are we doing enough to ensure the welfare of those at sea? Furthermore, could major improvements to crew welfare save the shipping industry millions of dollars per year?
Is crew welfare key to a safe voyage? A seafarer’s state of wellbeing can make the difference between a safe transit and an incident with resulting major cost to a shipping company. It’s not then surprising that shipowners are looking for innovative new ways to improve crew welfare and avoid unnecessary disruption and costs. Loneliness, depression, fatigue and stress all add to the problem and are a growing and huge scale problem at sea, due in part to the fast turnaround of ships which has significantly reduced crew’s interest to go ashore.
Improved crew welfare inspires productivity & efficiency. Efforts are being made to improve crew welfare: it is becoming common for ships to have a crew member who is responsible for the welfare of those onboard, such as a ‘welfare officer’ and new initiatives and charters are starting to emerge aimed at improving the welfare of those at sea. Last year, the Sustainable Shipping Initiative (SSI) introduced a charter to encourage shipowners to take crew welfare beyond Maritime Labour Convention (MLC) requirements. Owners that meet the charter’s criteria will be demonstrating that they recognize the value of their crew. SSI expects these owners will attract and retain the best talent, which will inspire more productivity and efficiencies within operations.
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 crewmember falls ill, a tough decision often has to be made by the crew.
Without a doctor and diagnostic equipment, judging the severity of a condition can be very difficult. Continuing a voyage when a crewmember falls ill could result in conditions worsening, yet diverting, or arranging a medical evacuation could lead to significant costs and delays. According to a study by the International Maritime Health Association (IMHA) on 23,299 commercial ships with 420,000 crewmembers, 1 in 5 ships are forced to divert due to crew illness each year and the average cost per ship diversion is $180,000.
Many costly and disruptive diversions are unnecessary. Difficult to diagnose conditions such as gastroenteritis add to the problem. Despite being responsible for a huge number of diversions & medical evacuations, patients typically recover within a few days of going ashore, making the costly and disruptive diversions unnecessary. Another key and growing issue, is the challenge surrounding ongoing monitoring of patients in the case of chronic conditions, or mental health concerns, particularly important on longer voyages.
Telemedicine is the answer according to 98% of seafarers. In fact, results released in a recent seafarers’ survey carried out by maritime professionals’ trade union Nautilus International and global maritime technology innovator Martek Marine, indicated that 98% of seafarers thought that a greater provision of telemedicine on vessels would not just improve crew welfare, but actually save lives at sea.
Telemedicine is the remote diagnosis and treatment of patients by means of telecommunications technology. On a vessel, monitoring devices are used with wireless sensors, such as a blood pressure monitor; pulse oximeter; IR forehead thermometer; ECG monitor and a glucometer. The sensors are attached to a crewmember to record their vital signs. The vital signs data is transmitted via wireless connection to an onshore doctor, and this data, combined with high-definition, one-to-one video service between the doctor and the patient, enables the clinician to make an accurate, informed diagnosis using real patient data, combined with the patient’s medical history.
Martek Marine offers the first complete telemedicine solution available for a monthly fee. Setting the system apart from other telemedicine services, iVital is a complete solution: offering the necessary hardware, software and specialist clinical service, which provides access to a team of medical experts who specialize in the health of seafarers. Foolproof, the medically certified hardware and software can be used by anyone. Wireless sensors are attached to the patient and vital signs data is transmitted to the clinician onshore. The clinician then uses the data, combined with the patient’s medical history and one-to-one video consultation with the patient, to make a quick and accurate diagnosis. iVital advances offshore medical care & ultimately save lives.
Further benefits offered by iVital include, improved crew retention, reduced lost time, and reduced unnecessary medical evacuations and diversions. Available with no capital investment, iVital is cost-effective and accessible, costing under $10 per day for the complete solution. Maritime professionals’ trade union Nautilus International and global maritime technology innovator Martek Marine’s 2017 survey of seafarers, indicates that much more must be done to improve the accessibility and quality of healthcare services onboard seafaring vessels.
The Maritime Labour Convention (MLC) states that all ships carrying over 100 crewmembers and passengers for voyages of three days or more must have a medical doctor onboard. However, the majority of merchant vessels are crewed by fewer than 25 people and therefore don’t benefit from an onboard healthcare professional offshore. 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 indicated how common medical evacuations and diversions are at sea: alarming considering the average cost of a ship diversion is $180,000. “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. Emergencies experienced at sea ranged from severed limbs and broken bones, to gunshot wounds, tropical diseases, allergic reactions and Sudden Cardiac Arrest. 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 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 a participant. “An instantly advisable system via video link to a qualified medical practitioner would be beneficial,” said 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. 98% of seafarers agreed that a greater provision of telemedicine on vessels would save lives. “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.
Martek Marine offers the first marine approved, wireless telemedicine solution available for a monthly fee. iVital advances offshore medical care and saves lives. Available with no capital investment, iVital is cost-effective and accessible. The impact on safety of life at sea is huge, with benefits including; increased patient engagement and better patient care quality; quicker and more convenient clinical access; a reduction in lost time through illness and injury, an improved crew retention, and a greatly reduced, unnecessary patient evacuations.
“The survey results show that crew, often with little medical training, are often left with an impossible decision to make when someone falls ill offshore,” says Paul Luen, Martek Group CEO. “They’re forced to judge the severity of a condition, typically without any diagnostic equipment, leaving them with the choice of risking the wellbeing of the crew member, or substantial diversion costs. Telemedicine is the answer. iVital gives seafarers access to top level healthcare at a small cost, meaning it’s an accessible way to safeguard the wellbeing of those onboard ships and dramatically reduce the amount of unnecessary diversions and medical evacuations.”
“This is truly an informative survey and such information assists Nautilus in seeking an improvement to medical provision at sea. Telemedicine is essential for today’s shipping industry. As well as establishing the need for appropriate treatment of seafarers and ensuring that they get it, the use of telemedicine may reduce the need for deviation,” said Allan Graveson, Nautilus Senior National Secretary.