Access to healthcare has been cast into the spotlight as coronavirus continues to threaten the well-being of seafarers.
Living in enclosed spaces, those who work at sea face a high risk of catching the virus if colleagues become infected.
In addition, they may have trouble accessing onshore medical facilities due to restrictive immigration measures introduced in many countries to control the spread of the pandemic.
The International Chamber of Shipping (ICS), which represents over 80% of the world’s merchant fleet, suggests ship operators should seek remote medical advice whenever the need arises.
In its guidance on the protection of seafarers’ health, the trade group states such advice can help those in charge of on-board medical care — usually shipmasters — when crew are suspected and confirmed to have been infected.
“Telemedicine services can come in as really useful, because you can liaise with telemedical centres if you see a problem,” ICS employment affairs director Natalie Shaw said.
“They can advise a most appropriate way to quarantine seafarers,” Shaw said, adding that service providers can also check with port authorities when there is a need for evacuation.
“[There are] very, very clear benefits to having access to telemedical services at these times.”
Evolution of telemedicine
Under the Maritime Labour Convention, cargo carriers are only required to have at least one seafarer on board with medical training, rather than a doctor.
Therefore, shipowners have had to seek professional medical assistance via radio, email, and mobile and satellite phone from port states or private services providers.
With the advance in information technology, Thomas Miller director Stephen Hunt said seafarers can even book appointments with doctors via video calls.
Hunt, who heads the insurer’s BlueMed telemedicine services, said: “There is a huge amount of very fancy technology available."
BlueMed itself has developed a secure iPad reporting system, which can allow its users to send photos to medical professionals and discuss symptoms via text messages.
This application requires small bandwidth and will erase personal information to protect data privacy when a case is closed, Hunt said.
Cost-benefit analysis
Ship operators need to have network connectivity to use more advanced telemedicine services.
Satellite data provider Marlink’s maritime president Tore Morten Olsen said the very-small-aperture-terminal service, which would allow live-video streaming, could cost about $1,000 per month. The monthly fee for the slower mobile-satellite service would start at somewhere between $300 and $400.
These costs come on top of telemedicine services charges. BlueMed has an annual subscription fee of $4,250 per commercial ship with 20 to 25 crew for unlimited use.
Hunt said the value of telemedicine lies in maintaining seafarers’ general well-being, thus avoiding medical emergencies that can require costly evacuations or vessel diversions.
“For instance, in parts of Australia it might be $60,000 to $100,000 to have somebody helicoptered off close to the shore,” he said.
“Thankfully, the majority of cases can be treated quite simply on board with pretty standard medication.”
According to Hunt, the role of telemedicine has probably developed towards monitoring medical issues for seafarers at an early stage.
“That helps keep the crew healthy. It prevents minor problems becoming major problems,” he said.
In-house services
Citing industry estimates, Synergy Marine director Rohit Banta said one in five ships is forced to divert from its course for medical reasons each year.
“Not only did it signify an incredible cost but more importantly, each precious moment could be the difference between life and death for the seafarer,” Banta said.
The shipmanagement company has opted to hire doctors in-house to provide telemedical services to the seafarers working aboard its managed fleet, rather than employ external providers.
Based in India and the Philippines, the doctors are able to offer round-the-clock advice by phone, email and video calls, Banta added.
“There have been instances where the doctors were able to give prescriptions online and the shipmaster could purchase the medicines locally through the agents in ports,” he said.
“The concept has worked enormously well for us over the years, irrespective of the nationality of the crew on board.”
