Delivering comprehensive onboard care for seafarers can be challenging. Most ships simply do not have the space, staff and budget to support specialist care, behavioural health and other needs. And despite the limitations of healthcare at sea, maritime workers carry out some of the toughest jobs on earth – both physically and mentally.

They are expected to work long and irregular hours, sometimes without access to quiet, comfortable sleeping quarters or nutritious diets. The high-pressure and demanding nature of their work can leave crew members stressed and vulnerable to a range of physical and mental health challenges.

That’s why it has become critical for seafarers to have access to remote healthcare support from medical professionals beyond what is available onboard.

The Effects of Working at Sea

An article in Safety Science explored the findings of a study on the occupational safety and health challenges faced by passenger ship crew members. It noted that shipboard jobs “include high physical load and strenuous working postures, poor workplace design, long working hours [and] limited time for recovery.”

The study also found that passenger ship crew members report:

• The highest levels of perceived exertion
• The highest rates of long-term sick leave lasting 60 days or more
• Most sick leave caused by musculoskeletal and psychological disorders
• Heavy mental and emotional load created by unclear boundaries between work and recreation, as well as social interactions with customers and colleagues

Work stress isn’t unique to maritime. An American Psychological Association survey found that 31% of workers felt stressed out during their workday. However, rather than allow threats to mental and physical health to go unchecked until they require reactive intervention, the maritime industry could benefit long-term from proactive investments in crew health and happiness.

Workplace stress management and wellness programs can reduce the degree and impact of stress and help restore an employee’s depleted psychological resources. In fact, assisting wellbeing, spotting early signs of distress, and initiating early interventions are all a part of good ship management, according to a study from the International Association of Independent Tanker Owners (INTERTANKO) titled “Crew Welfare Management and Mental Wellness.”

How VIKAND’s House Doctor Can Help

A key part of OneHealth – VIKAND’s all-inclusive, proactive approach to onboard health and wellness – is the monthly House Doctor call for each ship we serve. This is a standing monthly call between Vessel Command and the senior maritime clinician (i.e. House Doctor) assigned to that vessel.

The House Doctor call is an ongoing, two-way conversation designed to build a trusting relationship between Vessel Command and shoreside medical staff, with the ultimate goal of enhancing the health and wellness of crew members.

The call is a chance to get direct insights on the state of crew health – both as a whole and individually – and to understand what kind of interventions could improve overall crew wellness. Based on the data provided by Vessel Command, the House Doctor can recommend easy-to-implement, cost-effective measures for use onboard the ship.

These may include:

• Adjustments to physical activity
• Psychological and mental health interventions 
• Changes to sleep and dietary habits
• Tobacco and alcohol cessation 
• Preventive screenings and biometric assessments 

By speaking regularly with shipboard leadership, the House Doctor can get a clear sense of physical and mental health concerns, illness and injury rates, environmental factors affecting health, medication dispensing patterns, procurement needs and any training support that would help staff better handle wellness concerns. 

Regular calls are a great opportunity to proactively intervene before a health or wellness issue results in a crew member missing work, getting sick or injured, having to disembark or worse. The negative impact on productivity and finances created by a medical disembarkation is something operators want to avoid at all costs.

On average, the total cost of a medical diversion and repatriation event is $180,000. About 60% of this involves direct costs, such as diverting the ship’s route, transportation from ship to hospital, in-patient care, repatriation to their home country, sick benefits and more. The other 30% is comprised of indirect costs, such as lost productivity, unforeseen port fees, replacement labour, overtime pay and case administration.

Remote Video Consultations Can Help

As satellite internet options become increasingly stable and affordable, more ships are able to offer strong and consistent internet connections. Seafarers can use this for entertainment, communication, learning, and even personal health and wellbeing.

Data from numerous articles and studies suggests that telehealth video consultations are just as effective, if not superior, to telephone consultations. In one clinical study, patients preferred video over telephone visits, citing the benefits of providing visual feedback to both patients and healthcare providers.

Likewise, providers felt they were better able to assess the patient’s healthcare condition over video chat. In another study, video performed nearly as well as face-to-face – the gold standard – when it came to formulating treatment plans.

Participants in a panel discussion at this year’s Crew Welfare Week noted that many seafarers still feel that telling an employer about mental health struggles could put their job at risk. Helplines are a good last resort, but seafarers need safe, judgement-free support from medical professionals to deal with mental health issues before they become an emergency.

Today, a wide range of mental and physical health conditions can be managed both in-person and remotely, which can help keep more seafarers in the workforce and save operators significant time and money in the long term. The panel also shared strong consensus around the idea that wellness is holistic. Instead of just reactively treating symptoms, maritime healthcare should proactively address the many interconnected aspects of seafarer health – mental, physical, social, financial, spiritual and more.

The monthly House Doctor call, combined with regular video consultations between crew members and shoreside healthcare professionals, has the potential to make a game-changing impact on seafarer health and wellness.

Does Your Fleet Need a House Doctor?

At VIKAND, we believe the future of maritime depends on the ability to attract, retain and protect the people who make our industry possible. It’s why we developed OneHealth, our holistic approach to supporting seafarer health and happiness through policies, services and solutions that promote better physical and mental health, nutrition, safety, productivity, environment and much more.

The House Doctor is just one component of this revolutionary platform. If you’re interested in learning how we can positively impact your maritime operations, contact VIKAND today for more information.