Textbook of Maritime Medicine

The World Health Organization (WHO) is one of the most important bodies of the United Nations (UN). Its constitution entered into force on 7 April 1948[1].

WHO’s mandate is that of coordination authority for health within the UN system, taking responsibility for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulation evidence-based policy options, providing technical support to countries and monitoring and assessing health trends[2].

 Although shipping and seafaring are not mentioned specifically in the mandate of the organization, WHO has shown activities on the field of maritime medicine and related topics, like travel medicine, vaccination requirements, occupational medicine, infectious diseases, hygiene etc.  

WHO has been active within maritime health on many different topics. In 1984 WHO decided to develop Centres for Maritime Medicine in Poland and New Zealand, and the organizations stands behind a lot of different publications, regulations and guidelines, mostly in cooperation with ILO and IMO. Some of them are mentioned in the text below. See also Chapter 5 – international conventions and regulations.

4.1.1   International Medical Guide for Ships[3]

From the Department of Protection of the Human Environment, the International Medical Guide for Ships (IMGS) was first published in 1967 by WHO in cooperation with International Labour Organization and International Maritime Organization. Since then this book has been the standard of guidance for seafarers falling ill or being injured.

The second edition was written in 1988, and was translated into more than 30 languages.

The third edition was approved in 2007 by the three organizations. The text was also endorsed by International Transport Worker’s Federation, International Shipping Federation and International Maritime Health Association.

In addition to being a textbook for seafarers in cases of illness or injury, the book also includes the TheList of Recommended Medicines and Equipment based on WHO Model List of Essential Medicines[4] . It also includes the International Health Regulations (see below).

The book is designed mostly like a textbook, well suitable for teaching and training purposes, but not to the same extent suitable for practical purposes of manual on board. 

4.1.2   WHO -  International Health Regulations (IHR)

The Department of International Travel and Health publishes the International Health Regulations (IHR), which are based on consensus and agreement between 194 countries, including the member states of WHO. Key milestones are the development of plans of action, to ensure that surveillance and response capacities are functioning. The aim of the IHR is to help international communities to prevent and respond to acute public health risks that have the potential to cross borders and threaten people worldwide[5].

Although travelling by air has taken over as the most rapid and most voluminous way of transporting infectious diseases to other parts of the world, travelling by sea has always had the potential of carrying infectious diseases between different world regions.

Being a seafarer implies risk of acquiring infectious diseases. Hence vaccination requirements and prophylactic measures have always been important to the seafarer, and will so be in the future. WHO is responsible for the International Certificate of Vaccination or Prophylaxis, based on the IHR, widely used and well known to travellers.

Travel medicine and maritime medicine are medical fields which overlap each other to a great extent. WHO is on of the most important organizations in this field.

4.1.3   WHO - Occupational Health

WHO Collaborating Centres on Occupational Health are key institutions distributed all over the world. A few of these centres are specialized in seafarer’s health, and form their own network, cooperating on research and development.

Cooperation is established between this network and International Maritime Health Association.

Occupational medicine probably is the most important part of the field of maritime medicine. Hence, this is an important arena for workers within maritime medicine. With its close link to public health and health systems development, the Occupational Health Programme addresses many determinants of seafarer’s health, such as risks for disease and injury in working environment, social and individual factors and access to health services[6].

4.1.4   WHO - Guidelines for Conducting Pre-sea and Periodic Medical Examinations for Seafarers[7]

In May 1993 the Joint ILO/WHO Committee on the Health of Seafarers concluded that an international standard should be developed for pre-sea and periodic examinations.

In 1995, the Conference of Parties to the International Convention on Standards of Training, Certification and Watchkeeping for Seafarers (STCW Conference) adopted resolution No. 9, Development of international standards of medical fitness for seafarers and invited the International Maritime Organization in cooperation with the International Labour Organization and the World Health Organization, to develop international standards of medical fitness for seafarers.

Although published by the ILO, these guidelines are the result of a close cooperation between WHO, IMO and ILO. Currently the existing guidelines are being revised (2009), and IMHA is commissioned to produce draft guidelines to replace the 1997 WHO/ILO version. A new version will be published in connection with the new and revised STCW Convention, probably in 2010 or 2011.

[1] The Constitution of WHO: http://www.who.int/governance/eb/who_constitution_en.pdf

[2] About WHO: http://www.who.int/about/en/

[3] International Medical Guide for Ships: World Health Organization 2007, ISBN 978 92 4 154720 8

[4] http://www.who.int/medicines/publications/essentialmedicines/en/

[5] http://www.who.int/features/qa/39/en/index.html

[6] http://www.who.int/occupational_health/en/

[7] http://www.ilo.org/public/english/dialogue/sector/techmeet/ilowho97/index.htm