Textbook of Maritime Medicine

5.4.1        IMO Conventions – technology, structure and operation

A complete list of maritime conventions from the IMO is given in Table 5.2.

The IMO conventions addresses safety, environment, liability and compensation, salvage, ship recycling, to mention the most important ones. They deal with structure, organization, operation and technology.

There are a total of 32 adopted conventions, a few of them not yet entered into force, like the STCW-F 1995, BWM 2004, SUA 2005, NAIROBI WR 2007 and HONG KONG SRC 2009.

In additions there are a lot of protocols and amendments to the conventions, not all entered into force yet.

Table 5.4.2  IMO conventions and some of theirimportant amendments up to May 2009

5.4.2        ILO Conventions – the people

Table 5.4.2  ILO conventions of relevance to the maritime sector

The ILO perspective on shipping industry is different from that of IMO. ILO’s concern is the working environment and the health and welfare of workers.

A list of conventions from the ILO is listed in Table 5.3.

There are 47 Conventions, including the Maritime Labour Convention (MLC) 2006, the earliest one from1919, and the last one from 2007.

The MLC is not yet entered into force, but it is most probable that this will happen within a year or two, when at least 30 ILO member nations, representing at least 33 % of the worlds gross tonnage per flag, has ratified. By July 2009, 5 member nations, representing over 48% of the worlds gross tonnage, have ratified. The requirement of ratifying member nations representing at least a 33% share of the worlds gross tonnage was met when Panama, representing 25% of the worlds gross tonnage ratified the 6^th of Feb 2009.  According to the date of ratification, the member nations that have ratified are Liberia (2006), Marshall Islands (2007), Bahamas (2008), Panama (2009) and Norway 2009.

A large number of other countries in all regions have taken steps toward ratification, including the EU.  According to the Directive 2009/16/EC of 23 Apr 2009, the EU member nations are encouraged to ratify the MLC as soon as possible, preferably before 31 Dec 2010. The ILO expect that the MLC, 2006 will enter into force by 2011.

5.4.3               World Health Organization (WHO) – the health

The World Health Organization works in a slightly different way, as compared to the ILO and IMO. WHO is a UN agency, and responsible for the coordination within the UN. According to the organization’s own description, “WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends”.

WHO is an important partner in international cooperation. Besides having influenced a lot of the international conventions and regulations given by other organizations, it also have its own instruments which are of importance to maritime medicine.

One of the most important is the International Health Regulations. The IHR was first published in 1969, as a successor of the International Sanitary Regulations (1951). The IHR was amended in 1973 and 1981, but a complete revision was done in a process that started in 1995, and the second edition was adopted in 2005 and came into force in 2007.

The purpose and scope of the Regulations are to ”prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade”.

As spreading of disease inevitably will be connected with travel and trade, seafaring and ship transport is a natural part of these regulations, dealing with health measures on arrival and departure, ships in transit, maritime declaration of health when ships enters into port, ship sanitation control, etc.

Another important publication from WHO is the International Travel and Health (ITH). The book gives guidance on all significant health issues associated with travel. The medical profession, the travel industry and travellers themselves are recognized. The book provide recommendations in connection with health risks which derive from different types of travel.

WHO is the publisher of the International Medical Guide for Ships (IMGS), the most important medical handbook for seafarers. See: chapter 4.

The IMO/ILO Medical First Aid Guide for Use in Accidents Involving Dangerous Goods (MFAG) is a guide which supplements the IGS and is obligatory on board ships carrying dangerous goods. See also: IMDG Code discussed under IMO in this chapter.

The Department of International Travel and Health publishes the International Health Regulations (HR) which are based on consensus and agrrement between 194 countries including the member states of WHO. IHR is discussed in Chapter 4.

The WHO has given recommendations as to the content of the Ship Medicine Chest. These recommendations are included in the IMGS.

Almost all health topics are in some way covered to WHO activity. The topics which has to do with health in general, and not specifically dealing with the maritime sector, will not be mentioned here.

5.4.4        UNEP Conventions- the environment 

The United Nations Environmental Program has a third approach to shipping industry. Where IMO focuses on structure, technology, organization and operation and ILO focuses on people – UNEP focuses on the environment.

Although not usually named “UNEP Conventions” I will refer to these three conventions like this, for the purpose of understanding the connections between them.

The UNEP conventions of importance to maritime medicine numbers three different conventions, namely the Basel (BC), the Rotterdam (PIC) and the Stockholm (SC) Conventions, see Table 5.4. They are usually called by the name of the city where they were adopted. The secretariats for all of them, however, is located in the UNEP Office in Geneva, Switzerland.

There is a permanent joint WG with members from the three secretariats of BC, PIC and SC, coordinating their work.

Another important joint workgroup between ILO, IMO and the Basel Convention has been working for several years with coordination of the development of ship scrapping guidelines along the three different lines, people, technology and environment. It does not look likely (2009) that there will be one single convention for the dismantling of ships which take all these different aspects into account.

Hence, the cooperation and coordination in the joint WG will be even more important, and will probably continue as a form of permanent cooperation.

Table 5.4.4: The UNEP conventions

5.4.5        The EMSA regulations

The regulations from the European Maritime Safety Agency are not truly international but supranational in the European region. Nevertheless, they have a bearing far beyond the European borders, as some of them apply also to ships with non-European flags touching at European ports.

5.4.6        Hague and Geneva Conventions - Wartime

Special conventions apply for wartime. These are known as the Hague and the Geneva Conventions. They are listed in Table 5.5 in chronological order.

These conventions apply not only to wartime in general, but specifically addresses the maritime side of it, and how to deal with wounded, sick and shipwrecked members of armed forces at sea (2^nd Geneva Convention), medical treatment as well as quarters, etc. for prisoners or war (3^rd Geneva Convention), and how civilians are affected by war conditions (4^th Geneva Convention). The last Convention is the most significant in the development of international humanitarian law.

It will lead beyond the scope of this chapter to go into detail of these conventions. By mentioning them I want to direct the reader’s attention to the existence of these conventions which also are of some importance for maritime medical professionals, although mostly for military (naval) personnel.

 Table 5.5.5:  The Hague and Geneva conventions