An accurate and comprehensive list of all medical facilities along the world’s coasts, however seemingly practical, is not feasible and will be out-dated as soon as this document is released. The local RCC conducting the operation is the most reliable source of information as to what the options are in view of conducting the medical evacuation and as to where the patient is to be transported. They may also be consulted in cases where no evacuation by a third party is necessary, but where the vessel is advised to seek medical help in an “emergency” port.
It is evident that along many of the world’s coastlines, medical facilities are far apart. This may be either because the coast is un- or scantly inhabited, or because the local population have very limited resources, as is often the case in the tropics.
In an attempt to alleviate this shortcoming, the following entities have been devised to provide in the best possible medical help to sea-going vessels with limited medical facilities.
Mission statement: “ AMVER is a worldwide voluntary ship reporting system operated by the United States Coast Guard (USCG) to promote safety of life and property at sea. Amver’s mission is to quickly provide SAR authorities, on demand, accurate information on the positions and characteristics of vessels near a reported distress. Any merchant vessel anywhere on the globe, on a voyage of greater than 24 hours duration, is welcome in the Amver system and family. International participation is voluntary regardless of the vessel’s flag of registry, the nationality of the owner or company, or ports of call. ”
Amver information is protected as "commercial proprietary" information and is released only to recognized national search and rescue authorities, and only in an emergency.
AMVER was primarily devised to provide help to ships in distress. In a medical emergency, the RCC may also consult AMVER to obtain a “SURPIC” (surface picture); indicating if a vessel with more extensive medical facilities is in the vicinity of the vessel to provide help to the patient. These may be naval vessels under various flags, passenger cruise liners, floating hospitals etc.
The concept of a floating hospital is to bring secondary or even third level medical care to where these facilities are needed but not available. Examples of this are the floating hospitals that many of the world’s navies have in operation, although these ships are normally in service only in times of political tension. Other larger Navy vessels normally have their medical staff on board willing to give medical help to civilians at sea, but these are still limited as to what level of medical help they can offer.
For example: the US Navy is the only one operating two nearly 1000 bed hospital ships, the “Comfort” and the “Mercy”. The help of these ships is seldom practicable for medical cases in the merchant fleet. They are only in full operation when they are appointed specific missions, the last time being the Gulf War, and one was moored in New York after the 9/11 attack, moored nearby to offer medical help and support to the rescue workers. Otherwise the two are moored in the ports of Baltimore and San Diego respectively, strategically one on either coast of the USA.
“Mercyships” are an NGO that operate floating hospitals, mainly along the coast of Western Africa. These ships provide medical and surgical care for inhabitants along the coast, like for instance complications after childbirth and deformities after war injuries (Liberia and Sierra Leone).
- m/v “Esperanza del Mar“ This vessel is, from the point of medical help, of great practical value to international shipping, and especially the international fishing fleet This vessel is operated through the Spanish Institute of Marine Welfare and has extensive medical facilities for up to 60 patients. It is primarily focussed on medical help to the extensive international fishing fleet operating in the waters near the Mauritanian coast. It is lso equipped to provide help in case of naval emergencies and salvage operations.
Figure 6: “Esperanza del Mar”
- Bangla Desh and India operate a number of floating hospitals in the estuaries of the Ganges and the Brahmaputra. Because these vessels operate in shallow coastal waters and up river mouths, the better alternative of a hospital ashore may be relatively near.
- United States Coast Guard. The USCG have an extensive network of not only support vessels around the entire coast of the USA but also of numerous hospitals to which patients can be referred. The USCG has a staff of 60,000 people[jc1] and reserves and is part of the US Department of Homeland Security and has close ties with the US Navy. Apart from tasks involving Home Security, environmental protection, drug and illegal immigrant interdiction etc, they have an important task in SAR operations and operate an extensive network of support vessels and airplanes