International regulations (ILO-C164 and MLC 2006, IMO – MSC/Circ.960, 2000) state that medical care on board ships should be as comparable as possible with what is available ashore. This may to some extent be possible on large cruise ships, but on commercial transport vessels it is very difficult to achieve.
A ship at sea is in many ways a difficult location in which to provide for medical care: the facilities in terms of equipment and remedies may be less than satisfactory; the position of the vessel may be days away from nearest port and/or not reachable by a helicopter; the care has to be given by non-professionals with a varying degree of medical training; weather conditions may make the handling of the patient problematic; the medical chest may not have the most appropriate medicine, and the conventional treatment of some conditions may not be possible on board. Hence, the quality of medical care on board will depend on the following elements:
- Medical training of ship officers
- Ship hospital facilities
- The information in the International Medical Guide for Ships or other guides carried
- Medical chest and its contents
- Access to telemedical advice and its quality
- The possibilities for medical evacuation